Trump’s Pardons Included Health Care Execs Behind Massive Frauds

At the last minute, President Donald Trump granted pardons to several individuals convicted in huge Medicare swindles that prosecutors alleged often harmed or endangered elderly and infirm patients while fleecing taxpayers.

“These aren’t just technical financial crimes. These were major, major crimes,” said Louis Saccoccio, chief executive officer of the National Health Care Anti-Fraud Association, an advocacy group.

The list of some 200 Trump pardons or commutations, most issued as he vacated the White House this week, included at least seven doctors or health care entrepreneurs who ran discredited health care enterprises, from nursing homes to pain clinics. One is a former doctor and California hospital owner embroiled in a massive workers’ compensation kickback scheme that prosecutors alleged prompted more than 14,000 dubious spinal surgeries. Another was in prison after prosecutors accused him of ripping off more than $1 billion from Medicare and Medicaid through nursing homes and other senior care facilities, among the largest frauds in U.S. history.

“All of us are shaking our heads with these insurance fraud criminals just walking free,” said Matthew Smith, executive director of the Coalition Against Insurance Fraud. The White House argued all deserved a second chance. One man was said to have devoted himself to prayer, while another planned to resume charity work or other community service. Others won clemency at the request of prominent Republican ex-attorneys general or others who argued their crimes were victimless or said critical errors by prosecutors had led to improper convictions.

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Trump commuted the sentence of former nursing home magnate Philip Esformes in late December. He was serving a 20-year sentence for bilking $1 billion from Medicare and Medicaid. An FBI agent called him “a man driven by almost unbounded greed.” Prosecutors said that Esformes used proceeds from his crimes to make a series of “extravagant purchases, including luxury automobiles and a $360,000 watch.”

Esformes also bribed the basketball coach at the University of Pennsylvania “in exchange for his assistance in gaining admission for his son into the university,” according to prosecutors.

Fraud investigators had cheered the conviction. In 2019, the National Health Care Anti-Fraud Association gave its annual award to the team responsible for making the case. Saccoccio said that such cases are complex and that investigators sometimes spend years and put their “heart and soul” into them. “They get a conviction and then they see this happen. It has to be somewhat demoralizing.”

Tim McCormack, a Maine lawyer who represented a whistleblower in a 2007 kickback case involving Esformes, said these cases “are not just about stealing money.”

“This is about betraying their duty to their patients. This is about using their vulnerable, sick and trusting patients as an ATM to line their already rich pockets,” he said. He added: “These pardons send the message that if you are rich and connected and powerful enough, then you are above the law.”

The Trump White House saw things much differently.

“While in prison, Mr. Esformes, who is 52, has been devoted to prayer and repentance and is in declining health,” the White House pardon statement said.

The White House said the action was backed by former Attorneys General Edwin Meese and Michael Mukasey, while Ken Starr, one of Trump’s lawyers in his first impeachment trial, filed briefs in support of his appeal claiming prosecutorial misconduct related to violating attorney-client privilege.

Trump also commuted the sentence of Salomon Melgen, a Florida eye doctor who had served four years in federal prison for fraud. That case also ensnared U.S. Sen. Robert Menendez (D-N.J.), who was acquitted in the case and helped seek the action for his friend, according to the White House.

Prosecutors had accused Melgen of endangering patients with needless injections to treat macular degeneration and other unnecessary medical care, describing his actions as “truly horrific” and “barbaric and inhumane,” according to a court filing.

Melgen “not only defrauded the Medicare program of tens of millions of dollars, but he abused his patients — who were elderly, infirm, and often disabled — in the process,” prosecutors wrote.

Prosecutors said the scheme raked in “a staggering amount of money.” Between 2008 and 2013, Medicare paid the solo practitioner about $100 million. He took in an additional $10 million from Medicaid, the government health care program for low-income people, $62 million from private insurance, and approximately $3 million in patients’ payments, prosecutors said.

In commuting Melgen’s sentence, Trump cited support from Menendez and U.S. Rep. Mario Diaz-Balart (R-Fla.). “Numerous patients and friends testify to his generosity in treating all patients, especially those unable to pay or unable to afford healthcare insurance,” the statement said.

In a statement, Melgen, 66, thanked Trump and said his decision ended “a serious miscarriage of justice.”

“Throughout this ordeal, I have come to realize the very deep flaws in our justice system and how people are at the complete mercy of prosecutors and judges. As of today, I am committed to fighting for unjustly incarcerated people,” Melgen said. He denied harming any patients.

Faustino Bernadett, a former California anesthesiologist and hospital owner, received a full pardon. He had been sentenced to 15 months in prison in connection with a scheme that paid kickbacks to doctors for admitting patients to Pacific Hospital of Long Beach for spinal surgery and other treatments.

“As a physician himself, defendant knew that exchanging thousands of dollars in kickbacks in return for spinal surgery services was illegal and unethical,” prosecutors wrote.

Many of the spinal surgery patients “were injured workers covered by workers’ compensation insurance. Those patient-victims were often blue-collar workers who were especially vulnerable as a result of their injuries,” according to prosecutors.

The White House said the conviction “was the only major blemish” on the doctor’s record. While Bernadett failed to report the kickback scheme, “he was not part of the underlying scheme itself,” according to the White House.

The White House also said Bernadett was involved in numerous charitable activities, including “helping protect his community from COVID-19.” “President Trump determined that it is in the interests of justice and Dr. Bernadett’s community that he may continue his volunteer and charitable work,” the White House statement read.

Others who received pardons or commutations included Sholam Weiss, who was said to have been issued the longest sentence ever for a white collar crime — 835 years. “Mr. Weiss was convicted of racketeering, wire fraud, money laundering, and obstruction of justice, for which he has already served over 18 years and paid substantial restitution. He is 66 years old and suffers from chronic health conditions,” according to the White House.

John Davis, the former CEO of Comprehensive Pain Specialists, the Tennessee-based chain of pain management clinics, had spent four months in prison. Federal prosecutors charged Davis with accepting more than $750,000 in illegal bribes and kickbacks in a scheme that billed Medicare $4.6 million for durable medical equipment.

Trump’s pardon statement cited support from country singer Luke Bryan, said to be a friend of Davis’.

These treatments “involved sticking needles in their eyes, burning their retinas with a laser, and injecting dyes into their bloodstream.”

“Notably, no one suffered financially as a result of his crime and he has no other criminal record,” the White House statement reads.

“Prior to his conviction, Mr. Davis was well known in his community as an active supporter of local charities. He is described as hardworking and deeply committed to his family and country. Mr. Davis and his wife have been married for 15 years, and he is the father of three young children.”

CPS was the subject of a November 2017 investigation by KHN that scrutinized its Medicare billings for urine drug testing. Medicare paid the company at least $11 million for urine screenings and related tests in 2014, when five of CPS’ medical professionals stood among the nation’s top such Medicare billers.

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Amid COVID and Racial Unrest, Black Churches Put Faith in Mental Health Care

Wilma Mayfield used to visit a senior center in Durham, North Carolina, four days a week and attend Lincoln Memorial Baptist Church on Sundays, a ritual she’s maintained for nearly half a century. But over the past 10 months, she’s seen only the inside of her home, the grocery store and the pharmacy. Most of her days are spent worrying about COVID-19 and watching TV.

It’s isolating, but she doesn’t talk about it much.

When Mayfield’s church invited a psychologist to give a virtual presentation on mental health during the pandemic, she decided to tune in.

The hourlong discussion covered COVID’s disproportionate toll on communities of color, rising rates of depression and anxiety, and the trauma caused by police killings of Black Americans. What stuck with Mayfield were the tools to improve her own mental health.

“They said to get up and get out,” she said. “So I did.”

The next morning, Mayfield, 67, got into her car and drove around town, listening to 103.9 gospel radio and noting new businesses that had opened and old ones that had closed. She felt so energized that she bought chicken, squash and greens, and began her Thanksgiving cooking early.

“It was wonderful,” she said. “The stuff that lady talked about [in the presentation], it opened up doors for me.”

As Black people face an onslaught of grief, stress and isolation triggered by a devastating pandemic and repeated instances of racial injustice, churches play a crucial role in addressing the mental health of their members and the greater community. Religious institutions have long been havens for emotional support. But faith leaders say the challenges of this year have catapulted mental health efforts to the forefront of their mission.

Some are preaching about mental health from the pulpit for the first time. Others are inviting mental health professionals to speak to their congregations, undergoing mental health training themselves or adding more therapists to the church staff.

“COVID undoubtedly has escalated this conversation in great ways,” said Keon Gerow, senior pastor at Catalyst Church in West Philadelphia. “It has forced Black churches — some of which have been older, traditional and did not want to have this conversation — to actually now have this conversation in a very real way.”

At Lincoln Memorial Baptist, leaders who organized the virtual presentation with the psychologist knew that people like Mayfield were struggling but might be reluctant to seek help. They thought members might be more open to sensitive discussions if they took place in a safe, comfortable setting like church.

It’s a trend that psychologist Alfiee Breland-Noble, who gave the presentation, has noticed for years.

Through her nonprofit organization, the AAKOMA Project, Breland-Noble and her colleagues often speak to church groups about depression, recognizing it as one of the best ways to reach a diverse segment of the Black community and raise mental health awareness.

This year, the AAKOMA Project has received clergy requests that are increasingly urgent, asking to focus on coping skills and tools people can use immediately, Breland-Noble said.

“After George Floyd’s death, it became: ‘Please talk to us about exposure to racial trauma and how we can help congregations deal with this,’” she said. “‘Because this is a lot.’”

Across the country, mental health needs are soaring. And Black Americans are experiencing significant strain: A study from the Centers for Disease Control and Prevention this summer found 15% of non-Hispanic Black adults had seriously considered suicide in the past 30 days and 18% had started or increased their use of substances to cope with pandemic-related stress.

Yet national data shows Blacks are less likely to receive mental health treatment than the overall population. A memo released by the Substance Abuse and Mental Health Services Administration this spring lists engaging faith leaders as one way to close this gap.

Two congregants expressed suicidal thoughts to Carl Lucas, pastor at God First Church in northern St. Louis County. “The pandemic has definitely put us in a place where we’re looking for answers and looking for other avenues to help our members,” he says. (Evelyn Lucas)

The Potter’s House in Dallas has been trying to do that for years. A megachurch with more than 30,000 members, it runs a counseling center with eight licensed clinicians, open to congregants and the local community to receive counseling at no cost, though donations are accepted.

Since the pandemic began, the center has seen a 30% increase in monthly appointments compared with previous years, said center director Natasha Stewart. During the summer, when protests over race and policing were at their height, more Black men came to therapy for the first time, she said.

Recently, there’s been a surge in families seeking services. Staying home together has brought up conflicts previously ignored, Stewart said.

“Before, people had ways to escape,” she said, referring to work or school. “With some of those escapes not available anymore, counseling has become a more viable option.”

To meet the growing demand, Stewart is adding a new counselor position for the first time in eight years.

At smaller churches, where funding a counseling center is unrealistic, clergy are instead turning to members of the congregation to address growing mental health needs.

At Catalyst Church, a member with a background in crisis management has begun leading monthly COVID conversations online. A deacon has been sharing his own experience getting therapy to encourage others to do the same. And Gerow, the senior pastor, talks openly about mental health.

Recognizing his power as a pastor, Gerow hopes his words on Sunday morning and in one-on-one conversations will help congregants seek the help they need. Doing so could reduce substance use and gun violence in the community, he said. Perhaps it would even lower the number of mental health crises that lead to police involvement, like the October death of Walter Wallace Jr., whose family said he was struggling with mental health issues when Philadelphia police shot him.

“If folks had the proper tools, they’d be able to deal with their grief and stress in different ways,” Gerow said. “Prayer alone is not always enough.”

Laverne Williams got worried when she heard pastors tell people they could pray away mental illness. She created a multimedia presentation to educate faith leaders about mental health ― to show that faith and mental health can coexist. (Laverne Williams)

Laverne Williams recognized that back in the ’90s. She believed prayer was powerful, but as an employee of the Mental Health Association in New Jersey, she knew there was a need for treatment too.

When she heard pastors tell people they could pray away mental illness or use blessed oil to cure what seemed like symptoms of schizophrenia, she worried. And she knew many people of color were not seeing professionals, often due to barriers of cost, transportation, stigma and distrust of the medical system.

To address this disconnect, Williams created a video and PowerPoint presentation and tried to educate faith leaders.

At first, many clergy turned her away. People thought seeking mental health treatment meant your faith wasn’t strong enough, Williams said.

But over time, some members of the clergy have come to realize the two can coexist, said Williams, adding that being a deacon herself has helped her gain their trust. This year alone, she’s trained 20 faith leaders in mental health topics.

A program run by the Behavioral Health Network of Greater St. Louis is taking a similar approach. The Bridges to Care and Recovery program trains faith leaders in “mental health first aid,” suicide prevention, substance use and more, through a 20-hour course.

The training builds on the work faith leaders are already doing to support their communities, said senior program manager Rose Jackson-Beavers. In addition to the tools of faith and prayer, clergy can now offer resources, education and awareness, and refer people to professional therapists in the network.

Since 2015, the program has trained 261 people from 78 churches, Jackson-Beavers said.

Among them is Carl Lucas, pastor of God First Church in northern St. Louis County who graduated this July — just in time, by his account.

Since the start of the pandemic, he has encountered two congregants who expressed suicidal thoughts. In one case, church leaders referred the person to counseling and followed up to ensure they attended therapy sessions. In the other, the root concern was isolation, so the person was paired with church members who could touch base regularly, Lucas said.

“The pandemic has definitely put us in a place where we’re looking for answers and looking for other avenues to help our members,” he said. “It has opened our eyes to the reality of mental health needs.”

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Public Health Officials Are Quitting or Getting Fired in Throes of Pandemic

Vilified, threatened with violence or in some cases suffering from burnout, dozens of state and local public health officials around the U.S. have resigned or have been fired amid the coronavirus outbreak, a testament to how politically combustible masks, lockdowns and infection data have become.

One of the latest departures came Sunday, when California’s public health director, Dr. Sonia Angell, was ousted following a technical glitch that caused a delay in reporting virus test results — information used to make decisions about reopening businesses and schools.

Last week, New York City’s health commissioner was replaced after months of friction with the police department and City Hall.

A review by KHN and The Associated Press finds at least 49 state and local public health leaders have resigned, retired or been fired since April across 23 states. The list has grown by more than 20 people since the AP and KHN started keeping track in June.

Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention, called the numbers stunning. He said they reflect burnout, as well as attacks on public health experts and institutions from the highest levels of government, including from President Donald Trump, who has sidelined the CDC during the pandemic.

“The overall tone toward public health in the U.S. is so hostile that it has kind of emboldened people to make these attacks,” Frieden said.

The past few months have been “frustrating and tiring and disheartening” for public health officials, said former West Virginia public health commissioner Dr. Cathy Slemp, who was forced to resign by Republican Gov. Jim Justice in June.

“You care about community, and you’re committed to the work you do and societal role that you’re given. You feel a duty to serve, and yet it’s really hard in the current environment,” Slemp said in an interview Monday.

The departures come at a time when public health expertise is needed more than ever, said Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials.

“We’re moving at breakneck speed here to stop a pandemic, and you can’t afford to hit the pause button and say, ‘We’re going to change the leadership around here and we’ll get back to you after we hire somebody,’” Freeman said.

As of Monday, confirmed infections in the United States stood at over 5 million, with deaths topping 163,000, the highest in the world, according to the count kept by Johns Hopkins University researchers. The confirmed number of coronavirus cases worldwide topped 20 million.

Many of the firings and resignations have to do with conflicts over mask orders or shutdowns to enforce social distancing, Freeman said. Despite the scientific evidence that such measures help prevent transmission of the coronavirus, many politicians and others have argued they are not needed, no matter what health experts tell them.

“It’s not a health divide; it’s a political divide,” Freeman said.

Some health officials said they were stepping down for family reasons, and some left for jobs at other agencies, such as the CDC. Some, like Angell, were ousted because of what higher-ups said was poor leadership or a failure to do their job.

Others have complained that they were overworked, underpaid, unappreciated or thrust into a pressure-cooker environment.

“To me, a lot of the divisiveness and the stress and the resignations that are happening right and left are the consequence of the lack of a real national response plan,” said Dr. Matt Willis, health officer for Marin County in Northern California. “And we’re all left scrambling at the local and state level to extract resources and improvise solutions.”

Public health leaders from Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, down to officials in small communities have reported death threats and intimidation. Some have seen their home addresses published or been the subject of sexist attacks on social media. Fauci has said his wife and daughters have received threats.

In Ohio, the state’s health director, Dr. Amy Acton, resigned in June after months of pressure during which Republican lawmakers tried to strip her of her authority and armed protesters showed up at her house.

It was on Acton’s advice that GOP Gov. Mike DeWine became the first governor to shut down schools statewide. Acton also called off the state’s presidential primary in March just hours before polls were to open, angering those who saw it as an overreaction.

The executive director of Las Animas-Huerfano Counties District Health Department in Colorado, Kim Gonzales, found her car vandalized twice, and a group called Colorado Counties for Freedom ran a radio ad demanding that her authority be reduced. Gonzales has remained on the job.

In West Virginia, the governor forced Slemp’s resignation over what he said were discrepancies in the data. Slemp said the department’s work had been hurt by outdated technology like fax machines and slow computer networks. Tom Inglesby, director of the UPMC Center for Health Security at Johns Hopkins, said the issue amounted to a clerical error easily fixed.

Inglesby said it was deeply concerning that public health officials who told “uncomfortable truths” to political leaders had been removed.

“That’s terrible for the national response because what we need for getting through this, first of all, is the truth. We need data, and we need people to interpret the data and help political leaders make good judgments,” Inglesby said.

Since 2010, spending on state public health departments has dropped 16% per capita, and the amount devoted to local health departments has fallen 18%, according to a KHN and AP analysis. At least 38,000 state and local public health jobs have disappeared since the 2008 recession, leaving a skeleton workforce for what was once viewed as one of the world’s top public health systems.

Another sudden departure came Monday along the Texas border. Dr. Jose Vazquez, the Starr County health authority, resigned after a proposal to increase his pay from $500 to $10,000 a month was rejected by county commissioners.

Starr County Judge Eloy Vera, a county commissioner who supported the raise, said Vazquez had been working 60 hours per week in the county, one of the poorest in the U.S. and recently one of those hit hardest by the virus.

“He felt it was an insult,” Vera said.

In Oklahoma, both the state health commissioner and state epidemiologist have been replaced since the outbreak began in March.

In rural Colorado, Emily Brown was fired in late May as director of the Rio Grande County Public Health Department after clashing with county commissioners over reopening recommendations. The person who replaced her resigned July 9.

The months of nonstop and often unappreciated work are prompting many public health workers to leave, said Theresa Anselmo of the Colorado Association of Local Public Health Officials.

“It will certainly slow down the pandemic response and become less coordinated,” she said. “Who’s going to want to take on this career if you’re confronted with the kinds of political issues that are coming up?”

Weber reported from St. Louis. Associated Press writers Paul Weber, Sean Murphy and Janie Har and California Healthline senior correspondent Anna Maria Barry-Jester contributed reporting.

This story is a collaboration between KHN and The Associated Press.

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Can you mix the Covid vaccines?

Jeremy Corbyn slams ‘rich’ countries over ‘vaccine nationalism’

There are three coronavirus vaccines which have been approved for mass distribution in the UK. More than four million people have now received their first dose of the vaccine, with more than 450,000 having been given their second dose as well. But with three different vaccines available – can you mix the vaccines and is it safe to do so?

The UK was the first nation in the world to approve the use of a coronavirus vaccine.

As of January 18, 4,062,501 people have received their first dose of the vaccine, with 452,301 having received their second dose as well.

Speaking from Downing Street on Monday, Health Secretary Matt Hancock said: “I know the pain that this disease causes – and I’m determined to do everything we possibly can to defeat it, and I know that is what you want too.

“And our vaccine delivery plan is absolutely at the core of this, it is our way out. It’s also the biggest medical deployment in British history and it’s one of the biggest civilian operations that this country’s ever undertaken.

“Our approach is, of course, to save as many lives as possible – as quickly as possible and to reduce the pressure on the NHS.”

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The Health Secretary outlined the UK is on track to vaccinate the most vulnerable groups by the middle of February.

These groups currently account for 88 percent of Covid-related deaths reported in Britain.

From Monday, all those aged above 70 and those under 70 who are clinically extremely vulnerable will begin to be invited for vaccination.

Mr Hancock said: “We’re doing this because it’s the best way both to maximise the pace of the rollout and deliver according to the clinical prioritisation.

“All with the goal of saving as many lives as possible, as quickly as possible and reducing the pressures on the NHS.”

Can you mix the vaccines?

There are three different types of vaccine currently available in the UK.

The Pfizer/BioNTech vaccine, which requires storing at temperatures close to -75C, was the first to be approved in the UK.

The Pfizer/BioNTech jab uses a technology known as mRNA which introduces a messenger sequence which contains the generic instructions for the vaccinated person’s own cells to produce the antigens and generate an immune response.

The final data on this vaccine showed it offers 95 percent protection against the virus after two doses, with a 94 percent effectiveness among adults over the age of 65.

The Oxford/AstraZeneca was the second vaccine to be approved in the UK and it works by smuggling the coronavirus gene into human cells to make the spike protein which the immune system builds up a response to if the real virus enters the body.

The Oxford trial found after two doses, the vaccine was 62 percent effective, but later when people were given a half dose followed by a full dose efficacy rose to 90 percent.

The Moderna vaccine is the latest vaccine to be introduced and it uses the same mRNA technology as the Pfizer/BioNTech vaccine.

Moderna’s response indicates 94.5 percent effectiveness but said trials are ongoing and these final figures may change.

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The official guidance outlines everyone should receive the same vaccine for both doses.

However, in very rare circumstances, if only one vaccine is available or it is unknown which particular vaccine was used for the first dose, a different vaccine can be used.

The Government guidance reads: “JCVI advises that the second vaccine dose should be with the same vaccine as for the first dose.

“Switching between vaccines or missing the second dose is not advised as this may affect the duration of protection.”

Different vaccines will not be mixed in the same dose.

Mary Ramsay, head of immunisations at PHE, told The BMJ that “every effort should be made to give [patients] the same vaccine, but where this is not possible it is better to give a second dose of another vaccine than not at all.”

The UK has been the first country to announce it is prepared to mix and match the vaccines in limited circumstances.

NHS England has been keen to stress people can be given a different second dose from the first when absolutely necessary.

However, the United States in particular, has been critical of this approach.

The US Centers for Disease Control and Prevention said that the authorised Covid-19 vaccines “are not interchangeable” and that “the safety and efficacy of a mixed-product series have not been evaluated. Both doses of the series should be completed with the same product.”

Dr Ramsay’s comments were repeated in a press briefing involving Professor Munir Pirmohamed, chair of the Commission of Human Medicines expert working group.

Professor Pirmohamed said: “We’re not advising mixing different doses of the vaccines because we don’t have any data on that.

“Our advice is that if you have the Pfizer vaccine as a first dose, the second dose should also be the Pfizer vaccine.

“If you have the AstraZeneca vaccine as a first dose, the second dose should also be the AstraZeneca vaccine.”

Trials are currently underway where people receive different vaccines at different times to see how effective it is.

Public Health England said because all the available vaccines are based on the spike protein, it is likely the second dose will help to boost the response to the first dose, even if it is a different vaccine.

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Lockdown sleep: Why can’t I sleep? An experts tips to a great night’s sleep

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A study from the Economic and Social Research Council-funded Centre for Population Change at Southampton University has found that the number of Brits suffering sleep loss caused by worrying rose from one in six to one in four as a direct result of the pandemic, so it’s no wonder we are all exhausted during the day. Express.co.uk chatted to the in-house Sleep Expert at Emma, Dr Verena Senn, to find out how to get a great night’s sleep during lockdown.

Why can’t I sleep?

According to Dr Senn, the number one reason we’re all feeling so tired during the day is because of poor sleep quality.

Interrupted sleep or lack of sleep is probably caused by loneliness and lack of social interaction.

Dr Senn explained being lonely can “lead to higher levels of stress” and this then triggers a spike in the hormone cortisol.

The sleep expert said: “Cortisol is known for being part of our fight-or-flight response, keeping us alert and ready whilst high levels are in our systems.”

So with cortisol spiking, this can create trouble for those wanting to fall asleep and can also “increase the likelihood of having an interrupted sleep.”

Dr Senn also revealed loneliness can contribute to feeling stressed, or anxious explaining: “We’re also beginning to understand that the brain and body perceive loneliness and social isolation as a serious threat, similar to how our bodies react to any harmful external factor.

“It seems that loneliness puts us on high alert, which interferes with our bodies ability to wind down and relax.”

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How to sleep

The solution to a sleepless night caused by loneliness is to up your levels of social interaction.

Dr Senn said: “Make sure you take time out each day for some form of social interaction. Those living alone should look to meet people at least once a week, as well as carving time out for those important calls.

“Yes, Zoom fatigue is real, but so too is the danger of a lack of social interaction and humans’ brains are literally wired to connect.”

She also added there are some brilliant UK initiatives and organisations to help support those who are suffering with loneliness, including Tackling Youth Loneliness, Campaign to End Loneliness, WaveLength and The CO-OP Foundation’s Belong. The NHS also provides a portal complete with resources to help anyone suffering from loneliness, social isolation and those currently shielding.”

There are a number of other things you can do to improve your sleep quality.

Dr Senn said it is important to de-stress in the evening to ensure we start the next day fresh and break the cycle.

Don’t stress

If you’re finding it difficult to sleep, you shouldn’t get worked up about it.

Dr Senn explained: “If you cannot get to sleep at night due to stress, try not to fret over it too much. Doing so will only increase your stress levels, increase your cortisol and activate your sympathetic nervous system, continuing that never-ending cycle. Just know that you will drift off eventually.”

Read

Don’t lay there with your eyes clenched shut if you’re wide awake, try and distract yourself in order to doze off.

Dr Senn said: “If you feel you’re too focused on getting to sleep, take yourself out of your room and read a book, but make sure you keep the light dim and it’s a physical copy, otherwise blue light emitted from your e-reader will suppress the production of the sleep-inducing hormone, melatonin.

“Also, you don’t want to read anything too gripping, but enough to take your mind off of things.”

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Listen

You don’t have to read something, you could always just listen to something mildly distracting.

Dr Senn said: “This varies from person to person, but it could be low white noise, an audiobook read by a soothing voice or even some relaxing music.

“For many, something that they have listened to many times before is enough to distract their focus from their thoughts, but not too thrilling to keep them wide-awake.

“But no matter what, take stock in the fact that you will eventually drift off, ready for whatever the world has to throw at you.”

Meditate

Whether you’re an avid meditator or hate the idea of it, you should give it a go if you’re really struggling to sleep.

Dr Senn said: “Guided meditation has been proven to help positively impact sleep issues, lowering the heart rate by activating the parasympathetic nervous system – the counterpart of our fight or flight response – and is an age-old technique to help relax the mind and body.

“Of course, meditation isn’t a fix-all, rapid solution; you can’t meditate minutes before bed and expect to doze off.”

Temperature

No matter how cold it is outside, never let your home overheat before bedtime.

Dr Senn explained: “As tempting as it may be to sleep in a snug warm room, it’s actually counterintuitive.

“Cooling our bodies down at the end of the day is a key part of winding our bodies down for sleep. Our body core temperature fluctuates throughout the day, peaking in the afternoon and through the early morning hours.

“The optimal bedroom temperature is around 15.5-19°C, so keep that thermostat down or off. I’d suggest setting a timer to heat up your home for when you wake up; helping you not only sleep better, but also saving money on your energy bills.”

Snacks

What you eat can determine how well you sleep, and there are a few foods that will help you fall asleep more quickly.

Dr Senn said: “It may sound odd at first, but there are foods which can actually lull you into a deeper, more restful sleep: among these are eggs, kiwis and nuts.

“That’s because these protein-rich foods contain a small amount of an amazing amino acid known as tryptophan.

“Tryptophan is a precursor of other important molecules in your body, including melatonin- the sleep-inducing hormone.

“By helping your body to produce more melatonin, tryptophan can help you better regulate your circadian rhythm (our internal clock), helping you in dozing off into a well-needed rest.

“If that wasn’t enough, foods rich in tryptophan can also help your body regulate its core temperature; an important factor considering our temperature needs to drop roughly 1-2C to enjoy a good night’s sleep.

“A few kiwis or a handful of peanuts in the evening will help your body produce melatonin; but make sure you don’t eat too close to bedtime as the later you eat, the harder it is on your body to digest!”

Source: Read Full Article

Hair loss treatment: Apple cider vinegar restores the PH balance to increase hair growth

This Morning: Dr Ranj discusses treatments for hair loss

Hair loss is a problem that many men and women face today. According to recent studies, hair loss is found in as many as 70 percent of men, and in women, who are considered less likely to have this problem. Statistics show otherwise with about 30 percent of women face or will face hair loss later on in life. However, in women, hair loss usually does not end with total baldness, as is the case with men. Apple cider vinegar has become extremely popular for a number of health reasons and could be one of the best treatments to help increase hair growth.

In a study published in the US National Library of Medicine National Institutes of Health, pH levels in shampoos and how it can affect hair growth and breakage was investigated.

The study noted: “Dermatologists most frequently prescribe shampoos for the treatment of hair shed and scalp disorders.

“Prescription of hair care products is often focused on improving scalp hair density, whereas the over-the-counter products focus on hair damage prevention.

“Alkaline pH may increase the negative electrical charge of the hair fibre surface and, therefore, increase friction between the fibres and this may lead to cuticle damage and fibre breakage.”

As ACV has a high acidity, it could help maintain the pH balance, thus making hair smoother, stronger, and increasing hair growth.

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Medical News Today added: “Some advocates claim that apple cider vinegar deserves a place in everyone’s hair care routine, thanks to its powers to relieve a variety of scalp conditions, including flaking, dandruff, and psoriasis.

“Others have said it can boost hair growth.

“Hair has an ideal pH level of between four and five, but many commercial shampoos may disrupt this.

“Because apple cider vinegar has a high acidity, it follows that it could help maintain the pH balance, thus making hair smoother, stronger, and shinier.”

Adding apple cider vinegar (ACV) to your hair care routine “will help keep your scalp healthy by warding off bacteria and keeping a balanced pH level,” said Dr Debra Jaliman.

She added: “This will stimulate hair growth.

“ACV gently exfoliates the scalp which in turn will promote hair growth and healthier hair.”

“Of course, any hair loss concerns you might have should be discussed with your doctor or dermatologist, but having a cheap, natural tool in your arsenal can’t hurt, as well.”

How to use

An apple cider vinegar wash can be made very simply, said Healthline.

The site advised the simple steps to use apple cider vinegar to increase hair growth which include:

  • Mix a couple of tablespoons of apple cider vinegar with water.

  • After shampooing and conditioning, pour the mixture over your hair evenly, working into your scalp.

  • Let it sit for a couple of minutes.

  • Rinse it out.

  • More conventional treatments

    According to the NHS, finasteride and minoxidil are the main treatments for male pattern baldness.

    Male pattern baldness is a permanent type of hair loss that usually runs in the family.

    It is worth noting that finasteride and minoxidil come with drawbacks to consider first.

    As the NHS explains, these treatments:

  • Don’t work for everyone

  • Only work for as long as they’re used

  • Aren’t available on the NHS

  • Can be expensive.

  • Also, minoxidil can be used to treat female pattern baldness but women shouldn’t use finasteride, warns the health body.

    Source: Read Full Article

    DR MARTIN SCURR answers your health questions

    ‘My nightmares are so bad that I scream out loud’: DR MARTIN SCURR answers your health questions

    A few times a year, I have terrible nightmares during which I scream — but I don’t remember them in the morning. I am in my 70s, the only health problem I have is high blood pressure and I haven’t suffered trauma. Should I be concerned?

    Jane Thornton, via email.

    This is understandably distressing for you, but the good news is that the cause is not sinister. Your email amounts to a textbook description of sleep terrors, one of a group of disorders called parasomnias, which cause unusual or unwanted behaviour while you sleep.

    Although more common in children, they can affect people of any age, occurring during the deepest stage of non-rapid eye movement sleep (one of the two main cycles of sleep). They typically involve intense fear and screaming and last a few minutes.

    In the morning, those affected won’t recall anything because it all happened while they were sleeping (usually they only know about it through their partner).

    A visit to your GP should confirm the diagnosis and reassure you that this is nothing to worry about [File photo]

    Research suggests such episodes are triggered by physical and emotional stress, including excessive fatigue, fever and certain medication (for example, the sleeping tablets zolpidem and zopiclone).

    None of these factors appears to be relevant in your case, however, and I have not been able to find any research linking night terrors to high blood pressure, nor the drug felodipine, which you take to treat this.

    Knowing that these episodes are night terrors, a recognised disorder, and nothing more sinister is usually enough for most patients.

    There is some evidence that clonazepam (an anti-convulsant and sedative) may be helpful in the short term — but to take such medication long term for brief episodes that occur only two or three times a year does not seem ideal.

    A visit to your GP should confirm the diagnosis and reassure you that this is nothing to worry about.

    I had stents fitted nine years ago to help with angina and have since been taking beta blockers. Lately, my COPD (chronic obstructive pulmonary disease) has been worsening after exercise. I know beta blockers can cause breathlessness, but my GP won’t remove them from my prescription. Would it be dangerous to stop taking them?

    Roger Jones, St Albans, Herts.

    This is a reasonable question, but I urge you not to stop taking the beta-blocker (bisoprolol, as you mention in your longer letter), which is key to keeping your heart health in check.

    COPD is the umbrella term for chronic lung conditions that are characterised by breathlessness, such as severe asthma. You say this is now worse with exercise — known as exertional dyspnoea — but no one has explained why.

    Your heart disease (caused by a narrowing of the coronary arteries) was eased by stents, small metal cages used to prop open the blood vessels, almost a decade ago.

    The beta blocker you’ve been prescribed improves blood supply to the heart muscle by slowing your heart rate and improving the efficiency of each beat. This has worked as your chest pain, caused by angina, has gone.

    COPD is the umbrella term for chronic lung conditions that are characterised by breathlessness, such as severe asthma. You say this is now worse with exercise — known as exertional dyspnoea — but no one has explained why [File photo]

    Through your own research you found that beta blockers can cause breathlessness. This is correct in the case of the first-generation beta blockers (e.g. propranolol), but second-generation beta blockers, including bisoprolol, do not.

    Instead, a possible cause is that your COPD has deteriorated due to factors such as pollution, which can trigger more inflammation in the airways.

    Or this may be an sign of a further restriction of blood flow in the coronary arteries. This could be the case even without chest pain and notwithstanding your long-term treatment with the statin simvastatin (to lower cholesterol) and aspirin (to thin the blood).

    For this reason, I think it is essential that you see a cardiologist. Further investigations might include a form of heart X-ray and, depending on the findings, your medication will be reviewed.

    You should also consult your GP to organise for an expert to reassess the severity of your COPD.

    Write to Dr Scurr

    Write to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email [email protected] Replies should be taken in a general context and always consult your own GP with any health worries.

    Vitamin D is very much the nutrient du jour; its role in immunity is being studied closely as a result of the pandemic. But another, less well-known, benefit is its role in resolving dizziness.

    I receive many letters about dizziness — in particular benign paroxysmal positional vertigo (BPPV), which triggers the kind of spinning and unsteadiness you would feel after jumping off a children’s roundabout.

    It can be a very unpleasant and disabling experience. And, while it often resolves itself, the condition can recur.

    But now research suggests it may be prevented by taking vitamin D (400IU, international units, daily) and calcium carbonate (500mg twice daily) supplements. It seems that the treatment is especially effective in those with low vitamin D levels.

    In short, a very real and exciting advance for those plagued with this condition. And yet another reason to keep your levels topped up.

    Source: Read Full Article

    Cervical cancer symptoms: Bleeding after sex is a warning sign of the disease

    Lisa Maffia discusses her 'cervical cancer' diagnosis

    The neck of the womb (i.e. the cervix) connects the womb and vagina inside a woman’s body – it’s where a baby passes through before it’s born. Cervical cancer occurs when abnormal cells multiply in the cervix.

    Cancer Research UK pointed out that unusual vaginal bleeding is a sign of cervical cancer.

    What’s classified as “abnormal” vaginal bleeding?

    Abnormal vaginal bleeding occurs “at times other than when you’re having a period”. Examples include:

    • Between periods
    • During or after sex (post coitus)
    • At any time after your menopause

    Other signs of cervical cancer include:

    • Discomfort or pain during sex
    • A vaginal discharge that smells unpleasant
    • Pain in the area between the hip bones (pelvis)

    What causes cervical cancer?

    The Eve Appeal charity said that nearly all squamous cervical cancers are caused by a “common sexually transmitted infection (STI) called human papillomavirus (HPV)”.

    The charity emphasises that HPV is extremely common, around 80 percent of people will come in contact with it at some stage of their life.

    Usually, the immune system will be able to clear up the infection without any need for treatment.

    HPV is a group of viruses; there are more than 100 different types spread through skin-to-skin sexual contact.

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    This means people don’t need to engage in penetrative sex in order for HPV to be transmitted.

    Should the body be unable to clear the virus, there is a risk of abnormal cells developing, which can become cancerous over time.

    Am I at risk of cervical cancer?

    People at risk of developing cervical cancer must have a cervix, such as:

    • Females
    • Trans men who haven’t had a total hysterectomy

    “People with a cervix who smoke are twice as likely to develop cervical cancer as those who don’t,” said The Eve Appeal.

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    Smoking is thought to reduce the effectiveness of the immune system, meaning the body may struggle to clear a HPV infection.

    Those on immunosuppression drugs for a long time can also be at an increased risk of retaining the HPV virus.

    In the UK, people with a cervix between the ages of 25 to 64 should be invited for a free NHS cervical screening (i.e. a smear test).

    This invitation usually arrives by letter, so it’s vital to be registered to a local GP’s office, alongside updated contact details.

    The NHS added that the smear test isn’t a test for cancer, “it’s a test to help prevent cancer”.

    During the physical examination, cells in the cervix are checked for “high-risk” types of HPV.

    A small sample from the cervix may also be checked for any abnormal cells.

    People should receive their results via a letter two weeks after their appointment.

    For more information and support about going for cervical screening, results and treatment, you can contact Jo’s Cervical Cancer Trust; their helpline is available on 0808 802 8000.

    The Eve Appeal charity wanted to stress that the prospect of a complete cure is good for cervical cancer diagnosed at an early stage.

    However, “this decreases the further the cancer has grown into or around the cervix”.

    This highlights the importance of a regular smear test to identify anything troubling sooner.

    Source: Read Full Article

    Katie McGlynn health: Ex Coronation Street star ‘did feel really down’

    Coronation Street: Katie McGlynn 'happy' with BAFTA nomination

    Stepping into the shoes of Tinkerbell in the pantomime production of Peter Pan pre Covid, Katie McGlynn fainted and woke up in hospital. Medics put it down to exhaustion, which kicked off a health overhaul.

    Remembering back to 2019, Katie spoke to Lorraine Kelly on her TV show about her unfortunate spell of bad luck.

    “I was feeling a bit under the weather,” she said. “I just powered through.”

    The 27-year-old continued: “I was feeling off, sick… and I thought, ‘This is weird.'”

    Saying she felt “really spaced out”, Katie recalled fainting in between shows.

    Stating it was “all a bit of a blur” and “dramatic”, on one occasion the petite 5ft 4in actress woke up in A&E in her Tinkerbell outfit.

    “The doctor put it down to exhaustion and being ill, but I had a virus,” she said.

    “I needed bed rest, and I went to the doctor again and he said I needed one to two weeks.”

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    Katie decided to take part in a 12-week Ultimate Performance transformation plan.

    “Before the transformation, I don’t want to say I was depressed,” she began.

    “But I did feel very down about my weight, mentally and physically I was tired.

    “I didn’t feel like myself whatsoever. I felt sluggish,” she said.

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    Completing the fitness challenge, Katie gushed: “I am so happy with my overall physical and mental wellbeing after this transformation.

    “I’ve lost a dress size, I’ve gained more muscle, I’m getting stronger… I feel like myself again, finally. I feel like back-to-normal Katie.”

    How exercise impacts mood

    WebMD noted improved self-esteem is a “key psychological benefit of regular exercise”.

    Exercising releases chemicals called endorphins that “interact with the receptors in your brain”.

    Endorphins “trigger a positive feeling in the body” – similar to that of morphine.

    Known as a “runner’s high”, it can be accompanied by “a positive and energising outlook on life”.

    These happy chemicals also act as “analgesics”, meaning they diminish the perception of pain.

    Regular exercise has been proven to:

    • Reduce stress
    • Ward off anxiety and feelings of depression
    • Boost self-esteem
    • Improve sleep

    In additional to emotional improvements, regular exercise provides other physical health benefits.

    For example, regular exercise strengthens the heart, lowers blood pressure, improves muscle tone, and helps reduce body fat.

    There are various forms of exercise, such as:

    • Jogging
    • Biking
    • Housework
    • Low-impact aerobics
    • Walking
    • Yoga
    • Swimming
    • Playing tennis
    • Golf (walking instead of using the cart)
    • Dancing
    • Gardening

    Katie McGlynn will be starring on ITV’s Celebrity Catchphrase on Saturday, January 9 at 6pm.

    Source: Read Full Article

    Olly Alexander health: It’s A Sin star opens up about his mental health struggles

    It's a Sin: Channel 4 release trailer starring Olly Alexander

    An advocate for LGBTQ (lesbian, gay, bisexual and transgender), Olly Alexander is the celebrity who has gained thousands of fans, not only for his music, but also for his openness about mental health.

    “The likelihood is that you or someone you know closely will suffer from a mental health condition in your lifetime,” he told The Guardian’s Owen Jones.

    “It’s like any other part of your body – your mental health gets sick, and it needs treatment.”

    As a teenager, Olly would self harm, he told Alastair Campbell for GQ Magazine.

    At the same time, he also developed an eating disorder – bulimia, which lasted for seven years.

    The 30-year-old takes daily medication (sertraline) to manage his symptoms of depression.

    Am I depressed?

    The charity Rethink Mental Illness defined depression as a “long-lasting low mood disorder”.

    A common mental health condition, affecting one in 10 people, treatment and support is available.

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    Based on the NHS recommendation, people should talk to their GP if they’re experiencing symptoms of depression for most of the day, every day for over two weeks.

    Symptoms of depression include:

    • Low mood, feeling sad, irritable or angry
    • Having less energy to do certain things
    • Losing interest or enjoyment in activities you used to enjoy
    • Loss of concentration
    • Becoming tired more easily
    • Disturbed sleep and losing your appetite
    • Feeling less good about yourself (loss of self-confidence)
    • Feeling guilty or worthless.

    Experiencing a low mood can also lead to:

    • Feeling less pleasure from things
    • Feeling more agitated
    • Losing interest in sex
    • Finding your thoughts and movements slow down
    • Having thoughts of self-harm or suicide.

    Anyone struggling with their mental health are encouraged to call the Samaritans free helpline on 116 123.

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    There’s also a Samaritans Self-Help app available, where you can document how you’re feeling, and get recommendations on how to help yourself cope, feel better and stay safe.

    If you go to speak with a doctor about your feelings of depression, they should enquire about any possible causes of depression.

    Sometimes, feelings of depression can be triggered by stressful events in your life.

    Examples include divorce, redundancy, furlough, financial difficulties, and/or death of a loved one.

    Reactive depression is different from an adjustment disorder, whereby symptoms of depression can follow a major change in your life.

    This can include separation from people, retirement or migrating to a new area.

    “Having problems with your thyroid or having low levels of Vitamin B12 may also be linked to experiencing symptoms of depression,” said the charity.

    Lifestyle factors can also increase a person’s risk of experiencing depressive symptoms.

    This can include not exercising, being under or overweight, and having fewer social relationships.

    Evidence also suggests that drinking alcohol regularly or missing alcohol can put a person at greater risk of depression.

    Other health conditions, such as diabetes and cancer can also coincide with feelings of depression.

    Treatments for depression

    Talking therapies are available for free on the NHS, however private healthcare providers can also offer help and support.

    “The type of therapy you are offered will depend on the cause of your symptoms and their severity,” said Rethink Mental Illness.

    Olly Alexander will be starring on BBC One’s The Graham Norton Show, on Friday January 8 at 10:45pm.

    Source: Read Full Article