NYPD officer's widow gives birth to their child
http://ift.tt/2tZL87T Angelina was born Tuesday to Pei Xia "Sanny" Liu at Weill Cornell Hospital in New York City, the NYPD said in a blog post. Sanny's husband, Detective First Grade Wenjian Liu, was shot and killed on December 20, 2014. The night of the incident, Sanny requested that her husband's sperm be preserved. The slain officer's parents, Wei Tang Liu and Xiu Yan Liu, were there for the birth, according to the NYPD. Sanny became pregnant through a process called in-vitro fertilization. In-vitro fertilization is when a sperm and eggs are removed from each parent and mixed together outside of the woman's body in a laboratory to create an embryo. "I told my friend, 'It's going to be a baby girl,'" the new mom told the NYPD. "My friend said, 'No, you haven't even checked the sonograms,' but I was right." The couple had been married only a few months at the time of his death. The two had always dreamed of having a child together. Liu and fellow police officer Rafael Ramos were killed while working in a "critical response" detail in an area with higher crime, according to police. The two normally worked in downtown Brooklyn, but that evening, they were assigned to work elsewhere. The gunman approached the passenger side of the car and took a shooting stance. He opened fire and shot both officers in the head, then-NYPD police Commissioner William Bratton said at a news conference. They were "shot and killed with no warning, no provocation," Bratton said. "They were, quite simply, assassinated." CNN reached out to the Detectives' Endowment Association, which is handling media requests for the family, but had not received a response Wednesday. CNN's Joshua Berlinger, Ray Sanchez, Shimon Prokupecz and Sandee LaMotte contributed to this report. Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF July 26, 2017 at 01:29PM
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A rift among experts over analyzing Trump's mental health
http://ift.tt/2uCgpjf The American Psychoanalytic Association represents about 3,500 members from all mental health professions and academia. It polled its leadership in June and asked whether they continued to support the association's existing policy, that it "speaks to sociopolitical issues only, not about political figures." According to an association memo from July 6, all the leaders that answered the poll voted to keep existing policy. But, the memo continues, as far as members go, they are "free to comment about political figures as individuals." That means if individual experts want to share their thoughts about the President's behavior, for example, they are free to do so as "APsaA does not consider political commentary by its individual members an ethical matter. APsaA's ethical code concerns clinical practice, not public commentary," the memo states. The other group, the 37,000-member American Psychiatric Association, has a different ethics policy. "It is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement," according to its code of ethics. In fact, the APA's ethics committeemet this winter and it expanded its existing policy, known as the "Goldwater Rule," to be even more restrictive. In the past, the Goldwater Rule was interpreted by many to apply only to official diagnosis. Under new guidance about the rule, it is "fine for a psychiatrist to share their expertise about psychiatric issues in general," but "member psychiatrists should not give professional opinions about the mental state of someone they have not personally evaluated," according to an APA blogreleased after the committee's decision. That rule, it clarified, "applies to all professional opinions offered by psychiatrists, not just diagnosis." Doing so would be "unethical and irresponsible," wrote American Psychiatric Association PresidentDr. Maria A. Oquendo. "The complexity of today's media environment demands that we take special care when speaking publicly about mental health issues, particularly when what we say has the potential to damage not only our professional integrity, but the trust we share with our patients, and their confidence in our abilities as physicians." Conflicting advice for dual membersDr . Prudence Gourguechon, a Chicago psychiatrist, is a member of both groups, and was the past president of American Psychoanalytic Association.
Gourguechon
disagrees with the APA's expanded interpretation of the Goldwater Ruleand has fallen on the side of the APsaA's guidance. She said she believes that members should use their expertise on human behavior to help the public better "organize the experience that is happening around us." Her editorial suggested "as a psychiatrist, I believe we need a rational, thorough and coherent definition of the mental capacities required to carry out 'the powers and duties' of the presidency."
Gourguechon
wrote that there is little in scientific literature that defines what mental capacity means for people in positions of "great responsibility." A good source, she suggests, is the US Army's Field Manual 6-22 on leadership development. It emphasizes that a leader must be trustworthy, have discipline and self-control, good judgment and the ability for complex critical thinking, self-awareness and empathy. She does not directly disclose how she feels about the President's performance as it relates to these categories, nor does she make a diagnosis, but she does suggest that there is enough data out there that displays his behavior that "we are all free to compare that observable behavior to the list of traits deemed critical for leadership by the US Army," she wrote. "As professionals we should not be shy about talking about really difficult things," she said in an interview with CNN. "This is not about one person," she said. "The whole country is in a troubled place. I don't want be so grandiose to say we are treating the country as a patient, but there is terrible conflict right now and people aren't acting their best or thinking their best and we are not just talking about Donald Trump." Nor does she see the APsaA's different philosophy on this issue as a criticism of the APA's. "We would never tell a sister organization what to do with their own ethics policy," she said. She said she will continue to be a member of both organizations. A statement Tuesday from APsaAsaid it did not encourage its members to "defy" the APA's Goldwater Rule, but "rather, it articulated a distinct ethics position that represents the viewpoint of psychoanalysts. The field of psychoanalysis addresses the full spectrum of human behavior, and we feel that our concepts and understanding are applicable and valuable to understanding a wide range of human behaviors and cultural phenomenon," the statement said. One 41-year member of the APA told the association to change its guidance and publicly quit in July over the issue, but has remained a member of the APsaA and told the APsaA's president that he "applauded" its policy. Dr. Leonard Glass is a part-time associate professor of psychiatry at Harvard Medical School and works as a senior attending psychiatrist at McLean Hospital in Belmont, Massachusetts. He said while there is merit to the Goldwater Rule, he was among the professionals who signed the February letter about the President's mental health, which published in the New York Times. It refrained from making a diagnosis, but emphasized there was an urgency behind their need to share their opinions about the President's mental health, which may violate the expanded interpretation of the Goldwater Rule. "We fear that too much is at stake to be silent any longer," the letter states. Trump's speech and actions show that he has an "inability to tolerate views different from his own, leading to rage reactions" in which he is unable to empathize, and he is "attacking facts and those who convey them." The letter concluded the President's "instability" makes him "incapable of serving safely as president." In July, Glass wrote an opinion article for Psychiatric Timesin which he said he and fellow colleagues were "shocked by what we felt was the APA's 'gag rule' on this issue." Glass told CNN he feels the APA code is "insulting" and "self-defeating." With the abundance of data available from television and the President's own Twitter feed, one can make an educated observation, he said. To restrict members from doing so is "clinging to a 40 or 50 year old rule" and shortchanges the public, particularly in such an "extraordinary and frightening time." "It doesn't make sense that people with the greatest professional basis for commentary should keep silent," Glass said. "I'm unaware of any other medical specialty that gags its members." Members debateThe Goldwater Rule has defenders. In a counterpoint essay in the Psychiatric Times, Dr. Rebecca Brendel, a psychiatrist and director of the master's program in bioethics at Harvard Medical School Center for Bioethics, argued in favor of the Goldwater Rule , writing that"psychiatric opinions based on insufficient data and/or method, whether they include diagnoses, compromise both the integrity of the individual psychiatrist and the profession." But an analysis and commentary, published in the Journal of the American Academy of Psychiatry and the Lawlast year, argued that, in general, the Goldwater Rule was "excessive." APA member Dr. Claire Pouncey and her co-authors wrote that it's "not only unnecessary," it "detracts from the deeper dictates of ethics and professionalism." Pouncey told CNN that in trying to silence its members, the APA fails to "treat us like our own moral agents." This winter, Pouncey gave a presentation about the Goldwater Rule at the annual APA meeting. She also met with the group's ethics committee to urge them to change its mind about the policy. She said while ethics committee individuals treated her with professional respect, there were leaders outside the committee that dismissed her argument. "I've essentially been shushed," Pouncey said. The rule, Pouncey said, "gives me no space in my separate role as a citizen or as a school board member or as a parent." For example she said if she got arrested at a public protest, that is not automatically an ethics violation, but "if I shoot my mouth off and go a little too far in my professional opinion, this rule was now construed so broadly in March, that now I'm unethical," Pouncey said. Pouncey will continue her APA membership, but vows to continue to fight from within the organization. She adds that while she strongly opposes the policy, she does know that ultimately the Goldwater rule is "somewhat toothless" and is merely an ethics policy, meant to guide professionals. It is not a law, so no professional will lose their license if they violate these policies. "But it still gets to me." Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF July 26, 2017 at 01:07PM Health Care Showdown: Senate Health Care Vote: Where the Debate Left Off and What to Watch7/26/2017
Health Care Showdown: Senate Health Care Vote: Where the Debate Left Off and What to Watch
http://ift.tt/2tJ2lam But because the latest version of that measure has not yet been assessed by the nonpartisan Congressional Budget Office, it needed 60 votes for passage. Republicans have only 52 seats, so its failure was inevitable. In the end, the measure won only 43 votes, demonstrating that even after weeks of refining the legislation, Senate leaders still fell far short of enough support for their replacement plan, from both ends of the party’s ideological spectrum. The Senate adjourned around 10 p.m. Tuesday. What’s coming Wednesday?Senators are set to consider a different repeal measure on Wednesday. This measure would repeal the health law but would not provide a replacement for it. The legislation resembles a bill that passed the Senate in 2015 but was vetoed by President Barack Obama in early 2016. Senator Rand Paul, Republican of Kentucky, supports that approach. But some Republicans worry that repealing the law without providing a replacement would leave many Americans without health care coverage. Such a “repeal only” measure is not expected to garner enough votes for passage. The vote for this measure is scheduled for late Wednesday morning. Then what happens?Republicans are using special budget rules to try to pass a repeal bill, so the debate is limited to 20 hours, and Democrats cannot delay it with a filibuster. Later this week, the Senate will hold what is known as a vote-a-rama, an exhausting marathon of amendment votes. The nine Republicans who voted against the comprehensive replacement measure on Tuesday night are an indication of the problem that Senate Republican leaders continue to confront: The party caucus still does not agree on what should be in a health care repeal bill that would have enough support to win Senate approval. One solution might be to pass a pared-down health plan that has support from at least 50 of the 52 Republican senators, and then turn to working out a compromise with the House. Continue reading the main storyHealth via NYT > Health http://ift.tt/2koaaw3 July 26, 2017 at 12:00PM
Seared Tuna Salad with Wasabi Butter Sauce
http://ift.tt/2tYXJIy This panko-and-sesame crusted seared tuna on a bed of arugula and spinach, all topped with a wasabi butter sauce, takes Japanese food to whole new level! Please welcome guest post and my dear friend, Heather K Jones. Health via Skinnytaste http://ift.tt/13e6yyq July 26, 2017 at 11:47AM
Stop Obsessing Over the Numbers
http://ift.tt/2vIWCPd My friend, former co-competitor, business partner, and writing buddy Brad Kearns had been on a “Quantified Self” kick, tracking biomarkers, testing blood sugar and ketone levels, and staying abreast of all the various ways we can quantitatively check our progress. He’s months into a ketogenic experiment and had hoped to marry his subjective impressions to objective measurements to strengthen his intuition and improve his results. Then, several weeks ago, it all changed. Using the same finger prick sample, he checked his fasting blood sugar using three separate devices. Same blood sample, three devices purporting to give accurate readings. You’d think the results would be similar, if not identical. They weren’t: That’s not just a few points here or there. That disparity is well outside the standard deviation. The numbers can’t be trusted, because which one’s right? And if you can’t trust the numbers, what’s the point of gathering them? Brad’s results were extraordinary, but making any conclusions from the measurement of an organism’s secretions, emissions, and fluids must be tempered with the fact that biology is chaotic. It isn’t clean, neat, and predictable. If you dig deep enough, it might be predictable, but we don’t yet have the technology capable of untangling it. This isn’t just limited to over-the-counter glucose monitors either. Gut Biome Testing: The different gut biome sequencing services can produce different results. One person had about as contradictory a pair of results as you can get from the same sample. In another case, taking samples from different sections on the same poop gave different bacterial readings. Bacterial strains do not have uniform distribution throughout the turd. Blood Testing: Each blood drop is different from the next. This is where services like Theranos ran afoul of reality—they claimed they could test individual drops of blood for dozens of biomarkers. That’s all well and good, but a single drop is not representative of the the rest of the blood. Sleep Tracking: Commercial sleep tracking is notoriously inaccurate, overstimating sleep duration even comparing poorly to established medical devices for tracking sleep, like polysomnography (used in sleep studies) and actigraphs. They give a false sense of security. That’s dangerous. If you’re only sleeping 6 1/2 hours and feeling lousy, but the machine insists you’re getting a full 8 hours a night, and you trust it (it’s “objective” after all), you will jeopardize your health. Let’s say the numbers are even accurate. This is only a snapshot of one drop of blood in one minute in a living organism, so trying to discern the truth from a single blood test is like trying to understand the plot of Gone with the Wind by looking at a movie poster. Then, when you factor in how inaccurate the numbers can be from machine to machine or from lab to lab, it makes it even more ridiculous to try to craft any kind of lifestyle strategy based on them. Almost a decade ago, a routine visit to the doctor for a skin checkup almost got me placed on blood pressure meds. It was 140/100. I refused, opting to track my own blood pressure over the next week at home using a store-bought device. The results were stunning: Across 50 readings, I never got the same numbers twice. My highest was 133/92, taken after leaving the doctor’s office. My lowest was 102/66, that same night after dinner. So, I went from needing drugs and a low-salt diet to l0w-normal BP over the course of 24 hours. At night, my BP settled in around 110/67 on average. That cemented for me how ridiculous it is to determine someone’s long-term health trajectory based on a single reading. Blood pressure, as with any physiological biomarker, fluctuates for a reason. When you’re exercising, it’s high to help shuttle oxygen and nutrients around the body. Stress also heightens the need for oxygen and nutrients—so you can deal with whatever stressor ails you—and thus increases blood pressure. It’s helpful when required, bad in excess. Then there was the time I tested at almost 17% body fat despite looking like this. Even in that perfect world where every blood drop is identical to the next and every lab machine and OTC device are interchangeable, I’m just not sure if the objective measurements have any real use compared to the subjective measurements. Do you have energy all day? Do you wake up feeling refreshed? Do you want to work out? Can you make it to lunch without eating or complaining? Are you productive? Are you happy with your body composition? These are the questions to ask. If you can answer affirmatively, what more do you want? I have trouble seeing how numbers on a device that may not even be accurate can improve on those subjective biomarkers. Another danger of reliance on lab tests, not widely acknowledged, is that we lose touch with our bodies. When we have numbers for everything, why pay attention to something as inaccurate, imprecise, and subjective as “how I feel”? After all, nobody bothers remembering phone numbers anymore. This will only worsen the more technology improves and accuracy increases. You’ll have robot doctors or implants hooked up to your smartphone analyzing your health using complex algorithms based on biomarkers that are 100% accurate. “Trust the AI,” they’ll say, and there’s some truth to that. Who are you to disregard a supercomputer with 1000x the brainpower of John von Neumann? Call me a Luddite, but we lose something important in that scenario. Humans are the thinking and feeling animal. We ponder the meaning of life and possess intuitive powers. That’s what makes us so dominant—the ability to use executive functioning to harness and direct our more base urges and instincts. If we no longer have to feel and can rely on flawless biofeedback relayed by sensors and trackers, will we cease to be human? I don’t know the answer to that. That’s a tough one. For now, stop rejecting your birthright as intelligent animals. Hone your intuition rather than surrender it. Don’t enslave yourself to the numbers and lab results. That doesn’t mean ignore them outright—particularly if you have a serious condition that requires treatment. I’m not suggesting anyone skip out on their medical care. But there’s this to keep in mind: Quantification is a tool, it’s not the full answer. You come first. What you say matters. At least for now, it’s often the best biofeedback we have. To sum up:
What do you think, folks? How do you weigh objective biomarkers against subjective evaluations of how you’re looking, feeling, and performing? What provides the most value to your life and health? Thanks for reading. The post Stop Obsessing Over the Numbers appeared first on Mark's Daily Apple. Health via Mark's Daily Apple http://ift.tt/zxCBD6 July 26, 2017 at 10:50AM
Study: A suicide attempt in an Army unit can lead to more
http://ift.tt/2tDwbJp Positioned on a rolling Hawaiian hillside along the North Shore in Oahu, where the now-retired United States Army major was stationed, that tree was where Raciti said he planned to take his last breath. He planned to hang himself. "I did lose three medics after coming back from Iraq to suicide, which exasperated my PTSD, but mine is of survivor's guilt for the ones I could not save," Raciti said. The US Department of Defense has continued to investigate what factors might influence a military member's risk of suicide attempt, and a new study suggests that previous suicide attempts in a particular unit of members can play a significant role. Within Army units, the risk of suicide attempts among soldiers increases as the number of attempts made within the past year in their unit rises, according to the study, published in the journal JAMA Psychiatryon Wednesday. In other words, the greater the number of previous suicide attempts in a unit, the greater the individual risk of a suicide attempt for a soldier in that unit, said Dr. Robert Ursano, professor of psychiatry and neuroscience and director of the Center for the Study of Traumatic Stress at the Department of Defense's Uniformed Services University. "Historically, you were protected from suicide when you went in the Army. Rates of suicide were about half of those in the civilian population, and around 2009, they increased to above that of the civilian populationand they remained high since then," said Ursano, who was lead author of the new study. Now, about 20% of suicide deaths in the United States each year are military veterans, according to the Military Health System. "This is an important part of trying to understand that story," Ursano said about the new study. "Although we often talk about the clustering of suicides and suicide attempts, it's rarely been able to be examined in an empirical way, using actual data." The aftermath of a suicide attemptThe study involved data on 9,512 enlisted soldiers who attempted suicide between 2004 and 2009, documented in administrative and medical records. The data came from the Army's Study to Assess Risk and Resilience in Servicemembersresearch project, or STARRS, the nation's largest study of mental health risk and resilience among military personnel. After analyzing the data, the researchers found that soldiers were more likely to attempt suicide if assigned to a unit with one or more previous suicide attempts in the past year, and that risk increased as the number of previous suicide attempts went up. Among combat arms and other occupations, the risk of suicide attempt was about twice as likely among those in units with at least five previous suicide attempts in the past year versus units with none, the researchers found. The risk for a unit with at least one suicide attempt in the past year was 18.2%, "indicating that, if the risk associated with units that had at least one past-year significant attempt could be reduced to those with no attempts, 18.2% of attempts would not occur," the researchers wrote in the study. That increased risk remained significant even after adjusting for each soldier's sociodemographic factors, age, time in service, deployment status, occupation, and unit size, although the findings were particularly pronounced in smaller units, the researchers found. "It actually aligns with some research that's been published in the past few years using smaller samples that aren't necessarily representative of the Army, but have similarly found that exposure to suicide is associated with increased risk of suicidal thoughts and behaviors in other service members," said Craig Bryan, a psychology professor and executive director of the National Center for Veterans Studies at the University of Utah, who was not involved in the new study. The US Department of Veterans Affairsoffers a crisis help line, local suicide prevention coordinators, and other resources to the general public. However, Bryan said that the new study could help in developing improved approaches for what's known as postvention efforts-- an organized response after a suicide or suicide attempt -- specifically when a suicide attempt occurs in an Army unit. "How we react to the event could on the one hand potentially mitigate or reduce risk of other suicidal behaviors or conversely, if you don't respond to situations like that very well, you could inadvertently increase risk amongst others," Bryan said. "To be honest, postvention has not received nearly as much attention and as much focus as more traditional treatments and prevention methods," he said. "I think that's probably going to be the most important implication of this study, pushing forward that we should be doing a lot more and paying way more attention to how we effectively respond to suicide loss as well as suicide attempts within confined social groups." Kim Ruocco, who was not involved in the new study, agreed that more attention should be turned to the importance of postvention protocols. Ruocco serves as chief external relations officer for suicide prevention and postvention for the Tragedy Assistance Program for Survivors, a nonprofit that provides support, resources and referrals to those grieving a loved one who has served in the armed forces. "It's really important to implement postvention protocols after there's a suicide attempt," Ruocco said. "That would include balancing supporting the attempt survivor by maintaining a sense of belongingness and purpose within the unit while they are receiving the care they need, and identifying anything within the unit that increases risk," such as the deaths of many members in that unit or having a distrust of leadership in that unit. "It is also important after an attempt to highlight resources, review risk and warning signs and encourage self care and support of peers," she said. Encouraging conversations around suicide risk remain important for Ruocco, as she knows first-hand the dangers of remaining silent, she said. She's the surviving widow of Marine Corps Major John Ruocco. Her late husband died by suicide in 2005 after not telling anyone about his mental health struggles, she said. "I wish he knew just how valuable he was and how many people would have wanted to help him," she said. "Suicide is a very complicated event with lots of factors. ... I think what this study really shows us is that when there is a suicide attempt that it does increase risk for all those who are exposed to it." 'There's nothing worse than suffering in silence'The new study still comes with several limitations, including that the data in the study were collected during wartime. More research is needed to determine whether similar findings on suicide attempt risk would emerge among Army units not during a time of war, and what exactly those mechanisms of risk would be, Ursano said. "Future research, which is now being developed with a continuation of this study, is to examine soldiers after 2009. So after the war has gone away, do we see the same effects? It's important to replicate the findings, to see if it's only amongst during times of high stress, meaning during war in the military," he said. "And we don't know the mechanisms here, and that's certainly an important area for future research." Shawn Jones, Air Force and Army veteran and interim executive director for the nonprofit Stop Soldier Suicide, said that he would like to see more developmental studies on suicide risk. "When you have a friend or loved one or battle buddy take their lives, it's devastating. You wonder why. You tend to hit the different levels of grief and try to process through them," Jones said. "In the military culture, we're bred to be strong. We're the ones who help those who can't help themselves. So, there's that stigmatization, as well, that we don't need help. Everybody else needs help, but we never do," he said. "The military as a whole, we can do better as leaders, as to where that stigmatization lies, by helping soldiers go get help, whether it's psychotherapy or something else." Marc Raciti, the retired US Army major, said that he kept his silent suffering a secret from those around him, including both his military family and biological family, because of that stigma. 'There is a crisis on our hands'It was Marc Raciti's now-wife, Sonja, who encouraged him to find help before he acted on his suicidal thoughts on that distant, ghostly hillside. Sonja Raciti, 38, said that while dating Marc, she knew that he needed to get help. "We worked at the civilian health clinic, just different departments, and we both fell madly in love with each other," said Sonja, an Army civilian psychologist, who met Marc while they were both assigned at the Schofield Barracks US Army installation in Hawaii. "Right from, probably the third or the fourth date, it was pretty obvious that Marc had pretty severe PTSD," she said. "Every night he had nightmares and significant anxiety everyday." Following counseling and therapy, Marc said that his PTSD symptoms subsided and he wrote a book about his recovery, " I Just Want To See Trees: A Journey Through PTSD." "I remember telling Sonja if I can help one person with this book, my efforts would not have been in vain, and I did. I helped myself," Marc said. With those dark days behind him, the 53-year-old veteran credits years of counseling and therapy for the joy-filled life he now lives in Phoenix, Arizona, with Sonja, their two children, and his PTSD service dog, Douglas. Yet the memories of their military loved ones who died by suicide -- and Marc's own brush with death -- still haunt the couple to this day, they said. "These are the guys that I mentored, these are the guys that I instructed, these are the guys that I taught how to be medics," Marc said about the lives lost. "It's devastating because these are folks we were pretty close to." When it comes to military suicides, "there is a crisis on our hands," he said. Now, he hopes broader conversations around military suicide can help to change the stigma around mental health issues in the military. "PTSD is a disease of avoidance. Everybody's heard of having a grandfather or someone who's been to war but doesn't like to talk about it. There's a reason for that, because you're drudging up very old, very painful memories," Marc said. "Even to this day having PTSD or having any kind of mental syndrome, it's a sign of weakness in a lot of commands. You're just a weak person and that doesn't sit well within any military setting so that is a barrier to care when you look at it," he said. "This is a ... barrier to care that could result in a devastating result." Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF July 26, 2017 at 10:22AM
Sperm Counts Continue to Fall in Western Nations
http://ift.tt/2tAfuOZ By Dennis Thompson HealthDay Reporter TUESDAY, July 25, 2017 (HealthDay News) -- Sperm counts in Western countries have decreased by half in recent years, suggesting a continuing and significant decline in male reproductive health, a new evidence review reports. Sperm concentration decreased an average 52 percent between 1973 and 2011, while total sperm count declined by 59 percent during that period, researchers concluded after combining data from 185 studies. The research involved nearly 43,000 men in all. "We found that sperm counts and concentrations have declined significantly and are continuing to decline in men from Western countries," said senior researcher Shanna Swan. "We don't have a lot of data in men from non-Western countries, so we can't draw conclusions about that part of the world," added Swan, a professor of environmental medicine at the Icahn School of Medicine at Mount Sinai in New York City. But in Europe, North America, New Zealand and Australia, "the declines are strong, significant and continuing," she said. The new findings come on the 25th anniversary of the first study to observe a decline in sperm counts, Swan said. The original study, published in 1992, found that sperm counts had declined 50 percent over 50 years. "The story has not changed over the past 25 years. Whatever is going on, it's not transient and it's not disappearing," Swan said. "When we look at the data for the last five or 10 years, we don't see a leveling off of this decline." The continued decline raises concerns about male fertility, and also male health in general, Swan said. "We are worried about these low sperm counts not only because people have trouble conceiving, but also because men with low sperm counts go on to have higher all-cause mortality," Swan said. Studies have shown "they die younger and they have more disease, particularly cardiovascular disease and cancer," she added. "It really makes the implications of our study much greater," she continued. "We're not talking about making babies. We're also talking about survival and health." No one knows why sperm counts continue to decline, but researchers believe it's likely due to factors associated with a modern lifestyle, Swan said. These factors include exposure to man-made chemicals, increased levels of stress, widespread obesity, poor nutrition, lack of physical exercise and smoking. ContinuedThese factors can temporarily reduce a man's fertility, but researchers think the real damage is being done during exposures occurring in the womb, Swan said. "Research has found that when a mother smokes, her son has a lower sperm count, regardless of his own smoking," Swan said. "That says what a man is exposed to when he's in utero is important. The mother's exposure will cause a change that stays with the man his entire life." Experts are divided on whether the decline in sperm counts will have any impact on male fertility in the near future. Modern men still have 66.4 million sperm per milliliter of semen, compared with 92.8 million per milliliter from men nearly four decades ago, said Dr. Avner Hershlag, chief of Northwell Health Fertility in Manhasset, N.Y. "It's not all in the numbers," Hershlag said. "It is estimated about 20 percent of men who have achieved a pregnancy with their partners without treatment have abnormal sperm. There is no proof that parallel to the decline in numbers there has been a decline in the true ability of males to impregnate their partners." Furthermore, he said, "every person you know is the product of one egg and one sperm, so why do we need millions of sperm knocking on the wall of a single egg?" However, if the trend continues, it could have an impact, said Dr. Peter Schlegel, a professor of reproductive medicine and urologist-in-chief for New York-Presbyterian/Weill Cornell Medical Center in New York City. "It's possible we are seeing a progressive decline in sperm numbers over time, and it could get to the point where it is a significant problem driving many more couples to require fertility treatment," Schlegel said. One potential problem could be that decreased sperm counts reflect an overall decline in sperm quality, Hershlag said. "If you have a low number of sperm, then these sperm when facing the egg may have a lower capacity to fertilize the egg and lead to the creation of an embryo and, subsequently, a human being," Hershlag said. "But that's not been proven scientifically." The study appears in the July 25 issue of the journal Human Reproduction Update. WebMD News from HealthDay SourcesSOURCES: Shanna Swan, Ph.D., professor, environmental medicine, Icahn School of Medicine at Mount Sinai, New York City; Avner Hershlag, M.D., chief, Northwell Health Fertility, Manhasset, N.Y.; Peter Schlegel, M.D., professor, reproductive medicine, and urologist-in-chief, New York-Presbyterian/Weill Cornell Medical Center, New York City; Human Reproduction Update, July 25, 2017 Copyright © 2013-2017 HealthDay. All rights reserved.Health via WebMD Health http://www.webmd.com/ July 25, 2017 at 03:12PM
U.S. Kids Overdosing on Dietary Supplements
http://ift.tt/2uyamw1 By Kathleen Doheny HealthDay Reporter TUESDAY, July 25, 2017 (HealthDay News) -- A curious toddler opens a bottle of melatonin found on the kitchen counter, and accidentally overdoses on a supplement typically used by adults to help with sleep. In that case, the doctor who treated the child only had to deal with a very tired 3-year-old, but it might have been a far more serious scenario if a different dietary supplement, such as the energy product ephedra or the male enhancement herb yohimbe, had been swallowed. "We see it all the time," said Dr. Barbara Pena, research director of the emergency medicine department at Nicklaus Children's Hospital in Miami. Indeed, a new report from researchers bears out Pena's observations: From 2005 through 2012, the annual rate of accidental exposures to dietary supplements rose in the United States by nearly 50 percent, and 70 percent of those exposures involved young children. "The biggest increase [in accidental overdoses] was in children under 6. It got our attention," said study author Henry Spiller, director of the Central Ohio Poison Center of Nationwide Children's Hospital in Columbus. Ninety-seven percent of the time, the children swallowed the supplements while at home, the study found. It is a particularly difficult problem to try to solve: Dietary supplements are not regulated by the U.S. Food and Drug Administration as drugs, so they're not subject to the same scrutiny and oversight. The FDA can only take action if the supplements are shown to cause harm. During the 13 years of the study, Spiller's team also found an increase from 2000 to 2002, when the rates of calls to U.S. poison control centers involving supplements rose 46 percent each year. From 2002 to 2005, the researchers found the rates of calls declined. Spiller suspects that is because the FDA banned ephedra in 2004, after supplements containing it had been linked with adverse heart events and deaths. Overall, only about 4.5 percent of the cases in the study had serious medical outcomes. During the 13-year period tracked, 34 deaths were attributed to supplement exposure, Spiller said. ContinuedThe supplements most often associated with the greatest toxicity were ephedra (also known as ma huang) products, yohimbe (found in male enhancement and other products) and energy supplements. While ephedra is now banned, yohimbe is not, and nearly 30 percent of yohimbe exposure calls in the study resulted in moderate or major harm. Yohimbe can cause heartbeat rhythm changes, kidney failure, seizures, heart attack and death, the researchers noted. Often, children find the supplements on a kitchen counter, Spiller said. Parents and others often equate dietary supplements with being natural, and therefore safe. Parents usually don't keep track of how many pills are left in a supplement bottle, he said, making it more difficult to tell poison control staff how many pills were taken in an accidental exposure. One common scenario, Spiller said, is that a child finds a product containing yohimbe, opens it and takes it. Another common occurrence, Spiller said, is that high school athletes going to preseason football practices take an energy product loaded with caffeine and other ingredients and have abnormal heart rhythms or even a heart attack. The researchers said their findings point to need for the FDA to regulate yohimbe and energy products. Both Spiller and Pena suggest parents and others become more aware of the potential problems with supplements. If young children are in the house, keep supplements high on a shelf or in a locked cabinet, Spiller said. Pena, who was not involved with the study, tells parents to ''treat these supplements the same as they would treat prescription or over-the-counter medicines." Supplements are especially scary, she noted, because it's not always possible to know the potency of the product. The study was published July 24 in the Journal of Medical Toxicology. WebMD News from HealthDay SourcesSOURCES: Henry Spiller, M.S., director, Central Ohio Poison Center, Nationwide Children's Hospital, Columbus; Barbara Pena, M.D., Ph.D., research director, emergency department, Nicklaus Children's Hospital, Miami; July 24, 2017, Journal of Medical Toxicology, online Copyright © 2013-2017 HealthDay. All rights reserved.Health via WebMD Health http://www.webmd.com/ July 25, 2017 at 02:30PM
Fact Check: For Trump’s ‘Victims’ of Obamacare, Senate Bill May Be Worse
http://ift.tt/2v5cDle Mr. Trump also highlighted three families whose children have costly pre-existing medical conditions. But the 3-year-old with spina bifida, for example, would probably have been uninsurable before the Affordable Care Act’s passage, and the Republican bill may cause his premiums to skyrocket. If Senator Ted Cruz, Republican of Texas, wins approval of his addition, the revised bill would allow insurers to offer plans that do not comply with current regulations — like the one that prohibits denying coverage or charging more based on health status — if they offer at least one plan that does. According to America’s Health Insurance Plans, the industry trade group, the Cruz amendment could lead to two insurance pools, one with cheap plans for healthy people and another with “unaffordable premiums for those with pre-existing conditions.” “Millions of people who battle chronic diseases or disabilities, like heart disease, lung disease, or diabetes, would be negatively impacted by this legislation,” 10 patient advocacy organizations said in a joint news release. He claimed the bill would “significantly lower Americans’ premiums.”It’s unclear which Senate bill lawmakers will debate Tuesday, but Mr. Trump’s claim is not entirely accurate for either the bill to repeal and replace the current law or the bill that partially repeals it without a replacement. The Congressional Budget Office estimated that the repeal-only bill would drive up premiums 25 percent in 2018 and 50 percent in 2020, before they double in 2026 compared to the current law. Under the revised bill to repeal and replace the Affordable Care Act, premiums would initially increase and then drop about 20 percent in 2026, but that also comes with a few caveats. The plans under the bill would cover a smaller percentage of benefits than the ones today. The bill also allows insurers to charge older Americans more for health care. And it lowers the value of cost-sharing subsidies. He said the bill would provide “more flexibility for states to administer Medicaid to better serve their poorest citizens.”The bill offers states a block grant option to provide coverage for nondisabled adults beginning in 2020, which the budget office says would give them “additional flexibility.” But whether this option benefits low-income Medicaid enrollees depends on how states would offset the hundreds of billions of dollars in cuts to federal Medicaid funding. If states roll back eligibility or reduce services, for example, enrollees may lose coverage or have fewer benefits. The budget office estimates that 15 million fewer people would enroll in Medicaid under the revised Senate bill than under current law. Continue reading the main storyHealth via NYT > Health http://ift.tt/2koaaw3 July 25, 2017 at 12:54PM
Huge Number of Brain Injuries in Football Players
http://ift.tt/2tzKChD By Dennis Thompson HealthDay Reporter TUESDAY, July 25, 2017 (HealthDay News) -- Ninety-nine percent of former NFL players who donated their brain to science turned out to have the devastating disorder chronic traumatic encephalopathy (CTE), according to a new report. Researchers found evidence of the degenerative brain disease in 110 out of 111 deceased National Football League players, said study co-author Dr. Daniel Daneshvar. He is a researcher with the Boston University School of Medicine's CTE Center. "A remarkable proportion of the athletes who played at the highest level develop neurodegenerative disease," Daneshvar said. "This is incredibly concerning, because of the sheer numbers" of men who have ever played the game professionally. Evidence of CTE also was found in 91 percent of brains donated by college football players, 88 percent of those from Canadian Football League players, and 21 percent of brains donated by high school players, the researchers found. According to Dr. Gil Rabinovici, an associate professor of neurology with the University of California, San Francisco Memory and Aging Center, "CTE changes could also be detected in some individuals who played at the collegiate and even high-school level, suggesting lower levels of exposure may be sufficient to lead to brain injury." The report includes the autopsy results from 202 brains, with CTE diagnosed in 177 brains. "In this study," Daneshvar noted, "we more than double the total number of cases of CTE in the world's literature." CTE tends to occur in people who experience repetitive brain trauma. It shows up at autopsy as aberrant protein clumps and other signs of brain damage, according to the nonprofit Concussion Legacy Foundation. Previous studies have suggested that both full-fledged concussions and sub-concussive blows -- jarring head impacts but not actual concussions -- can contribute to the risk of CTE, Rabinovici said. People with the disorder experience problems with thinking and memory, mood disorders, and behavioral problems, Daneshvar said. Lack of impulse control, aggression, depression, impaired judgment, memory loss, paranoia, confusion and progressive dementia are some of the symptoms that can occur. Prior research has uncovered CTE in dozens of former NFL players. They include Pittsburgh Steelers center Mike Webster; Junior Seau, linebacker for the San Diego Chargers; Ken Stabler, the Oakland Raiders quarterback; and Frank Gifford, running back for the New York Giants. Health via WebMD Health http://www.webmd.com/ July 25, 2017 at 12:44PM |
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