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Dr. Lisa Iezzoni is all too familiar with the discrimination that patients who have a disability can face: Having lived with multiple sclerosis for more than four decades and now in a wheelchair, she has also studied health care experiences and outcomes for people with disabilities for more than 20 years. But her new survey on doctors’ attitudes towards disabled patients still surprised her — not for the attitudes the survey uncovered, but how widespread those attitudes were. “I did expect that there would be a lot of physicians who viewed quality of life of people with disabilities worse than that of other people,” said Iezzoni, a professor of medicine at Harvard Medical School in Boston. “I just didn’t expect it to be over 80%. That’s most physicians. That was a bit surprising.” In her study, she surveyed 714 doctors with practices in many different specialties across the United States. A majority of physicians surveyed (82.4%) believed that people with significant disabilities had worse quality of life than people without disabilities. Just under 41% of physicians felt very confident in their ability to provide the same quality of care to patients with disabilities as they did for other patients. “You would think that if they’re caring for these patients, that they would feel confident in their ability to care for them equitably,” Iezzoni said. About… read on > read on >

College football players suffer more concussions and head hits in practice than they do actually playing the game, a new study suggests. Across five seasons of football, 72% of concussions and 67% of head impacts incurred by players on six National Collegiate Athletic Association (NCAA) Division I teams happened during practice rather than on game day, researchers found. The incidence of concussion and head impacts also were disproportionately higher in the preseason than the regular season, said lead researcher Michael McCrea, director of the Brain Injury Research Program at the Medical College of Wisconsin in Milwaukee. “Our data suggest modifying preseason training activities and football practice throughout the season could lead to a substantial reduction in overall concussion incidence and head impact exposure,” McCrea said. The findings were published Feb. 1 in the journal JAMA Neurology. While these specific findings are new, experts and coaches have known for years that practice is at least as dangerous as actual play when it comes to head trauma, said Dr. Robert Cantu, medical director and director of clinical research at the Cantu Concussion Center at Emerson Hospital in Concord, Mass. That’s why the National Football League agreed in 2015 to dramatically reduce full-contact practices in its collective bargaining agreement with the NFL Players Association, said Cantu, who wrote an editorial accompanying the new study. The NFL now has… read on > read on >

The great outdoors can soothe the soul, but new research suggests that working outside might also guard against breast cancer. The study wasn’t designed to say how working outside affects chances of developing breast cancer, but vitamin D exposure may be the driving force, the researchers suggested. “The main hypothesis is that sun exposure through vitamin D production may decrease the risk of breast cancer after age 50,” said study author Julie Elbaek Pedersen, of the Danish Cancer Society Research Center in Copenhagen. Vitamin D deficiency has been linked to a host of diseases and conditions including breast cancer. Vitamin D is often called the “sunshine vitamin” because your body produces it when exposed to the sun’s ultraviolet B rays. The body mainly makes vitamin D in the middle of the working day so outdoor workers are exposed to considerably higher levels than those who work indoors, Pedersen said. “Women who work outdoors may regularly be exposed to sunlight and thereby have more sufficient long-term levels of vitamin D compared with women working indoors,” she said. You don’t need much sun exposure to make adequate amounts of D. “Maximum daily vitamin D levels are secured after only minutes in the sun in the summertime, and more time will not increase the levels further,” Pedersen said. In recent years, the push to wear sunscreen and avoid… read on > read on >

Living in a noisy neighborhood with less green space negatively affects teens’ sleep, which may lead to poorer memory and thinking skills, according to a pair of studies. In a study on residential environment, researchers found that as noise levels steadily increased, so too did the time needed for teens to fall asleep. They also didn’t sleep as long as kids in quieter, greener neighborhoods. But as the average number of trees rose, teens dozed off sooner and slept longer. “For adolescents, the harms of insufficient sleep are wide-ranging and include impaired cognition [thinking skills] and engagement in antisocial behavior,” said study author Stephanie Mayne. She’s assistant professor of pediatrics at Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine. As such, it critical to identify ways to prevent and treat the problem, Mayne said in a news release from the U.S. National Heart, Lung, and Blood Institute. “Our findings suggest that neighborhood noise and green space may be important targets for interventions,” Mayne said. In Mayne’s study, 110 teens wore watches that measured their rest and activity for 14 days each in both eighth and ninth grades. The researchers mapped their home addresses to determine sound levels, tree cover, housing and population density. The second study showed how sleep loss associated with reduced time in bed affected the brain waves of… read on > read on >

WEDNESDAY, Feb.3, 2021A majority of dermatology patients are happy with telehealth appointments in place of in-person office visits, a new study finds. The COVID-19 pandemic has forced many medical specialties to move from in-person to online appointments, but dermatology had already seen increased use of telehealth visits over the last decade, according to the George Washington (GW) University researchers. “Teledermatology boasts a number of benefits, including increased access to care, cost savings for patients, convenience, and, with the current pandemic, avoids physical contact,” study co-author Samuel Yeroushalmi said in a university news release. He’s a third-year medical student at the GW School of Medicine and Health Sciences in Washington, D.C. However, virtual appointments do have potential issues, including privacy concerns, appropriate image acquisition and adequate health care provider training, the study authors noted. To assess patient satisfaction with teledermatology appointments, the researchers distributed an online survey to dermatology patients at the GW Medical Faculty Associates. Nearly half (47%) of the respondents said they’d had a previous appointment canceled due to the COVID-19 pandemic, and almost 18% were new patients with no previous in-office appointment. Patients said they liked that telehealth visits were time-efficient, didn’t require transportation and maintained social distancing. Reasons they didn’t like virtual appointments included lack of physical touch and feeling they received an inadequate assessment. When asked if they would recommend telehealth… read on > read on >

If pandemic-related stress has you grinding your teeth, you’re not alone. Dentists say tooth-grinding and jaw-clenching are on the rise due to the many challenges stemming from the COVID-19 pandemic. “We’ve been seeing an increase in the number of patients looking for appointments to replace broken mouth guards” that have been cracked or chewed through, said Dr. Leopoldo Correa, director of the Craniofacial Pain Center at Tufts University School of Dental Medicine, in Boston. Grinding and clenching (“bruxism”) can cause cracked teeth, fillings and crowns; migraines and other headaches; face, neck and jaw pain. “You may resolve a stressful situation in the short term, or it may continue and develop into chronic stress,” which can result in symptoms such as fatigue, increased muscle tension, depression, an inability to fall or stay asleep, and bruxism, Correa said. “According to some data, the amount of force we create when clenching the jaw is around 300 pounds,” he said in a school news release. Five to 10 minutes of jaw and face exercise each day can help you cope, Correa suggested. Here’s what to do: Keep your teeth apart, bend your fingers and place your knuckles on each side of your face. Give yourself a self-massage, pushing down. If possible, briefly apply heat or an ice pack to the side of the face before doing the stretching exercise.… read on > read on >

For some patients suffering from knee arthritis, a special procedure may reduce the need for a total knee replacement, Canadian researchers say. By getting what is known as a ‘high tibial osteotomy,’ younger patients with less severe joint damage who are physically active might be able to delay the need for a knee replacement by 10 years or more, though they may have to search for a doctor who performs the surgery. “High tibial osteotomy is a knee surgery aimed at treating patients in earlier stages of osteoarthritis by correcting the alignment of bowed legs and shifting load to less diseased parts of the knee,” explained lead researcher Trevor Birmingham, the Canada research chair of musculoskeletal rehabilitation at the University of Western Ontario. During the procedure, the tibia (shinbone) is cut and then reshaped to relieve pressure on the knee joint. Beyond improving pain and function, a goal of the procedure is to prevent or delay the need for total knee replacement, Birmingham said. Although high tibial osteotomy can improve pain and function and is cost-effective, the procedure is underused in North America, Birmingham said. “Rates of high tibial osteotomy continue to decline, while rates of other knee surgeries continue to rise,” he added. “The low rates of high tibial osteotomy are partially due to the perception that the procedure is only suitable for a… read on > read on >

Expanded unemployment benefits, passed by Congress last spring to ease the economic pain of the pandemic, appear to have held hunger at bay for millions of Americans, new research shows. Called “The CARES Act” when it was put into effect nearly a year ago, the law expanded who is eligible for unemployment benefits and how long that coverage would last. A weekly federal supplement of $600 was also added to the coverage. The move ultimately cut in half the chance that a middle-class recipient would need to eat less because of financial hardship, the study authors said. And it cut by roughly one-third the risk that a recipient would face so-called “food insecurity.” The U.S. Department of Agriculture defines food insecurity as “limited or uncertain access to adequate food.” “The COVID-19 recession is markedly different from prior recessions in that it is so concentrated among people in low-income households,” explained study author Julia Raifman. She’s an assistant professor in the department of health law, policy, and management at Boston University School of Public Health. “This has led to millions of people experiencing food insecurity,” Raifman said. “And households with children are more likely to report food insecurity,” with potentially dire implications. For example, it is “not possible for children to concentrate on school if they do not have enough to eat. And there will be… read on > read on >

MONDAY, Feb. 1, 2021 (American Heart Association News) — Medical science has come a long way since the days of “bikini medicine,” when the only time doctors managed a woman’s health differently than a man’s was when treating the parts of her body found under a bikini. Over the past few decades, researchers have uncovered countless ways in which women’s and men’s bodies react differently to the same diseases. And just as it’s now widely recognized women experience heart disease differently than men, scientists are beginning to understand why the sexes experience illness differently in another vital organ – the brain. It’s not that male and female brains are built differently, said Lisa Mosconi, director of the Women’s Brain Initiative at Weill Cornell Medicine in New York. It’s that they age differently. Women bear the brunt of Alzheimer’s disease, the most common form of dementia, accounting for 2 of every 3 people diagnosed. Women are twice as likely as men to experience major depression. They are three times more likely to be diagnosed with autoimmune disorders that attack the brain, such as multiple sclerosis. They are four times more likely to have migraines and also are more likely to die from strokes. What’s driving these disparities? While multiple factors are at play, Mosconi said, it’s hormones – testosterone in men and estrogen in women –… read on > read on >

Homemade juices are a popular way for health-conscious people to get their veggies. But the juicing method of choice makes a difference, a recent study suggests. Researchers found that three different techniques — using either a blender or a low- or high-speed juicer — produced beverages with different levels of antioxidants and various plant compounds. But anyone hoping for a simple verdict on the best buy is out of luck. The nutrient findings were mixed, and no “winner” appliance emerged, according to senior researcher Bhimanagouda Patil. “We’re not making any recommendations on which method is best,” said Patil, who directs the Vegetable and Fruit Improvement Center at Texas A&M University. In general, the study found, both juicers beat the blender when it came to antioxidant activity and phenolics — a broad group of plant compounds. Low-speed juicing, in particular, often churned out the highest concentrations. But that also depended on the vegetable in question: With kale, for example, low-speed juicing clearly squeezed out the most phenolics. That wasn’t the case, however, with beets or carrots. Meanwhile, blenders were not always in last place. They performed well when it came to compounds called alpha-amylase inhibitors, which help control blood sugar levels after a meal. “It’s complicated,” Patil said. Beyond that, the study assessed only a limited number of vegetables and plant compounds — what Patil called… read on > read on >

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All Sauce from Weekly Gravy:

Too Many U.S. Doctors Biased Against Patients With Disabilities: Study

Concussions More Likely in Practice Than Play for College Football Players

Could Working Outside Help Prevent Breast Cancer?

How Your Neighborhood Can Hamper Your Teen’s Sleep

Most Dermatology Patients Like ‘Telehealth’ Visits: Survey

Tense Times Mean More Tooth-Grinding, Dentists Warn

Knee Procedure Done Earlier Might Prevent Knee Replacement Later

Pandemic Unemployment Benefits Helped Keep Millions of Americans From Going Hungry

AHA News: Hormones Are Key in Brain Health Differences Between Men and Women

What’s the Most Nutritious Way to Juice Your Vegetables?