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Smooth Operator

December 24, 2014

christmas musicby Laura McFarland, Communications Director

According to a 2008 survey, operating room staff play music during about two thirds of surgeries, as reported in this year’s British Medical Journal’s Christmas issue, which reviews the history of music in the operating room.

Aside from a more general effect on health, numerous data specifically support music for patients having surgery under local or general anaesthesia. BMJ notes that in a randomised trial of 372 patients having elective surgery, relaxing melodies (60-80 bpm, mimicking the resting heart rate) proved to be superior to midazolam as a pre-anaesthetic anxiolytic. Combined data suggest that this calming effect is maintained before, during (when awake), and after surgery, with music faring better than noise blocking devices alone. For patients requiring further respiratory support postoperatively, music’s ability to reduce anxiety, heart rate, and respiratory rate extends even to ventilated patients in intensive care.

My son, delivered by C-section, was born to the sounds of Loverboy, “Working for the Weekend.” Personally I would have preferred something a little more classical, which is apparently the preferred genre. Its popularity may be in part due to the lack of lyrics, which alas rules out holiday carols. The Journal offers a number of suggestions and some understandable don’ts (REM’s “Everybody Hurts,” for instance) if readers find themselves needing to make a selection.

MCN wishes a joyful holiday season to all of our readers. We will be closed on Thursday, December 25th and Thursday, January 1st. To meet the needs of our clients, MCN is open during regular business hours throughout the rest of the season. Our 26 offices nationwide, including operational centers in Tampa, FL, Long Island, NY, Chicago, IL, and Seattle, WA, are seamlessly connected through one fully integrated database. Whatever the weather, MCN staff are available to answer client questions, receive referrals, and review and deliver reports from 8 am – 8 pm EST.

And the MCN Charitable Giving Winners Are…!

December 19, 2014

holiday imageCongratulations to James McLaughlin and Laurel Seim!

MCN has picked James and Laurel as our contest winners who have in turn picked their non-profits of choice:

Anser Charter Schoola public charter school located in Garden City, ID, chartered by the Boise School District. Anser Charter School offers an inspiring and challenging educational environment for elementary and junior high children with a strong focus on a connection to and service to the community. (James McLaughlin)

Care to Share. Based in Beaverton, OR, Care To Share’s mission is to coordinate assistance to families and individuals seeking emergency food and other basic needs, with the goal of helping people through crisis situations and to connect them with other services, if continued support is needed. (Laurel Seim)

Each will receive a $200 donation from MCN in honor of our subscribers.

To give back some more, MCN has picked a third winner whose non-profit of choice will be announced at the start of 2015.

These donations are a small part of MCN’s annual giving campaigns. MCN as an organization and through our staff nationwide participate in annual drives to support United Way and ArtsFund. MCN also matches staff donations to non-profits to allow for a wide range of community involvement across the country. Additionally, staff are encouraged to participate in their communities through volunteer time as well as giving campaigns. We appreciate this opportunity our subscribers have given us to provide direct support to these valuable organizations.

Fewer People Taking Prescription Narcotics —but Abuse Remains a Problem, Study Suggests

December 17, 2014

oxycontin 12 14Last week pharmacy benefits manager Express Scripts released a study of 6.8 million Americans who had at least one prescription for an opioid filled between 2009 and 2013. The findings? One piece of good news and a lot of red flags related to a medication that was involved in 16,000 overdoses in 2012 alone.

  • Nearly 60 % of patients taking the painkillers to treat long-term conditions were also being prescribed muscle relaxants or anti-anxiety drugs that could cause dangerous reactions.
  • Nearly one-third of patients were prescribed an opioid and a muscle relaxant in the same month, and around the same percentage were prescribed a muscle relaxant and an opioid at the same time.
  • About 8% of patients were taking all three types of drugs — a combination known as a “Houston cocktail,” which gives a heroinlike high — during the same period.
  • 27% were taking more than one opioid at a time, another hazardous combination.
  • Of the patients taking the mixtures, two-thirds were being prescribed the drugs by two or more doctors
  • Nearly 40% filled their prescriptions at more than one pharmacy.
  • Overall use of opioids had fallen, especially for people using them to treat short-term ailments.

“Not only are more people using these medications chronically, they are using them at higher doses than we would necessarily expect,” said Dr. Glen Stettin, a senior vice president at Express Scripts. “And they are using them in combinations for which there isn’t a lot of clinical justification.” Read more…


Bogus Theories on Bugs, Yawns and Belly Fat

December 12, 2014
The BAHFest winner is presented with this trophy.

The BAHFest winner is presented with this trophy of Darwin.

Ever heard of BAHFest? It stands for Festival of Bad Ad-Hoc Hypotheses, a satirical conference on evolutionary biology held at the Massachusetts Institute of Technology in October. The event’s popularity led an additional  BAHFest held in San Francisco, also held this past October.  The concept was originally proposed in a Saturday Morning Breakfast Cereal strip proposing that human infants have been evolutionarily optimized for long-distance dispersal by catapult.

At each festival, six presenters, each armed with reams of research, vied to win over a panel of judges with a different bogus scientific theory. The winner got a statue of Darwin looking dubious—shoulders shrugging, hands turned upward.

Selection readers and judges graded theories on four criteria:

  1. Force of Science – how much “scientific” information was brought to bear (graphs, real citations, “research” etc.).
  2. Artistry – how unexpected and clever the idea and presentation were, and how well the presentation was delivered.
  3. Parsimony – the simplest theory that explained the most data is best.
  4. Strength of Defense – how well views were defended to the judges.

Presentations this year included “Influenza Knows When You’re Doing Yoga” from Barbara Vreede, a postdoctoral researcher in evolutionary biology at Hebrew University in Jerusalem, as well as one exploring why we yawn, from Emma Kowal of Harvard University. (The answer? To catch bugs. Flying insects are high in protein. They gather in dense swarms most frequently at dawn and dusk, not-so-coincidentally the times of day when we are most likely to yawn.)

The winner of the BAHFest trophy was Michael Anderson, a Boston lawyer specializing in First Amendment cases, for his theory on ubiquity of belly fat in middle-age men.

In ancient times, men’s “spare tires” served as a flotation device for them to rescue their families in times of flooding. Primitive art supports the theory, he said. The earliest depictions of humans were mainly stick figures. But when people began to settle down near rivers and other bodies of water, human images began to take on abdominal bulges, Mr. Anderson claimed.

In addition to the fun of the event, coming up with obviously wrong scientific hypotheses helps us think about how evidence can be used/misused in reaching conclusions.

Rate of Health Spending Increases on the Decline

December 11, 2014
Graphic from the New York Times.

Graphic from the New York Times.

Much has been noted recently about a decrease in the growth of healthcare spending as announced by the Obama administration early this month.

“The pattern observed in recent years is not unique and is consistent with historical patterns,” Anne Martin of the Centers for Medicare & Medicaid Services said. The agency’s report noted: “The key question is whether health spending growth will accelerate once economic conditions improve significantly; historical evidence suggests that it will.”

Three recent pieces in The New York Times explore different aspects of what causes this decrease in growth rate and what it means for consumers and for the future (“Good News Inside the Health Spending Numbers,” “Health Spending Rises Only Modestly,” and “The Health-Cost Slowdown Isn’t Just About the Economy.”).

The medical system really is changing, which is why cost growth has been slow. But the changes aren’t guaranteed to continue. Some key points include:

  • Health spending in 2013 grew at the lowest rate since government officials started tracking it — back in 1960.
  • 2013 is the fourth consecutive year that health spending growth has kept pace with the growth in the overall domestic economy, suggesting something more durable than random.
  • The slowdown in health spending growth began in 2002 and has become more pronounced in recent years.
  • Spending by the federal Medicare program, private health insurance and people’s out-of-pocket expenditures all declined, suggesting that the savings were systemwide and not due to changes in just one kind of insurance.


Happiness Is Love. Full Stop.

December 5, 2014

triumphIn 1938 Harvard University began following 268 male undergraduate students (including future President John Kennedy) and kicked off the longest-running longitudinal study of human development in history, The Grant Study.  The study’s goal was to determine as best as possible what factors contribute most strongly to human flourishing.

George Vaillant, who directed the study for more than three decades, published the study’s most recent findings in the his book Triumphs of Experience. Earlier work on the study include Adaptation to Life, 1977, and Aging Well, 2002. Triumphs of Experience has been widely reviewed, and with good reason.The book and the study are fascinating and informative.

Vaillant raises a number of factors such as the powerful correlation between the warmth of relationships and health and happiness in your later years as well as how significant men’s relationships with their mothers are in determining their well-being in life.  For example, Vaillant notes that Men who had “warm” childhood relationships with their mothers took home $87,000 more per year than men whose mothers were uncaring.  Men who had poor childhood relationships with their mothers were much more likely to develop dementia when old. Late in their professional lives, the men’s boyhood relationships with their mothers — but not their fathers — were associated with effectiveness at work.

Vaillant also notes that what separates those who viewed themselves as truly happy from those who did not was not in the events that made up their lives — it was in how they responded to those events. The key difference between the happy person and the unhappy one was that one viewed themselves as a victim to their circumstances, while the other sought ways to use their circumstances to their advantage. The degree to which happiness was attained was in the adaptations the participants employed to deal with and shape their reality.

In Vallant’s own words, the #1 most important finding from the Grant Study is this: “The seventy-five years and twenty million dollars expended on the Grant Study points to a straightforward five-word conclusion: Happiness is love.  Full stop.”


Subscribe and Win a Chance to Support Your Favorite Non-Profit

December 2, 2014

imagesCA3IVRWNThanks for reading our blog. To recognize current readers and encourage more subscribers, MCN is sharing in the holiday spirit and giving away $200 each to the non-profit of choice of two of our subscribers.

Subscribing is an easy one-step process. In the right hand column, below “MOST RECENT POSTS” you will see a box with the text “SUBSCRIBE TO MCN TALK.” Enter your email address and you’re finished. You will then receive direct notification of new postings by email. You control how often you receive notifications – from immediately, to daily or weekly – or you can always unsubscribe at any time and continue to visit MCNTalk on the web as you choose.

MCN will select two subscribers at random (with eligible client business email addresses) to designate their non-profit of choice to receive this $200 donation. You can bring benefit to your favorite charity – in your community, region, or nationally – just by subscribing!

Guidelines: While anyone may subscribe to MCNTalk, contest eligibility is restricted to those subscribing from a business email of a client company or entity that manages claims. MCN will contact the winners by email; they will have 5 days to respond or an alternate subscriber will be selected if we can’t reach them at the subscriber’s email.

  • The recipient must be a tax exempt US non-profit with a web presence.
  • The deadline for subscribing is December 16, 2014. 
  • The winning organizations will be announced by December 22 on MCNTalk.

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