MAJESTIC STAG
Michael Sepe snapped this beautiful photo in a meadow at sunset on Aug. 21 in his hometown of Stony Brook
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Cinema Arts Centre to host open mic series beginning Oct. 12
The Cinema Arts Centre, 423 Park Avenue, Huntington, joins with the Folk Music Society of Huntington in presenting the NorthShore Original Open Mic (NOOM) three Wednesday nights each month, beginning October 12. The open mic series, to be held in the Cinema’s Sky Room, is set for 7 p.m. with open mic sign-up beginning at 6:30 p.m. Although it is free to attend, donations will be sought and gratefully accepted.
“It’s our pleasure to continue the ever-deepening partnership between the Cinema Arts Centre and two pillars of Long Island music scene – the Folk Music Society of Huntington and NorthShore Original Open Mic (NOOM),” said Dylan Skolnick, co-director of the Cinema Arts Centre.
“The Folk Music Society of Huntington’s monthly Hard Luck Café series has been a mainstay of our programming for many years, bringing some of the country’s best folk music performers to dedicated folk fans here in Huntington. With the introduction of a weekly open mic night we are delighted to offer even more opportunities for music lovers and artists to come together, as well as a space where seasoned performers can try out their newest original pieces and where up-and-coming musicians can get used to performing for a crowd,” Skolnick added.
“NOOM is thrilled to partner with the Folk Music Society of Huntington and the Cinema Arts Centre and lay the groundwork for a weekly opportunity for original songwriters and performers to present their original songs in a welcoming and relaxed atmosphere,” said Toby Tobias, a Huntington-based singer-songwriter who launched the open mic series at a small coffee shop in Northport in the fall of 2013.
One of the longest running weekly original open mics on Long Island, NOOM has reincarnated itself at quite a few North Shore locations through the years — most recently at Finley’s in Huntington. Although the COVID-19 pandemic precluded NOOM from taking place in-person since March 2020, songwriter Richard Parr has been livestreaming the open mic every week since then and will also be playing a major role when it resumes in-person.
“We invite singer-songwriters of varying skill levels and those who love live music, to gather at the Cinema Arts Centre to listen to songwriters, dedicated to the craft of writing and singing their songs, play and talk about their original music in an environment of goodwill and open-mindedness,” said Tobias. He noted that each NOOM will also include a featured 20-minute performance by a known/emerging local or touring songwriter starting at around 8 p.m. “I am very excited to be a part of this,” he said.
Michael Kornfeld, longtime president of the Folk Music Society of Huntington, shares their excitement. “FMSH is delighted to extend its partnerships with both NOOM and the Cinema Arts Centre and to help provide opportunities for local singer-songwriters to share their music with our community,” he said. “NOOM has been an Acoustic Ally of FMSH for a number of years. We’ve cross-promoted each other’s events and presented a couple of joint livestreams over the past two years.”
Affording local artists opportunities to share their talents with appreciative audiences in an intimate listening room atmosphere was the initial impetus behind the nonprofit presenting organization’s Hard Luck Café concert series many years ago, Kornfeld noted. That series now features a mix of local, regional and national touring artists. The Cinema Arts Centre has partnered with the Folk Music Society of Huntington and hosted the monthly Hard Luck Café concerts in its Sky Room for more than a decade. That series resumes on October 19 with featured act No Fuss and Feathers and will take place on the third Wednesday of each month, from 7-9:30/10 p.m. An open mic also precedes most Hard Luck Café concerts.
Upcoming dates include:
October 12, 26
November 2, 9, 30
December 7, 14, 28
Sign up here.
For more information, visit www.cinemaartscentre.org.
Attorney At Law: Does Medicare cover skilled nursing care?
By Nancy Burner, Esq.
Skilled nursing care is a high level of care that can only be provided by trained and licensed professionals, such as registered nurses, licensed professional nurses, medical directors, and physical, occupational, and speech therapists.
Skilled care is short-term and helps people get back on their feet after injury or illness. Skilled nursing facilities are residential centers that provide nursing and rehabilitative services to patients on a short-term or long-term basis. Examples of the services provided at a skilled nursing facility include wound care, medication administration, physical and occupational therapy, and pulmonary rehabilitation.
Generally, patients who are admitted to skilled nursing facilities are recovering from surgery, injury, or acute illness, but a skilled nursing environment may also be appropriate for individuals suffering from chronic conditions that require constant medical supervision. If you or a loved one is interested in using Medicare for skilled nursing, though, there are specific admission requirements set by the federal government:
• The individual has Medicare Part A (hospital insurance) with a valid benefit period. The benefit period will start from the date of admission to a hospital or skilled nursing facility and last for up to 60 days after the end of the stay.
• The individual has a qualifying hospital stay. This generally means at least three in- patient days in a hospital.
• The doctor has recommended skilled nursing care for the individual on a daily basis. The care must be provided by skilled nurses and therapists or under their supervision and should be related to the condition that was attended to during the qualifying hospital stay.
• The individual is admitted to a skilled nursing facility that is certified by Medicare. A skilled nursing facility must meet strict criteria to maintain its Medicare certification.
Usually, the skilled nursing care services covered by Medicare include the room charges, provided that it is a semi-private or shared room, meals at the facility, and any nutritional counseling, as well as costs of medication, medical supplies, medical social services, and ambulance transportation. It also covers rehabilitative services that are required to recover from the condition, such as physical therapy, respiratory therapy, and speech therapy.
Medicare generally offers coverage for up to 100 days of treatment in a skilled nursing facility. Note that if the patient refuses the daily skilled care or therapy as recommended by the doctor, then the coverage by Medicare may be denied for the rest of the stay at the skilled nursing facility. Many patients are advised that they will not get the full 100 days of Medicare benefits because they had reached a “plateau” or that they failed to improve. This is known as the Improvement Standard and was a “rule of thumb” used to evaluate Medicare patients.
Applying the Improvement Standard resulted in the denial of much needed skilled care for thousands of Medicare patients. The denials were based on a finding that there was no likelihood of improvement in the patient’s condition. This standard ignored the fact that the patients needed skilled care in order to maintain their current state of health and to prevent them from deteriorating. More often than not, if the patient was not improving, Medicare coverage was denied. While this standard was widely used, it was inconsistent with Medicare law and regulations.
A court case brought by Medicare beneficiaries and national organizations against the Secretary of Health and Human Services (Jimmo v Sebelius) sought to change this. The plaintiffs argued that even though the term “plateau” does not appear in the Medicare regulations, it is this term that is often used and relied upon to deny coverage. The appropriate standard should be: will the covered services “maintain the current condition or prevent or slow further deterioration,” not whether the individual was showing signs improvement.
As a result of this litigation and the settlement on Jan. 24, 2013, patients should be able to continue receiving services provided by Medicare, even where improvement in the patient’s condition cannot be documented. However, the old standard continues to be used. Patients and their advocates should educate themselves on the correct standard to make sure coverage is not cut prematurely.
Nancy Burner, Esq. is the founder and managing partner at Burner Law Group, P.C with offices located in East Setauket, Westhampton Beach, New York City and East Hampton.
Emma Clark Library to hold Pet food drive through October 31
As part of “The Great Give Back” through Suffolk County libraries, Emma Clark Library, 120 Main St., Setauket will hold a Pet Food Drive through the month of October. They will be accepting new pet supplies (food, blankets, leashes, etc) in the Library lobby. All are welcome to donate (residents or non-residents) during Library hours. Library teen volunteers will then drop off the donated items at various locations. Questions? Call 631-941-4080.
Medical Compass: Eczema impacts are not only skin deep
Treatments are continually evolving
By David Dunaief, M.D.
The causes of eczema are unknown, but it is thought that nature and nurture are both at play (1). Essentially, it is a chronic inflammatory process that involves symptoms of rashes, itching, pain and redness (2).
It’s estimated that over seven percent of the U.S. adult population suffers from eczema (3), with twice as many females as males affected (4).
While there is no cure, there are treatments its symptoms. These range from over-the-counter creams and lotions to prescription steroid creams to oral steroids and injectable biologics. Antihistamines can also be used to treat itchiness. Some use phototherapy for severe cases, but research on its effectiveness is scant. Interestingly, lifestyle, specifically diet, may play an important role.
Two separate studies have shown an association between eczema and fracture risk, which we will investigate further.
Let’s look at the evidence.
Does diet play a role?
In a Japanese study involving over 700 pregnant women and their offspring, results showed that when the women ate either a diet high in green and yellow vegetables, beta carotene or citrus fruit there was a significant reduction in the risk of the child having eczema of 59 percent, 48 percent and 47 percent, respectively, when comparing highest to lowest consumption quartiles (5).
Elimination diets may also play a role. One study’s results showed when eggs were removed from the diet in those who were allergic, according to IgE testing, eczema improved significantly (6).
From an anecdotal perspective, I have seen very good results when treating patients who have eczema with dietary changes. My patient population includes about 15 to 20 percent of patients who suffer some level of eczema. For example, a young adult had eczema mostly on the extremities. When I first met the patient, these were angry, excoriated, erythematous and scratched lesions. However, after several months of a vegetable-rich diet, the patient’s skin significantly improved.
What about supplements?
There are two well-known supplements for helping to reduce inflammation, evening primrose oil and borage oil. Are these supplements a good replacement for – or addition to – medications? The research is really mixed, leaning toward ineffective – and with some important concerns.
In a meta-analysis of seven randomized controlled trials, evening primrose oil was no better than placebo in treating eczema (7). The researchers also looked at eight studies of borage oil and found there was no difference from placebo in terms of symptom relief. While these supplements only had minor side effects in the study, they can interact with other medications. For example, evening primrose oil in combination with aspirin can cause clotting problems (8).
The upshot? Don’t expect supplements to provide significant help. If you do try them, be sure to consult with your physician first.
Biologics
Injectable biologics are among the newest treatments and are generally recommended when other treatment options have failed (9). There are two currently approved by the FDA, dupilumab and tralokinumab-ldrm, with the latter recently approved in December 2021.
In trials, these injectable drugs showed good results, improving outcomes for moderate to severe eczema sufferers when topical steroids alone were not effective. Like any drug therapy, it does have side effects.
Deeper impacts of eczema
Eczema may be related to broken bones, according to several studies. For example, one observational study of 34,500 patients showed that those with eczema had a 44 percent increased risk of injury causing limitation and an even more disturbing 67 percent risk of bone fracture and bone or joint injury for those 30 years and older (10).
And if you have both fatigue or insomnia and eczema, you are at higher risk for bone or joint injury than having one or the other alone. The researchers postulated that the use of corticosteroids in treatment could be one reason for increased fracture risk, in addition to chronic inflammation, which may also contribute to the risk of bone loss.
Steroids may weaken bone, ligaments and tendons and may cause osteoporosis by decreasing bone mineral density.
A recently published study of over 500,000 patients tested this theory and found that the association between major osteoporotic fractures and atopic eczema remained, even after adjusting for a range of histories with oral corticosteroids (11). Also, fracture rates were higher in those with severe atopic eczema.
For those who have eczema, it may be wise to have a DEXA (bone) scan.
Eczema exists on a spectrum from annoying to significantly affecting a patient’s quality of life (12). Supplements may not be the solution, at least not borage oil or evening primrose oil. However, there may be promising medications for the hard to treat. It might be best to avoid long-term systemic steroid use, because of the long-term side effects. Lifestyle modifications appear to be very effective, at least at the anecdotal level.
References:
(1) Acta Derm Venereol (Stockh) 1985;117 (Suppl.):1-59. (2) uptodate.com. (3) J Inv Dermatol. 2017;137(1):26-30. (4) BMC Dermatol. 2013;13(14). (5) Allergy. 2010 Jun 1;65(6):758-765. (6) J Am Acad Dermatol. 2004;50(3):391-404. (7) Cochrane Database Syst Rev. 2013;4:CD004416. (8) mayoclinic.org (9) Medscape.com. (9) JAMA Dermatol. 2015;151(1):33-41. (10) J Allergy Clin Immunol Pract. 2021 Sep 24;S2213-2198(21)01018-7. (11) nationaleczema.org. (12) Contact Dermatitis 2008; 59:43-47.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.
Beo String Quartet ‘popped up’ at the Atelier at Flowerfield Sept. 24
On September 24 the Atelier at Flowerfield hosted a “Pop Up” concert featuring the Beo String Quartet. The quartet was presented by the Three Village Chamber Players.
By crafting original music and projects, engaging listeners through entertainment and thoughtful demonstration, collaborating with living composers, performing quartet masterpieces in a wide array of settings, and exploring technology’s capacity as a musical and social tool, Beo is expanding the role of chamber musicians in today’s global culture. Now in its seventh season, Beo has performed over 100 concert works in the US and Europe–including over 45 world premieres.
Music education outreach is essential to the quartet’s vision. Beo has earned a reputation for its thoughtfully-crafted educational shows. Although disguised as entertainment, each show is designed to teach real chamber music skills and a love for classical music to students ranging from complete beginners to pre-professionals. Through its educational tours of elementary, middle, and high schools, short-term residencies at colleges and universities, and its annual residency at Dakota Chamber Music, Beo has shared these unique, engaging experiences with more than 3,500 students to date.
The mission of The Atelier at Flowerfield is to stimulate and enhance appreciation of the arts on Long Island and the greater NY metro area. To learn more about The Atelier at Flowerfield, go to https://theatelieratflowerfield.org or call 631-250-9009.
PSEG LI monitoring the remnants of Hurricane Ian
PSEG Long Island is monitoring the remnants of Hurricane Ian that may impact the service area Saturday through Monday and is following its pre-storm processes to handle any outages that may occur.
The weather front is expected to bring showers during the weekend, followed by wind gusts up to 45 mph, enough to possibly topple trees and bring down branches on wires.
“PSEG Long Island has been carefully tracking the remnants of Ian, and we encourage our customers to prepare,” said Mike Sullivan, vice president of Transmission and Distribution at PSEG Long Island. “As we watch the forecast, we have performed system and logistic checks, and have a full complement of personnel who can jump into storm mode if needed. In the event of any outages, our crews will work to safely restore service as quickly as conditions will allow.”
COVID-19-related storm processes remain in place to ensure the health and safety of employees and the public. To that end, PSEF LI asks that customers remain in their homes when crews are working nearby. If customers must speak with the crews, please practice responsible “physical distancing” and remain at least 6 feet away. For more information about how PSEG Long Island continues to live up to its commitment to safety during the pandemic, please visit www.psegliny.com/covid19.
Customers are asked to note the important storm safety tips below and to visit https://www.psegliny.com/safetyandreliability/stormsafety for additional storm preparation information.
Customer Safety:
- Downed wires should always be considered “live.” Please stay away from them, and do not drive over or stand near them. It is best to maintain a distance of at least 30 feet from a downed power line. To report a downed wire, call PSEG Long Island’s 24-hour Electric Service number at 800-490-0075 or call 911.
- Electric current passes easily through water. If you encounter a pool of standing water, stop, back up and choose another path.
- Never use a generator, pressure washer, or any gasoline-powered engine inside your home, basement, or garage or less than 20 feet from any window, door, or vent. Use an extension cord that is more than 20 feet long to keep the generator at a safe distance.
Stay connected:
- Download the PSEG Long Island mobile app to report outages and receive information on restoration times, crew locations and more.
- Report an outage and receive status updates by texting OUT to PSEGLI (773454). You can also report your outage through our app, our website at www.psegliny.com/outages or with your voice using the Amazon Alexa or Google Assistant app on your smartphone.
- To report an outage or downed wire, call PSEG Long Island’s 24-hour Electric Service number at 800-490-0075.
- Follow PSEG Long Island on Facebook and Twitter to report an outage and for updates before, during and after the storm.
- Visit PSEG Long Island’s MyPower map for the latest in outage info, restoration times and crew locations across Long Island and the Rockaways at https://mypowermap.psegliny.com/.
WMHO unveils restored and upgraded sensory garden in Stony Brook Village
Project at Stony Brook Mill Pond Park supported by PSEG Long Island
The Ward Melville Heritage Organization (WMHO) has announced that the newly restored Sensory Garden at the T. Bayles Minuse Mill Pond Park has officially been planted, thanks to a sponsorship of $3,500 from PSEG Long Island. An official unveiling was held on Sept. 23.
The Sensory Garden was originally created as a place where those who are sensory-impaired could enhance their independence and interact with nature in a special way, over ten years ago. David Seyfert, a Stony Brook resident, visual teacher and mobility instructor assisted in the selection of plants and suggested wind chimes to ensure all visitors could enjoy the park.
Among the many plants incorporated into the sensory garden are lambs ear and wooly thyme for its texture; lavender, hydrangea and dogwood for its smell; and pink muhly grass, Japanese maple and a collection of hen and chicks for sound.
“Originally, the sensory garden began small — a residential visually impaired woman would come here to smell the flowers, listen to the birds, and sit in peace. Over the years, especially the last few during the pandemic, this park and garden have given that same peace of mind to all of its visitors,” said Dr. Richard Rugen, Chairman of the WMHO.
“Thanks to PSEG-LI and the PSEG Foundation, our newly enhanced Sensory Garden can continue to be a place where everyone come to relax, enjoy and find peace. Tropical Storm Isaias caused incredible damage throughout the park in August of 2020. The first phase of restoration was completed in October of 2021. This marks the completion of phase two of the park’s restoration,” said Rugen.
To learn more about the WMHO, visit www.wmho.org or call 631-751-2244.
BNL’s John Clarke uses music to deliver medical messages
By Daniel Dunaief
Live from Upton, New York, it’s … Dr. John Clarke.
While the arrival of the new Occupational Medicine Director and Chief Medical Officer at Brookhaven National Laboratory doesn’t involve late-night comedy, or a live studio audience, it does bring a medical doctor with a passion for bringing his rap and musical skills to a health care audience.
Formerly the director of occupational medicine at Cornell University, Dr. Clarke joined the Department of Energy lab as Occupational Medicine Director and Chief Medical Officer for BNL in June..
“My role is to help maintain safety and wellness among the workers,” said Dr. Clarke. “If we have employees who start coming in for some sort of complaint and we see a pattern, that may help us identify who could be at risk of something we didn’t know about that we are detecting.”
A doctor who served as chief resident at New York Medical College in family residency and Harvard University in occupational & environmental medicine, Dr. Clarke said he plans to support a range of preventive efforts.
“I’m excited about the potential to engage in what’s considered primary prevention,” said Clarke, which he defined as preventing a disease from occurring in the first place.
Through primary prevention, he hopes to help the staff avoid developing chronic illnesses such as cancer, while also ensuring the health and responsiveness of their immune systems.
Through physical fitness, a plant-based diet including fruits and vegetables, adequate sleep and hydration with water, people can use lifestyle choices and habits to reduce their need for various medications and enable them to harness the ability of their immune systems to mount an effective response against any threat.
“Modifying your lifestyle is the therapy,” he said. “If you engage [in those activities] in the right way, that is the treatment.”
Dr. Clarke added that the severity and stage of a disease may impact the effectiveness of such efforts. For any vaccine and for the body’s natural immunity to work, people need a healthy immune system.
When Dr. Clarke practiced family medicine, he saw how patients lost weight through a diet that reduced the need for medication for diabetes and high blood pressure.
“Losing weight and staying active does provide a therapeutic impact, where you could be medication free,” he said.
To be sure, living a healthier lifestyle requires ongoing effort to maintain. After reaching a desired weight or cholesterol level, people can backslide into an unhealthier state or condition, triggering the occurrence or recurrence of a disease.
In the vast majority of cases, Clarke said, “you have to make a permanent lifestyle change” to avoid the need for pharmaceutical remedies that reduce the worst effects of disease.
BNL has an exercise physiologist on staff who “we hope to engage in consultations with employees,” said Clarke. He would like the exercise physiologist to go to the gym with staff to show them how to use equipment properly to get the maximum benefit.
BNL already has some classes and various initiatives that promote wellness. “One of the things we’d like to do is coordinate and try to publicize it enough where employees are aware” of the options available at the lab to live a healthier and balanced life, he added.
BNL also has a dietician on staff. Dr. Clarke has not worked with the dietician yet, but hopes it will be part of an upcoming initiative. As he and his staff respond to the demand, they will consider bringing on other consultants and experts to develop programs.
Covid concerns
Like others in his position in other large employers around Long Island, Dr. Clarke is focused on protecting workers from any ongoing threat from Covid-19.
“We’re still learning more as [SARS-CoV2, the virus that caused the pandemic] evolves,” he said. BNL does a “great job about monitoring the prevalence and the numbers of cases in Suffolk County and among workers.”
Dr. Clarke said he and others at BNL are following the Department of Energy, New York State and Centers for Disease Control and Prevention guidance on these issues.
If the numbers of infections and hospitalizations increase in the coming months, as people move to more indoor activities, BNL may consider deploying a strategy where the lab provides more opportunities for staff to work remotely.
Prior to his arrival at BNL, Dr. Clarke worked as a consultant for a company that was looking to create numerous permanent jobs that were remote.
He suggested that workers need to remain aware of their remote surroundings and shouldn’t work near a furnace or any heater that might release dangerous gases like carbon monoxide.
Additionally, people should avoid working in areas that aren’t habitable, such as in an attic. Dr. Clarke urges people to notify and consult their employer if they have concerns about working safely at home or on site.
Music vs. medicine
A native of Queens who spent three years of his childhood in Barbados, Dr. Clarke attended Columbia University, where he majored in sociology and music while he was on a pre-med track.
While he was an undergraduate, Dr. Clarke wrote, produced and performed original music. An independent label was going to help secure a major label deal.
He chose to attend medical school at Icahn School of Medicine at Mount Sinai.
Dr. Clarke has championed a program he calls “health hop,” in which he has used rap to reach various audiences with medical care messages. In 2009, he won a flu prevention video contest sponsored by the Department of Health and Human Services for an “H1N1 rap.”
Train commuters may also recognize him from his work for the Long Island Railroad, for which he created a “gap rap.” The public service announcement was designed to protect children from falling into or tripping over the gap between the train and the platform.
Dr. Clarke has produced music for numerous genres, including for a children’s album and a Christian album.
As for life outside BNL, Dr. Clarke is married to Elizabeth Clarke, who is a nurse practitioner and is in the doctorate of nursing practice and clinical leadership program at Duke University.
When he’s not spending time with his wife or their children, he enjoys home projects like flooring and tiling.
Dr. Clarke is pleased to be working at the national Department of Energy lab.“BNL is a great place, because the science and the work they do has an impact,” he said.
Shelter Pet of the Week: Gina
MEET GINA!
This week’s shelter pet is Gina, a brown tabby cat who arrived at the Smithtown Animal Shelter in late August after being abandoned outside a local grocery store.
Gina was a little shell shocked initially, but as she learns to trust, she is becoming a sweet little lady. She is approximately two years old and has no medical issues. She would do best in a quiet home.
If you would like to meet Gina, please call ahead to schedule an hour to properly interact with her in a domestic setting.
The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. Visitor hours are currently Monday to Saturday from 10 a.m. to 3 p.m. (Sundays and Wednesday evenings by appointment only). For more information, call 631-360-7575 or visit www.townofsmithtownanimalshelter.com.
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