Bacterial Vaginosis Remedies: August 2011

Wednesday, 31 August 2011

Taiwan investigates organ transplants from HIV-positive donor

[unable to retrieve full-text content]Taiwan's health department is investigating how the organs of an HIV-positive donor were cleared for transplant for five recipients at two hospitals.

Source: http://rss.cnn.com/~r/rss/cnn_health/~3/uWB0u0w_TqU/index.html

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Precautionary warning on Nurofen Plus

Many newspapers have reported today that some packets of Nurofen Plus have been found to contain the wrong medicine.�A warning has been issued by the Medicines and Healthcare products Regulatory Agency (MHRA). It is advising people to be extra vigilant if taking Nurofen Plus pain relief tablets.

The warning, which the MHRA says is�"precautionary"�comes after reports that the anti-psychotic drug Seroquel XL has been found within some Nurofen Plus packets. Three defective packs have been found in pharmacies in London, but the affected batches may have been distributed across the UK.

The blister packs of the two different drugs look different, and should be easily spotted. The Seroquel XL 50mg tablets are large and capsule shaped and can be identified by their gold and black packaging; Nurofen Plus tablets are smaller and have silver and black packaging. Also, the packs involved are labeled as 32 tablets per pack.

Investigations are still�ongoing to establish the cause of the mix-up.

�

What do the Seroquel XL tablets look like?

The large capsule-shaped Seroquel XL 50 mg tablets can be identified by their gold and black packaging.

�

What do Nurofen Plus tablets look like?

The smaller Nurofen Plus tablets can be identified by their silver and black packaging.

�

What should I do if my packet contains Seroquel XL?

Anyone who finds Seroquel XL in their Nurofen packet, should return them to the pharmacy where they bought them. You can also report this to the MHRA on 020 3080 6574.

�

What should I do if I think I have accidentally taken Seroquel XL?

Anyone who thinks they have taken these tablets accidentally should speak to their GP.

�

What is Nurofen Plus?

Nurofen Plus tablets are over-the-counter drugs that can only be obtained by request from a pharmacist. The medicine is used as a painkiller for the short-term treatment of acute, moderate pains which are not relieved by paracetamol, ibuprofen or aspirin alone. It contains codeine.

�

What is Seroquel XL?

These tablets are prescription-only. The tablets that have appeared within Nurofen Plus packaging have been 50mg tablets. The medicine is an anti-psychotic used to treat several illnesses such as schizophrenia, mania and bipolar depression.

�

What are the side effects of taking Seroquel XL?

The more common side effects that are possible after a single dose include dry mouth, feeling light headed or faint, a fast heart rate, drowsiness, blurred vision, headache and some people might get muscle or jaw stiffness. Anyone who thinks they have taken these tablets accidentally should speak to their GP.

This drug may also impair your ability to drive or operate machinery.

�

What is the MHRA?

The MHRA is the government agency responsible for ensuring that medicines and medical devices work, and are acceptably safe.

More detailed information on the batch numbers of the packets of Nurofen plus affected by the alert can be found on the MHRA website.

Links To The Headlines

Psychosis drugs in Nurofen Plus packs.�The Sun, August 26 2011

Thousands of Nurofen Plus packets could contain anti-psychosis drugs.�Daily Mirror, August 26 2011

Warning over psychosis drugs in Nurofen packs.�The Independent, August 26 2011

Sabotage fear over Nurofen Plus 'mix-up?.�The Daily Telegraph, August 26 2011

Alert over nurofen plus drug mix-up.�Daily Express, August 26 2011

Pills recalled.�Daily Star, August 26 2011

Nurofen Plus warning over mix-up of painkillers and anti-psychotic drugs.�The Guardian, August 26 2011

Links To Science

Public warned to be extra vigilant when purchasing and using Nurofen Plus.�MHRA, August 26 2011

Source: http://www.nhs.uk/news/2011/08August/Pages/nurofen-plus-mhra-warning.aspx

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Malawi's 'Florence Nightingale' saving babies and mothers

[unable to retrieve full-text content]For one retired midwife, seeing too many mothers die during childbirth led her to quit her job and take on the third highest infant mortality rates in the world.

Source: http://rss.cnn.com/~r/rss/cnn_health/~3/rHWx3TJf98Y/index.html

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Precautionary warning on Nurofen Plus

Investigations are still�ongoing to establish the cause of the mix-up.

�

What do the Seroquel XL tablets look like?

The large capsule-shaped Seroquel XL 50 mg tablets can be identified by their gold and black packaging.

�

What do Nurofen Plus tablets look like?

The smaller Nurofen Plus tablets can be identified by their silver and black packaging.

�

What should I do if my packet contains Seroquel XL?

Anyone who finds Seroquel XL in their Nurofen packet, should return them to the pharmacy where they bought them. You can also report this to the MHRA on 020 3080 6574.

�

What should I do if I think I have accidentally taken Seroquel XL?

Anyone who thinks they have taken these tablets accidentally should speak to their GP.

�

What is Nurofen Plus?

�

What is Seroquel XL?

�

What are the side effects of taking Seroquel XL?

This drug may also impair your ability to drive or operate machinery.

�

What is the MHRA?

The MHRA is the government agency responsible for ensuring that medicines and medical devices work, and are acceptably safe.

More detailed information on the batch numbers of the packets of Nurofen plus affected by the alert can be found on the MHRA website.

Links To The Headlines

Psychosis drugs in Nurofen Plus packs.�The Sun, August 26 2011

Thousands of Nurofen Plus packets could contain anti-psychosis drugs.�Daily Mirror, August 26 2011

Warning over psychosis drugs in Nurofen packs.�The Independent, August 26 2011

Sabotage fear over Nurofen Plus 'mix-up?.�The Daily Telegraph, August 26 2011

Alert over nurofen plus drug mix-up.�Daily Express, August 26 2011

Pills recalled.�Daily Star, August 26 2011

Nurofen Plus warning over mix-up of painkillers and anti-psychotic drugs.�The Guardian, August 26 2011

Links To Science

Public warned to be extra vigilant when purchasing and using Nurofen Plus.�MHRA, August 26 2011

Source: http://www.nhs.uk/news/2011/08August/Pages/nurofen-plus-mhra-warning.aspx

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Leisure-Time Physical Activity Increases The Risk Of Atrial Fibrillation In Men

Main Category: Cardiovascular / Cardiology
Also Included In: Sports Medicine / Fitness;��Men's health;��Heart Disease
Article Date: 31 Aug 2011 - 0:00 PDT

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A Norwegian survey carried out between 1974 and 2003 showed that there was a graded independent increase in the risk of AF with increasing levels of physical activity in a population-based study among men with ostensibly no other heart disease. In women the data were inconclusive.

Speaking at a press conference at the ESC Congress in Paris, Prof Knut Gjesdal from Oslo University Hospital, said that competing athletes seem to be at higher risk of developing atrial fibrillation (AF) than their sedentary mates. Less is known, however, about the training threshold above which the risk for AF increases.

Diseases or life-style factors that influence the development of AF are often present for years before AF appears. Hence the exposition for a risk factor must be recorded at baseline, and the individuals must be followed for several years. Regional large epidemiological studies on individual subjects' cardiovascular risk factors contain such information, including the subjects' self-reported leisure-time physical activity.

"Heavy exercise in leisure-time increases the risk of atrial fibrillation 2 to 3-fold in men. However, the general health benefits from physical exercise certainly outweigh the increased risk of this heart rhythm disorder," explained Prof Gjesdal.

"We had the opportunity to merge data from three population-based Norwegian surveys that used standardized methods and were undertaken during 1974 - 2003. The present analysis comprises 428 519 participants, alive and aged 30-81 years by the end of 2003. The classification of physical activity was:

Sedentary: Reading, watching TV, or other sedentary activity.
Moderate: Walking, cycling, or other forms of exercise at least 4 hours per week (including walking or cycling to the workplace, Sunday-walking, etc.)
Intermediate: Participation in recreational sports or heavy gardening for at least 4 hours per week.
Intensive: Participation in hard training or sports competitions, regularly or several times per week.

The two major challenges were 1) to identify the subjects who later on developed AF, and 2) to exclude from the study all those who had a concomitant cardiovascular disease that could predispose to AF. Such diseases include hypertension, coronary heart disease and heart failure. The ideal group to study would be subjects with "lone AF", that is, subjects whose hearts are normal except for their AF.

Flecainide tablets are mainly used to prevent recurrencies of AF. The drug is fairly efficient and well-tolerated in patients with otherwise normal hearts, but in patients with heart disease beyond AF, serious and even lethal complications occur. Hence flecainide is prescribed only to patients with normal or near-normal hearts, and thus, flecainide users represent lone AF patients. A Norwegian Prescription Database was established in 2004. Without revealing patient identity, flecainide users and control subjects could be linked to information obtained in the health surveys, allowing researchers to compare baseline risk factors to AF.

During the follow-up period from 2004 through 2009, 1183 men and 609 women had a first-time flecainide prescription. They constitute the AF cases. The risk of AF increased with increasing levels of physical activity in men, whereas no such association was observed among women. The majority of the AF cases was 50-69 years old, non-smokers and had higher education. Resting heart rate was inversely related to the risk of having AF. The male cases had also lower levels of the major cardiovascular risk factors.

"We found a strong, statistically highly significant relationship between the level of self-reported leisure-time physical activity and AF, defined as new-onset prescription of flecainide in men. The relationship between physical activity and AF may be clearer than in previous reports since many Norwegian males are physically very active. In women, the number participating in heavy exercise was small, and the study lacks statistical power to answer whether women are running the same exercise-related risk for AF as men.

Since AF is associated with premature death, stroke and heart failure, should we conclude that strenuous leisure-time physical activity is bad for you? "This is definitely not the case. The majority of heavily exercising men have a normal heart rhythm. Our men were more fit, had slower heart rate, lower diastolic blood pressure, lower total cholesterol, they smoked less cigarettes and had more education, all factors that reduce the overall cardiovascular risk," said Prof Gjesdal.

Flecainide is a drug that does not affect physical performance. For this reason it is popular among competitive athletes, and it may be that physically active persons are overrepresented among flecainide users. Due to this concern researchers also analyzed data on sotalol users. Sotalol is an unselective beta-blocker with additional anti-arrhythmic effects. This drug is also used in non-permanent AF, even in patients with coronary heart disease. Reduced endurance capacity is a well-known side effect of sotalol, and athletes tend to avoid this drug. However, in sotalol users, a similar effect of exercise was seen: the more leisure-time physical activity at baseline, the higher was future sotalol use.

"Our selection of cases comprises only a minority of all lone AF patients. Some subjects with infrequent or mild episodes of AF are not included because they do not want long-term drug treatment. In others the AF may have progressed to a permanent, accepted state, and then there is no longer indication for flecainide," explained Prof Gjesdal.

"In conclusion, there was a graded independent increase in the risk of AF with increasing levels of physical activity in this population-based study among men with ostensibly no other heart disease. For women the data are inconclusive."

Article References:
Contributors: D S. Thelle, K. Gjesdal, R. Selmer, A. Tverdal, S. Graff-Iversen, A. Jugessur, S. Sakshaug, W. Nystad. Institute of Basic Medical Sciences (IMB), University of Oslo, Department of Cardiology, Oslo University Hospital, Norwegian Institute of Public Health, Oslo, Norway
About ESC Congress 2011: ESC Congress 2011 will take place from 27 August to 31 August at Paris Nord Villepinte, Paris. Information on the scientific programme is available at http://spo.escardio.org/Welcome.aspx?eevtid=48
European Society of Cardiology

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Source: http://www.medicalnewstoday.com/releases/233544.php

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Half of Americans sip sugary drinks daily

Americans get 8% of daily calories from sugary drinks, a study from the CDC's National Center for Health Statistics says.

STORY HIGHLIGHTS

Half of U.S. population over age 2 consumes sugary drinks daily, CDC says
Report says the drinks have been linked to weight gain, obesity and diabetes
Beverage makers say their products have not fueled obesity and diabetes
Male teens are most frequent consumers of sugary drinks, report says

(CNN) -- When it was first invented, soda pop was a treat most people had once in a while for special occasions.

Now it's a daily fixture in American life -- in bright containers glowing inside vending machines, chugged from 32-ounce bucket-like containers at self-service stations and served as the default beverage in fast-food meals.

In today's carbonation nation, half of the U.S. population over age 2 consumes sugary drinks daily, according to a report released by National Center for Health Statistics.

The sugary drinks include sodas, sweetened waters, and energy, sports and fruit beverages. Not included in the total were diet drinks, 100% fruit juices, sweetened teas and flavored milk. The report states that sugary drinks have been linked to "poor diet quality, weight gain, obesity, and in adults, type 2 diabetes."

Male teens are the most frequent consumers and guzzle about 252 to 273 calories every day from various drinks, the report says. Their one-day consumption is more than half the weekly intake suggested by the American Heart Association, which recommends no more than three 12-ounce cans of soda in one week (equivalent to 450 calories).

The consumption of such sugary drinks has increased over the last 30 years, the report stated.

A 2003 study published in the Journal of the American Dietetic Association found that soda drinking for youths between the ages of 6 and 17 was at 37% in the 1970s and then 56% in the 1990s. This latest research from the Centers for Disease Control and Prevention suggests that from 2005 to 2008, consumption increased again.

"If you look at male children, 70% consume on a given day," said lead author Cynthia Ogden, a CDC epidemiologist who specializes in obesity.

The analysis was based on 17,000 participants who were asked to recall what they ate in the last 24 hours in the National Health and Nutrition Examination Survey.

The American Beverage Association denied that its products fueled obesity: "Contrary to what may be implied ... sugar-sweetened beverages are not driving health issues like obesity and diabetes."

It pointed to market data indicating that the calories in beverages decreased by 21% from 1998 to 2008, while obesity rates climbed. It also stated that sugar-sweetened beverages account for 7% of calories in the average American diet.

"That means Americans get 93 percent of their calories from other foods and beverages," the group stated.

The latest CDC research released Wednesday also found similar results: Kids and teens get about 6.7% to 8.2% of their daily caloric intake from the beverages, and adults get about 5% to 8%.

But the extra calories from drinks could add several pounds every year, said Marisa Moore, a nutritionist.

"A lot of times, people don't think of beverages as part of their daily total calories," she said. "When I think about soda drinking -- in general, it provides empty calories. It takes the place of more nutritious options."

She suggested alternatives like water, sparkling water, tea and skim milk.

The CDC's report found major differences in soda consumption depending on race, sex and income level.

In every age category, males consumed more sugary drinks than females. This could be because males consume more calories than females, Ogden said.

In terms of race, black children got about 8.5% of their total daily calories from sugary drinks, compared with 8.2% for Mexican-American and 7.7% for white children. Black adults received 8.6% of their daily calories from sugary drinks, and the figure was 8.2% for Mexican-Americans and 5.3% for whites.

There was also a direct association between income level and sugary beverage consumption. Adults living in a family of four earning approximately $29,000 per year got 8.8% of their daily calories from sugary drinks, compared with 4.4% for those who earned about $77,000.

Last year, New York attempted to end subsidizing the purchase of sodas in the food stamps program, saying the benefits were used to fuel a serious public health problem. But this month, the U.S. Department of Agriculture rejected the city's proposal, citing agency concerns that "the scale and scope" of banning soda would be "too large and complex."

The Big Apple has actively campaigned for soda reduction with a stomach-churning ad that likened drinking soda to chugging dollops of fat.

The recent CDC report also found that while half of the population doesn't drink sugary beverages, about 25% consumes amounts of the drinks that total fewer than 200 calories per day. About 5% drink about 567 calories on any given day, which amounts to more than four 12-ounce cans of cola.

Sugary drinks became ingrained in American daily life because of effective ad campaigns, fast-food restaurants and increased serving sizes, said Michael Jacobson, executive director of the Center for Science in the Public Interest. But the tides are turning, he said.

The group announced a campaign Wednesday called Life's Sweeter to nationally organize civic associations, minority groups and religious communities to reduce soda consumption.

"There's pretty much a consensus among health officials that soft drinks are a major cause of obesity," Jacobson said.

Boston's government buildings have banned soda, several public school systems have kicked them out of their campuses, and the Cleveland Clinic has stopped selling the beverages in its hospitals.

"There's a real movement in that direction, and the soda industry recognizes this and is diversifying away from traditional carbonated drinks to bottled water and noncarbonated things like energy drinks and sports drinks," Jacobson said. "The soft drink industry is very nervous and will diversify to maintain their profits."

While energy drinks and sports drinks may have fewer calories and less sugar, they enjoy health halos that are not warranted, he said.

Pediatricians: No energy drinks for kids; greatly limit use of sports drinks

Dr. Sandeep Gupta, director of the Pediatric Overweight Education and Research Program at Indiana University Health, said it's easy to be misled by drink labels.

"Many times, they don't know," he said about his pediatric patients who guzzle sugar-sweetened beverages with labels touting vitamins and antioxidants. "The marketing is so skewed. 'Get your 100% vitamin C, juice.' They don't tell you how much sugar is there. Look at the back, not the front of the package."

Source: http://rss.cnn.com/~r/rss/cnn_health/~3/OXKEKqjiISQ/index.html

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Addicted to Your Cell Phone? Learn How to Unplug

Hold the phone: New research suggests that smartphones are habit-forming?study subjects checked their phones an average of 34 times a day! Phone addiction is the result of positive reinforcement turned compulsion, reports Elizabeth Cohen of CNN. Our brains like the feeling of receiving e-mails and other messages. And once you associate checking your phone with a positive response, you start to reach for that sucker unconsciously.

While cell phones are convenient and helpful in emergencies, there's no good reason to be tweeting at dinner with friends. Need some advice on how to unplug? Our Facebook fans share what works for them.

How to Leave Your Phone Alone
"Turning the ringer off helps. And a Sunday blackout is another good step."
?Pat Smith

"Sometimes I leave my phone at home while I?m out running errands. Initially it makes me crazy, but after a while I relax and enjoy not being at everyone's beck and call."
?Mandy Gracie

"I keep it in my purse so unless it rings, or a couple hours pass, I don't check it. I've even forgotten about it until it?s time to go to bed."
?Pamela Lobell

"When I go to the pool, I leave it in the car. Only so it won't get wet or stolen though, so that probably doesn't count."
?Jennifer McCormack

"It stays on alarm only most days. If it's important enough, they can leave a voicemail!"
?Kristin Sansosti

"I unplug by getting on my bike for a LONG ride."
?Pam Weick Campbell

"Don?t get unlimited everything. I have unlimited texts but not talk or data?it works, trust me."
?Melissa Robbins

Source: http://www.womenshealthmag.com/health/phone-addiction

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'Half of UK obese by 2030'

Many newspapers have reported that half of UK men could be obese by 2030 if trends continue.
The Guardian said that ?governments around the world need to make immediate and dramatic policy changes to reverse a pandemic of obesity?. The Independent reported that by 2030 there will be 26 million people in the UK who are obese - a rise of 73% from the current 15 million. The Daily Mail reported that women will be close behind, ?with four in ten similarly overweight? by that year.

These news stories and others are based on a series of papers in The Lancet examining issues surrounding the current worldwide obesity ?pandemic?. The predictions come from one of these studies, which looked at obesity data from the US and UK, which have had the highest obesity levels in the world over the past 20 years. The researchers predict that if the current trend continues, up to 48% of men and 43% of women in the UK could be obese by 2030, adding an additional �1.9-2 billion per year in medical costs for obesity-related diseases.

Modelling studies like this are valuable for alerting governments and health services to potential future scenarios, allowing them to decide what actions are needed. As the authors point out, these projections are merely extrapolations of currently available data, and uncertainties always exist when making predictions as past trends do not always predict future trends. Despite these limitations, this study and others in The Lancet series highlight how obesity is likely to weigh heavily on the country?s healthcare system and economy. How best to target preventative measures at the population level is clearly an important public health priority.

�

Where did the story come from?

The news stories are based on a series of papers on obesity published today in The Lancet. The papers critically examine what is known about the global obesity ?pandemic?: its causes, the biology behind weight control and maintenance, the economic and health burden of obesity, and what can be done to reverse the current rise in obesity and the expected rise in obesity-related chronic diseases in the future.

The media has mainly focused on a paper which analysed obesity trends in the US and UK, and their impact on the prevalence of disease and healthcare spending. This paper is the focus of this Behind the Headlines analysis.

The other three papers in the series examine what is causing the global epidemic, as well as the introduction of a new web-based bodyweight simulation model that incorporates the metabolic adaptations that occur as we lose weight. The papers also analyse the interventions needed to halt and reverse the rise in obesity. These papers are not discussed further here.

�

What kind of research was this?

The paper on obesity trends is a narrative review and modelling study. The authors discuss the threat to population health from the rise in obesity; the health burden resulting from the rise in chronic diseases and the projected rise in healthcare costs as a result of this, and economic costs due to lack of productivity.

The researchers used recent statistics and evidence to create a model predicting the health and economic consequences of obesity in the US and UK over the next 20 years. Making these projections required them to make various assumptions about future trends based on current trends and data. If there is some variation to these trends over the coming decades then these models will be inaccurate. Therefore they can be viewed only as predictions of what might happen based on what is now known.

The specific methodology of how the relevant studies and statistics were obtained for this article is not given. Consequently, it is not possible to comment on whether all relevant data has been considered.

�

What does the research discuss?

The researchers say that a recent review of data from 199 countries estimated that almost 1� billion adults worldwide were overweight in 2008. Among them, 502 million were obese. The researchers also say that another report by the Organisation for Economic Co-operation and Development evaluated 11 countries and found that of these the US and UK consistently had the highest prevalence of obesity over the past 20-40 years. The report predicted that this trajectory was likely to continue to 2020.

The paper points out that cardiovascular disease, diabetes and various cancers are the main chronic diseases associated with obesity. Given that the prevalence of these diseases is already rising due to the fact that people are living longer, the extra burden from obesity suggests a substantial cost to the healthcare system. The researchers say that a study estimated that obesity accounts for between 0.7 and 2.8% of a country?s total healthcare costs, and that obese people?s medical costs are 30% higher than those of normal-weight people.

The researchers say that the most recent US data estimated that obese people have 46% higher inpatient costs, 27% more doctor visits and outpatient costs, and 80% greater spending on prescription drugs. By 2030, healthcare costs due to obesity and overweight are projected to account for 16?18% of total US healthcare expenditure.

In the UK, a 2007 report by the Office for Science Foresight Programme projected that the continuing rise in obesity will add �5.5 billion in medical costs to the National Health Service by 2050. In addition to medical costs, society incurs substantial costs from obesity as a result of increased risks of disability and disability pensions, higher work absenteeism and reduced productivity, and increased risk of people retiring early or dying before they reach retirement age.

The researchers say that it is difficult to quantify future healthcare costs resulting from obesity as costs are affected by changing demographics, the economy and the availability of food. However, they say that they used the modelling framework used by the Foresight Programme and applied this to the US and the UK situation to provide updated projections for obesity trends and healthcare expenditure for obesity-related diseases.

�

What were the main findings?

The model indicated that in the US, past trends in BMI growth project an increase in the prevalence of obesity among adults from about 32% in 2007?08, (the latest available data) to 50?51% in 2030 for men. For women the projected increase is from 35% to 45?52%. From these projections it was estimated that by 2030 there will be an extra 65 million adults in the US who are obese compared to the number in 2010. Of these, 24 million would be aged over 60 years.

In the UK, past trends predicted that by 2030 the prevalence of obesity would rise from 26% to 41-48% in men, and from 26% to 35-43% in women. This would equate to 11 million more obese adults by 2030, 3.3 million of whom would be older than 60.

In both the US and UK, the rise in obesity is expected to be associated with an extra 6 to 8.5 million cases of diabetes, 5.7 to 7.3 million cases of heart disease and stroke, and between 492,000 and 669,000 additional cases of cancer. In addition, the increasing prevalence of debilitating disorders such as osteoarthritis would affect the duration of the person?s healthy lifespan.

Medical costs associated with treatment of these chronic diseases are estimated to increase by $48-66 billion per year in the US, and by �1.9-2 billion per year in the UK by 2030. Regarding economic effects of lost work productivity, the researchers say that the shortage of consistent and high-quality data prevents comparisons between countries. However, using estimates from the US 2008 National Health and Wellness study they estimated that by 2030 there would be a loss of 1.7 ? 3 million productive person-years among working-age US adults. This would be associated with an economic cost as high as $390?580 billion.

�

What were the researchers? conclusions?

The researchers highlight that excess weight and obesity have significant effects on lifespan, disability, quality of life, and work productivity, with subsequent burdens on population health and healthcare systems. Obesity is known to be associated with various chronic diseases, including diabetes, coronary heart disease, stroke, cancer and osteoarthritis, which impose considerable costs, from the use of healthcare services and medical treatments to the loss of productivity.

The researchers note that the health and economic effects of excess weight and obesity have a protracted time course, and their model has enabled them to link changes in obesity at the population level to disease burdens over the coming decade. They say that a clear understanding of the potential health and cost implications resulting from changes in obesity trends is crucial when choosing the most effective and cost-effective strategies, and how to best target research and funding towards this end.

�

Conclusion

This study evaluated current statistics on the obesity ?pandemic? and predicted rises in healthcare expenditure in the future if things continue to follow their current trend. As the authors highlight, effective policies to promote healthier weight would have clear economic benefits.

The modelling study presents valuable predictions of future trends in excess weight and obesity, which will be useful for governmental and public health planning. However, as the authors themselves highlight, these projections are merely extrapolations of currently available data. Uncertainties always exist when making predictions, as past trends do not always predict future trends. For example, it is not possible to be certain how the current trend will be affected by changes to the economy, demographics, agriculture, food prices, or technological advances. Also, though the study demonstrates a clear rise in expected healthcare expenditure, it is also difficult to accurately predict what cost savings could be expected from a reduction in obesity levels.

The authors also highlight that, though there is some benefit from having access to previous surveys that have consistently used the objective measure of BMI to assess excess weight and obesity, these surveys have not always been nationally representative. For example, these authors used data from the large National Health and Nutrition Examination Survey (NHANES) in the US, which only considers people living in the community; They also used the Healthy Survey for England, which does not cover Wales, Scotland or Northern Ireland. Also, the model was not able to study the future effect of rising childhood obesity.

Despite limitations to projected figures, this study and others in The Lancet series highlight how obesity is likely to weigh heavily on the country?s healthcare system and economy. How best to target preventative measures at the population level is clearly an important public health priority.

Links To The Headlines

Tougher action on obesity urged.�BBC News, August 26 2011

'Tax unhealthy foods or half will be obese by 2030'.�The Daily Telegraph, August 26 2011

UK fat alert: 26 million will be obese by 2030.�The Independent, August 26 2011

Half of UK men could be obese by 2030.�The Guardian, August 26 2011

Nearly half of UK men ?will be obese by 2030? and women won't be far behind.�Daily Mail, August 26 2011

Half of Britons will be obese in under 20 years.�Daily Express, August 26 2011

Links To Science

Series on Obesity.�The Lancet 2011, published August 26

Wang YC, McPherson K, Marsh T, et al.�Health and economic burden of the projected obesity trends in the USA and the UK. The Lancet 2011; 378: 815 ? 825�

Source: http://www.nhs.uk/news/2011/08August/Pages/half-of-uk-predicted-to-be-obese-by-2030.aspx

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Years spent obese increase health risks

The BBC News today reported that the ?health hazards of obesity may have been grossly underestimated because we are not measuring the condition adequately?. Its website says that we should not focus on weight gain alone, but also look at how long it persists.

This news story was based on an analysis of data from the Framingham Heart Study, a long-running research project started in 1948 that went on to study participants for up to 48 years. As part of the study, researchers measured whether participants were obese every two years, as well as recording various aspects of their health. This new analysis found that the longer people stayed obese the greater their risk of dying from any cause (all-cause mortality), as well as cardiovascular diseases specifically.

This study further highlights the health risks of obesity. The researchers say that the duration of obesity is particularly important in today?s society where people are becoming obese at an earlier age. A healthy body mass index (BMI) is considered to be between 18.5 and 24.9, whereas obesity is classified as having a BMI above 30. People who are concerned about their weight can obtain help and advice from their GP.

�

Where did the story come from?

The study was carried out by researchers from Monash University, Australia. It was funded by an AusAID scholarship, a fellowship from VicHealth and the Australian National Health and Medical Research Council. The study was published in the�peer-reviewed International Journal of Epidemiology.

The BBC News gave a top line review of this research and reported the research well.

�

What kind of research was this?

This was an analysis of a�prospective�cohort study that had followed people for up to 48 years. The researchers were interested in seeing whether there was a specific association between mortality and the length of time a person was obese, rather than just the fact that they were obese.

It has been well established that being obese increases the risk of death and numerous health conditions, for example heart disease, diabetes and cancer. The researchers say that when quantifying the risks of numerous diseases the measures used have generally been body weight and BMI, which are related to the severity of obesity. However, the researchers wanted to know the role that duration of obesity plays, e.g. whether the risks would be the same for a person who had been obese for one year compared to a person who had been obese for 20 years. They refer to this factor as either one ?obese year? or 20 ?obese years?.

To understand the association the researchers assessed how the number of years lived with obesity related to the risk of all?cause mortality, death due to cardiovascular disease, cancer and other conditions.

�

What did the research involve?

The researchers used data from a long-running cohort study called the Framingham Heart Study. In 1948 this extensive cohort study enrolled 5,209 participants aged between 28 to 62 years, following them up for around 48 years. The participants had been examined at two-yearly intervals. The current study included those participants who were free from pre-existing diseases of diabetes, cardiovascular disease or cancer at the start of the study - 5,036 people in total.

The study recorded demographic and health behaviour variables such as age, educational level, country of birth, marital status, smoking status, number of cigarettes smoked per day, alcohol consumption and physical activity. A participant was considered obese if their BMI was more than 30 kg/m2. Among the chronic diseases that were regularly measured and included in the analysis were diabetes, cancer and cardiovascular disease (CVD) outcomes such as heart disease and stroke.

The researchers calculated the cumulative duration of obesity for each participant at each examination. As people who were borderline obese or overweight could have fluctuated over the course of the follow-up period, the researchers defined obese individuals as people who were obese at two consecutive examinations, i.e. continuously obese for at least two years. People could have multiple periods of obesity during follow-up (with weight loss in between). For these people, the researchers added all of their obese periods together to generate a cumulative score.

The researchers calculated a ?time to event? score for each individual, which represented either their survival time in days from study start to their death, their loss to follow-up or the end of the study (examination number 24, given in year 48 of the study).

For parts of the analysis the researchers grouped the duration of obesity into the following periods:

Short: 1 to 4.9 obese years
Medium: 5 to 14.9 obese years
Long: 15 to 24.9 obese years
Over 25 obese years

What were the basic results?

The researchers found that 75% of the eligible study participants were not obese in any of the 24 examinations. Among participants who had two consecutive obese examinations, the average age of onset of obesity was around 50 years. The average number of years that this group lived with obesity was 13 years (time spent as obese ranged from 2 to 46 years).

The researchers then combined all the years of follow-up for the whole cohort. This resulted in 166,130 person years of follow-up. Over this time 3,397 (75%) of the participants died. Of the deaths, 39% were caused by CVD, 25% by cancer and 36% by other non-CVD and non-cancer causes.

The researchers adjusted their results within several models. The one used for the main results adjusted for the influence of sex, age at baseline, marital status, education level, country of birth, time-varying smoking, alcohol consumption and BMI.

Relative to people who had never been obese, the researchers calculated the increased risks of death due to any cause (all-cause mortality) during the study period:

Short duration of obesity increased the risk by 51% (Hazard ratio(HR) 1.51, 95%�confidence interval [CI] 1.27 to 1.79).
Medium duration of obesity increased the risk by 94% (HR 1.94, 95% CI 1. 71 to 2.20).
Long duration of obesity more than doubled the risk (HR 2.25, 95% CI 1.89 to 2.67).
Obesity for over 25 years more than doubled the risk (HR 2.56, 95% CI 1.89 to 2.67).

For CVD-related deaths relative to people who had never been obese, the pattern was similar:

Short duration of obesity increased the risk by 68% (HR 1.68 95% CI 1.29 to 2.18).
Medium duration of obesity more than doubled the risk (HR 2.18, 95% CI 1.78 to 2.68).
Long duration of obesity more than doubled the risk (HR 2.53,95% CI 1.99 to 3.23).
Obesity for over 25 years almost tripled the risk (HR 2.76, 95% CI 2.08 to 3.68).

For cancer-related deaths the risk increase associated with obesity was smaller:

Short duration of obesity ? no increased risk relative to non-obese people.
Medium duration of obesity increased the risk by 41% (95% CI 1.06 to 1.88).
Long duration of obesity increased the risk by 69% (95% CI 1.20 to 2.39).
Obesity for over 25 years increased the risk by 50% (95% CI 1.00 to 2.24).

They found that every two years living with obesity, relative to people who were never obese, resulted in a 6% increased risk of death due to any cause, a 7% increase in the risk of death following cardiovascular disease and a 3% increase in cancer-related mortality.

�

How did the researchers interpret the results?

The researchers said that ?the number of years lived with obesity is directly associated with the risk of mortality; this needs to be taken into account when estimating its burden on mortality".

The researchers said that their study ?confirmed that prior analyses examining the association between obesity and the risk of mortality? but ?by only considering the severity of obesity and ignoring the duration of obesity may have underestimated the adverse effects of current obesity?.

�

Conclusion

This analysis of data from a prospective cohort study shows that duration of obesity is associated with mortality risk, particularly CVD-related mortality. The researchers said the key strength of this study was its long follow-up (up to 48 years), but they highlight that this is also a limitation due to the demographic and medical changes that have occurred since the study began. For example, they say that rates of obesity and type 2 diabetes were relatively low in 1948 when the study commenced, but that the contemporary obesity epidemic is characterised by a much earlier onset of obesity, which would mean that people today may have an even longer duration of obesity than the study population. Likewise, advances in medical treatments since 1996 (the last follow-up date in this study) may have affected the prevalence of CVD or cancer-related deaths.

The researchers also pointed out that for the people who were obese at baseline, there is no indication of when they became obese. Therefore the estimation of duration of obesity in these people may be imprecise.

Taking these limitations into consideration, the researchers said that in current and future studies the duration of subjects? obesity needs to be taken into account in estimating the future life expectancy and burden of disease for the general population.

This research again highlights the health dangers of being obese. People who are obese and are looking for ways to lose weight can consult their GP for help and advice. Further research is needed to see whether weight loss following being obese lowers these risks over time.

Links To The Headlines

Call to measure duration of obesity. BBC News, August 23 2011

Links To Science

Abdullah A, Wolfe R, Stoelwinder JU et al. The number of years lived with obesity and the risk of all-cause and cause-specific mortality. International Journal of Epidemiology. (2011) 40 (4): 985-996

Source: http://www.nhs.uk/news/2011/08August/Pages/time-spent-overweight-important-health-marker.aspx

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Taiwan investigates organ transplants from HIV-positive donor

[unable to retrieve full-text content]Taiwan's health department is investigating how the organs of an HIV-positive donor were cleared for transplant for five recipients at two hospitals.

Source: http://rss.cnn.com/~r/rss/cnn_health/~3/uWB0u0w_TqU/index.html

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Addicted to Your Cell Phone? Learn How to Unplug

How to Leave Your Phone Alone
"Turning the ringer off helps. And a Sunday blackout is another good step."
?Pat Smith

"Sometimes I leave my phone at home while I?m out running errands. Initially it makes me crazy, but after a while I relax and enjoy not being at everyone's beck and call."
?Mandy Gracie

"I keep it in my purse so unless it rings, or a couple hours pass, I don't check it. I've even forgotten about it until it?s time to go to bed."
?Pamela Lobell

"When I go to the pool, I leave it in the car. Only so it won't get wet or stolen though, so that probably doesn't count."
?Jennifer McCormack

"It stays on alarm only most days. If it's important enough, they can leave a voicemail!"
?Kristin Sansosti

"I unplug by getting on my bike for a LONG ride."
?Pam Weick Campbell

"Don?t get unlimited everything. I have unlimited texts but not talk or data?it works, trust me."
?Melissa Robbins

Source: http://www.womenshealthmag.com/health/phone-addiction

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Latest generation of children will live 20 years longer than their grandparents

Lifespan tables show a 65-year-old man can expect to live another 17 years, and a woman of the same age another 20. A man now in his late 70s can also expect to continue to live for a further nine years and a woman for more than 11. Elderly people can expect more of their longer years of life will be spent in good health, the report in the ONS journal Social Trends also said.

Explaining the 20-year increase, the report said: ?One of the main reasons is the considerable decrease in infant mortality rates which were at their lowest recorded level in 2010.?

It added: ?As well as living longer, men and women are staying healthy and disability free for more of their lives.?

The life expectancy tables - calculated on evidence from 2009 - follow recent evidence that the middle classes have benefited far more from better health and living standards than those on lower incomes.

The character of neighbourhoods also has an effect and people in rural areas live longer, it added.

In 1930 the infant mortality rate stood at 6.3 per cent, with more than one in 20 children dying before their first birthday. Last year that rate was down more than tenfold to less than half of one per cent - 0.45 per cent.

Today, deaths overall are at a record low. Last year was the second in a row in which fewer than 500,000 people died in England and Wales. There were 493,242 deaths, nearly 45,000 fewer than in 2000.

Source: http://telegraph.feedsportal.com/c/32726/f/569020/s/16aee165/l/0L0Stelegraph0O0Chealth0Chealthnews0C86395690CLatest0Egeneration0Eof0Echildren0Ewill0Elive0E20A0Eyears0Elonger0Ethan0Etheir0Egrandparents0Bhtml/story01.htm

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Tuesday, 30 August 2011

Women gain weight after marriage, men after divorce

Dmitry Tumin of Ohio State University, who led the study, said: ?Clearly, the effect of marital transitions on weight changes differs by gender.

?Divorces for men and, to some extent, marriages for women promote weight gains that may be large enough to pose a health risk.?

The impact was greatest on older people because a marriage or divorce comes as a greater shock later in life, he added.

The study, to be presented at the annual meeting of the American Sociological Association in Las Vegas today [AUG 22], says it is not clear why men?s and women?s waistlines respond differently to marriage and divorce.

But Prof Zhenchao Qian, one of the researchers, said: ?Married women often have a larger role around the house than men do, and they may have less time to exercise and stay fit than similar unmarried women.

?On the other hand, studies show that married men get a health benefit from marriage, and they lose that benefit once they get divorced, which may lead to their weight gain.?

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/178fa808/l/0L0Stelegraph0O0Chealth0Cwomen0Ishealth0C87116140CWomen0Egain0Eweight0Eafter0Emarriage0Emen0Eafter0Edivorce0Bhtml/story01.htm

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Tanning Bed Risk Higher Than You Think

According to an article in USA Today, 35 percent of girls under 17 use tanning beds. Many of these girls give very little thought to the potential consequences they may see down the road as a result of using tanning beds. However, the fact is that if you're under 30 and using tanning beds, you are increasing your risk for skin cancer an overwhelming 75 percent!

Because of the risks associated with tanning beds, an FDA advisory panel has recommended that tanning beds use fall under stricter regulation. One recommendation under consideration is that teenagers before using tanning beds, parental permission should be required, or that teenagers be banned completely from using them.

Currently, tanning beds are classified as Class I medical devices. Class I medical devices include items such as elastic bandages -- hardly an equal danger. The FDA advisers have recommended reclassifying tanning beds and lamps to either Class II or Class III medical devices which would allow the FDA to require greater restrictions on these products.

One thing is changing on July 1, thanks to the new health care reform plan -- tanning bed users will have to pay a 10 percent tax for using them. Some hope that this new tax will discourage use of tanning beds among teenagers who may find it too expensive -- I doubt it will have much impact. What do you think?

Are Indoor Tanning Booths Safe?

Skin Cancer Symptoms

Source: http://womenshealth.about.com/b/2011/08/18/tanning-beds-more-risky-than-you-think.htm

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Women gain weight after marriage, men after divorce

Dmitry Tumin of Ohio State University, who led the study, said: ?Clearly, the effect of marital transitions on weight changes differs by gender.

?Divorces for men and, to some extent, marriages for women promote weight gains that may be large enough to pose a health risk.?

The impact was greatest on older people because a marriage or divorce comes as a greater shock later in life, he added.

?On the other hand, studies show that married men get a health benefit from marriage, and they lose that benefit once they get divorced, which may lead to their weight gain.?

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/178fa808/l/0L0Stelegraph0O0Chealth0Cwomen0Ishealth0C87116140CWomen0Egain0Eweight0Eafter0Emarriage0Emen0Eafter0Edivorce0Bhtml/story01.htm

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Being worried is so middle-class

One of the world?s biggest myths, other than that you can see the Great Wall of China from space, and that the composer of the Last of the Summer Wine theme tune also wrote for S Club 7, is that the middle classes are dull. This is quite patently not true. There is never a dull moment when you are middle-class. It is fraught with problems, strewn with obstacles and abundant with hurdles. At times, it seems like a never-ending rollercoaster of Boden catalogues, Farrow & Ball paint and Ocado deliveries.

- Concern over whether to reveal that you studied History of Art at university ? or worse, as I did, at A-level. Because people don?t understand that, far from being a subject for stupid Sloanes, it involves in-depth critical analysis, just like English Literature. Except with pictures.

- Endless worry that, despite having studied the history of art, everything you like culturally seems to involve Michael McIntyre, Coldplay or Stieg Larsson. Just why are people so pompous about them?

- And about whether you put paper in the plastic recycling bin. Well, did you? You probably did.

- Having a lengthy internal debate about whether you should send a thank-you note in reply to a thank-you note.

- Feeling guilty that you didn?t buy the Big Issue from the man outside the station. Or being unable to sleep at night because you were embarrassed into signing up to a charity by a chugger outside Peter Jones, only to feel angry that you were embarrassed into it, causing you to cancel the standing order. Which makes you feel bad.

- The endless worry that there is nothing immediate to worry about.

-------

Some very middle-class people have opened a very middle-class bar in the very middle-class neighbourhood that is Battersea ? or South Chelsea, as we middle-class residents like to call it. Described as ?an Englishman?s Italian?, it features pizza, karaoke and ? according to rumours the other week ? Prince Harry (not terribly middle-class, but hordes of middle-class girls, myself included, will flock there to get a glimpse of him). And the name of the place? Bunga Bunga. Frankly, it?s a wonder it took so long.

-------

Most women have had to endure the gentle mockery of men for hiding behind a cushion/handbag/the man himself during a horror movie. But now a theory has emerged as to why women get more scared than their male counterparts. Researchers at the UCL Institute of Cognitive Neuroscience found that we become more frightened because we are more likely to anticipate the terrifying scenes that lie ahead. In other words, we?re more intelligent.

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/17a67a3f/l/0L0Stelegraph0O0Cfamily0C8720A280A0CBeing0Eworried0Eis0Eso0Emiddle0Eclass0Bhtml/story01.htm

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Warning over painkiller addiction

?'Disaster' looms over addiction to painkillers,? reported The Independent.

This news story is based in part on a recent editorial published in the British Medical Journal, which discusses the rising use of opioid painkillers and the risk of death associated with these types of drugs.

Opioids are a class of drugs that include morphine, methadone and codeine. They can be addictive and may produce withdrawal symptoms if their use is suddenly stopped. They are commonly used for the treatment of cancer pain, but this editorial focused on their rising use for the treatment of chronic pain not related to cancer.

The authors mostly focused on North America and discussed trends in the prescription of opioid painkillers for chronic pain, as well as trends in opioid-related deaths. They also made recommendations for policy changes in North America that they said will reduce the number of these deaths.

The relevance of these recommendations for England is limited, due to different marketing practices and regulations between here and the US. However, the recommendations do highlight important areas for future policy discussions in England. These discussions are already planned. The Independent reported Public Health Minister Anne Milton as saying that experts will convene next month to discuss new evidence from recent studies on addiction to prescription medicines.

�

Where did the story come from?

This editorial was written by several researchers at the University of Toronto. The article was published in the British Medical Journal (BMJ) and was not peer reviewed.

In addition to the BMJ editorial, the media reports referred to findings from a report by the National Treatment Agency for Substance Misuse, which is an NHS special health authority overseeing the treatment of drug addiction in England.

The report, ?Addiction to Medicine?, investigated the treatment services that support people who develop problems with prescription-only or over-the-counter medicine. It was published in May 2011. The main statistics reported in both the Daily Mail and the Independent (the increase in ?prescribing of opioid analgesics by GPs from 228 million items in 1991 to 1.38bn items in 2009?), appear to be from this report. This report has not been reviewed in depth here, but can be found on the NTA website.

�

What kind of research was this?

This editorial was on trends in deaths and harm related to prescription opioid drugs and prescribing practices, primarily focusing on the US, although other countries are also mentioned. The article was not an opinion piece, was not a systematic review of the literature and has not been subject to peer review. The authors are lecturers and researchers at the University of Toronto.

The authors discussed the history of opioid use and trends in opioid-related deaths. They went on to make recommendations on health policy changes that could result in a decrease in the number of these deaths in the US.

�

What did the editorial say?

The authors said that deaths involving opioid painkillers in the US increased from about 4,000 in 1999 to nearly 14,500 in 2007. Such increases have been seen in other countries as well, including the UK. They also reported that most of these deaths are unintentional and are most often in young people.

The editorial highlighted concerns expressed by the former chair of the House of Commons All Party Parliamentary Group on Drug Misuse on the possibility that the UK will see a similar spike in opioid-related deaths within the next decade. It also referenced a 2010 BMJ article which reported that deaths involving methadone and codeine, two opioid drugs, nearly doubled in England and Wales between 2005 and 2009.

The authors discussed their growing concern that many of today?s opioid-related deaths could be prevented with adequate regulation of drug companies and more responsible and evidence-based prescribing practices.

The authors put forth several recommendations aimed at reducing the number of deaths involving opioid painkillers in the US, including:

Restricting the marketing practices of drug companies, especially the current practice of rewarding drug sales representatives with large bonuses based on the number of drugs they sell. The authors also recommend that drug companies no longer be allowed to give coupons to new patients for free prescriptions of potentially addictive drugs.
Requiring physicians and patients to register the prescription of methadone for the treatment of addiction so that prescribing habits can be tracked and drug-seeking behaviour can be detected.
Developing electronic databases that provide information on all patients? prescriptions, and requiring doctors and pharmacists to check this database before prescribing or dispensing opioid painkillers.
Increasing physician education regarding the lack of evidence supporting the long-term use of opioids for non-cancer related pain, the toxicity of different opioids, the potentially fatal interaction between opioids and other drugs (including alcohol), and the lack of trials comparing opioids to other alternative forms of analgesia, such as paracetamol and non-steroidal anti-inflammatory drugs.
Increasing public education efforts designed to inform people of the dangers of mixing opioid painkillers and other drugs.
Encouraging well-designed, long-term research into the effectiveness of opioids compared to other forms of pain relievers.

�

How did the author interpret the findings?

The authors concluded that there is no clear indication that the long-term benefits of prescribing opioid painkillers outweigh the risks. They said that opioid painkillers can be a ?valuable option for the treatment of acute pain and chronic cancer pain?, but that care needs to be taken when prescribing them for other conditions. The authors added that there must be a balance between making sure the drug is available to patients for whom the benefit has been supported by evidence, while reducing its use in patients for whom the benefit has not been proven or adequately researched.

�

Conclusion

This was an editorial written in response to the increasing number of opioid-related deaths in the US. The editorial reflected the views of the authors and the research and statistics that they had considered. While the article made several recommendations on possible ways to reduce the number of opioid-related deaths, without a formal systematic review it is not known whether all relevant evidence on the topic has been consulted. As such these recommendations may be considered to be opinion-based.

While similar trends in opioid use may exist in the UK, this editorial does not focus on the UK situation. Though research on the effectiveness and safety of opiods for non-cancer pain would be valuable, many other of the authors? recommendations and suggested policy changes would not be as relevant to the UK as they would be in the US due to different marketing practices and regulations. For example, in the UK, prescription drugs are not advertised or marketed to those outside of the healthcare profession.

This editorial did highlight important areas for future policy discussions on the UK?s drug prescribing practices. Addressing this potential problem before it reaches the scale reported in the US could prevent avoidable deaths. People who live with chronic pain should discuss the management of chronic pain and the risks of long-term use of opioid painkillers with their GP or other relevant pain specialist health professional, especially if they are taking other prescription or non-prescription drugs.

Links To The Headlines

Leading article: The dark side of prescription drugs.�The Independent, August 25 2011

'Disaster' looms over addiction to painkillers.�The Independent, August 25 2011

We're addicted to painkillers: How number has risen six-fold to hit 1.38 billion prescriptions a year.�Daily Mail, August 25 2011

Links To Science

Dhalla IA, Persaud N, Juurlink DN et al.�Facing up to the prescription opioid crisis. British Medical Journal 2011, 343: d5142

Addiction to Medicine�- The National Treatment Agency for Substance Misuse 2011

Source: http://www.nhs.uk/news/2011/08August/Pages/warning-over-painkiller-addiction.aspx

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Psychology Study Contradicts Popular Idea That Males Need To Feel Safe To Share Feelings

Main Category: Psychology / Psychiatry
Also Included In: Men's health;��Pediatrics / Children's Health
Article Date: 24 Aug 2011 - 0:00 PDT

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A new University of Missouri study finds that boys feel that discussing problems is a waste of time.

"For years, popular psychologists have insisted that boys and men would like to talk about their problems but are held back by fears of embarrassment or appearing weak," said Amanda J. Rose, associate professor of psychological sciences in the MU College of Arts and Science. "However, when we asked young people how talking about their problems would make them feel, boys didn't express angst or distress about discussing problems any more than girls. Instead, boys' responses suggest that they just don't see talking about problems to be a particularly useful activity."

Rose and her colleagues conducted four different studies that included surveys and observations of nearly 2,000 children and adolescents. The researchers found that girls had positive expectations for how talking about problems would make them feel, such as expecting to feel cared for, understood and less alone. On the other hand, boys did not endorse some negative expectations more than girls, such as expecting to feel embarrassed, worried about being teased, or bad about not taking care of the problems themselves. Instead, boys reported that talking about problems would make them feel "weird" and like they were "wasting time."

"An implication is that parents should encourage their children to adopt a middle ground when discussing problems. For boys, it would be helpful to explain that, at least for some problems, some of the time, talking about their problems is not a waste of time. Yet, parents also should realize that they may be 'barking up the wrong tree' if they think that making boys feel safer will make them confide. Instead, helping boys see some utility in talking about problems may be more effective," Rose said. "On the other hand, many girls are at risk for excessive problem talk, which is linked with depression and anxiety, so girls should know that talking about problems isn't the only way to cope."

Rose believes that the findings may play into future romantic relationships, as many relationships involve a "pursuit-withdraw cycle" in which one partner (usually the woman) pursues talking about problems while the other (usually the man) withdraws.

"Women may really push their partners to share pent-up worries and concerns because they hold expectations that talking makes people feel better. But their partners may just not be interested and expect that other coping mechanisms will make them feel better. Men may be more likely to think talking about problems will make the problems feel bigger, and engaging in different activities will take their minds off of the problem. Men may just not be coming from the same place as their partners," Rose said.

The study was funded by the National Institute for Mental Health and was co-authored by current and former MU psychology graduate students Rebecca Schwartz-Mette, Rhiannon Smith, Lance Swenson, Wendy Carlson, and Erika Waller and Rose's colleague Steven Asher.

Article References:
The paper, ?How Girls and Boys Expect Disclosure About Problems Will Make Them Feel: Implications for Friendships,? will be published in an upcoming edition of the journal Child Development.
University of Missouri-Columbia

The Impact Of Chemotherapy On Female Fertility

Main Category: Cancer / Oncology
Also Included In: Women's Health / Gynecology;��Fertility
Article Date: 28 Aug 2011 - 0:00 PDT

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Current estimates of the impact of chemotherapy on women's reproductive health are too low, according to a University of California, San Francisco (UCSF) study. The researchers say their analysis of the age-specific, long-term effects of chemotherapy provides new insights that will help patients and clinicians make more informed decisions about future reproductive options, such as egg harvesting.

Previous studies largely have focused on amenorrhea, or the lack of menstruation shortly after treatment, as the primary reproductive side effect of chemotherapy. In this analysis, the researchers also focused on longer-term, age-specific outcomes associated with chemotherapy, including infertility and early menopause. They also noted that the younger a woman is when diagnosed with cancer, the more likely she will experience early menopause.

"We found chemotherapy essentially narrows a woman's reproductive window by causing a range of damage to the ovaries, even if her menses resume after chemotherapy," said Mitchell Rosen, MD, senior author and assistant professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences.

Many of the women who responded to the survey had been told that as long as their periods came back, they would have no negative impact from treatment, he said.

"We currently make recommendations on preserving fertility based on limited data. These new findings, which also take into account cancer type and age, hopefully will enable us to offer more strategic and personalized counseling," said Rosen, who also is director of the UCSF Fertility Preservation Center.

The study is available online in the journal Cancer.

The researchers used the California Cancer Registry, a statewide population-based cancer surveillance system, to ask women about their reproductive history before and after cancer treatment. Survey questions addressed acute ovarian failure (cessation of menses after treatment), early menopause (menopause before 45 years old), and infertility (failed conception).

A total of 1,041 women diagnosed with one of five targeted cancers between the ages of 18 and 40 years old responded, and 620 reported having been treated with only chemotherapy. The five cancer types - leukemia, Hodgkin's disease, non-Hodgkin lymphoma, breast cancer and gastrointestinal cancers - were chosen because they are common non-gynecologic cancer groups that can be treated with systemic chemotherapy.

Key findings include:

The percentage of women reporting acute ovarian failure was 8 percent, 10 percent, 9 percent and 5 percent for Hodgkin's disease, non-Hodgkin lymphoma, breast cancer, and gastrointestinal cancers respectively. Acute ovarian failure increased significantly with age at diagnosis.
In women without acute ovarian failure, the incidence of infertility increased significantly with age at diagnosis. For instance, the proportion of infertile women with Hodgkin's disease was 18 percent at 20 years old and 57 percent at 35 years old.
The estimated probability of early menopause increased significantly with younger age at diagnosis. For example, using age as a predictor of early menopause in non-Hodgkin lymphoma, 56 percent of women 20 years old at diagnosis may experience menopause early, compared to 16 percent of those who were 35 years old at diagnosis.

Approximately 120,000 women younger than age 50 develop cancer each year in the United States, according to statistics from the 2006 Surveillance, Epidemiology, and End Results (SEER), and several studies show that loss of reproductive potential after cancer treatment can negatively impact quality of life in young survivors.

While 7 percent of women across the United States report 12-month infertility according to the researchers, the rates of infertility in young cancer patients are unknown.

"We noted proportions of infertility among cancer survivors that appear considerably higher than those in the general United States population," said Joseph Letourneau, MD, the study's lead author. Letourneau was a medical student under Rosen when the research was conducted and now works as a resident physician in obstetrics and gynecology at the University of North Carolina. "When counseling patients, focusing solely on short-term outcomes like loss of menses may give women unrealistically low assessments of their risks, since they could experience infertility or early menopause years to decades after treatment."

Rosen said that more research is needed since the retrospective study did not include specific patient characteristics such as genetics or variations in individual cancer treatments.

"Our analysis adds one more piece to the puzzle," he said. "Doctors will continue to need to use their gestalt and understanding of a patient's life to provide the best guidance."

Co-authors are Erin E. Ebbel and Marcelle I. Cedars, MD, of the UCSF Department of Obstetrics, Gynecology, and Reproductive Sciences; Patricia P. Katz, PhD; Wei Z. Ai, MD; Jo Chien, MD; Michelle E. Melisko, MD of the UCSF Department of Medicine; Kutluk H. Oktay, MD of the Department of Obstetrics and Gynecology, New York Medical College; and Charles E. McCulloch, PhD of the UCSF Department of Epidemiology and Biostatistics.