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sarrbrinton · 4 years

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Service Is The Answer

Introduction

Volunteering can produce greater benefits to any individual when compared to the benefits of medications, eating healthy, and exercise to the extent that it can relieve individuals of depression, lengthen humans lives, free people of loneliness, live life being happier, and help your life feel more fulfilling. With all the sicknesses, mental and physical, and the challenges that humans are going through in this time, the search for a cure is even greater than ever before. Therefore, I find the importance in writing a research paper on the effects of volunteering and service and how it truly can be that cure that many are looking for.

I am qualified to provide this research because of the major in which I am studying, I am going into the field of family science, therefore I am being educated on these subjects through classes which I am currently taking, the subject is fresh in my mind. Also, I have had much experience in the volunteer environment and have been blessed to be surrounded by many people who also share this love for service. I have seen and know the positive effects that come from volunteering because of the characters that these individuals possess and they truly are examples to me in my life. Throughout my life I have loved serving others and volunteering in different programs at school, church, or wherever I was needed, I found joy in serving. When I was about seventeen years old, I entered somewhat of a depression, my life was not focused on others, but I was wrapped up in myself, I was not happy. I realized that this was not how I wanted to live my life and this experience shook me to change my life around. I began to become involved again, with school, church, friends, and my community. These experiences gave me hope and showed me that I can choose to be happy and helped me see what truly brings that happiness. At the age of nineteen I went to Peru for a church service mission where I was able to dedicate a year and a half of my life, every day, all day, to serving the people in Peru, what a happy time in my life that was. I saw the impact that service made on others and even more than that, I saw the impact that service was making on me. I returned from Peru a little under two years ago, and since then I have promised to always try and make service a top priority in my life and I have been blessed with many opportunities to be able to serve since then. I can testify that service to others truly changes people and brings happiness. I wish for everyone to come to realize this and experience this true joy. I know that if we become a more service-oriented nation, we will have citizens who are changed for the better and because of the great impacts that service has, we will have an overall nation that is changed for the better. Therefore, I have chosen to study in this field and conduct this research project because, for me, this is my hope for America, that this nation and this world can become a better place. I hope that my studies and my experiences can make an impact on others for the good so that they too can thrive in doing the things that they love and make their impact as well.

Volunteering produces nothing but good for those who are providing the service and those who are receiving. I know that many people are aware of this effect that volunteering has on them but may not know how or why they feel so good after participating in an act of service or volunteering. The research I am wanting to do is to answer the questions, “What physical, mental, and emotional effects does service and volunteering have on humans? Is there correlation between service and happiness?” I hope to find and create data to prove that service does have positive effects. To do this I will look at the effects that service has on the doer of the service, I will do some research about how our brain works and the things that are triggered when one volunteers. I will also look at the long-term effects that volunteering has on people and why it is that those who make volunteering a large part of their life live longer, happier, more fulfilled lives. My purpose in addressing this topic is to gather scientific evidence to prove the positive effects of volunteering to the point that doctors are convinced that they feel the need to prescribe and promote volunteering because they can see that it is a cure to many problems and illnesses for the doer. The type of volunteering that I will be researching for my paper is service volunteering, such as helping out in the community, in schools, nonprofits, helping those living in poverty circumstances, immigrants, sharing talents and finding teaching opportunities to those who are wanting to learn a skill, or providing services to others who are in need for no cost. To prove that service has the power to change individuals for the better and leads to a happier, healthier, and longer life, I will first conduct social media surveys and look up responses online as to what type of effect volunteering has had on individuals. To collect data, I will conduct surveys and research studies that have been conducted by neurologists on the effects that service has on our bodies. These results will lead me to know whether service volunteering has a positive impact on us as humans and will explain the logistics behind the feelings felt when serving others. Based off my research I hope to better educate physicians of the positive, immediate, and long-term effects that service volunteering can have on those suffering from mental or physical illnesses so that they can prescribe/recommend service as a remedy for these individuals and then, at the same time, help them see the bigger picture and the consequences that could come if all physicians were to start prescribing service to their patients.

The Numbers

Out of curiosity, I conducted a small survey on Instagram of 100 people and asked them the question, “How do you feel after doing service?” and let them answer with either, “the same” or “better than I did before.” The audience was varied in age, ethnicity, race, and location; out of 100 people 96% of them answered that they feel better after doing service and 4% of them answered that they feel the same. Although I was surprised about the 4%, I was not surprised to see that 96% of them felt better afterwards.

In the United States, the top state with the most volunteers is Utah, Fox 13 wrote an article about this and it says that, “The Corporation for National and Community Service's Volunteering and Civic Life in America report has shown Utah to lead the nation in the percentage of volunteers for 8 years running. In Utah, 43.8 percent of adult’s volunteer compared with a national average at 26.5 percent (Statistics Show Utah Leads Volunteering in 1 Category, Lags behind in Many Others, 2014).” Then in an article done by USA Today, Utah comes up as the second happiest state in the US right behind Hawaii (Best states for happiness? WalletHub study ranks Hawaii first, West Virginia last, 2018). Is this a coincidence or is there a correlation between volunteering and happiness? To get a bigger picture, an article from Psych Central shows the stats of a couple of countries and the percent of adult volunteer that that country had in 2018, it states that, “Worldwide, the prevalence of adult volunteering varies, with estimates of 22.5 percent in Europe, 36 percent in Australia and 27 percent in the USA, according to the researchers.” Then in correlation, Forbes magazine posted an article in March of 2019 titled, Ranked: The 10 Happiest Countries In The World In 2019, and this is what they have to say about the US, “The US has seen fall in happiness despite its economic success, which has seen it slip a place from 18th last year to 19th this year. CEO of The Happiness Research Institute, Meik Wiking, attempts to explain why, "The main reason… is that the US has been facing a social crisis for several years, where more and more people find that they have no one to count on in times of need. The divide between rich and poor also creates an erosion of the cohesion and trust between people, which is so vital for the feeling of safety and security and therefore for the overall happiness level of the American people (Ranked: The 10 Happiest Countries In The World In 2019, 2019).”” This is no coincidence, the numbers speak for themselves and show that not only service, but trust, belonging, feelings of safety and security, all contribute to the happiness of the individuals.

The Science Behind It

Studies have been done to show that people who give their time to others are “rewarded with better physical health- including lower blood pressure and a longer lifespan (Volunteering May Be Good for Body and Mind, 2015).” “Many people find volunteer work to be helpful with respect to stress reduction, and we know that stress is very strongly linked to health outcomes,” therefore as we volunteer we reduce our stress which reduces our blood pressure and then leads to us living a longer life. But, how many hours of service do we need to put in to see results? “In the Carnegie Mellon study, 200 hours of volunteering per year correlated to lower blood pressure. Other studies have found a health benefit from as little as 100 hours of volunteering a year.” Knowing the number of hours that are needed to have an impact on someone is great information for prescribing service to patients who are suffering from depression or loneliness, etc.

There are chemicals in our brain that are released every time that we do something that tells us whether the thing that we did made us happy or sad, these chemicals trigger our emotions and when a certain chemical is triggered it then triggers other chemicals that help in producing other emotions. An example of this is The Happiness Trifecta, in a study published by Psychology Today, it educates us on the effects that service can have on our brains, “Helping others triggers a release of oxytocin, which has the effect of boosting your mood and counteracts the effects of cortisol (the dreaded stress hormone). Interestingly, the higher your levels of oxytocin, the more you want to help others. When oxytocin is boosted, so are serotonin and dopamine (The Neuroscience of Giving, 2014)!” I conducted a survey on Instagram to help enforce this study asking people if they felt better after doing service or if they felt the same. One hundred people responded in the survey and 96% of those people said that they did feel better after doing service. This just proves the positive mental effects that service can have on people and if we were to start prescribing it to people who are needing to lower their stress levels, lower their blood pressure, and to those who are struggling to find happiness and belonging, then we may just be able to help them find that through service.

My Position

Based on the research that I have done; I know that service leads to happiness. I believe that if physicians in all types of medical offices start prescribing or encouraging their patients to participate more in service that the physicians and loved ones of these patients will start to see these individuals who are suffering from all different kinds of illnesses (depression, loneliness, anxiety, heart break, cancer, etc.) are happier after participating in service. They will have a greater feeling of purpose as they see the impact, they are making in the lives of the people they are serving. They will more often trigger those neurons in their brain to produce more oxytocin, therefore relieving them of stress and allowing the Happiness Trifecta to kick in. When one does service, they usually do it in an environment or for a cause in which they believe in, whether that is volunteering to teach low-income kids to play piano, helping make Santa sacks for families in need around the Christmas season, or whatever it may be, as these individuals participate in these act of service they will be happy because they are sharing something that they love.

Counterargument

In a Psychology Today article it unlocks the secret of altruism, it says, “we do good deeds to others in the hope that they will return the favor someday, when we are in need (Why Do Human Beings Do Good Things? The Puzzle of Altruism, 2013).” This article also argues that humans are selfish and that there is always an explanation for why a human does some act of service and that it always comes back to benefitting the doer of the service. This may be true for some individuals but isn’t that the end goal anyways? This chain reaction of people serving each other is great because when one participates in service both the doer and the receiver reap benefits. If we allow others to serve us in return, then we are allowing them to also experience the happiness that comes from them being able to serve someone and it is just one happy chain reaction.

Conclusion

Becoming service focused takes some practice and may even take some pushing yourself out of your comfort zone but as humans we need connection, love, belonging, trust, help, health, and happiness. Service can help us fulfill these needs in a healthy way. As I mentioned at the beginning of this paper, I have personally experienced the benefits of doing service and it has brought so much happiness in my life and now I cannot afford to take it out of my life, it has become something that I crave. Service brought me out of my sad state, and I know that it can lift many others, the science is there, and there are many ways to serve. I invite you to find out what your patients’ passions are and to invite them to serve. It may just be the right amount of “medication” they need to be cured.

Research History

Up until this semester of school I don’t think I have ever researched anything that I am truly passionate about and write a paper on it, at least not to this extent. Before this, when I heard the words research paper, I would always be nervous because the teacher would always give a specific topic that we would need to research and usually it was something that we are not necessarily interested in. This year in one of my family science classes, we were asked to use a similar research process that we used in this class, only for this other class it had to be about a social problem. I loved that in ENGL 2010, the options were endless, that there were no restrictions on what we were to write about. I have never experienced such freedom in school and it really opened my eyes to seeing that the things we learn in school are for our benefit and can be used and applied to the things that we decide to do in our careers and in our lives, not just for that specific class. Some previous problems that I have had research is not caring about the things that I am researching; therefore, I just research the bare minimum and end up not learning about the subject that I should be learning about. This semester has been my most successful experience with researching because I was passionate in the topics I was researching and wanted to find solutions and had questions that I wanted to find answers to.

English 2010 helped me improve my research literacy by showing me a way to break things down. Research is not supposed to be neat and perfect, but it is free writes and rough drafts, it takes several steps to get to where you want to get to with a subject and that’s okay. Now I have a better idea of what it takes to really understand a subject. I also learned that there are endless resources when doing research and it is true, you never are really done, new questions will form and more ideas will always come up with research.

Synthesis

The three articles that I am going to synthesize are: one, an article published by Fox 13 News that was done in 2014, two, an article from a Harvard Health Blog in 2015, and three, an article from Psych Central from 2018. The first article talks about the number of adult volunteers that Utah has had from 2015-2017 and points out that Utah has been the top volunteer state for the past 11 years. They mention that those who volunteer also tend to also help do favors for their neighbors and then state the number of hours and the economic value that all these hours of service have added up to. It concludes with a true story of a man who gives free haircuts to people in the park who can’t afford haircuts. This article is great if you are looking for numbers and statistics, but it does not explain the why behind any of its claims. It doesn’t claim that those who are volunteering in Utah are necessarily happy nor does it explain the motive behind the man who gives free haircuts in the park. What this article does do though is spark many questions which then leads me to needing to do more research. After reading this article I started to wonder how many service hours are needed to really make a positive impact on someone?

This leads to the need of article number two; this article answers my question about how many service hours are needed to make an impact on an individual. This article talked about the health benefits of service and that they include having a lower blood pressure, a longer lifespan, and acts as a stress reducer. This information can also be connected to explain why volunteers may have a desire to help their neighbor. Individuals who volunteer have a better control on their stress, therefore being able to be patient or add on extra tasks from their neighbors whereas someone who doesn’t volunteer as often may feel like a needy neighbor is bugging them or is adding to the stress that that individuals is already experiencing with the many things that they are already dealing with. Then this article answers the question that I had at the end of reading article number one, they say that 200 hours of service leads to lower blood pressure and that 100 hours of service could lead to health benefits. This article also brought up another great point, the fact that our heart needs to be in the service and that we can’t be doing the service wanting to benefit ourselves but that we do the service wanting to benefit others and then we receive more of a positive effect on ourselves. This quote explains this new idea, “One key for deriving health benefits from volunteering is to do it for the right reasons. A 2012 study in the journal Health Psychology found that participants who volunteered with some regularity lived longer, but only if their intentions were truly altruistic. In other words, they had to be volunteering to help others—not to make themselves feel better.” This added another question, how can we know if our reasons are altruistic?”

The third article also talked about the person who is performing the service needs to be doing it for the right reasons, “Although people tend to volunteer for altruistic reasons, if they do not feel they are “getting something back,” then the positive impact of volunteering on quality of life is limited, the review found. Researchers also found that if people volunteer too much, the habit can become a burden, bringing problems of its own.” When reading articles two and three it opened a counterargument and I started to see that there could be a negative side to service. Could there really be people out there who feel that service is a burden or who do service only to get something back? There were now two articles that claimed the same idea and so I guess it should be something that I started to consider the counterargument. Must we need to get something back for something to benefit us? What truly are we getting back when we provide service? Is it a feeling, does it trigger some chemical in our minds? Some questions were answered but more questions always formed.

Sources:

“5 Reasons Why You Should Volunteer.” Psychology Today, Sussex Publishers, https://www.psychologytoday.com/us/blog/the-third-age/201403/5-reasons-why-you-should-volunteer.

Anderson, Eric. “Statistics Show Utah Leads Volunteering in 1 Category, Lags behind in Many Others.” fox13now.Com, 14 Feb. 2014, https://fox13now.com/2014/02/13/statistics-show-utah-leads-volunteering-in-1-category-lags-behind-in-many-others/.

Bright, Christopher. “Community Service.” Centre for Justice & Reconciliation, http://restorativejustice.org/restorative-justice/about-restorative-justice/tutorial-intro-to-restorative-justice/lesson-3-programs/community-service/#sthash.96qRe2Bg.dpbs

Brinton, Sarah. “Story.” Instagam, https://www.instagram.com/stories/sarrrbrinton/. December 2, 2019.

Leimer, Trisha. “Giving Goes Both Ways.” The Church of Jesus Christ of Latter-Day Saints, 1 Mar. 2017, https://www.churchofjesuschrist.org/refugees/stories/giving-goes-both-ways.

Ritvo, Eva. “The Neuroscience of Giving.” Psychology Today, Sussex Publishers, 24 Apr. 2014, https://www.psychologytoday.com/us/blog/vitality/201404/the-neuroscience-giving.

Taylor, Steve. “Why Do Human Beings Do Good Things? The Puzzle of Altruism.” Psychology Today, Sussex Publishers, https://www.psychologytoday.com/us/blog/out-the-darkness/201310/why-do-human-beings-do-good-things-the-puzzle-altruism.

US Census Bureau. “2018 National and State Population Estimates.” 2018 National and State Population Estimates, 20 Dec. 2018, https://www.census.gov/newsroom/press-kits/2018/pop-estimates-national-state.html.

“Utah Homelessness Statistics.” Homeless in Utah Statistics 2018. Homeless Estimation by State | US Interagency Council on Homelessness, https://www.usich.gov/homelessness-statistics/ut/.

Watson, Stephanie. “Volunteering May Be Good for Body and Mind.” Harvard Health Blog, 30 Oct. 2015, https://www.health.harvard.edu/blog/volunteering-may-be-good-for-body-and-mind-201306266428.

Wood, Janice. “Volunteering Can Improve Mental Health, Extend Life.” Psych Central, 8 Aug. 2018, https://psychcentral.com/news/2013/08/23/volunteering-can-improve-mental-health-help-you-live-longer/58787.html.

Companion Piece:

file:///C:/Users/sarah/Downloads/Writing%202010/Happiness%20workshop.pdf

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rjzimmerman · 5 years

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Excerpt from this Nation of Change/NRDC piece:

A lawsuit against the Trump Administration’s approval of Alton Coal’s mine expansion near Bryce Canyon National Park was filed today by Sierra Club, Natural Resources Defense Council (NRDC), the National Parks Conservation Association (NPCA), Grand Canyon Trust, Utah Physicians for a Healthy Environment and WildEarth Guardians. The organizations filed a National Environmental Policy Act (NEPA) challenge to the recent approval of the expanded mine, which would extract millions of tons of coal and exacerbate climate change impacts including air pollution and other threats.

In August of 2018, the Bureau of Land Management (BLM) approved an environmental report that allows Alton to expand its mine onto 2,114 acres of public land to extract more than 30 million tons of coal. The complaint argues that BLM failed to analyze the impacts of mercury pollution from burning coal, did not consider the enormous social costs of increased carbon emissions, and refused to take a broader, more cumulative look at the climate impacts of this project as is required under NEPA.

In addition to the pollution and climate impacts, this coal mine expansion threatens the natural resources and visitor experience at nearby iconic Bryce Canyon National Park. Even further, the BLM itself acknowledges that the expansion is likely to have a negative effect on North America’s southernmost population of Greater Sage Grouse.

#utah #Bryce Canyon National Park #coal mining

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your-dietician · 3 years

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New obesity drug semaglutide is safe and effective for weight loss and diabetes

New Post has been published on https://tattlepress.com/health/diabetes/new-obesity-drug-semaglutide-is-safe-and-effective-for-weight-loss-and-diabetes/

New obesity drug semaglutide is safe and effective for weight loss and diabetes

After learning that the venom of a Gila monster lizard contained hormones that can regulate blood sugar, Daniel Drucker started wondering why. And could the venom somehow help treat diabetes?

Drucker is a scientist and endocrinologist at the University of Toronto who has dedicated his career to understanding the universe of hormones in the body, which do everything from regulating appetite to helping with digestion. His curiosity about the Gila monster led to a call with a zoo in Utah. In 1995, Drucker had a lizard shipped from Utah to his lab and began experiments on the deadly venom.

Ten years later, a synthetic version of a hormone in the venom became the first medicine of its kind approved to treat type 2 diabetes. Known as a GLP-1 (for glucagon-like peptide-1) receptor agonist, the medicine set off a cascade of additional venom-inspired discoveries.

After doctors noticed mice and humans on the drug for diabetes appeared to lose weight, they began to consider its use in obesity science. In June 2021, another effective treatment, this one for obesity, got Food and Drug Administration approval. Called semaglutide and marketed as Wegovy, it also takes its structure from the lizard’s venom.

If this origin story sounds outlandish, consider the history of obesity treatments. Over the years, people have turned to extreme and unlikely interventions to try to lose weight, from jaw wiring, laxatives, and vagotomies to lap band operations and fen-phen, a “miracle” diet drug that was ultimately recalled.

The new treatment — a once-weekly injectable from Novo Nordisk, a Danish pharmaceutical company that has hired many leading diabetes and obesity scientists as consultants — is poised to safely help many people with health-threatening obesity, physicians and researchers say. It may even illuminate some of the mysteries around how appetite works in the first place.

“It’s phenomenal,” says Michael Krashes, a diabetes and obesity investigator at the National Institutes of Health. Semaglutide is “a big step forward — we finally have something that’s reliable and able to produce sustained effects over time,” adds Ivan De Araujo, a neuroscientist who studies brain-gut interactions at Mount Sinai’s Icahn School of Medicine. Neither scientist is affiliated with Novo Nordisk.

Doctors who treat obesity patients told Vox they wished they had a treatment option like semaglutide years ago, and patients described the drug as life-altering.

Yet many people with obesity may not seek out semaglutide, and doctors may not prescribe it to them — not only because of the dangerous history of weight loss medications, but also because of a persistent bias and stigma around a disease that now afflicts nearly half of Americans. Obesity is still widely viewed as a personal responsibility problem, despite scientific evidence to the contrary. And history has shown that the most effective medical interventions, such as bariatric surgery — currently the gold standard for treating obesity — often go unused in favor of dieting and exercise, which for many don’t work.

There’s also a practical challenge: Health insurers don’t typically cover obesity medications, says Scott Kahan, an obesity doctor and professor at Johns Hopkins Bloomberg School of Public Health and the George Washington University School of Medicine. “Medicare explicitly excludes weight medications,” Kahan, who consults with Novo Nordisk, says. “And most insurers follow what Medicare does.”

The new drug certainly won’t be a cure-all for obesity, Krashes adds. “You are not taking a 280-pound person and making them 130,” he points out, though reductions that are enough to improve health outcomes are typical. Drucker, who began consulting with Novo Nordisk and other drug companies after his reptilian discovery, agrees that it’s a starting point for obesity: “It will only scratch the surface of the problem in the population that needs to be healthier.”

But semaglutide is the most powerful obesity drug ever approved, he adds. “Drugs that will produce 15 percent body weight loss — we did not have that before in the medical therapy of obesity.” With additional, potentially more effective GLP-1 receptor agonists coming online in the future, we’re at the beginning of a promising new chapter of obesity therapeutics. A look at the fascinating science of how the medication works could also go a long way to changing how Americans think about this disease.

“We have to thank the lizard for that,” Drucker says.

What semaglutide reveals about weight problems

To understand how semaglutide causes some people to eat less, it’s helpful to understand what hormones do. They’re the body’s traveling messengers: Manufactured in one area, they move to another to deliver messages through receptors — molecules that bind to specific hormones — in distant organs and cells.

The gut makes dozens of hormones, and many of them travel to the brain receptors that either curb appetite or stimulate it, Drucker explains. GLP-1 is one such gut hormone. It’s unleashed in the gut in response to food and stimulates the pancreas to make more insulin after a meal, which lowers blood sugar. (GLP-1 is also made in the brain stem, where it may modify appetite.)

“It sends a signal to our brain that says, ‘You know, we’ve had enough to eat,’” says Drucker.

Enter semaglutide, one of a class of medicines — the GLP-1-receptor agonists — that imitate GLP-1, helping the body lower glucose (in the case of people with diabetes) and, researchers suspect, curb appetite (in the case of people living with obesity who may also have diabetes).

The precise way the drug works on obesity is still unknown, in part because scientists don’t understand exactly how appetite works. But researchers generally agree that the drug harnesses the brain’s GLP-1 receptors to curb food intake. When researchers delete the GLP-1 receptors from the brains of mice, the drug loses its appetite-suppressing effects, says Krashes.

Obesity is “primarily an issue of our brain biology, and the way it’s processing info about the environment we live in,” says Randy Seeley, a University of Michigan researcher focused on obesity treatments, who also consults with Novo Nordisk.

With semaglutide, the idea is that “we’re changing your brain chemistry for your brain to believe you should be at a lower weight,” Seeley added.

This brain-based pharmacological approach is likely to be more successful than diet and exercise alone, Seeley says, because “the most important underlying part of somebody’s weight has to do with how their brain operates,” not a lack of willpower.

Not quite a “game changer”

Some people with a higher body mass index are perfectly healthy and don’t require any treatment. Semaglutide was only indicated by the FDA for patients who classify as clinically obese — with a body mass index of 30 or greater — or those who are overweight and have at least one weight-related health problem.

For the many people who have used it, it has proved safe and effective, according to the FDA. In weight loss clinical trials, semaglutide helped people lose about 15 percent of their body weight on average — significantly more than the currently available obesity drugs and more than enough to improve health outcomes.

The drug’s most common side effects — nausea, diarrhea, constipation, and vomiting — were mostly short-lived. De Araujo is finding that adverse reactions might be caused by how the drug differs from the naturally occurring peptide hormone: The hormone acts mostly locally and degrades quickly, while the medicine works mainly on the brain and is designed to stick around in the body. “That’s where the nausea, vomiting probably derive from,” De Araujo argues.

Patients who have tried semaglutide told Vox that it helped them manage their weight and relationship to food, and that their side effects were manageable and quickly resolved.

Jim Eggeman, a 911 operator in Ohio, said that before taking semaglutide, “I could sit down and eat a large pizza, and now it’s one to two pieces at the most.” He started on the drug for diabetes after a heart attack in December 2019 and lost 35 pounds, bringing his weight to 220.

Paula Morris-Kaufman, of Cheshire, UK, used the drug to address weight gain following cancer treatments. It helped her bring her weight back to a normal range, she says, and curb her habit of compulsive eating. “If you give me a plate of food, I just eat a small portion of it — and feel full really quickly.”

It’s possible that some of the benefits of treatment come in part from lifestyle changes, which were encouraged by the clinical trials. In many cases, patients on semaglutide also switched to a healthier diet when they started on the drug and added exercise to their routines. But study participants taking the drug still lost significantly more weight than those under the same conditions who received a placebo.

The need for additional interventions — like diet and exercise — is one reason why Kahan stops short of calling this drug a game changer. “It’s an incremental improvement” over existing drugs, he says, and it’s still out of reach for many of the individuals who could benefit from it. “The ‘game changer’ description is not appropriate, because many people don’t have access to these medicines.”

A mindset shift

Only about 1 percent of eligible patients were using FDA-approved medications for obesity in 2019, a study showed. The same is true for bariatric surgery, currently the most effective intervention for obesity, which can also drive type 2 diabetes into remission.

“If someone walks into your office with heart disease and you as a physician don’t try to treat it, that’s malpractice,” Seeley says. “If somebody comes in with a BMI over 30 and you don’t treat it, that’s Tuesday.” He thinks some of the hesitancy for treating patients with obesity medications comes from the history of dangerous weight loss drugs.

“We would never blame other individuals for developing high blood pressure or cardiovascular disease or cancer”

Ingrained biases about obesity have also made it harder for patients to get access, Kahan says. “Obesity tends to be categorized as a cosmetic issue in health insurance policies,” he says. “In order to get coverage, employers have to explicitly decide to buy a rider and sign a contract to add weight management services and products to their insurance plans.” He’d like to see obesity treatments covered by insurers in the same way diabetes and hypertension drugs are.

That will require a shift in mindset, Drucker says. “We would never blame other individuals for developing high blood pressure or cardiovascular disease or cancer,” he says. It’s widely known that those conditions are driven by complex biological determinants, including genes, as well as environmental factors. “Obesity is no different.”

When Drucker started in endocrinology in the 1980s, he didn’t have many tools to help patients. With the addition of semaglutide, there are multiple surgical options and drugs for obesity and diabetes. The challenge now is helping those who would benefit gain access.

“I would be delighted if no one needed GLP-1 for diabetes and obesity,” Drucker says. That might be possible in a food landscape that didn’t nudge people toward the overeating and poor diet that leads to these chronic conditions. But for now, “we have new options that are safe, appear to reduce complications, and are very effective. … We shouldn’t just throw up our hands and say there’s nothing we can do.”

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psychbuilder · 3 years

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What One Health System Learned About Providing Digital Services in the Pandemic

Marc Harrison

Harvard Business Review

Originally posted 11 Dec 20

Here are two excerpts:

Lesson 2: Digital care is safer during the pandemic.

A patient who’s tested positive for Covid doesn’t have to go see her doctor or go into an urgent care clinic to discuss her symptoms. Doctors and other caregivers who are providing virtual care for hospitalized Covid patients don’t face increased risk of exposure. They also don’t have to put on personal protective equipment, step into the patient’s room, then step outside and take off their PPE. We need those supplies, and telehealth helps us preserve it.

Intermountain Healthcare’s virtual hospital is especially well-suited for Covid patients. It works like this: In a regular hospital, you come into the ER, and we check you out and think you’re probably going to be okay, but you’re sick enough that we want to monitor you. So, we admit you.

With our virtual hospital — which uses a combination of telemedicine, home health, and remote patient monitoring — we send you home with a technology kit that allows us to check how you’re doing. You’ll be cared for by a virtual team, including a hospitalist who monitors your vital signs around the clock and home health nurses who do routine rounding. That’s working really well: Our clinical outcomes are excellent, our satisfaction scores are through the roof, and it’s less expensive. Plus, it frees up the hospital beds and staff we need to treat our sickest Covid patients.

(cut)

Lesson 4: Digital tools support the direction health care is headed.

Telehealth supports value-based care, in which hospitals and other care providers are paid based on the health outcomes of their patients, not on the amount of care they provide. The result is a greater emphasis on preventive care — which reduces unsustainable health care costs.

Intermountain serves a large population of at-risk, pre-paid consumers, and the more they use telehealth, the easier it is for them to stay healthy — which reduces costs for them and for us. The pandemic has forced payment systems, including the government’s, to keep up by expanding reimbursements for telehealth services.

This is worth emphasizing: If we can deliver care in lower-cost settings, we can reduce the cost of care. Some examples:

The average cost of a virtual encounter at Intermountain is $367 less than the cost of a visit to an urgent care clinic, physician’s office, or emergency department (ED).

Our virtual newborn ICU has helped us reduce the number of transports to our large hospitals by 65 a year since 2015. Not counting the clinical and personal benefits, that’s saved $350,000 per year in transportation costs.

Our internal study of 150 patients in one rural Utah town showed each patient saved an average of $2,000 in driving expenses and lost wages over a year’s time because he or she was able to receive telehealth care close to home. We also avoided pumping 106,460 kilograms of CO2 into the environment — and (per the following point) the town’s 24-bed hospital earned $1.6 million that otherwise would have shifted to a larger hospital in a bigger town.

The info is here.

#Ethics and Psychology

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perfumetulip · 3 years

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A Witch Cannot Survive On Wine Alone She Also Needs A Pitbull Blood Moon T-Shirt

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magzoso-tech · 4 years

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New Post has been published on https://magzoso.com/tech/diet-autopilot-thistle-raises-5m-for-health-food-subscriptions/

Diet autopilot Thistle raises $5M for health food subscriptions

What if it was easier to eat salad than junk food? Most diet routines take a ton of time, whether you’re cooking from scratch, making a meal kit, or seeking out a nutritious restaurant. But on-demand prepared food delivery companies like Sprig that tried to eliminate that work have gone bankrupt from poor unit economics.

Thistle is a different type of food startup. It delivers thrice-weekly cooler bags customized with meat-optional, plant-based breakfasts, lunches, dinners, snacks, sides, and juices. By batching deliveries in the less-congested early morning hours and optimizing routes to its subscribers, or by mailing weekly boxes beyond its own geographies, Thistle makes sure you already have your food the moment you’re hungry. Whether you heat them up or eat them straight out of the fridge, you’re actually dining faster than you could even place an Uber Eats order.

The food on Thistle’s constantly rotating men is downright tasty. You might get a sunrise chia parfait for breakfast, a chicken tropical mango salad for lunch, a microwaveable bulgogi noodle bowl for dinner, with beet hummus and kale-cucumber juice for snacks. Thistle’s not cheap, with meals averaging about $14 each. But compared to competitors’ on-demand delivery markups and service fees, wasting ingredients from the grocer, and the hours of cooking for yourself, it can be a good deal for busy people.

“We see Thistle as part of a movement to make health convenient rather than a high will power chore” CEO Ashwin Cheriyan tells me. What Peloton did to shave time off getting a great workout, Thistle does for eating a nourishing meal. It makes the right choice the easiest choice.

Thistle COO Shiri Avneri and CEO Ashwin Cheriyan with their daughter

The idea of button you can push to make you healthier has attracted a new $5.65 million Series A round for Thistle led by its first institutional investor, PowerPlant Ventures. Bringing the startup to $15 million in funding, the cash will expand Thistle’s delivery domain. Dan Gluck of PowerPlant, which has also funded food break-outs like Beyond Meat, Thrive Market, and Rebbl, will join the board.

Currently Thistle delivers in-person to the Bay Area, LA metro, San Diego, and Sacramento while shipping to most of Washington, Oregon, Utah, Idaho, Nevada, and Arizona. Thistle actually held off on raising more since launching in 2013 to make sure it hammered out unit economics to prevent an implosion. It’s also planning broader meal options, additional product lines, and fresh distribution strategies like getting stocked in office smart kitchens or subsidized by wellness plans.

“The reasons that so many food delivery companies have failed likely fall into two buckets: one, a lack of focus on margins and unit economics, and two, premature geographic expansion before proving out the business model” says Cheriyan. “Thistle makes money similar to how a well run restaurant would make money – by having strong gross margins, efficient customer acquisition costs, and solid customer retention / lifetime metrics. We currently deliver tens of thousands of meals on a weekly basis to customers on the West Coast and our annual average growth rate since launch has been 100%+.”

It’s nice that Thistle hasn’t gone out of business because I’ve been eating its salads 6X a week for three years. It’s been the most efficient way for me to get healthier and lose weight after a half-decade of ordering takeout sandwiches and then feeling sluggish all day. I legitimately look forward to each one since they often have 20+ ingredients and only repeat every few months so they’re never boring.

It’s helped me keep my work-from-home lunches to about 20 minutes so I have more time for writing. Thistle is one of the few startups I consistently recommend to people. When asked how I lost 25lbs before my wedding, I point to Peloton cycling, Future remote personal training, and Thistle salads — none of which require me to leave the house.

Cheriyan tells me “We wanted the better-for-you and better-for-planet choice to be the default choice.”

Growing Out Of On-Demand

Thistle has already pivoted past the business model burning tons of cash across the startup world. The company started as an on-demand cold pressed juice delivery service, sending hipster glass bottles of watermelon and charcoal extract to doors around San Francisco. It was 2013, yoga was booming, and people were paying crazily high prices for liquified lemongrass. Health made simple seemed like a sure bet to the founding team of Alap Shah, Naman Shah, Sheel Mohnot, and Johnny Hwin, some of whom run Studio Management, a family office and startup incubator. [Disclosure: Hwin and Shah are friends of mine but didn’t pitch or discuss this article with me.]

Thistle eventually straightened things out with a shift to subscriptions and batched delivery under the leadership of the hired executives, Cheriyan and his wife and COO Shiri Avnery. “I came from a family of physicians – both my parents, brother, and enough aunts, uncles, and cousins are doctors that they could start a small hospital” Cheriyan, a former corporate attorney in M&A tells me. “A common point of frustration was about patients suffering from diet related illnesses who were unable to make a lifestyle change because it was too hard.”

Avenery, a PhD in air pollution and climate change’s impact on agriculture, had become exasperated with the slow pace of policy change and the inaction of governments and corporations. The two quit their jobs, moved to San Francisco, and searched for a point of leverage for positively influencing people diets and interaction with the environment. They teamed up with the founders and launched Thistle v1.

A lack of experience in logistics led to the initial detour into on-demand. But rather than trying to fix the problem with VC money, Thistle stayed lean and discovered the opportunity nestled between UberEats and BlueApron: sending people food they don’t have to eat now, but that takes low or no time to prepare when they’re peckish. Through its app, users can customize their meal plans, ban their allergens, pause deliveries, and see what they’ll eat next.

A sample of Thistle 8 meal plans

“The unit economics problem most heavily plagued the early on-demand food companies. Food / labor waste and inefficient deliveries were likely the biggest reasons why the economics were unsustainable without venture life support. We know this personally as Thistle started our delivery service as an on-demand company before quickly realizing that the unit economics couldn’t sustain a healthy business” Cheriyan explains, regarding companies like Sprig, DoorDash, and Grubhub. Beyond unsold food, “the margins very likely did not support ordering a $12-$15 single meal for immediate delivery when average hourly driver wages reached $18-20.”

Meal kits were supposed to make dining healtheir and cheaper, but they proved too much of a chore and led customers to boxes of ingredients piling up unused. Munchery and Nomiku went out of business while giants like Blue Apron have incinerated hundreds of millions of dollars and seen their share prices sink.

“The meal kit companies fared a little better from a gross margin perspective (due to preorders and more efficient deliveries) but suffer most from an easy-to-copy business model. This led to a rise in copycats, and, as a result, heavily rising customer acquisition costs, low switching costs and poor retention” Cheriyan tells me. “Fundamentally the meal kit companies face another challenge, which is that people have less and less time to cook and are increasingly looking for ready-to-eat options.”

Push-Button Health

A slower, steadier approach with less overhead, more convenience, and fewer direct competitors has helped Thistle grow to 400 employees from culinary to engineering to logistics.

Still, it’s vulnerable. It may still be too expensive for some markets and demographics. Logistics experts like Amazon and Whole Foods could try to barge into the market. Cloud kitchens without dining rooms are making restaurant food more affordable for delivery. And another startup could always take the gamble on raising a ton of cash and subsidizing prices to steal market share, especially where Thistle doesn’t operate yet.

Thistle could counter these threats would be further eliminating delivery costs by selling through partners like office smart fridges where employees pay on the spot, or equipping gym lobbies with more than just Muscle Milk.

“One opportunity we’re excited to test is attended and unattended retail – it would be great to be able to pick up Thistle products at your local grocery store, gym, or coffee shop” Cheriyan says. As for offices, “Today’s corporate lunchtime solutions often require a tradeoff between health and convenience: either wait in line for 30+ minutes at your favorite salad spot for a healthy option, or opt into catered restaurant meals that leave you feeling sluggish and unproductive.” Thistle could help employers prevent the 3pm energy lull.

The startup’s focus on plant-forward meals also centers it in the path of another megatrend: the shift to environmentally-conscious diets. Almost 60% of of Americans are trying to eat less meat and 50% are eating meat-alternatives like Impossible Burgers. That stems both from interest in the humane treatment of animals and how 15% of green house emissions come from livestock. But 45% of Americans say they hate to cook. That’s why Thistle makes pre-made meals where meat and egg are optional, but the food is healthy and delicious without them.

In the age of Uber, we’ve acclimated to an effortless life. The new wave of ‘push-button health’ startups like Thistle could finally take the hassle out of aligning your actions in the gym or kitchen with you intentions.

#Miscellaneous

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burkettxd · 6 years

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Rolly: Guess who put Utah Gov. Gary Herbert under for his <b>surgery</b>? One of his main critics on ...

When Gov. Gary Herbert went into LDS Hospital last week for surgery to remove kidney stones, he got a surprise. The anesthesiologist wound up being none other than Brian Moench, president of Utah Physicians for a Healthy Environment and one of Herbert's most ardent critics over the state's ... from Google Alert - surgery http://ift.tt/2EzKlS5

#IFTTT #Google Alert - surgery

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e-ellis-allen-is-girl-on-stilts · 7 years

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A Sad State: Seeing Orange makes Me See Red

Jan.19, 2017

I have the perfect view of the Wasatch Mountains outside my kitchen window. In the summer months, I watch the sun rise over majestic purple peaks. Yesterday, however, the mountains were cut off three-quarters down, with barely a top nosing above an ocean of gray clouds; the inversion, the Wasatch Front’s version of pollution-hide-and-seek.

Yesterday’s Air Quality color was Orange. Orange means that the quality of the air we’re breathing is unhealthy for “sensitive groups”.

I looked up who was included in this particular group and discovered they’re people with lung cancer, children/teenagers, older adults, and people who are athletic outdoors. What? Who’s left?

Later, I traveled through this pollution-soup from the Salt Lake Valley into Davis County. As I bumped along I15, the smog was so thick I couldn’t see downtown Salt Lake until I was right on it. I also noticed a line of oil refineries puffing away the gray haze.

Everyone in Utah knows about the inversion that comes every winter, particularly over the Salt Lake Valley. We are acquainted with the air quality codes, somewhat, but what do they mean? I looked that up, too.

According to air.utah.gov, these are the color rankings: Green means the air quality is good. Yellow means the air quality is adequate. Orange is unhealthy air for sensitive types. Red means straight out unhealthy for everyone. Purple indicates the air is “very unhealthy”, and finally there is the color, maroon, or as I saw it, Oxblood, meaning the air quality is “Hazardous”.

As far as I can tell, unless the ranking is green, someone feels health issues due to the air we’re breathing.

It means when the meteorologist announces there is a specified color you are expected to avoid breathing that air as much as possible. What? What do we do hold our breath?

KSL.com posted an article on January 16, 2017, sponsored by Utah Clean Air Partnership (UCAIR) titled, “6 myths about Utah’s air quality debunked”. The title alone made me feel a little better. Then I read it.

The article breaks into six paragraphs labeled Myths 1-6 with subtitles such as, “Lighting a fire in the fireplace now and then really isn’t a big deal”, and “When air quality is poor outdoors, it is also bad inside”. Beneath each myth is the word fact in bold followed by an explanation of why the statement is false, and then gives a solution.

The solutions are, use a gas fireplace over a wood burning one. If the air is bad outside, stay inside where the air is “dramatically better”, and use a snow shovel over a snow blower. Am I missing something? Has there been a rash of gas-guzzling snow blowers lately? What’s next, using scissors to cut grass rather than a lawn mower?

Also, the solution to simply stay inside when the air quality is horrendous outside, makes as much sense as giving a candy bar to someone who’s starving—yes it’s calorie-laden, but is it nutritious?

Yes, of course, we need to figure out a way to stop this pollution, or at least lessen it by a lot. But to ignore the smoke belching factories along Refinery Row is ridiculous.

To add to this disillusionment, KSL.com posted this as news rather than what it really is, an advertisement for Governor Herbert and his program. Isn’t this a conflict of interest?

I support carpooling and setting your inside thermostat two degrees lower (I’m as uncomfortable without heat in the winter as I am uncomfortable without air conditioning in the summer), and I’m vigilant about the upkeep of my cars, but it’s not just individuals to be blamed.

The Utah Physicians for a Healthy Environment (uphe.org), states that Rio Tinto/Kennecott Copper Mine is responsible for thirty percent of that dirty air in Salt Lake County. Oil refineries come in second as being the biggest contributors to our bad air quality. If this is true, which I believe it is, does what I do really matter that much?

Today is another Orange day. Outside my kitchen window, there is no trace of the majestic mountain range I love, only gray. It’s snowing, a little, and snowflakes swirl in the air like white ash. Although after this storm the projected color ranking of tomorrow will be green, I keep thinking, so what? I’m here now, today.

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craigshaw9856 · 4 years

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‘Diesel Brothers’ Fined $850,000 for Rolling Coal

The hosts of the Discovery Channel’s Diesel Brothers have been fined $851,451 for selling modified pickups that violate Utah law and the federally recognized Clean Air Act. U.S. District Court Judge Robert Shelby also said the plaintiffs, Utah Physicians for a Healthy Environment, could submit their attorney fees for the defendants to pay. Cole Cannon, lawyer to the […]

The post ‘Diesel Brothers’ Fined $850,000 for Rolling Coal appeared first on The Truth About Cars.

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sheminecrafts · 4 years

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Diet autopilot Thistle raises $5M for health food subscriptions

Thistle COO Shiri Avneri and CEO Ashwin Cheriyan with their daughter

The idea of button you can push to make you healthier has attracted a new $5.65 million Series A round for Thistle led by its first institutional investor, PowerPlant Ventures . Bringing the startup to $15 million in funding, the cash will expand Thistle’s delivery domain. Dan Gluck of PowerPlant, which has also funded food break-outs like Beyond Meat, Thrive Market, and Rebbl, will join the board.

Cheriyan tells me “We wanted the better-for-you and better-for-planet choice to be the default choice.”

Growing Out Of On-Demand

A sample of Thistle 8 meal plans

Push-Button Health

A slower, steadier approach with less overhead, more convenience, and fewer direct competitors has helped Thistle grow to 400 employees from culinary to engineering to logistics.

from iraidajzsmmwtv https://ift.tt/2uBoAjS via IFTTT

#IFTTT #iraidajzsmmwtv

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celticzone · 6 years

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Tweeted

Utah Physicians for a Healthy Environment receives $120,000 for air quality project in Summit County, Utah https://t.co/flMJBrf7rU

— Celtic Zone (@celticzone) October 4, 2018

#IFTTT #Twitter

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nathansandy · 6 years

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Utah Physicians for a Healthy Environment receives $120,000 for air quality project in Summit County, Utah https://t.co/XK48KThmHd

— Nathan Sandy (@nathansandy2020) October 4, 2018

from Twitter https://twitter.com/nathansandy2020

#SEO #PPC #PPC Marketing

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gothamelectionsdawn · 6 years

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Utah Physicians for a Healthy Environment receives $120,000 for air quality project in Summit County, Utah https://t.co/WGWHQIKvQn

— Dawn Granger (@Ge_Dawn_Granger) October 4, 2018

from Twitter https://twitter.com/Ge_Dawn_Granger October 04, 2018 at 09:16PM

#Twitter #CPTC

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maxihealth · 6 years

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Having Health Insurance Is a Social Determinant of Health: the implications of growing uninsured in the U.S.

The rolls of the uninsured are growing in America, the latest Gallup Poll indicates. The U.S. uninsurance rate rose to 12.2% by the fourth quarter of 2017, up 1.3 percentage points from the year before.

2017 reversed advancements in health insurance coverage increases since the advent of the Affordable Care Act, and for the first time since 2014 no states’ uninsured rates fell.

The 17 states with declines in insurance rates were Arizona, Colorado, Florida, Hawaii, Illinois, Indiana, Iowa, Missouri, New Mexico, New York, North Carolina, South Carolina, Texas, Utah, Washington, West Virginia, Wisconsin, and Wyoming.

Among these, the greatest losses of health insurance were for people living in West Virginia with the greatest drop of 4.2%, New Mexico falling 3.8%, and Hawaii and Iowa declining 3.3%.

Texas wins the award for the greatest percent of uninsured people at 22.1%. For ten years in the Gallup research, Texas has reigned the state with the highest level of the uninsured.

Massachusetts gets the nod for lowest level of uninsured at 4.0% (thank you, Romneycare, which was a model for the Affordable Care Act).

This research is part of the ongoing Gallup-Sharecare Well-Being Index surveys conducted every day, tracking questions for U.S. adults 18 and over.

Health Populi’s Hot Points: It’s insightful and correct that Gallup posts this survey on the uninsured under the tab, “Well-Being.”

That’s because being health-insured is a social determinant of health. As Dr. Vivek Murthy pointed out in his talk at the PwC 180 Health Forum earlier this week, there are six categories of #SDOH:

Economic stability, including housing, financial wellness and debt

Neighborhood and physical environment, such as housing safety, walkability, utilities

Education, arguably the big kahuna here, covering literacy and early childhood education which has proved to strongly correlate to health

Food security, increasingly recognized as central to health

Community and social factors, especially social connections, and

Healthcare system factors, such as health insurance coverage.

So having health insurance in America is a social determine for individuals’ health like access to healthy food, clean water (THINK: Flint), and living in safe housing.

This week, the Commonwealth Fund points out Americans’ falling confidence in their ability to pay for healthcare. One-third of people with individual health insurance coverage told the Fund their healthcare has become harder to afford over the past 12 months. This bar chart shows that 50% of working-age adults would not have sufficient funds to pay an unexpected $1,000 medical bill within 30 days.

We imminently await President Trump’s and Secretary of Health and Human Services Alex Azar’s proposed plans to reduce the cost of prescription drugs, which is a “tri-partisan” issue with which Democrats, Independents, and Republicans all agree is due for increased Federal regulation.

President Trump campaigned on this issue and was quoted in his TIME magazine “Person of the Year” profile saying, “we have to…create new bidding procedures for the drug industry, because they’re getting away with murder, pharma. Pharma has a lot of lobbies, a lot of lobbyists, a lot of power. And there’s very little bidding on drugs.”

Remember that prescription drug spending continues to hover around one-tenth of overall U.S. National Health Expenditures. A move to re-align prescription drug prices will be welcomed across the political spectrum as Big Pharma continues to take the bulk of the blame for rising healthcare costs. But actually, “it’s the prices, stupid” across the entire healthcare system that plague, ultimately, the patient-as-payor including but not limited to insurance premium costs, hospital and physician bills, and to be sure, prescription drugs.

As a final reminder, most Americans are looking for the Federal government to ensure that every U.S. health citizen is covered by health insurance. I’m just the messenger – this was the Gallup poll’s finding from December 2017. Just sayin’.

The post Having Health Insurance Is a Social Determinant of Health: the implications of growing uninsured in the U.S. appeared first on HealthPopuli.com.

Having Health Insurance Is a Social Determinant of Health: the implications of growing uninsured in the U.S. posted first on https://carilloncitydental.blogspot.com

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realselfblog · 6 years