Dear Parish Nurses: While I usually feature research in my updates, today I'll break with that and include an interesting book I just finished. I spent the morning condensing the "what you can do" chapters and will make that available to you at your request. This book was suggested by Theresa Brown, in the December, 2017, AJN. There was also some research worth noting,though.
1. Rosenthal, E. (2017). An American sickness: How health care became big business and how you can take it back. New York, NY: Penguin Press. Dr. Rosenthal writes a compelling book not only for healthcare providers to read but also the general public. She begins by reviewing the modern history of the healthcare delivery system in the United States. Subsequent chapters outline the healthcare system in place now and how we arrived at a healthcare delivery system where profits take priority over patient care. The concluding chapters give specific suggestions on how healthcare professionals and consumers can "take back" the system.
This is a book you won't be able to put down and you will keep saying "this is outrageous, how did we allow this to happen"! Send me an e-mail if you want the summary I put together: email@example.com.
2. Musiek, E.S., et al. (2018). Circadian rest-activity pattern changes in aging and preclinical Alzheimer's Disease. JAMA Neurology. doi:10.101/jamaneurol.2017.4619. The authors collected data about rest and activity levels from 189 people (average age, 66 years) who wore watch-like sensosrs for 7 to 14 days. These participants also kept a sleep diary, had either positron emission tomography brain scans, cerebrospinal fluid analysis, or both to look for any biological signs of Alzheimer's, including abnormal levels of the proteins amyloid and tau. "The research found that cognitively normal participants who had biological changes related to Alzheimer's were more likely that thoes without these changes to have fragmented sleep-wake cycles, with higher-than-normal periods of rest during the day and more periods of activity at night. Of the participants, 139 showed no evidence of Alzheimer's, but 50 had abnormal amyloid plaques seen on PET scans or other signs of the disease." Increasing age also was associated with circadian dysfunction, particularly in men, but, however, after adjusting for age and gender, the researchers concluded that aging and preclinical Alzaheimer's disease pathology have separate negative effects on circadian rhythm. Given that Alzheimer's disease starts years before symptoms appear, these differences in the sleep-wake cycle could merit further study as an early indicator of disease.
We are always looking for ways to predict the onset of a disease like Alzheimer's. This is just one component in the process.
3. Morris, M. C., et al. (2017) Nutrients and bioactives in green leafy begetables and cognitive decline. Neurology, 90:e214-e222. In a study with 960 older adults rerolled in the Rush Memory and Aging Project, the researchers focused on the level of consumption of green leafy vegetables, like spinach, kale, collards, and lettuce. Data was gathered from food frequencies questionnaires administered at the beginning of the study on how frequently people ate some 144 items over the previous 12 months. Results indicate that the consumption of green leafy vegetables was positively and significaltly associated with slower cognitive decline. The researchers concluded that these results may be pssibly due to the neuroprotective actions of specific nutrients.
So, I hope you have your summer garden planted with leafy green veggies - mine is!
4. Dutton, D. J., et al. (2018) Money spent on social services improves health outcomes. CMAJ, 190(3), e66-e71. These Canadian researchers conducted a retrospective, longitudinal study of spending in nine Canadian provinces during a 31 years period. They calculated the ratio of provincial governmental spending on social services to healthe care spending in each province and year. The three measures of health outcomes were potentially avoidable mortality, infant mortality, and life expectancy at birth. Data indicated that a one-cent increase in social spending per dollar spent in health was associated with a 0.1% decrease in potentially avoidable mortality and a 0.01% increase in life expectancy; increase in health care spending did not have similar associations. These findings, the researchers concluded, suggested that spending on health care may not be as effective as spending on social services. Social spending changes the risk of distribution for the entire population, whereas health care spending only applies to those who present with the disease. Redirect health care to social services may be an efficient way to imporve health outcomes.
So how do we get out govenment to look at this research? Increasing social spending by just a little can have important results.
4. There was an interesting article in NIH News in Health, January, 2018: "Sound Health, Music gets You Moving and More". Dr. Robert Finkelstein, who co-leads NIH's music and health initiative suggests that when you listen to or create music, it affects how you think, feel, move, and more. Ways music can impact health include: (1) facilitating movement which can help those with movement disorders like Parkinson's disease to walk and dance; (2) playing a musical instrument engages many parts of the brain at once and can benefit children and teens, whose brains are still developing; (3) listening to and making music on your own can bring health benefits like helping people regain abilities they have lost from a brain injury. Dr. Nina Kraus, a neuroscientist at Northwestern University suggests that "to see most health benefits, try to include music as a regular, consistent part of your life. It's never too late to add music to your life."
Start back on those piano lessons! If you are interested in receiving this newsletter, go to newsinhealth.nih.gov. It is free.
Summer - a time to focus on self-care. Get busy.
Andrea West, FCN