Monday, July 1, 2013

Getting a good night's sleep is a nightmare for many Americans

June 29, 2013 ? Summer means more hours of daylight and for many, it contributes to trouble falling asleep. More than 40 million Americans suffer from chronic sleep disorders, resulting in $18 billion in cost to employers due to sleep loss issues."The inability to get a good night's sleep can be a complex issue, and is not as simple to cure as telling people to count sheep," says John Wilson, MD, neurologist at Gottlieb Memorial Hospital, part of Loyola University Health System. Wilson regularly works with the sleep lab to diagnose patients with chronic sleep issues.

Omar Hussain, DO, pulmonologist at Gottlieb who is board certified in sleep medicine says, "Many societal trends such as working from home or swing shift workers have economic-based lifestyles that prevent regular sleep patterns." Obesity, which was recently declared a disease by the American Medical Association, also has a direct link to poor sleep, says Ashley Barrient, RD, who counsels patients at the Loyola Center for Metabolic Surgery and Bariatric Care. One-third of all Americans are overweight, according to the Centers for Disease Control.

Here are some healthful tips from Loyola medical experts Wilson, Hussain and Barrient on how to get a better night's sleep.

Do this:

Relax. "At least one hour before bedtime, start quieting down and relaxing. Don't exercise or engage in vigorous acitvities," says Wilson.

Turn off the handheld devices. "The need to text and email is a real problem for many when it comes to sleep," says Hussain. "Turn the electronic device off and put it in another room. That way, if you wake up in the middle of the night, you don't automatically reach for the phone but instead turn over and fall back asleep."

Read a magazine. "Lighter content and shorter articles are ideal," says Wilson. "Many like entertainment and celebrity-focused magazines as quick bedtime reads."

Darken the room. "Close the curtains or blinds; darkness is conducive to sleep," says Wilson

Diminish noise. "Use a sound machine to create white noise or experiment with soothing noises such as rain or the lap of waves," says Hussain.

Create a comfortable environment. "A consistent room temperature, bedding and mattress and even sleepwear should all be appropriate to the season and comfortable," says Hussain.

Go to the bathroom. "Waking up to use the bathroom is a complaint of many," says Wilson. "Do not eat or drink several hours before bed to avoid sleep interruptions from toileting."

Check medications. "Some people who take medications before bed may do better to take them in the morning when they wake up or vice versa," says Wilson. "Talk to your physician about changing your pill dosing schedule."

Write it down. "Jot down worries, future errands or simply what is on your mind before bed," said Barrient. "This helps to allay anxieties, organize thoughts and prepare for sleep."

Have a regular routine. "Try and go to bed at the same time every night to buiid routine and consistency," says Wilson.

Limit animals. "Pets may be comforting and companionable, but if they move in the night and make noise, they disturb sleep," says Wilson.

Partner with your partner. "Talk to those you live with and share your strategies," says Hussain. "You need to get the cooperation of those in the entire household to be successful."

Reserve the bedroom. "Train the body and mind to associate the bedroom with relaxation and sleep, not watching TV, playing games or exercising," says Wilson.

Stick with the new routine. "You may not change sleeping patterns overnight so give it a few weeks to acclimate your mind and body and establish the new habits," says Barrient.

Don't do this: Eat two hours or less before bed."If you bave to have something, try a small cup of hot chamomile or other decaffeinated tea," says Barrient.

Have an alcoholic drink. "Alcohol does induce sleep but it is not restorative sleep," says Wilson.

Watch TV or play electronic games before bed. "And don't turn them on if you awaken in the middle of the night," advises Hussain.

Many people with sleeping disorders undergo sleep studies and are diagnosed with chronic sleep apnea. Medical devices such as a Continuous Positive Airway Pressure (CPAP) machine pumps oxygen into the passages by way of a mask to keep the airway open. "Often it is the partner of the person with sleeping troubles who cannot stand the snoring or the irritability and issues an ultimatum for the person to get help," says Wilson. "When one person has a chronic sleep disorder, the whole family suffers."

Source: http://feeds.sciencedaily.com/~r/sciencedaily/living_well/~3/rQLxerZQNkU/130629164630.htm

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Sunday, June 30, 2013

Golf-In-form Dutchman Luiten leads Irish Open

June 29 | Sat Jun 29, 2013 5:30pm BST

June 29 (Reuters) - Dutchman Joost Luiten will be chasing his second European tour victory of the month when he takes a one-shot lead into the final round of the Irish Open on Sunday.

The world number 94, who won the Austrian Open three weeks ago, hit a six-under par 66 in the third round on Saturday to lead Spain's Pablo Larrazabal by one shot at Carton House, County Kildare.

Overnight joint-leader Robert Rock is third, three shots behind Luiten, who also finished tied for 10th at the BMW International Open in Munich and 11th at an event in Sweden this month.

"It was good today - a round in this wind with no bogeys is always good," the 27-year-old told the European tour website (www.europeantour.com).

"It looks like I'm playing good, playing consistently. I don't make a lot of silly mistakes, the game feels good."

Luiten made six birdies in his round of 66, a score matched by Larrazabal and England's Rock was steady on his way to a one-under-par 71.

England's Paul Casey, a former world number three and European Ryder Cup player, finished a shot behind Rock after a third-round 67.

A number of leading players, including Northern Ireland's world number two Rory McIlroy, missed the cut just three weeks before the British Open starting at Muirfield, Scotland on July 18. (Reporting by Josh Reich, editing by Ed Osmond)

Source: http://feeds.reuters.com/~r/reuters/UKGolfNews/~3/5SiMb27mn88/golf-european-idUKL3N0F507Y20130629

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Tuesday, June 25, 2013

Shrink Dreams

Man lying on a sofa while with therapist making notes Career changes become part of one's life story.

Photo by Wavebreakmedia Ltd/Thinkstock

Whenever I describe my career path to people, they seem a little perplexed. ?Journalism to psychiatry?? they say. ?How?d that happen?? I admit, it isn?t a common path. Young people have always left journalism, of course. Many get tired of eking out a living as a freelancer and seek something more stable. Some find that they don?t like the grind of constantly producing copy. And then there are those who are talented and thriving but nevertheless seek greener pastures. In my brief time in journalism, I saw two very talented twentysomething colleagues leave for law school and another depart for graduate school and then become a successful fiction writer.

But leaving journalism to enter a scientific field such as medicine is unusual. In fact, if you?d told me in college that several years later I would walk away from a budding career in journalism, I would have been surprised. Like most aspiring journalists, I had always been interested in politics and policy, and I wanted to be in the thick of it. Like many before me, I wrote for my college newspaper and parlayed my clips into internships and finally a post-college job. The job was at Slate. I was very fortunate.

But there was something amiss. I liked my job in many ways, but I was getting tired of covering daily politics. It was the summer of 2001, and I was writing a news-summary column for Slate called ?The Week/The Spin.? As this assignment compelled me to write about what was on the front pages, I found myself writing every day about the Chandra Levy-Gary Condit affair, one of those gossipy stories that people in Washington, D.C., occupy themselves with in slow news seasons. I found it draining.

Of course, burnout from the steady stream of dish from inside the Beltway didn?t require that I leave my profession. I could have carved out a new beat for myself. But there was something else going on. I had always been fascinated with folks who have trouble making it in society?with the people who mutter to themselves on the street; with the plucky outcasts in the photos of Diane Arbus; with the neurotic, obsessive narrators of Philip Roth novels; and with everyday people who struggle with grief and anger and trauma and loss.

I also had some personal connections to mental illness and its treatment. My paternal grandmother had been permanently institutionalized with schizophrenia when my father was 7 years old. Although I didn?t know her well, the knowledge that an unfathomable insanity had robbed my father of his mother had a strong effect on me. Moreover, my own experiences in psychotherapy had a profound effect on the way I viewed the world. It allowed me to be more open to new opportunities and to people and provided me with tools that helped me continue to grow, long after the treatment ended. Over time, it made me more flexible and optimistic.

It also made me want to practice the treatment myself. I was 26 years old, and I had been working in journalism for several years. I wasn?t sure I wanted to make a career out of mental health care, but I figured that I would regret it if I didn?t at least explore the option. I started by dipping my toe in the water?I became a weekly volunteer at both a suicide hotline and a homeless shelter. About six months later, I took the plunge. I quit my job at Slate and took a full-time position as a floor worker at the shelter where I had been volunteering. I didn?t have any formal qualifications, but I didn?t really need any: The position paid $10 an hour and didn?t require a college degree.

This position was everything you might expect. I dealt with the mundane?homeless people bickering over plastic folding chairs?to the profound?people withdrawing from heroin on a mattress in a corner, or lying stiff and cold on a bunk bed after morning wake-up, having overdosed the previous night. (You can read a five-day diary I wrote for Slate while working this job.) Of course, the job was tough and caused rapid burnout. After about a year, I managed to secure a position as a case manager at a community mental health clinic. I now had regular working hours and a caseload of patients to follow up with. But I had no formal training in mental health, was making just $12 an hour, and with only a bachelor?s degree in political science, I had hit my career ceiling as a mental-health practitioner.

Ah, the degree. As a job requirement, this was new ground for me. In the world of journalism, degrees are emphasized about as much as clear, jargon-free prose is in medical records. When I was an editorial intern at a magazine in college, recent j-school grads would send in r?sum?s looking to be hired. They thought their degree gave them a leg up, but many editors are disdainful of this academic professionalization of what, to them, is a trade. In journalism, you?re only as good as your clips. In the field of health care, the degree means nearly everything. Degrees determine ?scope of practice??who is allowed to perform which treatments?and who?s the boss of whom in a hospital ward or a clinic.

The medical profession?and doctors love to think of themselves as professionals, never as tradesmen?emphasizes the importance not just of degrees, but of hierarchy. In journalism, a certain combination of talent, hard work, and luck can land you a very good job at a very young age. In a way, that had been my story?I had been hired for a full-time staff job at Slate immediately after leaving college, which was an enviable ?get? for a young, ambitious writer. But in health care, no amount of talent and hustle will let you leapfrog the organizational chart. A crack surgical intern is still just an intern, and until he completes his five (or six or seven) years of residency, he will never wield much influence in his field, no matter how precocious he may be.

So, as a social worker at a community mental health clinic, I had a decision to make. I knew that I liked working with the mentally ill. I enjoyed their stories, I felt privileged by the intimacy they granted me, I could sit with their pain, and I felt I had the ability at least to begin to make things better. But, on a clinical level, I needed some real training. I had gotten as far as I was going to get with on-the-job experience, clinical intuition, and my own reading. And on a practical level, I needed some qualifications to put on my r?sum?.

My choices were a master?s degree in social work, a master?s- or doctoral-level psychology degree, or an M.D. The master?s-level choices didn?t really tempt me. Those degrees were useful for private-practice therapists, but I would be excluded from certain research and administrative career paths. As a former journalist unaccustomed to such hierarchical restrictions, I chafed at this. I didn?t want my degree to limit what I could do with my career.

A psychology Ph.D. or Psy.D. had its appeal, but ultimately I chose the long and winding path?the M.D. I was influenced by many things. For one, my therapist in college had been a psychiatrist, and I held him in high esteem. I also liked the practical bent of medical training. Given the choice between spending five to seven years in a narrowly focused doctoral program, burdened with an esoteric thesis, or spending a similar amount of time learning about treatments for all forms of bodily illness, I preferred the latter. But mostly I knew that much of what interested me about the field of mental health was the interplay between the psyche and the body, between the ?science? of psychopharmacology and the ?art? of psychotherapy, between the mind and the brain. At the end of the day, psychiatry is the discipline that truly allows one to straddle these multiple ways of looking at a person?s mental suffering.

Source: http://www.slate.com/articles/briefing/second_acts/2013/06/shrink_dreams.html

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Tuesday, May 14, 2013

Top IRS official didn't reveal tea party targeting

WASHINGTON (AP) ? Congress was not told tea party groups were being inappropriately targeted by the Internal Revenue Service, even after acting agency Chief Steven Miller had been briefed on the matter.

Miller was first informed on May, 3, 2012, that applications for tax-exempt status by tea party groups were inappropriately singled out for extra scrutiny, the IRS said Monday.

At least twice after the briefing, Miller wrote letters to members of Congress to explain the process of reviewing applications for tax-exempt status without disclosing that tea party groups had been targeted. On July 25, 2012, Miller testified before the House Ways and Means oversight subcommittee, but again did not mention the additional scrutiny ? despite being asked about it.

At the hearing, Rep. Kenny Marchant, R-Texas, told Miller that some politically active tax-exempt groups in his district had complained about being harassed. Marchant did not explicitly ask if tea party groups were being targeted. But he did ask how applications were handled.

Miller responded, "We did group those organizations together to ensure consistency, to ensure quality. We continue to work those cases," according to a transcript on the committee's website.

Earlier, Rep. Charles Boustany, R-La., had raised concerns with the IRS about complaints that tea party groups were being harassed. Boustany specifically mentioned tea party groups in his inquiry.

But in a June 15, 2012, letter to Boustany, Miller said that when the IRS saw an increase in applications from groups that were involved in political activity, the agency "took steps to coordinate the handling of the case to ensure consistency."

He added that agents worked with tax law experts "to develop approaches and materials that could be helpful to the agents working the cases."

Miller did not mention that in 2011, those materials included a list of words to watch for, such as "tea party" and "patriot." He also didn't disclose that in January 2012, the criteria for additional screening was updated to include references to the Constitution or the Bill of Rights.

The House Ways and Means Committee, chaired by GOP Rep. Dave Camp of Michigan, is holding a hearing on the issue Friday and Miller is scheduled to testify.

The Senate Finance Committee announced Monday that it will join a growing list of congressional committees investigating the matter.

The IRS apologized Friday for what it acknowledged was "inappropriate" targeting of conservative political groups during the 2012 election to see whether they were violating their tax-exempt status. In some cases, the IRS acknowledged, agents inappropriately asked for lists of donors.

The agency blamed low-level employees in a Cincinnati office, saying no high-level officials were aware.

When members of Congress repeatedly raised concerns with the IRS about complaints that tea party groups were being harassed last year, a deputy IRS commissioner took the lead in assuring lawmakers that the additional scrutiny was a legitimate part of the screening process.

That deputy commissioner was Miller, who is now the acting head of the agency.

Camp and other members of the Ways and Means Committee sent at least four inquiries to the IRS, starting in June 2011. Utah Sen. Orrin Hatch, the top Republican on the Senate Finance Committee, sent three inquiries. And Rep. Darrell Issa, R-Calif., chairman of the House oversight committee, sent at least one.

None of the responses they received from the IRS acknowledged that conservative groups had ever been targeted, including a response to Hatch dated Sept. 11, 2012 ? four months after Miller had been briefed.

In several letters to members of Congress, Miller went into painstaking detail about how applications for tax-exempt status were screened. But he never mentioned that conservative groups were being targeted, even though people working under him knew as early as June 2011 that tea party groups were being targeted, according to an upcoming report by the agency's inspector general.

The IRS issued a statement Monday saying that Miller had been briefed on May 3, 2012 "that some specific applications were improperly identified by name and sent to the (exempt organizations) centralized processing unit for further review." That was the unit in Cincinnati that handled the tea party applications.

Miller became acting commissioner in November, after Commissioner Douglas Shulman completed his five-year term. Shulman had been appointed by President George W. Bush.

On June 29, 2011, Lois G. Lerner, who heads the IRS division that oversees tax-exempt organizations, learned at a meeting that groups were being targeted, according to a draft of the report by the Treasury inspector general for tax administration.

At the meeting, Lerner was told that groups with "Tea Party," ''Patriot" or "9/12 Project" in their names were being flagged for additional and often burdensome scrutiny, the report says. Lerner instructed agents to change the criteria for flagging groups "immediately."

However, when Lerner responded to inquiries from the House oversight committee, she didn't mention the fact that tea party groups had ever been targeted. Her responses included 45-page letters in May 2012 to Rep. Darrell Issa, R-Calif., who chairs the committee, and Rep. Jim Jordan, R-Ohio, who chairs a subcommittee.

Lerner also met twice with staff from the House Ways and Means oversight subcommittee to discuss the issue, in March and in May 2012, according to a timeline constructed by committee staff. She didn't mention at either meeting that conservative groups had been targeted, according to the timeline.

On Monday, President Barack Obama said he first learned about the issue from news reports on Friday. White House spokesman Jay Carney said the White House counsel's office was alerted the week of April 22 that the inspector general was finishing a report concerning the IRS office in Cincinnati. But, he said, the counsel's office did not get the report and the president did not learn the focus until Friday.

"If, in fact, IRS personnel engaged in the kind of practices that had been reported on and were intentionally targeting conservative groups, then that's outrageous and there's no place for it," Obama said Monday at a press conference.

__

Associated Press writers Jim Abrams and Henry C. Jackson contributed to this report.

___

Follow Stephen Ohlemacher on Twitter: http://twitter.com/stephenatap

Source: http://news.yahoo.com/top-irs-official-didnt-reveal-tea-party-targeting-000016562.html

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Monday, May 13, 2013

Obama's Health Secretary Seeks Donations From Companies For Health Care Law


By David Morgan
WASHINGTON, May 11 (Reuters) - U.S. Health and Human Services Secretary Kathleen Sebelius is asking companies for financial donations to help implement President Barack Obama's healthcare overhaul, months before it is due to take effect.
In telephone calls that began around March 23, officials say, Obama's top healthcare adviser has been seeking assistance from companies in the healthcare field and other industries as well as from healthcare providers, patient advocacy groups, churches and other charitable organizations.
"The secretary has been working with a full range of stakeholders ... We have always worked with outside groups, and the efforts now ramping up are just one more part of that work," said Jason Young, a spokesman for the Department of Health and Human Services.
HHS declined to identify the targeted donors but said none of the companies are regulated by department agencies.
The administration's aim is to win financial help for nonprofit groups, including Washington-based Enroll America, which are mounting a private-sector effort to persuade millions of uninsured Americans to obtain health coverage in 2014 through new online marketplaces, known as exchanges, slated to begin enrollment for federally subsidized private insurance on Oct. 1.
With Republicans in Congress unwilling to consider allocating new money to finance government outreach efforts, the White House and HHS have appealed to private sources, including the insurance industry, to help with an implementation effort that could lead to higher costs and jeopardize a cornerstone of Obama's presidential legacy if it were to fail.
Senator Orrin Hatch of Utah, the top Republican on the Senate Finance Committee, blasted Sebelius' action as "absurd."
"Moving forward, I will be seeking information from the administration about these actions to help better understand whether there are conflicts of interest and if it violated federal law," he said in a statement.
HHS said the secretary began phoning companies after getting advice from department lawyers. "There is a special section in the Public Health Service Act that allows the secretary to support and to encourage others to support non-profit organizations working to provide health information and conduct other public health activities," Young told Reuters in an email.

OBAMA: DON'T BE 'BAMBOOZLED'
Sebelius' fund-raising activities were originally reported by the Washington Post.
Organizations like Enroll America are expected to play a key role in public outreach efforts set to begin this summer.
A nonpartisan group dedicated to extending health coverage to nearly 49 million uninsured people, Enroll America's board includes representatives from Teva Pharmaceuticals, the Kaiser Permanente health system and the American Hospital Association, a Washington trade group.
Enroll America President Anne Filipic said cooperation between the public, private and nonprofit sectors is vital to making sure the marketplaces are ready on time. "Secretary Sebelius recognizes the importance of the work Enroll America is doing and we're thrilled to be working with her," she said.
Obama defended his Patient Protection and Affordable Care Act on Friday at a White House event intended to kick off the administration's promotional campaign with a focus on the law's benefits for women.
The president said he was "110 percent committed" to the law's success and warned listeners not to be "bamboozled" by misinformation.
"This is too important for political games," Obama said. "Regular access to a doctor or medicine or preventive care - that's not some earned privilege, it is a right."
The law is expected to provide health coverage to 38 million people by the end of the decade through the new marketplaces and an expansion of the Medicaid healthcare program for the poor. Some 7 million people are expected to gain coverage through the marketplaces alone in 2014, according to the nonpartisan Congressional Budget Office.
Republicans have turned up the volume on their opposition to the law. The House of Representatives is to vote next week on a Republican measure to repeal the law. Like three-dozen previous House votes to repeal or defund healthcare reform, the measure is expected to go nowhere in the Democratic-led Senate.
HHS officials say the department has put together $1.26 billion to finance Affordable Care Act implementation between now and Sept. 30, the end of the fiscal year. That includes an outreach campaign that has already cost $240 million, as well as funding for the establishment of 17 state insurance exchanges, and 33 others that HHS will operate in states that are either not ready or unwilling to run their own.
The exchanges are scheduled to begin operating on Jan. 1, 2014, when the healthcare law comes into full force. (Editing by Mohammad Zargham)

Also on HuffPost:

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Source: http://www.huffingtonpost.com/2013/05/11/obama-health-care-donations_n_3259741.html

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