Cancer survivors may not get needed adult care

unduhan-66Children who’ve had cancer may be more likely to receive the follow-up care they need in adulthood if their parents take the time to teach them how to interact with doctors while they’re young, a recent study suggests.

“Parents who both act as a support for their children as they age and encourage their young adults to take responsibility for their health, for example talking to providers and understanding their health and health care, can provide a valuable balance of support and promotion of self-advocacy that is so important for young adults to stay engaged in their care,” said lead study author Dr. Dava Szalda.

Too often, adult survivors of childhood cancer don’t get appropriate care even when they do get regular checkups, Szalda, a researcher at the Children’s Hospital of Philadelphia, added by email.

“They may be seeing medical teams of some sort, but aren’t getting risk-based care which takes into account their cancer history and treatment to create a long-term follow-up plan or to provide care that addresses risk related to their prior treatment,” Szalda said.

While plenty of previous research has documented gaps in adult follow-up care for childhood cancer survivors, the current study focused on risk factors that parents and doctors of these children may be able to change.

Researchers examined data on 80 young adult survivors of childhood cancer who had finished treatment for their tumors at least five years earlier.

Participants were about 28 years old on average, and ranged in age from 23 to 36.

Most were diagnosed with cancer at around age 10, though some were babies or as old as 22.

Roughly 39 percent had leukemia, a cancer of the blood cells, and about 28 percent had lymphoma, or malignancies in the immune system. Some of them also had tumors of the brain or other solid tissue.

They were more likely to receive appropriate adult follow-up care when they were diagnosed at an earlier age, had insurance, got help with health care decision-making and felt more comfortable speaking to providers, researchers report in the Journal of Adolescent Health.

As young adults, childhood cancer survivors were more than twice as likely to get needed medical care when they understood the risk of tumors returning, the study found.

When they were comfortable discussing any concerns about their health, they were more than three times as likely to get appropriate follow-up care, the study also found.

These findings suggest that parents can boost the odds that kids get better care as adults if they encourage their children to become more involved in treatment while they’re growing up, the study authors conclude.

Beyond its small size and its reliance on data from a single hospital system, another limitation of the study is its dependence on patients to accurately recall and report on their health care utilization, the authors note.

Even so, the findings add to a growing body of evidence suggesting that parents and doctors can take steps while cancer patients are kids to increase the odds that they will get better care as adults, said Kirsten Ness of St. Jude Children’s Research Hospital in Memphis, Tennessee.

Many factors, like the long-term health risks linked to specific tumors or treatments such as radiation may not be possible to avoid, Ness, who wasn’t involved in the study, said by email.

Survivors may also not be able to influence things like whether they can afford insurance or demographic factors that might make it less likely that they receive needed care as adults, Ness said.

But there’s still plenty parents and clinicians can do, Ness said.

“Allow the child or younger adolescent to participate in discussions with pediatric provider about health risks as they are able,” Ness said.

“Get a survivorship care plan from the treating institution and hang on to it,” Ness added. “Select a primary care provider they feel comfortable communicating with.”

The dangerous of counter painkillers

unduhan-67More than 9 out of every 10 Americans use over-the-counter meds to manage pain, a new survey from the U.S. Pain Foundation found.

If you take them correctly, OTC painkillers are generally safe and effective, says Charles Vega, M.D., a clinical professor of health sciences at the University of California at Irvine.

But too many people don’t take the pills seriously—and skip the fine print on the bottle as a result, says Charles Vega, M.D., a clinical professor of health sciences at the University of California at Irvine.

“These are real medicines with real consequences,” Dr. Vega says.

Here are 5 common mistakes you might be making with your painkillers—and what might happen as a result.

PAINKILLER MISTAKE #1: YOU TAKE TOO MANY PILLS

A lot of people assume that by doubling the dosage, they’ll double the pill’s effectiveness.

But you’re probably just increasing your chances of side effects or even poisoning without getting any additional pain relief, Dr. Vega says.

Related: Gambling Addictions, Purple Sweat, Driving While Asleep—the Scary Side Effects Of Popular Meds

Lots of people learn this lesson the hard way. For example, taking too much acetaminophen—the active ingredient in Tylenol and many other OTC meds—is one of the most common causes of poisoning worldwide, the National Institutes of Health says.

“These OTC painkillers are shown to be effective at the dosage listed on the label,” Dr. Vega says.

For acetaminophen, that’s 4,000 milligrams (mg)—or 8 tablets of Tylenol Extra Strength—per day, max.

Pop two or three times the dosage of any painkiller, and you run the risk of nausea or an upset stomach, heartburn, rashes, or even liver or kidney damage, he says.

PAINKILLER MISTAKE #2: YOU TAKE PAIN MEDS TOO OFTEN

Unless you’re following a doctor’s instructions, you shouldn’t be taking OTC pain pills more than one or two days per month, Dr. Vega says.

For example, taking acetaminophen on a daily or weekly basis could raise your risk of liver failure or even death, according to the U.S. Food and Drug Administration (FDA).

And while A Daily Low-Dose Aspirin Can Help Your Heart if you’re already at risk of heart disease, it can also eat away at the lining of your stomach and gut.

In fact, daily aspirin may raise your risk of serious internal bleeding by 55 percent, a study in JAMA found.

Related: What You Should Do If You Pee Blood

So if you need painkillers on a daily or weekly basis—whether for joint pain, headaches, or something other chronic issue—see your doctor to identify your underlying problem and the best solution to actually treat it, Dr. Vega says.

PAINKILLER MISTAKE #3: YOU ASSUME ALL OTC PAIN MEDS ARE THE SAME

The active ingredient in Tylenol is different from the active ingredient in Advil (or Aleve, or Bayer). You should take each painkiller’s specific method of action into account when choosing a pain reliever—rather than just popping whatever you have in your medicine cabinet, Dr. Vega says.

For example, ibuprofen—the active ingredient in Motrin IB or Advil—works by lowering your levels of certain inflammation-causing hormones.

That makes it a great option for arthritis pain or swelling, but it might not be as effective at knocking out a headache. In that case, acetaminophen might be your best bet, since it works by interfering with your brain’s pain receptors.

One way for HIV treatment

images-43More than 18 million people now have access to life-saving AIDS treatment, 1.2 million more than at the end of last year, the United Nations said on Monday.

In a report on the AIDS pandemic, which has infected 78 million people and killed 35 million since it began in the 1980s, UNAIDS said the consistently strong scale-up of treatment has seen annual AIDS-related deaths drop by 45 percent to 1.1 million in 2015 from a peak of about 2 million in 2005.

But, as more HIV-positive people live longer, the challenges of caring for them as they get older, of preventing the virus spreading and of reducing new infections are tough, UNAIDS said, even though drugs can reduce virus levels in a patient’s blood to near zero and significantly reduce the risk of passing it on.

“The progress we have made is remarkable, particularly around treatment, but it is also incredibly fragile,” UNAIDS’ executive director Michel Sidibe said as the report was published.

With detailed data showing some of the many complexities of the HIV epidemic, the report found that people are particularly vulnerable to HIV at certain points in their lives.

It called for “life-cycle” approach to offer help and prevention measures for everyone at every stage of life.

As people with HIV grow older, they are at risk of developing long-term side-effects from HIV treatment, developing drug resistance and requiring treatment for other illnesses such as tuberculosis and hepatitis C.

The report also cited data from South Africa showing that young women who become infected with HIV often catch the virus from older men. It said prevention is vital to ending the epidemic in young women and the cycle of HIV infection needs to be broken.

“Young women are facing a triple threat,” said Sidibe. “They are at high risk of HIV infection, have low rates of HIV testing, and have poor adherence to treatment.”

The report, saying the number of people with HIV getting life-saving drugs was 18.2 million, also showed that the rapid progress in getting AIDS drugs to those who need them is having a significant life-extending impact.

Myths about making love

Like every other aspect of human health, your sex drive has been the subject of lots of scientific scrutiny. And, like every other aspect of human health, the answer experts give when asked about your libido is, “It’s complicated.”

One popular idea that’s at least partly hokum: That a man’s libido peaks when he’s young, while a woman’s jumps up in her 30s and 40s. (Here’s your essential guide to better sex at every age.)

While it’s true that some research has shown women aged 27 to 45 tend to have more sex than their younger selves, there’s little evidence a woman’s libido actually heats up during her 30s, says Susan Davis, PhD, director of the Women’s Health Research Program at Australia’s Monash University. (Looking for more simple, smart tips? Discover Prevention—and get 2 FREE gifts when you subscribe today.)

So what explains the uptick in sex that women in this age group experience? It’s possible that women in their 30s feel more comfortable with their bodies and with sex—and that the men they’re sleeping with are more competent at satisfying them, suggests research from the University of Texas. (That’s just one theory among many.)

As far as the guys go, testosterone levels play an important role in male libido. (They do for women, too.) And yes, T tends to drop steadily as a man ages. But research shows men, in general, tend to have stronger “let’s do it!” impulses than women, and that these urges don’t fall off a cliff after a guy leaves his teens. (Just never ever do these 7 things before or after sex.)

So no, men’s and women’s libidos aren’t mismatched the way popular theories would have you believe.

Here, a few more sex drive myths.

Oysters make you horny.

There is no evidence that so-called “aphrodisiac” foods crank up your sexual desire, says Debra Herbenick, PhD, director of the Center for Sexual HealthPromotion at Indiana University’s Kinsey Institute. Going out for a romantic seafood dinner with your partner might lead to some bedroom fun afterward, but it’s not because of the mollusks.

Birth control will kill your sex drive.

Davis says some women could experience a drop-off in sex drive while taking birth control. But research in the Journal of Sexual Medicine suggests some women actually experience a libido boost while taking hormonal contraceptives. As the authors of the JSM study put it, birth control has a “mixed” effect on a woman’s enthusiasm for sex.

After menopause, a woman’s libido plummets.

Again, while it’s true that some women experience a drop in libido post-menopause, 50% of post-menopausal women report no difference in sex drive compared to their pre-menopausal selves, finds a study from Rutgers Medical School. (This is how your vagina changes during menopause—and what you can do about it.)

Detects first H5N8 bird flu

The first case of H5N8 bird flu has been detected at a poultry farm in Denmark, the country’s environment and food ministry said on Monday.

About one-third of 30 ducks at a farm north of Copenhagen were killed by the same virus that had been found in Denmark in wild birds, it said.

A week ago, Danish authorities ordered farmers to keep flocks indoors after bird flu was found in wild birds.

Bird flu has been found in a number of countries across Europe over the last two weeks.

During the last case of bird flu in 2006, Denmark lost about 200 million Danish crowns ($28.58 million) in export revenue, the ministry said.

There is no evidence that so-called “aphrodisiac” foods crank up your sexual desire, says Debra Herbenick, PhD, director of the Center for Sexual HealthPromotion at Indiana University’s Kinsey Institute. Going out for a romantic seafood dinner with your partner might lead to some bedroom fun afterward, but it’s not because of the mollusks.

Birth control will kill your sex drive.

Davis says some women could experience a drop-off in sex drive while taking birth control. But research in the Journal of Sexual Medicine suggests some women actually experience a libido boost while taking hormonal contraceptives. As the authors of the JSM study put it, birth control has a “mixed” effect on a woman’s enthusiasm for sex.

Alert level as bird flu

Sweden has raised the alert level for poultry to the second highest following an outbreak of bird flu in neighboring Denmark, the Swedish board of Agriculture said on Monday.

The board raised the level to two on a scale of three, which means poultry must be kept indoors.

“We are raising the level of protection as a precaution,” the board said in a statement. “Bird flu is spread mainly by wild birds and therefore the risk of getting the disease to the Swedish poultry is now considered elevated.”

The H5N8 bird flu has been detected at a poultry farm in Denmark, the country’s environment and food ministry said earlier on Monday. Bird flu has been found in a number of countries across Europe over the past two weeks.

Even so, the findings add to a growing body of evidence suggesting that parents and doctors can take steps while cancer patients are kids to increase the odds that they will get better care as adults, said Kirsten Ness of St. Jude Children’s Research Hospital in Memphis, Tennessee.

Many factors, like the long-term health risks linked to specific tumors or treatments such as radiation may not be possible to avoid, Ness, who wasn’t involved in the study, said by email.

Survivors may also not be able to influence things like whether they can afford insurance or demographic factors that might make it less likely that they receive needed care as adults, Ness said.

But there’s still plenty parents and clinicians can do, Ness said.

“Allow the child or younger adolescent to participate in discussions with pediatric provider about health risks as they are able,” Ness said.

“Get a survivorship care plan from the treating institution and hang on to it,” Ness added. “Select a primary care provider they feel comfortable communicating with.”

Geese after low risk bird flu found on firm

German authorities are preparing to cull 8,800 geese on a farm in the north of the country where a low risk strain of bird flu has been found, authorities said on Monday.

Some 1,800 geese on a farm in Dithmarschen have a low risk H5 bird flu, said the environment ministry in the state of Schleswig-Holstein. Another 7,000 geese at a different location owned by the same farm are also suspected to have bird flu but it is not known whether this is the low risk type or the highly contagious H5N8 strain, the state ministry said.

A series of European countries and Israel have found cases of H5N8 bird flu in the past few weeks and some have ordered that poultry flocks be kept indoors to avoid the disease spreading.

Most outbreaks involve wild birds but Germany, Hungary and Austria have also reported cases in domestic duck and turkey farms where all poultry have had to be culled. A case was also reported on a farm in Denmark on Monday.

The contagious H5N8 strain has been found in wild birds in much of Germany over past days and the country’s government has tightened sanitary rules for farms and warned it may order poultry to be kept inside.

More outbreaks of a severe strain of bird flu in Europe are likely to occur in the next few weeks as wild birds believed to transmit the virus migrate southward, the deputy head of the world animal health body said.

Scouts Guides have better mental health

The mental health benefits of participation in childhood scouting activities might last for decades, a new study suggests.

In the middle-aged study participants, mood and happiness tended to range in association with childhood social position – but not for grown-ups who had been in the Scouts-Guides program when they were young, researchers found.

“Scout or Guide membership appears to almost completely remove the inequality in mental health (aged 50) associated with early life economic disadvantage,” said lead author Chris Dibben of the University of Edinburgh in Scotland.

“Given the difficulty governments around the world have in tackling health inequalities, we think any evidence of substantial impact is significant,” Dibben told Reuters Health by email.

The Scout Association provides active, outdoor, social activities for young people, male and female, age six to 25 in the U.K.

Girlguiding is a similar program, and the largest girls only youth program in the U.K.

For the new study, the researchers focused on more than 9,000 people born in 1958, 28 percent of whom had been in the Scouts or Guides program. Mental Health Index tests at age 50 assessed nerves, calmness, downheartedness and happiness over the previous four weeks, with answers scored on a scale of one to 100.

On average, participants scored about 75. Adults who had been in Scouts-Guides scored about 2.2 points higher than other adults. For those who had not taken part in the programs, mental health scores ranged along the lines of childhood social position, but there was no similar range for adults who had been in Scouts-Guides, as reported in the Journal of Epidemiology and Community Health.

“Detecting an apparent effect 40 or so years after an activity is always going to be notable, however in many ways existing research on social mobility, resilience and activities that may be protective of mental health, provide many explanations of why the kind of programs used by the scouts and guides and other similar youth organizations might be protective of mental health,” Dibben told Reuters Health by email.

Workout than a StairMaster

For anyone who has ever used a StairMaster at the gym, the time has come to really sweat—on a stepmill.

Stepmills look like moving staircases, and are so challenging that people brag about their workouts on social media with the tag #stairmonster. Gyms are adding them—and removing the classic stair climbers that have been a staple since the 1980s—as more people seek shorter, tougher workouts.

A traditional step climber’s pedals sink when you step on them and rise when you lift your feet, which can make workouts easier by shortening steps. Stepmill steps are a fixed height and move at a constant rate, pushing the user to keep up.

Stepmills quietly have become the most-used cardio machine after treadmills at gyms across North America. That’s according to data from 967 clubs collected by Ecofit, a company in Victoria, British Columbia, that lets gym owners track equipment usage through a wireless platform. Over the past year, stepmills were used for about 18 times as many hours as two-pedal step machines, Ecofit says.

“It’s a really good workout in a fast amount of time,” said Samantha VanderPutten, a graduate student in physical therapy at New York University, as she climbed onto a stepmill at an NYU fitness center. “I get bored on the treadmill.”

Transit regulators targeting sleep

Federal regulators are urging railroads across the country to test train operators for obstructive sleep apnea after the engineer in September’s deadly New Jersey commuter train crash was found to have the fatigue-inducing disorder.

The Federal Railroad Administration will issue a safety advisory this week stressing the importance of sleep apnea screening and treatment, Administrator Sarah Feinberg told The Associated Press. One railroad that already tests its engineers, Metro-North in the New York City suburbs, found that 1 in 9 suffers from sleep apnea.

The advisory, akin to a strong recommendation, is a stopgap measure while regulators draft rules that would require railroads to screen engineers for sleep apnea. That process could take years, and Feinberg said railroads shouldn’t wait for the government to force action.

“At this point it’s unacceptable to wait any longer,” Feinberg said.

Sleep apnea is especially troubling for the transportation industry because sufferers are repeatedly awakened and robbed of rest as their airway closes and their breathing stops, leading to dangerous daytime drowsiness.

“You end up with an engineer who is so fatigued they’re dosing off, they’re falling asleep in these micro bursts and they often have no memory of it, and they’re operating a locomotive at the time, so they’re putting hundreds of people in danger,” Feinberg said.

Airplane pilots with sleep apnea aren’t allowed to fly unless they’ve been successfully treated. Regulators are also pushing for bus and truck drivers to get tested.

NJ Transit engineer Thomas Gallagher, 48, was diagnosed with severe sleep apnea about a month after his train slammed into Hoboken Terminal at double the 10 mph speed limit on Sept. 29, his lawyer said. One woman on a platform was killed by falling debris. More than 100 people were injured.

Gallagher had passed a physical in July and was cleared for duty, lawyer Jack Arsenault said. The engineer told investigators he felt fully rested when he reported to work. He said he had no memory of the crash and only remembered waking up on the floor of the engineer’s cab.

NJ Transit already tests for sleep apnea, but updated its rules last week to prevent diagnosed engineers from operating trains until they’re fully treated, Feinberg said. It is not clear if Gallagher was screened.

NJ Transit declined to answer questions about its screening program, saying it was not authorized to discuss an employee’s medical information and couldn’t discuss specifics about the crash while federal investigators continued their probe.

Sleep apnea also went undiagnosed in the engineer of a commuter train that sped into a 30 mph curve at 82 mph and crashed in New York City in 2013, killing four people. He had fallen asleep at the controls. A deadly freight train crash in 2011 in Iowa and another freight crash in 2013 Missouri have also been attributed to sleep apnea.

Metro-North started testing for sleep apnea after the 2013 crash. Metro-North’s screening program has found sleep apnea in 51 of its 438 engineers and trainees, spokesman Aaron Donovan said. They are undergoing treatment, he said.