Health + Medicine

This was the year of the health review – on mental health care, the response to ice, Medicare, private health insurance, the pharmacy industry … and the list goes on.


Paying doctors a fixed sum to care for a patient for the entire year, rather than a fee for each visit or service, is one solution, Peter Sivey wrote.

Another is to better target the tests and treatments that are given, and to tame the tsunami of too much medicine, Ray Moynihan explained. The current review of the Medicare schedule presents an opportunity to do just this.

Population health, a push to keep people healthy and out of the hospital, gained traction in multiple settings across the U.S., including accountable care organizations, bundled-care plans and clinically integrated health-care networks. These networks link patients to the full spectrum of services, from preventive care to highly specialized hospital care. The goal is to help keep people healthy and intervene before costly care is necessary.

Consumerism is expanding. Wearable medical devices, cloud-based computing and transparency initiatives enable consumers to make more informed health care choices. Consumers also have more choice; they can purchase coverage privately, through their employers or through state and federal insurance marketplaces. Employers, in some cases, have established their own marketplaces. Those shopping for insurance can choose between comprehensive or high-deductible plans.

7 really weird ways bad teeth are destroying your body

It is absolutely essential that you treat your oral health just as you would your overall health.

Many people fail to brush and floss regularly, and more importantly, do not go to their yearly dentist checkups. If this is the case for you, this means you are unaware of the true damage you are doing to your body. There are a number of reasons for neglecting your oral health, but there are even more reasons why you shouldn't.

Understanding why proper oral hygiene is so important to your health will hopefully motivate you to take better care of your teeth and gums. Gum disease has the potential to pop up at any given time.

Here are 7 reasons why you simply cannot afford to neglect your oral health even a second longer:

1. Risk for Heart Disease and Stroke

People who have a periodontal disease are twice as likely to develop heart disease because of the narrowing of the arteries that causes plaque and bacteria to get into the blood stream through the mouth and gums.

This bacterium contains protein that promotes blood clots which can also clog the arteries while significantly increasing the risk for heart attack. This same bacteria has the ability to clog the artery that delivers blood to the brain which can cause you to have a stroke.

2. Risk of Dementia

Poor oral health and tooth loss increases your risk of suffering from memory loss at an early age.

Studies have shown that poor oral health can lead to a diagnosis of early stage Alzheimer's disease. If your gums become inflamed due to infection, this can also cause brain inflammation which could cause death of certain brain cells.

3. Respiratory Problems

Bacteria that is caused by periodontal disease has the ability to travel through the bloodstream and to your lungs where it can impact the respiratory system.

If you have already experienced respiratory problems in the past, then you have a greater chance of having further problems due to poor oral hygiene. If you have gum disease this also puts you at higher risk for pneumonia and other respiratory conditions.

4. Risk of Diabetes

95% of the individuals in the United States who have diabetes have also experienced severe periodontal disease that has led to tooth loss. This is because individuals who suffer from diabetes have a higher risk of infections. However, it is a two-way street: diabetes leads to gum disease and gum disease leads to diabetes.

5. Erectile Dysfunction

Men who suffer from periodontal disease are seven times more likely to also experience some sort of erectile dysfunction than men who practice excellent oral hygiene.

The bacteria caused by periodontal disease can travel into the bloodstream which inflames the blood vessels which blocks the flow of blood to the genitals.


6. Premature Birth

Many experts have stated that premature birth is caused by the overall health of the mother and her entire body. If she does not practice good oral hygiene and develops an infection in the mouth, this can travel to the unborn child which can lead to premature birth.

7. Cancer

A number of experts have confirmed that men who have gum disease were almost 50% more likely to develop kidney cancer and 30% were more likely to develop cancers of the blood. This makes it extremely important to see your dentist regularly and practice good oral hygiene.

If you are not taking care of your oral health, you could be causing severe damage to your body. Make sure that you get regular checkups from your dentist and continue practicing excellent oral health.

Examines solutions to community health problems

While many people think of staying well as an individual responsibility, where you live plays a huge role. Place and culture help determine social norms and access to affordable housing, safe neighborhoods, healthy food and places to exercise.



Benjamin said such solutions work for a few major reasons: "They're culturally sensitive. They're focused on the needs of people in the area. And they're designed to work where they are."

In September, USA TODAY and Cigna hosted a forum in Houston that focused more on challenges facing that part of the country and rural areas. Residents in the sprawling city talked about their health challenges, and barber Tre Sims discussed overcoming his. He's lost 100 pounds in the last three years by eating healthier and no longer suffers from high blood pressure. Now he picks up fruit at the convenience store near his work, instead of the junk food he used to eat. He can do that thanks to the Healthy Corner Store Network, a partnership between Go Healthy Houston and the community organization CAN DO Houston, which stands for Children and Neighbors Defeat Obesity.

The event, presented by USA TODAY and Cigna, runs from 9-11 a.m. at the Newseum in Washington. One panel will feature two public health thought leaders: Georges Benjamin, executive director of the American Public Health Association; and Richard Hamburg, deputy director of the Trust for America's Health. They will talk about keeping whole populations healthy and reducing health disparities, especially in urban areas.

Which Health Plan Should I Get?

This Q&A column addresses questions from real patients about health care costs. Have your own question? Get your answer here.


Question:

My company’s open enrollment period just started, and I have to choose a health insurance plan. Since I’m single and haven’t been to the doctor in years, I’ve always chosen the cheapest option, which offers low coverage. I’m getting older, though, and next year I’d like to take better care of myself, starting with a checkup, without going broke. How can I choose a health plan that’s right for me?

Answer:

First of all, congratulations on taking the initiative to improve your health! Making sure your health care is affordable is a great first step. Choosing the right insurance plan will be simpler for you than for many others because you don’t expect to need a lot of health care next year, but you may find you need more than you think.

For instance, during that first checkup, your doctor may want to order lab tests or refer you to a specialist based on your physical exam. And if you’re truly looking to make a commitment to better health, you may end up seeking out more care instead of toughing out what feel like minor illnesses or injuries.

Finding the right plan will be a balancing act, but I can help you evaluate plan options so you can find the right one for you.

7 ways to feel awesome while you're pregnant

Ladies, pregnancy is wonderful. But when morning sickness hits, your clothes start getting tight, and you eventually begin waddling, you'll be craving comfort worse than pickles. Keep in mind these things that help make the journey a bit more comfortable.

Get and wear clothes that fit

I know it feels like you need to try fitting into your regular clothes as long as possible during pregnancy. But this only causes feelings of uncomfortable chubbier-than-normal self-consciousness. The first time you slip on a pair of maternity pants, it's like an "I don't have buttons digging into my stomach all day anymore" miracle. You'll wonder why you didn't switch to these amazing, stretchy things earlier. Plus, preggo clothes offer some cute options — you may just have to look around. Leggings and long, stretchy shirts are comfortable options throughout pregnancy.

Put your feet up

Find some time throughout the day to rest and put your feet up. Taking some stress off of your tired legs can be a nice refresher. Read or take a short nap if you are able. Also, laying on your left side is preferable, as it is best for circulation.

Go to bed early, and use a body pillow

When you're pregnant and tired — which is like, always — you can feel a little zombie-esque. And uncomfortable sleep can be a regular occurrence during pregnancy. Try to go to bed at a decent time so you're getting more sleep. And get a body pillow (Seriously — you're welcome for that one).

Eat healthy, but give in to a craving once in a while

When you eat crappy, you feel crappy. The same happens while pregnant, but I think even more so, as bloating can be a common feeling due to the wee one already taking up room in your tummy. Try to eat healthy. But when donuts sound incredible, have one now and then to satisfy that craving. Also, be sure to drink a ton of water. Drinking enough water throughout your pregnancy is necessary for both you and your little one and comes along with many other benefits.

Slather on the lotion

Experts' opinions differ on whether regularly slathering up your stomach in lotion reduces stretch marks, but it's worth a try. And even if it doesn't, regularly putting lotion on — after a shower is a good time to remember and be consistent about it — will make your skin look and feel better, which is just an added bonus. Bio-oil is a good option for healthy, glowing skin and can be found at most major stores. (Tip: Check the prices on their websites before buying it -- they will usually price match if you find a lower price). Palmer's also offers some great pregnancy lotion options.

And remember, if you do get stretch marks, they are simply reminders of the beautiful little one your body was able to bring into this world — no shame in that whatsoever. Plus, they usually fade with time.

Exercise

Exercising will do wonders for your mood. A nice walk outside can be just what you need to get yourself feeling better. Just be sure to stay within the guidelines your doctor has given you. Check out these tips for exercising while pregnant.
Stretch

Again, don't overdo it -- but stretching feels awesome when you have crampy legs after being on your feet. Give these stretches a try for some much-needed relaxation.

Choking Our Health Care System With Coal

As if we don’t have enough problems with our health care system, burning coal for over third of our electricity makes it even worse.

Studies show coal kills ten times more people than any other energy source per kWh produced, and ten times more people in the developing world than in America, because of our Clean Air Act. These deaths are mainly from fine toxic particulates emitted from coal plants.

In fact, the Clean Air Act is the single piece of legislation that has saved the most American lives in history, and is why coal kills about 500,000 people in China each year, but only about 15,000 Americans per year.

However, there are a lot more health effects beyond actual death, and several studies have attempted to quantify those costs – costs that include lost work days, hospital visits, disability, prescription drugs and all the costs associated with illness in addition to death (1,2,3,4).


A study by EPA’s Ben Machol and Sarah Rizk found that the use of coal in America costs us anywhere from $350 billion to $880 billion per year. That’s up to 6% of our GDP, and well over 10% of our total health care costs. Total health care costs in this country are about $3 trillion per year.

Mental health stigma campaign starts

A campaign to reduce the stigma around mental health in children has been launched by the government.



It will use school visits and social media to urge young people and parents to talk more about mental health.

Health Minister Alistair Burt said the campaign was "the largest ever" and would include an online hub of mental health information.

Charities welcomed the move, but criticised a delay to a new survey of child mental health.

The Time to Change charity says three children in every classroom experience mental health problems ranging from self-harming to eating disorders.

The campaign will also see the launch of the Youth Mental Health Hub website to help children find accurate information about mental health conditions.

He will add the campaign marks the "biggest transformation to young people's mental health and one of the greatest investments the sector has seen".

Meanwhile, the first survey of young people's mental health since 2004 has been commissioned.

Nearly 10,000 people aged from two to 19 and their families will be interviewed to assess the prevalence of mental health issues.

Sue Baker, the director of Time to Change, said: "Young people have told us that stigma is life-limiting, it affects friendships and school life, and for a quarter it even makes them want to give up on life.


However, its chief executive, Sarah Brennan, said the long wait for the survey results would be a major barrier to improving care.

Is sitting as bad for our health as we think?

In recent years, studies have linked sitting for long periods of time to increased health risk, including an earlier death, even for people who are otherwise physically active.

But new research published in the International Journal of Epidemiology is challenging these claims and suggests that sitting may not be so bad after all.
Researchers from the University of Exeter and University College London followed more than 5,000 participants for 16 years, making it one of the longest follow-up studies looking at this area of research. The results show that sitting, either at home or at work, is not associated with an increased risk of dying early.
The authors say the results cast doubt on the benefits of sit-and-stand work stations, which many workplaces have adopted in an attempt to create a healthier work environment.

Participants in the study provided information on total sitting time and on four specific types of sitting behavior: sitting at work; during leisure time; while watching TV; and sitting during leisure time excluding TV. They also submitted details on daily walking habits and time spent on moderate to physical activity.
The results showed that over the 16-year study, none of the sitting modes influenced mortality risk.

The researchers also took into account factors such as age, gender, ethnicity, socioeconomic status, general health, smoking, alcohol consumption and diet.

Dr. Michael Roizen, Chief Wellness Officer of the Cleveland Clinic, said that all of the research surrounding the health effects of sitting is relatively weak, which accounts for the conflicting results.

To the woman wishing she had a different body

"You know what I wish?" My neighbor and new mother confided over lunch. "I wish I wasn't so ashamed of my body."

My neighbor is a beautiful person with four healthy and adoring children, yet I understood. Many women would empathize with her desire to feel more beautiful and be more confident about their appearance.

It isn't a matter of vanity. For many, it's celebrating the family they brought into this world but wishing that sacrifice hadn't taken such a physical toll on their bodies.

Cosmetic surgery. The very topic has a polarizing effect on most social circles. But in today's world, the perimeter of aesthetic medicine and plastic surgery reach beyond going "under the knife." Although there is plenty of that, too. When facing sagging breasts or a jowly jawline, how can we know if seeking cosmetic surgery is the best option? Here are 3 things to think about.
Are you looking for a better version of yourself or the copy version of someone else?

Often a patient's disappointment stems from expectations placed too high on the outcome. Kate Middleton has a fantastic nose, but not everyone can successfully pull off that same feature.

"Understanding what can be done given your personal situation is something you need to talk to your surgeon about." Wrote Christina Haller in the article, The pros and cons of plastic surgery. "If you walked in with Sarah Jessica Parker's nose expecting to walk out with Natalie Portman's and instead ended up with Anne Hathaway's, you have to be alright with that."

Another thing to consider is what is truly motivating this desire for change. Would this procedure bring about an inner confidence that is lacking due to a physical condition or is this desire motivated by a need to be accepted?

"Having low self-esteem as a result of a physical attribute you're not happy with can affect all areas of your life," wrote Haller. "There's nothing wrong with thinking you could be happier, as a result of being more confident, if you could put your best face forward. Remember though, surgery is not a cure for deeper issues such as depression or jealousy. Be sure you are working through the root of the problem before going under the knife."

The idea of pursuing plastic surgery is to improve what already exists. Don't expect to come out of surgery looking like a Victoria Secret model with tons of friends and a trouble-free life. Instead, your goal should be attaining a younger, firmer version of yourself that enhances a stronger inner self.
Do you need a procedure or just some pampering?

As new technology in aesthetic medicine is being introduced, many women are finding satisfaction in "treatments" instead of "procedures."

For example, a local company called Venus Concept has perfected a technique that offers patients a non-invasive treatment using a Multi-Polar Radio frequency that delivers fast, homogenous heating deep in the dermis where collagen is located without damaging the epidermis. This "massage" performs deep penetration, lymphatic drainage and stimulates both fibroblasts and circulation. In layman's terms, this means 30 minutes in a chair creates softened laugh lines and wrinkles, tighter skin, contoured upper arms and abdomen.

"It created subtle changes," explained KUTV Channel 2 media personality Shauna Lake. "Changes that made people say, 'You look great and well-rested.' Or, 'Have you lost weight?' After the first day I noticed results. That was really the only assurance I needed."

According to the American Society for Aesthetic Plastic Surgery, doctors are seeing the biggest increase in nonsurgical procedures with Botox leading the list followed by chemical peels (Hyaluronic acid), hair removal, microdermabrasion, and photo rejuvenation.

If you are feeling dissatisfied with how you feel or look, rather than focusing on major surgical procedures, first consider less committed options such as regular massages or non-invasive techniques that improve your appearance.
The cost

Because most procedures are considered an elective surgery, that bill is yours to pay in full. For example, breast augmentation can cost upwards of $4000 to $10,000Liposuction can reach totals of $11,000.

According to the American Society for Aesthetic Plastic Surgery, Americans spent 12 billion dollars on cosmetic procedures. "Of that total, more than 7 billion was spent on surgical procedures and more than 5 billion was spent on nonsurgical procedures."

What was the most popular surgical procedure this year? Liposuction replaced breast augmentation as the top procedure with eyelid surgery, tummy tuck, and nose surgery completing the list.

"In 2013, more than 2.5 billion dollars was spent on injectables alone. In addition, nearly 1.9 billion was spent on skin rejuvenation, a fast-growing sector of the aesthetic nonsurgical industry."

"A significant increase in the number of both cosmetic surgical and non-surgical procedures suggests that people are once again investing in their appearance and perhaps have more disposable income to do so," notes Michael Edwards, MD, President-Elect of ASAPS. "Given the state of the economy and the competitiveness of the job market, we expect to see the numbers for anti-aging procedures continue to increase."

Keep in mind, this isn't the time to settle on the cheapest bidder. Be sure to consult with a board- certified doctor who understands your desire, has experience in that type of procedure and can be someone you trust to handle the surgery well.

The "face" of cosmetic surgery is definitely changing. It brings with it exciting and affordable new options that are changing the way women view themselves. By considering your expectations, your motivations and the financial impact this decision may place on your family, you can consider whether or not cosmetic surgery is the right choice for you.

How to Maximize Mental Health Coverage

As Congress seeks to reach consensus on mental health reform, critics say deficits in insurance coverage often leave individuals and families struggling to afford therapy and medications to treat psychological issues, or worse: forgoing care altogether.
No overarching remedy exists to alleviate widespread impediments to access, rooted in everything from health plans that don’t cover many mental health providers to higher out-of-pocket costs for some drugs that treat mental health conditions. Still, there are situation-specific strategies that may maximize coverage and make mental health services and medications more affordable.



Do Your Homework Before Enrolling in a Plan

With the next open enrollment period under Obamacare set to begin Nov. 1, it’s a good time to get an early start researching health insurance plans. That's a solid idea whether you're getting a plan through a health insurance exchange or looking at several options an employer offers.
Large employer plans are not required to cover mental health services, but if they do offer mental health benefits, they must be on par or equivalent to benefits for general medical care, says Sita Diehl, director of state policy and advocacy for NAMI. “So the first thing to do if you’re shopping for a plan through your employer is to make sure that mental health benefits are covered. Most are – most plans do cover mental health – but you’ve got to check it out,” Diehl says. Those who work for a company that offers a plan that doesn't cover mental health may choose to purchase insurance outside their company. You may end up spending more of your own money on monthly premiums as a result, however.

Crunch Dollars and Cents Upfront

Take into account plan deductibles – including out-of-network versus in-network for preferred provider organization, or PPO, plans – and out-of-pocket limits, says Nicholas Moriello, a health insurance broker and president of Health Insurance Associates in Newark, Delaware.

Then go a step further in your cost assessment. Plans commonly use a tiered coverage system, in which drugs – including some for mental and behavioral health – falling into higher tiers receive less-robust coverage, resulting in higher out-of-pocket costs for consumers, says Moriello, who is also a member of the national legislative council for the National Association of Health Underwriters, an industry trade group. Check to see not only whether your medications are covered, but to what degree.

Why should teenagers be allowed to sleep in for as long as it suits them?

Dr Paul Kelly, the chap who knows all about teenagers’ circadian rhythms, is still begging the world to let them lie in, and come to school at 11am. He’s tried it at his former school and apparently it worked a treat. Exam results shot up and the general mood was enhanced. Well it would be, wouldn’t it? It is heaven to stay in bed as long as one pleases. We don’t want young persons back toiling up chimneys or in galleys and laundries, but why pander to these rather annoying creatures?

They’re not the only ones who are clapped-out at 8am. I would much prefer to wake up at lunchtime, and Fielding’s circadian rhythms always pressured him to doss until noon, but the world required that we override nature, rise at first light and go to work, along with all the drillion knackered parents, insomniacs and anyone else who stayed up later than was good for them, exerting themselves in all sorts of ways, often in, or glaring at, artificial light, which bedevils their body clocks. Why, out of all of these exhausted millions, should it just be teenagers who are allowed to moulder in bed for as long as it suits them?

Meanwhile, all the rest of us must let the dogs out, milk the cows, open the shops, run the buses, provide the breakfast, keep the world running and teach in the schools that the teenagers can’t be fagged to go to, because the 11-12 years olds are there already (their body-clocks woke them earlier, and even if they didn’t, the parents had to dump them somewhere while they went off to work). In Dr Kelly’s world, they’d be leaving their unsupervised teenagers festering at home. Imagine the anxiety this would cause the parents at work, reducing productivity. If only they too could rise late, work in bright, airy venues, with lovely long tea-breaks and lunch hours, which all researchers know would do them no end of good, but they can’t, because that’s not how the world works. It’s harsh. Which teenagers should perhaps learn at 9am assemblies.

Why walking to improve your health is not quite as straightforward as it seems

Getting people walking has proved a challenge

Although this sounds fairly easy in principle, getting people to do more exercise through walking is something that has been at the heart of public health policy in a major form since the publication ofphysical activity guidelines in 2008. These guidelines advocated at least 2.5 hours a week of moderate intensity physical activity, such as brisk walking. This target is echoed by the UK’s physical activity guidelines and those inAustralia.
The potential benefits in terms of improved public health are clear, if you consider that only 54% of adult men and 46% of adult women in the US meet the physical activity goal. Worse still, 28% or men and 32% of women reported that they had not done any physical activity that lasted more than 10 minutes in the previous week of being asked.

Getting people walking at the right level of intensity is even harder

Getting people to walk the minimum amount of time is a major challenge. The even bigger challenge comes with the part of the advice that is often ignored or simply not known or understood. In order for their to be a health benefit, the pace at which the walking is done needs to be above a certain intensity.
Although not specifically mentioned in the US Surgeon General’s “Step it Up” programme to promote walking, wearables such as those from Jawbone, Fitbit and others, are one way of tracking the number of steps walked in a day. For most users of these devices, the focus is on getting to the magical 10,000 steps a day. This isn’t really the best target to use however as to achieve the intensity guidelines to achieve a health benefit, it is only the steps that were above a certain pace that count.

The problem with the evidence

The problem with a large amount of the research done in the area of health benefits of walking is that it has been done using surveys and self-reporting which is notoriously inaccurate. Very few studies have been conducted using the “randomised controlled trial” approach to this type of scientific investigation using objective measures of activity that even consumer wearables can now provide.

As at least the US Surgeon General has made clear in his call to action, much more research is needed. Not only to make the evidence for the exact nature of the benefits clear, but also to investigate how people can be persuaded to start and stick with a programme of walking to achieve the recommended amounts of exercise. Although walking results in fewer injuries than say, running, it is not completely free of risk and so this is another area that requires more research.

Are painful experiences from your past slowly killing you?

• Many of us had painful experiences as a child or teen, and while it may seem obvious these experiences impact our mental health, we now know that there are some experiences which can also negatively impact our physical health.
  A study (Adverse Childhood Experiences study) that focused on one's home environment, experiences, family members' mental health, divorce and whether or not love and support was felt, proved that these factors do in fact matter in your physical health.
  
  
  
  
  Why should you be interested in this study? Why should you care? These findings are incredibly important on multiple levels. The authors of the study created the ACE Pyramid to explain why these experiences impact our health.
  Childhood experiences lead to social, emotional and cognitive damage. That devestation can lead to the adoption of health risk behaviors and potentially chronic stress from untreated PTSD (Post Traumatic Stress Disorder) or other mental health issues. This can lead to disease, disability and social problems.
  There is an undeniable link between our childhood experiences and our risk for various diseases, disorders and behaviors, and that the higher your ACE score, the higher your risk. The good news is that intervention at any point, whether in childhood or as an adult, can help decrease risk.

• Curious what you or your children's ACE score is?

  You can take this quiz to find out.
  More than half of the participants answered yes to at least one question, according to the study's findings. More than one in five reported three or more ACEs. Those with scores of four or more showed the greatest risk — four to 12 times higher risk than for those who reported just one ACE — for the following behaviors or diseases:
  
  • Alcoholism and alcohol abuse
  • Chronic obstructive pulmonary disease (COPD)
  • Depression
  • Fetal death
  • Health-related quality of life
  • Illicit drug use
  • Ischemic heart disease (IHD)
  • Liver disease
  • Cancer
  • Intimate partner violence
  • Multiple sexual partners
  • Sexually transmitted diseases (STDs)
  • Smoking
  • Suicide attempts
  • Unintended pregnancies
  • Early initiation of smoking
  • Early initiation of sexual activity
  • Adolescent pregnancy
  For adults, getting treatment for traumatic experiences decreases the risk of developing the above issues. And for those who are currently experiencing the impact of past trauma and struggle with any of the issues above, treatment now can have a dramatic, positive impact on how we will manage stress, heal from our physical and emotional issues and potentially change the direction of our lives!
  Treating the underlying traumatic experiences from the past — or increasing the safety and health of kids who experience trauma, leads to increased mental and physical health for individuals, families and our communities. This means the potential for fewer doctor and hospital visits, fewer sick days from work, more productivity and healthier families.

• How can we help kids who are at risk?

  Parents, teachers and medical professionals can use this information to provide support to children who have been exposed to ACEs. These children need adults to intervene, work to decrease their risks by increasing their safety at home and promote healing from the abuse or neglect they have already experienced.
  There are additional resources with further information on the ACE Study and how to use it, along with resources for the prevention of abuse.

Is a six-figure salary bad for your health?

Ten years ago, Catherine Salway was brand director at Virgin, jetting between LA, New York and London, earning a six-figure salary, flicking through property magazines and considering buying a larger home in west London.

By most corporate executive standards, she was living the dream: a high-flying career at a riotously successful company, accompanied by a jet-set lifestyle of copious champagne, canapés and transatlantic flights.

The trouble was, it didn't feel as good as it seemed. "I was two stone overweight, I drank far too much, and my moods oscillated between stressed and depressed," she says. "I was cash-rich but time-poor, rarely seeing my family and friends, eating and drinking far too much."

After 17 years as Richard Branson's "brand guru", leaving Virgin was a wrench, but three years ago Catherine quit to set up her own alcohol-free bar, Redemption, in Notting Hill. "Some people think they have a book in them; I felt I had a brand in me," she explains. This sidestep out of the corporate world transformed her health. "I had been propelled by ambition and didn't realise just how bad the lifestyle was, until I popped out the other end.

"I haven't had a manicure for three years, but I'm down to a healthy size 12, I book yoga into my schedule three times a week and I see my dad twice a month, instead of a few times a year," she says. "At 42, I look and feel so much better than I did 10 years ago."

But there is mounting evidence that the executive lifestyle is not all it is cracked up to be. Last week, a major new study showed that employees who work more than 55 hours a week have a 33 per cent increased risk of stroke, compared with co-workers who clock up 35-40 hours. "Sudden death from overwork is often caused by stroke and is believed to result from a repetitive triggering of the stress response," wrote researchers from University College London, in the medical journal The Lancet. While they can't state categorically that long hours cause people to have strokes, their study shows a clear link - one that gets stronger as the hours people put in get longer.

4 cures for morning sickness in pregnancy

Vomiting and nausea in pregnancy are nothing new. In fact, the Egyptians wrote about them over 2,000 years ago. Morning sickness is nearly a universal condition for women in the first part of their pregnancies. Seventy-five percent or more suffer the symptoms.

If you're pregnant and have morning sickness, you've probably asked the question "Why do they call it morning sickness?"

Read: Chugging hot sauce induces labor and other baby myths

Actually, most women have the symptoms of morning sickness at any and all times of the day, although some do find it more severe in the morning, when they first wake up. Some people feel that it is worse in the mornings because nausea seems to be worse on an empty stomach, and after not eating all night, those first moments in the morning can be difficult.

So, one cure for that first-thing-in-the-morning nausea is to keep a few crackers or cheese at your bedside to eat before venturing out of bed. Carbs often sound the best to a sore stomach, but there is evidence that protein is helpful, too. It's also best to eat frequent, small meals while in this stage for the same reason. Don't let your stomach get too empty. And, as your pregnancy progresses, this is a great habit to keep. Later, when your baby is larger, you may have trouble with acid or heartburn. Smaller, more frequent meals will help.

Here are some other ideas:

Avoid trigger foods

You may notice certain foods or smells trigger your nausea. Avoid them when possible. Sometimes even flickering lights or a stuffy room will set you off. Once you identify these you can do your best to stay away from them. Fatty foods are often problematic, as well as very spicy foods. Pay attention to your body's signs.

Not so hot

Sometimes, eating a food at room temperature, or cold, is more easily tolerated than hot.

Ginger

It's a time-honored antidote for morning sickness. Make ginger tea from raw ginger, or take capsules with real ginger for a better result than commercial ginger ale. Some people get relief from ginger candies or suckers.

Peppermint

Tea may be helpful, or using pure peppermint essential oil topically. Sometimes, even sniffing the bottle of essential oil will quell your stomach. Be sure to use a therapeutic grade oil to avoid synthetic peppemint--which may actually make it worse.

When vomiting is severe, staying hydrated is a problem, since drinking water is sometimes hard to tolerate. Try freezing Gatorade into icecubes and sucking on them as an alternative.

Good nutrition is important when pregnant, but try not to stress too much if you can't keep a well-balanced diet down. Prenatal vitamins will help cover some of the bases. (Be sure to take them with food!)

Two Great Things Exercise Is Guaranteed to Do For You

The Centers for Disease Control and Prevention as of last month were telling us two and a half hours of exercise could lower your risk for these diseases. You don't need to run a marathon or climb Half-Dome at Yosemite. You just need to do some moderate intensity aerobic activity. For any of you who don't know it, weight-bearing workouts (cables, weights etc.) are definitely aerobic...I know this first-hand. If you can handle it, doing more is better. Building up to something every day is the best. You can start slow and gradually get where you want to be.

According to Scientific American in a January 2009 article, they quote the Department of Health and Human Services (HHS) urging Americans to do moderate exercise for two and a half hours a week. They recommend brisk walking, water aerobics, or more vigorous running, swimming, or cycling for an hour and fifteen minutes a week. These are all good forms of exercise but are generally outside except for the cycling or running which you can do at the gym. I personally prefer weight-bearing exercise as it has many additional benefits such as weight-loss and toning and can be done indoors, even at home, all year. There is ample evidence now that exercise will add years to your life. People who are NOT couch potatoes live an average of three to seven years longer. You can get a lot of good stuff done in those extra years and have a lot of fun.

But these things are still not the ones I want to tell you about. So let's move on to those. The 2 Great Things Exercise is Guaranteed to Do For You are:

1. Improve your mental health and mood

2. Build your self-confidence

As a psychotherapist, I am particularly interested in these two benefits. I have worked with many, many people who have come to me because of problems in these two areas.

Sleep is crucial for your immune system to build itself back up after the stresses that tear it down through much of the day. A mix of aerobic and muscle-strengthening exercise three to five times a week for 30-60 minutes can provide these benefits. They will also help keep your thinking, judgment and learning skills sharp as you age (even if you're young, there will be improvements).

Self-confidence is crucial to everything we do. Much like our bodies, we take it with us everywhere we go. Even though we can't see it, it has an enormous impact on our lives, especially the quality of our lives. When our self-confidence is high, we can accomplish anything, or at least be willing to attempt anything.

Taking risks is what every super-successful person will tell you is necessary for achieving high levels of success. Just ask Tony Robbins or Deepak Chopra.

When we feel insecure, we tend to be more introverted, less social and less willing to try new things and meet new people. Exercise stimulates those good endorphins we need to feel good and in turn our behavior is positively impacted.


Working out consistently lets you get better and better and feel stronger and stronger and like the way you look and feel. So why not take a plunge into exercising and get the two great things (not to mention the many other great things) exercise is guaranteed to do for you!

Worm wars

              
1.Intestinal worms are a massive health problem in low- and middle-income countries, afflicting up to a quarter of the world's population.

2.Over the past 20 years, many organizations have pushed large-scale "deworming" initiatives, which often involve giving every child in a school deworming pills on a regular basis.

3.These programs — largely inspired by an influential study that ran in the late '90s in Kenya — were thought to not only treat children, but also improve their school performance and overall health. In other words, very inexpensive pills seemed to be"one of the most potent anti-poverty interventions of our time."

4.Researchers have been calling these promises into question. Most recently, a group of epidemiologists in London replicated and re-analyzed the results of that Kenya trial, and uncovered a number of flaws and exaggerations.

5.They aren't alone; for years, other research groups have been wondering whether mass deworming schemes are really the panacea some make them out to be. The high-stakes argument over their effectiveness has been dubbed the "worm wars."

6.And the worm wars aren't over. Many folks who work in development are pushing back on the latest debunking, saying the analysis was unfair.

Deworming schemes have been called one of the most important health interventions ever

Worms are terrible for human health. These parasitic bugs usually live in people's stomachs and intestines, stealing away nutrients from food and leaving their hosts weak, malnourished, even cognitively impaired. Left untreated, worms can cause organ damage and internal bleeding, and bring on other diseases. It's not surprising that people with worms — an estimated quarter of the world's population — may find going to school or working difficult.


Deworming schoolchildren with effective and inexpensive drug treatments has been called one of the most important health interventions ever. The World Health Organization, the Gates Foundation, and the World Bank all back large-scale deworming initiatives.

Biggest health lie of our time: Stress is bad for you

Biggest health lie of our time

In a June 2013 Ted talk, Kelly McGonigal, Ph.D, a health psychologist at Stanford University, told her listeners that stress is not the health problem we've believed it to be for more than 30 years. Rather, the danger lies in our perception that stress is harmful to our health. McGonigal's presentation, "How to Make Stress Your Friend," highlights three studies that show it's not stress that's the problem, but our anxiety over stress that's the killer.

Stress kills only when we believe it's harmful

The first study comes out of the University of Wisconsin. Researchers followed 30,000 adult Americans for 8 years. What the researchers found was fascinating. While people who had a lot of stress had a 43% higher risk of dying, this was true only if they believed that stress was detrimental to their heath. Those adults who had a lot of stress and didn't see stress as harmful did not have a higher risk of dying! As it turns out, it's anxiety over stress, not stress itself, that kills 20,000 Americans every year.

What happens when we see stress as helpful?

A Harvard study of psychosocial stressors found that when participants viewed stress as something that could help them cope with life, their physical response to the situation actually changed. Rather than their blood vessels constricting, as might be expected during times of stress, those participants who were told that the stressor was instead helping them had full, round, and relaxed blood vessels rather than constricted ones. Their physical response looked similar to what respondents would be expected to experience during moments of joy.

The stress hormone that actually makes you feel good

McGonigal says that when oxytocin is released as part of a stress response, it motivates us to seek support from others."Your stress response has a built-in mechanism for stress reliance — and that mechanism is human connection." McGonigal suggests when we look for social support in times of stress those connections boost our oxytocin levels.

Helping and serving others mitigates our risk of stress and death

While many faiths have long touted the spiritual benefit of helping others, it turns out that there's a physical benefit as well. A third study from the University of Buffalo that followed about 1,000 Americans found that stressful life experiences increased the risk of death by 30 percent — except in those cases where people spent time caring for others. Those folks had a 0 percent increase in their risk of death during stressful life experiences.

McGonigal concludes by advising: "Chasing meaning is better for your health than trying to avoid discomfort. Go after what creates meaning in your life, and then trust yourself to manage the stress that follows."

Readjusting your thinking about stress can literally save your life. When you find yourself under stress, think about how those events can motivate you to face life's challenges. Remember to connect with others rather than hibernating solo, and don't forget that helping others really does get your mind off of your own problems.

5 Surprising Healthy Foods You Can Throw On The Grill

Celebrating the Fourth of July is often associated with unhealthy snacks, sandwiches and deep fried anything. So how do grillers find an alternative to this caloric ritual? Throw a few nontraditional options in the mix.
We've gathered up 10 surprisingly healthy foods you can grill up this holiday weekend, effectively helping you avoid the grease and guilt that comes with overindulging while you salute the red, white and blue. From strawberries to asparagus, you may just find your new favorite summer dish -- no heartburn required. Take a look at the suggestions below, eat up, then sit back and enjoy the pop of the fireworks.

1.Lettuce

We typically think of salad as the cold counterpart to a warm, grilled meal, but turns out that lettuce can go right on the grates with the rest of your dinner. Slice romaine hearts in half and drizzle with olive oil, suggests registered dietician Heather Bauer, founder of Bestowed.com. Then sprinkle salt and pepper over the lettuce and drizzle vinegar on all sides. "Grill the romaine until it's slightly charred and flip them over for about three minutes," she says.
With very few calories per serving, romaine is a rich source of vitamins A, K and C.

2.Watermelon

Grilling up watermelon slices can add a smoky flavor that intensifies the sweetness of this summer staple, Bauer says. She recommends cutting the fruit into slices, sprinkling on some salt and adding to the grill.
Watermelon is a great source of the antioxidant lycopene, which gives the fruit its signature color (it's also found in red tomatoes). Research has identified lycopene as a possible fighter against heart disease, Bauer explains, and there's also evidence that lycopene could prevent certain kinds of cancer, according to Physicians Committee.

3.Pizza

Registered dietician Dawn Jackson Blatner, author of The Flexitarian Diet, recommends her personal "Farmer's Market Pizza" recipe for the grill.
Here's how to make it: start off with whole wheat pizza dough purchased from the store or local pizza shop. Roll it out with a rolling pin on a nonstick baking mat and then put the raw dough directly on the grill -- "Make sure [the] grill is hot otherwise the dough will stick," she cautions --until it comes off easily and has grill marks. Then take it off the grill with tongs, add toppings to the grilled side and put it back on the other side to cook.
Possible toppings include any leafy greens (like arugula, kale, watercress or even dandelion greens from your backyard), shaved asparagus, thin zucchini or yellow squash, basil, sliced tomatoes and a little bit of ricotta or parmesan cheese -- let the farmer's market guide you.

4.Mango

Here's a healthy barbecue twist: instead of traditional toppings, grill up a mango to top your burger, suggests Blatner.
Mangoes are a real superfruit, with tons of vitamins and minerals, she says. One sliced-up cup is a solid source of dietary fiber, vitamin B6 and vitamins A and C.

5.Grapes


Throwing some skewers on the grill? Consider adding grapes between pieces of chicken or shrimp, Blatner recommends. Grapes have no fat or cholesterol and "virtually no sodium," she says. Plus they pack a powerful punch of vitamins C and K.

7 simple health hacks for your busy schedule

• Seven days of changes to your routine may seem difficult, but these little switches easily fit into your daily schedule. Try starting with one fix a day, then continuing that habit all through the week. By the end of seven days, you'll have picked up seven healthy changes to your routine. Keep things up for a few weeks to make it a habit and maybe tackle a new set of challenges
  
  
  
  

• Monday Mentality

  Having positive thoughts can work wonders on your health. Research has shown that being optimistic boosts your immunity and increases your ability to cope with stress. Do yourself a favor and try thinking positively this week as you try the other 6 little fixes.

• Take Ten Tuesday

  Break up your afternoon routine by giving yourself 10, whether it's 10 minutes or 10 reps. Try sneaking in 10 jumping jacks while running around. Instead of sitting at your desk, answer a co-worker's email in person or take ten minutes to walk (not drive) to lunch.

• Wet n' Wild Wednesday

  Make Wednesdays a bit wild by drinking more water. Don't believe me? As it turns out dehydration has some unexpected symptoms (like bad breath and cravings). Sipping more water can clear your afternoon of breath mints and vending machine trips; leaving more time to liven up your day. You never know, this free time could make room for that afternoon salsa dancing class ­— or more "me time."
  Having trouble making the switch from sugary drinks to water? Mix things up by sipping a tall glass of infused water. Just add cucumbers and mint or find other combinations you love. Anything to make Wednesdays not so "middle of the week," right?

• Thursday Tutorials

  Though this little trick won't give you more than 24 hours in a day, it will probably feel like you've stashed away some extra time. We all know the benefits of exercise, but it can be tough to make time in your schedule or pocketbook for a class. But taking the time to get yourself to the gym isn't necessary if you YouTube your workout. There are tons of free tutorials you can stream right there in your living room.
  Along with eliminating all travel time, having a video workout allows you to try something new without feeling intimidated in a class full of experts. You can also pause your sun salutation for emergencies or break up the video into segments to fit in with your crazy schedule.

• Ferment your Friday

  Amp up your mental health with something fermented. Not only are probiotics good for regulating the millions of bacteria living inside of you, studies report some mental health bonuses from fermented foods. Research shows that those who regularly eat foods like yogurt, kimchi, kefir and kombucha reported experiencing less social anxiety than those who didn't. Conquering your fear of public speaking never tasted so good.

• Saturday Snacking

  This seven-item list is about making little changes, not drastic life-altering changes. Snacking is a great way to make little adjustments for a healthier you. Try taking things a step at a time; eliminate artificial sweeteners for a week, or dip vegetables into hummus instead of a mayonnaise-based dip. For something sweeter, try freezing a fruit-filled smoothie into popsicle molds instead of having ice cream.
  You don't have to give up your snacking habit, but snacking on fruit instead of candy or roasted chickpeas instead of chips will make your snacks more than just empty calories.

• Sunday Side-up

  Salads are a no-brainer for a veggie filled lunch or dinner. But are you really getting everything you can out of your salad? Maximize nutrients by adding an egg. Researchers have found that eating a cooked egg with raw, colorful vegetables (found in your salad) helps your body absorb more of the nutrients found in the greens.
  But be careful: Don't counteract your healthy week by overdoing it on the salad dressing. Try using the oozy yolk of a poached egg as a faux dressing. Not only will it amp up your nutrient level it also adds more protein to your meal.
  Can seven days make a difference in the quality of your life? Absolutely! By focusing on one day at a time, you are one week away from a richer, fuller life.

House votes to kill health law's Medicare savings panel

WASHINGTON (AP) — The House voted Tuesday to kill a federal panel that is supposed to find ways to curb Medicare spending, as Republicans ignored a veto threat and leveled their latest blow at President Barack Obama's health care overhaul.

Members of the Independent Payment Advisory Board have never been appointed, and the panel has never recommended savings from Medicare, the $600-billion-a-year health care program for the elderly.

Republicans have long targeted the board anyway, saying it would ration care and has too much power. When the health care law began working its way through Congress in 2009, defeated GOP vice presidential candidate Sarah Palin said the law would create "death panels" that could decide the care seniors would receive.

Democrats argue that the statute specifically forbids the board from rationing care, increasing recipients' premiums or reducing their coverage. That means its recommendations would fall largely on providers, such as doctors and nursing homes.

The White House has threatened to veto the bill, saying repeal would eliminate a way to "help reduce the rate of Medicare growth responsibly."

Tuesday's vote was a mostly party-line 244-154. The Senate has yet to consider similar legislation.

Most Democrats consider the Republican repeal effort an attempt to weaken the health care law.

Some Democrats agree that the board is too powerful, since its recommended savings automatically take effect unless Congress votes to change or block them.
   But much Democratic support for repealing the board evaporated when Republicans decided to pay the $7 billion, 10-year cost of eliminating it by cutting $8 billion from the health care law's prevention and public health fund, which the GOP says wastes money. Democrats call the prevention program a valuable part of that law.

Pregnancy food: what you eat can affect your child for life

“Listen to your body,” is one of the most overused phrases in the pregnancy-advice market. And, actually, it’s really hard to ignore your body when you’re pregnant; it mutinies and starts ordering you about. In many ways this is good – forcing you to go to bed early, or eat enough protein. But, in the unnatural food landscape of today, in which irresistible unhealthy snacks are the easiest foods to come by, it can also be bad.

The first time I was pregnant, I signed up for a daily email with tips and information on the baby’s development. Occasionally, I’d receive a gentle reminder to snack on carrot sticks instead of cakes, and I would think: “Up yours, patronising email service – don’t you realise you’re talking to someone who makes her own sodding muesli?” Then I’d inhale an entire carton of ice-cream, which obviously needed replacing every 48 hours, as was surely the right of all weary pregnant women everywhere.
But, as obesity researcher Nicole Avena sets out in her new book, What to Eat When You’re Pregnant, avoiding overindulgence and eating healthily is even more important when pregnant. Firstly, she says, the average woman (in the US) who becomes pregnant is already overweight or obese, which heightens the risk of conditions like pre-eclampsia, gestational diabetes and postpartum haemorrhage. And between 46% and 59% (depending on BMI) of these women will gain more weight than necessary when pregnant, which will likely be retained post-pregnancy.
Secondly, it’s widely accepted now that what happens in the womb does not stay in the womb. Research that Avena and colleagues have done (albeit mostly in rats) has found that not only can an in-utero diet high in fat or sugar lead to the child growing up obese, but maternal diet, she writes, “can have a long-lasting impact on the offspring’s risk of developing mental-health disorders, impaired social behaviours, lower cognitive abilities and increased response to stress”.
That’s a bitter pill to swallow, especially in a society that sometimes seems designed to make people fat. And, as more and more individual studies on the impact of maternal behaviour are reported, it can feel as though the media is building a case against mothers. “That’s a valid debate,” says a very pregnant Avena, via video link. “Part of the reason I wanted to do the book was because women are given guidelines about what not to eat during pregnancy. There’s a lot of weight-shaming that goes on when it comes to pregnancy, although we have to address it because it’s important. But it doesn’t have to be negative. I try to focus on the healthy aspects of eating while pregnant.”
So, after walking readers through the cold, hard science of pregnancy weight-gain and the risks associated with eating badly, the fun part begins: a week-by-week guide to what to eat, and what your baby is growing right now (brainstem, skin, fingernails), along with easy recipe suggestions. Week 34, for instance, is all about squash, which is high in fibre – an essential in beating third-trimester constipation. A nice prompt, but then fibre is always necessary. Isn’t a common-sense, healthy, balanced diet all that’s ever required? “The book is not necessarily meant to make women eat brussels sprouts during a certain week,” says Avena, “but, if they can focus on them in one week and try to incorporate them into their diet, I’m giving them a way to eat healthily in a prescriptive manner – not just telling them: ‘OK, eat healthily.’” Which, judging by obesity levels, isn’t enough.
In the throes of early pregnancy, however, all this is the last thing many women want to deal with. Traditionally, it’s a time to put your feet up and enjoy your extra calorie allowance. The hospital in New York where Avena works runs weight-loss clinics and, when female attendees become pregnant, many of them want to drop out. “We encourage them to stay in,” says Avena. Not because they think they should lose weight while pregnant, but because “you still can benefit from some of the advice on how to maintain healthy eating and dietary patterns”.
Could, I wonder, any ill-effects that my chocolate Häagen-Dazs habit had on my daughter, in the womb, be erased by her upbringing? It’s hard to accurately study nature versus nurture in humans, but Avena has placed baby rats, born to mothers fed on high-sugar and high-fat diets, with rats on healthy diets – to breastfeed and raise them. “They still grew up to have these changes in the brain, and have propensities to want to consume high-sugar and high-fat foods,” she says. However, in humans, if self-restraint is taught and the child is brought up to recognise their satiety signals, “then that’s going to mitigate the effects that might have occurred from in-utero exposure”.
Avena demystifies cravings by talking about the hormones involved and suggesting how to beat such mutinous urges. Taking a mindful approach has been shown to help addicted people move past their cravings; rather than trying to fight it or giving in, simply acknowledge and accept it. Planning ahead pays – make healthy foods more readily available than the contents of the nearest vending machine. Tipping off friends and family to resist feeding you treats helps, too, as does sufficient sleep. And, finally, know your cravings. Typically, Avena writes, genuine hunger-driven cravings are for food groups (like meat), rather than specific food items (like ice-cream). In other words, listen to your body, but only when you know its intentions are sound.
What to Eat When You’re Pregnant by Nicole Avena (Ten Speed Press, £13.99). To order a copy for £11.19, go to bookshop.theguardian.com or call the Guardian Bookshop on 0330 333 6846. Free UK p&p over £10, online orders only. Phone orders min. p&p of £1.99.

Why Obama Is Reaching Out to Catholics on Health Care

  President Obama’s decision to speak before the Catholic Health Association on Tuesday about the morality of caring

                                             

for society’s vulnerable is politically strategic. Coming not long before an expected Supreme Court ruling on national subsidies in his signature health care reform, the speech highlights key supporters in the Catholic community for Obama’s agenda ahead of Pope Francis’ September visit to the U.S.

Obama to Defend Healthcare Law in Speech Ahead of Supreme Court Ruling Texas Doctors Say They Did World’s First Skull and Scalp Transplant Almost 600 Accounts Hacked in 'Celebgate,' FBI Says NBC NewsParalympic Hopeful Gets New Legs after Devastating Theft NBC News 'Indefensible': Texas Cop Who Pulled Gun at Pool Party Resigns NBC NewsWhile the United States Conference of Catholic Bishops opposed the Affordable Care Act over its contraception and abortion coverage, the Catholic Health Association broke rank and consistently supported the law for making practical progress on helping working-class families and the poor. Obama even gave CHA president Sister Carol Keehan one of the 21 pens he used to sign the bill into law in 2010.

More recently, the CHA filed an amicus brief defending the law in the pending Supreme Court case, King v. Burwell, that could invalidate federal subsidies for more than 6 million people if it strikes down provisions of the law. “Our nation took a giant step forward [with the Affordable Care Act],” Keehan said in a statement in January. “And now if this case is decided wrongly, we’ll take a giant step back.”

Last month, Obama stressed his shared interests with Pope Francis in addressing poverty at Georgetown University conference sponsored by leading Catholic and evangelical groups. Obama’s speech to the CHA this week followed a keynote by Archbishop Blase Cupich of Chicago, who addressed the conference on Monday, and whose appointment as archbishop has been considered telling of the direction Pope Francis hopes to point the U.S. Catholic Church.

Only less austerity will improve our mental health

This is the first election ever in which mental health has been considered a
                                 

subject worthy of mainstream political discussion. The Lib Dems take the lead in this regard (closely followed by the Greens) with “equal care for mental health” being one of the five policy priorities featured on the front page of their manifesto, along with a promise of extra funding for the NHS.

In their Manifesto for the Mind, the Lib Dems set out in detail how their promise of an additional £500m a year over the course of the next parliament will be used to end “discrimination against mental health”, through better access to services, improvements in pre- and postnatal care, investment in children’s mental health, prevention, research and tackling stigma.

The Labour and Conservative promises are very much vaguer, indeed so vague in places as to be all but meaningless – the Conservatives’ pledge to ensure “that there are therapists in every part of the country providing treatment for those who need it” tops my personal piffle list. What does seem clear, however, is that politicians have finally clocked on to the fact that mental health is an issue of importance to many voters and, with more and more people prepared to speak out about their experiences, one that they can ill afford to ignore. Cinderella may not yet have made it to the ball, but she’s not about to go back into the scullery.

This is good news. Discussion is good. Additional funding is even better, if only to begin to reverse the decimation of mental health services overseen by the coalition government, with budgets in England having been cut by 8% in real terms since 2010, at the same time as demand rose by almost 20%, according to research by BBC News and the journal Community Care. But shocking as the treatment gap is, the most striking figure revealed by the research is that referrals to mental health services have increased by almost 20% in the space of just five years.

Though some of this increase will be due to the greater openness that now exists around mental health encouraging people to come forward, such a sharp increase in such a short space of time can only lead us to conclude that over the course of the past five years our society has become a good deal less conducive to mental wellbeing. What’s the reason? Austerity.

Parents – turn off those screens and get running with your kids

Some children are born sporty, some achieve a certain level of begrudging sportiness, others have it thrust upon them, often with accompanying bribery and/or threats. Some are so reluctant it seems almost cruel, but the statistics are stark. Almost a fifth of four to five-year-olds – and a third of 10 to 11-year-olds – are overweight or obese. Even toddlers get far less physical activity than they should.
As parents, we all know they should do more. But how to encourage those whose idea of a good time is nestling on the sofa with Frozen for the 351st time? Indeed, how to not merely encourage but to instil a genuine love of activity?
For my sofa-inclined six-year-old, it’s a delicate balancing act. Her natural inclination is always to say no to new things – and while I don’t ever want to force her, there are activities I know she will love if she would just give them a chance. Her school just started a yoga club – cue the usual hesitance to sign up – two weeks later her favourite activity is competitive downward dogs with her little sister.
I’ll admit that my encouragement/reward system also revolves rather heavily around ice-cream, but then, isn’t that half the reason I exercise myself, so I can indulge afterwards?
Young children are natural sprinters – short bursts of frenetic activity, followed by claims of exhaustion and the need for a smoothie, only to be sprinting off again a second later. So the best activities are those that capitalise on this. My own daughter tends to moan her way around the first lap of our local junior parkrun, proclaiming sudden hideous injuries (“I think I broke my ankle! I might need a plaster!”) and exhaustion. The second lap she perks up, and the final 100m or so she is off: “Time for top speed now Mummy, remember I beat you last week!” Seconds later she’s putting on an even more impressive sprint to the cafe with her friend for the post-run ice-cream.
So make activity sociable, and remember that your own definition of exercise is not theirs – hanging upside down from the climbing frame is a totally legitimate sport, honest. And, of course, set an example. Get off the sofa yourself – don’t blame me if no one buys you ice cream after.
Parkrun may just have celebrated its tenth birthday but it already has an offspring. Junior parkruns are springing up around the country – 2km free timed runs, mostly in local parks, staffed by enthusiastic volunteers, for 4 to 14-year-olds. If there isn’t one near you, consider starting your own. Go Run for Fun are also setting up nationwide events to get young children running.
Like the adult version, junior parkrun gives you an official time from a scanned barcode when you finish, delivered by email later that day. I don’t show my daughter these times – she’s never asked, doesn’t seem bothered, yet might just find it discouraging that she didn’t beat her best time. She doesn’t know what a PB is yet – plenty of time for that later.

What is carpal tunnel syndrome?

    Phil had been teaching tennis to young people for 20 years. Last year, when he started experiencing discomfort in his hands and wrists, a parent of one of his students suggested it could be carpal tunnel syndrome.
    Phil had his doubts. He led a very active life. The only injuries he treated had to do with his elbow and legs. "Isn't that something people get from typing and working on computers all day?"
    The short answer is "no."
    What is it?
\
    The carpal tunnel — literally a tunnel of ligament and bones at the base of the hand — encloses the median nerve and tendons, which provide sensation to the hand and fingers. Carpal tunnel syndrome occurs when that tunnel collapses and the median nerve becomes pressed or squeezed at the wrist (see the National Institute of Health for more information). This can cause a lot of pain for individuals.
    "It's like getting in an elevator," described Dr. M. Shane Frazier, Orthopedic Surgeon for Central Utah Clinic. "Everything is fine unless a couple of things happen. If the tendons start to swell (or everyone on the elevator gains 100 pounds), then the space seems cramped. Tendons and the area around the nerve become inflamed and swollen."
    What is the cause of this inflammation?
    "Carpal tunnel has something to do with use," concluded Dr. Frazier. "The biggest myth is that people get it who are on a computer a lot. That used to be the predominant way of thinking. It's not anymore."
    Dr. Frazier explained that while in many cases the cause of carpal tunnel syndrome remains unknown, a common cause involves repetitive and forceful actions like gripping, grasping and heavy lifting. People who use heavy vibratory machines like jackhammers or heavy machinery and who perform heavy manual labor, assembly line work, sewing or manufacturing are more likely to experience carpal tunnel syndrome.
    Frazier states that while it is difficult to pinpoint the exact cause of carpal tunnel syndrome, it does occur more often in women. According to an article published by the National Institute of Health, carpal tunnel occurs three times more often in women than men; affecting the dominant hand first and produces the most severe pain.
    How does it feel?
    How do you know if you have carpal tunnel syndrome?
    Many patients report experiencing numbness and an uncomfortable tingling feeling in hands and arms. Patients may also experience weakness in their hands and a reduced level of dexterity. Some patients reported dropping items due to an inability to grasp. But the only definitive way to determine whether or not carpal tunnel syndrome is present is to see your doctor.
    Although rare, cases of carpal tunnel syndrome have surfaced in children. The cause is often due to excessive video gaming, typing or playing a musical instrument.
    To verify whether a patient has carpal tunnel, Dr. Frazier uses an electromyogram (EMG), where tiny acupuncture needles are inserted in the patient's skin to stimulate nerves and muscles.
    "Through a machine, they can tell us how fast an impulse is going from point A to point B, and they can tell us a nerve is being compressed, how badly it's being compressed, and where," explained Dr. Frazier.
    Is there a treatment?
    Once carpal tunnel is diagnosed, it can be treated and cured.
    "There is a cure for carpal tunnel syndrome," said Dr. Frazier. "Sometimes nighttime bracing and steroids can cure it. Often activity modification, lifestyle changes, and routines can cure it. As a last resort, surgery will cure it. Treatment largely depends on the severity of the case."
    You don't have to suffer through the pain of carpal tunnel syndrome. Whether you are a mechanic, fish packer, a clerk, or a candy maker, there is a treatment plan available to help you gain relief and comfort.

The endurance run that's like climbing Everest four times

Excitement. Nervousness. Uncertainty. Fear. I have felt the effect of this heady cocktail of emotions before – two years ago, after some friends persuaded me to enter the Dragon’s Back along the brutally mountainous spine of Wales.
That race took five days – much further than anything I had run before. A complete leap into the unknown. But I did it. And more than that, I surprised everyone (including myself) by finishing third in a race where two-thirds of the entrants failed to make it past day one.
Fast-forward two years and I am back at square one. This time I am facing a challenge that makes even the Dragon look tame: an attempt to set a new running record around the unremitting, undulating South West Coast Path. All 630 miles of it.
The South West Coast Path doesn’t ascend any mountain peaks, but it boasts 115,000 feet (35,052 metres) of total climbing – or, to put it another way, in terms of elevation gain, it’s like going from sea level to the summit of Everest four times.

Patrick Devine Wright finishing third in last year’s Grizzly race Photograph: www.photo-fit.net

It winds its way from Minehead in Somerset to Poole in Dorset, and most people bite the path off in stages and can take a lifetime to complete the entire route. I hope to run it in one go. The current record, set by Mark Townsend and Julie Gardener, stands at 14 days and 14 hours. To beat it, I will have to run more than two marathons a day, every day for two weeks.
I started thinking about it last summer and started training for it over Christmas. Since then, I have slowly but surely plucked up the courage to tell people what I am up to – if only to explain to them why I am so tired (from the training) or sore (from the niggles) or hungry (four meals a day now being routine).
This run is much more public than my Dragon’s Back effort. I am raising funds for three excellent charities – the Devon Air Ambulance, the South West Coast Path Association and the Wave project – and I am looking for people to help me out, putting me up for the night as I wind my way around the coast, and meeting me at checkpoints to help me fuel up and recuperate.
So far my plan has been met with lots of encouragement, and more than a few scratched heads. Why am I doing it? All I can say is what I learnt from the Dragon’s Back: unless you put yourself in a situation that is new to you and filled with uncertainty – whatever that is – you never really know what you are capable of.
So once again I am sticking my feet (and neck) out to try something that most would consider utter madness. And come the end of April, I will be something the wiser for it.
Click here to sponsor Patrick and to find out more about the causes he is raising money for. If you want to assist Patrick during his epic run (with logistics and accommodation), please contact him on patrick@devinewright.com

Running blog: How was your weekend running?

I’ve been hanging out at two different tracks in the last few days. In Friday I was in Prague for the European Indoor Athletics, on Saturday back home at my local running club, running at a pace that probably doesn’t even count as a warm up for most of those professional athletes.
If you’ve never been to an athletics meet - do it. This was my first indoor event and it was utterly fantastic. The atmosphere - even early on the first day of competition - was lively, with huge roars greeting any Czech competitors. I got to watch the awesome Katarina Johnson-Thompson on her way to gold in the Pentathlon, if not, alas, the world record - though that surely is just a matter of time. What you see in the stadium that the TV can’t catch is fascinating - the warm-ups, the stretches, the drills, the pigeon-paces the athletes take to measure their long jump run up ...
An indoor arena with its 200m track also gives you a real sense of just how fast the sprinters are - blink and you will miss the 60m hurdles (or Richard Kilty blasting past to gold) - and just how high they jump. I think pole vaulting god Renauld Lavillenie should have been given a shot at jumping over Prague castle. He would probably have sailed over.
As for my own running - Prague is not the flattest city and cobblestones make for interesting footing, but I had some treadmill slogs and one particularly glorious run to and round Letna Park, which overlooks the city and has views so fabulous you just have to stop for a breath to appreciate. Being surrounded by athletes at the event itself, you also can’t help but want to pull the trainers on and run, run run.
So how was your weekend running, did you catch any of the athletics on TV - and can I persuade you to go and watch some athletics live yourself?

Healthy Breakfast For Your Life

The researchers noted how blood glucose levels differed between the groups, and found that those who had breakfast showed a much lower spike in blood glucose after lunch, compared to those who didn't have breakfast. Clearly, eating healthy meals in moderate portions and at scheduled times is the best way to manage diabetes. The American Diabetes Association recommends having a similar amount of carbohydrates for breakfast every day. Consistent carbohydrate intake for each meal helps keep your blood sugar levels within range.

A healthy breakfast, especially during the colder months, is hot cereal. You can prepare a healthy diabetes breakfast by adding fruit and a half-cup of milk to a cup of any hot cereal. A staple in diabetic breakfast ideas is a cup of cooked hot oatmeal, two tablespoons of raisins and a half-cup of skim milk. To prepare a healthy breakfast with 45 to 60g of carbohydrate, add three-quarters of a cup of whole-grain cold cereal to a cup of skim milk. Add one slice of whole-wheat toast with one tablespoon of margarine and you will have a great breakfast to start the day.

Just having breakfast is not enough; one has to ensure that breakfast is nutrient-rich, and not a platter full of sugary, fatty food. By helping your child develop the habit of eating breakfast at home, you can make better choice of food that follows the dietary guidelines. Since there are a specified quantity of people that a bed and breakfast will be able to accommodate chances are that you simply might run into fellow guests as well during the day or at breakfast.

Consider the activities you may like to view throughout holiday and check if this meshes with the type of environment where you would look for a bed and breakfast. All the rooms probably a name associated with it such as the white family room and the room's décor may reflect it. This sort of overnight accommodation makes a terrific weekend trip for couples that are looking for a calm room to escape their everyday lives.

Why can’t patients receive blood results via text or use Skype for appointments?

In 2011, I became the 11th person in the world to undergo an intestinal transplant which took place at the Churchill hospital in Oxford. I knew a key post-operative requirement would be the constant monitoring of my condition. What I didn’t appreciate was the time and effort it would take. On the third anniversary of my surgery I was diagnosed with high-grade B cell lymphoma.
Like so many I constantly use my mobile phone and technology as part of my everyday life. I want to manage my health journey in the same way. Why can’t I receive blood results via text or use Skype calls for routine follow-ups?
The truth is, I can. Information governance is no excuse, and privacy and security challenges can be overcome. The technology is also not to blame, and some companies are already helping NHS organisations to safely and securely unlock the value of their information with models that can be integrated within their IT systems.

In my case it took bravery – the bravery of a surgeon who said: “If that is how you want to interact, then let’s do it.” How much simpler is it to text routine blood results? It saves clinical and patient time and improves efficiency. Why wouldn’t you use this in everyday messaging of routine results? It takes a cultural change for the system to go from “no we can’t” to “yes and this is how we can”.
Being a long-term patient with multiple complex chronic conditions means two things to me. Firstly it’s imperative that I am an active participant in every aspect of my care. I want to know everything that is happening to me and be part of every decision. Secondly, I am aware that I am one of the biggest drains on healthcare resources.
When I asked my surgeon if I could Skype him instead of travelling for 90 minutes for a routine appointment he agreed and emailed me to confirm I had given my consent. As he was about to dial in, the four nurses in the room walked out from fear of interacting with a patient in this way. Here a patient was consenting to using a freely available and perfectly capable service but, because it was a health discussion they didn’t want to engage. The surgeon went home and we did the call from his house.
Eighteen months on at the same hospital, Skype clinics have become the norm. They are being adopted in other departments in the trust, and the email consent is now a three-line letter. It saves time, money and improves efficiency and patient satisfaction. When I come to the clinic, the medical team are up to date with what issues need managing and tests have been prearranged.
I recognise technology is not for everyone but the Pew Institute has some interesting health facts – 86% of people go online to look up health matters, 71% do it from home via their mobile and 25% of patients benefit from online communities. The biggest demographic of online patient users are those over 55, according to HIMSS. We are ready for this technological change but the cultural shift that is needed in the NHS is not there yet; there aren’t enough brave chief executives or clinicians.
Patients understand the benefits, and data protection issues can be overcome. Years ago, the idea of getting money by walking up to a cashpoint where anyone could see you typing in a pin number would have been laughed at. Now we can bank on our mobiles, we can shop and manage virtually every aspect of our lives through technology. I want to manage my healthcare in the same way.
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