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H. Andrew Schwartz Photo from SBU

By Daniel Dunaief

Ideally, doctors would like to know about health threats or dangers such as diseases or chronic conditions before they threaten a person’s quality of life or expected lifespan.

On a larger scale, politicians and planners would also like to gauge how people are doing, looking for markers or signs that something may be threatening the health or safety of a community.  

Researchers in computer science at Stony Brook University have been designing artificial intelligence programs that explore the language used in social media posts as gauges of mental health.

Recently, lead author Matthew Matero, a PhD student in Computer Science at Stony Brook; senior author H. Andrew Schwartz, Associate Professor in Computer Science at Stony Brook; National Institute on Drug Abuse data scientist Salvatore Giorgi; Lyle H. Ungar, Professor of Computer and Information Science at the University of Pennsylvania; and Brenda Curtis, Assistant Professor of Psychology at the University of Pennsylvania published a study in the journal Nature Digital Medicine in which they used the language in social media posts to predict community rates of opioid-related deaths in the next year.

By looking at changes in language from 2011 to 2017 in 357 counties, Schwartz and his colleagues built a model named TrOP (Transformer for Opioid Prediction) with a high degree of accuracy in predicting the community rates of opioid deaths in the following year.

“This is the first time we’ve forecast what’s going to happen next year,” Schwartz said. The model is “much stronger than other information that’s available” such as income, unemployment, education rates, housing, and demographics.

To be sure, Schwartz cautioned that this artificial intelligence model, which uses some of the same underlying techniques as the oft-discussed chatGPT in coming up with a model of ordered data, would still need further testing before planners or politicians could use it to mitigate the opioid crisis.

“We hope to see [this model] replicated in newer years of data before we would want to go to policy makers with it,” he said.

Schwartz also suggested that this research, which looked at the overall language use in a community, wasn’t focused on finding characteristics of individuals at risk, but, rather at the overall opioid death risks to a community.

Schwartz used the self-reported location in Twitter profiles to look at representation of a community.

The data from the model, which required at least 100 active accounts each with at least 30 posts, have proven remarkably effective in their predictions and hold out the potential not only of encouraging enforcement or remediation to help communities, but also of indicating what programs are reducing mortality. Their model forecast the death rates of those communities with about a 3 percent error.

Both directions

Schwartz explained that the program effectively predicted positive and negative changes in opioid deaths.

On the positive side, Schwartz said language that reflected a reduction in opioid mortality included references to future social events, vacation, travel and discussions about the future.

Looking forward to travel can be a “signal of prosperity and having adventures in life,” Schwartz said. Talking about tomorrow was also predictive. Such positive signals could also reflect on community programs designed to counteract the effect of the opioid epidemic, offering a way of predicting how effective different efforts might be in helping various communities.

On the negative side, language patterns that preceded increases in opioid deaths included mentions of despair and boredom.

Within community changes

Other drug and opioid-related studies have involved characterizing what distinguishes people from different backgrounds, such as educational and income levels.

Language use varies in different communities, as words like “great” and phrases like “isn’t that special” can be regional and context specific.

To control for these differences, Schwartz, Matero and Giorgi created an artificial intelligence program that made no assumptions about what language was associated with increases or decreases. It tested whether the AI model could find language that predicted the future reliably, by testing against data the model had never seen before.

By monitoring social media in these specific locales over time, the researchers can search for language changes within the community. 

Scientists can explore the word and phrases communities used relative to the ones used by those same communities in the past.

“We don’t make any assumptions about what words mean” in a local context, Schwartz said. He can control for language differences among communities by focusing on language differences within a community.

Schwartz recognized that fine refinements to the model in various communities could enhance the predictive ability of the program.

“If we could fully account for differences in cultural, ethnic and other variables about a community, we should be able to increase the ability to predict what’s going to happen next year,” he said.

With its dependence on online language data, the model was less effective in communities where the number of social media posts is lower. “We had the largest error in communities with the lowest rates of posting,” Schwartz explained. On the opposite side, “we were the most accurate in communities with the highest amounts” of postings or data.

Broader considerations

While parents, teachers and others sometimes urge friends and their children to limit their time on social media because of concerns about its effects on people, a potential positive is that these postings might offer general data about a community’s mental health. The study didn’t delve into individual level solutions, but these scientists and others have work that suggests this is possible.

As for his future work, Schwartz said he planned to use this technique and paradigm in other contexts. He is focusing on using artificial intelligence for a better understanding of mental health.

“We hope to take this method and apply it to other outcomes, such as depression rates, alcohol use disorder rates,” post traumatic stress disorder and other conditions, Schwartz said. “A big part of the direction in my lab is trying to focus on creating AI methods that focus on time based predictions.”

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Photo from MHAW

A partnership between L.L.Bean (www.llbean.com) and Mental Health America (www.mhanational.org) in March prioritized the power of going outside with 5 grant awards of $20,000 each to select not for profit agencies including The Association for Mental Health and Wellness in Ronkonkoma. Funding will provide for the development of innovative outdoor programs that supports and improves mental well-being while fostering connection and inclusion through time spent outside.

The Association for Mental Health and Wellness’s (MHAW) was awarded $20,000 for its Eco-Sposure program which will provide families enrolled in its care management program opportunities and resources to connect with the outdoors. The children in the families who will participate are living with chronic physical or mental health conditions, and face other barriers that limit their exposure to outdoor experiences- such as poverty and community violence. The grant program will serve 30 families and support them to engage in a range of outdoor green space activities that help to develop a sense of connection and inclusion that enhances each family members overall mental and physical health and leads to an ongoing connection to the natural environment.  

“Children and youth are facing a mental health crisis and we need to tap into every tool available to support wellness. Engaging in outdoor activities as a family provides a healthy outlet with opportunities to experience the fresh air and the beauty of nature, all which support good mental health. There are so many benefits to connecting with nature from stress reduction and improved focus. This program helps the entire family to develop a love of nature; and connections with each other and ourselves that can come about. The program has the opportunity to foster a lifelong love of nature,” said Colleen Merlo, Chief Executive Officer for MHAW. 

About the Association for Mental Health and Wellness (MHAW)

The Association for Mental Health and Wellness is a not-for-profit 501(c)(3) corporation based in Ronkonkoma with the mission to empower and inspire people of all Suffolk County communities to identify, pursue and sustain healthy, meaningful lives. MHAW provides programs, services, and advocacy for people facing mental health challenges with an enhanced focus on serving Veterans. MHAW is committed to the core practice values of empowerment, hope, recovery, and cultural humility. All of the agency’s direct service workers are trained in the importance of addressing health from trauma-informed and whole-person perspectives with an enriched understanding of the social and economic conditions that contribute to physical and mental health and substance abuse.

Central to its mission is the belief that mental health is just as important as physical health. As the local affiliate of Mental Health America (MHA) and the Mental Health Association in New York State (MHANYS),  they drive evidence-based practices and care, and provide information, education and resources to the community and behavioral health workforce. Its goal is to ensure that policy makers, educational institutions, hospital and healthcare systems businesses and individuals across our region prioritize social and emotional wellness.

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Vegetables and fruits.
Dietary changes can help control or reverse chronic kidney disease

By David Dunaief, M.D.

Dr. David Dunaief

Your kidneys are workhorses; they perform an array of critical functions for you. Primarily, they filter waste and fluid from your body and maintain your blood’s health. They also help control your blood pressure, make red blood cells and vitamin D, and control your body’s acid levels.

When your kidney function degrades, it can lead to hypertension or cardiovascular problems and it may require dialysis or a kidney transplant in later stages. For the best outcomes, it’s critical to identify chronic kidney disease (CKD) early and adopt techniques to stop its advance. However, of the estimated 37 million U.S. adults who have CKD, as many as 9 in 10 are not aware they have it (1).

One of the challenges with identifying early-stage CKD is that symptoms are not obvious and can be overlooked. Among them are high blood pressure, hand or feet swelling, urinary tract infections, and blood in your urine (2).

Fortunately, there are simple tests, such as a basic metabolic panel and a urinalysis, that will indicate whether you may have mild CKD. These indices for kidney function include an estimated glomerular filtration rate (eGFR), creatinine level and protein in the urine. eGFR is a calculation and, while the other two indices have varying ranges, depending on the laboratory used, a patient with an eGFR of 30 to 59 is considered to have mild disease. The eGFR and the kidney function are inversely related, meaning as eGFR declines, the severity of CKD increases.

What can be done to stem early-stage CKD, before complications occur? There are several studies that have looked at lifestyle modifications and their impacts on its prevention, treatment and reversal.

How do other medical issues affect your kidneys?

Among the greatest risks for your kidneys are uncontrolled diseases and medical disorders, such as diabetes and hypertension (1). If you have – or are at risk for – diabetes, be sure to control your blood sugar levels to limit kidney damage. Similarly, if you currently have hypertension, controlling it will put less stress on your kidneys. 

For these diseases, it’s crucial that you have your kidney function tested at least once a year.

In addition, obesity and smoking have been identified as risk factors and can be managed by making lifestyle changes to reduce your risk.

Can diet help protect your kidneys?

Fruits and vegetables may play a role in helping patients with CKD. In a one-year study with 77 patients, results showed that fruits and vegetables work as well as sodium bicarbonate in improving kidney function by reducing metabolic acidosis levels (3).

What is the significance of metabolic acidosis? It means that body fluids become acidic, and it is associated with CKD. The authors concluded that both sodium bicarbonate and a diet including fruits and vegetables were renoprotective, helping to protect the kidneys from further damage in patients with CKD. Alkali diets are primarily plant-based, although not necessarily vegetarian or vegan. Animal products tend to cause an acidic environment.

In the Nurses’ Health Study, results show that animal fat, red meat and sodium all negatively impact kidney function (4). The risk of protein in the urine, a potential indicator of CKD, increased by 72 percent in those participants who consumed the highest amounts of animal fat compared to the lowest, and by 51 percent in those who ate red meat at least twice a week. With higher amounts of sodium, there was a 52 percent increased risk of having lower levels of eGFR.

The most interesting part with sodium was that the difference between higher mean consumption and the lower mean consumption was not that large, 2.4 grams compared to 1.7 grams. In other words, a difference of approximately a quarter-teaspoon of sodium was responsible for the decrease in kidney function.

The National Kidney Foundation recommends diets that are higher in fruit and vegetable content and lower in animal protein, including the Dietary Approaches to Stop Hypertension (DASH) diet and plant-based diets (5). 

In my practice, when CKD patients follow a vegetable-rich, nutrient-dense diet, there are substantial improvements in kidney functioning. For instance, for one patient, his baseline eGFR was 54. After one month of lifestyle modifications, his eGFR improved by 9 points to 63, which is a return to “normal” functioning of the kidney. Note that this is anecdotal, not a study.

What are our takeaways?

It is important to have your kidney function checked with mainstream tests. If the levels are low, you should address the issue through medications and lifestyle modifications to manage and reverse early-stage CKD. If you have common risk factors, such as diabetes, smoking, obesity or high blood pressure, or if you are over 60 years old, talk to your doctor about testing. 

Don’t wait until symptoms and complications occur. In my experience, it is much easier to treat and reverse a disease in its earlier stages, and CKD is no exception.

References:

(1) CDC.gov. (2) kidneyfund.org. (3) Clin J Am Soc Nephrol. 2013;8:371-381. (4) Clin J Am Soc Nephrol. 2010; 5:836-843. (5) kidney.org.

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 or consult your personal physician.

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Pixabay photo

Amid an increase in adult and congenital infections, the Suffolk County Department of Health Services is urging pregnant mothers to get tested for syphilis.

Untested and untreated, infants born with the congenital bacteria can appear normal and healthy but can encounter developmental delays and health challenges later in their lives.

The county recommends that pregnant women get tested for syphilis at their first prenatal visit, at the beginning of their third trimester and again at delivery.

“Syphilis during pregnancy is easily cured with the right antibiotics,” Mary Pat Boyle, bureau chief for the Suffolk County STI Control Unit and member of the New York State Congenital Syphilis Elimination Strategic Planning Group, said in an email.

Pregnant New Yorkers can qualify for Medicaid at higher income levels. Uninsured pregnant residents may quality for a Special Enrollment Period to enroll in private health insurance through the NY State of Health Marketplace.

The county recognizes that “barriers to testing and treatment do exist,” Boyle said. “The county staff is aware that patients turning to urgent care for support find that the centers don’t treat syphilis and are referred to another provider causing delays in their treatment.”

At the same time, staff at Suffolk County, which has been social messaging about STIs during STI Awareness Week, has confronted issues with insurance companies that don’t cover benzathine penicillin G 2.4 million units, the medication needed in one to three doses as recommended by the Centers for Disease Control and Prevention and the only treatment safe for pregnant women.

Suffolk County Department of Health Services brought this to the attention of NYSDOH, which is “looking into the matter,” according to county officials.

The incidence of syphilis for the population of the country has climbed dramatically. A report from the CDC showed that the number of cases of syphilis rose 32% to over 176,000 in 2021 from the prior year.

In New York State, pregnant persons with reported syphilis increased by 51% in 2020 to 53 from 35 in 2016.

In July 2022, Suffolk County’s Board of Sexually Transmitted Disease staff launched the Suffolk County Congenital Syphilis Prevention Initiative.

“The groups have been raising awareness of increased cases of maternal and congenital syphilis among those who work with at-risk women of childbearing age and mobilizing to implement evidence-based practices to prevent congenital syphilis,” Boyle said.

The bureau staff has visited over 167 Suffolk County OB/GYN providers to discuss best practices and distribute educational materials emphasizing the importance of STI testing and timely treatment.

The county’s STI unit is planning training for team members at St. Catherine of Siena Hospital, Southampton Hospital, Stony Brook University Hospital and Planned Parenthood Hudson Peconic.

Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, noted the increase in congenital syphilis and suggested that newborns don’t necessarily show clear signs of the infection.

“You sometimes don’t know until perhaps years later, when the baby is not growing, thriving and meeting developmental milestones” that it has syphilis, Nachman said. “There are no abnormal blood tests. The baby looks fine.”

Nachman said that parents and doctors don’t want to “be in a position where you’re picking it up late” because untreated and untested syphilis could have a “lifelong” effect on the growing child.

Nachman added that testing for syphilis in newborns often involves a spinal tap, in which doctors take a small amount of fluid through a spinal tap. Spinal tap procedures in newborns can involve pain and tenderness, but do not generally present risks to the developing child.

Penicillin shortage

At the same time, the supply of penicillin could become a concern. As a generic drug, the profitability of penicillin has decreased dramatically.

The injectable form of penicillin, which is used to treat syphilis, may become a problem later this year and will “definitely be a problem next year and afterwards,” Nachman said.

Researchers are checking to see if there are other drugs, they can fine tune instead of penicillin. They are exploring whether they can convert other therapies that are short acting into longer acting treatments.

“Everyone is aware of the question and [researchers] are carving out different ways to answer” it, Nachman said.

If the county uncovers a shortage of syphilis treatment, it will work with the New York State Department of Health to address the problem, county health department officials said.

For adults, Nachman suggested that seeing an increase in syphilis among newborns suggest that the bacteria may be prevalent in the community.

“When I see an uptick in neonates, I think, ‘Oh, gosh, there are more adults out there’” with this infection, she said.

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Narcan kits will be placed in close proximity to automated external defibrillators in county facilities. Stock photo

A new bill sponsored by Suffolk County Legislator Kara Hahn (D-Setauket) has been approved by the county Legislature.

Her resolution requires kits of naloxone — or Narcan, its brand name — to be supplied in close proximity to automated external defibrillators  in all county facilities. The bill was co-sponsored by county Legislator Tom Donnelly (D-Deer Park).

An April 4 press release stated that Narcan “is a lifesaving medication that can reverse the effects of an opioid overdose when administered in a timely manner.” Hahn believes this bill will help to improve the outcomes of the opioid overdoses seen in the county.

Hahn has been passionate about fighting the opioid epidemic for more than a decade now. In April of 2012, she sponsored a resolution which enabled police officers to administer Narcan to overdose victims. The press release for the current resolution noted, “According to SCPD statistics, patrol officers equipped with Narcan have saved thousands of lives in the 10 years since the [original] bill was enacted.”

Old Field resident Carole Trottere came up with the idea for this legislation and brought it to Hahn’s attention only a few months ago.    

“It’s really a no-brainer,” Trottere said. “Put them in wherever we have AEDs. … If you save one life, it’s sparing the parents the horrible grief that I go through and giving someone a second chance to try to get into recovery.”

Trottere has been reaching out to grieving parent groups. “You cannot believe how many groups there are on Long Island alone and nationally of grieving parents who have lost children to fentanyl and overdoses,” she said.

She has also been working with the Suffolk County Police Department’s Behavioral Health Unit. Trottere lost her son, Alex Sutton, to a drug overdose in 2018, and last year planned an event in memory of him at his favorite pizza place. Police attended and carried out Narcan training at the event. This is something they would offer to anyone else who would like to plan an event in memory of a loved one.

According to the press release, the Long Island Council on Alcoholism and Drug Dependence also supports Hahn’s efforts.

She said this bill will be beneficial because Narcan kits need to be readily available. “What is frightening about the disease of addiction is that it can happen to anyone,” she added. “So it does need to be everywhere.” 

Hahn also mentioned that street drugs are now sometimes laced with fentanyl, so someone could be taking what they think is a simple Xanax, but it’s actually unexpectedly laced with fentanyl.

“It’s probably the person who unexpectedly overdoses that will benefit the most from its placement,” she said. “If it’s ubiquitously placed, then more people will be saved.”

Hahn said she’s working with local universities to build the pipeline of clinical social workers, psychologists and psychiatrists that can help people battling mental health issues. She indicated the system is under-resourced, and she would like to work toward strengthening child, adolescent, and adult mental health in our communities.

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Even if you don’t use a salt shaker, you’re likely getting more sodium than the current guidelines. METRO photo
Eating whole foods can improve your odds of victory

By David Dunaief, M.D.

Dr. David Dunaief

We hear a lot about sodium and the importance of limiting your sodium intake. But what if you don’t have a health condition like hypertension? Should you still be concerned? The short answer is, “yes.” Most of us consume far too much sodium, as much at 3,400 mg per day, without even trying (1). Even if we don’t have hypertension, the impact of sodium on our health can be dramatic.

Sodium is everywhere, including in foods that don’t taste salty. Bread products are among the worst offenders. Other foods with substantial amounts of sodium include cold cuts and cured meats, cheeses, pizza, poultry, soups, pastas, sauces and, of course, snack foods. Processed foods and those prepared by restaurants are where much of our consumption occurs (2).

On the flip side, only about two percent of people get enough potassium from their diets (3). According to the National Institutes of Health, adequate intake of potassium is between 2600mg and 3400mg for adult women and men, respectively.

Why do we compare sodium and potassium intakes?

A high sodium-to-potassium ratio increases the risk of cardiovascular disease by 46 percent, according to a study that looked at more than 12,000 Americans over almost 15 years (4). In addition, both may have significant impacts on blood pressure and cardiovascular disease. To improve our overall health, we need to shift the sodium-to-potassium balance so that we consume more potassium and less sodium. And if you struggle with high blood pressure, this approach could help you win the battle.

Can sodium intake be too low?

Before we dive in too far, let’s address an “elephant in the room.” I’ve read several commentaries where experts warn that too-low sodium levels can be a problem. While this is true, it’s quite rare, unless you take medications or have a health condition that depletes sodium. We hide sodium everywhere, so even if you don’t use a salt shaker, you’re likely getting more sodium than the current guidelines.

Why lower your sodium consumption?

Two studies illustrate the benefits of reducing sodium in high blood pressure and normotensive (normal blood pressure) patients, ultimately preventing cardiovascular disease, including heart disease and stroke.

The first used the prestigious Cochrane review to demonstrate that blood pressure is reduced by a significant mean of −4.18 mm Hg systolic (top number) and −2.06 mm Hg diastolic (bottom number) involving both normotensive and hypertensive participants (5). When looking solely at hypertensive patients, the reduction was even greater, with a systolic blood pressure reduction of −5.39 mm Hg and a diastolic blood pressure reduction of −2.82 mm Hg.

This was a meta-analysis that evaluated data from 34 randomized clinical trials, totaling more than 3,200 participants. Salt reduction from 9-to-12 grams per day to 5-to-6 grams per day had a dramatic effect. The researchers believe that the more we reduce the salt intake, the greater the effect of reducing blood pressure. The authors recommend further reduction to 3 grams per day as a long-term target for the population and concluded that the effects on blood pressure will most likely result in a decrease in cardiovascular disease.

In the second study, a meta-analysis of 42 clinical trials, there was a similarly significant reduction in both systolic and diastolic blood pressures (6). This study included both adults and children. Both demographics saw a reduction in blood pressure, though the effect was greater in adults. Interestingly, an increase in sodium caused a 24 percent increased risk of stroke incidence but, more importantly, a 63 percent increased risk of stroke mortality. The risk of mortality from heart disease was increased alongside an increase in sodium, as well, by 32 percent.

Is potassium consumption important?

In a meta-analysis involving 32 studies, results showed that as the amount of potassium was increased, systolic blood pressure decreased significantly (7). When foods containing 3.5 to 4.7 grams of potassium were consumed, there was an impressive −7.16 mm Hg reduction in systolic blood pressure with high blood pressure patients. Anything more than this amount of potassium did not have any additional benefit. Increased potassium intake also reduced the risk of stroke by 24 percent. This effect was important.

The reduction in blood pressure was greater with increased potassium consumption than with sodium restriction, although this was not a head-to-head comparison. The good news is that potassium is easily attainable; it’s found in many whole foods and is richest in fruits, vegetables, beans and legumes.

The bottom line: decrease your sodium intake by almost half and increase potassium intake from foods. Lowering sodium intake may have far-reaching benefits, and it is certainly achievable. First, consume less and give yourself a brief period to adapt — it takes about six weeks to retrain your taste buds, once you cut your sodium. You can also improve your odds by increasing your dietary potassium intake, striking a better sodium-to-potassium balance.

References:

(1) Dietary Reference Intakes for Sodium and Potassium. Washington (DC): National Academies Press (US); 2019 Mar. (2) www.cdc.gov. (3) www.nih.gov. (4) Arch Intern Med. 2011;171(13):1183-1191. (5) BMJ. 2013 Apr 3;346:f1325. (6) BMJ. 2013 Apr 3;346:f1326. (7) BMJ. 2013; 346:f1378.

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 or consult your personal physician.

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From left, Anthony Comerford, VP Health Services; Kathy Koutouvidis, RN, Assistant Director, Nursing; Patti Gallagher, Director, Environmental Services; Dawn Flowers-Leib, Director, Admissions; Richelle Rugolo, RN, Director, Nursing; and Bob Caulfield, President and CEO, Jefferson’s Ferry Life Plan Community.

For the fifth year in a row, Jefferson’s Ferry Life Plan Community of South Setauket has earned Pinnacle Quality Insight’s Customer Experience Award for outstanding resident satisfaction and overall achievement in the health care industry.  

This award recognizes the dedication of the staff of The Vincent Bove Health Center at Jefferson’s Ferry in providing “Best in Class” service in Skilled Nursing.  Jefferson’s Ferry’s health center scored in the top 15% of skilled nursing facilities nationwide over a 12-month period of study, excelling in  Nursing Care, Cleanliness, Individual Needs, Recommendation to Others, Activities, Admission Process, Safety & Security, and Overall Customer Experience.

“Since our founding more than 20 years ago as Long Island’s first Continuing Care Retirement Community, Jefferson’s Ferry has been committed to providing the highest quality experience in a community setting that promotes dignity, privacy, individuality and independence for every resident,” said Jefferson’s Ferry President and CEO Bob Caulfield. “The Pinnacle Award is a direct reflection of the outstanding work that our employees perform every day. It’s always gratifying to know that our residents recognize our dedication with this vote of confidence.” 

Over the course of 2022, a sampling of residents of the Vincent Bove Health Center and their families participated in monthly telephone interviews that asked open-ended questions to rate their experiences in specific categories.    

Every month, Jefferson’s Ferry staff evaluated the results from the interviews to gain a better understanding of resident needs and make improvements when necessary. 

“In addition to the high marks our residents and their families give us in the Pinnacle survey, they also recommend Jefferson’s Ferry to their friends and family,” added Anthony Comerford, Vice President of Health Service. “Our staff and residents form close relationships based on mutual respect, trust, and quality care.” 

“While we don’t come to work looking to win awards, we always do our very best for our residents and families,” concluded Caulfield. “Our goal is always to provide the people who call Jefferson’s Ferry  home with the means and peace of mind to live their best life here.  It is especially meaningful to know that we are consistently hitting the mark, meeting or exceeding the best standards or practices within our industry.  It’s the people who live and work here that make Jefferson’s Ferry the truly special and vibrant community we know so well.”  

For more information visit www.jeffersonsferry.org

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Pictured from left, Jackie Frank, RN; Dr. Salim Matar M.D., F.A.C.S., Cari Cioffi, Carly Montalto, PJCC Past President Mary Joy Pipe; PJCC Third Vice President Douglas Quattrock and PJCC Past President Dr. Suzanne Velazquez. Photo from PJCC

The Greater Port Jefferson Chamber of Commerce (PJCC) held a ribbon cutting welcoming new chamber member Long Island Sinus Institute on March 30. 

Located at 640 Belle Terre Rd. Bldg. C, Port Jefferson, the staff of ENT specialists offers complete, personal care plans to treat symptoms due to a variety of ear, nose and throat-related conditions including balloon sinuplasty (balloon sinus dilation) for recurrent sinus infections along with nasal allergies, nasal obstruction, nasal polyps, nosebleeds, recurrent sore throats, diagnosis and treatment of sleep apnea, upper airway obstruction and snoring.

“The  Greater Port Jefferson Chamber of Commerce welcomes Dr. Nahum Archin and Dr. Salim Matar and staff to the chamber! Their specialized medical expertise with the latest techniques in balloon sinuplasty surgery will provide needed services to our community. The Chamber wishes them well and much success,” said Barbara Ransome, Director of Operations at the PJCC. For more information, call 631-928-7750 or visit www.longislandsinusinstitute.com.

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Photo by Mary Pahlke/Pixabay

By Fr. Francis Pizzarelli

Father Frank Pizzarelli

Every newspaper, every news channel, no matter what their politics are talking about the serious concerns around the mental health of the young people in our country.

The mental health of our youth is on the verge of becoming, if it has not already, a national health epidemic!

Social media is out of control. The pandemic has not helped this national crisis. Candidly, it has intensified it. So, what do we do? First, we need to destigmatize any kind of mental health and substance use disorders. We have to have the courage to act bravely to provide competent, cost-effective treatment services for mental health and addictive health.

Telehealth is a great resource but is already overbooked and is geared more to working with the middle/upper class. They have waiting lists that are endless. Private practice is overloaded as well. The clinics of yesteryear who are capable of reaching out to the underserved need to be resurrected and properly staffed.

Our local hospitals need additional funds to build on the excellent services that already exist but do not meet the epidemic need. Mental health must become a priority; too many young people are toying with suicide. Most don’t want to die they just want the pain and anguish to stop.

Too often that pain is intensified due to our social media platforms, which can be unbearable triggers for those who are already struggling with self-esteem and self-worth. We need to challenge our schools to be more effective in teaching better coping skills and also creating more safe places where students can go and talk without fear of judgment, shame, and guilt.

Most school districts should consider increasing their social work staff. If they don’t have any social workers on their staff, they should consider hiring competent social workers with plans to better serve our children who are at risk. We need more of a collaborative effort between mental health staff faculty, administrators and support staff. This kind of collaboration really does make a difference.

TJ was 16; he was shy to begin with. The pandemic made him even more self-conscious and shy. His only outlet was social media. When given the freedom to go out, he stayed in and spent his life on social media. He was a good student, a good young man at home. No one really knew how addicted he had become to social media. He had joined a growing number of invisible young people who are in so much pain and are so closed that they are falling between the cracks.

We need to stop talking and need to think outside the box. We need to demand funding that will allow us to create life-giving opportunities for all of our young people to build their self-worth, their self-confidence and their self-value so that they will know they really matter and can make a difference that counts!

Father Francis Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

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METRO photo
Diet and exercise together are the key to success

By David Dunaief, M.D.

Dr. David Dunaief

If you suffer from osteoarthritis, you know it can affect your quality of life and make it difficult to perform daily activities. Osteoarthritis (OA) most often affects the knees, hips and hands and can affect your mood, mobility, and sleep quality.

Common first-line medications that treat arthritis pain are acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen. Unfortunately, these medications have side effects, especially with long-term use. Also, while they might relieve your immediate symptoms of pain and inflammation, they don’t slow osteoarthritis’ progression.

Fortunately, there are approaches you can use to ease your pain without reaching for medications. Some can even help slow the progression of your OA or even reverse your symptoms.

What role does weight play?

Weight management is a crucial component of any OA pain management strategy. In a study involving 112 obese patients, those who lost weight reported easing of knee symptoms (1). Even more exciting, the study authors observed disease modification, with a reduction in the loss of cartilage volume around the medial tibia. Those who gained weight saw the opposite effect.

The relationship was almost one-to-one; for every one percent of weight lost, there was a 1.2 mm3 preservation of medial tibial cartilage volume, while the opposite occurred when participants gained weight. A reduction of tibial cartilage is often associated with the need for a knee replacement.

Does vitamin D help?

In a randomized controlled trial (RCT), vitamin D provided no OA symptom relief, nor any disease-modifying effects (2). This two-year study of almost 150 men and women raised blood levels of vitamin D on average to 36 ng/ml, which is considered respectable. Researchers used MRI and X-rays to track their results.

In another study of 769 participants, ages 50-80, researchers found that low vitamin D levels – below 25 nmol/l led to increased OA knee pain over the five-year study period and hip pain over 2.4 years (3). The researchers postulate that supplementing vitamin D might reduce pain in those who are deficient, but that it will likely have no effect on others.

How does dairy factor into OA?

With dairy, specifically milk, there is conflicting information. Some studies show benefits, while others show that it may contribute to the inflammation that makes osteoarthritis pain feel worse.

In the Osteoarthritis Initiative study, researchers looked specifically at joint space narrowing that occurs in those with affected knee joints (4). Results showed that low-fat (1 percent) and nonfat milk may slow the progression of osteoarthritis in women. Compared to those who did not drink milk, patients who did saw significantly less narrowing of knee joint space over a 48-month period.

The result curve was interesting, however. For those who drank from fewer than three glasses a week up to 10 glasses a week, the progression of joint space narrowing was slowed. However, for those who drank more than 10 glasses per week, there was less beneficial effect. There was no benefit seen in men or with the consumption of higher fat products, such as cheese or yogurt.

However, the study was observational and had significant flaws. First, the 2100 patients were only asked about their milk intake at the study’s start. Second, patients were asked to recall their weekly milk consumption for the previous 12 months before the study began — a challenging task.

On the flip side, a study of almost 39,000 participants from the Melbourne Collaborative Cohort Study found that increases in dairy consumption were associated with increased risk of total hip replacements for men with osteoarthritis (5).

Getting more specific, a published analysis of the Framingham Offspring Study found that those who consumed yogurt had statistically significant lower levels of interleukin-6 (IL-6), a marker for inflammation, than those who didn’t eat yogurt, but that this was not true with milk or cheese consumption (6).

Would I recommend consuming low-fat or nonfat milk or yogurt? Not necessarily, but I might not dissuade osteoarthritis patients from yogurt.

Does exercise help with OA pain?

Diet and exercise trumped the effects of diet or exercise alone in a well-designed study (7). In an 18-month study, patients with osteoarthritis of the knee who lost at least 10 percent of their body weight experienced significant improvements in function and a 50 percent reduction in pain, as well as reduction in inflammation. This was compared to those who lost a lower percent of their body weight.

Researchers used biomarker IL6 to measure inflammation. The diet and exercise group and the diet-only group lost significantly more weight than the exercise-only group, 23.3 pounds and 19.6 pounds versus 4 pounds. The diet portion consisted of a meal replacement shake for breakfast and lunch and then a vegetable-rich, low-fat dinner. Low-calorie meals replaced the shakes after six months. The exercise regimen included one hour of a combination of weight training and walking “with alacrity” three times a week.

To reduce pain and possibly improve your OA, focus on lifestyle modifications. The best effects shown are with weight loss and with a vegetable-rich diet. In terms of low-fat or nonfat milk, the results are controversial, at best. For yogurt, the results suggest it may be beneficial for osteoarthritis, but stay on the low end of consumption, since dairy can increase inflammation.

References:

(1) Ann Rheum Dis. 2015 Jun;74(6):1024-9. (2) JAMA. 2013;309:155-162. (3) Ann. Rheum. Dis. 2014;73:697–703. (4) Arthritis Care Res online. 2014 April 6. (5) J Rheumatol. 2017 Jul;44(7):1066-1070. (6) Nutrients. 2021 Feb 4;13(2):506. (7) JAMA. 2013;310:1263-1273.

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 or consult your personal physician.

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