Healthy Connections Newsletter - Fall 2103
Transcription
Healthy Connections Newsletter - Fall 2103
Hospital Happenings... Healthy Connections Austin Satellite Senior Center Health Education Classes Held every Wednesday throughout the year. Call 773-854-5306 for more information. Golden Life Senior Birthday Celebrations A Publication for Friends of Loretto Hospital • 645 S. Central Ave. • Chicago, IL 60644 • Fall 2013 • 773-626-4300 • www.lorettohospital.org Held quarterly. We want to hear from you. Call 773-854-5306 for more information. Open House Send us your questions October 24, 2013, 10 a.m.- 2 p.m. or comments to: marketing@lorettohospital.org Visit with Santa December 7, 2013, 10 a.m.- noon Behavioral Health Disorders Treated as Criminal Mentally ill and drug addicts linked to inner city violence may be a form of discrimination. Inaccurate beliefs about the link between mental illness and violence have led to widespread stigma and discrimination against people with behavioral health disorders. The discrimination and stigma associated with mental illnesses may stem from the way the entertainment industry and the news media portray people with behavioral health disorders as being the most dangerous of all demographic group. Kiss the Wall Celebration (Honoring survivors of cancer) According to Mental Health America, an organization that addresses the full spectrum of issues associated with mental illnesses and substance use, many TBD news stories about people with mental illnesses are portrayed negatively. However, the vast majority of people with mental illness do not exhibit criminal behavior. Healthy Connections is a publication of Loretto Hospital. For more information about Loretto Hospital call 773-626-4300. Photo credits: 123RF and Microsoft.com Free Images. Newsletter design by Business Image Development, Inc.. Copyright © 2013, Loretto Hospital, All Rights Reserved. “Most mentally ill people in the streets are not violent. Take for instance people with schizophrenia or people with bi-polar disorders, they are usually very harmless,” said Addie Anderson, director of outpatient mental health at Loretto Hospital, during a recent intergovernmental taskforce public hearing organized by Cook U.S. Postage Place Stamp Here Country Commissioner Earlean Collins (1st District). 645 S. Central Avenue Chicago, IL 60644 and governmental sectors offered their input on how to reduce crime as proposed by the Criminal Justice Committee of Cook County. The proposal examined the role the mentally ill, substance abusers and the homeless may play in violence throughout the City. “There is a condition known as oppositional defiance disorder, but even individuals with Mailing Label Here No woman this condition are not necessarily violent,” Anderson said. Opposition Defiant Disorder (ODD) is a childhood condition with common features of excessive, often persistent anger, frequent temper tantrums or angry outbursts, as well as disregard for authority. Children and adolescents with ODD often purposely annoy wants to hear that she has breast cancer. But the sooner the cancer is found, the better her prognosis. During that hearing, leaders from various professional Is it time for your mammogram? Women with smaller tumors and cancer that hasn’t spread beyond their breasts more often survive the disease. Screening catches cancer early, when treatment can be more successful. Talk with your doctor about the screening schedule that’s right for you. For women at average risk, getting a mammogram every other year after age 50 may work best. Medical advances have made breast cancer treatment more effective than ever before. Every year, almost 300,000 American women will receive a breast cancer diagnosis. With proper treatment, many of them will soon join the ranks of the 2.6 million breast cancer survivors. These women have heard these four joyful words: “You’re now cancer-free.” use this trait to simply show the adults in their life that they are in control. For more information about how you can obtain your annual mammogram, contact Loretto Hospital’s Mammography Department at 773-854-5233. (Continued on Page 3) Source: American Cancer Society others, blame others for their own mistakes, and are easily disrupted. Most children with ODD are very strong willed and tend to 9 2 11 Healthy Connections Letter from the CEO I have exciting news to share with the Austin Community about Loretto Hospital’s continued progress. In my last letter, I addressed the importance of Loretto maintaining its integrity to 645 South Central Avenue Chicago, IL 60644 (773) 626-4300 our mantra “Loretto Cares” because it is the heartbeat of our organization and truly displays how much we value our patients and our commitment to Dr. Sonia Mehta, CEO/CMO providing quality healthcare. Medical Detox Program and Services Residential Rehabilitation Treatment 24-Hour Admissions, Seven Days a Week Intensive Outpatient (IOP), Traditional Outpatient, and Continuing After Care Onsite Services Include: DUI Evaluation Services, Compulsive Gambling Assessment and Education, Family HIV Support Program, Comprehensive Family Education Program, Active Alumni Group and Open Self-Help Groups (A.A., N.A, C.A., ALANON) Experienced and Compassionate Physicians, Nurses, Social Workers and Counselors Transportation Available Medicaid, Medicare and Most Private Insurance Accepted With this said, I am so proud to announce that earlier this year, Loretto Hospital was among several Illinois hospitals that had dramatically improved its scores in the areas of hospital safety and quality according to a recent report issued COMING SOON: by the Leapfrog Group, a nonprofit organization based in Washington, D.C., Loretto Hospital Youth Council quality health care. Loretto Hospital was one of the few safety-net hospitals For more information contact Thrishka McKinnor at 773-854-5337. that rates hospitals nationwide to help steer organizations towards higher on Chicago’s west side to receive a grade of ‘B’ or better. Receiving a grade To Find Out How We Can Help! of ‘B’ is proof that Loretto is striving to be the hospital of choice for this Call Central Intake at (773) 854-5445 community, as well as makes us stakeholders in promoting service excellence or the Clinical Outreach Coordinator at (773) 339-6421 and outstanding care to all of our patients and the communities we serve. We have added a new staff at the hospital to continue promoting our internal slogan, Raising the Bar in Service Excellence. We have recently hired a new chief nursing officer who has a wealth of experience in all areas from behavior health to pediatric care. We have also added the role of chief experience officer (CXO) to our roster. The CXO will play a crucial role in improving the hospital culture and interactions between our patients, their families and visitors within all levels of the organization. Our promise is to continue to build the right internal infrastructure to ensure that “Loretto Cares” remains the very essence of what we truly believe and stand for as healthcare professionals. Additionally, we have added new highly experience physicians to our staff of doctors which include a new orthopedic surgeon, general surgeon, OBGYN, as well as a geriatric specialist. October is National Breast Cancer Awareness Month as well as National Dr. Mark Benjamin to our hearts, we have provided a wealth of information regarding breast 40 Years of Experience Mental Illness Awareness observance. Since both subjects are near and dear cancer and mental illnesses. We also highlight facts about depression, flu season, inner city crime, and review many of our community initiatives we have had over the past several months. Sincerely, Specialty services include: Ophthalmology Cataract Surgery Glaucoma filtering surgery LASIK corrective eye surgery Dr. Sonia Mehta Chief Executive Officer/Chief Medical Officer Loretto Hospital To schedule an appointment, call the Ambulatory Care Clinic at 773-854-5475. 10 3 Healthy Connections A Depressed America! More than 25 million affected Mental and emotional health disorders are common issues that affect people from all walks of life. In fact, most people do not associate depression as a mental health or emotional disorder. While it’s natural to feel down sometimes, if that feeling lingers day after day for more than two weeks, that may be a sign depression. Depression is not just feeling sad; it is a medical illness that is treatable. Each year, depression affects 5-8 percent of adults in the United States, which means that about 25 million Americans will struggle with depression this year. But getting an accurate diagnosis is very important. For more than 40 years, Loretto Hospital has provided comprehensive treatment and care to individuals with behavioral health problems throughout the Chicago area. Each patient receives individualized treatment and care in a safe and therapeutic environment. Our treatment includes the use of Loretto Hospital’s supportive and ancillary services which are tailored to meet our patient’s needs. For more information about depression and mental health, go to www.mentalhealthscreening.org or contact Loretto Hospital’s Department of Behavioral Health Services at (773) 854-5320. Facts about Depression • In the United States, depression affects nearly 3 million men. • Four times as many men as women die by suicide in the U.S. • Men often deal with depression by withdrawing from others and throwing themselves into their work, engaging in risky or dangerous behavior, and/or becoming angry, frustrated and abusive. • Women 18 to 45 years of age account for the largest proportion of people suffering from depression. • Twenty to 40 percent of menstruating women experience premenstrual mood and behavioral changes. • In one major study, 100 percent of women who had experienced severe childhood sexual abuse developed depression later in life. • According to a 1997 National Ambulatory Medical Care Survey, the number of Latinos diagnosed with a depressive illness increased 72.9 % since 1992. • A recent study found that Latinos are disproportionately diagnosed as having major depression compared with the other ethnic groups. • Latinos are more likely to present “somatic” symptoms of depression, like body aches and nervousness. • According to the American Academy of Child and Adolescent Psychiatry, up to one-third of the 3.4 million children and adolescents with depression in the United States may actually be experiencing the early onset of bipolar disorder. • About 4% of teenagers have major depressive disorder (MDD) at any one time. Among teens, girls are more often affected than boys. • According to the APA’s HealthyMinds, 1 in 4 young adults will experience a depressive episode by age 24. • If left untreated depression can lead to suicide. Suicide is the third leading cause of death for those aged 15-24 and the second leading cause of death of college students. • Depression in its many forms affects more than 6.5 million of the 35 million Americans who are 65 years or older. • Symptoms in older persons may differ somewhat from symptoms in other populations. Depression in older people is often characterized by memory problems, confusion, social withdrawal, loss of appetite, inability to sleep, irritability, and, in some cases, delusions and hallucinations. • African Americans with depression were less likely to receive treatment than whites (16 percent compared to 24 percent). • Only 26 percent of African-Americans with diagnosed generalized anxiety disorder received treatment for their disorder compared to 39 percent of whites with a similar diagnosis, according to the 2001 Surgeon General’s report on mental health. New Orthopedic Surgeon Joins Loretto Hospital staff Dr. Chandrasekhar Sompalli joined the Loretto Hospital family beginning this summer. Dr. Sompalli brings more than 20 years of experience and is among the leading orthopedic surgeons specializing in sports medicine, knees and shoulder injuries. An expert in bone and joint trauma, Dr. Sompalli has authored a number of research papers, Dr. C. Sompalli, Orthopedics which were selected as the best of the best from trauma associations. He attended Loyola University School of Medicine where he completed both his medical degree and residency, and is board certified through the American Board of Orthopaedic Surgery. His memberships include: the American Medical Association, Midwestern Orthopedic Association and the American Academy of Orthopedic Surgeons. Currently, Dr. Sompalli practices at the Perry Memorial Orthopedic Clinic, in Princeton, Illinois. He will be available to see patients at Loretto Hospital on Mondays from 1:30 p.m. – 5:30 p.m. in the Ambulatory Care Clinic. Behavioral Health Loretto Appoints New CNO Loretto Hospital recently welcomed James Renneker as the new CNO. Renneker brings more than 25 years of nursing leadership experience to Loretto Hospital. Most recently, Renneker served as CNO of Aurora Health Care Sinai Medical Center in Milwaukee. Additional experience includes: serving as the CNO/ James Renneker, Loretto’s new Chief Nursing Officer COO at Weiss Memorial Hospital; vice president of nursing at Northshore University Health System; vice president of patient care services at Riveredge Hospital; and vice president of clinical services at West Suburban Hospital. Continued from Page 1 “But even young people with ODD shouldn’t be criminalized. I believe that most of the crimes we hear about in the inner City of Chicago are due to social issues,” Anderson said. But according to the proposed resolution issued by the Cook County Commissioner’s office, recent closings of Illinois State Mental Institutions, along with the decrease in resources at local facilities to treat people with mental illnesses, has influenced the growth in the City’s homeless population, an upwelling in crime, and the overcrowding at Cook County Jail. Additionally, the latest law enforcement data reports that approximately 65% of homicides are committed by individuals with a mental illness or substance addiction. “You have young people who have turned to a life of crime because they are products of broken homes, or they may come from a background of abuse, so they join gangs or exhibit behavior that is more for survival like stealing to eat and selling drugs to live. These issues are totally unrelated to mental illnesses,” Anderson said. The plan set forth by Commissioner Earlean Collins and the Criminal Justice Committee recommends special services for homeless veterans, expansion of crisis intervention teams throughout the city, a re-visitation of mandatory sentencing laws, crime prevention and intervention, and funding for education programs for students who live in high crime areas. “Majority of these issues are so overwhelming that it has to be a collaborative effort from hospitals, social services, churches, the government and police. Everyone has a role to play. Most importantly, police officers should be properly trained to understand the difference between a person with bad behavior versus someone who is mentally ill and need to be admitted into a healthcare facility for medical treatment opposed to being thrown into prison,” Anderson said. For more information about behavioral health disorders, or to receive treatment, contact Loretto Hospital’s Behavioral Health Center at 773-854-5320. Sources: Institute of Medicine, 2006, American Psychiatric Association, 1994 9 4 9 Healthy Connections Affordable Care Act promotes NO COST Health Insurance to Cook County Residents Cook County residents who are uninsured or underinsured may be eligible to receive no cost health insurance through a program called CountyCare under the new Affordable Care Act. CountyCare program members will receive primary care service, hospitalization, prescription drugs, labs, X-rays, mammograms, mental health and substance abuse programs plus many more healthcare services. Quality services will be available at all Cook County Health and Hospital sites plus local participating hospitals and Federally Qualified Health Care Centers. Individuals who want to apply must live in Cook County, be 19 years old up to age 64, have a Social Security number and be a legal immigrant for five years of more. In addition, an applicant’s yearly income must be below $15,282 for an individual or $20,628 per couple, and may not be receiving or eligible for Medicaid, Medicare or CHIP. To enroll or learn more information go to www.countycare.com or call 312-864-8200. Loretto Hospital partners with the Austin Weekly News and the Austin Chamber of Commerce hosts Business Development Seminar Loretto In a collaborative effort to strengthen local businesses in the Austin community, Loretto Hospital partnered with the Austin Weekly News and The Loretto Hospital Foundation presents Senator Kimberly Lightford (D-4th District) with the Distinguished Citizen Award Promoting heart health to the Austin Community Illinois State Senator Kimberly A. Lightford (D-4th District) was presented with the Distinguished Citizen Award at the Loretto Hospital Foundation’s (LHF) 13th Annual Golf Outing on Wednesday, July 31, 2013 at the Cog Hill Golf and Country Club, 12294 Archer Avenue in Lemont, Illinois. Senator Lightford was honored for her tremendous contributions to Loretto Hospital and the Austin Community and for supporting Loretto Hospital’s Healthy Heart Initiative. Since the beginning of her political career, Sen. Lightford has been a vocal champion of her strongest passion: promoting quality education and development programs for Illinois’ youth. After becoming Senate assistant majority leader in 2009, Lightford enhanced her role as an advocate for education reform. That same year, Sen. Lightford helped to erect a state-of-the-art emergency department at Loretto Hospital, funded by $8.2 million in capital improvement funds received from Lightford. Through her leadership, Sen. Lightford has also supported a number of healthcare initiatives on Chicago’s west side such as prostate and breast cancer screenings to help educate both men and women about the importance of early detection. “What is most intriguing about Sen. Lightford is that she fits the profile of an individual who is serving humanity above self; and she has a strong commitment of making Austin a better, safer and healthier community,” said Dr. Sonia Mehta, Loretto Hospital’s CEO. IL State Senator Kimberly Lightford D-4th District As the 2013 Distinguished Citizen Award recipient, Sen. Lightford supported the purchase of a MUSE® Cardiology Information System as part of Loretto Hospital’s Healthy Heart initiative. Overall, a portion of the proceeds from the golf outing will help Loretto Hospital grant access to quality healthcare and community outreach programs and services to men and women in the Austin and surrounding communities. As the only hospital in Austin, this new initiative is another strategy by the LHF and hospital staff to continue its mission to provide quality patient centered care and promote wellness and education. According to Dr. Mehta, in addition to generating much needed money for hospital programs, the annual golf outing has helped raise awareness of Loretto Hospital and affirm its long-standing promise to provide accessible health care to the underserved. “Because of this event and our other programs, we are changing lives and impacting the community in a positive way,” Dr. Mehta said. Loretto Hosts 3rd Annual Back-to-School Fitness Fun Fest the Austin Chamber of Commerce to host the “Business Development for Today’s Markets”, Wednesday, October 2, 2013 at Loretto Hospital, Featuring the Loretto Hospital Birth-Day Baby Celebration 645 S. Central Avenue. The seminar featured successful business owners who spoke about ways that entrepreneurs could enhance business Loretto Hospital hosted its 3rd Annual Back-to-School Fitness Fun Fest on August 3, 2013. The goal of the Fitness Fun Fest is to introduce inner city children to an alternative healthful lifestyle of fun and fitness to decrease obesity. As an added attraction, this year, the hospital featured the Birth-day Baby Celebration for adults performance by using the proper marketing, technology and by making smart financial decisions. The event attracted local business owners with decision-making authority, as well as individuals who have been in business for at least two years. who were born at Loretto Hospital. Attendees enjoyed entertainment and activities, including: fitness stations; jumping and rock climbing inflatables; nutritional stations; the Jessie White Tumblers; celebrity guests and much more. Speakers included: Bral M. Spight, executive director of Goldman Sachs 10,000 Business Initiative at Chicago Harold Washington College; Joanna Sobran, president of MXOtech, Amara Enyia, CEO of ACE Municipal Partners LLC; Elizabeth Gardner, director of community relations and corporate initiatives at the Women’s Business Development Center; and, Joanna Sobran, president of MXOtech, and Bral M. Spight, executive director of Goldman Sach 10,000 Small Business Initiatives at Chicago Harold Washington College, speaks at the Business Development for Today’s Markets seminar at Loretto Hospital. Dawn Ferencak, advertising consultant for Wednesday Journal, Inc. Sponsors of the event included: MXOtech, Austin Chamber of Commerce, Women’s Business Development Center, Austin Weekly News and the West Side Business Network. To learn more about Business Development for Today’s Markets, contact the Austin Weekly News West Side Business Network at 708-613-3329. Dr. Sonia Mehta, CEO, is with participants of the 3rd Annual Back-to-School Fitness Fun Fest, Saturday, August 3, 2013. A family of Loretto Babies! John Judge and Arlene Garcia (front row) with brothers Chuckie and Gary Whitfield attended the Fun Fest and participated in the Loretto Hospital Birth-day Baby Celebration. L-R: Camille Y. Lilly, VP of external affairs; Dr. Sonia Mehta, CEO/CMO; Ald. Deborah Graham (29th Ward); Comm. Barbara McGowan, Metropolitan Water Reclamation District of Greater Chicago. 8 Healthy Connections Get a $50 Mammogram Loretto Hospital proudly supports Breast Cancer Awareness Month. Throughout the month of October, qualified individuals can receive a mammogram for only $50* (restrictions apply). *Rate only applies to screening mammograms for women over 40. Patients must have no known symptoms present. Each year nearly 300,000 women are diagnosed with the disease. And, each year close to 40,000 of them die from it. Don’t take any chances. Get tested because early detection can save your life. Live Life. Beat Breast Cancer. Schedule your mammogram today. Call (773) 854-5233 Extended hours of operation and same day service are available throughout October. Have you had your fruits and veggies today? Eating fruits and vegetables provides a variety of healthful benefits. People who eat a healthy, balanced diet – including plenty of vegetables and fruits – can lower their risk of chronic diseases like heart disease and type 2 diabetes. However, most people do not consume enough fruits and vegetables as recommended by the United States Department of Agriculture (USDA). The USDA reports that only one in three adults eat the recommended amount of fruits every day; and about one in four adults eat the recommended amount of vegetables every day. According to the USDA, as a rule, you should make half your plate fruits and vegetables. For example, an 8 year old child would consume about 1 ½ cups of veggies each day while the recommended daily allowance for an adult between the age of 19-30 would be about 2 ½ cups of veggies. September was National Fruits and Veggie Month. Make a difference in your community by spreading the word about the importance of eating fruits and vegetables every day. For more tips on eating healthy, go to www.fruitsandveggiesmorematters.org. October Marks Crime Prevention Month October is the month when the National Crime Prevention Council (NCPC) honors those who work tirelessly all year to prevent crime and highlights new tips and resources for effective crime prevention in their neighborhood. It is also a time to honor individuals who have accepted personal responsibility for their neighborhoods and groups who work for the community’s common good. During Crime Prevention Month, individuals can commit to working in their communities to drive violence and drugs off the streets. The vitality of your community depends on your partnership with your family, schools, workplace and community. Get involved today to make Austin a safe place to live. For more information about what you can do to make your community safe, visit www.celebratesafecommunities.org. 5 6 7 Healthy Connections Prevent Infection - Recognizing International Infection Prevention Week – October 20-26 Most people associate getting infections with being in a healthcare facility. While it’s true that each year nearly 1.7 million people in the U.S. get infections in hospitals, in most cases, the spread of diseases and infections also takes place at school, in your home, in public facilities, and at work. Everyone plays a role in infection prevention — in and out of healthcare facilities. Aging Americans Leading Healthy, Productive Lives America is aging. The number of Americans over age 65 is increasing dramatically. Wherever you are, there is something you can do to stay safe from infections. Do your part! Here are several important things you can do at home, school, or at work to prevent the spread of infections: 1. Wash or sanitize your hands throughout the day, especially before eating, after using the rest room, or touching objects in public places. Most germs are spread from hand to hand. Respiratory Care Week, an annual they are staying increasingly respiratory care profession and in our nation’s history have issues and practices. Americans are living longer, event active and productive. Never promotes awareness of lung health so many people lived into the Respiratory This is The proportion of Americans age 65 and over comprises nearly 13 percent of the U.S. population. In fewer than 25 years, individuals over age the U.S. population. However, society’s view of “old age” is not 6. Clean, dust, and disinfect frequently touched surfaces on a regular basis, especially bathroom, kitchens and places where dust and dirt can collect. older Americans actually live independent, active, happy lives and maintain close relationships with family and friends. 7. Clean more often when there are sick family members in your home. September is Healthy Aging Month, an annual observance which 65 will make up 20 percent of around recognizes care the the professionals country and their workplaces and communities to celebrate respiratory therapists for the hard work and contributions they make every day to medical community, as well as educating patients and their families in their battles against lung disease. For more information about how to maintain healthy lungs and breathing, contact Loretto Hospital’s Ambulatory Care Clinic at 773-854-5475. always one with a positive outlook. As with many stereotypes, the stereotypes about aging are often inaccurate. For the most part, 8. Stay home when you are sick! Germs from focuses on the positive aspects of growing older. To learn more 9. For school-aged children, be sure to teach the importance of hand washing and good hygiene. years, contact Loretto Hospital’s Department of Geriatric Medicine Volunteer at Loretto Hospital ! about how you can maintain a healthy happy life in your senior at 773-854-5306 or 773-854-5417. To learn about Loretto Hospital’s Senior Wellness Program call 773-854-5063. Loretto adds Geriatric Specialist to Roster The Centers for Disease Control and Prevention suggests an annual flu vaccine for all people ages 6 months and older. While the vaccine is recommended for nearly everyone, certain groups are at higher risk for complications from the flu, including: • People age 65 and older • Children younger than 6 months old • Pregnant women For more information about receiving the flu shot, go to www.cdc.gov, or contact Loretto Hospital’s Ambulatory Care Clinic at 773-854-5476. that around the world come together in reaching their senior years. 5. Keep pet environments clean and remember to prevent pets from drinking out of the toilet. Keep pets vaccinated and bathed, and clean up accidents promptly. Provide clean bedding, water, and food dishes. Protect your pet and your family and keep disease out of your home by preventing fleas, ticks, and other pests from getting in. • People with certain ongoing medical conditions, such as diabetes, asthma or heart disease. from good news for those who are 4. Do not place purses or diaper bags on the kitchen table, on the kitchen counter, or anywhere else food is consumed in your home. Flu Season is Here! October 20-26 is designated as But the good news is that while remained so healthy. 3. Don’t share personal items, especially toothbrushes, towels, razors, handkerchiefs, and nail clippers can all be sources of infectious agents (think bacteria, viruses, and fungi). Source: Association for Professionals in Infection Control and Epidemiology, Inc. www.apic.org – Bringing Breath to Life later stages of their lives and 2. Use safe cooking practices. Foodborne illnesses frequently arise from poor food preparation and dining habits. 10. If possible, ensure you and your children receive proper vaccinations against communicable diseases such as measles, whooping coughs and the flu virus. Honoring Respiratory Care Professionals Across America Dr. Hubert Fernandes Geriatric Specialist Dr. Hubert Fernandes joined Loretto Hospital’s staff on August 1, 2013. Dr. Fernandes specializes in geriatric and internal medicine. His clinic hours are Monday, Tuesday, Thursday and Friday from 8:30 a.m. to 4:30 p.m. in the space formally known as the Women’s Health Center located on the first floor. To schedule an appointment, call 773-854-5306 or 773-854-5417. Volunteering can bring out the hidden potential in you. Whether your motivation is personal, educational or social, Loretto Hospital is honored to contribute to your life in a positive manner. For more information about Loretto Hospital’s Volunteer Program, visit our website at www. lorettohospital.org, or call 773-854-4200. 6 7 Healthy Connections Prevent Infection - Recognizing International Infection Prevention Week – October 20-26 Most people associate getting infections with being in a healthcare facility. While it’s true that each year nearly 1.7 million people in the U.S. get infections in hospitals, in most cases, the spread of diseases and infections also takes place at school, in your home, in public facilities, and at work. Everyone plays a role in infection prevention — in and out of healthcare facilities. Aging Americans Leading Healthy, Productive Lives America is aging. The number of Americans over age 65 is increasing dramatically. Wherever you are, there is something you can do to stay safe from infections. Do your part! Here are several important things you can do at home, school, or at work to prevent the spread of infections: 1. Wash or sanitize your hands throughout the day, especially before eating, after using the rest room, or touching objects in public places. Most germs are spread from hand to hand. Respiratory Care Week, an annual they are staying increasingly respiratory care profession and in our nation’s history have issues and practices. Americans are living longer, event active and productive. Never promotes awareness of lung health so many people lived into the Respiratory This is The proportion of Americans age 65 and over comprises nearly 13 percent of the U.S. population. In fewer than 25 years, individuals over age the U.S. population. However, society’s view of “old age” is not 6. Clean, dust, and disinfect frequently touched surfaces on a regular basis, especially bathroom, kitchens and places where dust and dirt can collect. older Americans actually live independent, active, happy lives and maintain close relationships with family and friends. 7. Clean more often when there are sick family members in your home. September is Healthy Aging Month, an annual observance which 65 will make up 20 percent of around recognizes care the the professionals country and their workplaces and communities to celebrate respiratory therapists for the hard work and contributions they make every day to medical community, as well as educating patients and their families in their battles against lung disease. For more information about how to maintain healthy lungs and breathing, contact Loretto Hospital’s Ambulatory Care Clinic at 773-854-5475. always one with a positive outlook. As with many stereotypes, the stereotypes about aging are often inaccurate. For the most part, 8. Stay home when you are sick! Germs from focuses on the positive aspects of growing older. To learn more 9. For school-aged children, be sure to teach the importance of hand washing and good hygiene. years, contact Loretto Hospital’s Department of Geriatric Medicine Volunteer at Loretto Hospital ! about how you can maintain a healthy happy life in your senior at 773-854-5306 or 773-854-5417. To learn about Loretto Hospital’s Senior Wellness Program call 773-854-5063. Loretto adds Geriatric Specialist to Roster The Centers for Disease Control and Prevention suggests an annual flu vaccine for all people ages 6 months and older. While the vaccine is recommended for nearly everyone, certain groups are at higher risk for complications from the flu, including: • People age 65 and older • Children younger than 6 months old • Pregnant women For more information about receiving the flu shot, go to www.cdc.gov, or contact Loretto Hospital’s Ambulatory Care Clinic at 773-854-5476. that around the world come together in reaching their senior years. 5. Keep pet environments clean and remember to prevent pets from drinking out of the toilet. Keep pets vaccinated and bathed, and clean up accidents promptly. Provide clean bedding, water, and food dishes. Protect your pet and your family and keep disease out of your home by preventing fleas, ticks, and other pests from getting in. • People with certain ongoing medical conditions, such as diabetes, asthma or heart disease. from good news for those who are 4. Do not place purses or diaper bags on the kitchen table, on the kitchen counter, or anywhere else food is consumed in your home. Flu Season is Here! October 20-26 is designated as But the good news is that while remained so healthy. 3. Don’t share personal items, especially toothbrushes, towels, razors, handkerchiefs, and nail clippers can all be sources of infectious agents (think bacteria, viruses, and fungi). Source: Association for Professionals in Infection Control and Epidemiology, Inc. www.apic.org – Bringing Breath to Life later stages of their lives and 2. Use safe cooking practices. Foodborne illnesses frequently arise from poor food preparation and dining habits. 10. If possible, ensure you and your children receive proper vaccinations against communicable diseases such as measles, whooping coughs and the flu virus. Honoring Respiratory Care Professionals Across America Dr. Hubert Fernandes Geriatric Specialist Dr. Hubert Fernandes joined Loretto Hospital’s staff on August 1, 2013. Dr. Fernandes specializes in geriatric and internal medicine. His clinic hours are Monday, Tuesday, Thursday and Friday from 8:30 a.m. to 4:30 p.m. in the space formally known as the Women’s Health Center located on the first floor. To schedule an appointment, call 773-854-5306 or 773-854-5417. Volunteering can bring out the hidden potential in you. Whether your motivation is personal, educational or social, Loretto Hospital is honored to contribute to your life in a positive manner. For more information about Loretto Hospital’s Volunteer Program, visit our website at www. lorettohospital.org, or call 773-854-4200. 8 Healthy Connections Get a $50 Mammogram Loretto Hospital proudly supports Breast Cancer Awareness Month. Throughout the month of October, qualified individuals can receive a mammogram for only $50* (restrictions apply). *Rate only applies to screening mammograms for women over 40. Patients must have no known symptoms present. Each year nearly 300,000 women are diagnosed with the disease. And, each year close to 40,000 of them die from it. Don’t take any chances. Get tested because early detection can save your life. Live Life. Beat Breast Cancer. Schedule your mammogram today. Call (773) 854-5233 Extended hours of operation and same day service are available throughout October. Have you had your fruits and veggies today? Eating fruits and vegetables provides a variety of healthful benefits. People who eat a healthy, balanced diet – including plenty of vegetables and fruits – can lower their risk of chronic diseases like heart disease and type 2 diabetes. However, most people do not consume enough fruits and vegetables as recommended by the United States Department of Agriculture (USDA). The USDA reports that only one in three adults eat the recommended amount of fruits every day; and about one in four adults eat the recommended amount of vegetables every day. According to the USDA, as a rule, you should make half your plate fruits and vegetables. For example, an 8 year old child would consume about 1 ½ cups of veggies each day while the recommended daily allowance for an adult between the age of 19-30 would be about 2 ½ cups of veggies. September was National Fruits and Veggie Month. Make a difference in your community by spreading the word about the importance of eating fruits and vegetables every day. For more tips on eating healthy, go to www.fruitsandveggiesmorematters.org. October Marks Crime Prevention Month October is the month when the National Crime Prevention Council (NCPC) honors those who work tirelessly all year to prevent crime and highlights new tips and resources for effective crime prevention in their neighborhood. It is also a time to honor individuals who have accepted personal responsibility for their neighborhoods and groups who work for the community’s common good. During Crime Prevention Month, individuals can commit to working in their communities to drive violence and drugs off the streets. The vitality of your community depends on your partnership with your family, schools, workplace and community. Get involved today to make Austin a safe place to live. For more information about what you can do to make your community safe, visit www.celebratesafecommunities.org. 5 9 4 9 Healthy Connections Affordable Care Act promotes NO COST Health Insurance to Cook County Residents Cook County residents who are uninsured or underinsured may be eligible to receive no cost health insurance through a program called CountyCare under the new Affordable Care Act. CountyCare program members will receive primary care service, hospitalization, prescription drugs, labs, X-rays, mammograms, mental health and substance abuse programs plus many more healthcare services. Quality services will be available at all Cook County Health and Hospital sites plus local participating hospitals and Federally Qualified Health Care Centers. Individuals who want to apply must live in Cook County, be 19 years old up to age 64, have a Social Security number and be a legal immigrant for five years of more. In addition, an applicant’s yearly income must be below $15,282 for an individual or $20,628 per couple, and may not be receiving or eligible for Medicaid, Medicare or CHIP. To enroll or learn more information go to www.countycare.com or call 312-864-8200. Loretto Hospital partners with the Austin Weekly News and the Austin Chamber of Commerce hosts Business Development Seminar Loretto In a collaborative effort to strengthen local businesses in the Austin community, Loretto Hospital partnered with the Austin Weekly News and The Loretto Hospital Foundation presents Senator Kimberly Lightford (D-4th District) with the Distinguished Citizen Award Promoting heart health to the Austin Community Illinois State Senator Kimberly A. Lightford (D-4th District) was presented with the Distinguished Citizen Award at the Loretto Hospital Foundation’s (LHF) 13th Annual Golf Outing on Wednesday, July 31, 2013 at the Cog Hill Golf and Country Club, 12294 Archer Avenue in Lemont, Illinois. Senator Lightford was honored for her tremendous contributions to Loretto Hospital and the Austin Community and for supporting Loretto Hospital’s Healthy Heart Initiative. Since the beginning of her political career, Sen. Lightford has been a vocal champion of her strongest passion: promoting quality education and development programs for Illinois’ youth. After becoming Senate assistant majority leader in 2009, Lightford enhanced her role as an advocate for education reform. That same year, Sen. Lightford helped to erect a state-of-the-art emergency department at Loretto Hospital, funded by $8.2 million in capital improvement funds received from Lightford. Through her leadership, Sen. Lightford has also supported a number of healthcare initiatives on Chicago’s west side such as prostate and breast cancer screenings to help educate both men and women about the importance of early detection. “What is most intriguing about Sen. Lightford is that she fits the profile of an individual who is serving humanity above self; and she has a strong commitment of making Austin a better, safer and healthier community,” said Dr. Sonia Mehta, Loretto Hospital’s CEO. IL State Senator Kimberly Lightford D-4th District As the 2013 Distinguished Citizen Award recipient, Sen. Lightford supported the purchase of a MUSE® Cardiology Information System as part of Loretto Hospital’s Healthy Heart initiative. Overall, a portion of the proceeds from the golf outing will help Loretto Hospital grant access to quality healthcare and community outreach programs and services to men and women in the Austin and surrounding communities. As the only hospital in Austin, this new initiative is another strategy by the LHF and hospital staff to continue its mission to provide quality patient centered care and promote wellness and education. According to Dr. Mehta, in addition to generating much needed money for hospital programs, the annual golf outing has helped raise awareness of Loretto Hospital and affirm its long-standing promise to provide accessible health care to the underserved. “Because of this event and our other programs, we are changing lives and impacting the community in a positive way,” Dr. Mehta said. Loretto Hosts 3rd Annual Back-to-School Fitness Fun Fest the Austin Chamber of Commerce to host the “Business Development for Today’s Markets”, Wednesday, October 2, 2013 at Loretto Hospital, Featuring the Loretto Hospital Birth-Day Baby Celebration 645 S. Central Avenue. The seminar featured successful business owners who spoke about ways that entrepreneurs could enhance business Loretto Hospital hosted its 3rd Annual Back-to-School Fitness Fun Fest on August 3, 2013. The goal of the Fitness Fun Fest is to introduce inner city children to an alternative healthful lifestyle of fun and fitness to decrease obesity. As an added attraction, this year, the hospital featured the Birth-day Baby Celebration for adults performance by using the proper marketing, technology and by making smart financial decisions. The event attracted local business owners with decision-making authority, as well as individuals who have been in business for at least two years. who were born at Loretto Hospital. Attendees enjoyed entertainment and activities, including: fitness stations; jumping and rock climbing inflatables; nutritional stations; the Jessie White Tumblers; celebrity guests and much more. Speakers included: Bral M. Spight, executive director of Goldman Sachs 10,000 Business Initiative at Chicago Harold Washington College; Joanna Sobran, president of MXOtech, Amara Enyia, CEO of ACE Municipal Partners LLC; Elizabeth Gardner, director of community relations and corporate initiatives at the Women’s Business Development Center; and, Joanna Sobran, president of MXOtech, and Bral M. Spight, executive director of Goldman Sach 10,000 Small Business Initiatives at Chicago Harold Washington College, speaks at the Business Development for Today’s Markets seminar at Loretto Hospital. Dawn Ferencak, advertising consultant for Wednesday Journal, Inc. Sponsors of the event included: MXOtech, Austin Chamber of Commerce, Women’s Business Development Center, Austin Weekly News and the West Side Business Network. To learn more about Business Development for Today’s Markets, contact the Austin Weekly News West Side Business Network at 708-613-3329. Dr. Sonia Mehta, CEO, is with participants of the 3rd Annual Back-to-School Fitness Fun Fest, Saturday, August 3, 2013. A family of Loretto Babies! John Judge and Arlene Garcia (front row) with brothers Chuckie and Gary Whitfield attended the Fun Fest and participated in the Loretto Hospital Birth-day Baby Celebration. L-R: Camille Y. Lilly, VP of external affairs; Dr. Sonia Mehta, CEO/CMO; Ald. Deborah Graham (29th Ward); Comm. Barbara McGowan, Metropolitan Water Reclamation District of Greater Chicago. 10 3 Healthy Connections A Depressed America! More than 25 million affected Mental and emotional health disorders are common issues that affect people from all walks of life. In fact, most people do not associate depression as a mental health or emotional disorder. While it’s natural to feel down sometimes, if that feeling lingers day after day for more than two weeks, that may be a sign depression. Depression is not just feeling sad; it is a medical illness that is treatable. Each year, depression affects 5-8 percent of adults in the United States, which means that about 25 million Americans will struggle with depression this year. But getting an accurate diagnosis is very important. For more than 40 years, Loretto Hospital has provided comprehensive treatment and care to individuals with behavioral health problems throughout the Chicago area. Each patient receives individualized treatment and care in a safe and therapeutic environment. Our treatment includes the use of Loretto Hospital’s supportive and ancillary services which are tailored to meet our patient’s needs. For more information about depression and mental health, go to www.mentalhealthscreening.org or contact Loretto Hospital’s Department of Behavioral Health Services at (773) 854-5320. Facts about Depression • In the United States, depression affects nearly 3 million men. • Four times as many men as women die by suicide in the U.S. • Men often deal with depression by withdrawing from others and throwing themselves into their work, engaging in risky or dangerous behavior, and/or becoming angry, frustrated and abusive. • Women 18 to 45 years of age account for the largest proportion of people suffering from depression. • Twenty to 40 percent of menstruating women experience premenstrual mood and behavioral changes. • In one major study, 100 percent of women who had experienced severe childhood sexual abuse developed depression later in life. • According to a 1997 National Ambulatory Medical Care Survey, the number of Latinos diagnosed with a depressive illness increased 72.9 % since 1992. • A recent study found that Latinos are disproportionately diagnosed as having major depression compared with the other ethnic groups. • Latinos are more likely to present “somatic” symptoms of depression, like body aches and nervousness. • According to the American Academy of Child and Adolescent Psychiatry, up to one-third of the 3.4 million children and adolescents with depression in the United States may actually be experiencing the early onset of bipolar disorder. • About 4% of teenagers have major depressive disorder (MDD) at any one time. Among teens, girls are more often affected than boys. • According to the APA’s HealthyMinds, 1 in 4 young adults will experience a depressive episode by age 24. • If left untreated depression can lead to suicide. Suicide is the third leading cause of death for those aged 15-24 and the second leading cause of death of college students. • Depression in its many forms affects more than 6.5 million of the 35 million Americans who are 65 years or older. • Symptoms in older persons may differ somewhat from symptoms in other populations. Depression in older people is often characterized by memory problems, confusion, social withdrawal, loss of appetite, inability to sleep, irritability, and, in some cases, delusions and hallucinations. • African Americans with depression were less likely to receive treatment than whites (16 percent compared to 24 percent). • Only 26 percent of African-Americans with diagnosed generalized anxiety disorder received treatment for their disorder compared to 39 percent of whites with a similar diagnosis, according to the 2001 Surgeon General’s report on mental health. New Orthopedic Surgeon Joins Loretto Hospital staff Dr. Chandrasekhar Sompalli joined the Loretto Hospital family beginning this summer. Dr. Sompalli brings more than 20 years of experience and is among the leading orthopedic surgeons specializing in sports medicine, knees and shoulder injuries. An expert in bone and joint trauma, Dr. Sompalli has authored a number of research papers, Dr. C. Sompalli, Orthopedics which were selected as the best of the best from trauma associations. He attended Loyola University School of Medicine where he completed both his medical degree and residency, and is board certified through the American Board of Orthopaedic Surgery. His memberships include: the American Medical Association, Midwestern Orthopedic Association and the American Academy of Orthopedic Surgeons. Currently, Dr. Sompalli practices at the Perry Memorial Orthopedic Clinic, in Princeton, Illinois. He will be available to see patients at Loretto Hospital on Mondays from 1:30 p.m. – 5:30 p.m. in the Ambulatory Care Clinic. Behavioral Health Loretto Appoints New CNO Loretto Hospital recently welcomed James Renneker as the new CNO. Renneker brings more than 25 years of nursing leadership experience to Loretto Hospital. Most recently, Renneker served as CNO of Aurora Health Care Sinai Medical Center in Milwaukee. Additional experience includes: serving as the CNO/ James Renneker, Loretto’s new Chief Nursing Officer COO at Weiss Memorial Hospital; vice president of nursing at Northshore University Health System; vice president of patient care services at Riveredge Hospital; and vice president of clinical services at West Suburban Hospital. Continued from Page 1 “But even young people with ODD shouldn’t be criminalized. I believe that most of the crimes we hear about in the inner City of Chicago are due to social issues,” Anderson said. But according to the proposed resolution issued by the Cook County Commissioner’s office, recent closings of Illinois State Mental Institutions, along with the decrease in resources at local facilities to treat people with mental illnesses, has influenced the growth in the City’s homeless population, an upwelling in crime, and the overcrowding at Cook County Jail. Additionally, the latest law enforcement data reports that approximately 65% of homicides are committed by individuals with a mental illness or substance addiction. “You have young people who have turned to a life of crime because they are products of broken homes, or they may come from a background of abuse, so they join gangs or exhibit behavior that is more for survival like stealing to eat and selling drugs to live. These issues are totally unrelated to mental illnesses,” Anderson said. The plan set forth by Commissioner Earlean Collins and the Criminal Justice Committee recommends special services for homeless veterans, expansion of crisis intervention teams throughout the city, a re-visitation of mandatory sentencing laws, crime prevention and intervention, and funding for education programs for students who live in high crime areas. “Majority of these issues are so overwhelming that it has to be a collaborative effort from hospitals, social services, churches, the government and police. Everyone has a role to play. Most importantly, police officers should be properly trained to understand the difference between a person with bad behavior versus someone who is mentally ill and need to be admitted into a healthcare facility for medical treatment opposed to being thrown into prison,” Anderson said. For more information about behavioral health disorders, or to receive treatment, contact Loretto Hospital’s Behavioral Health Center at 773-854-5320. Sources: Institute of Medicine, 2006, American Psychiatric Association, 1994 9 2 11 Healthy Connections Letter from the CEO I have exciting news to share with the Austin Community about Loretto Hospital’s continued progress. In my last letter, I addressed the importance of Loretto maintaining its integrity to 645 South Central Avenue Chicago, IL 60644 (773) 626-4300 our mantra “Loretto Cares” because it is the heartbeat of our organization and truly displays how much we value our patients and our commitment to Dr. Sonia Mehta, CEO/CMO providing quality healthcare. Medical Detox Program and Services Residential Rehabilitation Treatment 24-Hour Admissions, Seven Days a Week Intensive Outpatient (IOP), Traditional Outpatient, and Continuing After Care Onsite Services Include: DUI Evaluation Services, Compulsive Gambling Assessment and Education, Family HIV Support Program, Comprehensive Family Education Program, Active Alumni Group and Open Self-Help Groups (A.A., N.A, C.A., ALANON) Experienced and Compassionate Physicians, Nurses, Social Workers and Counselors Transportation Available Medicaid, Medicare and Most Private Insurance Accepted With this said, I am so proud to announce that earlier this year, Loretto Hospital was among several Illinois hospitals that had dramatically improved its scores in the areas of hospital safety and quality according to a recent report issued COMING SOON: by the Leapfrog Group, a nonprofit organization based in Washington, D.C., Loretto Hospital Youth Council quality health care. Loretto Hospital was one of the few safety-net hospitals For more information contact Thrishka McKinnor at 773-854-5337. that rates hospitals nationwide to help steer organizations towards higher on Chicago’s west side to receive a grade of ‘B’ or better. Receiving a grade To Find Out How We Can Help! of ‘B’ is proof that Loretto is striving to be the hospital of choice for this Call Central Intake at (773) 854-5445 community, as well as makes us stakeholders in promoting service excellence or the Clinical Outreach Coordinator at (773) 339-6421 and outstanding care to all of our patients and the communities we serve. We have added a new staff at the hospital to continue promoting our internal slogan, Raising the Bar in Service Excellence. We have recently hired a new chief nursing officer who has a wealth of experience in all areas from behavior health to pediatric care. We have also added the role of chief experience officer (CXO) to our roster. The CXO will play a crucial role in improving the hospital culture and interactions between our patients, their families and visitors within all levels of the organization. Our promise is to continue to build the right internal infrastructure to ensure that “Loretto Cares” remains the very essence of what we truly believe and stand for as healthcare professionals. Additionally, we have added new highly experience physicians to our staff of doctors which include a new orthopedic surgeon, general surgeon, OBGYN, as well as a geriatric specialist. October is National Breast Cancer Awareness Month as well as National Dr. Mark Benjamin to our hearts, we have provided a wealth of information regarding breast 40 Years of Experience Mental Illness Awareness observance. Since both subjects are near and dear cancer and mental illnesses. We also highlight facts about depression, flu season, inner city crime, and review many of our community initiatives we have had over the past several months. Sincerely, Specialty services include: Ophthalmology Cataract Surgery Glaucoma filtering surgery LASIK corrective eye surgery Dr. Sonia Mehta Chief Executive Officer/Chief Medical Officer Loretto Hospital To schedule an appointment, call the Ambulatory Care Clinic at 773-854-5475. Hospital Happenings... Healthy Connections Austin Satellite Senior Center Health Education Classes Held every Wednesday throughout the year. Call 773-854-5306 for more information. Golden Life Senior Birthday Celebrations A Publication for Friends of Loretto Hospital • 645 S. Central Ave. • Chicago, IL 60644 • Fall 2013 • 773-626-4300 • www.lorettohospital.org Held quarterly. We want to hear from you. Call 773-854-5306 for more information. Open House Send us your questions October 24, 2013, 10 a.m.- 2 p.m. or comments to: marketing@lorettohospital.org Visit with Santa December 7, 2013, 10 a.m.- noon Behavioral Health Disorders Treated as Criminal Mentally ill and drug addicts linked to inner city violence may be a form of discrimination. Inaccurate beliefs about the link between mental illness and violence have led to widespread stigma and discrimination against people with behavioral health disorders. The discrimination and stigma associated with mental illnesses may stem from the way the entertainment industry and the news media portray people with behavioral health disorders as being the most dangerous of all demographic group. Kiss the Wall Celebration (Honoring survivors of cancer) According to Mental Health America, an organization that addresses the full spectrum of issues associated with mental illnesses and substance use, many TBD news stories about people with mental illnesses are portrayed negatively. However, the vast majority of people with mental illness do not exhibit criminal behavior. Healthy Connections is a publication of Loretto Hospital. For more information about Loretto Hospital call 773-626-4300. Photo credits: 123RF and Microsoft.com Free Images. Newsletter design by Business Image Development, Inc.. Copyright © 2013, Loretto Hospital, All Rights Reserved. “Most mentally ill people in the streets are not violent. Take for instance people with schizophrenia or people with bi-polar disorders, they are usually very harmless,” said Addie Anderson, director of outpatient mental health at Loretto Hospital, during a recent intergovernmental taskforce public hearing organized by Cook U.S. Postage Place Stamp Here Country Commissioner Earlean Collins (1st District). 645 S. Central Avenue Chicago, IL 60644 and governmental sectors offered their input on how to reduce crime as proposed by the Criminal Justice Committee of Cook County. The proposal examined the role the mentally ill, substance abusers and the homeless may play in violence throughout the City. “There is a condition known as oppositional defiance disorder, but even individuals with Mailing Label Here No woman this condition are not necessarily violent,” Anderson said. Opposition Defiant Disorder (ODD) is a childhood condition with common features of excessive, often persistent anger, frequent temper tantrums or angry outbursts, as well as disregard for authority. Children and adolescents with ODD often purposely annoy wants to hear that she has breast cancer. But the sooner the cancer is found, the better her prognosis. During that hearing, leaders from various professional Is it time for your mammogram? Women with smaller tumors and cancer that hasn’t spread beyond their breasts more often survive the disease. Screening catches cancer early, when treatment can be more successful. Talk with your doctor about the screening schedule that’s right for you. For women at average risk, getting a mammogram every other year after age 50 may work best. Medical advances have made breast cancer treatment more effective than ever before. Every year, almost 300,000 American women will receive a breast cancer diagnosis. With proper treatment, many of them will soon join the ranks of the 2.6 million breast cancer survivors. These women have heard these four joyful words: “You’re now cancer-free.” use this trait to simply show the adults in their life that they are in control. For more information about how you can obtain your annual mammogram, contact Loretto Hospital’s Mammography Department at 773-854-5233. (Continued on Page 3) Source: American Cancer Society others, blame others for their own mistakes, and are easily disrupted. Most children with ODD are very strong willed and tend to