“Acute Bronchitis: Causes and Risk Factors - Verywell Health” plus 2 more
“Acute Bronchitis: Causes and Risk Factors - Verywell Health” plus 2 more |
- Acute Bronchitis: Causes and Risk Factors - Verywell Health
- Economics in Brief: Top Bank Regulator Presses Pause on Controversial Overhaul of CRA Rules - Next City
- As Pandemic Eases, Many Seniors Have Lost Strength, May Need Rehabilitative Services - Kaiser Health News
| Acute Bronchitis: Causes and Risk Factors - Verywell Health Posted: 21 May 2021 07:32 AM PDT /GettyImages-620924881-dd6ae9a866624ff9b5b24d2a076f5d69.jpg) Acute bronchitis is a condition that affects your bronchial tubes (bronchi), which are the airways located in the lungs. A virus or bacteria usually causes acute bronchitis. Sometimes exposure to environmental irritants may also cause this condition. JGI / Tom Grill / Getty Images Common CausesAlthough the most common cause of acute bronchitis is a virus, it is also possible for bacteria to cause this condition. Usually, acute bronchitis happens after you have: The virus or bacteria may travel from the nose or throat to the bronchi. Then the infection causes inflammation in the bronchi that makes them swell. As a result, you start coughing and make mucus as your body tries to eliminate the infection. The swelling also affects the ability of air to pass through the bronchi, so you may have wheezing or shortness of breath. It is also possible to develop this condition after breathing in substances that irritate your lungs, such as chemical compounds. Environmental causes may include:
GeneticsAlthough acute bronchitis is not a genetic condition, genetics may be a factor in developing the illness. You may have a higher risk of getting acute bronchitis or respiratory infections based on specific genetic variations, but researchers have not determined the exact genes that are responsible. Scientists have discovered that children with some genetic variants are more likely to develop bronchitis because they are more sensitive to secondhand tobacco smoke and chemical compounds in the air. It is possible that a combination of factors—such as air pollution and genetics—plays a role in having this condition. Cardiovascular and Other Health Risk FactorsHaving a cardiovascular disease does not cause acute bronchitis. However, cardiovascular and lung conditions can make the symptoms of acute bronchitis worse. For example, shortness of breath or wheezing may be worse. You are more vulnerable to getting acute bronchitis if you have:
Lifestyle Risk FactorsThere are certain lifestyle risk factors that increase the risk of having acute bronchitis. If you have the following factors, talk to your doctor. SmokingExposure to secondhand tobacco smoke or smoking yourself is one of the most common lifestyle risk factors. Using products such as cigarettes or cigars can damage your lungs and make it more likely that you will have bronchitis. If you do get acute bronchitis, it can last longer and cause more severe symptoms because you smoke. For example, you may have more trouble breathing or produce more mucus in the lungs. Ask your doctor for help if you have problems quitting smoking on your own. Chemical ProductsIf you are exposed to chemical products that can be inhaled, then you may be at a higher risk of getting acute bronchitis. Exposure can happen at work, school, or in other areas. Protect YourselfIf you are around chemical products or fumes, make sure to wear protective gear and limit how much time you spend in the setting. Air PollutionAir pollution is considered a lifestyle risk factor for bronchitis. You are more likely to be exposed to air pollution in urban environments with more cars and factories. However, anyone can come in contact with air pollutants that irritate the bronchi. Exposure to InfectionsIf you work or live in a setting that creates a high risk of coming into contact with viruses or bacteria, this increases your chance of developing acute bronchitis. Work settings such as hospitals are one example. You may be able to reduce your risk by following hygiene best practices, such as:
A Word From VerywellIf you are not feeling better two to three weeks after your first symptoms of acute bronchitis develop, then you should talk to a doctor. They can determine the cause of your illness and recommend more treatment. Finding the cause can eliminate confusion and ease your concerns. If you have heart or lung disease, it is important to monitor your symptoms and get help right away if you develop problems breathing. Sometimes the symptoms of acute bronchitis can be similar to other health conditions, so you should not wait to get help. People with heart or lung disease are more likely to have complications, such as pneumonia. |
| Posted: 21 May 2021 07:54 AM PDT Top Bank Regulator Presses Pause on Controversial Overhaul of CRA Rules The Office of the Comptroller of the Currency, which regulates most of the nation's banking system, announced on Tuesday it was pausing implementation of new regulations under the Community Reinvestment Act, or CRA. Passed in 1977, the act was intended to help counteract redlining and other discriminatory lending policies and practices that denied access to capital for low-income communities, particularly Black and immigrant communities. The Office of the Comptroller of the Currency shares responsibility for CRA enforcement with the Federal Reserve and the FDIC, both of which rejected the Comptroller's changes last year. The changes would have resulted in two sets of CRA rules for different parts of the banking industry. That scenario is now unlikely. Consumer advocates, community development organizations, fair housing groups and even the banking industry applauded the move by the Comptroller's office, with universal agreement that there should only be one consistent set of rules and regulations under the CRA. The Federal Reserve is currently undergoing its own overhaul of CRA rules, and both the FDIC and the Comptroller have the option to join the Fed and keep all three agencies under one set of rules. As Next City has covered over the past four years, since Trump's first days in office, officials in his administration talked about overhauling the rules and processes used to enforce the CRA. Those rules and processes hadn't been updated since 1997; and the banking industry has endured many drastic changes in the interim. Technological advances have changed how consumers bank, and there are just under 5,000 banks operating today compared with around 10,000 in the mid-1990s. But the Trump Administration's choice for Comptroller of the Currency was someone under investigation for violating anti-redlining rules — Joseph Otting, previously CEO of OneWest Bank. The bank agreed to a settlement to end the investigation in 2019. Throughout the multi-year overhaul process, community advocates confronted Otting in city after city to explain how his agency's proposed rules changes would result in less, not more lending to benefit low-income and formerly-redlined communities. Even some banking professionals weren't sure the changes proposed under Otting would be good for low-income communities. The Comptroller's office finalized its changes in May 2020, clearly ignoring key points of feedback from consumer groups, community groups and local public officials. But, a little over two weeks after the Biden Administration named Michael Hsu acting Comptroller of the Currency, that national banking nightmare is just about over. A Deal to Give Gig Workers Unionization Rights, But Not Employee Status? In New York State, a labor union has negotiated a deal to allow gig workers to unionize, but it comes with an apparent catch — the legislation would stop short of classifying gig workers as employees, instead codifying them as independent contractors. The deal, first reported in Bloomberg, was negotiated by the Transport Workers Union with state legislators in Albany. The new proposal would allow app-based workers to vote to form unions. The unions would then engage in "sectoral bargaining" with companies to hammer out standards governing an industry, such as app-based ride hailing. The new rules would take the form of recommendations to the state, which could then approve and enforce them. Transport Workers Union President John Samuelsen told Bloomberg he has talked with representatives of gig delivery and transportation companies and said he is confident they will not oppose the legislation. But there is a catch. As THE CITY reports, since the workers won't have employee designation under the measure, it would be up to the state to approve and impose any collective bargaining agreement. The proposal would also preempt local governments from imposing some forms of regulations on the apps. Speaking to THE CITY, Bhairavi Desai, executive director of the Taxi Workers Alliance, which represents cab and app-based drivers, slammed what she saw as labor "compromising" with tech giants hungry to undercut regulations being floated at the federal level. "I think that at this point, this is about a national strategy by Uber and Lyft to actually undermine — and to get a carve-out for themselves — from the PRO Act," Desai told THE CITY. Meanwhile in New York City, the Drivers Cooperative, a driver-owned ride-hailing app that Next City covered earlier this year, is now allowing users to download its app — though it's not advertising that it is fully operational just yet, as it continues to onboard new drivers. California Governor Wants to See More Guaranteed Income Pilots California Governor Gavin Newsom announced last Friday that he is including $35 million in funding in his May budget proposal to state legislators that will go to guaranteed income pilots targeting low-income Californians. Local TV news KCRA said it's believed to be the first statewide funding in the country for such programs. The news came not long after Mayor Ras Baraka announced a guaranteed income pilot program for his city of Newark, New Jersey — which will be all-privately funded instead. The idea, supporters of these programs say, is for the pilots to help build compelling evidence for a federally-funded guaranteed income program. Another goal is to figure out how to best structure the program so it affords the necessary flexibility for states and localities to customize as they see fit. "[The federal government is] printing money, so the idea is the money is there, but the will is not there," said Baraka in an online event on guaranteed income last year. "They're finding money somewhere, giving it out, and arguing about who gets it. We're saying this is where it needs to go, and we want them to understand it needs to be in perpetuity, not just a one-off thing." Oops, They Did It Again Two years ago, banking giant JPMorgan Chase committed to no longer finance private prisons. And yet, here we are. Oscar is Next City's senior economics correspondent. He previously served as Next City's editor from 2018-2019, and was a Next City Equitable Cities Fellow from 2015-2016. Since 2011, Oscar has covered community development finance, community banking, impact investing, economic development, housing and more for media outlets such as Shelterforce, B Magazine, Impact Alpha, and Fast Company. Follow Oscar .(JavaScript must be enabled to view this email address) |
| Posted: 21 May 2021 02:00 AM PDT Ronald Lindquist, 87, has been active all his life. So, he wasn't prepared for what happened when he stopped going out during the coronavirus pandemic and spent most of his time, inactive, at home. "I found it hard to get up and get out of bed," said Lindquist, who lives with his wife of 67 years in Palm Springs, California. "I just wanted to lay around. I lost my desire to do things." Physically, Lindquist noticed that getting up out of a chair was difficult, as was getting into and out of his car. "I was praying 'Lord, give me some strength.' I kind of felt, I'm on my way out — I'm not going to make it," he admitted. One little-discussed, long-term toll of the pandemic: Large numbers of older adults have become physically and cognitively debilitated and less able to care for themselves during 15 months of sheltering in place. No large-scale studies have documented the extent of this phenomenon. But physicians, physical therapists and health plan leaders said the prospect of increased impairment and frailty in the older population is a growing concern. "Anyone who cares for older adults has seen a significant decline in functioning as people have been less active," said Dr. Jonathan Bean, an expert in geriatric rehabilitation and director of the New England Geriatric Research, Education and Clinical Center at the Veterans Affairs Boston Healthcare System. Bean's 90-year-old mother, who lives in an assisted living facility, is a case in point. Before the pandemic, she could walk with a walker, engage in conversation and manage going to the bathroom. Now, she depends on a wheelchair and "her dementia has rapidly accelerated — she can't really care for herself," the doctor said. Bean said his mother is no longer able to benefit from rehabilitative therapies. But many older adults might be able to realize improvements if given proper attention. "Immobility and debility are outcomes to this horrific pandemic that people aren't even talking about yet," said Linda Teodosio, a physical therapist and division rehabilitation manager in Bayada Home Health Care's Towson, Maryland, office. "What I'd love to see is a national effort, maybe by the CDC [U.S. Centers for Disease Control and Prevention], focused on helping older people overcome these kinds of impairments." The extent of the need is substantial, by many accounts. Teodosio said she and her staff have seen a "tremendous increase" in falls and in the exacerbation of chronic illnesses such as diabetes, congestive heart failure and chronic obstructive pulmonary disease. "Older adults got off schedule during the pandemic," she explained, and "they didn't eat well, they didn't hydrate properly, they didn't move, they got weaker." Dr. Lauren Jan Gleason, a geriatrician and assistant professor of medicine at the University of Chicago, said many older patients have lost muscle mass and strength this past year and are having difficulties with mobility and balance they didn't have previously. "I'm seeing weight gain and weight loss, and a lot more depression," she noted. Mary Louise Amilicia, 67, of East Meadow, New York, put on more than 100 pounds while staying at home round-the-clock and taking care of her husband Frank, 69, who was hospitalized with a severe case of covid-19 in early December. While Amilicia also tested positive for the virus, she had a mild case. "We were in the house every day 24/7, except when we had to go to the doctor, and when he got sick I had to do all the stuff he used to do," Amilicia told me. "It was a lot of stress. I just began eating everything in sight and not taking care of myself." The extra weight made it hard to move around, and Amilicia fell several times after Christmas, fortunately without sustaining serious injuries. After coming home from the hospital, Frank couldn't get out of a chair, walk 10 feet to the bathroom or climb the stairs in his house. Instead, he spent most of the day in a recliner, relying on his wife for help. Now, the couple is getting physical therapy from Northwell Health, New York state's largest health care system. Just before the pandemic, Northwell launched a "rehabilitation at home" program for patients who otherwise would have seen therapists in outpatient facilities. (Medicare Part B pays for the treatments.)  The program is serving more than 100 patients on Long Island, in Westchester County and in parts of New York City. "The demand is very strong and we're in the process of hiring another 20 therapists," said Nina DePaola, Northwell's vice president of post-acute services. Sabaa Mundia, a physical therapist working with the Amilicias, said Mary Louise can walk up to 400 feet without a walker, after doing strengthening exercises twice a week over the course of three weeks. Frank had been using a wheelchair and is now regularly walking 150 feet with a walker after more than a month of therapy. "Older adults can lose about 20% of their muscle mass if they don't walk for up to five days," Mundia said. "And their endurance decreases, their stamina decreases, and their range of motion decreases." Recognizing that risk, some health plans have been reaching out to older members to assess how they're faring. In Massachusetts, Commonwealth Care Alliance serves more than 10,000 older adults who are poor and eligible for both Medicare and Medicaid, the federal-state program for people with low incomes. On average, they tend to have more medical needs than similarly aged seniors. Between March and September last year, the plan's staffers conducted "wellness outreach assessments" by phone every two weeks, asking about ongoing medical care, new physical and emotional challenges, and the adequacy of available help, among other concerns. Today, calls are made monthly and staffers have resumed seeing members in person. An increase in physical deconditioning is one of the big issues that have emerged. "We've had physical therapists digitally engage with members to coach them through strength and balance training," said Dr. Robert MacArthur, a geriatrician and Commonwealth Care's chief medical officer. "And when that didn't work, we sent therapists into people's homes." In California, SCAN Health Plan serves a similarly vulnerable population of nearly 15,000 older adults dually eligible for Medicare and Medicaid through its Medicare Advantage plans. Care navigators are calling these members frequently and telling them "now that you're vaccinated, it's safe to go see your doctor in person," said Eve Gelb, SCAN's senior vice president of health care services. Doctors can then evaluate unmet health needs and make referrals to physical and occupational therapists, if necessary. Another SCAN program, Member2Member, pairs older adult "peer health advocates" with members who have noted physical or emotional difficulties on health risk assessments. That's how Lindquist in Palm Springs connected with Jerry Payne, 79, a peer advocate who calls him regularly and helped him come up with a plan to emerge from his pandemic-induced funk. "First, he said, 'Ron, you should try getting up every hour and taking a few steps' — that was the start of it," Lindquist told me. "Then, he'd suggest walking another block when I would take my dog out. It was painful. Walking was not pleasant. But he was very encouraging." A month ago, Payne had a Fitbit sent to Lindquist. At first, Lindquist walked about 1,500 steps a day; now, he's up to more than 5,000 steps a day and has a goal of reaching 10,000 steps. "I'm sleeping better and I feel so much better all around," Lindquist said. "My whole attitude and physicality has changed. I tell you, this has been an answer to my prayers." Coming Monday: Tips for Older Adults to Regain Their Game We're eager to hear from readers about questions you'd like answered, problems you've been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips. |
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