Wash your hands!

Handwashing_SmallThe age-old “five-second rule” about food on the floor isn’t entirely about how long something sits on a surface – such as food on the floor – but more about how much bacteria is on that surface. As Aaron Carroll, MD, writing for  The Upshot column in The New York Times discusses the relative bacterial colonization of different surfaces in the home, he points out that the kitchen counter has more than double the level of bacteria compared to the floor. The kitchen sponge is likely to be the most dirty thing in the kitchen. Everything we touch is dirty including the money we use to pay for food which we then consume with the hands we paid for the food with!

As Dr. Carroll suggests, this should remind us all to wash our hands before we eat!

Don’t let falling leaves take you out this autumn

Autumn leavesThe autumn leaves produce a scene of changing colors that is beautiful to behold. When they have fallen to the ground and jumping in the piles is done, they need to be raked up. There are a number of possible injuries that can occur during this process and many of them can be avoided with the following basic advice suggested in MedlinePlus’ to Leave Those Raking Injuries Behind: warm up and cool down, clear debris and consider footwear to avoid falling down, avoid twisting motions, take breaks, use proper equipment, and protect your back. Good advice for providers and patients alike!

Farm living is the life for me – to avoid asthma?

A study published in the New England Journal of Medicine recently demonstrates tendencies to develop allergies and asthma may be diminished by early exposure to pooled bacterial dust samples found on family farms combined with low antibiotic use. Conversely, there appeared to be a higher rate of asthma and allergies in subjects exposed to antibiotic use and avoidance of bacterial dust samples. The study included comparison between two insular groups: single family farming with the Amish of Indiana and the highly industrialized farming of Hutterites in South Dakota. Although degree of exposure has not been established, the inverse link has been seen between the groups.

More evidence for adding exercise inquiries when talking with patients

The September 15, 2016 Morbidity and Mortality Weekly Report published an article online about a survey showing that 1 in 4 people in the US 50 years and older engage in no exercise other than that occurring during the work hours. Manual labor workers often feel they don’t need exercise, not realizing heavy manual labor may be the type of exercise that breaks down a body, rather than builds it up. There is great value in and the need to encourage and educate patients to understand how physical activity, including the lack thereof, affects the human body. This article highlights the need to ask patients about their exercise habits and to encourage patients over 50 to begin exercise programs.

Gluten-free diet triples in Americans

GlutenFreeCakeAccording to a report published online September 6th in JAMA Internal Medicine and covered in PracticeUpdate, between 2009 and 2014, the number of gluten-free Americans has tripled but the number of individuals with celiac disease has remained unchanged.  The rise in popularity of this diet in the absence of celiac disease is suggested to include the following: the perception that gluten-free diets are healthier and may benefit nonspecific gastrointestinal problems, gluten-free choices are much easier to find in stores and restaurants, increased population who have self-diagnosed sensitivity to gluten and have improved gastrointestinal symptoms after going gluten-free.

Section 1557 final rule effective October 17

The final rule implementing Section 1557 of the ACA will be effective October 17, 2016. Below are some frequently asked questions about Section 1557 and links to more info.

What is the history of this rule?

Section 1557 has been in effect since its enactment in 2010 and the HHS Office for Civil Rights has been enforcing the provision since it was enacted.  This year the Department of Health and Human Service finalized this rule after completing the public comment process.

What does Section 1557 cover?

Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). The law prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities. Section 1557 builds on long-standing and familiar federal civil rights laws.

How does it impact providers?

The final rule prohibits discriminatory practices by health care providers, such as hospitals that accept Medicare or doctors who participate in the Medicaid program.

 What is the effective date?

Beginning on October 17, 2016, covered entities will be required to post notices of nondiscrimination and taglines that alert individuals with limited English proficiency (LEP) to the availability of language assistance services. In advance of the approaching deadline, the HHS OCR website has been updated with new information to assist covered entities. Click here for translated materials.

“Stop running, it’ll ruin your knees…”

Young woman running on red dirt trail, rear view, low section

For as long as we’ve been told, “don’t cross your eyes or they’ll stay that way”, we have also been told running is bad for our knees. It turns out this is not true as reported in a new study in the journal of Arthritis Care and Research from June 22, 2016 which demonstrated that runners do not have an increased risk of symptomatic arthritis in their knees.  The study was not designed to show cause and effect but speculation as to why this is true included the following: runners tend to be lean so there is less weight on the knees, there may be some additional mechanical benefit to the action of running that prevents arthritis from developing, the general lifestyles of runners tend to be healthier which could decrease their risk for disease like arthritis.

Are common e-mail security mistakes putting you at risk?

Close-up of female hands touching buttons of black computer keyboard

The latest issue of “OUCH!”, a monthly security awareness newsletter from Securing the Human, a division of SANS Institute, is devoted to common e-mail security mistakes that any people might

be making. It details four security issues that can come up when using e-mail features such as auto-complete or reply all functions. For the full list of security risks and how to stay e-mail safe, check out the September 2016 “OUCH!”.


Is surgery the only option?

In the August 3, 2016 “The Upshot” column in The New York Times, author Gina Kolata reports on the rationale behind common surgeries, from meniscus to spinal fusion to vertebroplasty. When compared to drug trials, she reports, surgeries lack similar checks and balances. Outcomes have relied heavily on provider and patient impression of success, rather than statistical measures. This impression may be a type of placebo, as either the provider or patient has such a strong desire for improvement. Spinal fusion is one type of spine surgery that did not meet the test of statistical improvement and is now denied by many insurers. Conservative care options such as physical therapy (PT), chiropractic, acupuncture, massage, exercise therapy can be suggested to patient as a first line of care before surgery is considered.