Wednesday, July 27, 2016

Take a Break: Unplug Yourself & Reboot

Whether it’s your computer, phone or yourself, it all works better if you “unplug,” even for a few minutes, and then “reboot.” So here are 12 ways to do just that. Be sure to “unplug” from electronic devices. If you want to permanently reduce the electronic clutter remove Facebook/Twitter/E-mail/Instagram from your phone



Ways to Unplug & Reboot
• Take a nap

• Make a moving fish and share it with a child 

• Legs Up the Wall Pose: This is wonderfully restorative pose that benefits your heart as well as your soul.

• Go for a walk, hike, or swim

• Practice yoga, Qigong, Tai Chi and/or sit in quiet meditation

• Find a new recipe in one of the cookbooks you have on hand and try it
 
• Color, paint, draw 

• Journal

• Spend time with a pet

• Watch the sun rise/set

• Have a bonfire

• Read a book


• Go to an aquarium (or a fish store in a pinch) and watch the fish. 

Saturday, July 23, 2016

GMOs & Fake Food: What’s Real, What’s Hype and What You Can Do.

On July 1 Vermont enacted its GMO (genetically modified) labeling law, resulting in 3,000 products no longer being sold in Vermont. In the same week, 107 Nobel laureates sign a letter blasting Greenpeace over GMOs. The letter asks Greenpeace to cease its efforts to block introduction of a genetically engineered strain of rice that supporters say could reduce Vitamin-A deficiencies causing blindness and death in children in the developing world.

So who’s to be believed-107 of the leading scientific researchers in the world or the Vermont State legislature? How risky are GMOs?

The short answer is that food has been genetically modified ever since it was eaten-either by nature itself, farmers or food engineers. Foods have been fortified (modified) to help improve health since the 1920s. For example, eight studies have found that fortifying flour with folic acid reduced the incidence of neural tube birth defects such as spina bifida by 31% to 78%. Other than people’s fear, there isn’t reliable scientific data to support the GMO reaction. Note that GMO isn’t a scientific term and pretty much anything we eat has been genetically modified at some point or another.

What is more concerning, particularly for people with allergies and serious health conditions, is “fake food.”-it’s labeled one way but is something completely different. Almost every month there is a new “food scandal.” Commercial honey, is extended with beet sugar, corn syrup. Shrimp often comes from Southeast Asia where it may be full of antibiotics and is not known to be safe and in fact has been banned. Most of the imported extra virgin olive oil isn’t really olive oil and the list goes on. According to the Grocery Manufactures of America, up to 10% of food products contain adulterated or fraudulent ingredients.

An Inside Edition report  surveyed 28 restaurants across the county and found that 35% of them substituted something cheap for the lobster, such as whiting, Pollock or langostino. You’d think that the chain Red Lobster would probably only use lobster, not so for dishes that use lobster meat.

There is a lot more focus on this with the July 12th publication of Real Food Fake Food: Why You Don’t Know WhatYou’re Eating, What You Can Do About It”  by Larry Olmsted, who happens to live in Vermont. 

Time recently posted an article on Olmsted’s book with the following highlights:
• The single most defrauded fish in the US is red snapper with the number one substitute being tilefish or tilapia, which is on the FDA’s “do not eat list” for pregnant women due to its high mercury content
• 43% of “wild” labeled salmon sold in Chicago restaurants and grocery stores are actually farmed.
• In New York City 100% of sushi restaurants served fake fish and in fact, the worst fraudulent fish is sushi.

Some of the most commonly sold “fake” foods that aren’t what their labels promise include: Kobe beef, seafood, honey, coffee, orange juice, apple juice, wine, rice and cheese.

What is most concerning is that Olmsted documents that as quickly as they scandals are identified, the producers shift things around. Bottom line, food can be and will be continually faked. So what can you do?

When shopping consider the following:
• Read labels carefully If something has a huge number of ingredients, it’s probably fake. Stay away from things like high fructose corn syrup, hydrogenated oils, aspartame, and blue 25.


• Shop the perimeter of the store as most of the middle isles are packaged, processed goods. Buy whole rather than processed.

• Avoid artificial colors and so-called "natural flavors" Both the Food and Drug Administration (FDA) and U.S. Department of Agriculture (USDA) have rendered “natural” virtually meaningless for all foods, but when it comes to beef, chicken, pork, and lamb, literally every single animal raised in this country, regardless of drugs or diet, qualifies as “natural” under USDA regulations. Other labels to be wary of:
a)    Hormone-free” on poultry or pork. Unlike antibiotics, which are widely abused in agriculture, it is illegal to use hormones on poultry or pork in the U.S. (but not beef). So all poultry and pork is hormone-free. But producers have found consumers will pay a few cents more if they slip this on.
b)    Grass-fed” on beef.  This it just changed without many people noticing. For the past decade the USDA had a somewhat acceptable definition, but they just rescinded it, and it’s now OK to slap grass-fed on any beef, no matter what it ate. If you want to be sure it’s grass fed beef look for Niman Ranch, Certified Angus Beef Natural (as opposed to regular CAB), [or] the seal of the American Grassfed Association

• Cook more, which gives you control over your own ingredients.

• Recognize that if something seems too cheap to be real, it likely isn’t

• Shop discount big-box stores such as Costco, Trader Joe’s, BJ’s Wholesale Club and Walmart as their standards are as stringent as Whole Foods. This is particularly true for Seafood. However, avoid “organic” from China. Didn’t see that one coming did you? However, they have bulk purchasing power and can make demands that smaller grocers can’t.

• Get to know local producers when possible and buy local. This is particularly true for items like honey and maple syrup. In fact, Chinese honey can be really dangerous so purchase honey from a local beekeeper and avoid supermarkets brands altogether. Join a CSA (community sustainable agriculture) or grow your own produce if possible. Check out Honey is the Third Most Faked Food.

• Seafood is one of the worse “fake” foods. Look for reliable logos MSC (Marine Stewardship Council) for wild-caught fish and BAP (Global Aquaculture Alliance’s Best Aquaculture Practices for farmed. Alaskan wild caught seafood by law is not farmed as it is not allowed in this state. This is easier to do at a grocery store than a restaurant. Don’t buy or order Red Snapper because it’s most likely going to be something else. Order lobster whole and avoid things like lobster roll, ravioli, macaroni, soup etc., where it is easier to substitute another product. There are legal organic standards for produce and meats, but not for seafood. Totally meaningless, yet widely used.

• Buy French Champagne  as they have some of the strictest controls in the world. The U.S. produces a domestic champagne that is lower quality.

• Only buy Parmigianino Reggiano when it’s printed on the crust. If you can’t read it, don’t buy it. Check out Most Parmesan Cheeses in America Are Fake. Here’s Why


• For Extra Virgin Olive Oil, purchase it from Australia, Chili or California. Be very careful if you are allergic to peanut or soy as these are common additives in products that are coming out of Italy (the largest importer of olive oil). Check www.extravirginity.com for recommendations. Unless you use it up very rapidly-in less than 9 months- don’t buy in gallon containers since it goes bad. Don’t Fall Victim to Olive Oil Scam 

• For coffee lovers, buy the bean and grind you own, otherwise you may be getting chicory, cereals, caramel, parchment, starch, malt and even figs. Sadly tea can come with sawdust and leaves from other plants.

• Dry spices-Grow you own whenever possible and dry them. For nutmeg, buy the nut and grate it yourself. Use a pepper mill and grind your own pepper. Spiked Spices 

• Fruit Juice: Read the labels every single time, as Manufacturers aren't required to list the percentage of each ingredient on the packaging, and apple juice is much cheaper than juices like pomegranate or blueberry.

•  Almost no truffle oil is real, so skip the truffle fries.

• If you are a Kobe Beef lover, there are only 9 eateries in the U.S. that purchase the real deal. Many places that say they offer it actually are selling a cheaper cut. So if you see Kobe Beef on the menu, chances are it’s not. Check out The New Truth About Kobe Beef, which includes those places where Kobe Beef is actually sold.  

Additional reading/listening:



Wednesday, July 20, 2016

Take a Break: Write a 21st Century Fable

Aesop’s Fables  are a collection of fables attributed to a slave and storyteller, who may have lived in Greece between 620 and 564 BC. The race between the turtle and rabbit has been handed down for centuries and is just as relevant today as it was for the ancient Greeks.

The humorist James Thurber wrote and illustrated a delightful book of fables, which are available on-line for free-Further Fables for Our Time , that have interesting twists and morals.

Today’s “take a break” is about writing your own 21st century fable. If you need inspiration, check out Aesop  or Thurber.

Below is one that I wrote.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Jane had big news for her best friend Nancy. Nancy’s boss had just accepted a job at Jane’s office and Nancy was the ideal candidate to replace him. Jane learned this news on a Friday night at 11 pm.

The big question-should she call Jane’s landline or cell phone, text, or e-mail? Since all of these options would wake Nancy, who faithfully went to bed every night at 10 with her smart phone sitting on her nightstand, Jane chose the “wait till morning” option.

Waking to a ringing cell phone, Jane’s friends said they’d be at her house within a half hour. How could she have forgotten their beach day plans? In the middle of scrambling to pack her beach bag and feed the dog, Jane decided to wait and call Nancy on the way to the beach, rationalizing that “Nancy will want more than just ‘your boss is leaving and you should apply for the job.’”

Once settled in the back seat of her friend’s car, Jane discovered she hadn’t packed her phone. The offer of friends’ was useless since she had never bothered to memorize Nancy’s numbers-that’s what the ‘contact list’ is for. While annoyed with her forgetfulness, the sun, sand and ocean breezes quickly dissolved those feelings, particularly since a bucket of frozen strawberry daiquiris was always just a sip away.

The beach day evolved into cocktails, dinner and a nightcap. It was a good thing that Jane was not the designated driver. By the time she made it home, there was a vague memory of needing to call someone but whom and for what was a mystery. 

Crawling out of bed at 1 pm Sunday afternoon, the last thing on Jane’s mind was calling Nancy. Between a terrible hang over and a dog that demanded some attention, Jane once again put off contacting her friend saying, “first thing in the morning.”

Nothing like starting the workweek with rain and a dog who doesn’t want to get his paws wet so pees on the floor. Needless to say a whirl wind clean up before work left no time for a call. In fact, Jane finally sent a quick text to Nancy at about 1 in the afternoon.

Not only did Nancy know, but the job was already taken by another co-worker who had learned about the pending vacancy early Saturday morning and contacted the President to let them know of their interest in the position.

Moral: The more ways we have to communicate the less effective we are in doing so.







Saturday, July 16, 2016

Journal Watch July 2016


CHRONIC PAIN
• New Treatment Shows Promise for Crippling Knee Arthritis: For those who suffer debilitating arthritis in their knees, researchers report in a small study that just one injection of stem cells can reduce pain and inflammation. The idea is experimental: Extract stem cells from a patient's own body fat -- cells known for their ability to differentiate and perform any number of regenerative functions -- and inject them directly into the damaged knee joint. STEM CELLS Translational Medicine 

Giving OD Antidote to Those Using Powerful Painkillers Might Save Lives: A new study suggests some opioid-related deaths could be prevented by routinely prescribing an antidote for certain patients who take the medications. Researchers found that those who received prescriptions for the antidote naloxone (Evzio) were less likely to return for emergency care related to their painkiller use. Annals of Internal Medicine 

COMPLEMENTARY & ALTERNATIVE MEDICINE
• Alternative Medicine Taking Hold AmongAmericans: Americans spend a good chunk of their health care dollars on alternative medicine, such as acupuncture, yoga, chiropractic care and natural supplements, a new government report shows. In fact, they paid more than $30 billion out of pocket in 2012 on chiropractors and other complementary health practitioners, as well as supplements and other forms of alternative medicine. National Health Statistics Reports 

• Acupressure Reduce Fatigue in Breast Cancer Patients: Acupressure helped reduce persistent fatigue in women who had been treated for breast cancer, a new study finds. Fatigue is one of the most common long-term effects of breast cancer treatment. About a third of women experience moderate to severe fatigue up to 10 years after their treatment ends. JAMA Oncology 

FDA ACTION
• Epclusa Approved for Chronic Hepatitis C to treat the six major strains of HCV
Approved the Roche cobas HPV Test as the first test for Human Papilloma Virus (HPV) that can be used with cervical cells obtained for a Pap test and collected in SurePath Preservative Fluid.
• Approved the first fully absorbable stent to treat coronary artery disease. The Absorb GT1 Bioresorbable Vascular Scaffold System (BVS), which releases the drug everolimus to limit the growth of scar tissue, is gradually absorbed by the body in approximately three years.
• Approved the ExAblate Neuro device to treat Essential Tremor. The device delivers focused ultrasound to destroy small bits of brain tissue that are thought to be involved in essential tremor.
• Approves an Increase to the Amount of Vitamin D for Milk an Milk Alternatives

PREVENTION
• CDC Panel Says FluMist Nasal FluVaccine Ineffective: FluMist, has been largely ineffective in children in recent years and should not be used in the United States during the 2016-17 flu season according to the CDC's Advisory Panel on Immunization Practices (ACIP). U.S. Centers for Disease Control and Prevention 

 Healthy Living Slashes Cancer Risk: A healthy lifestyle that includes regular exercise and eating nutritiously can lower your risk of developing cancer by as much as 45 percent, a new evidence review concludes. Cancer Epidemiology, Biomarkers & Prevention 

• Exercise May Help Thwart OvarianCancer: Lack of exercise is associated with an increased risk of ovarian cancer and of death from the disease, two new studies suggest. Cancer Epidemiology, Biomarker Journal of Cancer

• Pedal Away Type 2 Diabetes: The study found that people who bike to work or regularly cycle for fun were less likely to get the illness. That was true even for those who started biking late in life. PLOS Medicine 

• Long Hours May Hurt Your Health: The link between long work hours and disease ''seems to be present a bit in men but is tremendously more evident in women." While the study cannot prove cause and effect, he said, the associations were strong in women. When the researchers compared men who worked more than 60 hours a week to those who worked 30 to 40, they found those who worked the longer hours had more than twice the risk of getting osteoarthritis or rheumatoid arthritis.
But men's risk for other chronic or serious diseases didn't go up substantially. In fact, those who worked 41 to 50 hours had a lower risk of heart disease, lung disease and depression, researchers noted. Journal of Occupational and Environmental Medicine 

• Exercise May Help Ease Adult ADHD Symptoms: A burst of moderate exercise may improve motivation and energy in adults with symptoms of attention deficit hyperactivity disorder (ADHD), a small new study suggests. Medicine and Science in Sports and Exercise 

• Mixing Pot and Tobacco IncreasesDependence Risk: People who mix marijuana with tobacco are at greater risk for dependency and less motivated to find support to quit these drugs, researchers report. Frontiers in Psychiatry

• Study Hints at HPV Vaccine’s Cancer Prevention Promise: The human papillomavirus (HPV) vaccine appears to prevent abnormalities that can lead to cervical cancer, a new study shows. Canadian researchers found that young women who received the vaccine through a school-based program were less likely to have such abnormalities when screened for cervical cancer than those who did not receive the vaccine. The young women were screened less than 10 years after they received their first HPV vaccine. CMAJ

StudyLinks Severe Head Injury to Parkinson’s Risk: A traumatic brain injury with loss of consciousness may increase the risk of developing Parkinson's disease, new research suggests. The head injury may not cause Parkinson's, but make it "more difficult for people who have sustained a head injury to recover, adjust to or deal with the cascade of events leading to Parkinson disease that are separate from the head injury itself." JAMA Neurology 

• No Association Between Bad Cholesterol and Elderly Deaths: A meta analysis, involving 68,000 participants over 60 years of age calls into question the "cholesterol hypothesis," which previously suggested people with high cholesterol are more at risk of dying and would need statin drugs to lower their cholesterol. This new analysis found that older people with high levels of low-density lipoprotein (LDL-C), live as long, and often longer, than their peers with low levels of this same cholesterol. the research team called for a reevaluation of the need for drugs, such as statins, which are aimed at reducing LDL-C as a step to prevent cardiovascular diseases.

NUTRITION/SUPPLEMENTS/VITAMINS
• Fiber: The RX for Disease Free Aging: Among more than 1,600 Australian adults, the top fiber consumers were 80 percent more likely to remain fully functional and disease-free as they aged, the study found. Fiber-rich foods include fruits and whole grains. Journals of Gerontology 

Vitamin D May not be the Great Solution to Health Problems: A new review examines the evidence for 10 common beliefs about vitamin D. The beliefs range from the ability of vitamin D to reduce falls and fractures, improve depression and mental well-being, prevent rheumatoid arthritis, treat Multiple Sclerosis, and lessen incidences of cancer and mortality. The review finds little evidence though that supplementation with this vitamin has much of an effect at all. Journal of General Internal Medicine

• Omega 3s Linked to Lower Risk for Fatal Heart Attack: Regularly eating fish and other foods rich in omega-3 fatty acids may lower your risk of fatal heart disease, concludes a meta analysis of 19 studies from 16 countries. Walnuts, flaxseed oil, canola oil and some other seeds and nuts contain the plant-based omega-3 known as alpha-linolenic acid. JAMA Internal Medicine 

ยช Now Pasta is Good for your Diet? New research suggests pasta -- specifically noodles in this study -- might actually help you lose weight. Moderate pasta consumption seems linked to lower chances of general and abdominal obesity, researchers found after analyzing data on thousands of Italians. Nutrition and Diabetes 

 Fats That Could Shorten Your Life: Hold the butter, margarine and high-fat dairy: A new study supports the notion that these "saturated" fats are bad for you. The study, which followed more than 126,000 people for three decades, found that people who ate higher amounts of saturated fats and trans fats died earlier than those who stuck to healthier unsaturated fats. Unsaturated fats include plant-based, unprocessed fats such as those found in olive, canola or soybean oil, the study authors explained. JAMA Internal Medicine 

• Dietary Mineral Could Be One Key to Blood Pressure Control: A meta analysis of 34 clinical trials, involving 2,000 people found that sufficient dietary levels of the mineral nutrient magnesium might be a boon to good blood pressure. Magnesium dilates arteries, and in doing so lowers the blood pressure. Foods high in magnesium include whole grains, beans, nuts and green leafy vegetables. The study found that taking about 368 mg of magnesium daily for about three months resulted in overall reductions in systolic blood pressure (the top number in a reading) of 2 millimeters of mercury (mm/Hg) and diastolic blood pressure (the bottom number) of 1.78 mm/Hg. Hypertension 

• Drink Water, Stay Slimmer: Water might be a secret weapon for dieters, research involving nearly 10,000 adults suggests. "Those who were inadequately hydrated had higher body mass indexes (BMIs) than those who were adequately hydrated.” Recommendations vary, but the Institute of Medicine suggests 125 ounces of water daily for men and 91 ounces for women, from all food and beverages combined. Water also can be found in water-laden foods such as apples, celery, cucumbers, plums and watermelon, to name a few. Annals of Family Medicine 

• Too Much Red Meat May Harm Kidneys: Eating red meat may boost the risk for kidney failure, but swapping even one daily serving of red meat for another protein may reduce the risk, a large study from Singapore suggests. Journal of the American Society of Nephrology 

• Pant Based Diets Tied to Improved InflammatoryProfiles: Plant-based diets are associated with improvement in obesity-related inflammatory biomarker profiles, including decreases in C-reactive protein and interleukin-6 levels, according to a review published. Obesity Reviews 

• Some Plant Based Therapies Associated with Modest Improvement in MenopausalSymptoms: An analysis of more than 60 studies suggests that some plant-based therapies are associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats, according to a study. Individual phytoestrogen interventions such as dietary and supplemental soy isoflavones were associated with improvement in daily hot flashes and vaginal dryness score. Several herbal remedies, but not Chinese medicinal herbs, were associated with an overall decrease in the frequency of vasomotor symptoms. JAMA 

TREATMENT
• Just a Little Statins’ Effect Enough to Help Heart: Giving high doses of statins to patients with heart disease doesn't lower the risk of future heart trouble any more than moderate doses of the cholesterol-lowering drugs do, a new study finds. "There is, however, no evidence at present that increasing the intensity of treatment to lower LDL levels further adds benefit.” JAMA Internal Medicine 

• Pre and Post Testing Show Reversal of Memory Loss From Alzheimer’s Disease in 10 Patients: A small trial of 10 patients using a personalized systems approach to memory disorders shows an unprecedented reversal of memory loss in those diagnosed with early stage Alzheimers. Pre and post results are based on quantitative MRI and neuropsychological testing. The study is based on a protocol dubbed 'metabolic enhancement for neurodegeneration-a 36-point therapeutic personalized program that involves comprehensive changes in diet, brain stimulation, exercise, optimization of sleep, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry. Aging 

• Old Drug Boosts Brain’s Memory Centers: A long-used drug called methylene blue may rev up activity in brain regions involved in short-term memory and attention, a small study suggests. Methylene blue has been used in medicine for more than a century. Radiology 

• 4 in 10 Popular Sunscreens Don’t MeetSun Safety Standards: Nearly half of the most popular sunscreen products sold in the United States fail to meet basic sun safety guidelines, new research shows. The finding stems from a look at the sun protection labels of 65 products that accounted for the top 1 percent of all sunscreens sold by Amazon.com. Forty percent of those sunscreens lacked the minimal resistance to water and sweat that the American Academy of Dermatology (AAD) recommends. The AAD recommends that consumers opt for sunscreens that provide "broad-spectrum protection" against both UVA "aging" rays and UVB "burning" rays. Screens should provide an overall "sun protection factor" (SPF) of 30 or more, AAD experts advise, to block out 97 percent of the sun's rays. JAMA Dermatology 

• Could Zaps to the Brain Help Fight Glaucoma? Electrical pulses to the brain may help restore vision in some partially blind patients, German researchers report. Glaucoma and other types of damage to the eye's optic nerve typically cause permanent damage. But, the new technique appears to kick-start the brain's visual control centers, the researchers explained. PLOS One 

• Cancer Drug Shows Early Promise for Parkinson’s Disease: A drug used to treat leukemia, nilotinib (Tasigna) has shown initial signs of promise for advanced cases of Parkinson's disease, researchers are reporting. The researchers found signs that the drug boosted the brain's production of dopamine, a chemical that helps regulate movement. It also appeared to reduce certain "toxic proteins" that build up in the brains of people with Parkinson's. Patients typically showed some improvement in both physical symptoms and problems with memory and thinking, the findings showed. Journal of the Parkinson's Disease 

Nerve Zap Eased Rheumatoid arthritis in Small Study: The study, of 17 adults with the painful autoimmune disease, tested the effects of vagus nerve stimulation -- a technique long used to control seizures in some people with epilepsy. It found that over six weeks, most of the patients showed some improvements in joint swelling and other symptoms. Proceedings of the National Academy of Sciences, online 

 CAREGIVING
 More Older Americans Cared for at Home: More older Americans with chronic health problems are opting to live at home, relying on help from family, paid caregivers or friends, a new study finds.
In 2012, half of seniors with a disability had some type of home health care, an increase from 42 percent in 1998. While the majority of seniors would prefer to remain at home, the unintended consequences is the strain it puts on caregivers. "Research has shown that 40 percent [of caregivers] spend 20 or more hours a week caring for an older relative -- that's half of a full-time job." Besides lost work and income, this can lead to depression and other health issues for caregivers. JAMA 

OTHER
• Many Could Face Steep Rise in Obamacare Premiums for 2017: Many buyers of health insurance under the Affordable Care Act need to brace themselves for sharply higher premiums in 2017, analysts and insurance brokers say. The rate hikes will mainly affect the millions who pay all of the cost of health insurance out of their own pockets -- or a sizable chunk of it, they explained. Buyers with modest incomes, $29,700 to $35,640 for an individual, may qualify for federal subsidies to help lower their monthly health plan premiums if they enroll through HealthCare.gov or their state insurance marketplace. But they don't get as much financial help as low-income earners, and may feel the pinch of higher rates. Health Day 

• Doctors Swamped by E Medicine Demands: Doctors say they're drowning in electronic paperwork, feeling burned out and dissatisfied with their jobs thanks to countless hours spent filling out computerized medical forms, researchers report. Electronic health records are a cornerstone in the effort to modernize medicine. But, new systems designed to chart a patient's progress and instruct their future care have proven to be very time-consuming, the study found. Mayo Clin Proceedings 

Is There a Cure for High Priced Drugs: The cost of prescription drugs for tens of millions of Americans rose $2 billion last year, and all signs point to a continued rise. At stake is nothing less than the ability of Americans to afford the medicines they need. Can we stop the madness? Consumer Reports 

Doctor Assisted Deaths Didn’t Soar After Legalization: In places where it's legal, physician-aided death remains rare. It's confined mostly to cancer patients who are white, wealthy and well-educated, researchers found. If Oregon and Washington are an indication, most patients choosing to hasten their death are in hospice or palliative care. (Palliative care is designed to improve the quality of life of patients with life-threatening disease such as cancer.) The main motivators? Fear of losing autonomy, no longer enjoying activities, and other psychological concerns, Pain is usually not the chief driver. JAMA


• US Cancer Survivors Living Longer: As the American population ages, more older adults will survive cancer and live with other chronic conditions that will burden the health care system, U.S. government health officials report. Cancer Epidemiology