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Flu-conomics: The next pandemic could trigger global recession

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Cervical Cancer Awareness and P9 Detection

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U.S. Health Care Spending Now at $2.7 Trillion: Report

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Premier Family Health & Wellness Brightens Holiday for Local Students P7

Dave Aronberg Sworn in as Palm Beach County P13 State Attorney

For the second consecutive year, physicians, staff and patients helped raise funds to brighten the holidays for students of the Indian Ridge School in West Palm Beach.

Dave Aronberg was sworn in on Tuesday, January 8 as the Palm Beach County State Attorney.

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The potential cost of a global outbreak of the flu or some other highly contagious disease, however ghoulish to calculate, is essential for government officials and business leaders to know. Only by putting a price tag on such an occurrence can they hope to establish what containing it is worth. P2

Mike Corvaia.

Ben H. Han, MD

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Flu-conomics: The next pandemic could trigger global recession high body count is not the only meaningful number attached to a pandemic. The potential cost of a global outbreak of the flu or some other highly contagious disease, however ghoulish to calculate, is essential for government officials and business leaders to know. Only by putting a price tag on such an occurrence can they hope to establish what containing it is worth. The financial damage by itself can be devastating. The expense of major epidemics is evident every time a health agency totes up the cost of treating infected people — the outlays for drugs, doctors' visits, and hospitalizations. But that spending is only the most obvious economic impact of an outbreak.

Consider the effect on international airlines. During the 2003 SARS (severe acute respiratory syndrome), which began in southern China and lasted about seven months, business and leisure travelers drastically cut back on flying. Asia-Pacific carriers saw revenue plunge $6 billion and North American airlines lost another $1 billion. The tourism industry also took a beating. The net revenue of Park

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afraid of becoming infected are less likely to go out to stores, restaurants or movies.

Place Entertainment, owner of Caesar's Palace in Las Vegas and other gambling and hotel complexes, plunged more than 50 percent in the second quarter of 2003 compared with the year before, mainly because Asian high rollers hunkered down rather than risk infection while traveling.

Fear even hurt businesses dependent on sales calls. AIG, which pulled almost 30 percent of its revenue from Asia back then, was hobbled when the epidemic kept its agents from visiting potential customers. That's just the easily measured stuff; the indirect costs pushed the total SARS bill much higher.

"The biggest driver of the economics of pandemics is not mortality or morbidity but risk aversion, as people change their behavior to reduce their chance of exposure," says Dr. Dennis Carroll, director of the U.S. Agency for International Development's programs on new and emerging disease threats. "People don't go to their jobs, and they don't go to shopping malls. There can be a huge decrease in consumer demand, and if (a pandemic) continues long enough, it can affect manufacturing" as producers cut output to align supply with lower demand. If schools are closed, healthy workers may have to stay home with their children. People

Most of China was essentially on lockdown in the first half of 2003 as the government did everything in its considerable power to minimize human-tohuman contact and, hence, the spread of SARS. Beijing was shut down tighter than at any time since martial law was declared during the 1989 Tiananmen Square protests. Discos, bars, shopping malls, indoor sports facilities, and movie theaters were closed, and 80 percent of the capital's fivestar hotel rooms were vacant. By May 2003, Singapore Airlines had cut capacity 71 percent and put its 6,600member flight staff on unpaid leave. Tourism to Singapore fell 70 percent, and the country's gross domestic product took a $400 million hit that year.

From Asia, where the disease was largely confined, the ripples spread in all directions. Toronto recorded 361 SARS cases and 33 deaths, and the World Health Organization issued an advisory against traveling there — surely a factor in the $5 billion loss Canada's GDP suffered in 2003.

Deborah Lynn Staff Writer and Sales Executive (312) 351-2383 deborah@globalhealthtribune.com

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CONTRIBUTING ARTICLES U.S. Department of Health and Human Services, ARA Content, Centers for Disease Control and Prevention, METRO Editorial Services, Family Features © SEA PUBLICATIONS, INC. ALL RIGHTS RESERVED.

Global Health Tribune is a newspaper published every month in Palm Beach county and surrounding areas. Copyright 2013, all rights reserved by SEA Publications, Inc. Contents may not be reproduced in any form without the written consent of the publisher. The publisher reserves the right to refuse advertising. The publisher does not accept responsibility for advertisement error beyond the cost of the advertisement itself. All submitted materials are subject to editing.

Many Americans Drive While Drowsy: Report

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1 in 25 reports falling asleep at the wheel, CDC says. riving drowsy is a major factor in traffic accidents and deaths in the United States, federal health officials reported on January. Federal statistics state that 2.5 percent of fatal motor vehicle crashes and 2 percent of crashes with non-fatal injuries involve drowsy driving.

But, data gathering methods make it difficult to estimate the actual number of accidents that involve drowsy drivers. In fact, some studies have estimated that between 15 percent and 33 percent of fatal crashes may involve sleepy drivers. And deaths and injuries are more likely in motor vehicle crashes that involve drowsy driving, the report stated.

According to the report by the U.S. Centers for Disease Control and Prevention, more than 4 percent of drivers quizzed said they had driven while drowsy in the month before the survey. "One out of 25 people reported falling asleep while driving in

the past month," said CDC epidemiologist Anne Wheaton, the report's lead author. "If you think of how many cars you see every day, one out of 25 -- that's a pretty big number."

And those numbers may underestimate the scope of the problem, Wheaton said.

"These were people who realized they had fallen asleep while they were driving," she said. "If you fall asleep for even a moment you may not realize it -- so that's not even taking those people into account."

What's more, many people drive drowsy and don't fall asleep, but still pose a risk, Wheaton said.

"Driving while drowsy you are driving impaired. Your reaction time slows down, you're less attentive and it impairs your decision-making skills," she said. "So even if you don't fall asleep at the wheel, it's still a serious problem."

The report was published in the Jan. 4 issue of the CDC's Morbidity and Mortality Weekly Report.

In the study, researchers found that people who slept six hours or less were about twice as likely

to report falling asleep while driving as those who got seven or more hours of sleep. Other contributing factors include sleep disorders such as sleep apnea and insomnia, Wheaton said.

In 2009, approximately 30,000 people were involved in car crashes due to drowsy driving and 730 died, according to the U.S. National Highway Traffic Safety Administration.

Drowsy driving also varied stateto-state, from a low of 2.5 percent in Oregon to a high of 6.1 percent in Texas, the report found.

The findings were based on a survey of almost 150,000 drivers. The best way to prevent drowsy driving is to get at least seven hours of sleep. And people with a sleep disorder should seek treatment, the CDC said.

The agency also recommends not drinking alcohol or taking sedatives before sliding into the driver's seat.

Wheaton said some of the signs of drowsy driving include: not remembering the last couple of miles driven; missing an exit on a highway; having trouble staying in a driving lane; and struggling to keep your eyes open.

"If you have these symptoms you need to get off the road and rest until you're not sleepy anymore," she said. "Even better is to change drivers with someone who is not sleepy." Russ Rader, a spokesman for the Insurance Institute for Highway Safety, said: "Drowsy driving is a lot like distracted driving -- it's not something you can outlaw and solve the problem. Technology may help. High-tech, crash-avoidance systems can alert drivers to hazards or even take action autonomously if your attention wanders or you're sleepy and may prevent a lot of crashes in the future. These systems are always on alert and never get tired like people do."


JANUARY ISSUE • 2013

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Morton’s Neuroma

Limiting condiments and reading nutritional labels are other ways to kick a high-sodium habit, the experts noted in an association news release. They also said people can change their palate and enjoy foods with less salt in just 21 days.

By Arthur Hansen DPM, M.S.

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Morton’s Neuroma is usually located between the 3rd and 4th toes, but you can also get neuromas in other places on the foot. A neuroma is a common foot ailment caused by abnormal function that leads to increased pressure placed on the nerves by surrounding tissues, usually bones. Some symptoms include numbness, cramping, and tingling. Pain is intermittent and is aggravated by increased pressures that increase the pinching of the nerve between the bones. It is more common in women. Diagnosis is mostly clinical with a

Conservative & Surgical Treatments Available Whirlpool with every visit!

Experts Challenge Americans to Reduce Salt Intake

Americans can dramatically reduce their daily salt intake by cutting bread, cold cuts and cured meats from their diet, according to the American Heart Association/American Stroke Association.

Neuroma

Sometimes it feels like a hot coal or a pebble in your foot. You want to take off your shoes and rub the ball of your foot several times a day. Sometimes your toes feel numb or burn. Sound familiar? You could be suffering from a neuroma. A Morton’s Neuroma to be exact.

Normal Nerve

thorough history from the patient being of vital importance. X-rays are usually taken to exclude any chance of bone pathology. Almost always, a clinical exam reveals an audible ‘click’ when the bones are rubbed together. While this is the classical presentation of a neuroma, if the diagnosis is not clear, additional testing can give more information.

Treatment is almost always conservative, with ninety percent of cases responding to conservative treatments. Treatment starts with altering shoe gear, accommodative padding and non-steroidal antiinflammatory medications. Varying physical therapy modalities can also be added to the treatment plan. If these fail to provide relief, more invasive treatments can be utilized. Cortisone injections, chemical nerve destruction and/or surgery are sometimes needed. Almost always

custom functional orthoses are indicated to control the abnormal functioning of the foot that leads to the development of the neuroma and for prevention of future painful episodes. So, the next time you feel pain, burning, tingling or numbness around the ball of your foot, think of your podiatrist…it may be a neuroma. Call to make your appointment

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Get back on your Feet!

The heart and stroke experts are launching a three-week Sodium Swap Challenge on January 7. The group is calling upon Americans to identify and track the Salty Six -- the foods in their diet loaded with extra salt that increase their risk for heart disease and stroke. The goal is for Americans to limit sodium intake to no more than 1,500 milligrams each day. Currently, the typical American consumes more than twice that.

"To get started with the association's challenge, we ask that consumers get familiar with the food labels and nutrition facts for the foods they eat and track their sodium consumption over the first two days to get an idea of how much they are eating, which I'm sure will be surprising to many people," said Rachel Johnson, spokeswoman for the associations and professor of nutrition at the University of Vermont.

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Be Active in 2013 egular physical activity is good for your health.

Physical activity is anything that gets your body moving. Start at a comfortable level. Once you get the hang of it, add a little more activity each time you exercise. Then try exercising more often. What kinds of activity should I do? To get the health benefits of physical activity, do a combination of aerobic and muscle-strengthening activities.

• Aerobic (“air-OH-bik”) activities make you breathe harder and cause your heart to beat faster. Walking fast is an example of aerobic activity.

• Muscle-strengthening activities make your muscles stronger. Musclestrengthening activities include lifting weights and using exercise bands.

What are the benefits of physical activity? Physical activity increases your chances of living longer. Exercise can also help:

• Control your blood pressure, blood sugar, and weight • Lower your “bad” cholesterol and raise your “good” cholesterol • Prevent heart disease, colorectal cancer, and type 2 diabetes

And that’s not all. Being more active can: • Be fun • Help you look your best • Improve your sleep

• Make your bones, muscles, and joints stronger • Lower your chances of becoming depressed • Reduce falls and pain from arthritis • Help you feel better about yourself How much aerobic activity do I need each week?

• If you choose moderate activities, do at least 2 hours and 30 minutes a week. Moderate activities include things like walking fast, dancing, and raking leaves. • If you choose vigorous activities, do at least 1 hour and 15 minutes a week. Vigorous activities include things like jogging, jumping rope, swimming laps, or riding a bike on hills.

Do moderate or vigorous aerobic activity for at least 10 minutes at a time. You can also combine moderate and vigorous activities.

How to Tell If Your Child Is Too Sick for School: Expert • Throwing up two or more times during a 24-hour period, or not being able to keep normal foods or drinks down. • A fever of 101 Fahrenheit or higher.

• Severe coughing or trouble breathing.

• Repeated severe diarrhea for at least a day.

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hildren often get colds, but when they are not feeling well enough to participate in their normal daily activities or not alert enough to learn or play, they are too sick to go to school, an expert advises.

"Young children's immune systems haven't learned to recognize and resist most common viruses," Dr. Robert Key, a family physician at Mayo Clinic Health System in Prairie du Chien, Wis., said in a Mayo news release. "That's why, until they're 8 or so, kids seem to bring home everything that's making the rounds at school. Children can typically have six to 10 colds per year."

Key added that there are other signs that kids should stay home from school, including:

• Stomach pains that last for more than two hours. • Open sores on the mouth.

• An unexplained skin rash or red eye.

Children who are diagnosed with contagious conditions such as strep throat, chicken pox and impetigo should not go to school until they can no longer pass the condition on to someone else, Key noted. Colds, the "stomach flu," pink eye and strep throat are the culprits behind most missed school days, Key said. Parents who notice symptoms that seem worse than a common cold should schedule an appointment with their child's pediatrician.

The best way children can stay healthy and avoid missing school is to wash their hands thoroughly and often, Key advised. The U.S. Centers for Disease Control and Prevention encourages people to wash their hands with soap and water for 15 seconds -- about as long as it takes to sing the "Happy Birthday" song twice.


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Healthcare Reform and Select Specialty Hospital By Mike Corvaia

y this time everyone knows healthcare is changing, whether you were an advocate for change or not, it's happening. How does this affect you and your loved ones? What will this mean if you're a healthcare provider? For the purpose of this short article, we will only highlight a few of the new changes and how Select Specialty Hospital might be able to assist you as a patient and if you're a healthcare provider, as our healthcare laws evolve. The following excerpt is from Healthcare.gov:

As of October 2012, Medicare will reward hospitals that provide high quality care for their patients through the new Hospital ValueBased Purchasing Program. This program marks the beginning of an historic change in how Medicare pays health care providers and facilities—for the first time, hospitals across the country will be paid for inpatient acute care services based on care quality, not just the quantity of the services they provide.

Hospital payments account for the largest share of Medicare spending, and Medicare is the largest single payer for hospital services. In 2009, more than 7 million Medicare beneficiaries experienced more than 12.4 million inpatient hospitalizations. One in seven Medicare patients will experience some “adverse” event such as a

preventable illness or injury while in the hospital. One in three Medicare beneficiaries who leave the hospital today will be back in the hospital within a month. Every year, as many as 98,000 Americans die from errors in hospital care. In addition to adding to the suffering of patients and their caregivers, these errors lead to significant unnecessary health care spending. Medicare spent an estimated $4.4 billion in 2009 to care for patients who had been harmed in the hospital, and readmissions cost Medicare another $26 billion.

Select Specialty Hospital of Palm Beach boasts some of the most impressive patient outcomes and statistics in Palm Beach County. In 2011 and 2012, our Central Line Blood Associated Infection Rate, Catheter Associated Urinary Tract Infection rate and Vent Associated Pneumonias (VAP) were all well under the national average. We are able to render these impressive results through active surveillance, hard wired processes for device maintenance, VAP bundles, as well as central line and Foley catheter protocols. Most facilities cannot compete with our positive outcomes. Physicians benefit from sending their patients to Select because of our strong outcomes. Patients, as well as family members, consistently have exceptional experiences with our hospital. As our healthcare system evolves, Select Specialty Hospital manages to stay ahead of expectations by providing the best

care to the patients that are admitted to us.

We have physicians in our hospital 24/7 and not just one specialty. Select Specialty has every subspecialty on staff as well, such as pulmonary, critical care, trauma surgeons, neurology, ear nose and throat (ENT), nephrology, psychiatry, pain management, infectious disease, thoracic and cardiovascular surgery, cardiology, gastroenterology, and nephrology to name a few. We have respiratory therapists on staff 24/7, a full line of rehab services including physical, occupational, and speech therapy, bedside dialysis, a radiology department including CT scanning, a full service pharmacy, an intensive care unit, a state of the art operating room where we perform tracheostomy placement, skin grafts, wound debridements, and GI procedures, in addition to a number of other advanced surgical procedures. We are a desired destination for many complex patients because we are a 60-bed hospital that is able to provide the highest levels of acute care in a very comforting intimate environment. Our patients do not get lost and neither do their concerns, especially if they are in need of additional rehab or other therapies. The patient comes first at Select and the best healthcare providers in Palm Beach County know that Select has the positive outcomes to back up our reputation.

My advice to friends, family and

potential patients is to do your homework and ask your physician, case manager, caregiver, nurse, and neighbor about their experience or knowledge about a particular facility your loved one may be admitted to for care. Select Specialty Hospital of Palm Beach has been labeled the best kept secret in Palm Beach by many healthcare professionals and previous/existing patients for a reason. We provide the best care and deliver the best outcomes on patients without misleading family members or other healthcare professionals. In essence, we are a proven and trusted healthcare provider in Palm Beach and that's one of the reasons some of the most respected physicians in the county utilize and trust Select Specialty Hospital.

Choosing the right hospital is perhaps the most crucial decision you can make in advancing or continuing the health care for you or a loved one. Make the decision for yourself, avoid here say from pushy marketing reps, many times they have ulterior motives. My rule of thumb is if someone has something negative to say about another facility, I immediately question their integrity and intentions. I urge you to visit your healthcare options personally, speak to the physicians that are providing care for you or your loved ones, ask to speak to the CEO or other Director from that hospital and make the best decision possible with as much information you can gather from respected healthcare

Mike Corvaia has been in healthcare administration for over ten years and is currently the Director of Business Development for Select Specialty Hospital in Palm Beach. He holds a Bachelor’s degree from the University of Florida and is completing his Master’s Degree this year in Business Administration, with an emphasis on Healthcare Administration.

Please feel free to send any healthcare related questions to mcorvaia@selectmedical.com

professionals. Remember, it's your choice as a patient to select your healthcare provider.

We look forward to you visiting our hospital and seeing for yourself what many people consider the finest institution in Palm Beach.

Select Specialty Hospital of Palm Beach is located at 3060 Melaleuca Lane, Lake Worth, Florida 33461. Our main number is 561-357-7200 and can be called 24 hours a day, answered by a live person.


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U.S. Health Care Spending Now at $2.7 Trillion: Report "offset by faster growth in personal health care goods and services," Hartman noted. "The main drivers of the spending trends were Medicare, private health insurance and consumer out-of-pocket payments," he said.

Although spending growth has been slow, it could accelerate as the economy rebounds, experts worry.

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ealth care spending grew nearly 4 percent in 2011, reaching $2.7 trillion -- a new high, according to a federal government report issued on January. Although this seems like a huge amount of money, the rise actually represents the third consecutive year of "relatively slow growth," the researchers said. Whether spending will pick

up again as the economy improves, as it has in the past, isn't known, they added.

"The stable growth in national health spending in 2011 is the result of mixed trends," Micah Hartman, a statistician in the Office of the Actuary at the Centers for Medicare and

Medicaid Services, said during a press conference.

These trends include slowed growth (compared to years past) in expenditures for health insurance, government-funded research and funding for public health, Hartman said. Those slowdowns, however, were

Health care reform has had little effect on spending numbers so far, the researchers said. Although some provisions of the Obama Administration's Affordable Care Act were in place in 2011, their effect on spending was minimal, Hartman said. It won't be until 2014 and beyond that the full benefits of the law will be seen, he said. The report, which is issued annually, was published in the January issue of the journal Health Affairs.

Active Video Games May Boost Fitness in Younger Students

Active video games -- such as those that get players to dance -can encourage inner-city children to be physically active and may reduce their risk of obesity, according to new research. The study included 104 children in grades three through eight at a Washington, D.C., public school. They were randomly assigned to three 20-minute sessions of their usual gym class or the active video games "Dance Dance Revolution" and "Winds of Orbis: An Active Adventure." In Dance Dance Revolution, players dance along to music in ever-increasing and complicated patterns. In Winds of Orbis, players take on the role of a virtual superhero who climbs, jumps, slides and goes through other types of active adventures.

The Time is Now...

By Bob Wolff

It’s been reported that Palm Beach County leads the country in home demand, and prices have increased a whopping 35%. Yes, Palm Beach is the place again and as I previously reported, inventory, homes that are listed and available for sale, has decreased dramatically. It’s the old story of supply and demand. The demand increases because the supply decreases, and the higher the demand, prices are forced up. It’s logical, isn’t it? If a home is priced correctly, and there are now 10 buyers for each home, as

be in this state for quite some time. We have years of short sales and foreclosures ahead of us. Eventually, these too will be off the market, sold, and we will return to a normal market.

opposed to one, people fight for the home, and prices increase.

Are there a large number of short sales as well as foreclosures, absolutely. This phenomenon, this current housing market, will

But now is the time to buy as prices increase. I recommend highly that if you do find a home you love, don’t wait. Because if you, there’s a line waiting to buy that home. Love your home, but don’t spend too much time weighing the pros and cons. If you do, call us and start your search anew.

"A lot of people say screen time is a big factor in the rising tide of childhood obesity," study lead author Todd Miller, an associate professor in the department of exercise science, said in a university news release. "But if a kid hates playing dodgeball but loves Dance Dance Revolution, why not let him work up a sweat playing [video] games?"

Inventory is low! Mortgage rates are low! Rents are high! It's time to act!

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Overall, children burned the most energy during regular gym class. But the active video games got children in third, fourth and fifth grades moving enough to achieve recommended levels of vigorous activity, according to the researchers at the George Washington University School of Public Health and Health Services. They said their findings, published online Jan. 9 in the journal Games for Health, suggest that active video games might be an effective alternative to traditional gym classes, at least for younger students.

The researchers noted that several hundred schools in at least 10 states use active video games in physical education classes in an effort to encourage inactive children, especially those who don't like gym class, to get physically active. This study was the first to focus on active gaming and black and other minority children, who are at high risk of obesity, the researchers noted.

Bob Wolff 561-352-0620

BobWolff@keyes.com

"Many of these children live in neighborhoods without safe places to play or ride a bike after school," Miller said. "If [video] games can get them to move in school then maybe they'll play at home too and that change could boost their physical activity to a healthier level."


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PREMIER FAMILY HEALTH & WELLNESS BRIGHTENS HOLIDAY FOR LOCAL STUDENTS hysicians and staff at Premier Family Health & Wellness, an innovative Family Medicine practice located on State Road 7 in Wellington, know the joy of giving. For the second consecutive year, physicians, staff and patients helped raise funds to brighten the holidays for students of the Indian Ridge School in West Palm Beach. The Indian Ridge School, the only therapeutic school in Palm Beach County, offers academic programming for students elementary through high school that have been identified with emotional/behavioral problems. In addition to academics, educators promote the social skills necessary for students to progress to post-secondary education, productive citizenship, employment and independent living. “We chose to support the students of the Indian Ridge School because we wanted to make certain that these children experienced the joy of Christmas. We wanted them to know that we believe in them and care about them,” stated nurse practitioner, Elizabeth Lofaso, a provider at the practice. On December 20th, following

Do Babies Begin Learning Language in the Womb?

Language development begins in the womb, during the last 10 weeks of pregnancy, a small new study of U.S. and Swedish infants suggests.

Researchers noted that these skills can be demonstrated within the first few hours of life.

weeks of fundraising activities, Premier staff members visited the Indian Ridge School to personally present the gifts—tshirts, toys and gift cards—to all 115 students and educators.

“It was gratifying to see the joy our visit brought to the students that day. We are proud of the collective efforts of our team at Premier. It was our pleasure and privilege to support the extraordinary educators at Indian

Ridge who are dedicated to making a difference in the lives of their students,” continued Ms. Lofaso.

Stacey Oak, Community Resource Person at Indian Ridge said, “We are very fortunate to have Premier Family Health & Wellness as part of our children’s lives. This not only brought smiles to their faces but will help teach them the importance of caring for others.”

From primary care to chronic disease management, Premier Family Health & Wellness provides a full continuum of care offering the convenience of an urgent care center, on-site diagnostic testing center and a Center for Healthy Aging all integrated through an electronic medical record system. Patients receive the highest standard of care from staff that remains at the forefront of the latest research findings on health, wellness and aging. For more information, please call 561-798-3030.

Indian Ridge School is located at 1955 Golden Lakes Blvd., West Palm Beach, FL 33411. For more information contact Ms. Stacey Oak at 561-681-0056 or via email at stacey.oak@palmbeachschools.org

"The mother has first dibs on influencing the child's brain," study co-author Patricia Kuhl, co-director of the Institute for Learning & Brain Sciences at the University of Washington, said in a school news release. "The vowel sounds in her speech are the loudest units and the fetus locks onto them."

Just hours after birth, babies can tell the difference between their mother's native language and a foreign language, the study authors found. They said this indicates that babies are able to listen to their mothers talk by the time they reach 30 weeks of gestational age, much earlier than previously thought.

The study involved 40 infants less than two days old. The babies, born either in Tacoma or Stockholm, were an even mix of girls and boys. While they were in the nursery, the babies listened to vowel sounds both in their mother's native language and in foreign languages.

The babies were given pacifiers that were wired to a computer set up to measure their reaction to the sounds they heard. The researchers assessed how interested the babies were in the vowel sounds by how long the babies sucked on their pacifier.


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JANUARY ISSUE • 2013 9

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Cervical Cancer Awareness and Detection • Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.

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Kishore K. Dass, MD

Board-Certified Radiation Oncologist

By Ben Han, M.D.

ervical cancer, when diagnosed early, is a highly curable disease. Screening and earlier detection has reduced the death rates from cervical cancer significantly in the U.S.

The American Cancer Society released new screening recommendations for the prevention and early detection of cervical cancer in March, 2012. Screenings are tests for women who have no symptoms of cervical cancer.

• Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical precancer should continue to be screened.

Ben H. Han, MD

Board-Certified Radiation Oncologist

Among the changes: the American Cancer Society no longer recommends that women get a Pap test every year.

During the past few decades, screening has reduced deaths from cervical cancer, as doctors have been able to find cancer early and treat it, or prevent it from ever developing.

Researchers continue to find out more about what causes cervical cancer, and the best ways to screen for it.

There are 2 types of tests used for cervical cancer screening.

• The Pap test can find early cell changes and treat them before they become cancer. The Pap test can also find cervical cancer early, when it’s easier to treat. • The HPV (human papilloma virus) test finds certain infections that can lead to cell changes and cancer. HPV infections are very common, and most go away by themselves and don’t cause these problems. The HPV test may be used along with a Pap test, or to help doctors decide how to treat women who have an abnormal Pap test.

The American Cancer Society regularly reviews the science and updates screening recommendations when new evidence suggests that a change may be needed. The latest recommendations are:

• All women should begin cervical cancer screening at age 21. • Women between the ages of 21 and 29 should have a Pap test every 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.

Eating Mindfully

F

Cindy Collins, Ph.D., R.D.

Experimental Health Psychology / Nutrition

or many cancer patients, mindful eating is a challenge. They find themselves in adversity with food due to gastrointestinal conditions or medication and treatment side effects. Often, side effects disable their ability to enjoy the foods they were accustomed to before treatment. They may even develop food aversions to foods that once brought satisfaction or were a joyful tradition. In some cases, taste has been altered for a long period of time but most often not permanently.

For those who eat automatically without being hungry, but to relieve stress or to achieve emotional fulfillment, the topic of eating is not a pleasant one. In all of these situations, people may find a way of eating that is

without awareness. We eat from emotion or habit, or in an effort to avoid any of these and other stressful issues. This is called “mindless eating.” According to Jan Chozen Bays, MD, “The fundamental reason for our imbalance with food and eating is that we’ve forgotten to be present as we eat. We eat mindlessly.” In addition, she states that we have tried to solve the problem with the wrong approach. For example, in response to obesity, we changed food by removing the calories and fat and substituting sweetness. Then we changed our bodies with liposuction, stomach stapling or gastric bypass. But the problem lies in the mind.

Mindful eating is eating with awareness, without criticism or judgment. Eating is done with close attention paid to the sensation and purpose of every bite. The concept of mindful eating has its roots in Buddhist teachings. Buddhist meditation can take many forms. It can be practiced sitting, standing, walking and even while eating. For many, eating fast means eating more. We should ask ourselves, “Why do I need this? What am I thinking and feeling? Am I responding to stress or to sadness?” Mindful eating can help us reestablish our body knowledge—to know when we are hungry; when we are satisfied. It can help us focus on

• Women who have had their uterus and cervix removed in a hysterectomy and have no history of cervical cancer or pre-cancer should not be screened.

• Women who have had the HPV vaccine should still follow the screening recommendations for their age group.

• Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES. They should talk with their doctor or nurse.

U.S. Cancer Death Rates Have Dropped 20 Percent Since 1991 The overall death rate for cancer in the United States has dropped by at least one-fifth over the past two decades, according to new statistics from the American Cancer Society. This steady decline translates to 1.2 million lives spared between 1991 and 2009.

"In 2009, Americans had a 20 percent lower risk of death from cancer than they did in 1991, a milestone that shows we truly are creating more birthdays," John Seffrin, chief executive officer of the American Cancer Society, said in a news release.

how to nourish our body. Many cancer patients begin a transition after treatment to normal eating again. The Nutrition for Cancer Survivorship group at SFRO Survivor Clinic enables patients to incorporate mindful eating as they transition to healthy living post-treatment. In that class you will learn some of the following exercises. Try one of the exercises below: • Try taking the first four sips of a cup of hot tea or coffee with full attention.

• If you are reading and eating, try alternating these activities, rather than doing both at once. Read a page, then put the book down and eat a few bites, savoring the tastes, then read

another page, and so on.

• At family meals, you might ask everyone to eat in silence for the first five minutes, thinking about the many people who brought the food to your plates.

• Try eating one meal a week mindfully, alone and in silence. Eat more slowly, ensuring that you chew the food longer. Before eating, take note of its color, shape and smell. Take note of the texture, smell and taste while it is in your mouth. Note your relaxed breathing and appreciation for the flavor and texture with each mouthful. Sources: www.nytimes.com 08/12, Psychology Today 02/09, ADA Times 12/12

Death rates continue to fall for colon, breast and prostate cancers thanks to improvements in the early detection and treatment of these forms of cancer, the new report revealed. Lung cancer -- still the leading cancer killer -- is also on the decline, since the number of smokers is also dropping.

But the cancer society noted that more progress could be made if the latest advancements in cancer prevention and treatment were extended to underserved populations.

Between 1991 and 2009, overall cancer death rates fell by 24 percent in men and 16 percent in women, according to the society's annual Cancer Statistics report. Cancer death rates in the United States peaked in 1991 at about 215 per 100,000 people. By 2009, however, death rates had fallen to about 173 per 100,000, the report revealed.


10 JANUARY ISSUE

• 2013

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The Importance of Healthy Lifestyle Modifications By Deborah Lynn

I had the pleasure of talking with Dr. Bambi Petrinic recently regarding making small modifications to your day-to-day routine that will make the world of difference in your life. As a younger physician, Dr. Petrinic certainly knows how to motivate her patients - through patience, understanding, and finding fun ways for them to incorporate healthier eating habits and exercise into their lifestyle.

According to Dr. Petrinic, “Genetics is not a done deal; environment does play a role. Eating healthy and exercising regularly plays a huge part in the overall picture and it’s never too late to improve your health.”

By starting small, people can begin to make important changes, and once they accomplish that goal, they can move on to another step of the plan. “For me DIET is a four letter word in more ways than one. It is supposed to be defined as a permanent eating habit. Instead, it’s now more recognized as a temporary, and often not so healthy, way to lose weight. People may be successful at temporarily losing weight on these 'diets,' but they almost always gain the weight back because they cannot maintain the restrictive diet that deprives them of the food they crave. Instead, if someone were to ease into a healthier eating pattern, they would be able to slowly build up to their goal. For example, let’s say you need to lose 50 pounds. For most people that can seem daunting. However, if you start out slow and set your goal to losing the five pounds that you know you can easily do, you will quickly be successful, which can keep you motivated to lose another five like you just did, and so on.”

If you try to make quick radical changes, it’s often difficult to find the motivation to stick with it. However, if you do it in painfree steps, you can incorporate those healthier changes while still enjoying some of the bad habits as they're gradually phased out on your way to a healthier lifestyle. “It may be less intimidating and easier to put your toe in the water and ease into it instead of just diving in.” stated Dr. Petrinic.

“I had this one patient that had bad cholesterol, high blood pressure, and was on insulin for uncontrolled diabetes, all of which were directly a consequence of his obesity. I had not seen him for several months when he came in one day for a follow-up visit. He had gradually stopped nearly all of his medications on his own, but in order to do that it required him to modify the lifestyle that he knew needed to be changed. Even though he still enjoyed pizza, since he ate fewer slices and

added salad, his diabetes was better controlled than when he was on insulin. He was motivated further to make pizza and other bad foods an uncommon habit, which along with regular exercise ultimately brought his weight down enough to safely be off all of his medications. When someone gets to the point where they refuse to accept their situation, the motivation fuels them to make change happen - on their own terms - not mine or anyone else's"

If you are simply trying to maintain your present weight, you should exercise five days a week for 30 minutes or more a day. Less than that and you could be losing ground healthwise. If you are overweight, you should exercise more, closer to seven days a week for an hour or more each day.

Patients often ask her, if their weight is normal, they eat healthy, and don’t smoke or drink, why isn't that enough to make up for lack of regular exercise in their busy lives?

Dr. Petrinic often uses analogies that others can relate to. “You could have a strong fortress that’s protected by the best military, but if there's even one open gate or unguarded side, you're vulnerable. No matter how well the rest of the fort is protected, the enemy can easily attack you by sneaking through that one gate.”

Dr. Petrinic tries to motivate patients to adopt healthier habits by example. She can relate to the difficulties of changing poor habits that have been lifelong. She admits that she could never get herself to eat vegetables and her picky eating has always worried her. "I had tried many different methods, but had always failed. I knew that no matter how good every other part of my health and lifestyle was, this could easily be the thing that could do me in one day. So I took a step back and asked 'why do I not like vegetables?’ This came to the conclusion that it was the texture that was not tolerable. Thinking more about that, I realized that I barely ate fruit either since it had a similar texture, but it was more tolerable since it was sweet. Then asked, 'why can't I eat at least one fruit a day?' but, I did not have a good excuse. So I started with eating one fruit a day until it was habit, then two. It took a little time to eat vegetables other than carrots, but I started slowly by incorporating small amounts of things that I could tolerate. Miraculously I was eating vegetables regularly for the first time, but it was so simple. I failed in the past since I was focused on the overwhelming goal of forcing myself to eat 5 servings of food a day that I hated. When it was instead broken down into a series of simple steps that I knew I could do, and getting used to that change before adding another, it was easier, and the confidence gained from each successful step fueled the motivation to keep going. I'm almost there, currently eating four servings a day each of both fruits and vegetables.

With enough time and motivation, anyone can climb a mountain when they take the stairs."

No matter how good you think your lifestyle habits are, Dr. Petrinic believes there is always room for improvement. "Life is like a video game. You don’t sit and let the clock run down because you feel you collected enough gold coins. You’re going to keep playing until the time runs out and you collect as many points as you can, no matter how

good your score is. When you’re finished, you might play the level again to see if you can beat it. When you reach a goal that seems too hard to win, much like a difficult game level, you can skip to a different one that's easier and go to it later, get a strategy guide to give you hints or instructions, or get help from a friend who's been there before. If the game is important enough to you, don't stop playing or lazily let the clock run out when you know you can win more points. Keep challenging yourself to beat your best score." Another way to mix up your

Bambi Petrinic, M.D.

routine is through some not so conventional forms of exercise. The following are some ideas that Dr. Petrinic has offered to make exercise more fun and spice things up a bit:

• Zumba • Kickboxing and martial arts • Staff spinning, baton or ribbon twirling • Poi spinning • Belly dance, salsa, pole dancing, (or any dancing!) • Hoop spinning (Dr. Petrinic's favorite)

Dr. Petrinic is so dedicated to making her patients lead healthier lifestyles that she even carries an adult-sized hula-hoop in her car for brief impromptu starter lessons for interested patients during clinic hours. It’s not only a great core exercise, but also a versatile prop to exercise and tone other parts of the body. In addition, she uses phone applications for patient education, including one called Everywhere Exercise EvEx Stealth to show her patients exercises that can be done anywhere – even when they claim they have no time to commit or are limited by disability.

The one thing that Dr. Petrinic recommends before you start a new exercise routine is to check with your physician. If you get the green light, just make sure you loosen up with the proper stretching exercises prior to starting any workout. Also, make sure that whatever form of exercise you choose, it’s not too strenuous or aggressive. For those individuals with painful medical conditions, you may want try some of the following: • Tai Chi • Elliptical • Pedal device (can use the arms or the feet) • Water exercises

The key to any good exercise program is to mix it up. Dr. Petrinic recommends that you have a good combination of exercises that work all of your muscle groups (not all at once though, as they do need to rest and recuperate). For those that are trying to lose weight, you may need to change your routine more frequently because your body will often reset its metabolism to compensate for the increase in exercise in order to regain a steady baseline. She offered these helpful tips when choosing the proper diet:

• Get adequate intake of dietary fiber through fruits, vegetables and whole grains. The Mediterranean and DASH (Dietary Advances to Stop Hypertension) diets were recently ranked high as two of the best overall healthy diets.

• Do not drink your calories. You get more than enough from the food you eat.

• Avoid caffeine from energy drinks or carbonated sodas. If you must have caffeine, opt instead for white or green tea that can provide other health benefits with less of the jitters or strain on the heart. • You don't have to be a vegan or vegetarian to be healthy, but aim for a more plantbased diet, with less animal proteins.

• While juicing may be popular, the whole fruit or vegetable is healthier due to the fiber content. A well-puréed smoothie of whole fruits and vegetables is a great compromise.

• Minimize processed foods or those that contain high fructose corn syrup. If the ingredient list is long or has a lot of chemicals that you can't pronounce, then put the box down and step away from the shelf.

One thing for sure, Dr. Petrinic is so passionate and definitely a joy to talk with. She has absolutely inspired me to start incorporating more vegetables into my diet – albeit one at a time.

Dr. Bambi Petrinic is one of the physicians on staff at Medical Consultants of Palm Beach. If you would like to make an appointment with Dr. Petrinic, please contact either the Jupiter office at 561-932-0995 or the Port St. Lucie location at 772-398-1305.


JANUARY ISSUE • 2013 11

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Why Women Don’t (But Should) Lift Weights By Jenna Bergen

espite study after study supporting the benefits of strength training, many women still opt for cardio over weights. Maybe they’re worried about “bulking up.” Women have seen a few too many beefy men grunting it out in the weight room and fear that if they pick up a dumbbell, they’ll suddenly start to resemble a linebacker, too. This can happen, although it’s extremely rare, as we reveal in 6 Ways to Beat Your Bad Genes. But for most women, “this just isn’t possible,” says personal trainer and Prevention fitness expert Chris Freytag. “Ladies have too much estrogen in their hormonal makeup.”

So what is the secret to looking toned (think: Michelle Obama’s arms, which we have the secret to) but not tough? Strength training. Here, nine reasons why women should strength train at least two or three times a week.

1. Your metabolism will soar. As women age, they naturally lose muscle mass. This causes your metabolism to slow, which means you could start building a spare tire by the time you reach your 30s. “When you do weightbearing exercises, you start revving up your metabolism— and it keeps burning for many hours after your workout,” says Wayne Westcott, PhD, director of fitness research at Quincy College and Prevention advisory board member.

30 Percent of U.S. Teen Girls Meet Up With Online Strangers Nearly a third of American teenage girls say that at some point they've met up with people with whom their only prior contact was online, new research reveals.

For more than a year, the study tracked online and offline activity among more than 250 girls aged 14 to 17 years and found that 30 percent followed online acquaintance with in-person contact, raising concerns about high-risk behavior that might ensue when teens make the leap from social networking into real-world encounters with strangers.

Girls with a history of neglect or physical or sexual abuse were particularly prone to presenting themselves online (both in images and verbally) in ways that can be construed as sexually explicit and provocative. Doing so, researchers warned, increases their risk of succumbing to the online advances of strangers whose goal is to prey upon such girls in person. The study, which was supported by a grant from the U.S. National Institutes of Health, appeared online Jan. 14 and in the February print issue of the journal Pediatrics.

2. You’ll you burn fat. Muscle tissue is more "active" than fat tissue, with each pound burning about 30 calories a day just to sustain itself. So even if you’re sitting on the couch or are stuck at your desk for eight hours a day, the extra muscle mass you develop will burn more calories, helping you finally get rid of that spare tire—and keep it off for good. (If you want to love your lower body more than you do, check out this fat-blasting doanywhere workout from Freytag.)

3. Your body will get tighter. While cardio is important and will help melt fat, weights sculpt your body, creating curves and definition right where you want it. They also help fight the effects of gravity, making you much less likely to have arm jiggle in your upper arms. (Scientists discovered the three best moved for perfect upper arms—check them out.) 4. You’ll fit into your skinny jeans. “One pound of fat takes up much more space than one pound of muscle,” says CrossFit athlete and certified level-1 trainer Cheryl Brost, a 41-year-old mother of two. “So even though muscle weighs more, what do you want all over your body? Something that’s bulky, like body fat, or something that’s lean, and takes up less space, like muscle?” 5. You’ll reduce your risk of heart disease and diabetes. Curbing age-related muscles loss isn’t just good for your looks; it can protect your heart and help

ward off type 2 diabetes, too. "Muscle helps remove glucose and triglycerides from the bloodstream, which reduces the risk of type 2 diabetes, as well as hardening of the arteries," says Timothy Church, MD, PhD, a preventive medicine expert at Pennington Biomedical Research Center. For specific exercises that can reduce your diabetes risk, check out our Diabetes Exercise Solution.

6. Your blood pressure could drop. "Strength training lowers blood pressure for ten to twelve hours after each session, which gives your heart a break," says William Haskell, PhD, professor emeritus of medicine at Stanford University. "How strength training does this is not

completely understood, but it probably has subtle effects on everything from hormones to nervous system regulation."

7. You can do it anytime, anywhere. You don’t need a lot of space or a lot of special equipment to get a great strength workout, says Westcott. Simply using your own bodyweight through the use of pushups, planks, chair dips, squats, and pull-ups is enough to tone and strengthen your entire body. Bonus: You can do it indoors, which means you don’t have to weather the cold, freezing temps of winter or the scorching heat of summer. 8. You’ll blast loads of calories. Plyometric strength moves (think squat jumps and burpees) and

kettlebell workouts skyrocket your heart rate, which boosts the calorie burn of regular strength training routines. These types of workouts give you cardio, strength, and sculpting all in one, which is a great timesaver, says Freytag. 9. It’s good for your bones. Strength training is one of the 12 best ways to break-proof your bones. “Lifting weights can help counteract age-related bone loss,” says Ethel Siris, MD, director of the Toni Stabile Center for Osteoporosis at Columbia Presbyterian Medical Center in New York City. “Strengthening your muscles also improves balance and keeps you as strong as possible which lowers your chances of a fallrelated fracture.


12 JANUARY ISSUE

• 2013

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Obesity with the US Department of Health. Severe obesity or morbid obesity is defined as BMI greater than or equal to 40. I currently use the table shown in my practice, when determining your BMI. You are defined as underweight if your BMI is less than 18.5. You are within normal range if the BMI is between 18.5 and 24.9. However, you are considered overweight or pre-obese if your BMI is between 25 and 29.9.

Obesity is a real epidemic in the United States, where evidence shows that nearly 75% of the adult US population are either overweight, obese or severely obese. In the past 50 years, obesity has increased by almost 50% and morbid or severe obesity has increased by 100% in the past 20 years. Unhealthy eating habits, lack of physical activity like exercise and walking are some of the causes of obesity, although hormonal and genetic factors do play a role.

Shekhar V. Sharma, M.D. Board Certified in Internal Medicine

What is obesity?

I would like to take this opportunity to not only define what it means, but educate you on how it has an impact on your overall health. For several decades, the definition of obesity has been evolving and changing. Simplistically said, obesity is defined as an excess of body fat. Today, we measure what is called BMI or the body mass index read where the body weight and height is utilized as a measure of obesity. Your BMI is calculated by weight in kilograms, divided by height in meters or weight in pounds, divided by height in inches then multiplied by 703. More than 10 years ago, the US Department of Health and Human Services Dietary Guidelines for Americans defined obesity as a BMI of 30 or more.

We as Americans are not making good nutritional choices and genetic factors do play a role. We are not exercising on a daily basis as one should, despite the fact that the benefits of exercise and good nutrition do reduce the risk of heart disease, diabetes mellitus, and hypertension.

Obesity is also a risk factor for sleep apnea. Most people who are obese do not even realize that they are at risk for major medical problems or premature death. To

Shortly thereafter, the National Institute of Health also concurred

BMI = WEIGHT (pounds) x 703 HEIGHT (inches)2

{

avoid further complications of obesity, I would like to advise and educate everyone out there, with a waist circumference of more than 40 inches in men or more than 35 inches in woman that you need to improve that number. Your body max index should be below 25, triglyceride level in the blood should be below 150, HDL or the high-density lipoprotein should be above 40mg/dL in men and above 50mg/dL in women, blood pressure should be less than 130/85 and fasting blood sugar should be below 110mg/dL.

If you meet the above criteria, then the chance of getting complications like heart disease, diabetes mellitus, and hypertension could mostly be avoided. Again, I have to mention sleep apnea, which is more commonly seen in obese patients which puts you at a higher risk of death if there are other risk factors that also exist, like coronary heart disease, diabetes mellitus and hypertension.

Obesity is treatable by essentially consuming less calories, exercising more often with a weight loss rate of 1 to 2 pounds per week. Your goal should be to reach a 10% weight loss over six months. Then of course, one has to maintain that weight loss. Few obese people have tried their best to lose weight with great willingness and motivation. Later, they may have also tried over-the-counter or prescription weight loss drugs without success and therefore have elected to have weight loss surgery

}

Dr. Shekhar Sharma BODY MASS INDEX CLASSIFICATION WHO Classification

BMI (kg/m2)

NHLBI Classification

Underweight Normal Preobese

<18.5 18.5-24.9 25.0-29.9

Underweight Normal Overweight

Obese Class I Obese Class II Obese Class III

30.0-34.9 35.0-39.9 >40.0

Obesity Class I Obesity Class II Obesity Class III

as they call it, which has been successful in the majority of people who are morbidly obese. We call this Bariatric surgery. Bariatric surgery should be reserved only for those morbidly obese people who have failed an exercise and diet program and who also have other related medical conditions like hypertension, diabetes mellitus, and sleep apnea. Surgery is always associated with its own risks and I would strongly advise you to maintain a good healthy diet and exercise program of at least 60 minutes of exercise daily.

Of course, I would recommend

you seek medical attention and clearance by a well-trained physician before you go on any diet and/or exercise program.

Lastly, I do want to tell you that I do exercise daily, eat healthy and take the staircase rather than use the elevator. I also try to park my car as far away as possible when I go shopping to the mall which allows me to get a little exercise by walking.

Please cut out the chart shown and affix it to a place where you can view it daily. It’s never too late to start healthier habits and take control of your health.

PALM BEACH PRIMARY CARE ASSOCIATES, INC. State of the Art Office Building with Imaging Center,

Shekhar Sharma M.D. Ebonee Johnson A.R.N.P.

Accepting New Patients

Southern Blvd.

MEDICARE, BLUE CROSS BLUE SHIELD, UNITED HEALTH CARE, AETNA, CIGNA, HEALTH CARE DISTRICT AND MOST MAJOR INSURANCES ACCEPTED On staff at Palms West Hospital and Wellington Regional Medical Center

Palomino Park

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PALM BEACH PRIMARY CARE ASSOCIATES

Lake Worth Rd.

Florida’s Turnpke

The Mall at Wellington Green

State Road 7 (441)

Forest Hill Blvd.

Monday - Friday from 9:00 am - 5:00 pm Same Day Appointments and 24-Hour Service Available

3347 State Road 7 Suite 200 Wellington, FL 33449

Tel: (561) 795-9087 • Fax: (561) 753-8730

SPECIALIZING IN: • Diagnosis of Complex Illnesses • Cholesterol Management • Diabetes • Cardiac Care • EKG/24-Hour Heart Monitoring/Spirometry • Hypertension • Geriatric Concerns • Osteoporosis 1200 South Main Street Suite 101 Belle Glade FL 33430

ACCEPTING NEW PATIENTS

Tel: (561) 996-7742 • Fax: (561) 753-8730


JANUARY ISSUE • 2013 13

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Dave Aronberg Sworn in as Palm Beach County State Attorney

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ave Aronberg was sworn in on Tuesday, January 8 as the Palm Beach County State Attorney. The official swearing in was performed at the Palm Beach County Courthouse by Palm Beach Circuit Judge Edward Fine.

Shortly thereafter, a reception was held in Dave’s honor at Embassy Suites in West Palm Beach. With a room full of supporters, this relaxed and exciting event was filled with a host of guests that honored and recognized not only his past

Sheriff Ric Bradshaw

service, but also anticipating what’s to come.

The event was hosted by the Honorable Robert Butterworth. Other guest speakers included Senator Joseph Abruzzo, Sheriff Ric Bradshaw, CeCe Dykas and Gary Lesser. Although his official swearing in took place earlier in the day at the courthouse, Palm Beach County Clerk and Comptroller, Sharon Bock, officiated an “expanded oath” during this ceremony. The event concluded with a benediction by Reverend Griffin Davis.

Dave thanked everyone in attendance – elected officials, those who worked so closely with his campaign, his family and everyone else who had supported him during his career and especially during this past year. As he so eloquently stated, “If I am standing tall here today it’s because I am standing on the shoulders of each and every one of you that was there for me through thick and thin and I will never forget. We have been through so much together, this is a celebration” and that it was.

Robert Butterworth and Dave Aronberg.

Sharon Bock, Joseph Abruzzo, Dave Aronberg, Robert Butterworth and CeCe Dykas.


14 JANUARY ISSUE

• 2013

Upcoming Charity and Medical Fundraising Events January 20 – February 14, 2013 JANUARY 20 Palm Beach County and Treasure Coast MDA Muscular Dystrophy Association. (MDA) Muscle Walk and 5k Run. The walk takes place at The Palm Beach Zoo in West Palm Beach and registration begins at 8:00 am. The 5k run takes place at Dreher Park in West Palm Beach and registration begins at 6:30 am. For additional information, contact 561-742-3748 or e-mail southpalmbeach@mdausa.org. You can also visit their website at www.mda.org/palmbeachfl.

JANUARY 24 Food for the Poor. Fine Wines & Hidden Treasures. The Mar-aLago Club, Palm Beach. Individual tickets are $450.00. For additional information, contact Carol Collins at 954-427-2222, ext. 6585 or by e-mail to carolc@foodforthepoor.org. JANUARY 26 March of Dimes. 75th Anniversary Gala. Mar-a-Lago Club, Palm Beach. Tickets are $600.00 per person. For additional information, call 561-290-0905 or e-mail jwhitaker@marchofdimes.com.

Komen South Florida. 2013 Susan G. Komen South Florida Race for the Cure. Downtown West Palm Beach. For additional information, contact 888-470-6374. Or, visit their website at www.komensouthflorida.org.

JANUARY 27 Ryan Licht Sang Bipolar Foundation. Eighth Annual Dinner Dance. Club-Colette, Palm Beach. For additional information, (888) 944-4408 or visit www.questforthetest.org.

H.O.W. Hearing the Ovarian Cancer Whisper. Time is of the Essence Luncheon & Lecture. Flagler Museum, Palm Beach. Individual tickets are $325.00 and a junior ticket is $150.00 (under 40). To make reservations or for additional information, please contact 561-837-2285 or e-mail jmcgrath@phfpbc.org.

FEBRUARY 1 American Cancer Society. 55th Annual Gala “Celebration of the Century.” The Mar-a-Lago Club, Palm Beach. For additional information, call 561-655-3449 or e-mail michelle.jaminet@cancer.org.

FEBRUARY 2 Food for the Poor. Boca Raton Gala. The Polo Club of Boca Raton. Tickets are $250.00. For additional information, contact Jameli Bedran at 954-427-2222 or e-mail jamelib@foodforthepoor.org, ext. 6685. Or, visit their website at www.foodforthepoor.org/boca.

University of Miami – Miller School of Medicine. “Solving the Neurological Puzzle” Gala. The Breakers, Palm Beach. Tickets are $500.00 each. For additional information, contact 561-655-2111 or e-mail janetlevy@aol.com. You can also visit their website at www.UMGala.org.

FEBRUARY 8 American Red Cross. International Red Cross Ball. The Breakers, Palm Beach. For additional information, contact Jennifer Durrant at 561-650-9105 or e-mail jennifer.durrant@redcross.org. Or, visit their website at www.pbtcredcross.org

FEBRUARY 10 Caron & Hanley Treatment Center. Family Picnic. Palm Beach International Equestrian Center, Wellington. Tickets $195.00/adult, $50.00/child (7-17 years old), $500.00 for a family table. For additional information, contact 561-841-1048. Or, you can visit their website at www.hanleycenter.org.

FEBRUARY 11 Palm Beach Habilitation Center. 22nd Annual Hab-a-Hearts Luncheon. The Mar-a-Lago Club. Palm Beach. Tickets are $225.00. Please contact Mary Dunning at 561-965-8500, ext. 212 or e-mail mdunning@pbhab.com.

Diabetes Research Institute. A Gift of Love...A Gift of Hope Luncheon. The Polo Club of Boca Raton, Boca Raton. Tickets are $85.00 per person. For additional information, contact Sheryl Sulkin at 954-964-4040 or e-mail ssulkin@drif.org. You can also visit their website at www.diabetesresearch.org. FEBRUARY 12 Richard David Kann Melanoma Foundation. 14th Annual SunSational Luncheon & Fashion Show. The Breakers, Palm Beach. For additional information, contact 561-655-9655.

FEBRUARY 14 American Heart Association. 58th Annual Heart Ball. The Breakers, Palm Beach. For additional information, contact 561-697-6607.

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Texting Could Help Spread the Word on Teen Health Study takes advantage of technology to educate kids on nutrition, fitness.

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ealthy lifestyle text messages could help improve teens' eating and exercise habits, a new study suggests.

University of Arizona researchers conducted a one-year trial involving 177 teens in order to find out their preferences for healthy lifestyle text message content, format, style, origin, frequency and mode of delivery.

The results showed that the participants liked an active style that referenced teens and recommended specific, achievable habits that were sent from nutrition professionals, according to the study in the January/February issue of the

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Journal of Nutrition Education and Behavior.

Many experts believe that current programs to prevent teen obesity have limited, short-lived success, according to study author Melanie Hingle. Such programs rely on nutrition and fitness education programs delivered in schools.

Hingle said new age-appropriate and teen-targeted approaches are needed, and the widespread use

of smartphones among teens offers an ideal way to encourage them to adopt healthy habits.

High school students consume an average of 1.2 fruit and vegetable servings per day, which is far below the recommended five servings, according to the U.S. Centers for Disease Control and Prevention. Research also suggests that teens receive an average of 3,417 text messages a month, or 114 tests per day, a journal news release pointed out.

Berries May Cut Heart Attack Risk in Women, Study Says

ating three or more servings of blueberries and strawberries each week may help reduce a woman's risk of heart attack, a large new study suggests. The study included nearly 94,000 young and middle-aged women who took part in the Nurses' Health Study II. The women completed questionnaires about their diet every four years for 18 years.

During the study period, 405 participants had heart attacks. Women who ate the most blueberries and strawberries were 32 percent less likely to have a heart attack, compared to women who ate berries once a month or less. This held true even among women who ate a diet rich in other fruits and vegetables. This benefit was independent of other heart risk factors such as advancing age, high blood pressure, family history of heart attack, body mass index, exercise, smoking, and caffeine and alcohol intake. The findings appear online Jan. 14 in the journal Circulation.

The study can't say specifically what about the berries seemed to result in a lower risk of heart attack among these women, or that there was a direct cause-andeffect link between eating the berries and lowered heart attack risk. But blueberries and strawberries contain high levels of compounds that may help widen arteries, which counters plaque buildup, the researchers

"Berries were the most commonly consumed sources of these substances in the U.S. diet, and they are one of the best sources of these powerful bioactive compounds," said study lead author Aedin Cassidy. "These substances, called anthocyanins -- a flavonoid -- are naturally present in red- and bluecolored fruits and vegetables, so they are also found in high amounts in cherries, grapes, eggplant, black currants, plums and other berries."

perspective because these fruits can be readily incorporated into the habitual diet," the study concluded. Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City, noted that this was a "huge study that followed women for a long period of time. Women who ate three or more servings of strawberries and blueberries per week decreased their heart attack risk by one-third. This is pretty compelling." Steinbaum's advice to both women and men is to include berries in their diet, and make them part of their daily fruit and vegetable fill.

Men are likely to benefit from eating berries as well, although this study included only women, said Cassidy, who is head of the department of nutrition at Norwich Medical School at the University of East Anglia, in England. Although more research is needed to confirm these benefits, "these data are important from a public health

The study was funded by the U.S. National Institutes of Health and the U.K. Biotechnology and Biological Sciences Research Council.

said. Heart attacks can occur when plaque blocks blood flow to the heart.

One serving of blueberries or strawberries equals about one cup. Dana Greene, a nutritionist in Boston, regularly tells her patients to consume more fruits and vegetables, including berries. "They are so good for you," Greene said. Besides flavonoids, berries also are loaded with other nutrients, including vitamin C, potassium and folate. "I tell all patients to make sure that half of their plate is filled with fruits and vegetables, especially richly colored ones like blueberries and strawberries," Greene said. "Berries can also help people lose weight and maintain that loss because they feel fuller faster. There is no downside."


JANUARY ISSUE • 2013 15

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Mitch Feldman, CEO of West Boca Medical Center By Deborah Lynn

aving been with Tenet Healthcare for over 23 years and as the current CEO of West Boca Medical Center, Mitch Feldman seems to have done it all. I was fortunate enough to sit down with Mr. Feldman to talk about his tenure and to get his view on a few topics that are in the forefront.

During his 23 years of service, Mr. Feldman has served as VicePresident of Tenet Florida and was the CEO of Delray Medical Center prior to accepting his position at West Boca Medical Center in 2008.

Having never met Mr. Feldman before, I was pleasantly surprised as he was laid back, easy-going and quite engaging. All of those components add up to an open and interesting discussion of which I have touched on a few topics below. Can you tell me some of the achievements that West Boca Medical Center has garnered?

West Boca Medical Center has achieved many distinguished accolades, including being in the top 5% in the country for their maternity services for the past seven years.

According to Mr. Feldman, “We have a very strong maternity unit. As you look inside, you will find that our staff of physicians, obstetricians and sub-specialists are very tenured. They work well together as a team and there is a considerable amount of trust and everyone is treated promptly. High responsiveness, mutual respect and admiration lead to good outcomes. We have an OB service that is supported by obstetric sub-specialties, such as having four prenatal and neonatal specialists on-site to help in the delivery of a high risk baby. We also have 24-hour MD anesthesia coverage. It’s the physician’s responsibility which distinguishes us from other hospitals that may not have inhouse coverage around-the-clock and by having the physician onsite, any issue can be addressed. In the event that something does go wrong, having the highest level of expertise available to our patients lends itself to the potential for mitigating any issues and allows for a great experience for the patient.

The spirit of West Boca Medical Center is a smaller hospital and it’s relatively easy for our physicians to get things completed in terms of responsiveness in dealing with their patients and families. Our staff is incredibly friendly and they try to get things done right the first time. That is a very positive thing.

We have an outstanding staff in

our Emergency Room (ER) department. Again, they are a tenured physician group that has been here a while, a tenured nursing staff as they work together as a team and we have specialists in our ER including a separate pediatric ER and a separate adult ER. The pediatric ER is staffed by pediatric ER doctors and the adults are staffed by Emergency Medicine (EM) Specialists.”

to expand the population base into prepaid medicine with quality goals to be associated with it.

“I like our hospitalist program and am very pleased with ours as it has evolved well over the years and is more service oriented than the earlier renditions of the hospitalists programs. It also lends itself, I think, as time has marched on to a better caliber, more dedicated, career-oriented hospitalist type physicians than an earlier generation of burned out physicians looking for a different mode of practice.”

Historically, most medical care is provided on a fee for service or an as needed basis, so the incentives in each financial setting for more care or in a capitated setting perhaps less care, but the doctors are trained to try and provide the right care. At that point, it depends on perspective. Should you be the one telling or should the doctor tell you that a loved one is not going to make it and give them more palliative care service or depending on you and your culture and your relationships to your loved one and since it’s not costing you one cent, you may say ‘doctor go for broke.’ These are issues that the government, through any paying mechanism, should not enter. But, there are different incentives on each of these mechanisms for addressing end of life issues.”

“Since 1973 with the Healthcare Maintenance Organization Act (HMO) Medicare has attempted, as a panacea for its own purposes, to put every government funded patient possible into an HMO setting. It hoped that the cost of providing care is more predictable not to say that it’s better or worse. I think the ACO’s are more of an elaborate form of advancement of that movement that has started

“According to our company analysists, the Affordable Care Act (ACA) is generally viewed favorably from the standpoint on the high level access to care should be improved. The more people that are insured, the more that they can be accessing main stream types of services from primary care physicians. Other conditions could be accessed through the specialist’s offices and other clinics as opposed to using the ER service as its

What are your thoughts on Hospitalist programs?

What are your thoughts on Accountable Care Organizations?

DEAR DEBORAH: I have a friend who is on one of those websites that promote extra-marital affairs. She’s in a relationship, but seems to have no problem taking money from the men she meets on the site, as that’s part of the arrangement. She hasn’t told her boyfriend about her extracurricular activities and he thinks they’re in an exclusive relationship. I have tried to push for her to tell him, but she doesn’t see the need. Should I tell him or just leave it alone? - To Tell or Not to Tell?

Dear To Tell or Not to Tell: It’s not your place to tell your girlfriend’s boyfriend how she earns her money or that she is not maintaining her exclusivity. Unless you are willing to lose her friendship, you need to keep quiet. The only thing that you can do is talk with her about protecting herself from catching any STD’s and passing them along to her boyfriend or anyone else. If her lifestyle bothers you, then you need to rethink your friendship. DEAR DEBORAH: I’m a 48 year-old man who has

Your thoughts on the Healthcare Reform Act?

never been married, by choice. The problem is that most of my friends are married and if they want to meet me out, they have to ask their wives. Since I have no one in my life, I do not have to consider anyone else prior to going anywhere. I can’t understand having to ask permission to go out to a sporting event, play sports, or even go to a bar to watch a game. My friends work hard all week and I feel they should be able to go out when they get the urge. As a woman, what are your thoughts on this? - Why Aren’t They Game?

Dear Why Aren’t They Game: I can certainly understand the need for male bonding. However, I am not sure that you are being fair to your male friends who chose a different path than you did. They chose to get married for love, companionship, loyalty, or perhaps they found their best friend in those partnerships. Each of your male friends knew that by getting married, things would change a bit and respecting their wife by asking if she minded if he went out to meet you would certainly be one

a broader way as part of the health system. Therefore, in many instances, you have to give up some of your autonomy, theoretically for the betterment of the goal.

Mitch Feldman.

primary care center. It’s an expensive setting, so there certainly are trade offs in providing the insurance for these patients to be handled in more of a routine setting where patients receive their care. In the 2,600 pages of regulatory components that are part of the ACA, that is a whole other story as to whether or not those things weigh down the system or provide higher quality of care of other bench marks.” Being the most tenured CEO out of all the Tenet Hospitals, tell me a little about your experience with West Boca Hospital.

“We have evolved from separate hospitals and free-standing to being part of a health system. That evolution continues as we speak and move forward. With that, the leadership of the hospital has more of a dual role as you have the advocacy at your own local facility, but you also now have to review your role in

Those are noteworthy goals and with the quality that I have seen over the years and with what the health system does, it helps us in many ways to give us the economies of scale and certain things in our market, such as our procurement of goods and supplies and makes us known as an employer of choice. It gives us the ability to centralize the use of certain consultants where in the past, we had more localized people at our facility to do that work and the economies of scale that go on with that and those are clearly some of the advantages. There are a lot of great things that are going on and for me, it’s important to keep those core strengths of the hospital intact while we realize that our population is getting a little older. While we have tremendous recognition in our market for women and children, babies and infants, we need to retool some of our adult services to recognize those demographic shifts of middle age and aging. We also need to develop new services to this changing demographic with affordability and quality.” West Boca Medical Center is located at 21644 State Road 7 in Boca Raton. For additional information, please call 561-488-8000.

Dear Deborah of those changes. You need to respect their union and not get upset if they cannot go out with you for one reason or another. If you are intent on remaining single, perhaps it would serve you better to find some other single male friends that do not have to ask someone else before meeting you out. Or, you can find a woman that will enjoy all of those activities with you. DEAR DEBORAH: I recently met someone at a political event. He is very nice and I believe he’s single, but I am not sure. I was hoping that since I gave him my business card he would have called me, but he has not. I would love to see him again in a more private setting, but since he has not contacted me, how do I go about pursuing him in a subtle way? - Subtlety is Not My Forte!

Dear Subtlety is Not My Forte: I would imagine half the population has been at an event at one time or another and met

someone whom they were interested in pursuing. Since that exact opportunity will never happen, you have a few options. If he gave you his business card, you can call or e-mail him and express interest in getting together. Or, you can call the event host and find out his contact information. A word of advice, the next time you meet someone that you want to get to know on a personal level, make your move then. When you hand someone your business card, simply say, “I would love to meet you for lunch or dinner in the next week or so.” Just show interest, it’s that simple. If he is interested, he will call or e-mail you. Remember, you rarely get a second chance in life and love – so when you have an opportunity – grab it!

Dear Deborah is a monthly advice column written by Deborah Lynn with a common sense approach to dating. If you have any questions or comments, please forward them to: questions@globalhealthtribune.com as we would love to help.


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2013 January edition