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5 Love Languages, 7 Days, 1 Couple


What makes for a good, lasting marriage? I can’t speak for everyone, and I don’t believe there’s just one magical thing. But my husband and I recently celebrated our 25th wedding anniversary, and I can share something that’s helped us: We’ve learned how to express our emotions in ways that are meaningful to each other. We’re fluent in each other’s “love language,” as Gary Chapman, PhD, would say.

You might know of Chapman’s bestselling book, The 5 Love Languages. My husband and I put it to the test 11 years ago, and I wrote about it for WebMD. As our marriage hit the quarter-of-a-century milestone, we gave Chapman’s method another try. Have the love languages held up to the test of time?

Thirty years ago, Chapman, a marriage and family therapist in Winston-Salem, NC, came up with five categories of things he’d noticed during his counseling sessions that couples want from each other:

  1. Words of affirmation: compliments or words of encouragement
  2. Quality time: their partner’s undivided attention
  3. Receiving gifts: symbols of love, like flowers or chocolates
  4. Acts of service: setting the table, walking the dog, or doing other small jobs
  5. Physical touch: having sex, holding hands, kissing

Chapman wrote about them in his book. Learning each other’s love language helps couples express their emotions in a way that’s “deeply meaningful” to one another, he says.

Our first time around, my husband and I took Chapman’s Love Language Quiz and then spent a week trying to fill each other’s “love tank” – Chapman’s metaphor for how much love each person is feeling.

We discovered that we shared the same love language: quality time. For a week, as we strolled through local farmers markets, went antiquing, and talked over glasses of wine at our favorite date-night bar/restaurant, we connected in ways we hadn’t in years.

Our respective love tanks were indeed very full. But that was then. What about now? Would the love languages still hold true for my marriage? For relationships in general?

A lot has changed since Chapman’s book came out. And technology is a big part of that.

“We’re all so tied to our phones that if we’ve got a free moment, we’re more likely looking at the phone than looking at each other,” Chapman said when I recently spoke with him again.

Guilty. Most nights you’ll find my husband and I curled up on the couch – him on one side, me on the other – both scrolling Facebook or Instagram while the TV blares in the background. The best antidote for technology interference, Chapman says, is to put down our phones two or three times a week and talk to one another.

So that’s what we did. But first, we took the 5 Love Languages Quiz again. This time, our results weren’t identical. My husband scored highest on physical touch. Quality time came up first again for me, but words of affirmation was a very close second.

“I think there are seasons of life, and perhaps circumstances, that will affect the love language,” Chapman says. “It doesn’t hurt to take the quiz every 5 years or so, just to see.”

My husband and I still speak each other’s love language. Sometimes, though, our dialects are slightly different. I love the theater. He’d rather spend time in a brewpub. I want a massage before bed. He’d prefer to … you get the picture.

This time, instead of planning activities to do together, we simply focused on each other more. We put down our phones a few times a week as Chapman suggested, looked into each other’s eyes, and listened. I touched him more, even if it was just a brief hug or arm rub. He told me every day how much he loves and appreciates me.

I asked my husband if his love tank is full. It is. So is mine.

In the book, Chapman says his technique has the potential to save “thousands of marriages.” Can it? I came into the process with an already solid marriage that just needed a little tweaking. Would it have the same effect on a teetering relationship?

Chapman is optimistic. He believes we can change our relationships for the better, no matter how rocky they are.

“What the love language does is give you the most powerful way to have a positive influence on your spouse, because you’re addressing one of their most powerful needs: the need for love,” he says. “When a person feels loved, they tend to be drawn to the person who’s loving them.”

While there’s nothing wrong with the 5 Love Languages approach, it doesn’t have the weight to solve more serious marital problems, says Julie Nise, a licensed marriage and family therapist and relationship trainer in Pensacola, FL.

“The 5 suggested expressions of love and care are quite lovely and would be a nice addition to an already pretty good, stable marriage,” she says. “However, couples with very poor communication and problem-solving skills, or in very damaged relationships with years of unresolved resentments and frequent arguing, should not expect them to work in the same way.”

Some couples have to sort out their basic issues and understand things like their goals, patterns, and perceptions before they can be a team that works well, Nise says.

Chapman agrees that the love languages won’t solve every problem couples have, but they can address the fundamental emotional need at play.

“If that need is met, you’re more likely to be able to deal with the other issues in the marriage,” he says. “This is just another tool to help you enhance the relationship, and particularly to enhance the emotional part of the relationship.”

So if you and your partner want to explore your love languages, go into it with the understanding that it’s a nice way to reconnect, but it isn’t a quick fix. Real love – the kind that lasts – takes a strong foundation and a lot of work.



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Nirsevimab is 90% Effective Against RSV-Associated Hospitalizations


Image Credit: Adobe Peter Hansen

This article first appeared on our sister site, Contemporary Pediatrics.

The effectiveness of nirsevimab (Beyfortus; Sanofi/AstraZeneca) against respiratory syncytial virus (RSV)-associated hospitalizations is estimated to be 90% in infants during their first RSV season, according to new data from the Centers for Disease Control and Prevention (CDC).

A March 7, 2024 publication of the CDC’s Morbidity and Mortality Weekly Report (MMWR) references that RSV is the leading cause of hospitalization in US infants, putting between 50,000 to 80,000 children aged 5 years and younger in the hospital annually.

Ahead of the typical RSV season, the long-acting monoclonal antibody was approved by the FDA on July 17, 2023. In August 2023, it was unanimously recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP) for infants younger than 8 months of age.

In the same month, the American Academy of Pediatrics (AAP) also voted in unanimous fashion to recommend the routine use of nirsevimab in newborns and infants.

In the following months, amid shortages and high demand for nirsevimab, the CDC recommended the antibody be prioritized for infants at the highest-risk for infection. In January 2024, some 230,000 additional doses became available, with recommendation from the CDC that health care settings with adequate supply return to the original ACIP recommendation.

The current analysis of nirsevimab is the first estimate in the United States for post-introduction effectiveness for infants in their first RSV season, stated the CDC.

Data was collected using the New Vaccine Surveillance Network (NVSN), a platform for acute respiratory illness (ARI) in infants, children, and adolescents under 18 years of age. The system monitors pediatric respiratory viruses across 7 US pediatric academic medical centers.

Received through parent reports, the receipt of nirsevimab was verified through state immunization information systems, birth hospitals, or primary care records.

Eligible infants had to be younger than 8 months of age as of October 1, 2023, or born after that date. They had to be hospitalized with ARI during October 1, 2023 through February 29, 2024, had verified nirsevimab status, reported gestational age at birth, and had to have medical record review to assess for underlying conditions, according to the authors.

Effectiveness against RSV-associated hospitalization was estimated using a test-negative, case-control study design, with case-patients being those who received a positive RSV test result and control patients being infants with a negative result.

Effectiveness was calculated as (1− adjusted odds ratio) × 100%.

In all, 699 infants at 4 sites were included in the study, with 407 case-patients and 292 control patients.

Nirsevimab was more frequent in infants with high-risk medical conditions compared to those without (46% vs 6% [P < 0.001]). A median of 45 days was observed as time since receipt of nirsevimab to ARI symptom onset, ranging from 7 to 127 days (IQR = 19-76 days).

In all, 6 case-patients (1%) and 53 (18%) control patients received nirsevimab, with effectiveness at 90% against RSV-associated hospitalization.

Likely because of the delayed availability in the first introduction season of nirsevimab, only a small proportion of hospitalized infants with ARI received nirsevimab, a limitation of the study.

Overall, data revealed in the study supports existing recommendations to prevent severe RSV disease with nirsevimab for infants in their first RSV season, as a single dose was highly effective.

Reference

Early estimate of nirsevimab effectiveness for prevention of respiratory syncytial virus–associated hospitalization among infants entering their first respiratory syncytial virus season — new vaccine surveillance network, October 2023–February 2024. Morbidity and Mortality Weekly Report. March 7, 2024. Accessed March 7, 2024.
https://www.cdc.gov/mmwr/volumes/73/wr/mm7309a4.htm?s_cid=mm7309a4_w



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What to Expect as a Parent


As your child reaches the 8- to 12-year-old age range, you may begin to notice subtle and obvious signs that they’re no longer a youngster but not quite a teen. Welcome to the “tween” years!

This in-between stage of development is a time of change. Your kid starts to be more independent. They may hit puberty. And their peers’ opinions outrank yours.

“Sometimes, it catches parents by surprise,” says pediatrician Sarah Ann Anderson-Burnett, MD, PhD, a Columbia University specialist in adolescent medicine.

Tween parents: Does this sound familiar?

Puberty brings on all the body change you recall from your own youth: Getting taller. Body odor. Hair where there wasn’t hair before. Acne. Girls may develop breasts and get their first menstrual period. Boys’ voices may deepen, and their testes may enlarge.

“It is normal to start seeing physical changes associated with puberty as early as 8 years old in girls and 9 years old in boys,” says pediatrician Sharifa Glass, MD. She’s an assistant professor at the University of Houston College of Medicine.

That’s a good time to talk about it with your tween, so they know what to expect.

“Starting at 8 and 9 is a really appropriate time to begin to have that conversation,” Anderson-Burnett says. “As scary as it is for parents, it is just as terrifying for the children.” You can get past the awkwardness together.

The child who used to tell you everything may become tight-lipped, sharing with peers instead.

“They do start to distance themselves from their parents, often considering their friends as more like their family,” says Shannon Odell, PsyD, a Portland, OR, child and adolescent psychologist. “This can look like picking fights with and ignoring parents, defying rules, and challenging parents’ authority.”

Get ready for a taste of what you might not have expected until the teen years.

Omar Ruiz, a licensed marriage and family therapist in Wellesley, MA, describes what this can look like. “Tweens are notorious for showing attitude, through rolling of their eyes, sucking their teeth, being short with their responses, elevated tone of voice, refusing to follow directions or using vulgar language towards adults,” he says.

Tween independence is normal and expected. You should allow it, up to a point.

“They still need you as their parent,” Anderson-Burnett says. “They still need structure. They still need guidance. But now they’re building their independence and learning to have their own voice. And that is just as critical in this development as is their physical development.”

In the past, you may have told your child what to wear, eat, and watch. As tweens, they’ll look to their friends.

“Their relationships with their peers become a primary factor in most of the decisions they make, the development of their personality, how they talk, how they behave, what they value, what they believe, and also how they dress, eat, exercise,” Odell says.

As the parent, you still count. But the dynamic may feel different to you both.

Even if your tween starts to pull away, keep talking — both about ordinary and important topics. “The relationship at this time lays a great foundation for your child to confide in you for even tougher, uncomfortable conversations,” Glass says.

Watch for signs of unhealthy peer pressure, like experimenting with drugs, alcohol, or sex. “Sometimes tweens will start to engage in risky behaviors at the urging of their peers,” Odell says. “Because their [brain’s] frontal lobe hasn’t fully developed and won’t be fully developed until they’re 25, they tend to not think through the consequences of their actions.”

Tweens develop opinions about their bodies. And the influences aren’t always what you’d like. They can be influenced by comments around them and things they see online.

“The idea of ‘I don’t like my body’ — that actually really does start in middle school and as early as 8 and 9,” Anderson-Burnett says. She likens those toxic ideas to seeds that, if they keep being watered, will flourish as the tween grows up and could lead to problems like disordered eating.

Take care with how you talk about eating habits and your child’s body type. “What they’re eating obviously contributes, but how you speak about it is how they’re going to see themselves,” Anderson-Burnett says.

Watch what you say about your own body, too. Your child will notice, and they may take on those messages themselves. The healthier your own body image is, the better it is for your son or daughter.

Some older tweens think about dating, including what gender(s) they’re attracted to. How you react matters.

“If you’re able to support them and say, ‘OK, this is who you are, I support you,’ it really leads to — [in] my personal clinical experience — different outcomes than when there is an actual resistance to it,” Anderson-Burnett says.

If you or your child feels awkward talking about certain topics, you could consider letting them talk with an adult you choose, like an uncle, aunt, family friend, or someone else within your circle.

“They’re listening for someone they can trust,” Anderson-Burnett says. “You’re essentially teaching your child early on the power of a network and how to use that network to their advantage [in] their development.”

Sometimes adults — like teachers, neighbors, or strangers — treat tweens as if they’re older than they are. Research shows that this is more likely to happen to Black and brown tweens than to white tweens, Anderson-Burnett notes.

“They’re still young kids, but they may be treated in school or interactions with other folks within society as adults,” she says. “Your kid might be being antagonized more because of the view of how they should be acting, despite the fact that they are a specific chronological age.”

Your child may not realize that they’re experiencing what’s known as “adultification bias,” so they may not know how to tell you. If you think that might be happening, ask your tween.

“Talk about, ‘Are people treating you differently? Do you feel like you’re being treated differently than your classmates?’ ” Anderson-Burnett says. “I think we undervalue the power of conversation.”

Just like with everything else your tween is going through, start the conversation, listen, and keep an open mind.



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Top 5 Infectious Disease Stories Week of March 2


This week, the FDA-approved antiretroviral lenacapavir as it showed treatment benefits; Oral Vancomycin Prophylaxis was explored for preventing C difficile in stem cell transplant recipients; Research into the after-effects of SARS-CoV-2 (PASC) uncovers biomarkers for post-infection sequelae; Chronic hepatitis B worsens COVID-19 outcomes, and cabotegravir ultra-long-acting (CABULA) has shown positive results.



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Chicken Cordon Bleu Casserole Recipe

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This Chicken Cordon Bleu Casserole is the perfect easy meal for those who love the combination of chicken and ham with plenty of cheese and creaminess in the classic cordon bleu recipe! This dish is easy to make and will be a hit with your whole family!

If you’re looking for more family-friendly casseroles that are easy to make and loved by all, we’ve got you covered! Try million dollar spaghettiKing Ranch casserole, or crack chicken casserole next!

A scoop of chicken cordon bleu casserole on a wooden serving spoon.

Chicken Cordon Bleu Casserole

This chicken cordon bleu casserole is an easy, foolproof meal that even the pickiest of eaters will enjoy! It’s made with simple ingredients like chicken, ham and cheese in a creamy sauce. Everyone from the kids to adults will go crazy for the flavor and texture in this irresistible dish!

Fuss-free and flavorful rotisserie chicken is layered with ham, Swiss cheese, an amazing lemon cream sauce and is topped with buttery panko breadcrumbs. Bake until bubbly and golden brown for a hearty, satisfying meal that’s perfect for busy weeknights. You can even assemble the casserole a day ahead of time! See the “storing leftovers” section for make-ahead instructions.

Ingredients Needed

This chicken cordon bleu casserole recipe uses many kitchen staples for a mouth-watering, amazing dinner! It’s a great recipe for using up leftover shredded chicken and ham, if you have it. You can find exact measurements for each ingredient in the recipe card below.

  • Chicken Breast: Rotisserie chicken is great because it is convenient and adds so much extra flavor.
  • Ham: Deli ham is really handy but if you have leftover cooked ham, that works great too!
  • Cheese: Swiss cheese is the traditional cheese variety used in cordon bleu recipes, but gouda or provolone would be delicious too. You want a creamy cheese that will get nice and melty.
  • Butter: Mix with the breadcrumbs and seasoning to make the topping bake up golden brown.
  • Breadcrumbs: We’re using panko bread crumbs for delicious crispiness.
  • Seasoning: Italian seasoning and salt gives the bread crumb topping extra flavor.

Lemon Cream Sauce

  • Butter: Unsalted butter makes the cream sauce flavorful and rich.
  • Flour: To thicken the sauce for the chicken cordon bleu casserole.
  • Broth: Use low sodium, good quality chicken broth for flavor and consistency in the lemon cream sauce.
  • Milk and Cream: This combo makes the sauce incredibly creamy and smooth.
  • Dijon Mustard: For a light tangy taste.
  • Cheese: The sauce is finished with a blend of shredded parmesan cheese and shredded Swiss cheese.
  • Lemon Juice: Adds wonderful fresh, lemony flavor.
  • Salt & Pepper: To taste!

How to Make Cordon Bleu Casserole

There are several steps to follow when making this casserole, but they’re all very simple and straightforward. Once you make the topping and the sauce for the cordon bleu casserole, just assemble all of the layers in a pan and bake! Here’s how it all comes together:

  1. Prep: Preheat the oven to 350 degrees Fahrenheit and spray a 3-quart baking dish with pan spray.
  2. Add the Meat: Spread the shredded chicken in the bottom of the pan. Sprinkle the ham evenly over the chicken.
  3. Make the Topping: In a small bowl, stir together the melted butter, panko, Italian seasoning, and salt. Set aside.
  4. Making the Sauce: Prepare the lemon cream sauce by melting the butter in a medium saucepan over medium heat. Once melted, add the flour and whisk to combine. Continue to whisk until the mixture becomes nutty and fragrant and the bubbling subsides, about 2 minutes.
  5. Finish the Sauce: Slowly whisk in the broth, milk, cream, and dijon. Whisk until smooth and thickened, which should only take a minute or two. Whisk in the cheese slowly, whisking until it is fully melted. Whisk in the lemon juice and salt and pepper to taste.
  6. Assemble and Bake: Pour the sauce evenly over the chicken and ham and top with the shredded Swiss cheese. Top with the panko mixture and bake for 30-35 minutes, until the casserole is bubbling and the bread crumbs are golden brown. Top cordon bleu casserole with chopped parsley and hollandaise, if desired.
4-photo collage of the chicken, ham, sauce, and breadcrumb coating being layered.

Tips and Variations

Here are some helpful tips and ways to make this dish your own! This Chicken Cordon Bleu Casserole is so tasty, I know your family is going to go crazy for it just like mine does!

  • Different Chicken: Rotisserie chicken is called for in the recipe card, but you can use any cooked, boneless chicken. This could be leftover chicken from another recipe, frozen cooked chicken, canned, or some you have cooked up and cut up or shredded just for this recipe! Make it easy and use what you have on hand.
  • Type of Ham: While cubed ham adds great texture, any ham will do. Use deli ham that has been chopped up, diced ham, leftover baked ham…just be sure whatever ham you use is cut into bite-sized pieces.
  • Broil: Don’t be alarmed if the panko isn’t browning very deeply! You can brown it by turning the oven to broil for a minute or two, but keep a close eye on it so it doesn’t burn.

Top-down view of chicken cordon bleu casserole with a scoop being taken out of it.

Storing Leftovers

  • Make Ahead: Cordon bleu casserole is a great prepare-ahead meal! You can make the sauce up to 3 days in advance and store it in the refrigerator in an airtight container until you’re ready to assemble your casserole. You may also assemble the whole casserole the day before, cover it, and store it in the refrigerator. Allow 10-15 extra minutes of baking time, since all the ingredients will be chilled.
  • Leftovers in the Refrigerator: Store leftovers in an airtight storage container in the fridge for up to 4 days. 
  • In the Freezer: To freeze, transfer leftovers to an airtight freezer-safe storage container and freeze for up to 3 months. Let thaw overnight in the refrigerator before reheating. 
  • To Reheat: Heat leftover cordon bleu casserole in the oven at 350 degrees Fahrenheit for 10-15 minutes, until the casserole has reached 165 degrees Fahrenheit. You can also reheat individual servings in the microwave. 

A scoop of the casserole served with asparagus in a cream-colored dish.

More Delicious Casserole Recipes

Casseroles are some of our favorite go-to meals! They’re easy to make, flavorful and so comforting! For all of my family’s favorites, check out this full list of casseroles!

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  • Preheat the oven to 350 degrees Fahrenheit and spray a 3-quart baking dish with pan spray.

  • Spread the shredded chicken in the bottom of the pan. Sprinkle the ham evenly over the chicken.

  • In a small bowl, stir together the melted butter, panko, Italian seasoning, and salt. Set aside.

  • Prepare the lemon cream sauce by melting the butter in a medium saucepan over medium heat. Once melted, add the flour and whisk to combine. Continue to whisk until the mixture becomes nutty and fragrant and the bubbling subsides, about 2 minutes.

  • Slowly whisk in the broth, milk, cream, and dijon. Whisk until smooth and thickened, which should only take a minute or two. Whisk in the cheese slowly, whisking until it is fully melted. Whisk in the lemon juice and salt and pepper to taste.

  • Pour the sauce evenly over the chicken and ham and top with the shredded Swiss cheese. Top with the panko mixture and bake for 30-35 minutes, until the casserole is bubbling and the bread crumbs are golden brown. Top with chopped parsley and hollandaise, if desired.

Serving: 1servingCalories: 572kcalCarbohydrates: 20gProtein: 24gFat: 44gSaturated Fat: 25gPolyunsaturated Fat: 2gMonounsaturated Fat: 13gTrans Fat: 1gCholesterol: 132mgSodium: 1139mgPotassium: 310mgFiber: 1gSugar: 5gVitamin A: 1241IUVitamin C: 5mgCalcium: 468mgIron: 2mg

Nutrition information is automatically calculated, so should only be used as an approximation.





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Mindfulness Can Beat Tech Stress at Work


Editor’s note: Doctors get burned out, too. Read the Medscape Physician Burnout & Depression Report 2024: ‘We Have Much Work to Do’

March 8, 2024—Texts. Emails. Video meetings. Texts to remind you of upcoming video meetings.

And on and on it goes, until what technology experts and psychologists call the digital dark side of technology — stress, anxiety, a feeling of being overloaded — wipes you out, jeopardizing your mental and physical health.

However, preventing that burned out feeling is possible, experts say,  by practicing mindfulness, an age-old approach focused on being aware of your feelings in the moment without judgment or interpretation. Mindful breathing, for instance, focuses on paying attention to your breath as you inhale and exhale. With a mindfulness approach, workers can leverage technology so they are more productive, less stressed, and more in control.

Mindfulness Over Digital Confidence?

In a new study,  researchers looked at participants’ mindfulness as well as their confidence with technology to determine if either, or both, buffered the dark sides of the digital workplace. These dark sides include stress, overload, anxiety, fear of missing out (FOMO), and addiction, said Elizabeth Marsh, a PhD student at the University of Nottingham in England and a mindfulness teacher who led the study.

At the start, Marsh briefly described mindfulness to the participants but didn’t teach it to them. Many were already familiar with the practice. The researchers surveyed 142 workers, ages 18 to 54, 84% of them women, about their level of mindfulness in the digital workplace and their confidence in technology. 

They asked, too, about their levels of stress, overload, anxiety, FOMO (such as when working from home), and addiction. In addition to the survey, they did more in-depth interviews with 14 of the workers. Most worked 25 to 40 hours a week, with 25 workers logging more than 40. Only 5% said they were not stressed, with more than 73% reporting mild or moderate stress and more than 21% reporting extreme or very extreme stress.

Mindfulness was more effective than confidence in technology to protect against all the dark side effects, she said. But “confidence in technology was particularly helpful when people felt anxious and had fear of missing out [such as during remote work].’’

She wouldn’t go so far as to say mindfulness won out over being technologically confident. “But we can definitely say it’s really important,” she said. 

They also found, as suspected, that technology’s dark side effects took a toll on both physical and mental health, with digital stress and other dark side effects linked to higher burnout and poorer health.

Expert Perspectives

The growth of mindfulness in the Western world is traced back to Jon Kabat-Zinn, PhD, who set up a mindfulness-based program at the University of Massachusetts in 1979. Since then, many U.S. companies have launched mindfulness programs in the workplace. However, most are focused on coping mechanisms after the fact, trying to remedy the effects of technology overload, said Michael Foster, founder and chairman of the Institute for Organizational Science and Mindfulness, which advocates for science-based mindfulness and mental health in the workplace.

The new study, he said, “starts with untwisting the various mental and emotional challenges at work so that they can be addressed through intentionally aimed neural training [with mindfulness.]”  

According to Foster, who wasn’t involved in the British study, “workplace wellness is completely reactive and way behind the science.”

Companies should see this new study as proof that mindfulness training can shift the organization to a more proactive stance and give leaders and workers the mental and emotional skills to “more effectively and successfully navigate the digital workplace.” 

Mindfulness programs in the workplace can reduce health care costs and increase productivity by double digits, according to Foster’s organization.

Mindfulness in Action

Participants in the British study shared some of their mindfulness techniques during the interviews. One cited taking a few deep breaths when the work gets overwhelming and pausing before continuing.

Checking in with oneself throughout the workday, another said, is important, actually asking yourself, “Am I mentally OK?” “How am I feeling physically?”

Others decided they needed more boundaries around technology, reducing the amount of engagement time when working from home. Others would turn off notifications at times or unplug totally in the evening.

Google’s Mindfulness Guru

The new research echoes previous evidence about the value of mindfulness, said Mirabai Bush, a mindfulness expert and senior fellow at the Center for Contemplative Mind in Society, a global community advocating for contemplative practices such as mindfulness. What’s unique about the recent study, she said, is it combines mindfulness with the concept of digital confidence and the finding that mindfulness protects against more of technology’s side effects. 

That, she said,  “raises up its potential and importance in the workplace. No one seems to know what to do with this digital stress.” 

In 2007, Bush was co-developer of Google’s mindfulness program, called Search Inside Yourself.  It has become an independent educational institute, teaching mindfulness to government workers and nonprofit organizations. During the launch at Google, Bush taught mindfulness to young engineers who, as she put it, had spent the greater part of their working lives looking at screens, with little face-to-face interaction. Persuading engineers to talk about feelings and taking a breath was a challenge but doable, she found.  

In the early course, she said, “we talked about mindful email.” It includes: “Write out the email. Take three breaths. Look again. Imagine how the person who was going to receive it will feel emotionally and intelligently.” Ask: Is it the wrong message? 

One engineer needed to convince a worker to do something and aimed for a tone that was asking but not demanding. He wrote and rewrote an email mindfully, then reported back: “I did something radical. I picked up the phone.” He realized the tone of an email would make his request sound demanding, no matter how many times he rewrote it. 

Mindfulness Communities

Four years ago, Megan Whitney set up a mindfulness community at Feeding America, a nationwide network of food banks, pantries, and local meal programs. Workers from 200 food banks can access the online program, said Whitney, a senior manager at the organization who is also certified to teach mindfulness. One practice, called “minutes to arrive,” invites everyone to set a timer for 1 minute before a meeting and just breathe, eyes open or closed.

“Food bank work is highly stressful,” Whitney said. One user told her: “It can feel lonely in the nonprofit world. People don’t understand what I do as a food banker.” The community helps her feel connected, she said.

Other Mindfulness Research

“Practicing mindfulness can help digital users to become more aware of their habitual and unconscious responses to digital interaction –for example, doom scrolling, task switching, and habitual phone checking — and take decisive action to protect their well-being,” said David Harley, PhD, principal lecturer in psychology at the University of Brighton in the U.K. who wrote a book based on his research of using mindfulness in a digital world.

He does take exception to one measure used in the new study, which looked at “trait mindfulness,” which he said indicates that the mindfulness has to be a characteristic the person already has. Instead of looking for people who practice mindfulness, employers should provide the training, he said.

Do-It-Yourself Workplace Mindfulness

Workers at companies without formal mindfulness programs can learn and practice it on their own. Here are some suggestions from the experts:

  • Anchor yourself in your immediate bodily experience, Harley said. “Pay attention to how your body feels while engaged in digital interactions.”
  • Reducing your digital distractions can help. “Close down all devices, windows, and apps other than the one you are currently working with and turn off all notifications,” Harley said.
  • “Come back to your breath,” Harley said, explaining that being aware of how you are breathing is valuable, even for a moment.
  • Silence the phone or turn down notifications for the different apps, Marsh suggested.
  • Learning basic mindfulness is straightforward, Bush said. “Sit down, close your eyes, watch your breath.”  While self-teaching is possible, “it’s good to learn from a teacher in the beginning.” Many online resources guide users through the practice of mindfulness.

The research was funded by the Economic and Social Research Council-Midlands Graduate School. 



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Antibiotic Stewardship Programs Help Curb Superbug Threat by Leveraging Data


Outpatient health facilities are critical battlegrounds in the fight against antibiotic-resistant infections that sicken nearly 3 million Americans and kill 35,000 each year. From doctor’s offices to urgent care centers, these outpatient settings account for about 60% of all U.S. antibiotic-related expenditures.

However, about one-third of outpatient antibiotic prescriptions are unnecessary. Fortunately, no-cost software tools are available to help health care systems preserve the efficacy of antibiotics by prescribing them only when they’re needed.

Each time an antibiotic is used, pathogens have the opportunity to “learn” to evade the drugs designed to conquer them, contributing to the emergence of drug-resistant bacteria that make infections deadlier and more difficult and costly to treat. That’s one reason why these medications must be prescribed only when necessary and appropriate for people with bacterial infections. In addition, overprescribing antibiotics for patients with common outpatient infections is expensive, resulting in millions of dollars in increased annual health care costs. And inappropriate prescribing of antibiotics can lead to alarming adverse patient outcomes, including C difficile, a stubborn, sometimes life-threatening infection related to antibiotic use.

Antibiotic stewardship programs promote responsible antibiotic use, including ensuring that the right drug is prescribed in the right dose at the right time. These programs are underutilized in outpatient settings, but, when used strategically and effectively, they can improve the quality of care patients receive by providing clinicians with data on their prescribing practices. Indeed, “tracking and reporting” are fundamental components of the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship. Making clinicians aware that they prescribe more frequently than their peers has been shown to result in doctors prescribing these drugs more judiciously.

And although it can be challenging to promote antibiotic stewardship among the diffuse outpatient facilities, health systems are well-positioned to support this expansion of stewardship efforts. One study estimated that about half of all primary care physicians were affiliated with a health system in 2021, giving health system-led antibiotic stewardship efforts the potential to affect a vast number of outpatient facilities in the U.S.

A recent commentary in the Joint Commission Journal on Quality and Patient Safety discussed specific approaches health systems can take to support outpatient stewardship, including standardizing stewardship practices throughout their facilities and leveraging their centralized resources and infrastructure to help minimize duplication of efforts. One way health systems can support outpatient stewardship by using shared electronic health record (EHR) systems to inform providers—through direct feedback—about how their antibiotic prescribing compares to their peers.

However, developing these feedback mechanisms—even at the health system level—can be time-consuming. That’s where open-source tools such as OASIS (Outpatient Automated Stewardship Information System) come in. Launched by Denver Health in the spring of 2023, OASIS is a first-of-its-kind tool that aims to support antibiotic stewardship efforts in health systems throughout the country by harnessing data from electronic health recordsto evaluate antibiotic prescribing. This tool, created with support from The Pew Charitable Trusts, is free to use and requires no modifications to the EHR. Additionally, anyone with access to R, a free statistical software, and an EHR data warehouse can begin to use OASIS.

OASIS addresses some of the long-standing barriers health systems have experienced in their stewardship efforts by streamlining the lengthy data analytic process. OASIS simplifies this process, which is necessary to effectively track and report antibiotic use by automatically pulling key data on how antibiotics are being used for specific diagnoses. The tool then creates antibiotic prescribing reports and directly emails the findings to clinicians, who can then more effectively evaluate their prescribing practices and ensure the appropriate use of these critical drugs.

Simple, affordable, effective interventions such as OASIS can make outpatient antibiotic stewardship an easy yes for health systems looking to expand their stewardship efforts. By using tools such as OASIS to harness antibiotic prescribing data, health systems can scale stewardship programs to their outpatient facilities and help slow the emergence of deadly superbugs that cost our nation billions of dollars and tens of thousands of lives each year.

Contagion interviewed a clinician on how she is using Oasis at her institution.



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The Best Irish Soda Bread

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This Irish soda bread recipe uses just 4 pantry staples for a warm, crusty loaf that’s perfect for slathering with butter and jam, or soaking up your favorite soup. No kneading required!

If you want homemade bread but without a lot of prep, this Irish soda bread is a great option along with one-hour rolls, peasant bread, and garlic knots!

A whole loaf of baked Irish soda bread.

Irish Soda Bread Recipe

Have you ever had Irish Soda Bread? I first tried it a few years ago and have been a fan ever since. It’s super easy to make and has great flavor. You start off by combining all the dry ingredients and cutting in a few tablespoons of butter. Then stir in the buttermilk until a dough forms. From there, you dump it out onto a lightly floured surface and form it into a round loaf, (no kneading required!) bake it in a cast iron skillet, brush with melted butter and that’s it. See? Super easy.

It totally reminds me of biscuits in loaf form! And even though soda bread has way less butter than biscuits, it still has a great buttery flavor. Plus it has an amazing texture- the crust is crisp and the center is soft and tender. Serve it plain, with butter or smothered in jam. Give it a try, I know you’ll love it!

4 Ingredients to Make It

I don’t know about you… but the fact that Irish soda bread only requires 4 simple ingredients and it doesn’t need any kneading or proofing makes this recipe a winner. Here’s everything you’ll need:

  • All-Purpose Flour: The base of the soda bread, providing structure and body.
  • Baking Soda: There’s no soda bread without the baking soda! It’s the leavening agent, reacting with the buttermilk to create bubbles that make the bread rise.
  • Salt: Enhances the flavor of the bread.
  • Buttermilk: Adds a slight tang and moisture, and also helps activate the baking soda.
  • Softened Butter (for serving): The perfect addition to this tasty soda bread!
  • Jam (for serving): For some sweet flavor. Try this homemade strawberry jam recipe if you’re up for the challenge!

How to Make Irish Soda Bread

When it comes to homemade bread, this recipe is as easy as it gets. Even without yeast, proofing, and kneading, Irish soda bread is perfect- it’s crisp on the outside and perfectly tender on the inside.

  1. Preheat Oven: Preheat the oven to 375 degrees Fahrenheit.
  2. Prepare Dough: Whisk together the flour, baking soda, and salt. Then create a well in the middle of the dry ingredients and pour the buttermilk into the center.
  3. Shape: Mix the dough together using your hands, or a wooden spoon until a shaggy dough forms. Dump the dough out onto a lightly floured surface and bring it together just until it forms a round.
  4. Bake: Place the loaf on a parchment lined baking sheet. With a knife, score the top of the loaf in an x. Place it in the oven and bake for 35-45 minutes or until the crust is a golden brown.
  5. Cool and Serve: Take the soda bread loaf out of the oven and allow it to cool at least 10 minutes before cutting into it. Serve with butter and jam or alongside my Guinness Beef Stew.

Tips and Variations

  • Buttermilk Substitute: If you don’t have buttermilk, mix 2 cups milk, whole milk is best, with 2 tablespoons vinegar or lemon juice, mix the liquids together and allow the milk to curdle before using it.
  • Don’t Overwork: Do not work this soda bread dough much at all, you just want to mix it until it comes together and then form it into a round that stays together on its own. If you work the dough too much it will be tough in texture.
  • Add Raisins: Some people like to add raisins to their Irish soda bread. If this is a preference of yours you can fold in ¾ cup raisins after most of the liquid has been incorporated into the dry ingredients, taking care not to overwork the dough.

Irish soda bread cut into slices.

Storing Leftovers

Store at room temperature in a bag or airtight container once the loaf is cooled, for up to 4 days.

Can I Freeze Soda Bread?

Yes you can! Wrap the cooled baked loaf tightly in plastic wrap or foil for up to a month of freezer storage. Thaw on the counter, then warm it in the oven on low heat for a refresh.

You can also freeze the unbaked soda bread dough after shaping it. Wrap it tightly and freeze for up to 3 months. When you’re ready to bake, simply thaw the dough in the refrigerator overnight and then pop it straight into the oven.

Spreading butter and jam over a slice of bread.

More Easy Homemade Bread Recipes

 

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  • Preheat the oven to 375 degrees fahrenheit.

  • Whisk together the flour, baking soda, and salt. Create a well in the middle of the dry ingredients and pour the buttermilk into the center.

  • Mix the dough together using your hands, or a wooden spoon until a shaggy dough forms. Dump the dough out onto a lightly floured surface and bring it together just until it forms a round.

  • Place the loaf on a parchment lined baking sheet. With a knife, score the top of the loaf in an x. Place it in the oven and bake for 35-45 minutes or until the crust is a golden brown.

  • Take the loaf out of the oven and allow it to cool at least 10 minutes before cutting into it. Serve with butter and jam or alongside my Guinness Beef Stew.

Originally posted March 3, 2017
Updated on March 8, 2024

Calories: 2118kcalCarbohydrates: 405gProtein: 67gFat: 21gSaturated Fat: 10gPolyunsaturated Fat: 3gMonounsaturated Fat: 4gCholesterol: 53mgSodium: 5028mgPotassium: 1183mgFiber: 14gSugar: 25gVitamin A: 792IUCalcium: 628mgIron: 23mg

Nutrition information is automatically calculated, so should only be used as an approximation.





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My Review of OneSkin Skincare Products


Skincare suddenly becomes more important to women once we’ve reached our thirties and forties. The products that seemed like a luxury before now seem essential for looking and feeling our best. OneSkin is a skincare company that develops products to promote skin health at the molecular level.

I love their products, which support healthy skin from the outside while I focus on my diet for the inside. While it’s a topical product, I’m fascinated by how they focus on rejuvenation from within the cell. 

Here are my thoughts on OneSkin products and how they’re revolutionizing the way we look at skincare and promoting skin longevity.

What Causes Skin to Age?

Skin health is very much connected to our overall health. In fact, the skin often reflects what’s going on inside the gut and the blood vessels. Aging in general is caused by a loss of integrity within the cells of the body – wherever they may be, including our skin cells. 

How fast our skin ages depends on our genetics and our environment. Things like too much sun, pollution, diet, and lifestyle choices can make aging worse. These skin stressors damage the skin and create senescent “zombie” cells, now known to be the root cause of skin aging.

When cells become senescent, they stop dividing like normal cells. They grow larger and just sit there like zombies, accumulating over time. However, they still influence metabolism, and not in a good way. While taking up space, they begin secreting pro-aging factors, including inflammatory cytokines, and immune modulators.

Senescent cells also influence the healthy cells surrounding them. They trigger neighboring cells to begin aging faster and start breaking down collagen. This leads to widespread inflammation, poor barrier function, and visible signs of aging. That’s when we look in the mirror and start noticing sagging, fine lines, and wrinkles.

Our skin is also the main protective barrier against the external environment. It filters out toxins, controls hydration, protects us against UV radiation, and more. Maintaining healthy, strong skin throughout our lives protects the health of our internal organs.

What Can We Do to Reduce Internal Aging?

Inflammation is key when it comes to aging. There’s a term out there called “inflammaging,” which reflects that close association. Diet can make a massive difference. Focusing on a whole-food diet with plenty of fresh produce can reduce internal aging. 

Fresh foods are high in vitamins and antioxidants that fight free radicals. They also supply polyphenols, minerals, and other nutrients necessary for healthy cells.

Avoiding sugar is also key. Sugar contributes to inflammation, oxidative stress, and the internal aging process. Internal aging leads to structural changes in the skin, leading to fine lines, sagging, wrinkles, and dryness.

Sleep is also a vital part of slowing down skin aging. According to a 2017 study, just two days of sleep restriction makes a person look older and less healthy. Regularly getting a full night’s sleep (at least 8 hours) can make you appear healthier and more youthful.

So what else can we do to help our skin be its healthiest?

What Sets OneSkin Apart in Reducing External Aging? 

Most skincare products out there have toxic ingredients that can age us from the outside! Ingredients like parabens, toxic metals, and phthalates can break down the skin barrier. They can also create free radicals and oxidative damage. Even retinol can be irritating and drying to the skin, doing more harm than good. It also doesn’t remove senescent cells. 

Many of the so-called “anti-aging” cosmetics out there could be accelerating aging. Irritating ingredients and toxins can increase the accumulation of senescent cells.

I love that OneSkin has cutting-edge research into skin biology, genetics, and aging. The results speak for themselves. First, they have plenty of clinical studies to prove their products work. Second, co-founder Alessandra Zonari has a biological age 15 years younger than her current age! 

What sets OneSkin apart is its discovery of a new peptide called OS-01. Peptides are fragments of proteins, the structural components of the human body, including skin. The scientists at OneSkin studied over 900 different peptides before discovering a unique one they called OS-01. 

The Science Behind OneSkin Products

The OS-01 peptide really changes dermatology and anti-aging science. That’s because it’s the only peptide scientifically proven to reverse the skin’s biological age. This means your skin could age at a slower rate than the years pass. Your skin could be younger than you are!

OS-01 peptide reduces the accumulation of senescent cells, helping the skin tissue look and behave years younger. It also supports collagen and hyaluronic acid synthesis, which are considered biomarkers of healthy skin.

To offset the daily exposure to damaging oxidative stress, OS-01 peptide also supports repair pathways at the cellular level. As a result, the skin more effectively heals from sun damage and maintains its elasticity. That means you can still get vitamin D from the sun but not worry as much about damage.

OneSkin’s Other Active Ingredients

Besides the OS-01, OneSkin has six other active ingredients in their Face formulation. These elements were selected to complement the peptide’s ability to rejuvenate skin:

  • Pracaxi oil – Praxaci oil comes from the seeds of the Pracaxi tree and helps the skin in several ways. It’s moisturizing, smoothing, and has anti-inflammatory and antioxidant effects. It may reduce the appearance of scars by supporting collagen production.
  • Andiroba oil – Andiroba oil is an oil from the seeds of the andiroba tree. It’s rich in antioxidants to help protect the skin from free radical damage. This can help prevent fine lines, wrinkles, and age spots. It also has compounds known to stimulate cell regeneration and tissue repair.
  • Niacinamide – Aka vitamin B3, niacinamide is an important nutrient for the skin. Niacinamide helps strengthen the skin barrier, preventing moisture loss. It also stimulates collagen production and helps even out skin tone.
  • Oleic Pau Mulato Extract – This extract comes from the seeds of the Pau Mulato tree, also known as Brazilian mahogany. Oleic Paul Mulato extract also supports the skin barrier, reducing dehydration. Plus it has antioxidant and anti-inflammatory effects and stimulates tissue repair.
  • Allantoin – Allantoin naturally occurs in several plants, including comfrey and chamomile. It’s known to soothe, moisturize, and condition the skin. It also promotes tissue regeneration by stimulating collagen synthesis.
  • Hyaluronic Acid – Hyaluronic acid (HA) is a molecule found in human skin, connective tissues, and eyes. It’s important for maintaining hydration, lubrication, and elasticity in tissues. HA is used in skincare products for its hydrating and plumping effects.

OneSkin Products

OneSkin includes OS-01 in all its products, including those in its Face and Body lines. The Face line includes an entire skincare routine, including a facial cleanser, daily moisturizer, and eye cream. They’ve even created a sunscreen to further protect the skin from UV rays.

OS-01 Face 

  • The PREP Facial Cleanser – This cleanser has enzymes that help break down impurities and product residues without damaging the skin. It protects the skin’s natural barrier so it’s best prepared for the OneSkin topical supplements. Studies have shown using PREP can increase peptide absorption by 200%.
  • OneSkin OS-01 FACE Topical Supplement – OneSkin’s Face product is a topical supplement that targets the root cause of skin aging. It includes those six ingredients above, plus antioxidant ingredients like grape seed oil, rose hips, and plum seed oil.
  • OS-01 EYE Topical Supplement – The eye cream adds specific nutrients to nourish the delicate skin around the eyes. Moringa, algae, and vegan collagen help reduce dark circles and boost collagen production.
  • OS-01 SHIELD Protect + Repair – The “shield” refers to this product’s ability to help shield the skin against UV rays, reducing damage from sun exposure. This sunscreen adds vitamin C, green tea, acai extract, and tara fruit extract to further support the skin. While I don’t recommend sunscreen every day, this is a good option for those times when it’s needed!

OS-01 Body

OneSkin also has an OS-01 Body lotion to help reduce senescence throughout the body.  And clinical research shows their Topical Supplement improves skin hydration while supporting the skin barrier. Seventy percent of study participants noticed improved skin texture.

My Experience with OneSkin

I started using OneSkin products after researching their ingredients and scientific development processes. It was important to me that they were truly clean and appropriate for all skin types before recommending them on Wellness Mama.

I got to try an early release of their eye product and I absolutely loved it! Their Body lotion is great as well. I tried it for the first time after a freezing cold, windy, and long day outside in the sun. My skin just drank up the lotion and instantly felt so much better. 

I use their Face lotion for a good part of the year and my skin instantly feels lighter, tighter, and nourished. The bottle lasts me over a month and is one product that I always have in my bag when I travel.

You can learn more by tuning in to my interview with OneSkin co-founder Alessandra Zonari here. And check out OneSkin products for yourself here!

Have you tried OneSkin yet? How did it work for you? Share with us below!



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Spread of West Nile Virus Across Europe Linked to Climate Change


The mosquito-transmitted West Nile virus (WNV) has emerged as a new public health concern in Europe. This research demonstrates that the geographical spread of WNV in Europe has been influenced by climate change, in addition to alterations in land use and human population density. By employing ecological models to evaluate both actual and hypothetical scenarios, researchers have been able to distinguish the specific role of climate change in influencing the likelihood of WNV transmission.

The results indicate a significant expansion in the region ecologically conducive to WNV transmission from 1901 to 2019. In contrast, this region shows little change in a hypothetical scenario without climate change. They demonstrate that the sharp rise in the population at risk of WNV exposure can be attributed partially to historical shifts in population density.

“Our assessment indicates that Europe experienced a notable increase in WNV ecological suitability from the 1980s, which coincides with a rapid warming during this time in Europe as well as the establishment of WNV hotspots in Romania from 1996, in Italy from 2008, and in Greece from 2010,” according to investigators. “We here find that the relative contributions of air temperature in summer and winter to the ecological suitability of WNV were higher than the one of spring temperatures.”

3 Key Takeaways

  1. The research highlights climate change as a driver in expanding the geographical reach of WNV in Europe, impacting the ecological conditions conducive to mosquito vectors and the spread of the virus.
  2. Utilizing ecological niche models to analyze the impact of climate change on WNV transmission provides an understanding of the disease’s dynamics, emphasizing the importance of such tools in forecasting and preventing future outbreaks.
  3. The findings advocate for the integration of climate change adaptation into public health strategies, addressing the broader environmental determinants of health is essential for the control and prevention of mosquito-borne diseases.

The researchers developed ecological niche models to forecast the likelihood of WNV transmission resulting in human infections. This enabled them to isolate the specific impact of climate change by contrasting actual simulations with a hypothetical scenario that reflects the same environmental shifts but assumes a stable climate with no long-term trends.

“We identify that current WNV hotspots in Europe are most likely to be attributed to climate change,” according to the investigators. “With climate change emerging as a critical public health challenge, future work should explore the evolution of infectious disease distributions under different scenarios of future climate change to inform surveillance and intervention strategies.”

The study faces limitations in analyzing WNV ecological suitability. First, the absence of historical data on mosquito and bird diversity/abundance limits the models. Second, the reliance on ISIMIP environmental data restricts the incorporation of land-use variables to understand mosquito-bird interactions in WNV transmission. Third, the use of WNV presence/absence data, instead of incidence rates or serological surveys, assumes an equal surveillance effort across different areas, which may distort the accuracy of the models. Fourth, the models only indirectly account for human impacts on the climate and are based on data up to 2019, highlighting the necessity for continuous updates to the models.

Understanding the relationship between environmental shifts and the pattern of disease is essential to avert upcoming vector-borne outbreaks and safeguard public health.

Reference

Erazo D, Grant L, Ghisbain G, Marini G, Wint W, et, al. Contribution of Climate Change to the Spatial Expansion of West Nile Virus in Europe. Nature Communications. Published February 8, 2024. Accessed February 22, 2024. https://doi.org/10.1038/s41467-024-45290-3



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