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Winter— VIDEO GAMES Getting to Know PAs & NPs Winter is prime time for people to catch the influenza (flu) virus, which causes the all-too-familiar symptoms of coughing, fatigue, fever, muscle soreness and a stuffy nose. "It is not entirely clear why influenza circulates in the winter months, but a major reason may be that people are in closer contact for longer periods of time when it's cold outside, allowing for increased transmission," says Harold Horowitz, M.D., infectious disease specialist at NewYork- Presbyterian Brooklyn Methodist Hospital. "Other possible explanations include immune system changes due to lower vitamin D levels from less sun exposure, drier mucous membranes from less moisture in the air—which decreases clearance of the virus from nasal passageways—and the lower humidity and temperatures of winter that allow the virus to survive longer on surfaces." The single most important preventive step to reducing the risk of catching or spreading the flu is to receive an annual flu shot. People age 65 and older may be eligible for a high-dose flu vaccine or a vaccine made with MF59 adjuvant (an added medicine)—both of which are believed to provide greater protection than the standard flu shot. In addition to the flu vaccine, some measures that lessen the risk of developing the flu are coughing or sneezing into a tissue or a shirt sleeve instead of the hand, and cleaning hands with soap and hot water or hand sanitizer—especially after touching shared surfaces. Amblyopia, or lazy eye, occurs when one eye is unable to focus as well as the other due to causes like a muscular imbalance in the eye or significantly different vision in each eye because of nearsightedness, farsightedness or a cataract (clouding of the eye's lens). "In cases of amblyopia, the brain can be trained to better use the eye," says Robert Feig, M.D., ophthalmologist at NYP Brooklyn Methodist. "If the underlying amblyopia is corrected, the person will be able to see normally out of both eyes." The most popular traditional treatment for amblyopia is to use an eye patch to cover the dominant eye with the goal of strengthening the affected eye, but some research shows that playing video games while wearing an eye patch or special goggles that encourage both eyes to work together may be more effective for this purpose. This is believed to help because video games tend to capture and hold the attention of players, enticing them to exercise the brain and eyes to a greater extent than other activities. Video games designed specifically to treat amblyopia utilize high- and low-contrast images to help strengthen connections between the brain and the eyes. These games are expected to be available for purchase in 2018, but virtual reality-based games are available now through vision centers. When used in conjunction with an eye patch or goggles, some off-the-shelf video games, including falling block games and aiming games, may also help improve amblyopia. You have seen them at offices where medical services are provided, and maybe even scheduled an appointment with one—but do you understand the role of physician assistants (PAs) and nurse practitioners (NPs)? "One misconception is that PAs and NPs are 'doctors' helpers,'" says Brian Wilkow, P.A., director of physician assistant services at NYP Brooklyn Methodist. "But actually we're advanced practice clinicians. PAs and NPs are extensions of physicians. For the most part, a treatment by one of them doesn't look different from that of a primary care doctor." PAs earn advanced degrees in medicine, and NPs earn advanced degrees in nursing. Both complete internships in a variety of medical environments as part of their training, and both enhance patient care and often spend additional time explaining diagnoses, lifestyle change advantages and treatment plans to patients. "NPs can practice independently or as part of a care team with doctors," says Howard Guia, N.P., nurse practitioner in the cardiothoracic surgery department at NYP Brooklyn Methodist. "In my job, I work with a team of intensivists [intensive care doctors] and cardiac surgeons, helping with the pre-op and post-op care of cardiothoracic surgery patients. I also focus on patient discharge planning, following Hospital and national protocols to help guide and encourage patients to safely return home after a hospital stay." for AMBLYOPIA FLU'S FAVORITE SEASON WINTER 2018 W W W.N Y P.O RG / BRO OKLY N 6 I N S I G H T S