By Lawrence Jones,Ph.D.
On January 9, 2023, the New York State Nurses Association (NYSNA), a labor union of more than 42,000 members, decided to strike in New York. About 7000 nurses have been on strike since yesterday. ABC News ( January 9, 2022) reported that more than 7,000 nurses at two hospitals in New York City went on strike early Monday morning, demanding better working conditions and more staffing. The strike began at 6 a.m. after nurses at Montefiore Medical Center in the Bronx and Mount Sinai Hospital in Harlem disagreed with hospital administration during a bargaining session Sunday night, according to the NYSNA.
Jones (September 18, 2022) reported that 15,000 nurses decided to strike in Minnesota, representing the largest nursing strike in the history of the United States. Unfortunately, nurses are increasingly required to take on more patients for bedside care to compensate for labor shortages. In addition, the high turnover has created gaps in patient care. For years, hospitals in the United States have faced understaffing problems, and the pandemic did not help.
Unfortunately, as Jones (September 18, 2022) reported, patients are more likely to die because of preventable reasons when healthcare providers are overworked. When the 15,000 hospital nurses in Minnesota walked off the job after marking two years without a contract, it signaled a tide of more strikes around the country and the western world. The pandemic exacerbated the already strained healthcare system. Short staffing has reached critical levels to provide the best quality care for many patients.
Another concern that should highlight is that more nurses and healthcare workers have experienced increased violence by violence by demanding patients dealing with understaffed facilities. Jones (September 18, 2022) reported that the number of healthcare workers in the United States still needs to recover to its pre-pandemic levels, down over 37,000 workers compared with February 2020.
The upcoming days, weeks, and months will reveal a lot about the priorities of the healthcare systems and administrations. Prolonged strikes will create a vulnerability in the New York system as time goes by. We hope an agreement comes soon and the facilities will have better staffing and protection against violent patients and visitors on worker safety. Rates of workplace violence in healthcare and social assistance settings have almost doubled since 2010.
ABCNews (January 9, 2022). More than 7,000 nurses go on strike in this city demanding better pay, more staffing. More than 7,000 nurses go on strike in this city demanding better pay, more staffing (msn.com)
Isidore, C. Yurkevich, V, and Luhby, T (January 9, 2023).7,000 ‘exhausted and burnt out’ NYC nurses walk out. Nurses strike: 7,000 nurses at two New York City hospitals walk out after contract negotiations fail | CNN Business
Jones. L (September 18, 2022). Are Registered Nurses Across America Under Appreciated and Pushed to Their Limits? Are Registered Nurses Across America Under Appreciated and Pushed to Their Limits? - The Narrative Matters
Kaufman, M. (January 9, 2023).Thousands of nurses strike across New York City in push for higher staffing levels. Thousands of nurses strike across New York City in push for higher staffing levels - POLITICO
NYSA (2022). New York State Nurses Association. New York State Nurses Association - InfluenceWatch
By Dr. Lawrence Jones II
Since October, early increases in seasonal influenza activity have accelerated nationwide. CDC (November 12, 2022) reports that "the southeastern and south-central areas of the country are reporting the highest levels of activity followed by the Mid-Atlantic and the south-central West Coast regions." Twenter (November 4, 2022) prescriptions for Tamiflu (oseltamivir), a popular influenza antiviral, are higher this year than for the last nine flu seasons. The flu season typically peaks in the winter months.
But Americans are at risk of contracting the flu virus during most of the year. Flu season tends to increase since collectively, people will congregate indoors and in more proximity. Of course, Covid-19 will still be on the radar. When Covid-19 hit our society, Tamiflu was a drug of choice before a reliable antiviral could be identified and used for people with Covid-19.CDC (2022) adds that antiviral treatment works best when started soon after the flu illness begins. When treatment starts within two days of becoming sick with flu symptoms, antiviral drugs can lessen fever and flu symptoms and shorten the time you are disgusted by about one day.
They also may reduce the risk of complications such as ear infections in children, respiratory complications requiring antibiotics, and hospitalization in adults. For people at higher risk of severe flu complications, early treatment with an antiviral drug can mean having a milder illness instead of a more severe infection that might require a hospital stay. Twenter (November 4, 2022) reports that strikingly, from a nationwide perspective, "filled prescriptions for Tamiflu are 11.5 times higher compared to last year when they accounted for 0.02 percent of fills. As of November 1, the fill rate is at 0.33 percent, a 65 percent increase compared to last year's flu season's peak."
The CDC reports that the week ending October 29 saw a flu positivity rate up 0.5 percentage points across the U.S., with the Southeast and South reporting the highest activity levels. Landman (November 12, 2022) more than five times as many folks have been hospitalized for the flu this season compared to all of the flu seasons at this calendar time in the last decade. The severity of the flu disease affects people of all ages. So the Narrative Matters!
CDC. (November 12, 2022). Weekly U.S. Influenza Surveillance Report. Weekly U.S. Influenza Surveillance Report | CDC
CDC. (2022). What You Should Know About Flu Antiviral Drugs. What You Should Know About Flu Antiviral Drugs | CDC
Cisneros, T. and van Mejgaard, J. (November 7, 2022). Live Updates: Tracking Tamiflu Fills During the 2022-2023 Flu Season. Live Updates: Tracking This Year’s Flu Season - GoodRx
FDA. (November 14, 2017). Tamiflu: Consumer Questions and Answers. Tamiflu: Consumer Questions and Answers |FDA
Landman, K. (Novemebr 12, 2022). This flu season is looking really scary, in one chart. The 2022-2023 flu season is on tract to be very, very bad-Vox
Swetlitz, I. and Milton, I (November 9, 2022).Tamiflu Supplies Are Seen Limited in Fast Start to Flu Season. Tamiflu Influenza Treatment Supplies Are Limited in Fast Start to Flu Season - Bloomberg
Twenter, P. (November 4, 2022). Common flu drug in high demand. Common flu drug in high demand (beckershospitalreview.com)
Photo credit: https://www.wellrx.com/news/ta...
Illustration by Brianna Gilmartin, Verywell
By Dr. Lawrence Jones II
Antihistamines are frequently used to treat allergy symptoms, especially during the Fall and Spring seasons. Climates with leaves falling plants flowering, and extreme changes in temperature in a given day can produce environments with many allergens. Unfortunately, antihistamine misuse is on the rise and has been documented primarily in adolescents and young adults around the country. The misuse may be unintentional, but in some cases, the misuse of antihistamines is intentional.
NIH(2022) defines an antihistamine as “a type of drug that blocks the action of histamines, which can cause fever, itching, sneezing, a runny nose, and watery eyes. Antihistamines prevent fevers in patients receiving blood transfusions and treat allergies, coughs, and colds.” Dinwiddie and associates (October 14, 2022) report that antihistamine involvement overdose deaths is a topic that requires more study. They report that various antihistamine subtypes can cause anticholinergic effects, including solid sedation and worsen when used with other sedative drugs, such as opioids.
Dinwiddie and associates consider that their survey in 44 jurisdictions might not be nationally representative. Also, they keep in mind that drug testing methods are not standardized across jurisdictions, which could limit the interpretation of results. Even though there may be limitations, data on antihistamine misuse could reveal the importance of continued surveillance to understand the drugs and drug combinations contributing to overdose deaths. The CDC analyzed 2019–2020 data from the State Unintentional Drug Overdose Reporting System (SUDORS) in 43 states and the District of Columbia.
Just recently, George (October 13, 2022) reports that “Antihistamines were involved in at least 15% of recent overdose deaths, according to 2019-2020 data from 43 states and the District of Columbia. Of 92,033 overdose deaths, 14.7% were antihistamine-positive, and 3.6% were antihistamine-involved.” Death was defined as antihistamine-positive if any antihistamine was detected in an autopsy toxicology test; the cause of death was antihistamine related on the death certificate. Descriptive data for deaths are presented by sex, age, race, and ethnicity.
Researchers at the National Center for Injury Prevention and Control in Atlanta report that the rise of antihistamine-related deaths typically was Benadryl; 71.1% of antihistamine-positive fatalities and 66.5% of antihistamine-involved deaths). Although Benadryl is a common, over-the-counter medication, caution must be applied when using opioids. In addition, all medicines have side effects. The Narrative Matter
Dinwiddie AT, Tanz LJ, Bitting J. (October 14, 2022).Notes from the Field: Antihistamine Positivity and Involvement in Drug Overdose Deaths — 44 Jurisdictions, United States, 2019–2020. MMWR Morb Mortal Wkly Rep 2022;71:1308–1310. DOI: http://dx.doi.org/10.15585/mmwr.mm7141a4
George, J. (October 13, 2022). Allergy Meds May Make Drug Overdoses More Dangerous, CDC Says. Allergy Meds May Make Drug Overdoses More Dangerous, CDC Says | MedPage Today
NIH. (2022). Antihistamine. Definition of antihistamine - NCI Dictionary of Cancer Terms - NCI
by Lawrence Jones, PhD
An aspect of adequate health care will rely on effective communication. Although communication is often interpreted in a contextual form by healthcare providers, verbal and non-verbal communication can directly affect patient health outcomes. Communication can be the source of any problems, and intercultural communication is a topic that does not get talked much about. Health care providers must understand that there is a need for intercultural communication. Black maternity health, low representation of black people in clinical trials, medication over medication among African Americans, and poor nutrition (particularly for the young), to name a few. Childhood obesity has been one of the significant epidemic pandemics for the last four decades, long before the COVID pandemic. Although we live in a very affluent society, there are still discrepancies in our health care system.
Even within the African American communities defined as middle class or upper-middle-class, there are still inadequacies, particularly in the black indigenous and people of color communities in the United States. Verbal and nonverbal health communication in the media and print is essential to reduce barriers that interfere with doctor-patient health care communications and relationships. For instance, patients have to be transparent about their ailments and the side effects of any prescribed medication. Often there are social biases that stem from systemic racial discrimination. Ledford (2019) reveals a study that shows racial disparities exist in health care by statistical algorithms which look at racial inequality objectively.
Neuliep (2000) talks about different types of communication that influence effective communication between people. He mentions a cultural environment, the physical environment, the relational environment, and the perceptual domain. Perhaps communication for direct health care effectiveness, whether face to face or through virtual social platforms, has to consider this. England (1992) mentions that communication is how people influence and persuade others across geographies. England explains that our differences with others are made up of individuals working collectively for the benefit of everyone, not just their own group; through open and honest intercultural communication, people can learn to work.
Neuliep (2000) also mentions that as you communicate with people from different cultures, you retain more. You will know that although your cultures are different, you have much in common as human beings. We just have different ways of achieving them.
England, J.T. (1992) Building Community for the 21rst Century.
Hall, E. T., & Hall, T. (1959). The silent language (Vol. 948). Anchor books.
Ledford, H. (2019). Millions of black people are affected by racial bias in healthcare algorithms.
Nature, 574(7780), 608-610.
Neuliep, J. W. (2020). Intercultural communication: A contextual approach. Sage Publications