Take a chill pill if you want to avoid the flu this year

Along with snow and frigid temperatures, the winter months also bring coughs, colds and the flu. Lower respiratory tract infections, the ones that cause feelings of chest congestion despite the deepest coughs, are one of the top 10 causes of death in the United States and around the world.

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Avoiding stress could help stave off the flu. Sick woman via www.shutterstock.com.

Along with snow and frigid temperatures, the winter months also bring coughs, colds and the flu. Lower respiratory tract infections, the ones that cause feelings of chest congestion despite the deepest coughs, are one of the top 10 causes of death in the United States and around the world. In the U.S. the flu alone kills thousands of people each year.

Besides causing poor health, the flu and other respiratory illness also have a huge impact on the economy. A study published in 2007 suggests that flu epidemics account for over US$10 billion per year in direct medical care costs, while lost earnings due to illness account for an additional $16.3 billion per year. And that doesn’t cover run-of-the-mill colds and coughs. The total economic impact of non-influenza viral respiratory tract infections is estimated at another $40 billion per year.

Avoiding the flu or catching a cold in the winter months can be tough, but there is something you can do in addition to getting the flu shot and washing your hands.

Relax. There’s strong evidence that stress affects the immune system and can make you more susceptible to infections.

Big doses of stress can hurt your immune system

Health psychologist Andrew Baum defined stress as “a negative emotional experience accompanied by predictable biochemical, physiological, and behavioral changes that are directed toward adaptation.” Scientists can actually measure the body’s stress response – the actions the body takes to fight through arduous situations ranging from difficult life events to infections.

In most stress responses, the body produces chemicals called pro-inflammatory cytokines. They activate the immune system, and without them the body would not be able to fight off bacteria, viruses or fungi. Normally the stress response is helpful because it preps your body to deal with whatever challenge is coming. When the danger passes, this response is turned off with help from anti-inflammatory cytokines.

However, if the stress response cannot be turned off, or if there is an imbalance between pro-inflammatory and anti-inflammatory cytokines, the body can be damaged. This extra wear and tear due to the inflammation from a heightened stress response has been termed allostatic load. A high allostatic load has been associated with multiple chronic illnesses, such as cardiovascular disease and diabetes. This partly explains the focus on taking anti-inflammatory supplements to prevent or treat disease.

Short-term stress hurts too

An inappropriate stress response can do more than cause chronic illness down the road. It can also make you more susceptible to acute infections by suppressing the immune system.

For example, when mice are subjected to different environmental stressors, there is an increase in a molecule in their blood called corticosterone, which is known to have immunosuppressive effects on the body. This type of response is mirrored in research on humans. In a study of middle-aged and older women, stress from being instructed to complete a mental math or speech test was associated with higher levels of similar immunosuppressive molecules.

A similar response has been documented among medical students. A 1995 study showed that the students who reported “feeling stressed” the most during exam periods also had the highest levels of molecules with immunosuppressant characteristics.

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Stress won’t make you healthier.
Stressed out man image via www.shutterstock.com.

Stress makes it easier to get sick

There is also direct evidence that stress can increase risk of infection. For instance, a group of scientists in Spain used surveys to assess stress in 1,149 people for a year and then measured how many colds occurred within the group. They found that every dimension of stress they measured was associated with an increased risk for getting the common cold. While this study’s large sample size and design make it particularly noteworthy, the relationship between colds and stress has been reported since the 1960s.

canada goose More recently, we presented a study that calculated allostatic load scores in over 10,000 people that were a part of the National Health and Nutrition Examination Survey between 1999 and 2002. We searched for associations between those allostatic load scores and the likelihood of having reported symptoms of a communicable disease, like the common cold. We found that the higher the score, the more likely an individual was to have reported symptoms of illness.

While causality cannot be completely confirmed in the type of analysis we conducted, our calculations included multiple biological and clinical markers that would not likely have been significantly impacted by short-term illnesses alone. This suggests that the correlation between allostatic load score and disease symptoms was not simply due to the stress of having an illness.

Our results mirror what is generally accepted in the field. There are whole book chapters dedicated to describing the impacts of stress and infection risk. All this evidence seems to suggest that stress reduction might lead to a healthier cold and flu season.

A prescription for relaxation

While there are medications that can treat the flu, the latest evidence suggests they are only marginally effective at relieving symptoms and may have no impact on reducing the rate of hospitalizations. And Vitamin C, which is often touted as an over-the-counter cold remedy, has little impact on the incidence of the common cold according to the latest compilation of studies from the Cochrane Collaboration, an independent network of scientific researchers.

So keeping stress at bay might be a better bet for staying healthy. But besides just remembering to take deep breaths, participating in activities to reduce stress during the winter months has been shown to help reduce the burden of respiratory illnesses. This may include making good on that New Year’s resolution to get to the gym. In fact, a recent randomized controlled trial concluded that those who exercised or meditated had fewer severe acute respiratory illnesses than did a control group that did neither.

canada goose It may also help to talk to somebody, such as your physician or a psychologist, about techniques to manage stress. In a clinical trial done with children between the ages of 8-12, those who talked with therapists about relaxation management had improved mood and decreased frequency of colds. On a cellular level, those in the therapist group had increased levels of secretory immunoglobulin A, one of the molecules that is responsible for protecting mucosal surfaces, like the lung, from infection. These types of relaxation techniques are not just for kids. Review articles conclude relaxation techniques are an important therapeutic strategy for stress-related diseases.

canada goose canada goose Cold and flu season is here, but getting worried about it might only hurt your chances of staying healthy. Instead, consider how stress hurts your immune system, and write yourself a prescription for relaxation.

canada goose celine handbags The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

Read the Original Article at TheConservation.com

We can avoid weight creep – here’s how

Many of us enter a new year reflecting on where we have been and our plans for the future. For some, this will mean acknowledging that a couple more kilos have crept on over the past year.

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Walking briskly for at least 30 minutes on most days of the week is a good start. etorres/Shutterstock

celine handbags canada goose Many of us enter a new year reflecting on where we have been and our plans for the future. For some, this will mean acknowledging that a couple more kilos have crept on over the past year. Others will have health on their hit list for 2016; resolving to eat better and lose weight could be part of that.

canada goose It can be difficult to lose weight and keep it off in the long term. So how can we support communities to avoid weight gain over time?

New research published today in PLOS Medicine suggests that simple lifestyle programs can help prevent weight gain. But GPs, communities and individuals also have a role to play.

It’s OK to aim low

Even a small weight loss can result in positive health impacts. It has been estimated that a 1% reduction in body mass index (BMI) – the equivalent to approximately 1kg for an average adult – across the United States population would avoid 2 million cases of diabetes, 1.5 million cardiovascular diseases, and more than 73,000 cases of cancer.

It is the norm to be overweight or obese in Australia. Figures released last month showed 63% of adults (71% men, 56% women) and 27% of children were in this category in 2014/15. Further, rates of obesity in women in Australasia are growing faster than anywhere else in the world.

Challenging the accepted dogma that we will gain weight as we age was put to a recent meeting of the Queensland Clinical Senate, which helps set the agenda for long-term health strategies. The resolution of the meeting, convened with Health Consumers Queensland, was to focus on preventing weight gain in the community, rather than weight loss, particularly given the problems faced in achieving the latter.

Lifestyle programs

canada goose In today’s study, the researchers randomly assigned 649 women in 41 rural Australian towns to either the intervention group or the control group.

Women in the intervention group took part in information sessions, received a personalised self-management plan, were sent monthly text message reminders and undertook a 20-minute phone-based coaching session.

Women in the control group attended a general session on women’s health.

Over 12 months, the women in the towns who received the targeted intervention program lost almost half a kilogram, while those in the control towns gained almost half a kilo.

This shows that delivering programs with community integration, a focus on small changes in behaviour, self-management, and minimal burden on the participants using a mix of personal and electronic modes of delivery, can be feasible, cheap and effective.

Role of GPs

General and nurse practitioners play an important role in providing advice and strategies on healthy and active lifestyles to prevent and manage obesity.

However, a Monash University study, published in The Medical Journal of Australia, found GPs recorded the weight of only 25.8% of a sample of 270,426 patients. Some of the barriers for recording this information are difficulty in approaching the discussion and a perceived lack of available training.

It is important for governments to support all health-care providers to be able to raise the issue of weight control – not just with those who are overweight or obese, but also to encourage those who are a healthy weight to remain in that category.

canada goose Guidelines for health professionals already exist, however, better integration with community programs (particularly those which offer social benefits), referral to tailored services and alignment with mass media campaigns are likely to add enormous value at relatively low cost.

There is no single strategy that will address excess weight and obesity in our community. But health professionals are important influencers. Empowering this group with effective, low-intensity strategies and programs is one element of a comprehensive approach to address poor diets and weight issues.

Community response

Another key element is to support communities to create healthy environments, to make the healthy choice the easy choice. Schools, workplaces, sports and community centres are all environments that should support healthy eating and active lifestyles.

If communities are funded and empowered, such as through the OPAL (Obesity prevention and lifestyle) program in South Australia and Healthy Together Victoria, they can link into statewide programs but also develop local solutions to solve the unique issues that exist in their catchment.

canada goose Recently we saw the funding removed from the National Partnership Agreement on Preventive Health, which provided valuable investment for the implementation of policies and programs to support healthy lifestyles. Funding to support community based initiatives so local populations can engage this issue is critically important, along with the implementation of policies such as reducing junk food marketing to children, mandatory health star labels and taxing sugary drinks.

Individual action

In the meantime, how can individuals who regularly pledge to get fit and lose weight make sustainable and significant healthy changes, as the women in today’s rural Australia study have done?

celine bags Aiming to avoid weight gain is a good starting point, followed by small lifestyle changes, such as:

  • reducing serving sizes
  • aiming for two serves of fruit and five serves of vegetables a day
  • reducing sugary drinks
  • walking briskly for at least 30 minutes on most days of the week.

These changes can make a big difference to your risk of weight gain and developing serious health problems in the future.

Jane Martin does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

Read the Original Article at TheConservation.com

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It’s that time of year when many are trying, and some are failing, to live up to their New Years’ resolution of losing weight.

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‘Despicable Me 3’ is a movie genre Adventure, was released in June 29, 2017. Kyle Balda was directed this movie and starring by Steve Carell. This movie tell story about Gru and his wife Lucy must stop former ’80s child star Balthazar Bratt from achieving world domination.

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John Wick: Chapter 2(2017)

Over the last few decades, medicine has witnessed a sea change in attitudes toward chronic pain, and particularly toward opioids. While these changes were intended to bring relief to many, they have also fed an epidemic of prescription opioid and heroin abuse.

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Movie ‘John Wick: Chapter 2’ was released in February 8, 2017 in genre Thriller. Chad Stahelski was directed this movie and starring by Keanu Reeves. This movie tell story about John Wick is forced out of retirement by a former associate looking to seize control of a shadowy international assassins’ guild. Bound by a blood oath to aid him, Wick travels to Rome and does battle against some of the world’s most dangerous killers.

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Why isn’t learning about public health a larger part of becoming a doctor?

Chronic conditions, such as Type II diabetes and hypertension, account for seven in 10 deaths in the United States each year. And by some estimates, public health factors, such as the physical environment we live in, socioeconomic status and ability to access health services, determine 90% of our health.

Public health isn’t a standard part of medical school curricula. Medical school class images via www.shutterstock.com.

Chronic conditions, such as Type II diabetes and hypertension, account for seven in 10 deaths in the United States each year. And by some estimates, public health factors, such as the physical environment we live in, socioeconomic status and ability to access health services, determine 90% of our health. Biomedical sciences and actual medical care – the stuff doctors do – determine the remaining 10%.

Clinical medicine can treat patients when they are sick, but public health provides an opportunity to prevent disease and poor health. But too often, medical students don’t get to learn about public health, or how to use it when they become doctors. That means many of today’s students aren’t learning about health care in a broader context.

Why doctors need to know about public health

What should a physician do if patients are unable to visit a physician because their workplace doesn’t give them sick days? What about an obese individual who has trouble following healthy eating recommendations because their neighborhood doesn’t have a grocery store?

If we want the next generation of medical professionals to understand why some patients have an easier time following a care plan than others, or understand what causes these conditions so we can prevent them, medical schools need to look toward public health.

Epidemiology, a core discipline within public health, emphasizes the study and application of treatment to disease and other health-related issues within a population. It is focused on prevention, which means understanding what makes people sick or unwell.

You might hear about epidemiologists who work on figuring out how infectious diseases spread. But they also study obesity, cancer, how our environments affect our health and more.

So a doctor with training in public health would have an understanding of how environmental, social and behavioral factors impact their patients’ health. These physicians might also draw on other medical professionals to treat individuals who are sick, and prevent sickness from occurring in the first place.Watch Full Movie Online Streaming Online and Download

Medical schools recognize that their students should learn more about public health. But according to the Association of American Medical Colleges (AAMC), about one-fourth of 2015 medical school graduates report that they intend to participate in public health-related activities during their career, and nearly one-third of graduates report that training related to community health and social service agencies was inadequate.

Putting public health into medicine

But this is slowly starting to change.

For instance, the Medical College Acceptance Test (MCAT), which all medical school applicants in the US take, used to focus on just physical and biological sciences and verbal reasoning. But in 2014 the MCAT added a new section on the psychological, social and biological foundations of behavior. The idea is to provide students with a foundation learn about what public health scholars call the social determinants of health. These are conditions and environments in which we are born, work, live and interact with others.

Students are expected to know more about public health.
Medical students image via www.shutterstock.com.

Expectations for students transitioning from medical school to their postgraduate residency are also starting to change.

The AAMC has a list of 13 activities that medical school graduates are expected to be able to do on their first day of residency. The activities (called Entrustable Professional Activities, or EPAs) integrate, among other core competencies, principles of public health into everyday practice. They include guidelines for working with individuals who have different belief systems, patient-centered practice and understanding how to access and use information about the needs individuals have and the community resource available to them.

Having students make house calls

At the University of Florida, where I teach, population health-based topics are integrated into our medical school curriculum, and also into curricula for other health professions.

Each fall, 700 first-year health science students studying everything from dentistry to clinical psychology, health administration, pharmacy, nursing and more take part in a service learning project with local families.

Students complete coursework about public health, but they are also assigned to work with a family through the year. Students make a series of home visits, which means that they can see, firsthand, how the family’s home environment shapes their health. Because the project includes students from all the health professions, it helps them understand each other’s roles and responsibilities in providing care.

In these visits, students get a chance to see the myriad factors that can make it easier or harder for a patient to follow the care plan their doctor prescribes. Students may learn that their patients have priorities in life that come before monitoring their own health. And for many students, this may be the only home visit that they make during their entire career.

For instance, a team of our students were humbled to learn that one of the patients they visited, a woman with severe hypertension and Type II diabetes, put her desire to provide Christmas presents for the six grandchildren she was raising over her medication adherence or her glucose monitoring. She was more focused on her grandchildren than spending time on monitoring her health and taking medications.

These home visits show students how complex their patients’ lives really are. And that give these future doctors a perspective on their patients that they may never get in a clinical visit.

Other medical schools putting public health on the agenda

The University of Florida isn’t the only medical school investing time and energy to explore new methods to teach students about public health.

Some are adopting dual-degree models that allow medical students to earn degrees in both public health and medicine. Often, these programs extend students’ training by 12 months, but some institutions, like the University of Miami and the University of Texas Health Science Center at San Antonio, have developed four-year dual-degree programs.

Other institutions, such as the University of Illinois and Florida International University, are integrating population and public health perspectives throughout their curricula, to make sure that all students learn about public health.

Erik Black does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

Read the Original Article at TheConservation.com

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Measuring up: this year, aim for fitness over fat loss for long-term success

Getting fit and losing weight are consistently among the top New Year’s resolutions, and January is the boom period for the billion-dollar gym industry.

January is the boom period for the billion-dollar gym industry. Hotel Der Oeschberghof – Golf – Spa – Tagung/Flickr, CC BY-ND

Getting fit and losing weight are consistently among the top New Year’s resolutions, and January is the boom period for the billion-dollar gym industry. While any attempt to incorporate more exercise into our lives should be welcomed, it’s time to rethink the reasons for joining the gym. And, in particular, the way we measure success when it comes to exercise.

Weight loss is one of the most common reasons why people start an exercise program, linking sweating it out with reduced fat. Sadly, they’re setting themselves up to fail because there’s good evidence that exercise in the absence of dietary modification is not all that effective for weight loss. In other words, “you can’t outrun a bad diet.”

In fact, the idea that exercise will lead to weight loss is potentially dangerous because it acts as a disincentive for people who stick to their exercise goals to only find the scales haven’t turned in their favour – and throw in the towel.

A better measure

Research published a few months ago shows the likelihood of an obese man achieving normal weight without surgery is one in 210. And the chances are only a little better for women, at one in 124. Among those who manage to lose significant weight (at least 5% of bodyweight), at least half will regain it within two years.

Weight loss is very important for improving health and reducing risk of chronic disease. But when focusing on the reasons people should be physically active and engage in regular exercise, fitness, as opposed to fatness is a better focus.

Exercise can directly improve fitness independent of changes in weight. And it may be protective of developing chronic diseases, such as type 2 diabetes, even for people who are overweight or obese. But the importance of trying to lose weight through broad lifestyle change shouldn’t be ignored.

A recent study of over 1.3 million Swedish men found that when it comes to risk of dying early, high fitness isn’t protective for people who are obese. But it showed fitness was an important factor nonetheless and didn’t measure other key health outcomes. Most importantly, improving fitness is a tangible and achievable outcome, so it’s more motivating.

Poor fitness is a modifiable factor associated with heart disease. Other benefits people may gain from exercise, apart from weight loss, include improved mental health, improved sleep and reduced risk of conditions, such as Alzheimer’s and dementia.

Helpful hints

Joining a gym may work for some, but it’s not the only way of getting the benefits of regular exercise. Here are some practical tips to get moving.

You can’t outrun a bad diet.
liebeslakritze/Flickr, CC BY-SA

1. Avoid a “all-or-nothing” mentality and remember that every bit of time spent exercising instead of being sedentary counts.

When you’re in the habit of exercising regularly, it’s easier to keep going and find the motivation to continue. But when you’ve been inactive for a while, such as over the holiday season, it’s often difficult to overcome the mindset of feeling overwhelmed and out of touch with exercising. This often leaves people feeling unsure about where to begin.

To avoid feeling lost, try setting some realistic, and achievable goals that can be written down and achieved every day. Plan for the worse-case scenario (such as those extra long lunches). Even one set of squats, five minutes of yoga, or a brief walk around the block may be enough to avoid the build-up of post-holiday exercise fear.

2. Seek help getting active, especially if you have a chronic or complex medical conditions. Australia has one of the most progressive physical activity referral schemes in the world, which means people with chronic conditions can be referred to accredited exercise physiologists or physiotherapists to receive individualised exercise programs.

If weight loss is your primary aim, seek help from an accredited practising dietitian to help modify your diet.watch full Fifty Shades Darker film

3. When it comes to exercise, forget the scales and focus on moving more and sitting less. Wearable technology can help with monitoring and goal setting.

Use other ways of measuring progress, such as how breathless you feel after walking up that set of stairs or how much easier it is to carry the groceries, as well.

4. Don’t forget resistance training (muscle building exercise). Working muscles is not only for young men; it has considerable benefits for men and women of all ages.

Most importantly, the best exercise program is the one that’s realistic for your situation, enjoyable and progressively more challenging. And it’s not necessarily one limited to the gym.


This article is part of our series about New Year’s resolutions, A Fresh Start.

Simon Rosenbaum is funded by a Society for Mental Health Research Early Career Fellowship. He is a National Director of Exercise and Sports Science Australia.

Read the Original Article at TheConservation.com

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In spite of the bad press, stored fat is actually a really wonderful thing. Without the capacity to store energy in the form of fat, we would have been unlikely to survive through millions of years of evolution and we would certainly look very different to the way we look today.

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‘Lion’ is great film tell story about A five-year-old Indian boy gets lost on the streets of Calcutta, thousands of kilometers from home. He survives many challenges before being adopted by a couple in Australia; 25 years later, he sets out to find his lost family. This film have genre Drama and have 118 minutes runtime.

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The Director of this movie is Garth Davis. The film Lion is produced by The Weinstein Company, Screen Australia, Sunstar Entertainment, See-Saw Films, Aquarius Films and released in November 24, 2016

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We’ve known for a long time that aspirin can help prevent damage from a heart attack or a stroke if taken during one of those events.

What’s the harm? Aspirin via www.shutterstock.com.

We’ve known for a long time that aspirin can help prevent damage from a heart attack or a stroke if taken during one of those events. In fact, you might have seen ads about how aspirin can be lifesaving during a heart attack.

Research backs that up. For people who have already experienced a heart attack or stroke, a daily aspirin regimen can actually prevent future heart attacks and strokes.

But, as helpful as aspirin is to prevent recurrent heart attacks or strokes (this is called secondary prevention), a daily aspirin has long been controversial to prevent a first heart attack or stroke (this is called primary prevention).

To use aspirin for primary prevention, doctors are supposed to assess a patient’s risk of a first heart attack or stroke and decide when benefits of aspirin outweigh risks. But new draft guidelines for aspirin use have created confusion about who, exactly, should actually take aspirin.

What do the new draft guidelines say about aspirin?

The new draft guidelines from the United States Preventative Services Task Force recommend adults between the ages of 50-59 take aspirin if they have at least a 10% 10-year risk of having a heart attack or stroke as measured by a risk calculator .

For people 60-69, the task force says there is less benefit compared to for those ages 50-59, but that aspirin should still be used as long as there is a low risk of bleeding as a side effect.

But for patients younger than 50 or older than 70, the task force decided there was not enough evidence to make a recommendation about using aspirin. This is a major departure from the 2009 recommendation, which suggested use in all adults between the ages of 45-79 with an elevated risk of a heart attack or stroke.

This change happened in part because of a push to make medical guidelines strictly evidence-based. Right now, there are no randomized trials comparing aspirin to placebo in adults older than 70 or younger than 50. Without evidence, you can’t have evidence-based recommendations.

Basing guidelines strictly on evidence makes sense, but clinical trials are rarely perfect, and recommendations on how to use drugs need to make sense to primary care providers in order to avoid confusion.

What do the data say about aspirin for primary prevention?

Early trials that treated patients with aspirin during a heart attack or stroke found they were more likely to survive. But these trials also found that leaving patients on aspirin for months and years afterwards reduced future heart attacks and strokes.

For every 100 patients who’ve had a heart attack or stroke and stay on a daily aspirin, five recurrent heart attacks or strokes are prevented in the next year. While there is a small risk of serious bleeding with aspirin (mostly stomach bleeding, but also bleeding in the brain), fewer than one in 100 patients experience this. Therefore, everyone agrees that the benefits of aspirin outweigh the risks for people who have had a heart attack or stroke.

But for patients with no history of a heart attack or stroke, the data say that the risk of serious bleeds and the benefit of reducing heart attacks and strokes are about equal for a population of middle-aged and older adults.

According to the new calculations in the task force guidelines, for every 100 men 55-60 years old with an average risk of a first heart attack or stroke of 1% per year, starting a daily aspirin would have a lifetime effect of avoiding about two heart attacks and one stroke among those 100 men, but causing about three serious stomach bleeds and about one hemorrhagic stroke.

What do the new guidelines mean for you?

The draft guidelines from the Preventative Services Task Force might not offer a lot of clear yes’s and no’s about who should and shouldn’t take aspirin for primary prevention. And guidelines from other groups offer differing advice.Watch Full Movie Online Streaming Online and Download

Guidelines from The American Heart Association, American College of Cardiology and American Diabetes Association all endorse aspirin for primary prevention in certain higher-risk patients. However, the Food and Drug Administration denied a petition from the aspirin manufacturer Bayer Inc for wording on their label that said aspirin could prevent heart attacks and strokes for people who had never had them.

And the European Society of Cardiology does not endorse aspirin for primary prevention for any patient – even those at high risk.

But, the “over-the-counter” availability of aspirin means that Americans, many Europeans and potential patients all over the world can decide for themselves whether or not to take aspirin. And many are deciding to do so. A national survey that we published in 2015 showed that nearly half of all US adults without CVD indicated that they “regularly” used aspirin as a preventive therapy.

So what should patients do? If you are over the age of 40 and don’t have a history of cardiovascular disease, check your predicted 10-year risk of CVD.

If your individual risk is greater than 10%, talk to your doctor about taking aspirin. Patients who don’t have a risk of bleeding could be considered good candidates for therapy, but they should understand that the odds of a serious bleed are about the same as the odds of preventing a heart attack or stroke. Not all patients will want to take the trade-off.

For patients who are under 70 with a CVD risk of less than 10%, aspirin therapy should generally be avoided.

While it is widely believed that these new task force recommendations will cut down on how many people go on an aspirin regimen in the US, that remains to be seen. It depends whether busy primary care providers read and agree with the guidelines, and then translate them into clinical practice.

Craig Williams does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

Read the Original Article at TheConservation.com

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Sugar isn’t just empty, fattening calories — it’s making us sick

Children are manifesting increased rates of adult diseases like hypertension or high triglycerides. And they are getting diseases that used to be unheard of in children, like Type 2 diabetes and fatty liver disease.

Don’t add sugar. Sugar bowl via www.shutterstock.com

Children are manifesting increased rates of adult diseases like hypertension or high triglycerides. And they are getting diseases that used to be unheard of in children, like Type 2 diabetes and fatty liver disease. So why is this happening?

Everyone assumes this is the result of the obesity epidemic – too many calories in, too few out. Children and adults are getting fat, so they’re getting sick. And it is generally assumed that no one specific food causes it, because “a calorie is a calorie”.

I’ve been studying the role that sugar plays in contributing to chronic disease for years, and my research group at the University of California, San Francisco has just published research in the journal Obesity that challenges this assumption. If calories come from sugar, they just aren’t the same.

Diabetes is increasing faster than obesity

It’s clear that the cause of rising rates of health conditions like Type 2 diabetes isn’t as simple as people just eating too many calories.

Obesity is increasing globally at 1% per year, while diabetes is increasing globally at 4% per year. If diabetes were just a subset of obesity, how can you explain its more rapid increase?

And certain countries are obese without being diabetic (such as Iceland, Mongolia and Micronesia), while other countries are diabetic without being obese (India, Pakistan and China, for instance). Twelve percent of people in China have diabetes, but the obesity rate is much lower. The US is the fattest nation on Earth and our diabetes prevalence is 9.3%.

While 80% of the obese population in the US is metabolically ill (meaning they have conditions like diabetes, hypertension, lipid problems and heart disease), 20% is not. Conversely, 40% of the normal weight population has metabolic syndrome.

If normal weight people have these conditions, how then are they related to obesity? Indeed, we now know that obesity is a marker rather than a cause for these diseases.

Epidemiological studies have found a correlation between added sugar consumption and health conditions like cardiovascular disease. So could cutting excess sugar out of our diets reverse metabolic syndrome?

What happens when you stop feeding kids added sugar?

Our group at UCSF studied 43 Latino and African-American children with obesity and metabolic syndrome over a 10-day period. We started by assessing their metabolic status – insulin and glucose levels, as well as blood fats and other markers for disease, like lactate and free fatty acids – on their home diet.

For the next nine days, each child ate an individual tailored diet. We catered their meals to provide same number of calories and protein and fat content as their usual home diet. We gave them the same percentage of carbohydrate, but we substituted starch for sugar. The big difference: this special diet had no added sugar. This means their diet had no sugar from sugarcane or high fructose corn syrup. The kids consumed foods such as fruits and other whole foods that naturally contain some sugar. These foods also have fiber, which reduces the rate of sugar absorption, so they don’t affect the body the same way that added sugar does.

We took chicken teriyaki out. We put turkey hot dogs in. We took sweetened yogurt out. We put baked potato chips in. We took donuts out. We put bagels in. We gave them unhealthy processed food, just with no added sugar. Each child was given a scale to take home, and if their weight was declining, we made them eat more. Then we studied them again.

The children had eaten the same number of calories and had not lost any weight, and yet every aspect of their metabolic health improved. With added sugar cut out of their diet for 10 days, blood pressure, triglycerides, low-density lipoprotein (LDL, or “bad cholesterol”), insulin sensitivity and glucose tolerance all improved. And remember, we weren’t giving them just leafy greens and tofu – we fed the kids processed foods, just ones without sugar.

Further studies are needed to see if this will also work in adults, and if the benefits are short-term or long-term.

Sugar is like alcohol

This study demonstrates that a calorie is not a calorie, and that sugar is a primary contributor to metabolic syndrome, unrelated to calories or weight gain. By removing added sugar, we improved metabolic health.

Sugar may not be the only contributor to chronic disease, but it is far and away the easiest one to avoid. Kids could improve their metabolic health – even while continuing to eat processed food – just by dumping the sugar. Can you imagine how much healthier they’d be if they ate real food?

The naysayers will say, “But sugar is natural. Sugar has been with us for thousands of years. Sugar is food, and how can food be toxic?”

Webster’s Dictionary defines food as:

material consisting essentially of protein, carbohydrate, and fat used in the body of an organism to sustain growth, repair, and vital processes and to furnish energy.

Sugar by itself furnishes energy, and that’s about it. In that sense, sugar is like alcohol. It’s got calories, but it’s not nutrition. There’s no biochemical reaction that requires it. And at high doses, alcohol can fry your liver.

Same with sugar. Fructose, the sweet molecule in sugar, contains calories that you can burn for energy, but it’s not nutrition, because there’s no biochemical reaction that requires it. In excess, it can fry your liver, just like alcohol. And this makes sense, because where do you get alcohol from? Fermentation of sugar.

Too much sugar causes diabetes, heart disease, fatty liver disease and tooth decay. When consumed in excess, it’s a toxin. And it’s addictive – just like alcohol. That’s why children are getting the diseases of alcohol – Type 2 diabetes and fatty liver disease – without alcohol. But our research suggests we could turn this around in 10 days – if we chose to.

Robert Lustig does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

Read the Original Article at TheConservation.com

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Sometimes less is better – so why don’t doctors ‘deintensify’ medical treatment?

Doctors know a lot about when to start medications to treat disease. But sometimes our focus on starting medicines means we can confuse providing more care with providing better care.

Doctors know a lot about when to start medications to treat disease. But sometimes our focus on starting medicines means we can confuse providing more care with providing better care. And better care sometimes means fewer medicines, not more.

For instance, patients with high blood pressure who have lost weight or are exercising more may find that they may no longer need blood pressure pills. Patients with heartburn who take proton-pump inhibitors (such as Nexium) may do just as well with a lower dose or occasional therapy. Patients who take medications for osteoporosis may be candidates for “drug holidays.”

And as we age, our bodies process medications differently and we become susceptible to different side effects. What may have been the right treatment for a patient when she was 50 can turn out to be dangerous at 80.

That may mean many patients can have their treatment deintensified – changing or stopping medicines when they are no longer needed. But it turns out, doctors often don’t do this, even though it means patients risk fewer side effects and can avoid extra health costs. So why, and when, should a person’s drugs be deintensified?

Who benefits from having treatment deintensified?

Diabetes makes a great case study for deintensification, because patients often need treatment over the course of a lifetime. For decades, doctors have focused on treating diabetes intensively to lower their patients’ risks of developing kidney disease and other complications. But we now know that intensive treatment for diabetes, like nearly all medical treatments, can have also cause serious harm, such as low blood sugar levels, which can lead to falls and memory problems, and even death.

Many patients with diabetes may benefit from deintensification. Older patients, in particular, are more likely to experience drug side effects, and patients taking more than one medicine run a risk of harmful drug interactions. Older patients also have less to gain from intensive treatment of their diabetes because they have fewer years to develop the long-term effects of diabetes on their bodies. And as a person’s health status changes, they may need fewer – not more – medicines to manage their diabetes.

That doesn’t mean intensive treatment is bad – it just means that not every patient needs it, and some patients may need it for only a certain amount of time. For example, intensive treatment to lower blood sugar in younger people lowers their risk of developing kidney and eye disease, and other harmful long-term effects of diabetes.

So drug choices need to be individualized based on what a person stands to gain from intensive treatment, balanced against their risk of treatment side effects. Deintensifying treatment means finding the sweet spot between too much and too little medicine.

Even though many clinical practice guidelines already recognize that goals for diabetes control and other chronic conditions should be based on a patient’s individual risk and benefits of treatment, this message hasn’t gotten through to all doctors and patients. And none of these guidelines specify who should have treatment deintensification and when that should happen.

Older diabetes patients are often overtreated

Several studies have found that older patients with diabetes are often overtreated – meaning that they are taking more medications, or medications at too high doses, than they need to achieve a safe level of sugar control.

Recently, we reported that doctors deintensified medications for only a quarter of nearly 25,000 older patients with diabetes who were treated to potentially dangerously low levels of sugar control. Deintensification rates barely budged even if the patient has had low blood sugar multiple times or had severely limited life expectancy.

In patients with low blood sugar who did not have their treatment deintensified, 40% did not even have their diabetes control values rechecked within six months. This means that the majority of overtreated patients continued to take medications that they did not need or at doses that were too high.

Why don’t clinicians deintensify treatment?

Doctors usually focus on intensifying therapy to control blood sugar, which means that deintensifying treatment can take a completely new mindset.

In another study, we asked primary care providers what they thought would be appropriate treatment for a hypothetical patient in his late 70’s who has had diabetes for 20 years and also has kidney disease. The patient takes two pills every day to manage his diabetes, but could be fine just taking one of them. We found that 39% of almost 600 respondents felt that this patient would continue to benefit from stringent diabetes control – despite current expert recommendations to the contrary.

When we looked at reasons why, 42% of providers worried that not treating him intensively could harm the scores on their clinical report cards, which track the quality of care the doctors’ provide to their patients. Nearly one-quarter worried about legal liability resulting from decreasing medications.film The Hunger Games: Mockingjay – Part 2 download

Just as troubling, 30% wouldn’t deintensify the diabetes medications because they worried they wouldn’t have enough time to discuss these changes with the patient.

Finding the treatment sweet spot

This isn’t just an issue for people with diabetes – it’s an issue for anyone living with a chronic condition.

So how do we encourage appropriate deintensification in order to get to the sweet spot for treatment? There are many changes that could help.

First, health care systems should institute programs that systematically engage providers and patients to consider stopping medications that are no longer necessary.

For example, the VA has instituted a national “Hypoglycemia Safety Initiative“ to encourage appropriate deintensification of diabetes medications in order to decrease the harm of intensive treatment among those at risk for hypoglycemia (low blood sugar).

Second, patients should ask their providers if their medications are still necessary. Some could possibly be stopped or the dose decreased. Providers should regularly reexamine their patients’ medication lists and discuss the options.

As a person’s health changes, so should the medicine they take.
Prescription pad via www.shutterstock.com.

Third, while existing clinical practice guidelines already say that treatment should be based on risk and benefits for an individual patient, these guidelines should go a step further and include explicit recommendations for deintensification to help providers and patients decide when stopping a medication might be wise.

Fourth, the way we assess whether doctors are providing high-quality care should look not just at whether high-intensity treatment is provided for a patient, but also if doctors are deintensifying treatment when possible and beneficial.

Finally, we must get out the message that more is not always better. Campaigns such as Choosing Wisely®, in conjunction with Consumer Reports, educate the public about care that might not be needed, but only 21% of US doctors surveyed were aware of the campaign.

Changing the “more is better” mindset among both patients and providers will not be easy, but it will be essential if we want to ensure that patients get the treatments they need but not those that are unnecessary and potentially harmful.

Eve A. Kerr receives funding from the Veterans Health Administration, the National Institutes of Health and the Robert Wood Johnson Foundation. She is affiliated with the American College of Physicians. free hosting no ads

Jeremy Sussman receives funding from the Veterans Health Administration.

Tanner Caverly receives funding from the Veterans Health Administration.

Read the Original Article at TheConservation.com

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Movie ‘The Mummy’ was released in June 6, 2017 in genre Action. Alex Kurtzman was directed this movie and starring by Tom Cruise. This movie tell story about Though safely entombed in a crypt deep beneath the unforgiving desert, an ancient queen whose destiny was unjustly taken from her is awakened in our current day, bringing with her malevolence grown over millennia, and terrors that defy human comprehension.

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Director : Jon Gunn.
Writer : Brian Bird.
Release : April 7, 2017
Country : United States of America.
Production Company : Pure Flix Entertainment.
Language : English.
Runtime : 112 min.
Genre : Drama.

‘The Case for Christ’ is a movie genre Drama, was released in April 7, 2017. Jon Gunn was directed this movie and starring by Mike Vogel. This movie tell story about Based on the true story of an award-winning investigative journalist — and avowed atheist — who applies his well-honed journalistic and legal skills to disprove the newfound Christian faith of his wife… with unexpected, life-altering results.

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Director : Patty Jenkins.
Writer : Geoff Johns.
Producer : Charles Roven, Deborah Snyder, Zack Snyder, Richard Suckle.
Release : May 30, 2017
Country : United States of America.
Production Company : Dune Entertainment, Atlas Entertainment, Warner Bros., DC Entertainment, Cruel & Unusual Films, TENCENT PICTURES, Wanda Pictures.
Language : Deutsch, English.
Runtime : 141
Genre : Action, Adventure, Fantasy.

‘Wonder Woman’ is a movie genre Action, was released in May 30, 2017. Patty Jenkins was directed this movie and starring by Gal Gadot. This movie tell story about An Amazon princess comes to the world of Man to become the greatest of the female superheroes.

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