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A PRAAT dog serves as a reading assistant at a local library. Photo from Dr. David Roy Hensen and Dr. Pamela Linden

By Lisa Steuer

It is quite obvious that people love their pets. In fact, 62 percent of U.S. households contain a pet, and about $45 billion is spent on pets annually, according to Pamela Linden LMSW, Ph.D., a clinical associate professor in the Occupational Therapy program at Stony Brook University.

But what many people may not realize is that these animals could be positively impacting the pet owner’s health, and that emerging research shows that therapy and comfort animals could have a place in therapeutic and trauma settings. Currently, a lot of the research on the health benefits of pet ownership has to do with the bond between the animal and its owner, Linden said.

“There’s a book by Meg Daley Olmert called ‘Made for Each Other’ and the whole book is about oxytocin — and that’s why we bond with others, including other mammals, like dogs,” said Linden. “A lot of it has to do with the gazing and the staring, so studies have been done, especially one interesting study that measured oxytocin levels in both the human and the dog after gazing— oxytocin levels raised for both of them,” resulting in good feelings not only for human, but for the dog, too.

Pella, of PRAAT, visits the children cancer ward at Stony Brook Hospital. Photo from Dr. David Roy Hensen and Dr. Pamela Linden
Pella, of PRAAT, visits the children cancer ward at Stony Brook Hospital. Photo from Dr. David Roy Hensen and Dr. Pamela Linden

Linden’s hope is that more people will be motivated to understand the role of pets in our lives. She developed the first social work internship with Patchogue Rotary Animal Assisted Therapy, a not-for-profit organization in Patchogue that screens, trains and supports human-dog teams that visit individuals in schools, hospitals and hospice facilities. Linden hopes to work with PRAAT to research the effect that comfort animals have on people who are already sick.

In addition, Linden is the faculty advisor for Stony Brook University’s first Animal Assisted Activity student club anticipated to begin in spring 2016. So far, more than 150 students have signed up for the club, which has goals to help provide education about animal -assisted therapy while partnering students with organizations like PRAAT and local shelters to help prepare dogs to become adoption-ready.

Linden pointed out that people often get confused between service animals, therapy dogs and comfort animals. Service dogs are protected by law, are allowed anywhere animals typically aren’t allowed and have been trained to perform special functions, like open doors, push buttons and retrieve objects for people with visual impairments, for instance. A comfort dog has been trained to visit hospitals, nursing homes and similar places to provide comfort to patients, and a therapy dog is an animal used by a licensed health professional to achieve a therapeutic outcome.

“I’ll give you an example [of a therapy dog],” said Linden. “As a social worker, I’m working with someone who is grieving. And they’re either too numb or too emotional to process the grief. I might bring in a dog with a therapeutic goal of bridging between the client and the therapist by doing those behaviors that we do— you can snuggle up to a dog, pet it, stare into the eyes and have your oxytocin kick in and relax.”

Physical, Psychological and Emotional Benefits

Although the research is limited, studies have demonstrated the healthy benefits of pet ownership and companionship. Linden shared the physical, psychological, and emotional benefits:

Hans, of PRAAT, provides comfort to students during college exams. Photo from Dr. David Roy Hensen and Dr. Pamela Linden
Hans, of PRAAT, provides comfort to students during college exams. Photo from Dr. David Roy Hensen and Dr. Pamela Linden

• Physical: Pet owners have fewer minor health complaints and have greater levels of exercises and physical fitness. Studies have found that pet owners had reductions in some common risk factors for cardiovascular disease, such as lower systolic blood pressures, plasma cholesterol and triglyceride values.

“People experience a decrease of blood pressure talking to pets. Blood pressure decreases for people with normal pressures and those with hypertension when watching fish in a standard aquarium,” said Linden.

• Psychological: Studies have found that pet owners enjoy better well-being than non-owners, and that pet owners have greater self-esteem and tend to be less lonely.

“People find comfort in talking to their animals. People walking with their dog experience more social contact and longer conversations than when walking alone — pets stimulate conversations between people,” Linden said. “Companion animals can help people to laugh and maintain a sense of humor.”

She added that Children with ADHD and defiant disorders exhibit significantly less antisocial and violent behavior than a matched group that did not involve animals.

• Emotional: Companion animals have been shown to alleviate anxiety. Stony Brook brings dogs in during exam time to help relax the undergraduate students.

“Any discussion regarding pets should include the notion of responsible pet ownership — ensuring that their physical, medical and emotional needs are met. This requires adequate financial resources and time to devote to caring for the pet,” added Linden.

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By Matthew Kearns, DVM

Flea allergic dermatitis was something that I used to only warn pet owners about in the summertime. However, with warm spells in the fall and winter, as well as the flea’s ability to set up shop in our homes, we really have a year-round problem.

Before we can address the problems fleas cause and how to treat/prevent them, we must understand the life cycle of the flea. The flea has four stages in its lifecycle: egg, larva, pupa, and adult.

An adult female flea can lay up to 2,000 eggs in a lifetime and eggs will usually hatch in one to six days. Once the eggs hatch, a slender, white, segmented flea larva forms; it looks similar to a maggot but, luckily, is too small to see with the naked eye. These larvae are not blood suckers, but rather feed on organic debris in the environment. The organic debris can be outside — leaves, dirt, etc. — or inside — carpet fibers and fibers from furniture or bedding.

After five to 11 days, the larvae will spin a whitish, loosely spun, silk-like cocoon, where they develop into pupae. The pupal stage, because of the outer cocoon, are very resistant to the environment and insecticides. The pupa is usually fully developed at seven to 14 days. However, the pupa can develop into an adult flea as quickly as a few days, or slowly, for many weeks, up to 180 days, depending on environmental conditions.

Once the adult flea emerges from the cocoon, it immediately starts looking for a host — our dogs and cats — for a blood meal. Fleas find hosts via various stimuli: body heat, movement, and exhaled carbon dioxide. Once a host is found, the flea feeds through a long, slender mouthpart called a proboscis. Before feeding, the flea pumps anticoagulant-containing saliva into the wound to prevent the blood from clotting. It is suspected that the anti-coagulant proteins in the saliva may be responsible for what is called Flea Allergic Dermatitis.

Luckily, fleas do not carry many parasites or organisms that cause significant disease in our pets. The most common parasite associated with fleas, in my experience, is tapeworm. This parasite is significant in younger pets but I will usually take tapeworms, seen on the fur, or in the stool, as a clue that there is an undiagnosed flea infestation in adult dogs and cats. More commonly, fleas lead to FAD.

Now, I understand that any dog or cat that has a flea infestation is going to be itchy. However, dogs or cats with FAD will break out with a rash that is much more severe from very few, or even a single, flea bites. More specifically, cut your pet in half — just kidding!

Actually, make an imaginary line dividing your pet into two halves: toward the head, and toward the tail. If the rash is primarily in the half of your pet towards his or her head, it is probably not FAD. If it is toward the tail, which would include the ventral (lower) abdomen, inguinal (groin), base of tail, and back legs, then one should put FAD at the top of the list.

Previously, we had to not only treat our pets with foul smelling, and even dangerous, shampoos, powders and dips, but also many times expose ourselves to noxious chemicals to treat the environment, like “flea bombs.” More recently, we found that although fleas need a host and will bite humans, they cannot live on us. More specifically, by treating our pets, we can treat the entire environment.

Nowadays, there is a large selection of flea preventatives that are much safer and treat the pet specifically. Some of the older products, and still best advertised, are now available over-the-counter. This is a double edged sword — the products are much safer and readily available without a prescription, but these products are ones in which I personally see significant failure and suspect resistance.

If you are seeing a specific rash that resembles FAD, even if you are using flea preventatives, see your veterinarian to not only get relief for your pet, but also to discuss alternative flea preventatives.

Dr. Kearns has been in practice for 16 years.

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Port Jefferson residents say taxes should cover cost of medical care

The ambulance company serves Port Jefferson, Belle Terre and Mount Sinai. File photo

A presentation about the service of the Port Jefferson Volunteer Ambulance Company devolved into an argument about perceived unfair billing practices on Monday night, with residents, village officials and the ambulance company’s deputy chief going back and forth for an hour.

A few villagers are in a lather over the process for recouping expenses after an ambulance ride through a billing program that began a handful of years ago. Faced with rising costs in the ambulance district — which also serves Belle Terre and Mount Sinai — Port Jefferson Village officials authorized the emergency medical organization to bill insurance companies for service within their jurisdiction, with the funds offsetting local ambulance taxes.

The friction that heated up Monday night’s Port Jefferson Village Board of Trustees meeting built around cases when an insurance company denied a claim or the patient had a hefty deductible — thus obligating the ambulance service and its third-party billing company to send a tab to that patient, according to PJVAC Deputy Chief Rob Stoessel.

Two residents who received such bills, Monica Williams and Mary Moore, expressed their dissatisfaction over the matter, saying the taxes they pay each year to the ambulance district should be enough and also complaining about the price tag.

“I’m paying my ambulance district tax,” Williams said. “I don’t really think that any village resident … should be looking at a bill like that. It’s surprising. It’s disappointing.”

She called it “being billed for the same thing twice.”

Before insurance, Stoessel said, the fee on a call for emergency medical care is $900, with an additional $18 for each mile the ambulance transports a patient.

“We went based on other agencies, other 911 services throughout the region,” he said about how the ambulance company arrived at that figure. “We went on what it cost us to provide the service,” including non-medical expenses like gasoline.

The deputy chief said the ambulance service and its billing company is required to make a “good faith attempt” to solicit deductibles from patients or whatever costs are associated with a trip that an insurance company denies coverage for.

According to comments from the residents, Williams was denied Medicare coverage for her treatment and Moore has a high deductible.

Mayor Margot Garant insisted it was not the board’s intention, when it authorized the ambulance company to bill insurance, to pass large bills along to residents.

“We didn’t want the resident to be pursued for any of the fees,” she said. But “the insurance companies, God bless them — collect every nickel from them.”

Although the mayor and Stoessel rejected responsibility, debating whether the billing was a village program or an ambulance program, they agreed that the idea was for patients to receive three notices for bills and there would be no consequences for not paying, as the ambulance company does not have a mechanism for collections.

But there was debate from the public about whether that was common knowledge in the village, or whether not paying would affect someone’s credit rating.

According to Garant, village officials are working out a method of waiving costs that would otherwise be passed along to patients — to limit the ambulance company to recouping costs only from insurance companies. She said that measure could be ready for approval by the next board meeting in two weeks.

Port Jefferson is not the only area with the idea of using insurance companies to offset taxpayer dollars. The Commack Volunteer Ambulance Corps argued recently that billing private insurance companies for patient care would ultimately save taxpayer dollars for constituents. At an August work session in Smithtown, Tom Lowenberg of the Commack VAC said insurance reimbursements are a resource utilized typically at private ambulance companies, but not as much by volunteer groups.

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By Lisa Steuer

In the 1990s, low-fat food products lined the shelves. Consumers believed that choosing a product with a low-fat label was essential for optimal health and fat loss. But today, experts say that a low-fat diet can be detrimental — as food that has the fat removed can instead be high in sugar and calories to make up for the lack of fat.

“The whole low-fat phase was problematic because people substituted refined carbohydrates, and that is a huge problem,” said Dr. Josephine Connolly-Schoonen, Ph.D., RD, the executive director of Stony Brook Medicine Nutrition Division and author of “Losing Weight Permanently with the Bull’s Eye Food Guide: Your Best Mix of Carbs, Proteins, and Fats.”

So with so many diets out there today, which work best for weight loss and health? Here is Connolly-Schoonen’s input.

Going Gluten Free
Gluten is a name for proteins found in wheat, and some common foods that contain gluten include pasta, bread, flour tortillas, oats, dressings, cereals, sauces and more. Go to any grocery store these days and you will most likely find a “gluten-free” section. And while people with Celiac disease cannot eat gluten because they will get sick, many people who aren’t allergic to gluten are touting the weight loss and health benefits of going gluten free.

But if you don’t have a gluten allergy, is it necessary or nutritionally wise to go gluten free?

“I think that many people are gluten intolerant and can benefit from a gluten-free diet,” said Connolly-Schoonen. “But, [it should be] a high-quality gluten-free diet — foods that never had gluten. So your starches are going to be from potato and rice and quinoa, not from gluten-free bread and gluten-free pasta.”

So while foods that are naturally gluten free are generally healthy, those who are not gluten-intolerant should be wary of processed foods that have had the gluten removed, as there now exists a big market and opportunity for companies wanting to take advantage of the gluten-free trend — and products such as “gluten-free cookies” may not necessarily be nutritionally sound.

“In my practice, I’ve seen many people benefit from gluten-free styles of eating, but using whole foods, not processed gluten-free food … A slice of gluten-free bread is rather small and has the same or perhaps a little bit more calories than regular bread,” said Connolly-Schoonen. “Foods that are naturally gluten-free are quite healthy and I really do think people may benefit from a gluten-free style of eating, but it has to be natural.”

The Paleo Diet and Going Vegan
The idea behind the paleo diet is that we should eat as our ancestors or “cavemen” ate, including meat, fish, vegetables and fruit, and excluding processed food, grains and dairy. And while many people have reportedly lost weight on the diet, some argue that the paleo diet does not necessarily follow what our ancestors ate, and there is now a market for processed paleo bars and drinks.

But Connolly-Schoonen says the concept of consuming fewer processed foods is a good one to follow, especially when it comes to sugar-laden beverages.

“With the advent of the high fructose corn syrup, it became so cheap to make sweetened beverages … that have the equivalent of 17, 19, 20 packets of sugar in them, and we genetically cannot handle that.”

In addition, some people choose to go vegan or vegetarian for a variety of reasons — moral, health or a combination. Both vegans and vegetarians do not eat meat, fish or poultry, while vegans also do not use other animal products and byproducts, such as eggs, honey, cosmetics, and more.

“I don’t think you need to be a vegetarian to be at your optimal health, but there is a lot of research over an extended period of time showing that vegetarians, more than vegans, who eat a high-quality vegetarian diet — so no Snickers bars — do quite well in terms of decreasing the risk for chronic illnesses like diabetes and heart disease, and there really is a lot of research behind the vegetarian diet to support that,” said Connolly-Schoonen. “Vegan diets could be healthy, but it’s much more challenging to make sure that you get all of your micronutrients.”

Juicing Up
Juicing is still considered healthy in moderation and as a quick way to get antioxidants. But when you use a juicer, the juice is extracted from fruits and vegetables, leaving behind a pulp that is often thrown away. In addition, this strips the fruit of its fiber but leaves the sugar.

“Even if you’re juicing vegetables, you’re still getting the sugar … and making the sugar much more highly available,” said Connolly-Schoonen. “And most people are more satiated when they chew their food.”

In addition, many people subscribe to the idea of doing juicing “detoxes” or “cleanses” every so often — which have found to be not really necessary, as we already have a natural detoxification system that occurs in our livers. In addition, any sort of diet that deprives one of nutrients is never a great idea. Instead, work on supporting your body’s natural ability to detox.

“If you have an unhealthy gut environment, you’re taxing your liver’s detoxification system. So first you want to have a healthy gut environment, which means lots of fiber and a good source of probiotics,” said Connolly-Schoonen. “Then you need to support your liver’s detoxification system with a wide array of micronutrients, which is going to come from a wide array of whole foods like protein, fish, lean meats, beans and then your vegetables, fruits and nuts.”

The Bottom Line
Instead of following a super strict diet, you may want to simply remember Connolly-Schoonen’s “two key factors” for healthy nutrition: quality and quantity. In terms of quality, choose foods that are less processed — lean proteins like chicken and fish, a huge variety of vegetables, beans, nuts and olive oil for healthy fats.

Once one works on the quality of foods in his or her diet, “it’s been my experience that patients can then much more easily work on moderating the quantity,” she said. “Once you’re eating whole foods and you’re mixing your quality proteins and fats, it becomes much easier to manage your appetite.”

Does this mean you can never have dessert again? Not at all.

“I tell patients if you’re eating ice cream, it should be real ice cream made from whole milk fat and real sugar. You shouldn’t get artificially sweetened products,” she said. “When you want chocolate and you want ice cream, have the real stuff. And that you should be able to include in your diet, maybe not every day, maybe a few times a week — it all just depends on how active you are.”

Lisa Steuer is the managing editor of FitnessRx for Women and FitnessRx for Men magazines. For fitness tips, training videos and healthy recipes, visit www.fitnessrxformen.com and www.fitnessrxwomen.com.

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When we were younger, falls usually did not result in significant consequences. However, when we reach middle age and chronic diseases become more prevalent, falls become more substantial. And, unfortunately, falls are a serious concern for older patients, where consequences can be devastating. They can include brain injuries, hip fractures, a decrease in functional ability and a decline in physical and social activities.(1) Ultimately, falls can lead to loss of independence.(2)

Of those over the age of 65, between 30 and 40 percent will fall annually.(3) Most of the injuries that involve emergency room visits are due to falls in this older demographic.(4)

What can increase the risk of falls?

A multitude of factors contribute to fall risk. A personal history of falling in the recent past is the most prevalent. But there are many other significant factors, such as age; being female; and using drugs, like antihypertensive medications used to treat high blood pressure and psychotropic medications used to treat anxiety, depression and insomnia. Chronic diseases, including arthritis, as an umbrella term; a history of stroke; cognitive impairment and Parkinson’s disease can also contribute. Circumstances that predispose us to falls also involve weakness in upper and lower body strength, decreased vision, hearing disorders and psychological issues, such as anxiety and depression.(5)

How do we prevent falls?

Fortunately, there are ways to modify many risk factors and ultimately reduce the risk of falls. Of the utmost importance is exercise. But what do we mean by “exercise?” Exercises involving balance, strength, movement, flexibility and endurance, whether home-based or in groups, all play significant roles in fall prevention.(6) We will go into more detail below.

Many of us in the northeast suffer from low vitamin D, which strengthens muscle and bone. This is an easy fix with supplementation. Footwear also needs to be addressed. Non-slip shoes, if last winter is any indication, are of the utmost concern. Inexpensive changes in the home can also make a big difference.

Medications that exacerbate fall risk

There are a number of medications that may heighten fall risk. As I mentioned, psychotropic drugs top the list. Ironically, they also top the list of the best-selling drugs. But what other drugs might have an impact?

High blood pressure medications have recently been investigated. A recent propensity-matched sample study (a notch below an randomized control trial in terms of quality) showed an increase in fall risk in those who were taking high blood pressure medication.(7) Surprisingly, those who were on moderate doses of blood pressure medication had the greatest risk of serious injuries from falls, a 40 percent increase. One would have expected those on the highest levels of BP medication to have the greatest increase in risk, but this was not the case.

While blood pressure medications may contribute to fall risk, they have significant benefits in reducing the risks of cardiovascular disease and events. Thus, we need to weigh the risk-benefit ratio, specifically in older patients, before considering stopping a medication. When it comes to treating high blood pressure, lifestyle modifications may also play a significant role in treating this disease.(8)

Where does arthritis fit into this paradigm?

In those with arthritis, compared to those without, there is an approximately two-times increased risk of two or more falls and, additionally, a two-times increased risk of injury resulting from falls, according to the Center for Disease Control and Prevention.(1) This survey encompassed a significantly large demographic; arthritis was an umbrella term including those with osteoarthritis, rheumatoid arthritis, gout, lupus and fibromyalgia. Therefore, the amount of participants with arthritis was 40 percent. Of these, about 13 percent had one fall and, interestingly, 13 percent experienced two or more falls in the previous year. Unfortunately, almost 10 percent of the participants sustained an injury from a fall. Patients 45 and older were as likely to fall as those 65 and older.

Why is exercise critical?

All exercise has value. A meta-analysis of a group of 17 trials showed that exercise significantly reduced the risk of a fall (9). If their categories are broken down, exercise had a 37 percent reduction in falls that resulted in injury and a 30 percent reduction in those falls requiring medical attention. But even more impressive was a 61 percent reduction in fracture risk. Remember, the lower the fracture risk, the more likely you are to remain physically independent. Thus, the author summarized that exercise not only helps to prevent falls, but also fall injuries. The weakness of this study was that there was no consistency in design of the trials included in the meta-analysis. Nonetheless, the results were impressive.

What specific types of exercise are useful?

Many times, exercise is presented as a word that defines itself. In other words: just do any exercise and you will get results. But some exercises may be more valuable or have more research behind them. Tai chi, yoga and aquatic exercise have been shown to have benefits in preventing falls and injuries from falls.

A randomized controlled trial, the gold standard of studies, showed that those who did an aquatic exercise program had a significant improvement in the risk of falls (10). The aim of the aquatic exercise was to improve balance, strength and mobility. Results showed a reduction in the number of falls from a mean of 2.00 to a fraction of this level — a mean of 0.29. There was no change in the control group.

There was also a 44 percent decline in the number of patients who fell. This study’s duration was six months and involved 108 post-menopausal women with an average age of 58. This is a group that is more susceptible to bone and muscle weakness. Both groups were given equal amounts of vitamin D and calcium supplements. The good news is that many patients really like aquatic exercise.

Thus, our best line of defense against fall risk is prevention. Does this mean stopping medications? Not necessarily. But for those 65 and older, or for those who have “arthritis” and are at least 45 years old, it may mean reviewing your medication list with your doctor. Before considering changing your BP medications, review the risk-to-benefit ratio with your physician. The most productive way to prevent falls is through lifestyle modifications.

(1) MMWR. 2014; 63(17):379-83. (2) J Gerontol A Biol Sci Med Sci. 1998;53(2):M112. (3) J Gerontol. 1991;46(5):M16. (4) MMWR Morb Mortal Wkly Rep. 2003;52(42):1019. (5) JAMA. 1995;273(17):1348. (6) Cochrane Database Syst Rev. 2012;9:CD007146. (7) JAMA Intern Med. 2014 Apr;174(4):588-95. (8) JAMA Intern Med. 2014;174(4):577-87. (9) BMJ. 2013;347:f6234. (10) Menopause. 2013;20(10):1012-1019.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For more information, go to the website www.medicalcompassmd.com and/or consult your personal physician.

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New trustee uses policy committee role to suggest better student accommodations

Smithtown Trustee Jeremy Thode is one of the newest members of the school board. Photo by Victoria Espinoza

The Smithtown board of education has decided to look into adopting policy for transgender students.

School board Trustee Jeremy Thode introduced the issue at the board meeting on Tuesday, Oct. 13.

Thode is a chairperson for the policy committee and said he thinks the board needs to start looking into this issue. He said that at some point in the near future the policy committee would try to obtain language for a policy on transgender students.

“It’s important to ensure that all students are accounted for,” Thode said. “So that they understand what their rights are.”

Thode said that this is purely the beginning and that there are not many other details currently about how the board will approach adopting local policy for transgender students.

New York State Education Commissioner MaryEllen Elia has had transgender issues in her sights since she first took office in May.

Elia released the Transgender and Gender Nonconforming Guidance Document in July to public school districts throughout New York State.

According to a press release from the New York State Education office, the document is intended to help districts foster an educational environment safe and free from discrimination for transgender and nonconforming students.

It includes information to help districts comply with federal, state and local laws concerning bullying, harassment, discrimination and student privacy.

“All students need a safe and supportive school setting to progress academically and developmentally,” Elia said. “We have a moral responsibility to foster civility in our schools, and to ensure that every student has equal access to educational programs and activities.”

This document also provides guidance on using pronouns and handling issues like restroom and changing room use. It will complement existing resources like the Dignity for All Students Act that was signed into law in 2010. DASA seeks to provide New York State’s public elementary and secondary students with a safe and supportive environment free from discrimination, intimidation, taunting, harassment and bullying on school property, a school bus and at school functions.

Smithtown school district Superintendent James Grossane recently renewed coordinators for this act throughout the school district. 

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Event raises money for cancer patients

Michele Pincus, a breast cancer survivor, walks in the show. Photo by Victoria Espinoza

Pink Aid Long Island hosted its second annual fashion show and luncheon to benefit victims of breast cancer at Mitchells|Marshs in Huntington on Thursday, Oct. 15.

Pink Aid is a nonprofit organization, with branches in Connecticut and Long Island and seeks to support breast cancer survivors and provide screenings to women in   financial need.

Pink Aid’s grant programs provide services like free breast cancer screenings and help cover nonmedical expenses such as wigs, recovery garments and transportation for patients undergoing treatment.

The event featured a fashion show with models wearing Mitchells fall 2015 and spring 2016 lines. There were also silent and live auctions, where items ranging from a Gucci iPad case to a two-night stay at an inn in Ireland were prizes.

Allison Mitchell, president of Pink Aid Long Island, said she was proud of how this event has grown in just one year. Last year, the event raised more than $225,000 from its 300 attendees.

She said while they can only fit a certain number of people in the store for the event, they also had the option of an online auction this year for those who didn’t have a chance to reserve a ticket.

“Pink Aid helps women that are underinsured or not insured to get through their treatment and their diagnosis,” Mitchell said. “I think it’s really important we’re giving back to women here on Long Island right in our backyard [who] are struggling with treatment and keeping their families together.”

Mitchell’s husband Chris heads the Huntington store, previously known as Marshs, which is part of an independent family chain. “We own a retail store [here] with a lot of amazing clothes,” he said. “Women love clothes and this event allows us to have women come and support other women while having a fun day that is really a celebration.”

During the Celebration of Life portion of the fashion show, breast cancer survivors walk the runway in Mitchells after the professional models. The survivors are accompanied by an escort, specifically someone who supported them during their journey, according to Diana Mitchnick, co-chair of the Celebration of Life fashion show.

“I am going to walk this year,” she said. “I am very excited and a little nervous.”

Mitchnick said the entire event is uplifting, and that the room is filled with love and support: “Everyone who has been through the breast cancer journey knows how much help you need. Many people don’t have it and they need it.”

This year’s guest speaker was Marisa Acocella Marchetto, a breast cancer survivor and award-winning cartoonist and graphic novelist. Her graphic novel, “Cancer Vixen: A True Story,” follows her journey from when she discovered she had breast cancer through to the end of her treatment.

“What a positive impact you’ve made creating real positive change,” Marchetto said to the room. “You’ve made Strong Island ever stronger.”

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Squad says it services highest call volume in town

Huntington Community First Aid Squad is the subject of a recent study. File photo

A report shows that Huntington Community First Aid Squad is requesting more help from neighboring fire departments than any other ambulance service in Huntington.

According to the report, commissioned by Huntington Town, five volunteer fire departments in the town approached town officials about an increase in requests from the Huntington ambulance squad to respond to calls in the squad’s service area.

HCFAS made more requests for ambulance support than those five departments combined, according to the report.

In a phone interview this week, Alyssa Axelrod, vice president of HCFAS, said that the study is misleading because it does not mention that the squad receives more calls than the five other departments combined.

HCFAS was formed in 1967 as a nonprofit and is the only exclusive volunteer ambulance program in the town. The taxpayers and Huntington Town fund the squad’s operations.

The chiefs at the respective fire departments started noticing an increase in requests starting in 2013, according to the study.

Huntington Town responded to those concerns by hiring Medic Health to assess the operational practices of HCFAS and provide recommendations to reduce the number of requests to neighboring fire departments and ambulance squads.

The study began in June 2014. Consultants worked with the Huntington ambulance squad, representatives of Suffolk County Fire Rescue and Emergency Services and Huntington Town to gather and analyze information.

The study found instances where HCFAS was understaffed during certain shifts.

In one graph, the study shows times of the day and days of the week where current staffing levels, which is a minimum of two staffed ambulances, may not be sufficient to cover the community’s demand. The study states that 1 and 5 p.m. are the two times of the day where resources are lacking the most, during six out of the seven days of the week, according to the study. Saturday from 1 to 7 p.m. is the busiest.

Currently the HCFAS services Huntington Town with a minimum of two on-duty ambulance crews based at the station for daytime shifts, and one crew for overnight shifts, according to Axelrod.

The study also highlighted a problem caused by the staff being made up entirely of volunteers.

Commitments from volunteers varied considerably for overnight and daytime coverage, according to the study. The report stated that 17 percent of the planned shifts had an insufficient number of members to staff the desired two ambulances. A chart showed the number of ambulances the HCFAS can field during different shifts based on member commitment. Friday, Saturday and Sunday overnight shifts only have enough member commitments to staff one or fewer ambulances, according to the chart. This is the same for 7 to 11:00 a.m. shifts on Friday and 3 to 7 p.m. shifts on Friday and Saturday.

Although there is no official time for how quickly an ambulance should respond to a call, organizations have given time limits to respond to life-threatening calls.

The Commission on Accreditation of Ambulance Services said a total response time standard of eight minutes and fifty-nine seconds is expected for life-threatening calls.

In 2014, the HCFAS was able to be on the scene to 62 percent of their calls within eight minutes of the call receipt, 76 percent within 10 minutes and 89 percent within 15 minutes. According to the study, 11 percent of the calls required more than 15 minutes for an ambulance to arrive on the scene.

If an ambulance can’t respond to the scene, mutual aid requests come into play.

Mutual aid requests were designed to allow surrounding departments to assist each other during times of unusual demand for services, like mass casualty situations or disasters. Volunteer-based organizations like HCFAS also resort to mutual aid requests when they are unable to muster sufficient resources to staff an ambulance and respond to a call.

During the first five months of 2015, HCFAS requested mutual aid 41 times compared to 23 times by all the adjacent departments.

The study concludes with eight recommendations for the HCFAS to reduce its mutual aid requests. They include employing dedicated staff to provide coverage for shifts that are too difficult to staff with current volunteer squad members, restructuring the recruitment and orientation process to reduce time investment for prospective members, and more.

It also states Huntington Town should mandate the submission of monthly performance measurements, including response time performance reports and establishing response time expectations.

Axelrod said she believes that there is a misunderstanding about what this study is about.

“We are a busy department,” Axelrod said. “This year we will do 60,000 calls. We’re stripped of our percentage of calls we get in this report. The report doesn’t show that we respond to more calls than the five other departments combined.”

She said this makes the report confusing, but there were helpful discoveries and some recommendations that HCFAS wants to integrate moving forward, according to Axelrod.

She said the squad is changing how it brings in members as it’s currently a lengthy process.

“The process is steeped in caution,” Axelrod said. “We are very careful when we vet people before we let them ride in an ambulance.”

She also said the squad has considered non-volunteers, and has added a line item to their budget for 2016 to add paid personnel. According to Axelrod, the squad’s budget for this year will be cut by 15 percent, so they will have to look into other funds if they want to hire employees.

“The bottom line is we do a great job and these other departments do a great job,” Axelrod said. “But when you take out the number of calls we respond to, it makes us look deficient.”

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A view of a healing garden at Mather Hospital’s new pavilion. Photo from the hospital

New facilities at John T. Mather Memorial Hospital aim to reduce infection rates and bring more doctors to the area.

The Port Jefferson hospital recently dedicated its new Arthur & Linda Calace Foundation Pavilion, adding more than 28,400 square feet of space to the north side of the hospital that is being used to house patient rooms as well as medical offices and conference rooms.

According to Mather spokesman Stuart Vincent, there are 35 one-bed rooms in the new pavilion. Rather than using the space to add to the hospital’s 248 beds, beds were moved from existing double rooms into the new pavilion, creating 70 new single-bed patient rooms throughout the hospital.

A view of a patient bedroom at Mather Hospital. Photo from the hospital
A view of a patient bedroom at Mather Hospital. Photo from the hospital

Taking away those 35 double rooms and adding the 70 single rooms means “for the first time, the majority of rooms at Mather are now single-bedded, which aids in both patient healing and in reducing the risk of infection spreading among patients,” Vincent said in an email.

The patient rooms in the new pavilion will be used for intermediate care and will each have their own medication cabinet and a computer for managing patient information, according to Vincent. The unit also keeps nurses close to patients, with nursing stations throughout the floor.

Joseph Wisnoski, CFO at Mather, said in a previous statement, “A single-bed patient room is no longer a luxury, but the standard for hospitals across the nation.”

That patient unit is located above two floors of new offices and conference rooms and a 180-seat conference center. When the hospital broke ground on the expansion project two years ago, officials said the office space would be used to combat a shortage of primary care physicians by training more of those professionals — who would then hopefully stay in the area — in a graduate education program that includes seminars and symposia.

The pavilion is Mather’s first expansion in more than a decade, and Vincent said it is the sixth expansion since the hospital opened in 1929. It was named for Arthur and Linda Calace, the primary donors on the project, who raised their family nearby and wanted to give back to the community. The Calaces and other donors combined to cover $5 million of the total construction cost.

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Dr. Frederick Schiavone with emergency medicine residents in the Clinical Simulation Center. Photo from Melissa Weir

Stony Brook is sending some fresh faces to one of its neighboring hospitals.

Earlier this month, Stony Brook University Hospital heralded in a new partnership with John T. Mather Hospital that will transition the Port Jefferson facility from a community hospital into an academic teaching hub. But that doesn’t mean Mather will be losing its community-centric feel, hospital officials said.

The partnership began in 2012 when Mather officials started seeking advice from Stony Brook Medicine on how to establish a new graduate medical education program, and quickly evolved into Stony Brook Medicine’s sponsorship of the program. Mather welcomed its first class of 19 residents studying internal medicine in July 2014 and it has been all-systems-go ever since. And if all goes well, Mather said it aspired to reach 100 residents at the end of five years.

“It’s an investment in the future,” said Dr. Joan Faro, chief medical officer at Mather, who works as the site’s designated institutional officer for the graduate medical education team and initially reached out to Stony Brook Medicine to explore the partnership. “Our standards will be as high, or even higher, as they have been as they are passed down, and we are so fortunate to take advantage of [Stony Brook Medicine’s] expertise and guidance.”

Under the new system, Stony Brook’s graduate medical education program reviews Mather’s selections for residency program directors and then Faro sends recommended candidates back to Stony Brook. The candidates are then interviewed and authorized for appointments. When Mather residents graduate, they will receive a Stony Brook University Hospital crest alongside the Mather crest on their graduation certificates.

With Stony Brook Medicine’s help, Mather has instituted its own de facto recruiting system for promising prospects in the medical arena. By inviting residents into Mather, the hospital is not only ingraining its culture into the learners at an early stage, but it is also setting them on a path that could potentially lead to long stays working there, Faro said. And with the recent opening of a new 35-bed facility on the Mather campus, the time could not be better for residents to be learning on-site.

Dr. Frederick Schiavone, vice dean of the graduate medical education program at Stony Brook Medicine, teamed up with Carrie Eckart, executive director of the same program, to help transition Mather into an academic teaching hospital over the past year and said it could not be going more smoothly, as Mather’s staff steps up to new teaching roles.

“It’s a passion,” Schiavone said. “People like to teach, love to teach. It’s built into what being a doctor means. When residents thank us for helping teach them, you couldn’t ask for a better reward.”

One of the benefits of becoming a teaching hospital for Mather, Faro said, is that the staff are required to stay on top of the latest developments in medical education and training, which means that Mather’s patients receive advanced methods of health care delivery. Schiavone said the affiliation was ideal for Stony Brook Medicine as it allows staffers to train residents from the beginning as they are brought up throughout the system.

“We need to reach out to our community,” Schiavone said. “The focus is always to deliver the best health care in Suffolk County. Mather’s success is our success.”

And by putting collaborative patient care at the center of the model of delivering health care, Schiavone said Stony Brook Medicine was benefitting from having more residency spots to dole out.

Having residents under the same roof as Mather’s experienced medical professionals would only raise the level of care the community hospital provides by reinforcing the facility’s standards, Faro said.

Editor’s note: This version of the story was updated to correctly reflect the number of residents Mather has taken in as its inaugural class.

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