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Walk to fend off disability

Senior man walking

Zing Images/Getty Images

People who have reached their later years may think it’s primarily a time to relax, not to increase their physical activity. Not so. Previous research has suggested that exercise can improve memory and reverse muscle loss in older adults, among other benefits. And a study out Monday finds that a regular program of physical activity reduces the time spent with mobility-limiting disability.

Researchers took more than 1,600 sedentary people between 70 and 89 years old who had some functional limitations, but who could walk about a quarter of a mile in 15 minutes or less, unassisted by another person or a walker. (Canes were OK.)

Half of the participants got a health education program involving regular in-person sessions and some stretching exercises, while the other group was told to aim for 150 minutes of aerobic activity as well as strength, flexibility and balance training both at the study’s facilities and at home. “Walking was the cornerstone of the program,” saysThomas Gill, a professor of geriatrics at the Yale School of Medicine and an author of the study, which appears in Annals of Internal Medicine.

The study followed participants for about 2.7 years, and found that the physical activity program cut the amount of time that people spent with a “major mobility disability” — defined as being unable to walk a quarter mile — by 25 percent compared to the education program. Previous findings from the same study showed that the exercise program lowered the risk of becoming disabled in the first place; this one showed that it sped recovery from an episode of disability and lowered the risk of subsequent episodes.

“They’ve done a really nice job of showing the incredible power of physical activity,” says Bradley Cardinal, a professor of kinesiology at Oregon State University who wasn’t involved with the study. “It’s the secret ingredient to successful aging in terms of quality of life.” An editorial accompanying the study, by the University of California, San Francisco’s Patricia Katz and the University of South Carolina’s Russell Pate, also noted that people who engage in physical activity have a lower risk for heart disease, diabetes, certain cancers, depression, cognitive impairment and functional decline.

The exercise program pretty closely followed the government’s recommendations for all adults, including older ones: 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise per week, plus two strength sessions that hit all the major muscle groups.

But most Americans don’t get that much exercise, and that becomes increasingly true as people age. According to statistics from the Centers for Disease Control and Prevention, just 28 percent of those 75 and up meet the recommendation for aerobic activity, and only 8 percent also did the suggested amount of strength training.

Cardinal says older adults need to realize that exercise can greatly improve their quality of life by maximizing function as long as possible. But he says that many believe that older age is for relaxing and that physical activity is somehow dangerous or unnatural. That belief “is pervasive among older adults,” he says, even though for many of them, meeting the minimum requirements “is doable.”

Semantics can help. “We try to frame this as more physical activity than exercise,” says Gill. “We talk with older folks and many say, ‘I can’t exercise, but maybe I can become more physically active.’ ” Study participants were advised to “start low and go slow,” and some were even able to get rid of their canes after six months of exercise, which Gill says they found particularly rewarding.

Physicians can also help. “Prescribing exercise may be just as important as prescribing medications — perhaps even more important in some cases,” the editorial said. The authors called on medical schools to “start preparing students to prescribe exercise as effectively as they prescribe statins, and for health systems to support physicians in addressing inactivity just as they provide support in addressing other health risks.” (The American College of Sports Medicine has an “Exercise is Medicine” initiative to help physicians integrate exercise recommendations into their treatment plans.)

There are also some basic behavioral strategies for getting yourself to get moving, no matter your age, including giving yourself an incentive to change and engineering your environment to encourage the activity.

Katherine Hobson

Why I take cold showers

1. INCREASES ALERTNESS

Taking a cold shower in the morning, and  feeling cold water pour down over our body seems more horrifying than soothing. However, the deep breathing in response to our body’s shock helps us keep warm, as it’s increases our overall oxygen intake. Thus, our heart rate will also increase, releasing a rush of blood through our entire body. This gives us a natural dose of energy for the day.

Katherine Hepburn, a Hollywood actress, was a fan of cold showers. She began taking them daily after being pushed by Dr. Thomas Norval Hepburn, a urologist and pioneer in social hygiene, The New York Times reported. Katherine would take ice-cold baths or showers during childhood and for the rest of her life — she would advise others to do so as well. The actress swore by cold showers, and had a high energy level to support her claims.

2. REFINES HAIR AND SKIN

When it comes to hair and skin, one of the most natural ways to maintain your appearance is with cold showers. Hot water has the tendency to dry out our skin, so it’s best to use cold water to tighten your cuticles and pores, which will prevent them from getting clogged. Cold water can “seal” the pores in the skin and scalp too, preventing dirt from getting in.

Jessica Krant, board-certified dermatologist, told The Huffington Post that ice-cold or lukewarm water can help our skin and prevent it from being stripped of its healthy natural oils too quickly. Remember, cold water only temporarily tightens skin as it constricts blood flow, but it does not shrink pores. When it comes to haircare, cold showers can make hair appear shinier, stronger, and healthier by flattening hair follicles, and increasing their ability to grip the scalp.

3. IMPROVES IMMUNITY AND CIRCULATION

Cold water can improve circulation by encouraging blood to surround our organs, which can then help combat some problems of the skin and heart. As cold water hits the body, it’s ability to get blood circulating leads the arteries to more efficiently pump blood, therefore boosting our overall heart health, according to Dr. Joseph Mercola, a natural health expert. It can also lower blood pressure, clear blocked arteries, and improve our immune system.

4. STIMULATES WEIGHT LOSS

Cold showers can aid weight loss in an unexpected way. The human body contains two types of fat tissue,white fat and brown fat. White fat is accumulated when we consume more calories than our body needs to function, and we don’t burn these calories for energy. This body fat piles up at our waist, lower back, neck, and thighs, and is the one we all struggle to eliminate. Brown fat is the good fat, which generates heat to keep our bodies warm, and is activated when exposed to extreme cold, according to the Joslin Diabetes Center, a Harvard Medical School affiliate. Thus, cold showers can promote brown fat activity.

A 2009 study found that exposure to extreme cold temperatures activated brown fat in 23 and 24 participants by a 15-fold increase, meaning someone could lose up to nine pounds in a year if they kept this practice up.

5. SPEEDS UP MUSCLE SORENESS AND RECOVERY

We have all seen athletes taking ice baths after training to reduce muscle soreness, but a quick cold shower after breaking a sweat at the gym can be just as effective, especially in relieving delayed-onset muscle soreness. A 2009 study analyzing 17 trials involved over 360 people who either rested or immersed themselves in cold water after resistance training, cycling, or running. It found that 24-minute cold water baths were effective in relieving sore muscles one to four days after exercises with a water temperature of 50 to 59 degrees Fahrenheit, or 10 to 15 degrees Celsius. However, some studies involved colder temperatures.

6. EASES STRESS

Jumping into the shower without letting it heat up, or going into the ocean without slowly acclimating to it, can help promote hardening, increasing tolerance to stress, and even disease. A 1994 study found a drastic decrease in uric acid levels during and following exposure to a cold stimulus. There was also an increase in gluthathione, an antioxidant that keeps all other antioxidants performing at their optimal levels. The participants, who were 10 healthy people who swam regularly in ice-cold water during the winter, adapted to repeated oxidative stress.

7.  RELIEVES DEPRESSION

Cold showers have been shown to relieve depression symptoms due to the intense impact of cold receptors in the skin, which send an overwhelming amount of electrical impulses from the peripheral nerve endings to the brain. Thus, it produces an antidepressive effect, and boosts moods, making it a pick-me-up. A 2008 study found that cold hydrotherapy has an analgesic effect, and does not appear to have noticeable side effects or cause dependence. This treatment included one to two cold showers of 38 degrees Fahrenheit, two to three minutes long, followed by a five-minute gradual adaptation to make the procedure less shocking.

It’s time to take a duck to water, and try the benefits of hydrotherapy.


Connie’s comments: In California, I take cold shower after the 30-min NC Fit cross-fit training in the gym. In the Philippines, we have no choice but use cold shower only.

Concussion Leaves The Brain Vulnerable To PTSD

There’s growing evidence that a physical injury to the brain can make people susceptible to post-traumatic stress disorder.

Studies of troops who deployed to Iraq and Afghanistan have found that service members who have suffered a concussion or mild traumatic brain injury are far more likely to develop PTSD, a condition that can cause flashbacks, nightmares and severe anxiety for years after a traumatic event.

And research on both people and animals suggests the reason is that a brain injury can disrupt circuits that normally dampen the response to a frightening event. The result is like “driving a car and the brake’s not fully functioning,” says Mingxiong Huang, a biomedical physicist at the University of California, San Diego.

Scientists have suspected a link between traumatic brain injury (TBI) and PTSD for many years. But the evidence was murky until researchers began studying troops returning from Iraq and Afghanistan.

What they found was a lot of service members like Charles Mayer, an Army sniper from San Diego who developed PTSD after finishing a deployment in Iraq.

In 2010, Mayer was on patrol in an Army Humvee near Baghdad when a roadside bomb went off. “I was unconscious for several minutes,” he says. So he found out what happened from the people who dragged him out.

The blast fractured Mayer’s spine. It also affected his memory and thinking. That became painfully clear when Mayer got out of the Army in 2012.

“Two weeks later, I started school,” he says. “And a simple math equation like 120 times 7, where I previously would do that in my head very easily, I all of a sudden couldn’t do that.”

And Mayer had a bigger problem. His time in Iraq had left him with an uncontrollable fear of improvised explosive devices, or IEDs.

“When I would walk down the street, I would walk away from trash piles because that’s often how they would hide IEDs,” he says. “I stayed away from large crowds.”

Mayer’s fear was not only disturbing, it was disabling. “I would get severe panic attacks to the point where I would have to go to the hospital,” he says. “I would feel like I’m actually having a heart attack.”

Eventually, Mayer went to a Veterans Affairs hospital for help. An exam confirmed that he had PTSD.

The wars in Iraq and Afghanistan have produced thousands of Charles Mayers. First they got a concussion from a bomb blast. Then they got PTSD.

“We had people who were looking very miserable when they came back,” says Dewleen Baker, a psychiatrist at UCSD and the VA San Diego Healthcare System.

Baker kept asking herself: Was the PTSD just from the emotional trauma of combat? Or did a concussion alter the brain in a way that amplified fear and anxiety?

“I could easily diagnose the PTSD,” she says. “But I found it very, very difficult to tease apart the contribution of traumatic brain injury.”

Enlarge this image

Mayer in Iraq in 2010, where he served as a sniper and was injured in a roadside explosion.

Courtesy of Charles Mayer

So Baker and a team of researchers began studying more than 1,600 Marine and Navy service members from Camp Pendleton, in San Diego County, Calif. The service members had been assessed before deploying to Iraq or Afghanistan, and then again three months after returning.

“At one point we got this battalion that went to Helmand province in Afghanistan, and literally 50 percent of them were complaining of blast exposures and symptoms,” Baker says. “I got concerned.”

Baker had reason to worry. The study found that troops who experienced a traumatic brain injury were twice as likely to develop post-traumatic stress disorder.

But why? There was no easy way to answer that question in people. But several years ago some answers began to emerge from animal studies.

In one experiment, a team of scientists at the University of California, Los Angeles compared healthy rats with rats that had experienced a traumatic brain injury. All of the rats received a type of behavioral conditioning known to induce fear.

They found that fear response learned by the animals that had experienced a TBI was much greater than it normally would be, says Michael Fanselow, a psychology professor at UCLA and an author of the study.

Next, the team looked at cells in the amygdala, a part of the brain that takes sensory information and decides whether to be afraid. They found changes that would amplify the animal’s response to a frightening experience.

“And we think that that’s the way TBI has of increasing your susceptibility to post-traumatic stress,” Fanselow says.

If brain injuries really do change the brain’s fear circuitry, there should be some way to detect that change in people, says Baker.

So Baker teamed up with her colleague Mingxiong Huang, the biomedical physicist. Huang has been using a technology that measures electrical activity in the brain. It’s called magnetoencephalography,or MEG.

Huang and a team of researchers used MEG to scan the brains of 84 people who had experienced a brain injury. Some of the participants were service members, some were civilians.

Those scans found abnormal signals coming from the brains of people who’d had a concussion. And the location of those abnormal signals suggested that there was too much activity going on in the amygdala and not enough in an area that normally tempers emotional reactions.

The result is a brain that is “like a car with no brake,” Huang says.

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After leaving the Army and starting school, Charles discovered he could no longer do simple math equations in his head.

Stuart Palley for NPR

To learn more about the brain circuitry involved in both TBI and PTSD, Dewleen Baker is expanding her earlier study of Marines. She plans to scan the brains of about 200 combat veterans, including some with both TBI and PTSD.

And Baker will have help from a researcher with a personal stake in the project: Charles Mayer, the former soldier whose college career was interrupted by PTSD.

After getting treatment, Mayer was able to finish his undergraduate degree in December. Then Mayer, who is now 30, started looking for a job that would let him study the problems that had affected his own brain.

“I looked up the psychiatrists that were doing research that I really cared about, and Dr. Baker was definitely up there,” he says. And Baker hired him.

Their research will focus on veterans. But the findings could also help identify civilians who’ve suffered a brain injury that could make them vulnerable to PTSD.

http://www.npr.org/sections/health-shots/2016/09/26/495074707/war-studies-suggest-a-concussion-leaves-the-brain-vulnerable-to-ptsd

Educate and empower caregivers to reduce health risks

Caregiver stories

One of my caregivers at Motherhealth uses her knowledge of whole foods cooking to her 92 year old client who was told by the doctor has few months to live. She fed her client with Filipino dish filled with bitter greens and all kinds of whole foods and her client lived for another 5 years.

Each day, she would hug and exercise his legs and give him enough sunshine in the morning hours. She cared for him like her father.

In many of my clients and clients in care homes who were served gourmet whole foods, they survive longer than others in care homes and their homes fed with frozen or processed foods.

As I interact with seniors, I dance with them and listened to their stories of beautiful memories of time past. They know when something is wrong that they cannot sleep, cannot eliminate or gets constipated and just cannot move.  Many of them live longer because their family members spent time massaging their head for 30min each day during their visits.

Many emergencies are prevented because many caregivers went through a training and knows holistic ways of caring.

I ensured that caregivers complete a daily log detailing food taken, meds taken, time of elimination, presence of constipation, lack of sleep, lack of exercise, time spent in walking and exercise, and more observations that should be relayed to their doctors. And we do relay this message to their children and during doctor’s visits.

We are looking for investors for a mobile app that will speed learning by caregivers, communication of health data generated by the patient, use of telemedicine, genetic information and other health markers/risk formula to empower all members of the health team especially the consumers. Learn from the global health data and use all these data insights toward actionable health outcomes.

Email Connie at motherhealth@gmail.com to participate in any way you can.

https://www.indiegogo.com/projects/cancer-riskfactor-and-doctor-video-chat-mobile-app-medicine#/

indie


 

Health IT

Integrate and analyze data from across the community—including medical, behavioral, and social information—to provide the big picture of patient and population health. Further, the operational information about moving a patient through the care process (e.g., outreach, education, arranging a ride, etc.) is vital to tuning care delivery as a holistic system rather than just optimizing the points of care alone. This innovative approach consolidates diverse and fragmented data in a single comprehensive care plan, with meaningful insights that empowers the full spectrum of care, from clinical providers (e.g., physicians, nurses, behavioral health professionals, staff) to non-clinical providers (e.g., care managers, case managers, social workers), to patients and their caregivers. Armed with granular patient and population insights that span the continuum, care teams are able to proactively address gaps in patient care, allocate scarce resources, and strategically identify at-risk patients in time for cost-effective interventions.

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Predictive, preventive, personalized and participatory medicine (P4)

Health Data Insights

Focus on optimizing wellness through longitudinal data collection, integration and mining of individual data clouds, enabling development of predictive models of wellness and disease that will reveal actionable possibilities.

What can we learn from others who are healthy?

P1  whole genome sequencing

P2  clinical and functional laboratory testing (every three months)

P3  gut microbiome (every three months)

P4  quantified self and traits (physical activity, sleep, weight, blood pressure, personality and lifestyle factors, happiness factor and so on)

Connie’s comments: It is time that we have a voice in our health, that we can share with others so that others might learn what makes a healthy person.

I added happiness factor above to see what data insights can be derived from a 100k population who are happy and healthy.

http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0238-7

Does screening asymptomatic individuals potentially cause psychological distress?

There is a common myth that if a healthy individual receives information (especially genetic information) revealing increased risk for a disease that is not currently treatable, it will lead to anxiety, depression or other psychological distress. However, a fairly large body of literature contradicts this assumption. For example, Bloss et al. [4] looked at the responses of more than 2,000 healthy adults to direct-to-consumer genetic testing over one year and found no overall increase in health-related anxiety, with <3% of the sample reporting any degree of test-related distress. Conversely, 62% perceived the testing to be ‘of high personal utility’. Similarly, a meta-analysis of studies where people were told their genetic risk for obesity, heart disease, depression or diabetes revealed no impact on individuals’ perceived control or ‘fatalism’ [5]. Perhaps most striking, Green and colleagues [6] analyzed the psychological impact of receiving information on personal genetic risk for Alzheimer’s disease in individuals with a family history of this currently untreatable disease. They found no difference in anxiety or depression up to one year post-testing in those who received genetic results versus those who did not, regardless of whether they had the high-risk allele or not. Thus, on the basis of current evidence, one cannot argue that a positive finding in a screening test causes psychological distress, regardless of whether or not treatment or prevention is available. This concern is particularly unlikely in the HPWP where only actionable findings are being reported.

False positives and negatives

It is inevitable that screening thousands of data points will generate false positives, as well as false negatives, and we take this concern seriously. One reason for the necessity of conducting a project on a very large scale (that is, the 100 K project) is so that appropriate analytics and methods development can be performed to improve the reliability and reproducibility of results, reducing the problem of false positives and negatives. Another key approach that we are using in the HPWP is thoughtfully tailored messaging and communications with participants about the likelihood of false positives and negatives, so that they can make well-informed decisions. Utilization of health coaches, advised by physicians, to discuss study results and provide appropriate context about false positives and negatives, particularly for newer technologies such as gut microbiome and whole-genome sequencing, is another essential element of our approach.

 

 

Your Testicles and your health

Too often, a man’s penis is the centerpiece of his pant-less legs. But a man’s package is more than just his penis. Testicles (a.k.a. balls) chill in men’s scrotums (or ball sacks) both literally and figuratively — they need to be at a temperature slightly lower than the body’s — where they create sperm cells, which are halfway responsible for human life (that’s rather important, actually). But there’s more to the walnut-sized body part. In fact, a lot of it involves their size, which can tell us some things about the person they belong to.

BIGGER TESTICLES, MORE HEART PROBLEMS

Men with larger testes may be more prone to developing heart disease, a 2013 study on over 2,800 men found. After following up with the men seven years later, the researchers found that those with bigger testes had a higher chance of developing heart disease. Granted, these men were also more likely to drink heavily and have high blood pressure. Along with stress that probably came from being sexually dysfunctional, these men were kind of setting themselves up for a higher risk of heart disease.

Still, the researchers suggested that the reason men with larger testes developed heart problems more often was because of the testosterone-producing hormone called luteinizing hormone, which is responsible for stimulating testosterone production. Studies have linked higher levels of testosteroneto heart disease.

testicles From better parenting to testicular cancer, your testicles say more about your health than you may think.Photo courtesy of Shutterstock

SMALLER TESTICLES, NO SLEEP?

A study from researchers at the University of Southern Denmark found an interesting correlation between a man’s quality of sleep and his testicle size. They surveyed almost 1,000 men about their sleep schedules, sleep interruptions, and sleep habits, and then tested their testicular sizes and sperm counts. They found that those men who reported insomnia, stayed up late, or slept inconsistently had sperm counts that were 29 percent lower. On top of that, their testicles were also 1.6 percent more deformed while also being smaller in size.

It’s obvious that smaller testicles aren’t causing someone to sleep less. The study shows, however, that a person with smaller testicles might not be getting all the sleep they need. The researchers also noted that people who had poor sleep also tended to lead unhealthier lives filled with fatty foods, alcohol, and smoking, among other habits. So, smaller testicles could actually indicate a person is unhealthy in other ways too.

SMALLER TESTICLES, BETTER DADS

This may be a stretch, but dads who stick around for their kids seem to be the ones with smaller testicles. A study from Emory University interviewed 70 dads with 1- or 2-year-old children. Both father and mother were interviewed about the dads’ involvement in child rearing, including how often they changed diapers, bathed the child, or took them to the doctor when they were sick. They also measured the fathers’ testosterone levels.

Their results showed that dads who were more involved tended to have lower testosterone and thus smaller testicles. “We’re assuming that testes size drives how involved the fathers are,” anthropologist Dr. James Rilling said. “But it could also be that when men become more involved as caregivers, their testes shrink. Environmental influences can change biology. We know, for instance, that testosterone levels go down when men become involved as fathers.”

What does this mean for men’s health? Well, seeing as dads are more nurturing, chances are they have better relationships with their children, which in turn translates to better mental health for them.

TESTICULAR CANCER

No story on the testicles and health should leave out perhaps the most important health indicator the testicles can provide: a testicular cancer self-exam. In 2014, there will be an estimated 8,820 new cases of the cancer, with 380 deaths, according to the American Cancer Society. While that number is small, the only reason is because treatment options are widely available and effective. Nevertheless, it’s a cancer that can affect one or both testes, where it appears as a lump on the testicle, an enlarged testicle, a heaviness in the scrotum, an aching pain in the lower abdomen or groin, or a collection of fluid in the scrotum.

The cancer can affect men at any age, though it appears most often around 20 to 34 years of age, especially among white men, who face a risk four to five times that of black men. If you didn’t know already, you can check for testicular cancer by yourself after each bath or shower. To perform the self-exam, follow these steps from the Cleveland Clinic:

1.       Do the exam after a warm shower or bath. The warmth relaxes the skin of the scrotum, making it easier to feel for anything unusual.

2.       Use both hands to examine each testicle. Place your index and middle fingers underneath the testicle and your thumbs on top. Roll the testicle between your thumbs and fingers. (It’s normal for testicles to be different in size.)

3.       As you feel the testicle, you might notice a cord-like structure on top and in back of the testicle. This structure is called the epididymis. It stores and transports sperm. Do not confuse it with a lump.

4.       Feel for any lumps. Lumps can be pea-size or larger and are often painless. If you notice a lump, contact your health care provider.

5.       Although the left and right testicles are often different sizes, they should remain the same size. If you notice a change in the size of your testicles, contact your health care provider.

http://www.medicaldaily.com/what-your-testicles-say-about-your-health-4-ways-size-matters-300918