Tuesday, December 11, 2018

Flu Vaccine: The Best Protection

Fight the Flu Before You Get It

By Laura Korin, MD, MPH

HEALTH- There were nearly 80,000 deaths and 960,000 hospitalizations due to influenza in the United States last year, making it one of the worst influenza seasons in years. The best protection is yearly influenza vaccination, but too few people receive this important vaccine. 

According to the Centers for Disease Control and Prevention (CDC), only 37% of adults and 58% of children ages 6 months and older were vaccinated last year. 

Influenza, the “flu,”is a contagious respiratory infection caused by a virus. It spreads easily through droplets from flu infected people when they cough, sneeze, or talk, and can spread to others up to 6 feet away. These droplets can directly infect you by landing in your mouth or nose or if you touch a surface that has flu virus on it and then touch your mouth or nose. 

The flu virus can live 24 hours or longer on certain surfaces. While strategies such as hand-washing and avoiding people who are sick are important, they are not enough to prevent infection with the flu.

Certain people are more vulnerable to becoming infected and developing serious complications from the infection. This includes people 65 years and older, people with chronic medical diseases (such as asthma and diabetes, among others), pregnant women, and children younger than 5 years. 

However, even healthy people can get the flu and develop these serious complications. The vaccine not only protects you but others around you as well, which is important for those who cannot receive the vaccine. 

Studies have shown that pregnant women should receive the vaccine not only to protect themselves but also because it protects their babies for several months after birth. 

Those who cannot be vaccinated are those who are younger than six months, have medical contraindications, such as an impaired immune system, or those with severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine (such as gelatin). Those who have an egg allergy can still get the vaccine. Even if the egg allergy is severe, it can still be given in a supervised medical setting with a health care professional who can recognize and treat severe allergic reactions. 

There are several misconceptions about the vaccine:

The vaccine does not cause the flu. 

The vaccines either contain inactivated virus which are not infectious or a particle that looks like the virus. The nasal spray flu vaccine is the only vaccine type that has the live virus, but the virus is weakened. 
Any of the vaccines may cause mild flu-like symptoms, but these do not compare to the symptoms and consequences of the actual flu virus infection. 

For those who do get the flu soon after receiving the vaccine, it is likely because the vaccine was not yet effective. It takes 10 to 14 days for the body to develop the antibodies that fight the flu virus. 

The vaccine does not work. 

The vaccine effectiveness varies from year to year. The flu viruses mutate frequently. Health officials design the flu vaccine early each year based on predictions on which strains will be common in the coming season. 
Sometimes their predictions do not match well or the flu virus strains mutate further. However, the flu vaccine is still a powerful tool in preventing infection and reducing the severity of illness in those who get the flu infection. In a CDC study of the 2016-2017 influenza season, the flu vaccine prevented an estimated 5.3 million illnesses, 2.6 million visits and 85,000 hospitalizations. 

The vaccine is not safe.

Severe allergic reactions are very rare. Guillain-BarrĂ© syndrome, a rare disorder where nerve cells are damaged by the body’s immune system, is more common after flu infection than flu vaccination. 

It is not too late to get the flu vaccine. While the earlier you get vaccinated, the better protection you will have. There are different types of vaccines available depending on your age and medical conditions and should be discussed with a health care provider. 

-Laura Korin, MD, MPH, is the director of Montefiore Health System’s Preventive Medicine Residency Program and an assistant professor at Albert Einstein College of Medicine in the department of Family & Social Medicine

Community Heroes Honored Throughout NYC

WellCare Health Honors Community Leaders

HEALTH- The 2018 WellCare Community Heroes awards are based on nominations received from Brooklyn, Bronx, Manhattan, and Queens. WellCare’s Community Connections sponsor the Community Heroes award program to recognize unsung heroes in our communities. 

The awards honor community members and healthcare professionals who take action to improve our communities.

For six years, Rocio Garcia has helped transform the Soundview Community Partnership Program through activities like the
annual women’s empowerment event, Father’s Day BBQ and a back-to-school event to help disenfranchised children prepare for a new school year. She is also a domestic violence advocate with Violence Intervention Program, Inc. in the Bronx.

Rocio Garcia, Maxine Ketcher, joined by WellCare Associates Stephen Ritz is the founder of Green Bronx Machine, which pioneered the use of indoor, urban agriculture in the South
Bronx. Through his work, Ritz founded the first edible classroom in America, which regularly feeds 450 students. His indoor and outdoor farms across the community provide food, workforce development and community access, while transforming culture and academic performance in schools.

For 10 years, Jessica Chacha has worked to bring greater community resources to families in northwest Queens. As co-founder of the Together We Can Community Resource Center, Inc., she has held resource fairs, events and workshops, with a focus on supporting immigrant families and closing gaps to bring
resources to those in need.

Camera Jackson is the founder of Elite Learners, a school- and community-based organization providing athletic, educational
and mentorship programming to youth and their families.

Through her work, she manages an athletic program, a mentoring program for young men and women, and a program for foster children transitioning out of foster care.

For the past three decades, Joseph Corace has been serving his community, through Kiwanis. Corace joined Kiwanis in 1984, and is a charter member of the Mapleton Kiwanis Club, serves as the club’s president. He also serves on the board of VISIONS/Services for the Blind and Visually Impaired and has been active in the Brooklyn School for Special Children, the Coney Island Sharks Football Association and the Rory Sparrow Foundation.

After battling her own substance abuse challenges, Jada Hawthorne sought out the Alliance for Positive Change for support with her addiction. Since then, she has made it her mission to help others. Today, as a client liaison with the alliance, she is the first person program
participants meet when they walk in the door, and she greets them with enthusiasm and compassion.

About WellCare Health Plans, Inc. Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace.

WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. For more information about WellCare, please
visit the company's website at www.wellcare.com<http://www.wellcare.com>.

Monday, December 10, 2018

Flu Season- Survey to Help Combat the Flu

Montefiore and The Bronx Borough President Want to Hear Your Thoughts on Flu 

HEALTH- Every year flu tears across the country, hitting the Bronx particularly hard. In fact, last year, we saw the worst flu season in decades.  

This year, Montefiore and the Bronx Borough President Ruben Diaz Jr. are conducting a survey to learn how our community makes decisions about getting the flu vaccine. 

Please answer our four- question survey here:https://www.surveymonkey.com/r/feedbackflu

Your feedback will help us create social media posts that directly respond to your point of view.
We look forward to hearing from you and wish you a happy, HEALTHY, holiday season! 

Thursday, November 29, 2018

Ambulances Get New Home at NCB Hospital

HEALTH- NYC Health + Hospitals/North Central Bronx celebrated the opening of two newly designated ambulance bays.

Directly adjacent to the emergency room, the additional bays were created to ensure dedicated parking spaces for ambulances dispatched to NYC Health + Hospitals/North Central Bronx. 

Hospital administrative and clinical leaders were joined by representatives from the New York City Fire Department Bureau of Emergency Medical Services, which controls the operation of all ambulances in the New York City 911 system, and elected officials in cutting the ribbon on the two new bays, which, combined with the existing two bays, doubles ambulance capacity.

When ambulances bring patients to the hospital, the duties of their emergency medical technicians (EMTs) take time. The EMTs come into the emergency department to provide a report on the patient to the clinical staff and to answer any related questions. They also often need to hose down stretchers and clean out the ambulance to prepare it for the next patient.

Typically, an ambulance may occupy a bay for 15 to 30 minutes. In the past, when the hospital’s two ambulance bays were occupied, EMTs would need to take their patients to another hospital where the ambulances could park. The added capacity will allow more patients to get emergency care at NYC Health + Hospitals/North Central Bronx.
“These spaces were designated specifically to provide FDNY and other ambulance providers increased access to our emergency room,” said Cristina Contreras, executive director of NYC Health + Hospitals/North Central Bronx. “The additional ambulance access will be reassuring to the north Bronx community. It’s just another way we are working to engage, encourage, and empower our patients to live their healthiest lives.”

“With these new ambulance spaces, the hospital is making a positive impact in the emergency medical care FDNY members provide,” said FDNY Fire Commissioner Daniel A. Nigro. “Every second matters when transporting a patient to the emergency room, and these spaces will provide greater and quicker access for our members as they care for their most critical patients.”

“In the first few weeks since our soft launch, we have already seen a dramatic decrease in the number of times ambulances are diverted from NYC Health + Hospitals/North Central Bronx because there was previously not enough room for them to park,” said Dr. Mark Melrose, chief of emergency services at the hospital. “As a result of this change, we will see more patients arriving by ambulance, and that is a win for everyone.”

“I’m extremely excited about the ambulance bay expansion at NYC Health + Hospitals/North Central Bronx,” said New York State Senator Jamaal Bailey. “This will provide even greater capacity and better access for the hospital to admit patients and provide even more incredible service to Bronx residents, specifically the Norwood/Bedford Park section. Congratulations to the leadership of Christina Contreras and Christopher Mastromano and the entire hospital staff for this and providing excellent care to the community.”

“I am excited to see these two new ambulance bays next to the emergency room at NYC Health + Hospitals/North Central Bronx,” said Assemblywoman Nathalia Fernandez. “Providing easier access to FDNY and ambulance providers to emergency rooms will be greatly beneficial to our community, and I’m proud that the investment has been made here in the Bronx.”

“We must ensure that our community always has access to immediate medical attention, so it is important that we designate more space for emergency service vehicles,” said New York Council Member Andrew Cohen. “I know that in critical times these new ambulance bays will have a major impact. I am thrilled that NYC Health + Hospitals/North Central Bronx Hospital is committed to offering high caliber services while expanding to meet the needs of our growing community.”

Wednesday, November 28, 2018

Lincoln Nurse Honored for Caring for Diabetes Patients

HEALTH- NYC Health + Hospitals honored six nurse professionals from across the public health care system, as part of its annual Nursing Excellence Awards celebration. The awardees are nurse trailblazers who demonstrate leadership in various capacities.

“While our nurses work in various specialties and provide care in a wide range of settings, they share a common characteristic: a deep commitment to the New Yorkers who seek our care,” said Mitchell Katz, MD, president and chief executive officer of NYC Health + Hospitals.

“Our nurses are at the heart of our mission to care for every New Yorker without exception. They are also at the frontlines of health, delivering the patient-centered, collaborative, community-based care that will help us succeed in the future. I cannot thank them enough for the work they do.”

One hundred fifty-nine nurses from across the health system were nominated by their colleagues in honor of their valued achievements and commitment to providing the best possible care and experience for our patients. The nurses honored today are among the 8,000 nurses at NYC Health + Hospitals—women and men who provide care around the clock each day for New York City through our hospitals, post-acute care centers, community health centers and neighborhood clinics, home care, and the correctional health system, throughout the five boroughs.

“Our Nursing Excellence honorees embody NYC Health + Hospitals’ guiding principles by always keeping patients first and pursuing excellence in clinical, educational, leadership, and service aspects of the profession,” said Mary Anne Marra, DNP, MSN, RN, NEA-BC, interim chief nursing officer for NYC Health + Hospitals. “These nurses exhibit various talents all put to use to demonstrate a commitment to providing the best possible care and experience for every patient, every time.”

When my patient makes good progress and improves, and realizes self-improvement, I am most proud,” said Tsae Jiang Su, RNC, who is recognized for being a bundle of energy, passion, and expertise. 

At NYC Health + Hospitals/Lincoln since 1993, Ms. Su provides care to around 20 patients each day, providing critically important diabetes management and lifestyle changes to every individual she sees. In the South Bronx, diabetes affects a disproportionate share of the community.

Ms. Su’s diabetes patients are always energized and as excited as she is to see them. Due to her dedication and creativity, patients learn to manage diabetes through interactive projects, guest speakers, neighborhood and celebrity chefs, the Lincoln Greenmarket’s weekly visits, and healthy cooking events. Her ready smile, easy laughter, and obvious love of her patients pull them close to her.

As a Nurse Supervisor, Ms. Su partners with endocrinologists and the hospitalist to adjust insulin and oral medication regimens for patients. She also works collaboratively with a multidisciplinary diabetes team to perform a thorough assessment of each patient and establish an education plan to assist in the management of their disease.

Ms. Su earned her Bachelor of Nursing from Taiwan Nursing College.

The 2018 Nursing Excellence Awards program is available in its entirety at https://www.nychealthandhospitals.org/nursing-excellence.

Jacobi Hailed for #Cancer Treatment

HEALTH- The Commission on Cancer, a quality program of the American College of Surgeons, has granted three-year accreditation With commendation to the cancer program at NYC Health + Hospitals/Jacobi.

To earn voluntary Commission on Cancer accreditation, a cancer program must meet or exceed its quality care standards, be evaluated every three years through a survey process, and maintain levels of excellence in the delivery of comprehensive patient-centered care. 

Three-year accreditation with silver-level commendation is awarded only to a facility that exceeds standard requirements at the time of its triennial survey. 

As a Commission on Cancer-accredited cancer center, NYC Health + Hospitals/Jacobi takes a multidisciplinary approach to treating cancer as a complex group of diseases that requires consultation among surgeons, medical and radiation oncologists, diagnostic radiologists, pathologists, and other cancer specialists. This multidisciplinary partnership results in improved patient care.

The accreditation with commendation is the result of over a year of training, coordination, and collaboration among many members of the care team at NYC Health + Hospitals/Jacobi. The hospital received special commendation for several standards, including:
Oncology Nursing Care – More than 25 percent of the nursing staff is certified in cancer care. 

Patient Enrollment in Clinical Trials – The cancer programs at NYC Health + Hospitals/Jacobi enroll 10 percent or more cancer patients in clinical trials. Because patient access to the kinds of cutting-edge treatment available through clinical trials can benefit both current and future cancer patients, a screening process has been developed to track effectiveness.

Public Reporting of Outcomes – The Community Advisory Board of NYC Health + Hospitals/Jacobi reports on participation in screening and prevention activities. 
“Our entire team worked very hard to achieve this important designation,” said Tarek Elrafei, MD, chair of NYC Health + Hospitals/Jacobi’s Oncology Department. 

The Commission on Cancer Accreditation Program provides the framework for facilities to improve quality of care through various programs that focus on the full spectrum of cancer treatment and encompass prevention, early diagnosis, cancer staging, optimal treatment, rehabilitation, life-long follow-up, and end-of-life care. When patients receive care at a Commission on Cancer facility, such as NYC Health + Hospitals/Jacobi, they also have access to information on clinical trials and new treatments, genetic counseling, and patient-centered services, including psycho-social support, a patient navigation process, and a survivorship care plan that seeks to improve cancer survivors’ quality of life. 

The new accreditation builds on earlier third-party validation of the exceptional cancer care available at the hospital, including from the American College of Surgeons’ National Accreditation Program for Breast Centers, which has recognized the hospital’s Breast Health Service as a “Center of Excellence,” and from the American College of Radiology, which has bestowed multi-year recognition of the service as a “Breast Imaging Center of Excellence.” 

The hospital’s Breast Health Service performs more than 12,000 mammograms each year and provides treatment and care for more than 1,600 patients annually.

If you or someone you know has been diagnosed with cancer and is looking for extraordinary care, please call 718-918-4318. 

Tuesday, November 27, 2018

Keep Chronic Inflammation in Check with Your Diet

HEALTH- Inflammation isn’t always a bad thing—it’s an effective tool that your body uses to get you to pay attention, whether to a blister or bursitis. But when inflammation becomes chronic, it goes beyond helpful.

In fact, numerous studies have found that it may play a serious role in a wide variety of diseases including heart disease and stroke. 

The good news is? “The same practices that keep your heart in good shape can help you to reduce your chances of developing chronic inflammation and reduce inflammation already present: get regular exercise, improve sleep, don’t smoke, adequate hydration and eat right,” says registered nurse Constance Washington with VNSNY CHOICE Health Plans. 

VNSNY CHOICE, a special plan from the not-for-profit Visiting Nurse Service of New York, was created especially for New York seniors who are eligible for Medicaid and/or Medicare and want to live independently in their own homes as they face the challenges of getting older, instead of moving into a nursing home.

“Many of the members I care for find eating healthy meals a challenge—especially those who live alone,” says Washington. “I spend time on the phone with each person and their personal care workers helping them better understand the importance of eating a balanced diet which is vital for good health and overall well-being. Personal Care Workers often help with grocery shopping and food preparation, which really helps members with adopting new and healthier habits.”

To reduce inflammation and improve health in general, here are four tips that Washington shares with her patients:

1) Up the Produce Factor
Shoot for two cups (or two pieces) of fruit and two to three cups of vegetables or more every day.  

Those that are high in pigments called carotenoids – such as carrots, sweet potatoes, tomatoes, bell peppers and dark green leafy vegetables (spinach, kale & collard greens) – are particularly beneficial.  

Deep red or purple grapes, berries and beets also are excellent choices, but all fruits and veggies will add to your anti-inflammation arsenal. According to a 2001 Harvard University study, just one extra serving a day can reduce your risk of heart disease by four percent.

2) Get Omega Smart

When it comes to fats, the right balance of omega-3 and omega-6 fatty acids can help to reduce inflammation. How can you find the right balance? Washington says to cut back on processed and fast foods which can be high in omega-6’s and focus on increasing omega-3’s found in fatty fish such as salmon, sardines, tuna and mackerel, or vegetarian sources such as walnuts, almonds, flax seeds and cruciferous vegetables such as cauliflower, cabbage, garden cress, bok choy, broccoli, brussels sprouts.  

3)  Eliminate Trans Fats

This type of fat is abundant in processed and fried foods. It increases foods shelf life and boosts flavor. However, it also clogs arteries, contributes to weight gain and causes inflammation. Avoid crackers, cookies or other packaged baked goods (or stay well within portion sizes) and limit fried foods or those made with hydrogenated oils. 

To find delicious heart-healthy recipes for Quick Lasagna, Fruit Muffins, Oven Barbequed Chicken and other favorites, visit http://www.cooks.com/rec/

4) Go with the Grain

Whole grains are packed with compounds that can help protect against disease, and they’re teaming with B and E vitamins, minerals like iron and magnesium, and fiber—all of which are great at holding off inflammation and promoting cardiovascular health.
For more information about VNSNY CHOICE Health Plans from the Visiting Nurse Service of New York, please call 1-866-469-7774 or visit www.VNSNYCHOICE.org.  

Friday, November 23, 2018

Diabetes and Your Neighborhood

1 in 5 in the Bronx have Diabetes

BySandra ArĂ©valo, MPH, RDN, director, Nutrition Services and Outreach at Community Pediatrics, 

HEALTH- In the United States today, diabetes affects 9.4% of the population, over 30.3 billion people. Do you think that is a lot? Consider the Bronx, NY, where diabetes affects up to 15% of the population.

That means that almost 1 in 5 individuals in the Bronx have diabetes.

Diabetes is a chronic condition characterized by high sugar levels in the blood. There are different types of diabetes. The most common is type 2 diabetes. It is caused by resistance to insulin, which is the hormone that regulates your blood sugar levels. Diabetes is the leading cause of blindness, kidney disease, and amputations. It also puts you at higher risk for cardiovascular disease including heart attacks and strokes. The good news is that many consequences are preventable if diabetes is diagnosed and treated timely and effectively. 

Diabetes disproportionally impacts blacks and Latinos. In the Bronx about 80 of the population falls into these categories. Risk factors for diabetes include obesity, low income, lack of exercise, high levels of stress, lack of healthy foods in your diet such as an abundance of vegetables and fruits, and family history of diabetes.

Lack of money, as well as many other stressors such as legal issues, lack of child care, taking care of a sick family member, unemployment, divorce, etc. bring stress into the picture as well. High levels of stress generate resistance to insulin. This means that when you are stressed your insulin doesn’t work properly and your sugar levels can rise above the normal and cause diabetes. 

If you suffer from diabetes or if you think you are at risk for diabetes you should visit your health care provider and ask to have your Hemoglobin A1c, or A1c, checked. The A1c is a blood test that will indicate how your blood sugars have been in average for the past 3 months. If your A1c is lower than 5.7 you have nothing to worry about. If your A1c is 6.4 and above, you need to get further testing to confirm if you have diabetes. If you have an A1c in between 5.7 and 6.4 you might have pre-diabetes. Pre-diabetes is a condition in which your sugars are not high enough to be diagnosed with diabetes but if you don’t take care of yourself you could get diabetes. In the United States 34% of individuals have pre-diabetes - that is about 84.1 million adults. 

What you didn’t know about diabetes. 
But not all is dark in the picture. Being aware of your A1c and the factors that cause diabetes is a good start. If you want to better manage your diabetes or if you have pre-diabetes you can join free and fun classes that help you with both. These classes not only teach you about diabetes but most importantly they help you set goals towards a healthier you. They cover nutrition education, and share exercise and stress management tips that you can actually do. Montefiore Hospital offers classes in different locations. For more information call 718-991-0605 or 781-920-4011.

If you know that you don’t eat well and you want to eat better you are not alone. In the Bronx there are many resources that can help you achieve your dietary goals. Eating a half of a plate of fruits and vegetables with your lunch and/or dinner every day makes a huge difference in your weight and sugar levels. Non-starchy vegetables such as spinach, kale, carrots, cucumbers, string beans or okra provide lots of dietary fiber, vitamins and minerals that can help lower your sugar levels.

If vegetables aren’t in your budget, reach out to your health care provider and ask if they have Health Bucks available. Health Bucks are $2 coupons that you can use at the Farmers Markets. Different health centers in the community, including Montefiore clinics, have partnered with the Department of Health to be able to distribute Health Bucks among their patients.  City Harvest also has two markets in the Bronx and is offering free fresh fruits and vegetables to families in the community twice a month for a year. The Melrose Mobile Markets are held at 286 E 156th Street, at the Classic Center every 2nd Saturday & 4th Wednesday of each month from 9:30 am – 11:30 am. The St. Mary’s Mobile Markets are held in the parking lot adjacent to 595 Trinity Avenue every 2nd Saturday & 4th Tuesday of each month from 9:30 am – 11:30 am. 

To learn if you qualify call City Harvest at 646.412.0600. 

If what you need is exercise but you can’t afford a gym membership? Consider joining Shape Up New York. This is a program from the Department of Health that offers an array of fitness activities for adults and families. From Zumba, to swimming, yoga and cross training there are programs for everyone. These programs are free and most of them are in the evenings, so you can exercise after work or school. To learn about the programs in the Bronx visit https://www.nycgovparks.org/programs/recreation/shape-up-nyc.

Managing your stress is important too. Oftentimes we don’t know how to deal with it. If you can, try to walk to release your stress. Not only will you be relaxing, you will be active too. Every time you walk your glucose levels go down. Taking deep breaths during the day, learning how to meditate, doing some yoga or counting backwards from 10 are all simple techniques that can help release some stress. Other people feel more relaxed when they share their concerns or vent to friends or family members. If you have no one to listen to you, you are not alone. You can reach NYC Well 24 hours a day, 7 days a week by phone, text and online chat. They provide bilingual help in Spanish and other 200 languages. 

To contact NYC Well, call 1-888-NYC-WELL (1-888-692-9355) or text “WELL” to 651-73. Health insurance is not required. 

Diabetes can be prevented or controlled when it is with simple lifestyle changes. Visit your health care provider to learn what your A1c is, and if you are at risk create a plan to lower your blood sugar levels. Your doctor, dietitian, or certified diabetes educator can help you put a plan together that targets your needs and means. Use the resources that our community offers to be healthier and help change the statistics for a healthier you and a healthier Bronx.