Take a Break: Honor International Homeless Animals’ Day

 August 17^th is International Homeless Animals’ Day.  The ISAR (International Society for Animal Rights) consider doing something special for not only the animals in your life but also for those that may be at area shelters

While your pet may like a special treat, an extra walk or longer play time with you, consider some of the following ways you can help your local animal shelter:

• Donate pet supplies such as gently used towels, water, food, bowls, cleaning supplies, leashes, collars, grooming supplies, kitty litter, animal beds and pet toys. It’s always good to check your local shelter’s website to see if they have a “wish list.” Make sure all items are in good condition and clean.

• Consider being a foster parent: You can bring a pet to your home for a few days or longer. Shelters will generally cover the cost of the supplies you’ll need.

• Volunteer to take dogs for a walk, or spend time socializing with the animals. Larger shelters may need help in getting animals to the vets office or foster homes. Big cities and islands have the most need for this type of service. Also, there are many times that supplies are needed and it’s helpful to have a volunteer who can go do that

• If you engage in social media, forward notices from your local shelter via tweets, Facebook, Instagram etc.

• Do you have a talent that could be of benefit to your local shelter? Things that are needed include help with a fundraiser, designing a logo, taking photographs, building repairs, assist with administrative tasks such as book keeping. Check with your local shelter to see what type of help they need.

Not interested in today’s activity, go to the Take a Break Pinterest and pick out something else.

What You Can Do to Help Stop Violence

After the Boston Marathon bombings in 2013, I wrote a post Reducing Violence/Reducing Chronic Disease: The Solution is the Same . If you haven’t read it, the post outlines the link between chronic conditions and violence.

This week, following the mass shootings in California, El Paso and Dayton, as well as the stabbing deaths in Southern California, I thought it useful to revisit the issue of violence from a slightly different slant.

While considerable emphasis is placed on gun control, it’s important to recognize that weapons are only one part of the story. Attitudes, emotions, and reactions are just as important. Without working on all aspects of the issue, only limited progress will be made.  This is particularly concerning when the data for sexual and domestic violence, as well as work place violence, far outstrips the mass violence that grabs the headlines.

• Two million Americans report suffering from workplace violence every year, making it the second leading cause of work-site deaths in the country, according to the Occupational Safety and Health Administration (OSHA). Many incidences go unreported. People in the caring professions (e.g. nurses, home health aides, social workers, hospital employees) and those who handle cash experience a much greater proportion of these incidents.

• One in five women and one in 71 men will be raped at some point in their lives. 91% of the victims of rape and sexual assault are female, and 9% are male. National Sexual Violence Resource Center

• Women with disabilities have a 40% greater risk of intimate partner violence, especially severe violence, than women without disabilities

• Most cases of domestic violence are never reported to police. Men who are victimized are substantially less likely than women to file a report.

• On average, 24 people per minute are victims of rape, physical violence or stalking by an intimate partner in the United States — more than 12 million women and men over the course of a year. National Domestic Violence Hotline

What you can do to stop violence in their homes, workplace and communities.

Stop the Hate: By expressing tolerance and acceptance you send a positive message. Slurs and negative comments harm so be conscious of what you say and to whom. Learn more at Ten Ways to Fight Hate: A community Response Guide. 

Role model & Take Responsibility for your  behavior: Actions speak louder than words. Those around you, including children, see how you handle things. They watch how you deal with others and observe your reaction to challenging situations. Whether we are aware of it or not, we are role models for one another. If you preach respect and tolerance but then make comments about people in the news, neighbors etc. you send a very mixed message. None of us are saints, so if you screw up, own it and make amends.

Know the signs of Violence: Whether it’s in the workplace, home, a relationship or some other venue, people who exhibit these behaviors are or have the potential to be violent.

-       Jealous, controlling, hypersensitive or explosive mood, blames others for their feelings, Dr. Jekyll and Mr. Hyde (rapidly switching between being explosive and being nice)

-       Isolates you from friends, family and resources

-       Threats, insults, breaking objects

-       Bullying

-       Violence or use of force during sex

-       Cruel to kids or pets, past history of abuse

-       Unrealistic expectations

-       Verbally abusive

-       Rigid sex roles

-       Physically forceful during an argument

Studies show the perpetrators of mass violence are often suicidal and more than half will talk about their plans for a violent act.

Don’t ignore it: Call 911 if you feel that you or someone else is in imminent danger.

• If this happens at work, report it immediately to your supervisor. You can help prevent workplace violence by attending personal safety training programs that teach you to prevent and diffuse violent situations. Talk with your employer about implementing zero-tolerance policies on workplace violence and, if not in place, work with your employer on a workplace violence prevention program. For more information: Workplace Violence 

• If this is a domestic violence situation, contact the National Domestic Violence Hotline 1−800−799−7233 or TTY 1−800−787−3224 or use their secure website. They can help you outline a safety plan, help you assist someone who is in an unsafe situation, legal assistance, help for survivors and much more. This is free and confidential and available 24/7. Another Resource is the National Network to End Domestic Violence  If you are in danger, please use a safer computer, or call 911, a local hotline, or the U.S. National Domestic Violence Hotline at 1-800-799-7233 and TTY 1-800-787-3224. Libraries are good places to use a computer that can’t be traced.

• If this is sexual assault contact the National Sexual Assault Telephone Hotline-800-656-4673 or use their website. This is free and confidential and available 24/7.

If you know someone who is discussing violence to themselves or others, get them help immediately. Unfortunately, many active shooters have been reported to authorities prior to their shooting. Because information is often not passed on, it’s important that you consider contacting multiple sources-state police, local police, FBI, social worker, school counselor etc and ask for a behavioral risk assessment.

People are accountable for their behavior. Don’t make excuses for them or blame yourself for their behavior.

Be part of a group that works at ending violence in your community. Learn more at the following:

• Ten Things Adults Can Do to Stop Violence 

• Cure Violence 

 

Be a mentor. Attachments to others is key. Being a mentor to a child can make all the difference. See that your own children are surrounded by supportive and good role models.

If you are a gun owner, be a leader in responsible gun ownership and practice Firearm Safety at all times.

2019 Take a Break: August Holiday Gifts to Start Now: Candles

The first Wednesday in August is our annual “gifts to start now for holiday giving.” At the end of this post are links to previous holiday gifts to start now.

Capture the warmth of the summer sun by making candles, which place a part in many of the Winter Solstice traditions.

Candle basics: You’ll need a dedicated double boiler or can make one by using a clean tin can and an old pot. The wax is put into the tin can and placed in a pot of water. Note that water should be at such a level that when it boils, about an inch in the bottom, so it wont bubble into the melting wax. Keep the tin as centered as much as possible.

You can repurpose candles or buy wax at your local craft store or even hardware store. Beeswax and soy however are sold at craft stores or on line. While you can purchase wicks, you can make your own using cotton string.

It’s worth noting that lard, Crisco and tallow can all be manufactured into candles. Yes, the various kids science experiments show that Crisco can candles can burn for up to 66 hours. Tallow as well as lard have been used for centuries to make candles. Living in a farming community, people still make candles by melting the “fat” down. Coconut oil can also be used, but it’s best to mix with another wax since it melts easily when temps go up.

While many videos and on-line resources add scents, because of allergies and smell sensitivities I don’t recommend them. When it comes to color, old broken crayons work just fine. Just remember to peel off the wrapper.

Finally, there are many many options you can choose for candle holders-glass jars, tea cups and mugs (sprinkle some nutmeg or cinnamon while it cools for a unique look), milk cartons and even sand. August is the perfect time to check out local thrift stores and yard sales to see what can be re purposed to hold a candle

No Wax Candle using Crisco: So the fascinating thing about Crisco is that it’s made from soy and palm oil. You can make this candle in the microwave. If you want to make your own wick, just dip cotton string and tie it off with a tiny metal nut. 

Make Sand Candles 

DIY All Natural & Non Toxic Candles 

Previous Years  August Holiday Gifts to Start Now

• 2010: Candles; Eyeglass case and bookmarks; fabric flower brooch 

• 2011: Environmentally friendly cleaning products; Cookie Cutter Fudge; Balloon Candle Holders; Popsicle Bracelets; Frame a game Board 

• 2012: Make a variety of items using the sun including sun stencils and art work 

• 2013: From fruitcakes to fabric covered canvas

• 2014 Infinity scarf,  knife block or stripe, fire starters, flavored syrups, activity books  

• 2015 Presents for the gardener in your life

• 2016 Bowls

• 2017 Jars

• 2018 Puzzle Pieces

Life with Chronic Disease: Granny Pods Aren’t Just for Grannies

The tiny house movement has swept the country by storm. However, one of the downsides of the “tiny home,” which is designed to be moved, is how narrow it can be. Enter the independent prefab “home,” ranging from 288 to 600 sq ft., which can be set up in a back yard, connecting to the home owner’s sewer, water etc.

Known by a variety of names-Granny Pod, In-Law Cottage, Granny Flat, Back Yard Cottage-there are various products on the market that allow for easy installation. MedCottage  has gone step farther These can be rented or purchased and comes with a lot of medical extras that traditional tiny houses don’t have. The cottage can be compared to a bungalow from the outside, and a nice hotel suite on the inside with room for a bed, living room space, kitchenette and bathroom. Standard safety features include hand railings, defibrillators, first aid supplies, lighted floorboards and a soft floor to minimize damage from falls. About 12 by 24 feet—essentially the size of a spacious master bedroom—the structures feature double French doors and can accommodate a wheelchair and hospital equipment, if needed.

At any age, having a smaller independent space, that still keeps you close to family, friends and community can be a real advantage both financially as well as a way to reduce social isolation. Further, for those with chronic conditions, this approach allows you to design a living space that can accommodate your changing needs.

In Vermont, many of our older homes have apartments attached to them. As a son or daughter married and took over more and more responsibilities of the farm, smaller living structures were built for the parent(s). Today, many of these homes have converted their “apartments” into rentals, AirBnB, and offices. Basically, what’s old is new again.

With the Granny Pod movement in full swing, it’s worth considering the advantages and disadvantages.

ADVANTAGES:

• Accessibility-doors are wider to accommodate walkers and wheel chairs, bathrooms are handicap equipped and everything is on one floor.

• Homelike-comes equipped with all the conveniences to do laundry, cook, and even entertain. Pets can remain with their owners.

• Independence-provides freedom to be in one’s own space but yet be in close proximity to family, community and caregiver.

• Flexibility-not only can these be rented for as long as you need them, they provide privacy, safety and security. They also come occupant ready and, if you decide to keep them after the original occupant no longer needs it, they can be converted into an AirBnB option, guest housing etc. They can also be resold. Most companies manufacturing offer financing.

POSSIBLE CONCERNS

• Cost-While cheaper than nursing home and other forms of long-term care, purchasing a pre fab “pod” can be expensive. Prices range from about $40,000 to $125,000, based on size, configuration and enhancements. However, comparing that to other options, it can certainly be cheaper- basic assisted living efficiency $50,000 to $60,000 a year, nursing facility costs about $125,000 a year.

• Utilities/Zoning- Pods are designed to connect to your existing utilities, which may require upgrades to your system. You will also need to check for zoning as there maybe restrictions where you live. Some areas may require demonstrated need, others may require that the structure be removed after the original occupant is no longer there.

• Neighborhood-Some neighbors may object to having the “pod” next door. In addition, if the person is moving away from their neighborhood and community, this could be isolating for them.  

The DIY (Do it yourself) Approach: Depending on your property, it can be cheaper and avoid some of the issues with zoning, neighbors etc. If you consider converting existing spaces, such as a garage, old shed, carriage house, milk house into a “cottage," check out All You Need to Know about Granny Pads.

The video below, while from Australia, explores not only the multiple uses of a Granny Flat and how it can evolve over time, it also highlights both the advantages and impacts of purchasing a pre fab Granny Flat.

Life with Chronic Disease: How to “beat the heat

It’s summer and heat waves are happening all over the country. While high heat indexes, particularly if they are occurring for multiple days, can be serious for anyone, it’s particularly challenging for those with chronic conditions. Not only can medications change how people respond to heat and sun, they also might be less likely to sense temperature change. In addition, those overweight tend to retain body heat and are therefore more at risk for heat related illnesses.

Be aware of signs of overheating: cramps, dizziness, fainting, headaches, heavy sweating, increased heart rate, nausea. Get help if you exhibit any of these signs.

Enjoy a long cool shower, a swim or use a cooling tie. Keep a squirt bottle in the refrigerator, squirting yourself when it gets to be too much. As the water evaporates, it cools you.

Air conditioning is better than a fan. Don’t have one and can’t afford one? Make a makeshift air conditioner by putting ice in a shallow bowl in front of a fan. As the ice melts, it will cool you. Note this doesn’t work so well when it’s humid. Seal any cracks between a window unit and the frame with peelable caulking or a sealant strip. These steps help ensure good airflow and keep the coils cleaner, which means more efficient and more effective cooling. If you have a fireplace, make sure the damper is closed. When the AC is on keep windows and doors closed.

Take it easy. Avoid strenuous activities

Take steps to avoid the sun such as wearing a wide brimmed hat, using sunscreen (reapply if you are swimming), stay in the shade or use an umbrella,

Have sun blockers on windows to reduce sunlight in your house. Look for curtains and blinds that block the sun. You can find these at many stores, including places like Walmart.

Eat Cool Foods. When possible avoid turning on the stove. Spicy foods can cool you down. Chili peppers contain capsaicin, which can make you sweat more. As the water evaporates it makes you feel cooler. Not surprising a lot of spicy salsa gets consumed in the summer. Salads and other light foods are perfect when the temps are high.

Hydrate, hydrate, hydrate. As you lose water you can become dehydrated and your body temperature rises. Replacing fluids is essential to keeping cool.

Evaporative Coolers can be a good option depending on where you live. They tend to work best when relative humidity is 60% or less; however, evaporative coolers can work in humid conditions when they are used in semi-outdoor settings (loading bays and docks, garages) or outdoors(sporting events, festivals). In general, evaporative coolers (also called swamp coolers) are cheaper, more energy efficient and more environmentally friendly than air conditioners. You can move them from room to room, including outdoor patios. Check out 5 Things to Consider When Buying an Evaporative Cooler.

Avoid alcohol, caffeine and drinks with lots of sugar. They can cause you to become dehydrated.  Drink water instead.

Turn off appliances, computers etc. They can generate heat. If you are using a lap top, keep it off your lap. Skip the drying cycle on the dishwasher and leave the door open to let the dishes dry. Use appliances only when necessary and in the evening if possible, when the air is cooler. Instead of the dryer, hang clothes outside and even consider hand washing dishes Use compact fluorescent bulbs as they not only save money, they give off less heat than standard incandescents.

Some extra tips:

• Read and watch movies about snow and cold temps.

• Take a clean cotton sock. Fill it with rice and tie it off. Put it in the freezer for two hours before bed time. Slide it between the sheets. Rice retains cold for a long period of time.

Take a Break: Try Forest Bathing

The term “forest bathing” or Shinrin-yoku was coined in Japan, where nature therapy has ancient roots. The idea of “park prescriptions” in urban areas first started in Asia and caught on worldwide.

To “bathe” or bask in nature is to engage all fives senses-smell the flowers; taste the wild blackberries; listen to the birds; feel the bark of a tree; and enjoy the beauty that surrounds you. However, walking in a relaxed manner on a nature path can do wonders. In fact, a recent study  found two hours a week of being in nature to be a crucial threshold for promoting health and well being. The study used data from nearly 20,000 people in England and found that it didn't matter whether the 120 minutes was achieved in a single visit or over several shorter visits. It also found the 120 minute threshold applied to both men and women, to older and younger adults, across different occupational and ethnic groups, among those living in both rich and poor areas, and even among people with long term illnesses or disabilities.

Learn more ways to forest bathe at Shinrin Yoku or watch the video below:

Not interested in today’s activity, go to the Take a Break Pinterest and pick out something else.

Journal Watch July 2019

PAIN

Cancer Survivors Have High Prevalence of Chronic Pain: The prevalence of chronic pain and HIPC were higher for survivors with less than a high school education, low household income, public insurance, or no paid employment. The adjusted prevalence of chronic pain was highest among survivors of cancer of the bone, kidney, throat-pharynx, and uterus. JAMA Oncology

Tanezumab Improves Scores for Pain, Function in Osteoarthritis: For patients with osteoarthritis (OA) of the knee or hip, tanezumab is associated with significant improvements in pain and physical function versus placebo, according to a study published in the July 2 issue of the Journal of the American Medical Association.

Rimegepant Shows Promise for Relief From Migraine Attacks: Compared with placebo, rimegepant, an orally administered, small-molecule, calcitonin gene-related peptide (CGRP) receptor antagonist, can increase the percentage of patients free of pain and free from their most bothersome symptom during a migraine attack, according to a study published in the July 11 issue of the New England Journal of Medicine.

Galcanezumab Can Cut Frequency of Cluster Headache Attacks: Galcanezumab can reduce the frequency of episodic cluster headache attacks, according to a study published in the July 11 issue of the New England Journal of Medicine.

COMPLEMENTARY & ALTERNATIVE MEDICINE

Hepatitis C and Dietary Supplements: A new report from the National Center for Complementary and Integrative Health  has found that no dietary supplement has been shown to be effective Hep C or its complications. Research on other dietary supplements for hepatitis C, such as zinc, licorice root (or its extract glycyrrhizin), SAMe, and lactoferrin, is in its early stages, and no firm conclusions can be reached about the potential effectiveness of these supplements. Colloidal silver is sometimes promoted for treating hepatitis C, but is not safe. Colloidal silver can cause irreversible side effects, including a permanent bluish discoloration of the skin.

Safety concerns: Herbal supplement used to treat addiction and pain: The herb kratom is increasingly being used to manage pain and treat opioid addiction, but it's not safe to use as an herbal supplement, according to new research led by faculty at Binghamton University, State University of New York. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy

Music Relieves Pre op Anxiety Before Peripheral Nerve Block: Patients undergoing preoperative peripheral nerve block placement have a similar change in anxiolytic scores when they receive music medicine versus midazolam, according to a study published online July 18 in Regional Anesthesia & Pain Medicine.

FDA ACTION

• Approved Recarbrio (imipenem, cilastatin and relebactam), an antibacterial drug product to treat adults with complicated urinary tract infections (cUTI) and complicated intra-abdominal infections (cIAI)

• Granted accelerated approval to Xpovio (selinexor) tablets in combination with the corticosteroid dexamethasone for the treatment of adult patients with relapsed refractory multiple myeloma (RRMM) who have received at least four prior therapies and whose disease is resistant to several other forms of treatment, including at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti-CD38 monoclonal antibody.

• Issued warning letters to three repackers of active pharmaceutical ingredients (API), B&B Pharmaceuticals, Inc., Asclemed USA, Inc., doing business as Enovachem and Spectrum Laboratory Products, Inc., for significant violations of current good manufacturing practice (CGMP) requirements.

• Warned patients and health care providers that certain Medtronic MiniMed insulin pumps are being recalled due to potential cybersecurity risks and recommends that patients using these models switch their insulin pump to models that are better equipped to protect against these potential risks.

• Approved Soliris (eculizumab) injection for intravenous use for the treatment of neuromyelitis optica spectrum disorder (NMOSD) in adult patients who are anti-aquaporin-4 (AQP4) antibody positive.

• Approved Dupixent (dupilumab) to treat adults with nasal polyps (growths on the inner lining of the sinuses) accompanied by chronic rhinosinusitis (prolonged inflammation of the sinuses and nasal cavity). This is the first treatment approved for inadequately controlled chronic rhinosinusis with nasal polyps.

• Issued warnings to companies selling illegal, unapproved kratom drug products marketed for opioid cessation, pain treatment and other medical uses

• Approved Vyleesi (bremelanotide) to treat acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women.

• Expanded the indication for Symdeko (a combination of tezacaftor/ivacaftor) tablets for treatment of pediatric patients ages 6 years and older with cystic fibrosis who have certain genetic mutations.

PREVENTION

Long work hours associated with increased risk of stroke: People who worked long hours had a higher risk of stroke, especially if they worked those hours for 10 years or more. Stroke

Morning Preference Has Protective Effect on Breast Cancer Risk: Morning preference seems to have a protective effect on breast cancer risk, according to a study published online June 26 in The BMJ.

HPV Vaccination Program Has Considerable Impact: After five to eight years of vaccination, prevalence of HPV 16 and 18 decreased and anogenital wart diagnoses was down in girls, women, boys, men. The Lancet

Three Interventions Could Cut Cardiovascular Deaths: Lowering blood pressure, cutting sodium intake, and eliminating intake of trans fat could cut the incidence of premature death from cardiovascular disease by 94 million people worldwide during the next 25 years, according to a study published online June 10 in Circulation.

Timing of Exercise May be Key to Successful Weight Loss: In a study of 375 adults who have successfully maintained weight loss and who engage in moderate-to-vigorous intensity physical activity, most reported consistency in the time of day that they exercised, with early morning being the most common time. Being consistent in the timing of physical activity was associated with higher physical activity levels, regardless of whether people exercised consistently during the morning, afternoon, or evening. Obesity

Smokers three times likely to die from heart disease: The study, the most in-depth in the world, shows for the first time how smoking harms all of the cardiovascular system - the heart and major blood vessels. BMC Medicine

Extremely Low LDL Cholesterol May Up Stroke Risk: Cholesterol levels that are too low may increase the risk for hemorrhagic stroke, according to a study published online July 2 in Neurology.

Healthy lifestyle may offset genetic risk of dementia: The study was led by the University of Exeter -- simultaneously published today in JAMA and presented at the Alzheimer's Association International Conference 2019 in Los Angeles. The research found that the risk of dementia was 32 per cent lower in people with a high genetic risk if they had followed a healthy lifestyle, compared to those who had an unhealthy lifestyle. Participants with high genetic risk and an unfavourable lifestyle were almost three times more likely to develop dementia compared to those with a low genetic risk and favourable lifestyle. 

Mentally Stimulating Activities Lower Risk for Cognitive Decline: Among community-dwelling older persons, engaging in a higher number of mentally stimulating activities(reading books, using computers, social or craft activities, playing games) particularly in late life, is associated with a lower risk for developing mild cognitive impairment (MCI), according to a study published online July 10 in Neurology.

Take a bath 90 minutes before bedtime to get better sleep: A stematic review protocols -- a method used to search for and analyze relevant data -- allowed researchers to analyze thousands of studies linking water-based passive body heating, or bathing and showering with warm/hot water, with improved sleep quality. Researchers in the Cockrell School of Engineering found that bathing 1-2 hours before bedtime in water of about 104-109 degrees Fahrenheit can significantly improve your sleep. Sleep Medicine Review 

Excess Risk for Diabetes-Linked Heart Failure Greater in Women: The excess risk for heart failure associated with diabetes is significantly greater in women than men, according to a meta-analysis published online July 18 in Diabetologia.

NUTRITION/SUPPLEMENTS

Diet quality may affect risk of frailty in older adults: Poorer overall diet quality was linked with an increased risk of becoming frail in a study of U.S. community-dwelling older adults, published in the Journal of the American Geriatric Society. The quality of the overall diet appeared to be more important than protein intake for a lower risk of frailty.

Vast majority of dietary supplements don't improve heart health or put off death,study finds:In a massive new analysis of findings from 277 clinical trials using 24 different interventions, researchers say they have found that almost all vitamin, mineral and other nutrient supplements or diets cannot be linked to longer life or protection from heart disease. Although they found that most of the supplements or diets were not associated with any harm, the analysis showed possible health benefits only from a low-salt diet, omega-3 fatty acid supplements and possibly folic acid supplements for some people. Researchers also found that supplements combining calcium and vitamin D may in fact be linked to a slightly increased stroke risk. Annals of Internal Medicine.



Possible link between sugary drinks and cancer: A study published by The BMJ  reports a possible association between higher consumption of sugary drinks and and an increased risk of cancer. While cautious interpretation is needed, the findings add to a growing body of evidence indicating that limiting sugary drink consumption, together with taxation and marketing restrictions, might contribute to a reduction in cancer cases.

Are testosterone-boosting supplements effective? Not likely: Men who want to improve their libido or build body mass may want to think twice before using testosterone-boosting supplements -- also known as "T boosters" -- as research shows these alternatives to traditional testosterone replacement therapy may not have ingredients to support their claims. The World Journal of Men's Health

Frequent Fried Food Intake Increases Risk for Coronary Artery Disease

The frequency of fried food consumption shows a positive linear relationship with the risk for coronary artery disease (CAD), according to a study recently published in Clinical Nutrition.

TREATMENT

Study challenges 'no pain no gain' requirement for patients with clogged leg arteries: Patients with peripheral arterial disease should be given the option of pain-free exercise, according to a study published today in the European Journal of Preventive Cardiology. This study compiled the best evidence and compared completion and adherence rates between traditional versus alternative exercise programmes of at least four weeks duration. Traditional programmes consisted of walking until moderate to severe pain was induced, resting until the pain subsided, then repeating the process. Alternative exercises included walking without pain, arm ergometer (an exercise bike for the arms), resistance training, circuit training, lower limb aerobic exercise, and walking with poles. "Many patients with PAD exercise very little or not at all. It has been suggested that the pain component of conventional exercise programmes is a deterrent. More recent studies have shown that pain-free forms of exercise are equally effective, but patients are not always given the option."

Outcomes Improved After ACL Repair With Three Tendon Graft Types

Patients who received patellar tendon, hamstring tendon, or "double-bundle" hamstring tendon grafts for anterior cruciate ligament (ACL) repair had no significant difference in quality of life at five years postsurgery, according to a study published in the June 5 issue of The Journal of Bone & Joint Surgery.

Testosterone replacement therapy (TRT) can increase men's risk of stroke and heart attack: Aging men with low testosterone levels who take testosterone replacement therapy (TRT) are at a slightly greater risk of experiencing an ischemic stroke, transient ischemic attack (TIA), or myocardial infarction, especially during the first two years of use, reports a new study. The findings confirm concerns voiced by many health agencies about the potential risks associated with the treatment. American Journal of Medicine

 

Link found between gut bacteria, successful joint replacement: Having healthy gut flora -- the trillions of bacteria housed in our intestines -- could lower the risk of infection following knee and hip replacement surgeries, while an unhealthy intestinal flora may increase the risk of infection. Clinical Orthopaedics and Related Research

CAREGIVING

At-home support helps stroke patients adjust after hospital stay: Michigan State University researchers have found that many stroke patients feel unprepared when discharged from the hospital. Their caregivers feel the same.  But when a home-based support network using social work case managers and online resources is put into place, quality of life and confidence in managing one's health improve, according to a new study published in the American Heart Association's journal Circulation: Cardiovascular Quality and Outcomes.

OTHER

Nursing home care cost significantly out paces general inflation and medical care prices: One of the largest studies on out-of-pocket costs for nursing home care finds prices are high and rising faster than other medical care and consumer prices, reports a team of health policy researchers. Medical Care Research and Review

Electronic Health Record medication lists lack accuracy, may threaten patient safety:When it comes to keeping track of prescribed medications between clinic visits, many patients rely on printed medication lists automatically generated from electronic health records (EHRs). An examination of the EHRs of a cohort of ophthalmology patients revealed that one-third had at least one discrepancy between the medications discussed in the clinician's notes and those on the medication list. JAMA Ophthalmology

One in 10 people have 'near-death' experiences, according to new study: Near-death experiences where people report a range of spiritual and physical symptoms, including out-of-body sensations and seeing or hearing hallucinations, affect 10% of people, according to a new study analysing participants from 35 countries. Experiences most frequently reported by participants in their study included: abnormal time perception (87 per cent), exceptional speed of thought (65 per cent), exceptionally vivid senses (63 per cent) and feeling separated from, or out of their body (53 per cent). The study group who reported NDEs variously described feeling at total peace, having their 'soul sucked out', hearing angels singing, being aware they were outside their body, seeing their life flashing before them, and being in a dark tunnel before reaching a bright light. European Academy of Neurology Congress

 

Older adults: Daunted by a new task? Learn 3 instead: Learning several new things at once increases cognitive abilities in older adults, according to new research. After just 1.5 months learning multiple tasks in a new study, participants increased their cognitive abilities to levels similar to those of middle-aged adults, 30 years younger. Control group members, who did not take classes, showed no change in their performance. One important way of staving off cognitive decline is learning new skills as a child would. That is, be a sponge: seek new skills to learn; maintain motivation as fuel; rely on encouraging mentors to guide you; thrive in an environment where the bar is set high. The Journals of Gerontology

Do You Need That Surgery? How To Decide, And How To Pick A Surgeon If You Do: So your doctor has told you some of the scariest words you can possibly hear: You need surgery. What do you do next? Advise from a primary care doctor that he gives his patients. NPR

The unpopular truth about biases toward people with disabilities: Needing to ride in a wheelchair can put the brakes on myriad opportunities -- some less obvious than one might think. New research from Michigan State University sheds light on the bias people have toward people with disabilities, known as "ableism," and how it shifts over time. Contrary to popular belief, the findings suggest that biases toward people with disabilities increase with age and over time, but that people are less likely to show how they really feel publicly. Journal of Social Issues