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Support For Health Law Grows, Leaving Republicans In A Bind

Republican members of Congress are at home this week, with many of them getting an earful from anxious constituents about their plans to “repeal and replace” the Affordable Care Act. A poll out Friday gives those lawmakers something to be anxious about, too.

The monthly tracking poll from the Kaiser Family Foundation finds overall support for the health law ticked up to 48 percent in February, the highest point since shortly after it passed in 2010. That was a 5-point increase since the last poll in December. (Kaiser Health News is an editorially independent project of the foundation.)

In addition, 6 in 10 people said they did not favor current GOP proposals for turning control of Medicaid, the federal-state program for low-income residents, over to the states or changing the federal funding method. More than half said Medicaid is important to them or family members.

The increase in the law’s popularity is almost entirely due to a spike in support among independents, whose approval of the law has risen to 50 percent, compared with 39 percent unfavorable. Continuing a trend that dates to the passage of the law, the vast majority of Democrats approve of it (73 percent), while the vast majority of Republicans disapprove (74 percent).

Poll respondents are also concerned about the way Republicans say they will overhaul the measure. While they are almost evenly divided between wanting to see the law repealed (47 percent) or not repealed (48 percent), very few (18 percent) of those favoring repeal support the idea of working out replacement details later. More than half of the repeal supporters (28 percent of the sample) say the repeal and the ACA’s replacement should come simultaneously.

Interestingly, even among Republicans, fewer than a third (31 percent) favor an immediate repeal, while 48 percent support simultaneous repeal and replacement, and 16 percent don’t want the law repealed at all.

Simultaneous repeal and replacement, which is what President Donald Trump has promised, could prove difficult since Republicans have not agreed to a plan. They are using a special budget procedure, called reconciliation, that allows them to move legislation with only a simple majority in the Senate, but that bill is limited in what it can remove from the law and what can be added to it. Other bills would likely have to overcome a filibuster by Democrats in the Senate, which requires 60 votes. Republicans currently have a 52-48 majority in that chamber.

When asked about the Republican plans to overhaul the Medicaid program, nearly two-thirds of those polled prefer the current Medicaid program to either a “block grant” that gives states more flexibility but would limit Medicaid’s currently unlimited budget, or a “per capita cap,” which would also limit spending to states but would allow federal funding to rise with enrollment increases.

Respondents also strongly favor letting states that expanded Medicaid under the Affordable Care Act continue to receive federal funding. The Supreme Court in 2012 made that expansion optional; 31 states (plus Washington, D.C.) adopted it. Eighty-four percent said letting the federal funds continue was very or somewhat important, including 69 percent of Republicans, and 80 percent of respondents in states that did not expand the program.

Republicans are counting on savings from capping Medicaid to pay for other health care options they are advocating.

The national telephone poll was conducted Feb. 13-19 with a sample of 1,160 adults. The margin of error is plus or minus 3 percentage points for the full sample.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Threat Of Obamacare Repeal Leaves Community Health Centers In Limbo

Treating people for free or for very little money has been the role of community health centers across the U.S. for decades. In 2015, 1 in 12 Americans sought care at one of these clinics; nearly 6 in 10 were women, and hundreds of thousands were veterans.

The community clinics — now roughly 1,300-strong — have also expanded in recent years to serve people who gained insurance under the Affordable Care Act. In 2015, community health centers served 24.3 million people — up from 19.5 million in 2010. Most of the centers are nonprofits with deep roots in their communities and they meet the criteria to be a federally qualified health center. That means they can qualify for federal grants and a higher payment rate from Medicaid and Medicare.

The ACA was a game changer for these clinics — it has enabled them to get reimbursement for much more of the care they provided, because more of their patients now had private insurance or were on Medicaid. Revenue at many clinics went up overall, and many of the health centers used federal funding available under the law to expand their physical facilities and add more services, such as dentistry, urgent care or mental health care.

With repeal of the ACA looming, clinic directors said they stay up at night wondering what’s next. We spoke with four, who all say their clinics are in a holding pattern as Congress debates the health law’s future.

Saban Community Clinic, Los Angeles

Julie Hudman, the CEO of Saban Community Clinic in Los Angeles, Calif., said there’s a lot at stake for her patients.

“A lot of the folks that we see are single adults,” she explained. “They’re maybe more transitional. They’re homeless patients. They have behavioral health challenges. They’re really, to be honest, some of the most vulnerable and poorest patients of all.”

Before the ACA went into effect, eligibility for Medi-Cal, as Medicaid is known in California, depended on a variety of factors, including income, household size, family status, disability and others. Under Obamacare, according to the California Department of Health Care Services, people can now qualify for Medi-Cal on the basis of income alone if their household makes less than 138 percent of the federal poverty level — that’s $16,395 for an individual and $33,534 for a family of four.

Prior the ACA, about half of the Saban clinic’s 18,000 patients were uninsured, Hudman said. They paid little for treatment — maybe a copay of $5 or $10. Almost all of those patients qualified for Medi-Cal after the health law expanded eligibility, she said, and that’s made a big difference for the clinic’s bottom line: Medi-Cal pays the clinic around $200 per patient visit.

These days, more than half of Saban’s revenue comes from health insurance. The possibility of losing some of that money, Hudman said, is forcing some hard decisions. She had been looking to lease or buy a fourth facility, she said, but now that plan is on hold; as are her hopes of expanding free help for the homeless.

“I’m not willing to move forward and take some of those risks,” she said. “I need to make sure that we’re able to pay our bills and pay our staff.”

Before the last election, Hudman said, “we had a lot of momentum moving forward. And now we’ve just sort of stalled.” — Rebecca Plevin, KPCC, Los Angeles

Jordan Health, Rochester, N.Y.

In the last few years, funding has been on the rise at Jordan Health, in Rochester, N.Y., and so has the extent of the clinic’s services.

The boost in funding has partly come from higher reimbursement rates the ACA authorizes, and from the increased number of patients at the clinic who have insurance. But Jordan Health, which has 10 locations in the area, has also benefited from the federal government’s pumping of more money into what are known as section 330 grants that enable expansion of services and facilities.

[caption id="attachment_702819" align="alignright" width="270"] Janice Harbin, CEO of Jordan Health in Rochester, N.Y. says section 330 grants have allowed Jordan Health to hire more health practitioners. (Karen Shakerdge/WXXI)[/caption]

The 330 grant money gives qualified clinics the option of offering services that aren’t billable to insurance plans. At Jordan Health, the funds enabled the hiring of some different types of health practitioners who were not previously part of the team — dietitians, behavioral health specialists and care coordinators. And that, in turn, said Janice Harbin, president and CEO of Jordan Health, means patients can increasingly get the different kinds of care they need in one place.

Almost 90 percent of Jordan’s patients are considered a racial or ethnic minority, and over 97 percent live at or below 200 percent of the federal poverty line, according to data gathered by the federal Health Resources & Services Administration.

“When you’re dealing with a situation of concentrated poverty,” Harbin said, “your patient needs more than just ‘OK, let me give you a checkup, and pat you on the back and say now go out and do all these things I told you to do.'”

Jordan Health received an increase of about $1 million since 2013, according to its grant coordinator, Deborah Tschappat.

Tschappat said she expects Jordan will get about the same annual award in 2017, assuming federal funding for the 330 program stays about the same. If federal funding is cut significantly, they would potentially lose some services.

For now, Jordan Health plans to “expand services judiciously, while increasing efficiency and productivity,” Tschappat said.

In the coming months Harbin and her colleagues will be lobbying lawmakers in Albany and Washington, D.C., to renew Jordan’s funding — including the 330 grant, which is set to end in September.

“We’re used to doing a lot with a little, but we increasingly know that we do need to have financial support,” Harban said. “And that’s keeping us up at night.” — Karen Shakerdge, WXXI, Rochester

Adelante Healthcare, Phoenix

Adelante Healthcare has been part of the health safety net in Phoenix for nearly four decades — when its doctors began helping farm workers in the city’s surrounding fields. But the Affordable Care Act enabled Adelante to expand like a brand new business.

“Adelante has grown by 35 percent in the last 12 months,” said Dr. Robert Babyar, Adelante’s assistant chief medical officer. “We’ve increased our provider staffing — almost doubled our providers. And the number of services we provide has doubled.”

Adelante operates nine clinics throughout the Phoenix metro area. The one where Babyar met with me includes play areas for children and a dental office.

Most of their 70,000 patients are low-income and about half are covered by either Medicaid or KidsCare — Arizona’s version of the Children Health Insurance Program. In 2014, Arizona became one of the Republican-led states that expanded Medicaid under the ACA. That brought more than 400,000 people onto the state’s Medicaid rolls and created big demand for Adelante. Low-income patients who did not have insurance before the expansion had relied on Adelante’s sliding fee schedule. Much of that population now has health coverage, either through the ACA marketplace or the state.

“That opened up more options for our patients, more specialists they could see, procedures they could have done,” Babyar said.

As Congress moves to repeal and replace the health care law, Adelante is in a holding pattern. It has delayed the groundbreaking of a new site until later this year because of the uncertainty. A full repeal of the ACA — without a replacement that keeps its patients covered — would limit any future growth, and strain the new staff and resources it has added. It wouldn’t be the first time Adelante had to scale back its services because of changes to Medicaid. In 2010 and 2011, Arizona lawmakers froze enrollment for its CHIP program and for childless adults in Medicaid. Then, in 2012, Adelante lost more than a million dollars.

Babyar said it has taken several years to get their new patients into the system and working with doctors consistently to manage their conditions.

“All the progress we made with those patients to stay and be healthy — that can fall apart really quick,” said Babyar. — Will Stone, KJZZ, Phoenix

Denver Health, Denver

Denver’s Federico F. Peña Southwest Family Health Center is part of Denver Health — the safety-net system that takes care of low-income people.

“Definitely this clinic has benefited from Obamacare,” said Dr. Michael Russum, who practices family medicine for Denver Health and helps lead the clinic. “And this population has benefited from Obamacare by the expansion of Medicaid.”

That’s what helped make the economics work as Denver Health put a new $26 million clinic in a high poverty neighborhood in 2016, said Dr. Simon Hambidge, Denver Health’s CEO of Community Health Services. With the ACA in place, he said, the health system was able to count on the new clinic having a population of paying patients with insurance that could help support it.

Hambidge predicted the hospital will weather the storm if Obamacare is repealed and there are serious cuts to safety-net programs, like Medicaid and Medicare, as some Republicans have suggested. But it will probably be harder to open new clinics in other high-need neighborhoods, he conceded.

“We’ll survive,” Hambidge said. “We may not be able to be as expansive, because we would be back to less secure times.” — John Daley, Colorado Public Radio

This story is part of NPR’s reporting partnership with local member stations and Kaiser Health News.

A Safety-Net Medical Center Wrestles With Specter of ‘Repeal’

SAN MATEO — Little surprises Lynda Sutherland, who has been a licensed vocational nurse for 35 years at San Mateo Medical Center. But in the past few years, Sutherland said, she’s been surprised by what’s missing: the patients who used to return again and again to the public hospital for the same ailments.

“They’re just not coming back,” she said.

Spurred by the Affordable Care Act (ACA), medical centers like this one have overhauled the way they deliver care in an effort to keep patients healthier and out of hospital beds. They have connected newly insured patients with primary care doctors in outpatient clinics, helped them manage chronic diseases and tried to reduce their reliance on emergency rooms for routine care.

Now, with President Donald Trump and congressional Republicans pledging to repeal Obamacare, such hospitals fear the gains they have made could be lost or diminished. In particular, they worry that if patients lose health insurance, their revenue will fall — to the detriment of the patients, the hospital staff and the community.

“It would be felt on a daily basis,” said Erin O’Malley, director of policy for America’s Essential Hospitals, a nationwide association of nearly 300 hospitals that serve low-income patients. “Our mission will not be changing, but the challenges will be mounting … especially if we have a ‘repeal’ without a comparable ‘replace.’ ”

The California Hospital Association sent a letter Feb. 8 to California’s congressional delegation on behalf of hundreds of hospitals and health systems, saying that repealing the Affordable Care Act without replacing it “would upend the financial stability of hospitals and their patients.”

The association wrote that it was particularly concerned about proposals that would reduce federal dollars for Medicaid, which was significantly expanded under the 2010 health law to include low-income childless adults. The association also expressed concern about dismantling the changes hospitals have made to promote the quality of care over the quantity. For instance, as a result of new financial penalties under Medicare, many hospitals invested in changes to ensure they weren’t readmitting patients too soon after discharge.

Although all hospitals would be affected if the health law were repealed, public and safety-net facilities such as San Mateo Medical Center would suffer more, said Gerald Kominski, director of the UCLA Center for Health Policy Research.

“The Affordable Care Act has certainly stabilized the financial situation of safety-net providers,” he said. “If we roll back the ACA completely and don’t have a replacement plan that specifically improves funding for safety-net providers, then those hospitals are going to become more vulnerable again.”

Across the nation, hospitals that serve the poor have raised similar concerns. A recent analysis by America’s Essential Hospitals showed that hospitals could lose more than $40 billion in funding from 2018 to 2026 if the law is repealed.

[caption id="attachment_226053" align="aligncenter" width="770"] Over the past several years, safety-net hospitals like San Mateo Medical Center have worked to help patients better manage their chronic diseases and reduce their reliance on emergency rooms for routine care. Administrators worry if the Affordable Care Act is repealed, they will lose revenue and be unable to focus as much on prevention. (Anna Gorman/KHN)[/caption]

Republicans have put forward several proposals that worry hospital administrators. Among them are Medicaid block grants, which could result in less funding for beneficiaries, and withdrawal of federal support for insurance exchanges.

About 72,000 patients are seen annually at the county-run San Mateo Medical Center, which includes the hospital and nine outpatient clinics. Before the health law took effect, 48 percent of patients were uninsured and 31 percent were on Medi-Cal, the state’s version of Medicaid. Now, 17 percent are uninsured and 57 percent have Medi-Cal.

“If Medicaid rolls back … not only does the revenue disappear, but then people will delay care, get sicker and then costs will go up,” said Chester Kunnappilly, CEO of the medical center.

The hospital and clinics receive $166 million annually in Medi-Cal revenue — which makes up about 60 percent of the total budget. At least $50 million would be at risk with a repeal of the ACA, Kunnappilly said.

“People will lose their jobs, and it becomes this vicious cycle,” he said. “How many people we can take care of continues to shrink because the teams get smaller.”

[caption id="attachment_226054" align="alignright" width="270"] Michael Asip enrolled in expanded Medi-Cal under the Affordable Care Act before switching to Medicare when he turned 65 last year. Now, the San Mateo resident sees a cardiologist, a primary care doctor, a psychologist and an endocrinologist through the San Mateo Medical Center. “I’m the poster boy for the safety net,” he said. (Anna Gorman/KHN)[/caption]

San Mateo Medical Center made numerous changes over the past few years to catch patients before they became seriously ill. For example, it created teams of outpatient providers — including pharmacists, medical assistants and social workers — to coordinate care. It began reminding patients when they needed to get mammograms and other preventive tests. They expanded substance abuse and mental health treatment, which was required to be covered under the law.

In addition, the medical center sent patients with urgent needs to “express care” so they wouldn’t have to go to the emergency room or wait to see their doctor. Hospital administrators changed the discharge process, sending some patients home with the medications they needed and even dispatching staff to visit others after release.

Dramatic changes were made by safety-net hospitals elsewhere in response to the ACA. In Los Angeles County, for example, a computer system was developed to the ensure less duplication of care and better monitoring of patients, and patients were assigned to clinics that served as their medical “homes.”

“The ACA provided the economic incentive to do what should have been done anyway,” said Mitch Katz, director of the Los Angeles County health department. “It won’t go back to the way it was done before.”

On a recent day at the San Mateo Medical Center, Marla Muniz, a 46-year-old waitress from San Mateo, came to a clinic at the medical center for a physical and treatment for worsening pain in her shoulders and arm. She has Medi-Cal now, because of the program’s expansion, after going years without health insurance.

“I am scared they are going to take away my Medi-Cal,” she said. “If I had a good job that paid well, it wouldn’t matter. But I don’t. And I have a lot of pain. I have more and more pain every day.”

Another patient, Michael Asip, was there to see one of his physicians. He’d enrolled in expanded Medi-Cal before turning 65, then switched to Medicare. Long uninsured, he had gone months without seeing a doctor even after a heart attack. Now, the San Mateo resident sees a cardiologist, a primary care doctor, a psychologist and an endocrinologist through the medical center.

Sumita Kalra, a physician at a primary care clinic, said she has seen numerous patients like Muniz and Asip who put off health care for years. When they finally got coverage through the ACA, some were diagnosed with diabetes, cancer and other serious diseases.

Now “we can catch those ticking time bombs before something worse happens,” Kalra said.

Louise Rogers, chief of the San Mateo County Health System, said that kind of change, fostered by the ACA, should not be reversed.

“We don’t want to see a turning back of the clock,” she said.

KHN’s coverage in California is funded in part by Blue Shield of California Foundation.

5 Mind-Body Exercises for a Healthier Heart

There are a myriad of factors that affect heart health. From regular exercise to smoking cessation to eating a nutritious diet, there are a number of things you can do to strengthen your heart. But did you know that the mind-body connection can also be a strong ally in reducing your risk of heart disease? While many of us think of physical health when it comes to heart health, research shows that your mood, outlook, and stress levels strongly affect the body—and the heart. This means that heart disease prevention isn't just a matter of eating better or exercising; engaging in stress-reducing exercises and mind-body practices can significantly improve the health of your heart, too. As a bonus, these activities have other body and mind benefits, too, like boosting your mood, helping you focus, improving your fitness, and increasing your overall life satisfaction. Talk about a win-win! Here are five mind-body activities you can incorporate into your healthy lifestyle to help your mind, body—and heart! Yoga Yoga is probably best known for its flexibility benefits, along with its ability to help you sleep better, feel better about yourself and promote mindfulness. But, yoga has also been shown to be a powerful contributor of heart health. In fact, according to November 2009 research published in the International Journal of Medical Engineering and Informatics, those who practice yoga have higher heart rate variability (a sign of a healthy heart) than those who do not regularly practice yoga. In addition, the study found that regular yogis had stronger parasympathetic control, which indicates better autonomic control over heart rate—a sign of a healthier heart. Another recent study by Ohio State University researchers, published in the journal Psychosomatic Medicine, found that women who routinely practiced yoga had lower levels of the cytokine interleukin-6 (IL-6) in their blood. IL-6 is part of the body's inflammatory response and has been correlated with heart disease, stroke, type 2 diabetes, arthritis and a host of other age-related chronic diseases, making it a key marker in heart-health research. The women doing yoga also showed smaller increases in IL-6 in their blood after stressful experiences than women who were the same age and weight but who were not practicing yoga. Scientists believe that this indicates that yoga may also help people respond more calmly to stress in their everyday lives, which is a boon to heart health. Although researchers can't exactly pinpoint which part of yoga—the breathing, stretching, relaxation or meditation—is responsible for the positive results, it's encouraging to say the least! How to incorporate yoga in your life: Reap the heart-healthy benefits of yoga with just 20 minutes of yoga three times a week. Be sure to read our beginner's guide to yoga to get you started! Meditation There is ample research on how meditation can help reduce stress, which helps the heart stay healthy. But the most impressive study came from researchers from the Medical College of Wisconsin in Milwaukee in collaboration with the Institute for Natural Medicine and Prevention at Maharishi University of Management in Fairfield, Iowa. After following about 200 patients for an average of five years, researchers found that high-risk patients who practiced Transcendental Meditation (where you sit quietly and silently repeat a mantra) cut their risk of heart attack, stroke and death from all causes almost in half compared to a group of similar patients who did not meditate. In addition, the group that meditated tended to remain disease-free longer, reduced their blood pressure and had lower stress levels. Researchers hypothesize that some of the benefits of meditation come from stress reduction, which causes a reduction of the stress hormone cortisol and dampens the inflammatory processes associated with atherosclerosis or the hardening of the arteries. How to incorporate meditation in your life: While the research focuses on Transcendental Meditation, there are a variety of ways to meditate including walking meditation, guided meditation via a CD or simply sitting and listening to the sounds around you. Starting out with just five minutes a day of quiet time with your thoughts can yield big results. For seven ways to get your zen on, click here. Pilates Pilates is a great form of exercise. Its mat-based moves have been shown to increase flexibility, build core strength, improve posture and alleviate lower-back pain. But did you also know that it can help prevent heart disease by improving the fitness of your heart? According to a 2005 report from the American College of Sports Medicine, a beginner Pilates workout counts as low- to moderate-intensity exercise, which is comparable to active stretching. Intermediate Pilates workouts are the cardio equivalent of working at a moderate-intensity level, such as speed walking at a rate of 4 to 4.5 mph on the treadmill. Advanced Pilates workouts provide the most cardiovascular benefit with a moderately high intensity, similar to basic stepping on a six-inch platform, according to the report. All Pilates workouts have also shown to improve circulation. In addition to improving the cardiovascular system, similar to yoga, Pilates also links movement to breath, enhancing your mind-body connection, and thereby reducing stress and lowering the heart rate. How to incorporate Pilates in your life: If you're ready to try Pilates, try this short lower body Pilates workout. You can add this on to the end of your usual cardio workout or do it first thing in the morning before heading to work. For best results, try to get in a short 10- to 20-minute Pilates workout three times a week. Tai Chi Also known as moving meditation, Tai Chi combines mental concentration with slow, controlled movements to focus the mind, challenge the body, and improve the flow of what the Chinese call "chi," or life energy. If you've ever seen someone doing Tai Chi, it looks like a slow and graceful low-impact dance. But Tai Chi isn't just slow dancing; it has serious health benefits, including improving heart function and decreasing blood pressure and stress reduction. In fact, a May 2010 systematic review in the journal BMC Complementary and Alternative Medicine found that Tai Chi was effective in reducing stress, anxiety, depression and mood disturbance, and increasing self-esteem. How to incorporate Tai Chi in your life: Sign up at your local health club or community center for a series of Tai Chi classes with an experienced instructor. Practicing formally in class each week will give you the skills to practice Tai Chi on your own! Deep Breathing What do most of the above mind-body practices listed above have in common? That's right: deep, slow and controlled breathing! While not really an "exercise," the simple act of sitting and focusing on your breathing can do wonders for your heart. While there isn't much research on how deep breathing affects the heart, you can feel the results for yourself when you simply sit and take five big deep breaths, focusing on a deep inhale and exhale. You can almost instantaneously feel your body release stress and your mind calm down. Because it helps fuel your body and its cells with nutrient-rich oxygen, deep breathing has been shown to slow down the heart rate and lower blood pressure, making it the perfect heart-healthy activity when you're short on time and need a quick way to relieve some stress. How to incorporate deep breathing in your life: Try to take a few deep breaths at multiple times throughout the day. Making a habit to take three deep breaths upon waking, at lunch and when sitting in traffic can greatly benefit your heart health without disrupting your busy schedule. And, of course, when you're really feeling stressed, excuse yourself to the restroom for some deep breathing. They don't call it a "restroom" for nothing! Mind-body exercises are a powerful way to boost your heart health and keep your ticker ticking stronger and longer, so be sure to incorporate one or more of these mind-body exercises in your heart-healthy lifestyle. This article has been reviewed and approved by SparkPeople fitness experts and certified personal trainers, Jen Mueller and Nicole Nichols. Sources: American College of Sports Medicine. "Pilates Research Offers New Information on Popular Technique," accessed March 2011. www.acsm.org. Associated Press. Breath Deep to Lower Blood Pressure, Doc Says," accessed March 2011. www.msnbc.msn.com. Circulation: Journal of the American Heart Association. "Effects of Stress Reduction on Clinical Events in African Americans With Coronary Heart Disease," accessed March 2011. www.circ.ahajournals.org. Cleveland Clinic. "Heart and Vascular Health Prevention: Pilates," accessed March 2011. www.my.clevelandclinic.org. Framson et al. Development and Validation of the Mindful Eating Questionnaire. Journal of the American Dietetic Association, 2009; 109 (8): 1439 DOI: 10.1016/j.jada.2009.05.006 Sarnataro, Barbara Russi. "Tai Chi Exercises Both Mind and Body," accessed March 2011. www.webmd.com. Science Daily. "Tai Chi Gets Cautious Thumbs Up for Psychological Health," accessed March 2011. www.sciencedaily.com. ScienceDaily. "Yoga Boosts Heart Health, New Research Finds," accessed March 2011. www.sciencedaily.com. ScienceDaily. "Yoga Reduces Cytokine Levels Known to Promote Inflammation, Study Shows," accessed March 2011. www.sciencedaily.com. text Smith, Rebecca. "Meditation 'cuts risk of heart attack by half'," accessed March 2011. www.telegraph.co.uk.Article Source: http://www.sparkpeople.com/resource/wellness_articles.asp?id=1613

How to Tame Wedding Planning Stress

It's a gross understatement to say that planning a wedding is stressful. With all of the coordination, timing and numerous things to prepare for (not to mention family politics!), it's no wonder that nice, normal people turn into grumpy grooms and bridezillas. However, you don't have to become a stressed-out stereotype on your big day. In fact, it is possible to plan a wedding and keep your healthy cool—no matter the situation. 6 Common Wedding-Planning Stressors—and How To Remedy Them You and Your Fiancé Want Different Types of Weddings One of the biggest wedding stressors occurs when you and your fiancé have very different ideas of what your special day should be like. Traditional and in a church? Small and in your parent's backyard? A tropical destination wedding? The options are limitless, and couples are less bound by tradition now than ever before. But if the soon-to-be-wed couple can't agree on what kind of ceremony to have, or worse—one person wants a wedding and the other just wants to go to the courthouse—stress can be high from the get-go. How to de-stress: Before you plan any wedding details, sit down with your fiancé and make a list of the top three things that are important to each of you as far as the ceremony and reception are concerned. Then, calmly and patiently compare lists to see where you can compromise. If he wants a small wedding but you want a big one, you can always hold a small ceremony and then a big after-party. Or, if he wants a destination wedding and you want to be home, simply have the ceremony out of town and the reception in your hometown. Remember that this is the person you are agreeing to spend the rest of your life with, so take a few deep breaths and find a solution that you can both be happy with. Marriage is all about give and take! Overbearing Family Members or Friends Almost every bride and groom deals with at least one or two overbearing (yet well-meaning) family members or friends while planning a wedding. Whether it's a future in-law, your own parents or even a bossy friend, all seem to have an opinion on what you should and shouldn't do. How to de-stress: Remember that this is your wedding—not everyone else’s. It may be hard to tell your loved ones "no" or disagree with Aunt Millie about your bridesmaids wearing tangerine, but if you want your wedding day to be truly special and unique you must stand your ground. Politely, yet firmly state your decisions with the support of your partner. Think of it as if others are trying to derail or sabotage your diet—it's really none of their business! Fear that Your Dress Won't Fit Of course you want to feel confident and healthy on your wedding day, but don't spend the months before your wedding stressing about your size or what you look like—especially if you're trying to drop a few pounds before the big day. Remember that stress only hurts your weight-loss efforts. How to de-stress: First, make sure that you aren't being unrealistic about your body image on the big day. Make sure that any wedding weight-loss goals you have are realistic. After all, planning takes a lot of time and can be stressful, so you may not have as much time as you think you do to exercise and cook healthy foods. Second, be sure to drink enough water, eat lots of fruits and vegetables, and get that beauty rest. These three things will really give you that wedding-day glow. Lastly, visualize yourself walking down the aisle with confidence on the big day. Picturing yourself in a positive light helps squash stress and can give you the energy to plan, plan, plan! Your Wedding Budget More money, more problems, right? Well, in the case of wedding budgets, less money and big expectations can equal more problems, too. On average, U.S. couples spend almost $20,000 on a wedding. And that number doesn't include a honeymoon or engagement ring. Unless you have a large budget already in place, or family members with deep pockets, keeping costs down can be challenging at best. How to de-stress: Remember to prioritize any and all expenses, and balance costs as you go if necessary. If you go over on catering, don't spring for those chair covers or pricey linens. If your bouquets cost more than you expected, trade out half of your centerpieces for less costly decorations. Ask yourself what you'll remember when you look back on this day. Will it be your beautiful dress or suit? Will it be the music and DJ? How about those expensive invitations? Determine your needs versus your wants and be realistic about them. You know what's more stressful than wedding planning? Coming back to wedding debt after your honeymoon. The Guest List I have yet to meet a couple who didn't have at least a few stressed-out moments due to their wedding guest list. From being afraid of offending others to your in-laws insisting that your fiancé's fourth and fifth cousins just have to be there, compiling a guest list can get tricky. How to de-stress: Sit down with your partner and agree on a guest policy together. Decide if children are or aren’t welcome and the maximum number of guests you want (and can afford). Consider dividing guest counts evenly between your two families and have the first and final say on who attends. If you have room and one family wants more guests to come, many couples have that side of the family fund the extra seats. No matter how you do it, agree on a policy and don't waiver from it. Sticking to rules helps you and your family members explain to others why Wally, your third-removed cousin, wasn't invited. You Want the "Perfect" Wedding—No Exceptions Of course you want your wedding day to be perfect. Who doesn't? But how realistic are your expectations, and what will happen if everything doesn't go perfectly? Will you consider the day to be ruined, after all of that planning and thought? How to de-stress: Vow to be easy going on your wedding day and take it all in stride. There is no such thing as a perfect wedding. You know the saying, "Don't sweat the small stuff"? Well, during the wedding planning process and the day itself, remember the big picture and take a deep breath. After all, no one will remember the lopsided cake or miss the parting gift that the reception staff forgot to put out. No one will know if you fudged your vows or forgot your earrings. They'll be too busy remembering what a great time they had sharing the start of your marriage with you! In any stressful wedding-planning event, remember to always take time to eat healthy foods, exercise, sleep well and practice stress busters like yoga, meditation or these other techniques. Making time for just a few minutes of stress reduction each day can go a long way now—and during your marriage, too! Sources: http://www.costofwedding.com/ Dealing With Wedding Stress, from Wednet.comArticle Source: http://www.sparkpeople.com/resource/wellness_articles.asp?id=1582

Healthy Smile, Healthy Body

You probably don't think about your teeth that much unless you drink something icy cold or that little postcard reminding you to schedule your next dental appointment shows up in the mail. However, you should really give your pearly whites more attention. After all, your teeth are one of the first things people see when you smile and greet them, and your oral health can have a major impact on the health of not just your mouth, but your entire body. Cavities and gum disease may contribute to many serious conditions, including diabetes and respiratory diseases, and untreated cavities are not only be painful, but they can also lead to serious infections. While you may have been notoriously hard on their teeth as a kid and teenager (forgetting to brush and floss sometimes), most adults have it in their routine to brush at least twice a day. But what about flossing? Only 28% report doing it daily, even though most of us know better. And while you may also know better, Americans are also overconsuming junk food and sugar, which, when combined with a lack of flossing, is a recipe for oral health problems.  The Academy of General Dentistry estimates that 75 percent of Americans have some form of gum disease or gingivitis. And, according to the Centers for Disease Control and Prevention, tooth decay affects one out of three adults. So how do your teeth have such an impact on your well-being, and how do you stay healthy by focusing on your mouth? Here's a guide to what you need to know about your oral health, and how to keep your mouth and teeth clean and beautiful! Gum Disease So just what is gum disease? Also called periodontal disease, it's an inflammation of the gums. Gum disease occurs when plaque, a sticky colorless film of bacteria, builds up on your teeth and hardens into a tartar that can cause infections in the gums. If it's not treated, gum disease can increase your risk of respiratory disease, as the bacteria in plaque can travel from the mouth to the lungs, causing infection or aggravating existing lung problems. Gum disease can also spread and affect the bones underneath the teeth, which eventually dissolve and no longer support the teeth in its place. (That's basically just a complicated way of saying that your teeth can fall out!) Research also shows a link between diabetes and gum disease. People with diabetes are more likely to have gum disease than non-diabetics are, so if you have diabetes or it runs in your family, you definitely want to take care of your teeth. (More on prevention later!) The moral of the story? Gum disease is bad news. The symptoms of gum disease can vary from one person to the next, but one telltale sign is usually swollen, tender and red gums. If your gums bleed when brushing or flossing, that can be a warning sign, as can receding gums, bad breath that won't go away, loose teeth or a change in your jaw alignment. If you're having any of these symptoms, be sure to tell your dentist. A dentist or a periodontist can tell you if you have gum disease or gingivitis (a type of gum disease) with an exam and usually an x-ray. Treatment usually involves plaque removal, medication and, in the worst cases, surgery. Cavities You probably already know a little about cavities, and chances are, you may have even had one or two. Cavities are a sign of tooth decay, which is a breakdown of a tooth's structure. The decay can affect the enamel of the tooth and the inside of the tooth, and is caused when sugary and starchy foods like soda, breads, baked goods and candy are left on the teeth. Your dentist will be able to tell if you have a cavity during your regular exam, but in the advanced stages of a cavity, you may get a toothache, especially after having sweet, hot, or cold food or drinks. You may also be able to see pits or holes in your teeth. A cavity is treated by a dentist. He or she can remove the decayed portion and replacing it with a filling. If the tooth decay is advanced and the tooth structure is affected, your dentist may have to put in a crown. Another good reason to avoid sugary foods, right? Teeth Spacing You may think that the spacing of your teeth is just a cosmetic issue, but it affects the health of your mouth, too. Teeth that are spaced too tightly together can create gum problems, just as teeth that are spaced improperly can allow food to get stuck between the teeth, therefore increasing the risk of gum disease. An orthodontist can help straighten out your teeth (yep, even as an adult) with braces, invisible retainers, or other treatments for optimal oral health. Other Issues If that wasn't enough, poor oral health has also been shown to cause sleeping issues, hurt your self-esteem, and diminish your ability to chew and digest food properly. And if you smoke (hopefully you don't!), it can be horrible on your teeth. Tobacco smoke and chewing tobacco are both very harmful to your gums, and toxins within these drugs can cause oral cancer, damage the bones around your teeth and result in tooth loss. Tips to Keep Mouths Happy Now that you know how important your mouth is to your overall health, how do you keep it healthy? Here are some tips for a clean mouth!

  • Mom was right! Brush your teeth at least twice a day and floss daily. This keeps plaque at bay, improves breath and prevents stains. Plus, a study published in the British Medical Journal found that people who brushed twice a day were 30% less likely to develop heart disease compared to people who only brushed once. That's because, according to health experts, gum disease can lead to inflammation and can damage your arteries.
  • Don't eat junk food, and stay away from sweets. Eat those vegetables!
  • Make sure your toothpaste and mouth rinse include fluoride, which helps prevent tooth decay.
  • If you wear braces, be sure to keep the space between your teeth and archwires clean by using floss threaders and orthodontic toothbrushes.
  • If you play contact sports, consider having a custom-made mouth guard fitted to protect those pearly whites.
  • Visit your dentist twice a year to make sure everything is in tip-top shape!
Having healthy teeth isn't just about looking great (although that's a nice perk!). Good oral health is really about your body's overall wellness. So brush right, brush often and take care of those teeth!Article Source: http://www.sparkpeople.com/resource/wellness_articles.asp?id=1528

60-Second Health and Fitness Boosters

When it comes to losing weight or making healthy choices, you probably think that it takes hours at a gym plus long nights preparing and planning nutritious meals. What you may not realize is that quick and easy changes can really improve your immediate health and wellness. So just how quick is quick? One minute—that’s it! Try any one of these 60-second activities to easily reap the healthy benefits. 1. Drink a tall glass of water. We all know the many health benefits of drinking water, but did you also know that even mild dehydration can cause fatigue? So, the next time you feel your energy waning, grab a glass of cold water and guzzle it down! 2. Twist it out. So many of us spend every weekday seated in front of a computer. Not only can sitting all day wreak havoc on your posture, but it can also compress your spine and exaggerate its curvature. Not fun. A simple twist can help undo this. As you sit in your desk chair, simply twist your upper-body to one side, hold for 30 seconds, and then repeat on the other side. If you have the space to sit on the floor, try this torso twist stretch. It’s guaranteed to make you feel better! 3. Take a deep breath. How often do you think about breathing? If you are like most people, you probably don’t think about it often enough. For a quick pick-me-up, simply take five deep breaths. Slowly inhale for at least five seconds and exhale for 10 seconds each time. Your body will thank you for the extra oxygen. 4. Do 20 jumping jacks. Research has shown that long periods of sitting can be detrimental to the body and our overall health. So get up out of that chair and jack it out! Just one minute of jumping jacks is an easy way to get your heart pumping and blood flowing. 5. Smile. Smiling can actually make you happier. So go ahead—smile! 6. Go outside. You’ve probably heard the health buzz about vitamin D lately. Preliminary research suggests that vitamin D helps regulate the immune system, supports heart health, can help normalize blood pressure and promotes healthy aging. Vitamin D has also been linked to improved mood. If you have a minute to spare, step out into the sunshine! 7. Put on a favorite song. There’s nothing quite like your favorite music to perk you up and get you feeling good. Listening to music has been shown to improve immunity and release endorphins. Bonus points if you dance along! 8. Sit up straighter. Did you know that bad posture can put unnecessary stress on your low back? Take a minute to focus on sitting up straight with your shoulders down and back. Don’t you feel better already? 9. Be grateful. Write down five things you’re grateful for, no matter how large or small (your hair, your family, your morning cup of Joe—whatever). Do you feel more thankful, generous and overall happier after? Funny how a little reminder of what we have can turn a frown into a smile. 10. Tell a joke. Awake your inner child and tell a silly joke—whether it’s a knock-knock joke or even a funny line from a movie. Anything that gets you laughing is enough to get your happy endorphins flowing! 11. Do 10 pushups. Being strong is important, but having functional strength is even more important because it makes everyday activities easier to accomplish. A push-up is a great, quick exercise for building functional strength. Drop down and give me 10—or as many as you can do in 1 minute. 12. Encourage someone. Isn’t it interesting how you always seem to feel better after helping someone else feel better? Whether you post a supportive comment on a SparkFriend’s page or write a few kind words in a card or an email, taking a minute out to help someone can quickly boost your mood. 13. Set a goal for the day. Fact: People who set goals have more success than people who don’t. So why not take a few seconds and write down what you want to do today? Then, just commit to making it happen! 14. Focus on one thing you love about yourself. At times, we put so much effort in focusing on what we don’t like about ourselves that we fail to see the good. Take 60 seconds to think about what you like about you. Is it your eyes? Your strong legs? Your giving nature? Thinking about how great you are will instantly increase self-confidence. 15. Wash your hands. It seems like cold and flu season is always in full force (or just around the corner).  One of the simplest and easiest ways to stay well year round is to wash your hands. All you need is warm water, soap and 20 seconds of rubbing to rid your hands of unwanted germs. 16. Compliment a stranger. What better way to make yourself feel good than to unexpectedly brighten someone else’s day? The next time you admire someone’s clothes, positive attitude or eyes—say so! 17. Try aromatherapy. A number of different smells can have a positive effect on your mind and body. For example, peppermint is known to calm the stomach while its smell can energize you through a workout. And the scent of jasmine has been shown to reduce anxiety. To benefit, grab some scented lotion and either take a whiff from the bottle or rub some on your hands. 18. Salute the sun. Sun salutations are a well-known set of yoga poses that are said to warm up the body and increase blood flow and flexibility. So grab your mat and do one or two sets—rain or shine! 19. Give yourself a mini-massage. Massage has a number of health benefits, including reducing stress, lowering blood pressure and speeding muscle repair. While you may not be able to spend the time or money getting one at a spa, pampering yourself with just 1 minute of self-massage by rubbing your own hands, feet or shoulders can do wonders. 20. Be absolutely present. When we are wrapped up with work, to-do lists, and just getting by, sometimes we can forget to focus on what we are doing in the here and now. Try spending a minute just being. Focus on sounds, smells and whatever else is going on around you; instead of thinking ahead to what you'll do next, think about what you're doing right now. You’ll be amazed at how peaceful you feel. Just be! See? In the quest to be healthier, you don't have to spend a lot of time. Even if all you have is a few spare seconds here and there, you can make a positive difference in your overall health! Sources: Clean Hands Save Lives, from Centers for Disease Control and Prevention Fight Fatigue with Your Fork, from Psychology Today Here Comes the Sun, from Yoga Journal Highlights from the Research Project on Gratitude and Thankfulness, from University of California, Davis Peppermint, from University of Maryland Medical Center Research Briefs: Did You Know? from NammFoundation.org Vitamin D Research, from National Fluid Milk Processor Education Board, GetYourD.comArticle Source: http://www.sparkpeople.com/resource/wellness_articles.asp?id=1557

Baby panda clings to worker’s leg, won’t be stopped in funny video

A baby panda at the Chengdu Research Base of Giant Panda Breeding in Sichuan, China, took a shine to one of the workers this week.

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A video of the episode shows the baby at the Chengdu Panda Base clinging to the worker’s leg and holding on as the worker tries to spread around bamboo. The employee repeatedly removes the little bear from his leg, but the baby keeps coming back.

The base, which opened in 1987, is a nonprofit research and breeding facility for the endangered giant panda

#MoodBooster--Nanny, play with me, no working!--Baby, just a minute.--hmmm, I will stop you with my cuteness!Posted by iPanda on Wednesday, February 22, 2017

There are an estimated 1,600 giant pandas left in the wild and some 300 in zoos and breeding programs worldwide, according to the Smithsonian National Zoological Park.

13-ounce baby goes home after 4 months in NICU

The smallest patient to survive at Mount Sinai Hospital in Chicago was given the all clear to leave the neonatal intensive care unit on Wednesday after four months in the NICU.

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Baby Eirianna weighed just 13 ounces when she was born premature on Oct. 4, 2016. She was expected to arrive in January.

She was admitted to Mount Sinai's NICU after her birth, where she received around-the-clock care for 140 days, WLS-TV reported. She's the smallest patient to survive at the hospital.

"She was the smallest baby I ever took care of here," Amanda Kim, a NICU nurse, told WLS.

But according to Sinai Health System, Eirianna now weighs more than 6 pounds and breathes room air.

One of the nurses said it's not obvious that the baby girl was born premature anymore.

Enitan Martins was only 23 weeks pregnant when doctors told her it would be best for her to deliver the baby. Martins, who was on bed rest, had preeclampsia, a pregnancy complication characterized by high blood pressure for which the only cure is delivery of the baby.

"He comes in one day and says, 'We're having the baby now. I'm calling your husband, we're gonna do it,'" Martins told WLS of her doctor.

Doctors performed a C-section, and Eirianna was born so fragile that her parents couldn't touch her for weeks.

This week, after many days and nights at the hospital, Eirianna got to go home with her family.

"I'm just grateful," Martins told WLS. "It's been a long haul."

Read the original story at WLS-TV

Activists say tigers in viral drone video live on farm accused of animal rights abuses

EDITOR'S NOTE: Reports that the tiger habitat seen in the video is actually a farm with a long history of animal rights abuses have surfaced since the video went viral. A 2014 investigative report by McClatchy outlines the allegations of abuse. 

Read the original report below.

Siberian tigers in northeast China were seen chasing a drone in their snowy habitat.

Handlers used the drone to give the tigers, which CCTV described earlier this month as "chubby," some much-needed exercise.

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To these tigers in northeast China, a drone is just a giant cat toy pic.twitter.com/BoDzdLyNHG— CNN International (@cnni) February 23, 2017

As the tigers romped around, one tiger managed to knock the drone to the ground, where it proceeded to claw and chew on the device. The other tigers moved closer, curious to explore the drone.The drone began to smoke, which caused the tigers to move back. Handlers came to retrieve the mangled machine.

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