10 Tips to Help You Become More Resilient

By Jen Uscher
WebMD Feature

Reviewed by Joseph Goldberg, MD

Some people seem to be born with the ability to overcome setbacks with relative ease. It’s a trait that experts call resilience.

People with resilience have a greater sense of control over their lives, says psychologist Robert Brooks, PhD. That makes them more willing to take risks.

“Also, because of their optimistic outlook, they are more likely to develop and maintain positive relationships with others,” as well as live more meaningful lives, Brooks says. He co-wrote The Power of Resilience: Achieving Balance, Confidence, and Personal Strength in Your Life.

So, how do you make yourself more resilient? Here are 10 things to focus on:

1. Stay Flexible. Resilient people expect to face challenges at different points in their lives. They are able to adjust their goals and find ways to adapt. 

2. Learn Lessons. “When you have a negative experience, focus on the positive lessons you can learn from it,” says Ani Kalayjian, EdD, DSc, DDL, a psychologist in New York City. When a tough situation arises, don’t focus on who is to blame. Let go of asking “Why me?” and feeling like a victim. Ask yourself what you could do differently next time to have a better result.

3. Take Action. Think about what you can do to improve your situation, and then do it. “Resilient people work on solving a problem rather than letting themselves get paralyzed by negativity," Brooks says. For example, if your boss cuts back your hours at work, you could look at it as a chance to explore other job options. In the long run, it could bring about career growth.

4. Stay Connected.  Nurture your relationships with friends and family. When you’re going through a hard time, don’t withdraw from other people. Accept help from those who care about you. Resilient people have at least one or two people in their lives they can turn to for support, Brooks says.

5. Release Tension.  Make sure you have outlets to express your emotions and let go of tension.  Kalayjian recommends these:

• Write in a journal.
• Draw.
• Meditate.
• Talk with a friend or counselor. 

6. Have a Sense of Purpose. Do things that bring meaning to your life. That may be spending time with your family, but volunteering or other work for a cause can also make you feel stronger. People who've had a serious illness often find that being in a marathon or walk to raise money for a health-related charity makes them feel better. “Volunteering can help … by giving you a sense of purpose and often a feeling of mastery,” Brooks says.   

7. Learn Healthy Habits. You’ll manage stressful times better if you:

• Exercise regularly.
• Eat a balanced diet.
• Take time to rest. 

"People who stay physically strong tend to be more emotionally resilient," Kalayjian says.

8. Believe in Yourself.  Take pride in your abilities and what you’ve done. Recognize your personal strengths. 

9. Keep Laughing.  Hold on to your sense of humor even when times are tough.  Laughter relieves stress and helps you keep things in check.

10. Be Optimistic. A positive, hopeful outlook will make you much more resilient. Remember that many of the problems you’ll face in life are temporary, and that you have overcome setbacks in the past.

source : 10 Tips to Help You Become More Resilient

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Conn. Tries To Sell Its Obamacare Success To Other States

By Jeff Cohen, WNPR

Thu, Feb 27 2014

Kevin Counihan, the CEO of Access Health CT, is walking through the 15th floor of a downtown Hartford office building that houses Connecticut's health insurancemarketplace. He passes the legal department, the IT folks and the consultants, then stops in front of three large, wall-mounted computer screens.

"These are showing in real time activity on our website. So, for example, right now you're looking at the number of concurrent users on the site," Counihan says. "So you can see that there are 212 people in the process of applying for insurance on the site."

Those metrics, monitors and technology are just a part of what his agency is doing well. Connecticut is widely seen as one of the states that is succeeding with the Affordable Care Act. Its website works well, and it has already exceeded its first-year enrollment goals. Other states have noticed.

"We were approached by several states who called us and said, 'Would you have any interest in franchising your exchange to us as a state?' And so, as we thought about that, we began coming up with this concept of an Exchange In A Box," says Counihan.

Think of it as Obamacare a la carte. Need a better executive team? Let Counihan's people run your show, for a fee. Need help managing your vendors? They can do that, too. His technology infrastructure is "scalable," he says, which means don't rebuild your own website - let them do it. They can deliver a state-specific look and feel, too. Sales. Marketing. Legal. Why do it yourself, when Connecticut can do it for you?

"My only point to some of these other states is, why go through all that agita?” says Counihan, referring to the aggravation involved. “Why recreate a wheel somebody else already built?" Counihan says, sounding every bit the salesman. And he is, because the effort could help Counihan bring new revenue into the exchange.

The question is, can it work? Consultant Rosemarie Day of Day Health Strategies worked with Counihan years ago when Massachusetts built its own health insurance system. She says the idea of an Exchange In A Box is intriguing, but it's got to be nuanced, too.

"I think you can't just cut and paste, if it works in Connecticut, boom," Day says. "Doing that kind of organ transplant and reconnecting things can take longer."

She cautions that it's important to consider the complicated insurance markets in different states and their politics.

"States that have embraced having their exchange have a fair amount of buy-in from their governor's office, and the governors wanting to put their own stamp on what they're doing for their constituents," says Day.

Ego plays a role, too. States that seem like they are running successful exchanges may still need help behind the scenes, she says.

source : Conn. Tries To Sell Its Obamacare Success To Other States

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FDA-Approved Painkiller Zohydro Concerns Critics

By Rita Rubin
WebMD Health News

Reviewed by Michael W. Smith, MD

Feb. 27, 2014 -- A new narcotic painkiller is due to come on the market in March, and critics want the FDA to reverse its approval of the drug, Zohydro ER. They claim it could become the next OxyContin, another opioid that’s become a popular drug of abuse.

Critics of the FDA's ruling include attorneys general from 28 states and FED UP!, a union of consumer groups, addiction treatment providers, drug and alcohol prevention programs, and other interested groups. They have petitioned FDA Commissioner Margaret Hamburg, MD, to prevent Zohydro from coming on the market. The FDA approved the drug even though its advisory committee voted 12 to 2 against approval.

"I firmly believe that the benefits of this product outweigh its risks," the FDA’s Bob Rappaport, MD, wrote in the summary review explaining why he approved Zohydro last October. Rappaport is director of the FDA's Division of Anesthesia, Analgesia, and Addiction Products. "Many patients in the U.S. suffer from untreated or poorly treated chronic pain. Further limiting access to potential treatments is not the answer when new treatments are critically needed.”

Opioids are a man-made type of narcotic pain medication. They subdue the central nervous system, ease pain, and induce sleep. They can have serious side effects if not used properly.

Here are some commonly asked questions about Zohydro, made by Zogenix, a San Diego company.

Q. Why do people want the FDA to reverse its approval of Zohydro?

A. Zohydro is too easy to abuse, critics say. It is the only approved extended-release product that contains the man-made opioid hydrocodone. It will be available in doses as high as 50 milligrams per pill -- five times the amount in immediate-release hydrocodone pills. Even though it is meant to release hydrocodone slowly over 12 hours, the pill could be tampered with to release a large dose all at once, says Andrew Kolodny, MD, co-founder of the group Physicians for Responsible Opioid Prescribing.

Two members of the FDA’s controlled substance staff warned about the potential for abuse in materials presented to the advisory committee. “If approved and marketed, Zohydro ER will be abused, possibly at a rate greater than that of currently available hydrocodone combination products,” wrote medical officer Lori Love, MD, PhD, and pharmacologist James Tolliver, PhD.

Zogenix is “currently evaluating two different technologies to ensure we develop the most effective formulation to minimize misuse and abuse,” says company spokeswoman Julie Normart. The company is also taking other actions to lower the risk of abuse, according to a statement supplied by Normart. These include locking pill bottle caps and an external “safe-use board” made up of experts in abuse, misuse, and diversion.

Jason Jerry, MD, an addiction specialist at the Cleveland Clinic, questions why Zogenix doesn’t wait to introduce Zohydro until they develop a version of it that's harder to abuse. “I’m not sure why there’s this great rush to get this to market,” Jerry says.

source : FDA-Approved Painkiller Zohydro Concerns Critics

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