DC Women's Journal Vol 49/Issue 6

JWomen’s ournalA Lifestyle MagazineCOMPLIMENTARY

Volume 49 Issue 6

Why Rob Campbell is Vital to your organization

WHY TELEMEDICINE

IS HOT NOW

Washington

wjwomen.com2

BUSINESS

Telemedicine is a significant and rapidly growing component of health care in the United States. Over half of all U.S. hospitals now use some form of telemedicine. There are currently close to 1

million Americans currently using remote cardiac mon-itors and the Veterans Health Administration delivered over 1,000,000 remote consultations using telemedicine. Around the world, millions of patients use telemedicine to monitor their vital signs, remain healthy and out of hos-pitals and emergency rooms. Consumers and physicians download health and wellness applications for use on their cell phones.

Telemedicine has made a big impact in rural areas where visits to doctors are difficult, and is expanding part-ly because broadband network coverage is improving, pa-tients and doctors are more comfortable with telemedicine technologies, there is pressure for increasing cost savings, and a shift in paradigm that favors telemedicine. This new paradigm says that the patient’s total health status is now the focus, as evidenced by new policies issued by insurers, Medicare and state governments.

Quality healthcare is now viewed to be based on a long-term relationship between patient and physician, about both long term health efficiencies and acute issues. Remote encounters are usually more efficient and convenient for both patient and physician.

Medicare and states are holding hospitals responsible for readmission rates, which requires the doctor and the patient to have an ongoing relationship, and telemedicine facilitates that relationship.

Incentives play a big role, but better healthcare out-comes and better use of medical resources are key drivers. The VA medical system has made significant investments in its adoption of telemedicine, and today is considered to be one of the world leaders in telemedicine. The di-rect primary care movement (e.g, www.dpcare.org) advo-

cates are working to move primary care doctors from the pay-for-procedure compensation system to payments that are outcome-based. Direct primary care is growing very fast now as both plan sponsors and doctors come to believe that it offers major advantage in both quality of care and overall healthcare cost.

Key factors for Growth:• Government support, funding will increase• Practice management systems will have telemedicine

capabilities• Consumer demand will make telemedicine mainstream• Travel to the medical offices, regional medical centers

and hospitals can be difficult, particularly if the patient is elderly, lives in a remote or rural areas, or have trau-matic injuries

• Reduction in hospital readmissions• Mitigation of distance, mobility and time constraints• Saves the patients, providers and payers money when

compared with traditional approaches to providing care.

Future of Telemedicine: The global telemedicine market is expected to grow

from $11.6 billion in 2011 to $27.3 billion in 2016.1. Source: BCC Research

Worldwide revenue for Telemedicine devices and ser-vices is expected to reach $4.5 billion in 2018, up from $440.6 million in 20132. Source: IHS

The number of patients using Telemedicine services will grow to 7 million in 2018, up from 350,000 in 2013.3. Source: IHS

Telemedicine could potentially deliver more than $6 billion a year in healthcare savings to U.S. companies.

Why is Telemedicine Hot Now? “Telemedicine has made a big impact in rural areas where visits to doctors are difficult,

and is expanding partly because broadband network

coverage is improving.”

December - January 2015 3

BUSINESSBUSINESS4. Source: Towers Watson

Although many physicians may be hesitant to adopt telemedicine the evidence is clear telemedicine is not going away. Telemedicine companies that threaten the existing primary care infrastructure by competing with physicians are not favorable but, companies like Click It Clinic that work with physicians make telemedicine much more attrac-tive to doctors. Click It Clinic works with independent phy-sicians, ACOs, IPAs and large physician networks to inte-grate telemedicine into their practices and also provides on call coverage for physicians throughout the country. With the right app, the proper training and call coverage support, Click It Clinic is helping to put the future of healthcare back where it belongs, back in the hands of doctors.

Privacy and Security Concerns:Telemedicine technologies can create, large volumes of

electronic health information, and create some additional operational challenges for organizations in meeting their existing privacy and security obligations under HIPAA as well as any relevant state privacy laws. These organizations will definitely need to update their security risk analyses as well as modify and adapt their data privacy and security practices to respond to the specific risks and compliance challenges of using Telemedicine technologies.

Consequently, existing policies and practices should be reviewed carefully, and will likely need to be modified or adapted to ensure effective and reliable verification and authentication of the identities of patients and providers in-volved in a Telemedicine encounter. In addition, Telemed-icine interactions typically involve providers from multiple organizations. Organizations operating Telemedicine pro-grams will need to address questions like shared respon-sibility for securing and managing the health information generated through a Telemedicine encounter – including responsibilities

Privacy and Security considerations related to data breach notification and reporting—to confirm compliance with privacy and security requirements. Telemedicine transmissions also may be vulnerable to interference, sig-nal errors or transmission outages that can result in inter-rupted communications and the alteration or loss of im-portant clinical information which would potentially be a HIPAA violation. The additional risks of Telemedicine programs require a health care organization’s privacy and security professionals to participate from the start in the design and implementation of Telemedicine programs, and assume responsibility for actively monitoring opera-tions. Telemedicine technology brings new privacy and security issues that could raise concerns about protection of privacy, confidentiality, and security of sensitive patient information.

They are: A lack of uniform confidentiality and privacy legislation

at the state level in terms of the transfer of health information in telemedicine encounters. Telemedicine consultations can take place over state lines, the potential for confusion over which state’s standards should be employed could arise.

A long-distance telemedicine consultation typically involves a clinician-patient session that can be videotaped (most are) in its entirety, and this record is maintained as part of the documentation of the consultation. As a result, practitioners have less discretion to remove sensitive items that they might otherwise not record. From the patient per-spective, the patient may not be able to “see” who else is viewing the session along with the clinician on the other side of the long distance consultation.

The use of telemedicine equipment usually adds addi-tional personnel to the typical provider-patient encounter. For instance, a technical outsider, like an engineer, may be privy to the consultation. From a technical standpoint, there is a higher volume of data and complexity involved in the various communication mediums used during a typical telemedicine consultation. That could make securing the data more problematic.

It is now more important and necessary to conduct regular HIPAA/HITECH Risk Assessments under the fast evolving telemedicine landscape.

Conclusion:However, in this day of ever increasing data breaches,

it is imperative that both physicians and patients insist that their telemedicine organization at least meets the minimum standards mandated by HIPPA Privacy and Security Rule. In addition to the importance of HIPPA compliant tele-medicine providers, it is just as important that the organi-zation’ s Telemedicine technology companies and business associates be HIPAA compliant.

Privacy and Security concerns notwithstanding, Tele-medicine enables outcome-based medicine: doctors can maintain the conversation with the patient in a manner that is far more efficient and effective than traditional en-counters; they can serve more patients well. Patients can get attention faster and more conveniently when they need it. This is why telemedicine is likely to continue to boom in the years ahead.■

Robert Campbell, CEO of Med Cyber Security. Med Cyber-Security provides cost-effective,

cyber security privacy and security consultations HIPAA covered organizations such as health-

care providers, business associates and telemed-icine organizations. To learn more, contact Med

Cyber-security for a free consultation.301-266-2457, email: [email protected].

wjwomen.com4

Volume 49 issue 6

02 - 0910 - 2122 - 28

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With over 32 years of experience, The Women’s Journal is a brand you can trust. It is a primary resource for women. Each edition is published bi-monthly and distributed free of charge. You can find a copy of the journal where savvy women shop. The journal also has subscribers that pay to have the journal delivered to their home or business.


Safety Tips for Online Shopping this Holiday SeasonOnline shopping is a great way to grab some deals for your holiday purchases AND avoid the crowds of shoppers at your local mall. Unfortunately, the increased internet traffic and potential for cyber attacks increase the threat of hacking and identity theft. Make sure your holiday shopping stays safe and secure with these helpful tips:

Make sure your antivirus and malware protection software is up to date and that you have a firewall installed on your computer to block any unwanted intrusions.

Update to the latest internet browser available for your system, such as Google Chrome, Mozilla Firefox or Internet Explorer. Browsers, as well as antivirus programs offer some type of verification of websites, making sure they are the original site and not a spoofed one.

Update your passwords frequently. Use a combination of letters, numbers, and special characters to create a stronger password; longer passwords are also more secure. Don’t use common words or phrases, or words that could be easily guessed.

Don’t click unknown links in your email. Most phishing attacks will try to scam shoppers with an email that presents some sort of incredible, can’t-be-beat-deal. If you’re skeptical of an offer or email, go directly to the retailer’s website to confirm the offer, and don’t click the email link.

Don’t use public computers and unsecured wireless connections - shop at home if you can. Public networks, such as at libraries, cafes, airports or even work computers, could be compromised with malware. Hackers also have access to these networks, and could be tapping into them to get your personal information. Always do your online shopping from networks secured with a WEP or WPA password.

Shop only on encrypted sites. Websites that begin with “https” are encrypted, rather than just “http.” The “s” means that the site allows for secure transactions.

Save or print all payment confirmations. Printing these order confirmations allows you to have written history of your shopping expenditures.

Check your account balance and transaction history frequently to make sure your purchases have gone through and that there is no unauthorized activity. If you identify an unauthorized transaction, contact your financial institution immediately.

At Andrews Federal Credit Union, we have a site dedicated to protecting our members from being victims of potential fraud. Visit www.andrewsfcu.org to find out more information on how to protect yourself this holiday season, and all year long.

Andrews Federal Wants to be Your Financial Partner Did you know you don’t have to be active or retired military to become a member of Andrews Federal Credit Union. In fact, if you live, work or worship in Washington, D.C., you are eligible to join today!

View our entire list of eligibility requirements by visiting andrewsfcu.org/join. For more information, call 800.487.5500 or visit your nearest Andrews Federal branch location.

wjwomen.com6

BUSINESS

As the year draws to an end and the New Year quickly approaches, now is the time to think about resolutions

and look towards the future. One New Year’s resolution you should consider this year is to think very long term. In-stead of just planning for how you can improve life in the upcoming year, the dawn of a new year is the perfect time to create a concrete plan to take care of your family after you are gone.

Here are some statistics to think about: As many as 55% of adults in America have no will or estate plan in place. For minorities, the number is even higher. A full 68% of African American adults and 74% of adult His-panics have no Will.

Without a plan in place, the state (not you) gets to decide how your assets are going to be divided. You’ll have no say over who distributes your assets, or over what happens to your property. (You could also cost your heirs some money or leave your heirs fighting about who inherit what.)

So, why don’t more people have a plan? Some don’t know how to create one, while others are hesitant to make the tough choices about how to distrib-ute their assets among those they love. An estate planning attorney can help with the legal process of dividing your assets and can even offer advice on some of the decisions you’ll have to make when planning for life after your death.

Creating Your Last Will & Testament

There are lots of reasons why peo-ple need to create a comprehensive es-tate plan. While around 59% of people who plan for the future do so in order to avoid probate, limiting family chaos is the second most important reason people cite for engaging in estate plan-ning. Protecting children’s inheritances is a prime goal for around 39% of estate

planners, while just 34% of people are motivated by minimizing estate taxes.

Whatever your reasons for sitting down with an estate planning attorney, some of the key decisions you’ll need to make include:• How to distribute assets: Only

27% of Boomers think about how much money they will leave to others. For millennial children, 31% of whom expect an inher-itance averaging over $350,000, this lackadaisical attitude by mom and dad may come as a big shock.

• Who will make decisions after your death or disability: You may need to name a Trustee, a person-al representative or an executor of your estate as part of your estate plan. You may also want to create a durable power of attorney and designate someone to act as your agent if you remain alive but un-able to manage your own affairs. Both of these issues can be really

contentious. For example, as Reuters explains, disinheriting a child could lead to a lawsuit to have your plan overturned (especially if the assets in your estate are large enough to make a case worthwhile). At the same time, sometimes leaving your kids an equal amount is not going to be a fair choice either, especially if you have provided more for one of your children over the course of your life than for the others. One article on USA Today, for exam-ple, suggested that parents level the playing field at death if they paid more for one child’s education or if one child took care of them at old age.

When it comes to naming a Trustee, a personal representative, or an executor, family fighting and chaos could also re-sult if you are not clear on your wishes.

Fortunately, an estate planning at-torney can help you to overcome the challenges in creating an estate plan.

As you consider the future and set your New Year’s resolutions, put it on your list to talk to your lawyer about how you can create a comprehensive plan that will give you control over your assets and avoid fighting among your loved ones after you are gone. So, this New Year’s, make your resolution one you can keep: resolve to make important decisions now about life after your death.■

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For more info: 410-573-4818

Decisions, Decisions, DecisionsBy The American Academy of Estate Planning

Attorneys Presented by SinclairProsser Law, LLC


“As a contractor, bidding on a firm fixed-price (FFP) con-tract can be a great opportu-nity to earn attractive profit

margins. But those higher potential margins also carry higher risks which should be understood and mitigated. By its very definition, an FFP contract has a price that is “fixed”. Regardless of how much time, effort, and money is expended to deliver, the price will nev-er change (for the same scope of work).

If costs can be managed well and risks controlled, there is usually a po-tential to earn higher than normal prof-it margins. However, if contractors ap-proach an FFP contract like they would a general services time and materials contract (T&M) or cost plus contract, they are in trouble. Without an under-standing of what it means to control cost and scope changes, the contractor can lose millions of dollars, triggering all kinds of unwanted attention inside and outside the corporation.

Here is a short list of do’s and don’ts that will hopefully generate the right kinds of conversations the next time you bid on an FFP contract.

DO understand the scope of work and acceptance/ exit criteria. Signing up for a scope of work that was not well understood or poorly defined can lead to heavy losses as you try to satisfy requirements that never were well-defined. For your company’s ben-efit and for the benefit of the client’s expectations, make sure that all work and acceptance criteria are clearly de-fined and articulated without vague or ambiguous terminology.

DON’T allow “scope creep” or “gold plating”. What do we mean? Scope creep is when a client asks for small things that are beyond the existing

scope as defined and the contractor ac-cepts many of these informal requests along the way, increasing costs beyond what was budgeted for. “Gold plating” is when a well-intentioned contractor team gives a level of quality or features that are within the scope of work, but at a cost that is well beyond what was bud-geted. Both have the potential to erode or eliminate profit margins.

DO plan the project with a great deal of detail BEFORE it is bid. If you aren’t able to outline the project and plan execution with reasonable confidence prior to bidding, then you most like-ly don’t need to be bidding on an FFP contract. These contracts should always be well-defined. Other contract types should be used when the scope is less well-defined. Estimates and planning for FFP projects should be done with a well-defined work breakdown structure (WBS), a logic-driven resource loaded schedule, and an analysis of future cash flows. You should know how “deep” your pockets need to be and the specif-ic points when they will need to be their deepest. Always use a just-in-time (JIT) approach for large material buys that may drain resources before payments from milestones or deliverable comple-tion is achieved. For guidance, email us for our presentation, “An Approach to Costing and Pricing Firm Fixed-Priced Contracts For Profitable Results.”

DON’T bid an FFP project like you would a straight level of effort with no reserves built in. Every FFP proj-ect with a defined scope of work and firm acceptance criteria should have reserves established based on quan-tified risk. Elements of the WBS and scope of work should be examined for risk elements. These risks should be entered in a formal risk register that

quantifies risk based on the potential impact weighted by the probability of occurrence. These quantified risks should be added to the cost basis of the bid before applying profit or fee.

DO Manage the contract against a tightly controlled cost, schedule, and technical baseline. Changes to the base-line should go through a formal change management process. Undocumented changes = loss of profit. Though it is not typical in most organizations, con-sider using a light version of earned value management (EVM) on FFP contracts to ensure that value is being generated for dollars spent and there are no financial surprises at the end of the contract.■

By Eric McCamey

Don’t Lose Your Shirt Over a Fixed-Price Contract!

www.nymbuscorp.com 703.574.8181

Eric McCamey, CEO Nymbus Corporation is a management consult-ing firm that accelerates growth for GovCon. We provide executive sup-port services that assist

government contractors in the analysis, implementation and monitoring of holis-tic systems that improve contract awards ratios, profitability and operational per-formance.

“If costs can be managed well and

risks controlled, there is usually a potential to earn higher than

normal profit margins.”

BUSINESSBUSINESS

wjwomen.com8

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Fort Washington, MD 20744

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Creates Beautiful Smiles that Last a Lifetime!

Call today for an Appt.(202)546-0690

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We accept various insurance plans and all Medicaid plans. We accept Group Dental Insurance and other

insurance plans

701 K St NE. Washington, D.C. 20002

wjwomen.com10

”

“

Flair Beauty Institute is a bilingual training center under the leadership of Paula Granados with over 20 years of hands on client service and salon man-agement experience. Drawing from her personal

experience as a stylist, Paula knows firsthand what it takes to succeed in the beauty industry. Paula and her team are devoted to developing prepared and qualified beauty pro-fessionals in all areas of the beauty industry. The Flair team of instructors is committed to instructing, mentoring and developing students.

Not only do the students receive textbook instruction but, they learn important industry protocol, laws and in-sights from seasoned professionals with several years of experience in their respective areas. The instruction amply prepares a student to pass their state board exam. The Sa-lon Management programs gives professionals the tools to succeed as a business owner in the marketplace. The Re-certification classes are taught in Spanish as well as English and meet the State Board requirements for all stylists from braiders to cosmetologist.

Recertification became a requirement effective Septem-ber 30, 2011 for all cosmetologists in Washington, D.C.

Cosmetologists and Cosmetology Specialists must com-plete six (6) CEs by their next renewal date as well as Barbers must complete six (6) CEs by their next renewal date.

Testimonials from the StudentsI am excited even though I have not completely

mastered English-I passed my state board exams and mastered all categories 100%. Thanks to the step by step coaching from the Flair staff.”

-Areli, recent cosmetology student

“I learned new tools that are helping me to run a better business. I now have a website, new management skills and important business tools.” “My business has in-creased by 80% because of the management training pro-gram at Flair under the direction of Ms. Smith.”

-Aisha, Owner of Aisha’s Braids, Braiding Mgr. Program.

“The staff at Flair Institute is super attentive and sup-portive. Because of the instruction I have received I am confident on how to apply all types of chemicals from col-ors to relaxers.”

-Jessica, Senior Cosmetology student.■

3328 Georgia Ave NW, Washington, DC 20010(202) 291-1909

Bilingual Recertification Program for Cosmetologist and Barbers Sunday and Monday training for required 6 hour continuing education credit for current cosmetologists and barber. Call

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Start a New CareerClasses Starting in

January

CAREER


Daleesha was diagnosis with breast cancer at age 32. Though she felt an unusual lump, she thought it was just a cyst and did not seek immediate medical attention. This self-diagnosis she later realized was the wrong approach.

Today Daleesha is happy to report she is in remission but, chal-lenged by the chronic pain of Fibromyalgia. Daleesha does not al-low health challenges past or present to keep her down. She credits God for her wonderful life and passion to enrich other womens’ lives through her Mary Kay business. Daleesha’s Mary Kay business gives her the flexibility to work from home, travel and pamper women. Daleesha is on a mission to let women know with opportunities like Mary Kay they can have big dreams. She advises women to put work into their business and set goals beyond life’s challenges. Daleesha is offering special services for survivors and their families as Christmas presents. Dates and times by appointment. Email [email protected]

The Victorious Dream Team Cadillac Unit of the Future Keita Powell Area honors all Breast Cancer survivors! Join the unit this month for a Christmas service project “Adopt a Grandparent” on December 20.■

“Practice Self-Care, but, Not Self-Diagnosis”Survivor, Daleesha Proctor

Stories of Hope

pportunities to ServeO

The Pink Cadillac Mary Kay Unit of Dr. Brenda Carver-Taylor is sponsoring a service project for the seniors of Marwood Apartments. For just $12 one senior will receive a “MK Satin Hand Cream Gift” set with am acknowledgment card.

Delivery will be Sunday, December 20, 2015 at 3:00 pm. at the Marwood Senior Apartments 5605

S. Marwood Blvd. Upper Marlboro, MD 20772

Volunteers and sponsors: High school students, Business professionals and Families. Contact

Dr. Belinda Carver Taylor at 301-672-4716

Support ResourcesThe Rosemary Williams Mammoday Program

Mammograms are being provided to women who are at least 40 years of age, low income, underinsured or uninsured. All women receive a clinical breast examination and mammogram

at no cost. Women are also provided with educational materials.

Contact: Kimberly Higginbotham at (202) 865-4655 or (202)865-5399 Howard University Cancer Center

Find out how you can sponsor a story of hope relat-ed to overcoming homelessness, business recovery, domestic violence or a youth that is on the move.

Email [email protected]

wjwomen.com12

HEALTH & WELLNESS

If you are looking for an alternative to metal brac-es, ClearCorrect is the clear and simple choice. Clear-

Correct invisible braces are the clear and simple way to straight-en your teeth so that you can show off your smile. No wires. No brackets. Just clear, convenient comfort – giving you every rea-son to smile.

ClearCorrect is an easy and discreet solution to align and straighten a broad range of dental conditions for a stunning, healthy smile. The fact that it does this so well is remarkable; the fact that it does this with little to no effort is almost unbelievable. ClearCor-rect is for both adults and teenag-ers – age is not a problem. Chil-dren who might not yet have all of their molars and even seniors with more complicated den-tal cases may be candidates for ClearCorrect, but should consult with their doctors first.

With ClearCorrect, your dentist can straighten your teeth using a series of clear, custom, removable aligners. Each align-er moves your teeth just a little bit at a time until you eventually get straight teeth. And ClearCor-rect is one of the clearest align-er systems available. The Clear-Correct aligners offer superior clarity, are virtually invisible and

unnoticeable, and their smooth surface finish withstands cloud-ing from wear.

Schedule an appointment with your dentist so you can have your teeth evaluated and talk about any problems or goals you have for your smile. Once your dentist establishes that ClearCor-rect is the right treatment option for you, the dental staff will take impressions, photos, and some-times X-rays of your teeth.

ClearCorrect will then create 3-D models of your teeth. Follow-ing the instructions provided by your dentist, ClearCorrect then creates a treatment setup repre-senting the desired position of your teeth at the end of treat-ment. At the same time, Clear-Correct also manufactures Phase Zero passive aligners designed to fit your teeth and get you accus-tomed to wearing aligners right away.■

NO M

ORE

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AL B

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1) CLEANING FoR $79.99 (not if insurance is used)

2) $600 oFF oN DENTURES (not if insurance is used)

Dr. MErAI COuPON OFFErS (coupons cannot be combined)

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clear, convenient comfort – giving you every reason

to smile.”If you would like to learn more about ClearCorrect, call your dental office to

set up a consultation to see if ClearCorrect addresses your

dental concerns and cosmetic goals.


Teaching children to be grateful is what all par-ents want and can attain in surprisingly simple ways such as sending thank you notes to feeding pets.

Children emulate the adults in their lives in every way. Be they parents, grandparents, aunts, uncles, siblings, or childcare providers. Make sure you use “thank you” and “please” when you talk to them. Insist that they use their words too. Remember, good manners and gratitude overlap.

Here are several ways to help with teaching gratitude to your children:1. Work gratitude into your daily conversation. Weave ap-

preciation for mundane things into your everyday talk. When you reinforce an idea frequently, it’s more likely to stick. Pick an “I am thankful for …” part of the day to turn up the gratitude in your home. This can be done at dinnertime or at night time just before bed as part of a nightly routine. Teach children to be grateful for the creations around them, the seasons, the sunshine, the falling leaves and the rain. Children will quickly un-derstand that there is beauty all around, and that it has come from something much bigger than we are.

2. Have kids help. Give your child a chore. By participat-ing in simple household chores like feeding the dog or stacking dirty dishes on the counter, kids realize that all these things take effort. There is a better appreciation for the person who does the chore on a more regular basis.

3. Provide your family opportunities to serve. Figure out some way your child can actively participate in helping someone else. Even if it is to help cook a meal, bake a cake, or walk a pet for a sick person. Start by encourag-ing your children to serve other family members, and then help them find ways to actively serve others. Let them help as you serve others. They will learn by ex-ample.

4. Encourage generosity. Donate toys and clothes to less fortunate kids; it inspires them to go through their own closets and give something special to those in need, as well.

5. Insist on thank-you notes. If your child knows how to draw or write, let them write thank-you notes for gifts. For toddlers, the cards can be just scribbles with your own thank-you attached. As they grow, they can be-come drawings, then longer letters. Younger children can even dictate the letter while you write. Just the act

of saying out loud why they loved the gift will make them feel more grateful.• Practice saying no. Kids ask for toys, video games,

and candy sometimes on an hourly basis. It’s diffi-cult, if not impossible, to feel grateful when your every whim is granted. It is important for us to be reasonable and say “No”. We also have to be care-ful rewarding our children for everything. We want them to do good because it is the right thing to do, and not because they get something, like a new toy or money.

• Teach your children to be grateful for adversity. When things are hard, or uncertain, or don’t go as planned, we need to teach our children to be grate-ful. To recognize the blessings that comes from hard things. We need to help children see what can be learned from our adversity, and how we can take what we learn into other situations to help others and ourselves.

• Be patient. Don’t expect gratitude to develop over-night. This kind of work requires weeks, months, even years of reinforcement. Lead by example and mostly with love. The goal is to give them “grateful eyes”, so they begin to for see the need before they have to be told. With time and patience you will be rewarded with a child who has an attitude of grat-itude.■

Having an Attitude of GratitudeBy Janet Johnson, M.D.

3311 Toledo Terrace Suite C-201, Hyattsville, Maryland 20782Office: (301) 403-8808 / Fax: (301) 403-1341

Loving Care Pediatrics: Dr. Johnson and Staffaccepting new patients, birth to age 21

HEALTH & WELLNESS

wjwomen.com14

HEALTH & WELLNESS

Suicide is the act of de-liberately doing harm to oneself with the in-tention of dying, while

understanding the permanence of death. Suicide exclude such acts by those not yet develop-mentally able to understand the concept of death like young children; developmentally dis-abled individuals; conditions in which one is in a confused state as in severe intoxication; or acts by those who are permanently cognitive-impaired such as in-dividuals with dementia.

Suicide by the NumbersSuicide is a public health

concern nationally and inter-nationally. In the US there are over 36,000 suicides annually. Suicide occurs across all ages, economic, social and ethnic boundaries. It is the third lead-ing cause of death for 10-24-year- olds, according to the Na-tional Center for the Prevention of Youth Suicide.

Male youths die of suicide four times more frequently than female youths, although females are more likely to make more attempts. The majority of completed suicide were by firearms. For every completed suicide there are many more suicidal attempts. The Nation-al Youth Risk Behavior Survey found that among high school students, about a third had at-

tempted, made plans for, or se-riously considered attempting suicide in the previous year.

Military SuicidesSuicide has been in the

headlines recently because of the alarming rate of suicides among returning troops, as de-picted in the August 2012 Time Magazine cover story titled “One a Day”. In Maryland, of the 25 suicides reported in the military, all were under 25 years old.

Common CausesSuicide is not a disease. It

is a result of many risk factors. Over 90 percent of suicide vic-tims suffer from a significant psychiatric disorder at the time of their death. The most com-mon are mood disorders (disor-

ders involving depression) and substance abuse. These disor-ders are often undiagnosed and untreated, partly due to inade-quate information about them, but also due in large part to the continued misunderstanding and stigma about mental ill-nesses. Studies have shown that only a third of all those who suf-fer from depression seek treat-ment.

A depressive episode often affects the mood (persistent sadness). It also affects one’s usual physical or behavior pat-terns, and may result in fatigue, impaired sleep, or altered eating habits. However the effect on the thought pattern is the most devastating and accounts for suicidal thinking and attempts in severe cases. One often feels

We Can Help Prevent It

Submitted by Dr. Corder

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HEALTH & WELLNESS

inexplicably guilty, hopeless and help-less about situations, and in severe cases concludes they are a burden on others and better off dead. As de-pression worsens there are recurrent thoughts of death, developing into suicidal thoughts, which may ulti-mately result in suicidal attempt.

Studies show that most people who attempt suicide do not want to die but are unable to see alternatives to their problems. Many initially re-sist the suicidal impulses with various mental convictions. However, with the severity of depression, even this resistance is not strong enough.

Increased Risk FactorsPeople with dependence on al-

cohol and other drugs, in addition to being depressed, are at greater risk for suicide. Suicide risk during depres-sion may be higher amid heightened anxiety, impaired sleep, irritability and previous suicide attempts, no matter how minor it seemed.

Firearms in the household in-crease the risk of suicide completion. Being isolated is also a risk factor for suicide when depressed. Some exhibit warning signs of suicidal in-tentions or even talk about it. There is a myth that talking about it means

the person is not serious. Some may become very withdrawn from those around them. In others there are no visible signs. It is therefore import-ant to communicate openly with the young person who appears to be in persistent emotional distress to ex-plore their thoughts.

Ways to Prevent Suicide1. Even though there is a genetic

risk for depressive illnesses and it can occur without a specific trig-gers, it may also be triggered by overwhelming stress related to negative life events. Promotion of adequate coping skills to stressful events may prevent some depres-sive states.

2. Early recognition and treatment of depressive symptoms is key. In spite of the medical facts, there is still reluctance to seek mental health treatment, mainly due to stigma. Everyone can help erode stigma by dropping derogatory remarks about mental illnesses, often magnified in the media. De-velopment of better attitudes to-ward mental illnesses will indeed improve the chances of early rec-ognition.

3. Arm yourself with facts about de-pression. If you suspect your child may be exhibiting some symp-toms, have an open discussion in a non-judgmental manner and seek medical help from a mental health clinician, psychiatrist or counsel-or. If a mental health professional is unavailable, see the family phy-sician immediately.

4. If your child is diagnosed with or exhibiting some signs of depres-sion, be alert to the risk factors of substance abuse, isolation, or vis-iting social media sites with focus on suicidality, and continue open dialogue.

5. Encourage their friends not to keep secrets about suicide intent but tell a parent or school guid-

ance counselor. Many people have talked about their intent pri-or to attempting suicide but have sworn friends to secrecy.

6. Remove all firearms from the house.

7. If there is a suspicion, attempt or expression of intent to harm one’s self, get your child to the emer-gency room right away or call 911. Many people who have had suicid-al ideas or even made attempts in the past and have had treatments, go on to live emotionally success-ful lives.■

For more information about suicide prevention, contact:

American Association of Suicidology @ www.suicidology.org 1-800-273-TALK (8255)

Prevention of Teen Suicidewww.sptsusa.org

Dr. Corder attended medical school at Howard University College of Medicine and graduated in 1977. He is board cer-tified by the American Academy of Pedi-atrics. Dr. Corder was formally the Chief Health Officer for Prince George’s County and the medical Director of several health plans. Dr. Corder has been in Pediatric practice for over 35 years. Dr. Corder, his wife Dr. Marilyn Corder ad their daugh-ter Adrienne Corder started the Corder Pounders Youth Fitness program and the Family Fitness Center.

Frederick Corder,MD FAAP

Bowie,MD•(301)805-2229Cheverly,MD•(301)341-7494

Children’s Medical CenterWashington, DC T: 202-291-0147

Suicide is a public health concern nationally and

internationally.”“

wjwomen.com16

HEALTH & WELLNESS

Before intraocular lenses (IOLs) were developed, people had to wear very thick eyeglasses or spe-cial contact lenses to be able to see after cataract surgery. Now, with cataract lens replacement, sev-

eral types of IOL implants are available to help people enjoy improved vision. Discuss these options with Dr. Bovelle to determine the IOL that best suits your vision needs and life-style.

Cataract lens replacement: How IOLs workLike your eye’s natural lens, an IOL focuses light that

comes into your eye through the cornea and pupil onto the retina, the sensitive tissue at the back of the eye that relays images through the optic nerve to the brain. Most IOLs are made of a flexible, foldable material and are about one-third of the size of a dime. Like the lenses of prescription eye-glasses, your IOL will contain the appropriate prescription to give you the best vision possible. Read below to learn about how IOL types correct specific vision problems.

Which lens option is right for you?• Before surgery your eyes are measured to determine

your IOL prescription, and you and Dr Bovelle. will compare options to decide which IOL type is best for you, depending in part on how you feel about wearing glasses for reading and near vision.

• The type of IOL implanted will affect how you see when not wearing eyeglasses. Glasses may still be needed by some people for some activities.

• If you have astigmatism, Dr. Bovelle will discuss toric IOLs and related treatment options with you.

• In certain cases, cost may be a deciding factor for you if you have the option of selecting special pre-mium lOLs that may reduce your need for glasses.

Intraocular lens (IOL) typesMonofocal lens

This common IOL type has been used for several de-cades.

• Monofocals are set to provide best corrected vision at near, intermediate or far distances.

• Most people who choose monofocals have their IOLs set for distance vision and use reading glass-

es for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.

• Some who choose monofocals decide to have the IOL for one eye set for distance vision, and the other set for near vision, a strategy called “monovision.” The brain adapts and synthesizes the information from both eyes to provide vision at intermediate distances. Often this reduces the need for reading glasses. People who regularly use computers, PDAs or other digital devices may find this especially useful. Individuals considering monovision may be able to try this technique with contact lenses first to see how well they can adapt to monovision. Those who require crisp, detailed vision may decide monovision is not for them. People with appropri-ate vision prescriptions may find that monovision allows them see well at most distances with little or no need for eyeglasses.

IOL Implants: Lens replacement and Cataract Surgery

Submitted by Dr. renee Bovelle

“Like the lenses of prescription eyeglasses,

your IOL will contain the appropriate prescription to give you the best vision

possible.”


HEALTH & WELLNESS• Presbyopia is a condition that affects everyone at

some point after age 40, when the eye’s lens be-comes less flexible and makes near vision more difficult, especially in low light. Since presbyopia makes it difficult to see near objects clearly, even people without cataracts need reading glasses or an equivalent form of vision correction.

Multifocal or accommodative lensesThese newer IOL types reduce or eliminate the need for

glasses or contact lenses.• In the multifocal type, a series of focal zones or

rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly.

• The design of the accommodative lens allows cer-tain eye muscles to move the IOL forward and back-ward, changing the focus much as it would with a natural lens, allowing near and distance vision.

• The ability to read and perform other tasks without glasses varies from person to person but is gener-ally best when multifocal or accommodative IOLs are placed in both eyes.

• It usually takes 6 to 12 weeks after surgery on the second eye for the brain to adapt and vision im-provement to be complete with either of these IOL types.

Considerations with multifocal or accommodative IOLs• For many people, these IOL types reduce but do

not eliminate the need for glasses or contact lenses. For example, a person can read without glasses, but the words appear less clear than with glasses.

• Each person’s success with these IOLs may depend on the size of his/her pupils and other eye health factors. People with astigmatism can ask Dr Bovelle about toric IOLs and related treatments.

• Side effects such as glare or halos around lights, or decreased sharpness of vision (contrast sensitivi-ty) may occur, especially at night or in dim light. Most people adapt to and are not bothered by these effects, but those who frequently drive at night or need to focus on close-up work may be more satis-fied with monofocal IOLs.

Toric IOL for astigmatismThis is a monofocal IOL with astigmatism correction

built into the lens.• Astigmatism: This eye condition distorts or blurs

the ability to see both near and distant objects. With astigmatism the cornea (the clear front window of

the eye) is not round and smooth (like a basket-ball), but instead is curved like a football. People with significant degrees of astigmatism are usually most satisfied with toric IOLs.

• People who want to reduce (or possibly eliminate) the need for eyeglasses may opt for an additional treatment called limbal relaxing incisions, which may be done at the same time as cataract surgery or separately. These small incisions allow the cornea’s shape to be rounder or more symmetrical.

Other important cataract lens replacement considerations

• In some cases, after healing completely from the cataract lens surgery, some people may need fur-ther correction to achieve the best vision possible. Their ophthalmologist may recommend additional surgery to exchange an IOL for another type, im-plant an additional IOL, or make limbal relaxing incisions in the cornea. Other laser refractive sur-gery may be recommended in some cases.

• People who have had refractive surgery such as LASIK need to be carefully evaluated before getting IOLs because the ability to calculate the correct IOL prescription may be affected by the previous refractive surgery.

• People with Dry Eye need to be evaluated before cataract surgery. Untreated Dry Eye can affect the calculations needed to choose the specific IOL for you. So if you have Dry Eye please take your eye drops as directed.■

Article written by Kierstan Boyd, reviewed by Dr. Elena Jiménez and reprinted from:

Dr. Renee Bovelle

“Your Best Vision is Our Focus”

12200 Annapolis Rd., Suite 116, Glenn Dale, MD 20769301-805-4664

www.EnvisionEyeAndLaser.com

wjwomen.com18

In the United States, breast cancer is the most common cancer among women of all races. Unfortunately, it is also the second leading cause of cancer death in this gender population. It is estimated that in 2012, About

227,000 new cases of invasive breast cancer and about 63,000 new cases of non-invasive breast cancer (an early form of breast cancer) were diagnosed in this country. This will lead to about 39,500 deaths from breast cancer. In their lifetime, about 1 in 8 (12%) women in the US will develop invasive breast cancer. This is a very chilling statistic, which makes early screening and detection only that much more important. Breast cancers that are discovered at earlier stag-es have a much higher change of cure and survival.

Up to 10% of breast cancers are thought to be hered-itary. These cancers are a result of genetic information passed from a parent to their offspring. Genetic informa-tion is passed through chromosomes. During conception, half of the chromosomes are obtained from the mother and half from the father. The genetic information in these chromosomes is encoded in DNA. This DNA contains the instructions for building proteins that make up your body and help with all its functions. Unfortunately, if there is an error, or mutation, in this DNA, that mutation will appear in all the cells produced by that particular DNA.

Most inherited cases of breast cancer are associated with two abnormal mutations in the DNA: BReast CAncer gene one and BReast CAncer gene two, abbreviated BRCA1 and BRCA2. It is a fact that everyone has BRCA1 and BRCA2 genes, since the normal function of the BRCA genes is to repair cell damage and keep breast cells growing normally. This prevents us from developing cancer. But the problem is that when these genes contain abnormalities or mutations , the breast cancer risk increases, since this leads to irregu-larities with the normal repair mechanism in breast cancer tissue.

Abnormal BRCA1 and BRCA2 genes may account for up to 10% of all breast cancers, or 1 out of every 10 cases. Women having these particular abnormal genes can have up to an 80% risk of being diagnosed with breast cancer during their lifetimes. Breast cancer in these women is more likely to occur at a younger age, be more aggressive with a higher chance of spreading, and occur in both breasts. Apart from breast cancer these women are also much more likely to de-velop cancer of the ovary (2nd most common after breast), pancreas, cervix, uterine, colon, stomach, gall bladder, bile duct, thyroid, and a type of skin cancer called melanoma.

We all have 23 pairs of chromosomes, for a total of 46 chromosomes, half of which come from our mother and

HEALTH & WELLNESS

The Effects of Genetics on Breast Cancer: An Update

By Kashif Ali, M.D.

“In the United States, breast cancer is the most common cancer among

women of all races.”


the other half from our father. The BRCA1 and BRCA2 mutations are passed onto children in a autosomal domi-nant pattern. This means that even if one parent is carrying a mutation on even one of their 46 chromosomes, half of their children will be affected.

The BRCA mutation is detected through a blood test collected at your doctor’s office or a lab. Possible women who qualify for BRCA mutation testing include those with a personal or family history of:

• Breast cancer diagnosed at age 50 or younger • Ovarian cancer at any age • Two separate breast cancers in the same person, or

two family members with breast cancers on the same side of the family

• Male breast cancer • Triple negative type of Breast Cancer (meaning

breast cancer carrying no receptors to target) • Pancreatic cancer and a breast or ovarian cancer in

the same person, or on the same side of the family• Ashkenazi Jewish ancestry with breast, ovarian, or

pancreatic cancers• Two or more relatives with breast cancer, one under

age 50 • Three or more relatives with breast cancer at any age • A previously identified BRCA mutation in any mem-

ber of the family

Women who carry a BRCA mutation tend to have breast cancers that are triple negative. Triple negative breast can-cers are: Estrogen receptor-negative, Progesterone recep-tor-negative, and HER2/neu-negative. This means there is no receptor on the outside of the cancer cell to target during treatment. These cancers also tend to be more aggressive and have a high chance of metastasis (meaning spread to other parts of the body).

To bring some positive light to this discussion, a recent study at the M. D. Anderson Cancer Center showed that triple-negative breast cancer patients with BRCA muta-tions experienced a significantly lower chance of the cancer coming back after completing treatment. Also a new class of drugs, called PARP inhibitors, have shown promise in BRCA mutations and/or triple negative breast cancers. Even women who were treated with and failed multiple prior chemotherapies responded favorably to these new agents.

In conclusion, it is imperative that women at risk for carrying the deleterious BRCA mutations be identified pri-or to the development of a BRCA-associated cancer. In the event that this mutation is detected after the development of cancer, then she be treated with the most up-to-date, new, and robust treatments that oncologists have to offer at this time.■

HEALTH & WELLNESS

Dr. Kashif Ali earned his MD degree from Ross University School of Medicine. He completed his residency in Internal Medicine at Seton Hall University in New Jersey. While at Seton Hall University, he became the Chief Resident and then went on to complete his training in Hematology and Oncology. During this training he was appointed Chief Fellow. Dr. Ali is presently board certified in Internal Medicine, Hematology and Oncology.

wjwomen.com20

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Dr. Ndidi Agholor is a caring and dedicated pediatrician whose top priority is the well-being of her patients. She is committed to providing quality healthcare for all her patients from birth to age 21.

Dr. Agholor has worked in the Maryland/DC area for over a decade. She graduated from Howard University College of Medicine and completed her pediatric residency at the University of Maryland Medical Center. She is board certified by the American Board of Pediatrics and is also a member of the American Academy of Pediatrics. Dr. Agholor enjoys caring for children of all ages, participating in community activities and promoting healthy lifestyle choices for her patients and their families.

She has special interests in Newborn/Infant Care, Behavioral Disorders, Asthma Management, Nutrition, Adolescent/Teenage Health, Preventative/Well Child Care.

AcEPtAndo nuEvoS PAcIEntES


Let’s get up and be active! Plain and simple inactively contributes to weight gain and even obesity. Obesity is a risk factor for Type 2 diabetes, hypertension, arthritis, cancer, stroke, heart disease and even death. Accord-

ing to the Center for Disease Control and Prevention (CDC) in 2011, there was 128,932 stroke related deaths; 596,577 heart related deaths and 576,691 cancer related dates.

Get to know your BMI. Body mass index (BMI) is a math-ematical equation that is based upon your weight and height; it is used to determine your health status. A BMI of 18.5 to 24.9 is normal weight, 25 to 29.9 is over-weight, 30 to 34.9 is mild obesity, 35 to 39.9 is moderate obesity and 40 or greater is se-vere obesity. What is your BMI?

We can minimize our risk for various medical conditions by getting up out of our seats to move! DID YOU KNOW 20 MINUTES OF BRISK WALKING BURNS 100 CALORIES AND 30 MINUTES BURNS 150 CALORIES?

Below are 15 easy ways to burn 100 calories in less than 30 minutes!

• Brisk walking: 20 minutes• Biking: 23 minutes casual cycling• Cardio dance class: 15 minutes• Elliptical: 8 minutes• Squats: Perform 20 repetitions

• March/Jog in place: 1 minute• Push-ups: 10 repetitions• Pilates: 24 minutes• Rowing machine: 13 minutes• Running stairs: 6 minutes• Swimming: 15 minutes moderate intensity• Walking stairs: 11 minutes• Water aerobics: 23 minutes• Yoga: 20 minutes• Zumba: 11 minutesDon’t Be A Statistic! GET UP AND MOVE. JUST MOVE! I

challenge you to do 1 to 3 different exercises 3 or more times this week. JUST MOVE! I dare you. JUST MOVE!

However, if you have mobility issues, physical limitations and previous sports injuries that are keeping you from being as active as you desire there are solutions. Make an appointment with our office for an evaluation. Most insurances are accepted, as well as Health Savings Plans.■

BurN 100 CALOrIES IN LESS ThAN 30 MINuTESBy Vernise L. Burs PT, CSCI

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wjwomen.com22

COMMUNITYCOMMUNITY

IngredientsYour Choice of Nutrient Rich Greens

1/2 Bunch of washed and shredded Kale1 Apple chunk diced, 3 grapes sliced

1/2 pecan crushed, Sweet pepper, Onion

DressingBalsamic vinegar – 3 tbs.

Dijon mustard – 1 tbs.Honey – 1 tbs.

Olive oil – 6 tbs.

PreparationMix everything together and add salad dressing. Yum!■

mIxeD GReeN

LacinatoKale

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Ingredients2 cups of yellow or green lentil beans

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1 bell peppers (you may use organic salsa for the tomato, onion

and bell pepper)2 cups of butternut squash

1 cup of diced carrots1/2 bunch of steamed collard greens

2 garlic clovesAdd salt, pepper

Preparation1. Mash butternut squash & black beans once soft

boiled2. Mix cooked lentils into squash and black bean

sauce3. Let stew for 15 min stir and add water as need-

ed.■

Lentil Stew

wjwomen.com24

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DC Women's Journal Vol 49/Issue 6

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Transcript of DC Women's Journal Vol 49/Issue 6