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|Posted on December 26, 2018 at 4:33 PM||comments (49)|
Nearly every night of our lives, we undergo a startling metamorphosis.
Our brain profoundly alters its behavior and purpose, dimming our consciousness. For a while, we become almost entirely paralyzed. We can’t even shiver. Our eyes, however, periodically dart about behind closed lids as if seeing, and the tiny muscles in our middle ear, even in silence, move as though hearing. We are sexually stimulated, men and women both, repeatedly. We sometimes believe we can fly. We approach the frontiers of death. We sleep.
Around 350 B.C., Aristotle wrote an essay, “On Sleep and Sleeplessness,” wondering just what we were doing and why. For the next 2,300 years no one had a good answer. In 1924 German psychiatrist Hans Berger invented the electroencephalograph, which records electrical activity in the brain, and the study of sleep shifted from philosophy to science. It’s only in the past few decades, though, as imaging machines have allowed ever deeper glimpses of the brain’s inner workings, that we’ve approached a convincing answer to Aristotle.
Everything we’ve learned about sleep has emphasized its importance to our mental and physical health. Our sleep-wake pattern is a central feature of human biology—an adaptation to life on a spinning planet, with its endless wheel of day and night. The 2017 Nobel Prize in medicine was awarded to three scientists who, in the 1980s and 1990s, identified the molecular clock inside our cells that aims to keep us in sync with the sun. When this circadian rhythm breaks down, recent research has shown, we are at increased risk for illnesses such as diabetes, heart disease, and dementia...
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|Posted on December 24, 2016 at 10:56 PM||comments (77)|
The quest to contain health costs while improving the quality of care typically focuses on service delivery, such as reducing unnecessary or harmful medical procedures. But changes in health care financing are pushing some health systems to take a more holistic approach and address social factors that directly impact patients’ health. Think of it as the “community cure” for health care.
The rationale for thinking outside the clinical setting is compelling. According to a recent Robert Wood Johnson Foundation study, only 20 percent of the factors that influence a person’s health are related to access and quality of health care. The other 80 percent are due to socioeconomic, environmental, or behavioral factors –including unhealthy housing, poor diet, inadequate exercise, and drug and alcohol use. As federal and state reforms prod payers to move away from traditional fee-for-service—which pays for volume, not outcomes—and toward a pay-for-performance model that rewards keeping people healthy, the economic argument for addressing social determinants of health becomes clear...
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