Birdman or The Unexpected Virtue of Ignorance - Review

Recently I watched Birdman or (The Unexpected Virtue of Ignorance) and was HORRIBLY DISAPPOINTED!! Now I knew nothing of the film except for (and this is my own understand before watching) the movie was supposed to be based on the superhero Birdman from the 1960s show Birdman and the Galaxy Trio. Birdman was the main character of two out of three of the show's segments. This incarnation of Birdman was voiced by Keith Andies and did not use the name Harvey (Birdman's actual name was given in the show as Ray Randall). The original Birdman was a regular, non-comedic superhero with an eagle sidekick named Avenger. His powers came from the energy of the sun's rays, and he was able to fly using his wings.

This movie I thought would follow along the plot line of Harvey having been out of the superhero, crime fighting loop for awhile would re-adorn his suit (as shown here in a movie clip) and take back to fighting crime and become an "underdog" superhero movie. WRONG!!!

The movie billed as a comedy/drama left much to be laughed at. Instead the story follows Riggan Thomson's (Michael Keaton)  attempts to recover his family, his career and himself in the days leading up to the opening of a Broadway play, based on Raymond Carver’s What We Talk About When We Talk About Love.
To me this movie was more about the staging of the play within a play, and less about Birdman himself. It was all the frustration of a has-been, washed up actor trying to recapture the glory of yesteryear.  With the production budget and the high-end Birdman Costume, and the star power of Michael Keaton, Zach Galifianakis, Edward Norton, and Emma Stone, this movie could have been a power house likened to that of X-Men or Avengers. But instead this dribble was created.

I was and am very glad I didnt waste money on a ticket for this "movie" and that I got to view the screener copy for award consideration. I am not a film critic but I do not know nor understand what the buzz about this movie was. I just feel left wanting and wishing that there was something more.

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IDINA MENZEL HOLIDAY WISHES

Idina Menzel livens up the holidays with her new CD Holiday WIshes. With her powerful yet classical voice, she brings many of the favorites to live, such as Baby It’s Cold Outside (Duet with Michael Buble), and Silent Night.

The album was produced by Grammy Award-winner Walter Afanasieff (Barbra Streisand, Celine Dion, Mariah Carey) and features such classic favorites as “All I Want For Christmas Is You” and “Have Yourself A Merry Little Christmas,” as well as Joni Mitchell’s Christmas-themed “River,” one of Menzel’s favorites.

Idina’s career has traversed stage, film, television, and music. She was most recently heard as Elsa in Disney’s global box-office smash Frozen, in which she sings the film’s Oscar-winning song “Let It Go.” After her performance of the multi-platinum song at the 86th annual Academy Awards, she made history as the first person with both a Billboard Top 10 hit and a Tony Award for acting.

This is sure to be a go to holiday classic that the whole family will come to love, and look forward to.  Powerful, moving, and full of holiday cheer, this was a fun delight to listen to and write about.

Holiday Wishes Track Listing

1. Do You Hear What I Hear


2. The Christmas Song


3. Baby It’s Cold Outside (Duet with Michael Buble)


4. Have Yourself A Merry Little Christmas


5. All I Want For Christmas


6. What Are You Doing New Year’s Eve?


7. December Prayer


8. When You Wish Upon A Star


9. Silent Night


10. River


11. Holly Jolly Christmas


12. White Christmas

Bonus Tracks on Target Exclusive


Let It Snow, Let It Snow, Let It Snow

Mothers Spiritual

Get a copy all for your own

* iTunes: http://bit.ly/IMHolidayWishes
* Amazon:  http://bit.ly/IDINAHOLIDAY

 

 

 

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Mary J Blige The London Sessions - Album Review

Mary has hit the studios once again and belts out a whole new sound for her. Being a lover of Mary J Blige I have to say The London Sessions is unexpected. The first few tracks start off slow and almost gospel. They take you through a more spiritual side and her opening up and saying "I dont need your permission."

As the album continues we get into a R&B Techno Dance Fusion, which when paired with her ineradicable voice, creates a whole new sound that is sure to bring in a new audience. I must say that I was expecting classic MJB but am extremely happy with this album. Its refreshing and on point.

* iTunes: http://bit.ly/MJBLondon
* Amazon:  http://bit.ly/MJBLS
*Official Mary J Blige Website: www.maryjblige.com
* Twitter - @maryjblige
* Facebook - https://www.facebook.com/maryjblige
* YouTube - http://bit.ly/MJBVIDEO



With a track record of eight multi-platinum albums, nine Grammy Awards (plus a staggering 31 nominations), a 2012 Golden Globe nomination, and four American Music Awards, Mary J Blige is a global superstar. And in ensuing years, the singer/songwriter has attracted an intensely loyal fan base – responsible for propelling worldwide sales of more than 50 million albums.

– Mary J. Blige has once again confounded expectations and ventured into new musical territory by crossing the Atlantic to collaborate with some of this decade’s most celebrated UK musical talent – including Disclosure, Eg White, Emile Sandé, Jimmy Napes, Naughty Boy, SAM ROMANS and Sam Smith – and recorded a new studio album, The London Sessions. This extraordinary new collection will be released December 2 on Capitol Records.

Track Listing
1. Therapy
2. Doubt
3. Not Loving You
4. When You're Gone
5. Right Now
6. My Loving
7.Long Hard Look
8. Whole Damn Year
9 .Nobody But You
10. Pick Me Up
11. Follow
12. Worth My Time

 

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Neil Diamond Melody Road CD Review

For years Neil Diamond has wooed the world with his campy folk style singing. Bring such great hits as Sweet Caroline, Cracklin Rose, and his timeless duet with Barbra Streisand, You dont bring me flowers.
Neil has once again hit the studio to create a new instant classic with his Melody Road. The album, marks his first original studio release in six years and first since signing with Capitol Records.  Acclaimed producers Don Was and Jacknife Lee co-produced the album. In addition, there will be a special 36-page lyric book with guitar chords included in the packaging of each album.

This album takes you on a journey, with his story like song writing style. It takes you through the ups and downs of a new relationship and overcoming cultural boundaries with his song  Seonagh and Jimmy. A story of two love birds from opposite ends of the world, who come together and make a life together while learning to over come cultural barriers. With the albums namesake Melody Road he gleefully sings about the creative process of his music writing and the inspiration that he takes from the world around him.

I am happy to announce that you can own this new album Today Oct 21st you can buy it on Amazon for just $7.99 http://amzn.to/1x5z0Oe

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Mary Lambert - Heart on my sleeve Album Review

I just got a copy of Mary Lambert's Heart on my Sleeve, this is one of the most heart felt and personalized, put all the cards on the table, albums I have heard in a while.

Brutal and honest, Mary sings from the heart about her ups and downs in life and most of all the emptiness she feels.
Each song is like a page from her diary. A no punches held look at what she keeps inside, and how he anguishes over her inability to properly communicate her feelings to those around and to her love interest.

Though the album is only 11 songs in total, you feel as if you are walking with her as she tells the story of her life. Powerful and moving, many times I was able to relate to her struggles of self worth, and just wanting to be loved.

Secrets - This is a very fun song about how she is depressed, bipolar, and how she really is tired of always having to hide secrets from everyone. She belts it out to tell the world, love me or leave me but this is who I am. It to me is a fun anthem that is likened to Lady GaGa's Born this way. Its a raw, in your face look at how no matter what the world says about you, that you need to be your own cheerleader and take a stand and be happy being you.

So Far Away - Laments the long distance between her and a love interest. How she wishes that they were back together and didnt have to be apart from one another saying "im a better person with you near...but you are so far away." Anyone who has ever had to be away from the person that they love or care about can truly understand this longing. I connected with it remembering a few of my past love interests who I am no longer in contact with.

Rib Cage - This song is about how she is open and exposed and how she feels that people take from her but never give back, and how she doesn't know how to fill the space left behind from people using her and walking all over her.  I myself dealing with depression and being bipolar feel this way more often than I'd like to admit to. The constant struggle of putting yourself out just to make others happy and the empty feeling you have at the end of the day.

Dear One - A personal sonnet to someone who she is in love with and feels at peace being around. It speaks of how she has a 'moth to a flame' need to be with this person but that they act as if she isnt alive. This resounded with me and helped me to connect with her and this song. Many times I have thought about just telling people how I feel only to not do so because of self doubt.

When you sleep - Asks the question so many of us wonder when we like someone, "do you think of me when Im not around?" She sings about the different scenario's in which they have the chance to think about her but if they ever did/do.  She takes it a step further by saying 'I could make a home and marry you and completely disappear" meaning (at least to me) that she would give up her whole self just to make this person happy if they would just only acknowledge her.

Chasing the Moon - A more upbeat song. this song is about escape and wanting to out run the problems and wanting to make the wonderful night last forever by "chasing the moon". This song reminded me of some of the great times that I've had with friends, and how it was so amazing that we all wished that it never had to end.

Jessie's Girl - This is a cover of the original song by Rick Springfeild but done in a more broken hearted, soulful way.

Monochromatic -This speaks about how emphatic she is and how she dreams in color but lives in a monochromatic world of pain. She sees it on the blank expressions of those she passes and feels that she is to vibrant to live in an emotionally dead city. It is a very interesting piece. It to me drums up imagery of walking through the slums.

Heart on my sleeve - The Album Namesake. Again she laments the unspoken thoughts, feelings, and desires she has for a love interest. She states in the song "when you opened your door, you opened what I had closed". To me this sounds like she let down her guard and allowed this person to come in.

Wounded Animal -  An apologetic Ballard of how she is sorry for not being more sympathetic for this persons break up and broken heart. But that basically she saw an opening and went for it and hoped for the best.

Sum of our parts -  In this song that builds to a rampant visualization of having to fight and become 'more than our scars....mare than the sum of our parts'. This is a song about rising from the ashes and not letting something keep you down.  Its about how far you've come regardless the pain of the past.

This album really is soulful and full of pain, regret, and strength. Anyone who has ever felt awkward growing up, or like the 3rd wheel, or just left out can relate to at least one of these songs. It is a close look at the pain she has harbored and a testament to the strength she has in order to push forward.

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Back to School with Eyebuydirect.com

Lets face it, going back to school hits everyone right in the wallet. Buying new shoes, and clothing, and school supplies can get rather expensive, especially if you have to get a new pair of glasses for you or the kiddos. Im here to help you save even more money in that department.

Enter Eyebuydirect.com the only place where you can get excellent quality glasses starting at only $6.95 + shipping which typically makes it about $12 total, and if you use this special 15% off coupon IFSW4F2T4X you can save even more money.

How does it work you ask? Well you head over to the website with your prescription and pupil distance (you can obtain this information from your Optometrist free of charge) and begin browsing their massive selection of frames.
If you do not have an updated prescription, here is another little secret to save you even more money. From Aug-Sep Wal-Mart Vision Centers typically have a back to school deal where you can get your eyes examined between $40-$60. Where they get you is in their glasses. They offer you bundled packages were if you get your eye exam with them then you can get a pair of glasses for $99. This really isn't a great deal seeing how you can get your glasses with Eyebuydirect.com for less than $20.

Shipping typically takes about 5 days, which is about the same as what you would wait for if you got your glasses at Wal-Mart or Pearl Vision. Eyebuydirect.com even has a way that you can virtually try on the glasses by uploading a picture to their site and seeing how the different styles of frames will look. They even tell you if the frames are small, medium, or large.

So if you have more than one person in your family that needs glasses then check this wonderful resource out. They even have prescription sunglasses too..

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The Appeal of Her–a movie review

I just got done watching the movie Her with Joaquin Phoenix. I must say that this movie hit a little to close to home for me. The movie revolves around a heart broken man who is in the midst of divorce and isnt sure how to move on with his life. Then he learns of a new Artificial Intelligent Operating System (AI OS) that is being marketed as the very first personal computer operating system.

After installing the software to his computer, he and the OS begin conversing, asking simple ‘get to know you’ questions. He at one point asks if she has a name of which she chooses Samantha. As the movie progresses Joaquin and Samantha begin growing closer and form a relationship. As an AI, she is able to expand and learn past her programming. So they begin “dating” and he shows her new experiences, and he falls in love with her because she understands him and is able to fill that void in his life.

Well I began thinking about it, and I could see myself in Joaquin Phoenix’s shoes if that were me and an AI OS. Here you have ‘someone’ who is with you at any given moment, who has the ability to ‘feel’ and to ‘enjoy’ your company and time you two spend together. I could see myself becoming wrapped up in something like that, because of the emotional connection vs the physical. If you think about it, we pretty much already have those types or relationships.
With things like Facebook and Twitter and Social Networking Sites, we develop virtual relationships with people that many times we don’t ever know in real life. Yet we come to depend on our daily interactions with them. We love seeing their photos, their status updates, the funny random things that they post on their profiles, but whats to say that they are actually ‘real’? We take for granted that they are real but what if it was just a computer program and Photoshop that makes up that person that we have come to know and love on some level?

I could see depressed and lonely people latching on to their computer systems and falling madly in love with the digital persona. I for one know that I would/could. But with the development of such a system, I fear for the human race, as we would become so self absorbed in our digital romances and lives that all physical interaction would cease to exist, except for maybe persons who could not afford computers and the OS, or those people who are anti-technology.

But all in all it was an amazing movie that had complex emotions and feeling, and personal undertones of how people who suffer from depression and loneliness seek out comforts and build bonds with things that are sometimes either inanimate or that feel real.

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What side are your lines?

Mine will be on my left. I will also have some on the right. Those lines will be hearts and stars, signifying that the hopes and dreams of those suffering will one day come true.

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Nanoparticle Suspension and Ultrasound Deliver Insulin Without Regular Injections

 

Insulin injections are no fun for diabetics and they have to be taken as needed by the body, not by the patient’s personal schedule. This means if you have diabetes, you can’t just pre-inject yourself and go worry-free throughout the day. A nanotechnology developed at North Carolina State University and the University of North Carolina at Chapel Hill may end all that thanks to a self-assembling network that can release insulin whenever the patient wants.

The system consists of poly(lactic-co-glycolic) acid (PLGA) nanoparticles filled with insulin and coated with either negatively or positively charged substances. These stick to each other when mixed, so when injected into the body the solution remains together and when you want some insulin released, you simply hold an ultrasound transducer to the injection site and shake up the substance to release the insulin.

From NC State:

The researchers believe the technique works because the ultrasound waves excite microscopic gas bubbles in the tissue, temporarily disrupting Nano-network in the subcutaneous layer of the skin. That disruption pushes the nanoparticles apart, relaxing the electrostatic force being exerted on the insulin in the reservoir. This allows the insulin to begin entering the bloodstream – a process hastened by the effect of the ultrasound waves pushing on the insulin.

“We know this technique works, and we think this is how it works, but we are still trying to determine the precise details,” says Dr. Yun Jing, an assistant professor of mechanical engineering at NC State and co-corresponding author of the paper.

When the ultrasound is removed, the electrostatic force reasserts itself and pulls the nanoparticles in the Nano-network back together. The nanoparticles then diffuse more insulin, refilling the reservoir.

Advanced Healthcare Materials: Ultrasound-Triggered Regulation of Blood Glucose Levels Using Injectable Nano-Network…

original article http://news.ncsu.edu/releases/wms-gu-ultrasound2013/

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iBGStar Blood Glucose Monitoring System

Recently I was granted the opportunity to demo the iBG Star Blood Glucose Monitoring System for iPod/iPhone.
When I first saw this I was really excited and couldn’t wait to get my hands on it. Having and loving my iPhone and iPod I thought what a great way to use them to help me monitor my glucose levels.

When it finally arrived, I tore into the box and opened the case and felt like a child at Christmas. I was happy to see how un-intrusive the device was. It wax no bigger than a pack of gum but very sleek. I quickly grabbed my iPhone and downloaded the app from the App Store.
At first, it took me a minute to get everything set up. I tend not to read instruction's right off the bat just to see how intuitive things are. So once I got it synced with the app everything was really straight forward after that.

I've been using the iBG Star now for about a week and a half. One of the things that I love about it is the fact that it’s a standalone meter all by itself. You do not need to have it hooked to your phone or other supported Apple device until your ready to sync the information.
When doing some more research on the iBG Star, I saw you could get phone cases that allows you to keep the monitor connected to the phone all the time, which is handy but you still have to carry the lancets, and test strips so why not just keep the whole thing together?

One thing that I did notice that has me a bit put off is that the iBG Star seems to be off  by sometimes up to 200 points. I have been using my Bayer Contour USB Glucose Monitor along with the iBG Star and at my highest reading both machines read differently. The iBG Star read 486 where my Contour USB read 268.
I did a control test and still found it to be off by 40-60 points, which I have been told by my Diabetes Educator that is to be expected, but that its nothing to really worry about. Well being someone who is on a sliding scale for his insulin injections that’s the difference between a little and a lot of insulin. But I imagine if I was using the iBG Star as my only meter then I wouldn’t worry to much.

Getting into the app itself, I must say is very clean and easy to navigate. You have some fun features like being able to change the background on the app, as well as tailoring it to your needs by inputting your highs and lows, as well as your insulin etc..
It also gives you a nice on screen display to let you know when you need to apply your blood sample and when the meter has been disconnected or connected.
I am one for super easy, intuitive, and visually appealing software. The iBG Star merges flawlessly with the iOS.

All in all I have to say I really do love the iBG Star. I really like the fact that you do not need to keep it connected to your phone all the time and that it is a stand alone reader. I also like the fact that you can get the app for your iPod and iPad as well. Making it fully intergraded into the Apple owners life. I do not like the fact that it is only Apple based. I would like to maybe see a future version of this released to Android just to be more inclusive and opening the market for new users. 

Another feature that I really like about iBG Star is that you have the ability to share your meter readings via email with your doctors. This provides them with detailed information that allows you to get instant results, especially if you are being monitored closely for other Diabetic complications.

All in all I would give the iBG Star 9/10 stars. The only reason I did not give it a full 10 is due to it being only for iOS and not more readily available to all devices. However, that being said. I find it being one of the better devices offered for Apple that is a stand alone machine.

^{Images borrowed from Google Images. I do not claim ownership to them.}

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Health Website that actually is…Healthy

I have always come across sites that boaster that they have excellent articles about heath, beauty and the like. But I found one that isn’t just a bunch of fluff and hot air. Behealthy24.com is one of the best sites that I have ever come across! They are on Online Magazine or E-zine that has informative articles, and research that is provided to you in a way that makes you truly understand what they are trying to say.

Most times when it comes to health and beauty you are bombarded with tons of information that makes it hard to really understand what it is that you are reading, but with behealthy24 its provided to you in a familiar format that is a easy and convenient read.
What first brought me to this site is that I was researching Diabetics and Skin Tags and Mole removal click here found an article about it (link) and then found other internal links to information about Skin Tags which provided me with information about them that I never knew.

I have bookmarked the site and started following them on Twitter and Facebook just so that I can keep up with their informative articles and helpful tips and tricks resource.

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• Stop & Remove Skin Tags, Exercise "maGic"™ (recoveryhealth.me)
• Cosmedics Skin Clinics Doctor Advises Patients Not to Ignore Warts and Skin Tags (prweb.com)
• Get Rid of That Skin Tag (nichronized.wordpress.com)
• Natural Home Remedies: Removing Moles, Skin Tag Removal And Warts Treatment (naturalholisticremedies.wordpress.com)

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Banana Power

This is interesting. After reading this, you’ll never look at a banana in the same way again.
Bananas contain three natural sugars – sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy.
Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world’s leading athletes.
But energy isn’t the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet.

DEPRESSION: 

According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier.

>PMS:
Forget the pills – eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood.

ANEMIA:
High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia.

BLOOD PRESSURE:
This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit’s ability to reduce the risk of blood pressure and stroke.

BRAIN POWER:
200 students at a Twickenham school ( England ) were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert.

CONSTIPATION:
High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives.

HANGOVERS:
One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system.

HEARTBURN:
Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief.

MORNING SICKNESS:
Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness.

MOSQUITO BITES:
Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation.

NERVES:
Bananas are high in B vitamins that help calm the nervous system..
Overweight and at work? Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and chips. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady.

ULCERS:
The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chroniclercases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.

TEMPERATURE CONTROL:
Many other cultures see bananas as a ‘cooling’ fruit that can lower both the physical and emotional temperature of expectant mothers. In Thailand , for example, pregnant women eat bananas to ensure their baby is born with a cool temperature.

So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has FOUR TIMES the protein, TWICE the carbohydrate, THREE TIMES the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals.. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, ‘A BANANA a day keeps the doctor away!’

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YouTube Internet Sensations Then and Now

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Adults With Diabetes And Limited Health Literacy Less Likely To Adhere To Prescribed Antidepressants

Adult patients with diabetes who don't understand basic health information are significantly less likely to take newly prescribed antidepressant medication, according to a new Kaiser Permanente study in the Journal of General Internal Medicine.
In this study conducted by the Kaiser Permanente Division of Research and the University of Washington School of Medicine, 72 percent of the 1,366 study participants had limited health literacy, and had significantly poorer adherence to newly prescribed antidepressants, compared to patients with no limitations.
"Research shows that those with health literacy limitations are more likely to have poor control of their chronic medical conditions such as diabetes, congestive heart failure and HIV," said Andrew Karter, PhD, research scientist at Kaiser Permanente and senior author on the study. "However, this is the first study to examine the association between health literacy and antidepressant adherence among patients with diabetes. This type of research gives our health care systems important feedback because, as providers, we often remain unsure whether the critical health information we convey to our patients is fully understood."
The Institute of Medicine defines health literacy as the capacity for patients to "obtain, process, and understand basic health information and services needed to make appropriate health decisions." Because nearly 90 percent of Americans have some difficulty using routine health information, the U.S. surgeon general has identified the improvement of health literacy as a national priority.
Adequate adherence for antidepressants is particularly important for patients with diabetes and other chronic medical conditions. Depression occurs twice as frequently among adults with diabetes compared to adults without diabetes, and has been associated with an increased risk of the serious diabetic complications, dementia and mortality.
In the study, health literacy was based on a self-reported scale in which participants with type 2 diabetes responded to three questions:

• How often do you have problems learning about your medical condition because of difficulty understanding written information?
• How confident are you filling out medical forms by yourself?
• How often do you have someone like a family member, friend, hospital or clinic worker or caregiver, help you read health plan materials?

The study examined medication nonadherence during the 12 months after the initial antidepressant prescription, and researchers found that many patients failed to adhere to their treatment. Although most patients filled the prescription at least once, 43 percent failed to fill the prescription a second time, and nearly two-thirds had discontinued the antidepressant by the end of the 12-month period.
Poor adherence to antidepressant medications has been described previously, but what was not known is that those with health-literacy limitations were significantly less likely to take their antidepressant medications. In fact, diabetes patients with limited health literacy were much less likely to refill their antidepressant medications in a timely fashion than patients with no limitations. These patterns were not explained by other factors known to be associated with medication nonadherence, including age, race/ethnicity, English proficiency and income, which were accounted for in the study.
Depression in adults with diabetes is frequently chronic, suggesting the need for long-term antidepressant therapy. "The high rates of early discontinuation that were observed among adults with diabetes who had any health literacy limitation suggest that few of these individuals received an adequate course of antidepressant therapy. Getting that sufficient treatment is critical in preventing relapse and recurrence of depression," said lead author Amy Bauer, MD, of the University of Washington School of Medicine. "Physicians should be aware of this. For antidepressant treatment to succeed, patients with limited health literacy may require more intensive counseling and clearer explanations about use of antidepressant medications and closer follow-up."
The researchers said the study findings underscore the importance of national efforts to address healthy literacy, simplify health communications regarding treatment options, improve public understanding of the importance of depression treatment, and monitor antidepressant adherence.
Additional authors on the study include Wayne Katon, MD, University of Washington; Dean Schillinger, MD, University of California, San Francisco Division of General Internal Medicine; Melissa Parker, MS, Alyce Adams, PhD, and Howard H. Moffet, MPH, Kaiser Permanente Northern California Division of Research; and Nancy Adler, PhD, University of California, San Francisco Center for Health and Community.

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Inspirational

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Lone Star College Shooting

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U.S. Medicare Part D Can't Explain North-South Disparities

Patients' access to diabetes and heart failure drugs through U.S. Medicare plans in the first two years of the Part D option did not guarantee proper therapy, researchers at the University of Maryland (UM) found in a nationwide study published today in the journal Health Affairs.

The study revealed that Medicare patients in the northern regions of the nation spent more for Part D drugs for the two conditions and tended to adhere better to taking them than did patients in southern regions.

All of the 10 lowest-spending areas were in southern states, and all of the 10 highest-spending areas were in northern or central states. Of the 50 lowest-cost regions, 43 were south of the 37th parallel, which extends roughly from the Virginia-North Carolina border to central California, and 43 of the 50 highest-cost regions were above that line.

"Is it because of the patients or the physicians?" lead researcher Bruce Stuart, PhD, asks rhetorically. "Well, patients can't get the drugs without the physicians. How well they take the drugs is up to the patients. We think it is more patient behavior than physician behavior. We are trying to find out what those factors might be. Why would there be regional differences in terms of patient behavior?"

Stuart is the Parke-Davis chair in geriatric pharmacotherapy at the UM School of Pharmacy, executive director of the Peter Lamy Center for Drug Therapy and Aging, and a professor in the Department of Pharmaceutical Health Services Research.

Researchers did not find any strong evidence of Medicare savings in treating diabetes and heart failure -- savings such as lower hospital costs or fewer medical services -- as a result of higher Part D spending.

"However, this is only half a story because there are several plausible conjectures behind these findings," says Stuart. "The (Part D) program came into play in 2006 and for many of the people who got the benefit, this could be the first time they were using the drugs." Also, these drugs are primarily for long-term benefit. "The answer is likely that it takes a while for these drugs to work," Stuart says.

Stuart says analysis of subsequent years of Part D will be needed to make firm conclusions as to the payoff in hospital costs and services for people using and adhering to the heart and diabetes drugs regimens. Stuart hopes to begin a follow-up study to replicate the first one.

For the first study, Stuart and his team analyzed a 5 percent random sample of the Medicare population from a database compiled by the Centers for Medicare and Medicaid Services. They chose heart failure and diabetes because managing those chronic conditions is heavily dependent on drugs, they are very common chronic diseases, and the drugs have been proved effective in clinical trials.

Stuart says the study team formed two preliminary "bottom lines." First, although the researchers couldn't find much difference in who was taking the drugs, they clearly found that among people who used them, regimen adherence was higher in the north and that made drug spending higher. "Then we asked, 'Do people who are spending more and having higher adherence have lower spending on Part A and Part B services to treat diabetes and heart failure?' Stuart explains. The researchers did not see that relationship, but when they looked at total Medicare costs, they found that regions in the South with lower adherence had higher average Medicare spending for all A and B services compared to northern regions.

"Discovering which regional factors are responsible for differences in medication practices should be a high priority," the researchers wrote in Health Affairs.

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'Protecting' Psychiatric Medical Records Puts Patients At Risk Of Hospitalization

Medical centers that elect to keep psychiatric files private and separate from the rest of a person's medical record may be doing their patients a disservice, a Johns Hopkins study concludes.
In a survey of psychiatry departments at 18 of the top American hospitals as ranked by U.S. News & World Report's Best Hospitals in 2007, a Johns Hopkins team learned that fewer than half of the hospitals had all inpatient psychiatric records in their electronic medical record systems and that fewer than 25 percent gave non-psychiatrists full access to those records.
Strikingly, the researchers say, psychiatric patients were 40 percent less likely to be readmitted to the hospital within the first month after discharge in institutions that provided full access to those medical records.

"The big elephant in the room is the stigma," says Adam I. Kaplin, M.D., Ph.D., an assistant professor of psychiatry and behavioral sciences and neurology at the Johns Hopkins University School of Medicine and leader of the study published online in the International Journal of Medical Informatics. "But there are unintended consequences of trying to protect the medical records of psychiatric patients. When you protect psychiatric patients in this way, you're protecting them from getting better care. We're not helping anyone by not treating these diseases as we would other types of maladies. In fact, we're hurting our patients by not giving their medical doctors the full picture of their health."
Kaplin says that as more and more hospitals embrace electronic medical records, many choose to exclude psychiatric illnesses, even if that means keeping vital information about diagnoses and medications from primary care doctors who need it.
After the surveys were completed, the researchers tapped the University Health System Consortium Clinical Database, which includes information on readmission rates on 13 of the hospitals in the study. At institutions where psychiatric records were included in the EMR, psychiatric patients were 27 percent less likely to be readmitted to the hospital within a week of discharge, with little statistical difference after two weeks and a month. But in those hospitals where records were included in the EMR and non-psychiatrists were given access to them, patients were 40 percent less likely to be readmitted at seven days, 14 days and a month.
"If you have electronic medical records, that's a good step in the right direction," Kaplin says. "But what you really need to do is share the records with non-psychiatrists. It will really make a difference in terms of quality of care and readmission rates. Let's not keep mental health records out in the cold."
The researchers found no difference in length of stay in the hospital, a marker for severity of illness, between patients whose records were shared or not, nor was there a difference found in overall readmission rates at the hospitals, suggesting that the higher readmission rate for the patients whose information was not shared was a psychiatry department issue, not a hospital-wide one, Kaplin notes. Readmission rates have been a hot topic because the federal Centers for Medicare and Medicaid Services has begun to penalize some hospitals financially for readmissions, seen by many as a marker for poor quality of care.
Kaplin argues that while non-psychiatrists don't need access to all of the specifics of a patient's psychiatric history, they need to know details about diagnoses, treatment and medications prescribed. The latter is perhaps the most vital because drugs prescribed by a primary care doctor could produce bad interactions when mixed with psychiatric drugs that they are not aware have been prescribed by a psychiatrist.
Kaplin says it makes no sense that a physician can find out if a patient is being treated at the HIV clinic, for erectile dysfunction or for drug addiction, but not whether the patient is being treated for depression.
Information about depression can be critical, Kaplin says, because depression after a heart attack is the number one determinant of whether the patient will be alive one year later. Moreover, he says, by keeping psychiatric records separate, the stigma is perpetuated.
Hospitals take great care to ensure confidentiality of patient records, electronic or not, and that information is used only by those with a need for it. With electronic records, each access leaves behind an electronic fingerprint, and if someone without authorization accesses the records, a red flag goes up. Hospital staff members have been fired for improperly viewing medical records.

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Sandy Hook Elementary School Shooting

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Link Between Multiple Media Use And Depression, Anxiety

Using multiple forms of media at the same time - such as playing a computer game while watching TV - is linked to symptoms of anxiety and depression, scientists have found for the first time.
Michigan State University's Mark Becker, lead investigator on the study, said he was surprised to find such a clear association between media multitasking and mental health problems. What's not yet clear is the cause.

"We don't know whether the media multitasking is causing symptoms of depression and social anxiety, or if it's that people who are depressed and anxious are turning to media multitasking as a form of distraction from their problems," said Becker, assistant professor of psychology.
While overall media use among American youth has increased 20 percent in the past decade, the amount of time spent multitasking with media spiked 120 percent during that period, Becker said.
For the study, which appears in the journal Cyberpsychology, Behavior and Social Networking, Becker and fellow MSU researchers Reem Alzahabi and Christopher Hopwood surveyed 319 people on their media use and mental health.
Participants were asked how many hours per week they used two or more of the primary forms of media, which include television, music, cell phones, text messaging, computer and video games, web surfing and others. For the mental health survey, the researchers used well-established measures, although the results do not reflect a clinical diagnosis.
Becker said future research should explore cause and effect. If it turns out media multitasking is causing depression and anxiety, recommendations could be made to alleviate the problem, he said.
On the other hand, if depressed or anxious people are turning to media multitasking, that might actually help them deal with their problems. It could also serve as a warning sign that a youngster is becoming depressed or anxious.
"Whatever the case, it's very important information to have," Becker said. "This could have important implications for understanding how to minimize the negative impacts of increased media multitasking."

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