Saturday, August 31, 2019

Life with Chronic Conditions: Be an Optimist you'll live longer


Decades of research show that individuals with greater optimism are more likely to live longer and to achieve “exceptional longevity,” that is, living to age 85 or older. This new study  was based on 69,744 women and 1,429 men. The results were maintained after accounting for age, demographic factors such as educational attainment, chronic diseases, depression and also health behaviors such as alcohol use, exercise, diet and primary care visits. Proceedings of the National Academy of Sciences 

This is not a unique study, as other research supports that optimists have lower stress levels, better mental health, are more highly motivated, have better health and well-being and ultimately live longer.

Martin Seligman, the father of the Positive Psychology and the author of Learned Optimism: How to Change Your Mind and Your Life compared the difference between optimists and pessimists,  

The optimists and the pessimists: I have been studying them for the past twenty-five years. The defining characteristic of pessimists is that they tend to believe bad events will last a long time, will undermine everything they do, and are their own fault. The optimists, who are confronted with the same hard knocks of this world, think about misfortune in the opposite way. They tend to believe defeat is just a temporary setback, that its causes are confined to this one case. The optimists believe defeat is not their fault: Circumstances, bad luck, or other people brought it about. Such people are unfazed by defeat. Confronted by a bad situation, they perceive it as a challenge and try harder….A pessimistic attitude may seem so deeply rooted as to be permanent. I have found, however, that pessimism is escapable. Pessimists can in fact learn to be optimists, and not through mindless devices like whistling a happy tune or mouthing platitudes…but by learning a new set of cognitive skills.

Things to consider
• Are you Optimistic or Pessimistic? Try Dr. Martin Seligman’s Learned Optimism Test

• Recognize that Optimism is a choice

Approach life stressors and difficulties in a more productive way. Viewing the situation as temporary, recognizing that positive events will take place in the future and avoiding blaming oneself for negative outcomes will make a significant difference.

Shift perspective from negative to positive. For example, you wake up and it’s raining. Instead of thinking how your plans for the day are ruined, consider some indoor relaxing activities.

• You are the company that you keep: If you hang out with chronic complainers and gossipers the negativity will be contagious. However, if you spend time with people who are upbeat and happy, it will increase the chance that you will be too. Notice who you spend time with. The more you connect with optimistic people, the more positive you will feel. In short, avoid the energy vampires and whiners.

• Limit News Coverage: The goal of the media is “if it bleeds it leads.” Know enough to be informed but limit your exposure as the news media is geared to provide a pessimistic viewpoint.  

• Count your blessings: Writing down what you are grateful for is linked to greater feelings of optimism. Keeping a journal where you write down both gratitudes as well as your own acts of kindness can you give a boost.

• Acknowledge what you can and cannot control: Learn to accept what you have control over and let go of what you can’t. You can’t control the weather, but you can have a positive approach to it, such as appreciating you don’t have to water the plants, it’s helping with the local drought etc.

• Take responsibility for choices: Recognize that you have the ability to make choices, and if you make one where the results are less than ideal, own it and acknowledge that you can make changes so it won’t happen again.

• Be realistic: There are times it is appropriate to be worried and concerned. If you are sitting in an ER and worried about a friend that’s seriously injured that’s appropriate. However, if your friend is five minutes late for a luncheon date, thinking the worst possible things have happened to them, is not helpful. Reframing your exaggeratedly negative thoughts into more realistic statements can help you maintain a healthy dose of optimism.

• Show positivity towards others: Complementing and saying something nice at least once a day to someone picks up their mood as well as your own.

• Focus on Solutions Not the Problem: Replacing problem-focused thinking with solution-focused thinking immediately gives you a sense of forward movement, possibility, and hope — the foundations of optimism.

If you have the time, it’s interesting and can be helpful to watch some of Martin Seligman’s videos available on-line, such as his Ted Talk. https://www.youtube.com/watch?v=9FBxfd7DL3E

Saturday, August 24, 2019

Life with Chronic Conditions: Climate Change/Be a Zero Waste Patient


The lungs of the world are on fire. Brazil’s Amazon rain forest is burning at a record rate.  Considering that this is the world’s largest rain forest,  providing more than 20% of the earth’s oxygen, this is not only very concerning, it’s impact will be felt worldwide. 

The purpose of this post is to a) understand the impact of climate change on people with chronic conditions and b) identify what you can do to make a difference.

While everyone is and will be impacted by climate change, those with chronic conditions are even more vulnerable. According to the EPA (Environmental Protection Agency), People with existing medical conditions are at increased risk for illness and death from climate change-related impacts on health, including changing exposures to extreme heat, extreme weather events, and poor air quality. Existing medical conditions can make individuals more sensitive to these exposures, increasing the potential for health impacts and worsening symptoms. For example, individuals with respiratory conditions are more likely to be negatively affected by exposure to poor air quality than those without these conditions. In addition, some underlying health conditions can make it difficult for a person to limit their exposure or adapt to risks. For example, individuals with Alzheimer’s disease may have difficulty responding to and evacuating during an extreme weather event. Certain medications may also impair the body’s ability to regulate temperature or maintain fluid or electrolyte balances. The number of people with common chronic medical conditions (such as cardiovascular disease, diabetes, obesity, and respiratory diseases including asthma) is expected to increase over the coming decades. This means more people will be at risk of medical complications from climate change-related exposures. Climate Change and the Health of People with Existing Medical Conditions.

Make a difference
Do the numbers
• Calculate Your Carbon Footprint: By knowing how big it is, you can learn ways to reduce and/or offset it. Use the Carbon Footprint Calculator

• Check how environmentally friendly your car is at Greener Cars.

Use the Home Energy Checklist The Smarter Home website has lots of tips on saving energy in your home.

What you eat matters: Believe it or not your eating habits impact those around you.
• Eat less meat.
• Grow your own food
• Don’t waste food
• Compost all food scraps
• Use a reusable water bottle and say no to single use cups and water bottles
• Shop farmers markets and bulk food bins- bring your own bags
• Cook from scratch as much as possible
• Purchase food items in containers that are recyclable. Save glass containers and re use to store left overs, as well as bulk food purchases.

Reduce your mobility Carbon footprint: Going car free is the number one most effective action an individual can take. If you can’t walk, ride a bike, use a scooter or skateboard, take public transportation. Next is car sharing using a car share program, particularly an electric or hybrid. If you fly consider offset emissions. 

Consume less: Upcycle, recycle, only purchasing what you need. Buy used when possible. Bring your own shopping bag when you shop and remember Pete Seeger’s lyrics:
If it can't be reduced, reused, repaired
Rebuilt, refurbished, refinished, resold
Recycled or composted
Then it should be restricted, redesigned
Or removed from production
 
Become a Zero Waste Patient
• Skip the freebies when you attend conferences
• When you refill prescriptions, decline the bags and all the inserts.
• Donate unused medications. Many states now have donation drug laws and have started programs specifically for collecting and redistributing. Talk to your pharmacist about programs in your state. You can also call the FDA at 888-INFO-FDA (888-463-6332).
• Before purchasing medical equipment, check for “loan closets” in your area. If your medical provider can’t help you with this, talk to your local home health agency as well as your state’s independent living center. If you have items you no longer need, donate to your local loan closet. Note that many condition specific groups, as well as senior centers, have loan programs.
• When possible use reusable products in place of single use products. For example, some sharps containers and certain medical instruments can be disinfected and reused. Check to see if products are reusable before buying.
• If you need a medical waste container, keep it small, otherwise it can quickly become a regular trash bin. Mark it so others know not to use it.
• Eliminate single use items as much as possible. Carry a reusable water bottle with you and fill up as you need it. Avoid plastic bottles as they can leach plastic
• Choose environmentally friendly cleaning supplies
• Talk to your dentist about replacing flossing with a water pick
• Pay attention to how materials are packaged as well as what they are made of.
• If you need to use a straw, there are excellent reusable ones on the market-silicone, stainless steel or stainless steel with silicone tips all work well and will save money in the long run.

Connect with your state’s Energy Efficiency Program: They offer a wide variety of programs that can help you be energy efficient, while saving money.

Contact Corporations and Local Government about Climate Change: Get involved with local groups. Talk about how climate will affect your health. Organize your condition specific support group to take action. It can include letter writing campaigns, public speaking to discussing ways you can be a Zero Waste patient, lobbying legislatures

More Ideas

Wednesday, August 21, 2019

Take a Break: Make Table Top S’Mores




Before summer completely disappears, try making S’mores using a terra cotta pot. At this point, you can probably pick one up for sale anyplace that sells garden supplies. Make sure it’s unglazed.

It’s very simple:
Option one: Put a can of Sterno in the unglazed pot. Should sit safely on the bottom with at least 1-2 inches of clearance at the top

Option two: Line the inside of the unglazed pot with heavy duty aluminum foil and put in a few pieces of charcoal. Let it burn down a bit before starting to roast your marshmallows.

Other options for table top cookers-
• Tin bucket with small stones-pour rocks in the bottom of the bucket and then put them around the sterno. Make sure the sterno sits level with the rocks keeping it in place.
• Planter box with small stones-The stones are places around the Sterno cans for both stability and so it doesn’t touch the sides making the planter hot.

Beyond Graham Crackers and Chocolate-some interesting ideas for S’Mores:
• Key lime curd (can use pie filling) + marshmallow +graham cracker
• Lemon curd or other pie filling + marshmallow + graham cracker
• Ghirardelli squares + marshmallow + graham cracker
• Bacon + chocolate + marshmallow + graham cracker
• Nutella + marshmallow + graham cracker
• Peanut Butter (or other nut butters) + marshmallow + graham cracker
• Dark chocolate + banana slices + strawberry + marshmallow + graham cracker
• Peanut Butter Cup + banana slices + bacon + marshmallow + graham cracker
• Mint chocolate Square + marshmallow + chocolate graham cracker
• Dulce de leche + marshmallow + cinnamon graham cracker
• Carmel sauce + marshmallow + sea salt + cinnamon graham cracker
• Chocolate covered potato chip + marshmallow + graham cracker
• Mini candy bars (Snickers, Milky Way, Kit Kat, etc.) + marshmallow + graham cracker

Try various combinations using waffle cookies in place of the graham crackers. Tate cookies would also be a good replacement since they are very flat. Another option is Oreo or another sandwich cookie. Take them apart and place a square of chocolate, add the marshmallow and then the top. Sounds over the top sweet, but for Oreo fans it’s a hit.

For those who are gluten free, use Rice Krispy Treats in place of the graham crackers.

Saturday, August 17, 2019

Journal Watch August 2019


PAIN
Online Symptom Self-Management + Telehealth Aids Pain, Mood: Online symptom self-management plus clinician telecare can be effective for individuals with pain, depression, and anxiety, according to a study recently published in the Journal of General Internal Medicine.

Filgotinib Bests Placebo in Tx of Refractory Rheumatoid Arthritis: Among patients with moderately to severely active rheumatoid arthritis (RA) resistant to previous therapy with biologic agents, a significantly higher clinical response rate was seen at 12 weeks for those receiving filgotinib versus placebo, according to a study published in the July 23/30 issue of the Journal of the American Medical Association.

Sleep Disorders Up Health Care Visits, Costs for Low Back Pain: The presence of a sleep disorder diagnosis has a significant effect on low back pain (LBP)-related health care visits and costs, independent of pain intensity and disability, according to a study published online July 5 in Spine.

Adults who mix cannabis with opioids for pain report higher anxiety, depression: Adults who take prescription opioids for severe pain are more likely to have increased anxiety, depression and substance abuse issues if they also use marijuana. Journal of Addiction Medicine

Conservative treatment with a sling can replace surgery for shoulder fractures: There is nothing to be gained by operating on a patient with a so-called displaced fracture of the shoulder. Three weeks with the arm in a sling so that the shoulder is kept inactive yields the same results. PLOS Medicine

1-2 caffeinated drinks not linked with higher risk of migraines; 3+ may triggerthem: In a study published in the American Journal of Medicine researchers found that, among patients who experience episodic migraine, one to two servings of caffeinated beverages were not associated with headaches on that day, but three or more servings of caffeinated beverages may be associated with higher odds of migraine headache occurrence on that day or the following day.

Evidence Supports Meds Used for Pain Relief in Pediatric Migraine: Evidence-based therapies are available for the acute symptomatic treatment of migraine in children and adolescents, but evidence is lacking for the impact of many treatments for migraine prevention, according to two updated guidelines published online Aug. 14 in Neurology.

NSAIDs Contribute to Increased CVD Risk in Osteoarthritis: Osteoarthritis (OA) is an independent risk factor for increased cardiovascular disease (CVD), and nonsteroidal anti-inflammatory drugs (NSAIDs) contribute substantially to this risk, according to a study published online Aug. 6 in Arthritis & Rheumatology.

COMPLEMENTARY & ALTERNATIVE MEDICINE
Saw Palmetto: Although several small studies have suggested modest benefit of saw palmetto for treating symptoms of Benign Prostatic Hyperplasia (BPH), a large study evaluating high doses of saw palmetto and a Cochrane review found that saw palmetto was not more effective than placebo for treatment of urinary symptoms related to BPH. A single randomized controlled trial showed combination therapy of saw palmetto plus lycopene, selenium, and tamsulosin was more effective than single therapies alone.
NCCIH Clinical Digest

Adults with mild cognitive impairment can learn and benefit from mindfulness meditation: A pilot study shows promising evidence that adults with MCI can learn to practice mindfulness meditation, and by doing so may boost their cognitive reserve. Journal of Alzheimer's Disease

Pediatric Cannabis Exposure Up after Medical Legalization: Following medical marijuana legalization (MML) in Massachusetts in 2012, there was an increase in pediatric cannabis exposure calls of 140% according to a study published online Aug. 16 in JAMA Network Open.

A Fatty Meal Might Affect How You Absorb CBD: A new study suggests that fatty foods might boost the body's absorption of cannabidiol (CBD). There were no differences in mental functioning when the patients took CBD after eating or fasting, according to the study in the August issue of the journal Epilepsia.

 FDA ACTION

• Approved Turalio (pexidartinib) capsules to treat adults with symptomatic tenosynovial giant cell tumor (TGCT)
• Streamlined four tests for marketing with new indications to diagnose Lyme disease using a modified approach with only enzyme immunoassay (EIA) technology-based tests
• Approved the first noninjection glucagon therapy for emergency treatment of severe hypoglycemia
• Approved for the first generic versions of Lyrica (pregabalin) to manage neuropathic pain from diabetic peripheral neuropathy or spinal cord injury, postherpetic neuralgia, and fibromyalgia
• Sent a warning letter has been issued to Massachusetts-based Curaleaf Inc. for illegally selling unapproved cannabidiol (CBD) products online with unproven claims that the products treat cancer, Alzheimer disease, opioid withdrawal, pain, and other health problems
• Approved Pretomanid for drug resistant TB
• Warned about Miracle Mineral Solution, which is sold online as a medical treatment, and can cause serious and potentially life-threatening health problems and should not be bought or used by consumers.
• Approved transcatheter Heart valves for use in low risk patients
• Approved tether device to correct idiopathic scoliosis as an alternative to fusion surgery when patient does not respond to bracing
• Proposes graphic warning labels on cigarettes
• Recalled RELPAX® (eletriptan hydrobromide) 40 mg tablets, lots AR5407 and CD4565, because continued use -treats acute migraines in adults- could lead to serious, life-threatening infections

 PREVENTION
Flu vaccine reduces risk of early death for elderly intensive care patients: An influenza vaccine does not just work when it comes to influenza. A new study shows that elderly people who have been admitted to an intensive care units have less risk of dying and of suffering a blood clot or bleeding in the brain if they have been vaccinated. And this is despite the fact that they are typically older, have more chronic diseases and take more medicine then those who have not been vaccinated. Intensive Care Medicine

 

Socially active 60-year-olds face lower dementia risk: Being more socially active in your 50s and 60s predicts a lower risk of developing dementia later on, finds a new UCL-led study. PLOS Medicine

7 'simple' steps for heart health may also stave off dementia: New research suggests that "Life's Simple 7" steps for maintaining heart health may also be a useful tool for predicting dementia risk and preventing the neurological condition. Life Simple 7 are manage blood pressure and cholesterol, lower blood sugar, stay physically active, follow a healthful diet, lose weight and don’t smoke. The BMJ

'Tickle' therapy could help slow aging, research suggests: 'Tickling' the ear with a small electrical current appears to rebalance the autonomic nervous system for over-55s, potentially slowing down one of the effects of ageing, according to new research. Scientists found that a short daily therapy delivered for two weeks led to both physiological and wellbeing improvements, including a better quality of life, mood and sleep. The therapy, called transcutaneous vagus nerve stimulation, delivers a small, painless electrical current to the ear, which sends signals to the body's nervous system through the vagus nerve. This could help protect people from chronic diseases which we become more prone to as we get older, such as high blood pressure, heart disease and atrial fibrillation. The researchers, who published their findings today in the journal Aging, suggest that the 'tickle' therapy has the potential to help people age more healthily, by recalibrating the body's internal control system.

Poor fit between job demands, reasoning abilities associated with health conditions: Older workers whose reasoning abilities no longer allow them to meet the demands of their jobs may be more likely to develop chronic health conditions and retire early, which may not be ideal for the employee or employer, according to research published by the American Psychological Association.

Study reveals 6 top exercises for offsetting 'obesity genes': New research examines the effect of 18 different kinds of exercise on people with a high genetic risk of developing obesity. The findings identify six exercises that can offset the genetic effects on five measures of obesity. While jogging ranked the best, mountain climbing, walking, exercise walking, dancing and a longer practice of yoga also reduced the genetic effects on obesity.

ACIP Recommends Catch-Up HPV Vaccines Through Age 26: Catch-up human papillomavirus (HPV) vaccinations are recommended for all persons through age 26 years and should be considered for some persons aged 27 to 45 years, according to research published in the Aug. 16 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Vaccination Does Not Up Risk for Developing Multiple Sclerosis: Evidence shows that vaccination is not associated with an increased risk for being diagnosed with multiple sclerosis (MS) within the next five years, according to a study published online July 30 in Neurology. Odds of MS were lower in participants with vaccination, especially for influenza and tick-borne illness.

Recent Stressful Life Events Linked to Later Verbal Memory Decline: Middle-aged women, but not men, with a greater number of recent stressful life events have memory decline later in life, according to a study published in the July issue of the International Journal of Geriatric Psychiatry.

Severe Lung Injury After Vaping Reported: Four cases of severe lung injury possibly linked with vaping in Minnesota are similar to dozens of cases in Wisconsin and Illinois. The patients had symptoms such as shortness of breath, fever, cough, vomiting, diarrhea, headache, dizziness and chest pain, and some were hospitalized for "multiple weeks, with some patients being admitted to the intensive care unit," according to a Minnesota Department of Health statement, CNN reported.

 

NUTRITION/SUPPLEMENTS
Vitamin D supplementation may slow diabetes progression: Vitamin D supplementation may slow the progression of type 2 diabetes in newly diagnosed patients and those with prediabetes, according to a study published in the European Journal of Endocrinology. The study findings suggest that high-dose supplementation of vitamin D can improve glucose metabolism to help prevent the development and progression of diabetes.

 

Dangerous Sesame Allergy Affects Many Americans: More than 1.5 million children and adults in the United States have sesame allergy -- more than previously believed, a new study finds. And even though sesame allergy can cause severe reactions, sesame is often not declared on food product labels, the Northwestern University researchers said.

 

Plant-Based Diets May Lower CV Disease, Deaths in Middle-Aged: Diets higher in plant-based foods and lower in animal-based foods are associated with lower risks for developing or dying from cardiovascular disease among middle-aged adults, according to a study published online Aug. 7 in the Journal of the American Heart Association.

Reduced carbohydrate intake improves type 2 diabetics' ability to regulate blood sugar: Patients with type 2 diabetes improve their ability to regulate blood sugar levels if they eat food with a reduced carbohydrate content and an increased share of protein and fat. This is shown by a recent study conducted at Bispebjerg Hospital in collaboration with, among other partners, Aarhus University and the Department of Nutrition, Exercise and Sports at the University of Copenhagen. The findings are contrary to the conventional dietary recommendations for type 2 diabetics. "The study shows that by reducing the share of carbohydrates in the diet and increasing the share of protein and fat, you can both treat high blood sugar and reduce liver fat content. Further intensive research is needed in order to optimise our dietary recommendations for patients with type 2 diabetes," says Thure Krarup, stressing that the findings should be confirmed in large-scale, long-term controlled trials.

Mankai duckweed plant found to offer health benefits: In this new study, the researchers compared Mankai shake consumption to a yogurt shake equivalent in carbohydrates, protein, lipids, and calories. Following two weeks of monitoring with glucose sensors, participants who drank the duckweed shake showed a much better response in a variety of measurements including lower glucose peak levels; morning fasting glucose levels; later peak time; and faster glucose evacuation. The participants also felt more full. Diabetes Care

Replacing Beef with Chicken couldreduce breast cancer risk: Researchers, using data from more than 40,000 women, conclude that eating red meat is associated with an increased risk of breast cancer, but consuming poultry appears to link to a lower risk. women who ate the most red meat had a 23% higher risk of developing breast cancer than those who ate the least red meat.


Robotic neck brace dramatically improves functions of ALS patients: A novel neck brace, which supports the neck during its natural motion, was designed by Columbia engineers. This is the first device shown to dramatically assist patients suffering from Amyotrophic Lateral Sclerosis (ALS) in holding their heads and actively supporting them during range of motion. This advance would result in improved quality of life for patients, not only in improving eye contact during conversation, but also in facilitating the use of eyes as a joystick to control movements on a computer, much as scientist Stephen Hawkins famously did. 

Osteoporosis drugs linked to reduced risk of premature death: Two studies led by the Garvan Institute of Medical Research have revealed that nitrogen-bisphosphonates, drugs commonly prescribed for osteoporosis, reduced the risk of premature mortality by 34% in a cohort of over 6,000 individuals. This reduction in early mortality risk was significantly associated with a reduction in bone loss compared with no treatment.

Study proves hepatitis C drugs reduce liver-related deaths by nearly half: A new study from the UT Southwestern Simmons Comprehensive Cancer Center demonstrates that antiviral drugs for hepatitis C reduce liver-related deaths by nearly 50% in patients with a history of liver cancer. The finding builds on a December 2018 study by the same researchers who found that antiviral drugs do not increase the risk of liver cancer recurrence, as was previously feared. Gastroenterology

Anti arrhythmic Drugs May Up Fall Injuries in Older A-Fib Patients: Use of antiarrhythmic drugs (AADs) is associated with a higher risk for fall-related injuries and syncope among older patients with atrial fibrillation (AF), according to a study published online July 24 in the Journal of the American Geriatrics Society.

Major Surgery Linked to Lasting Change in Cognitive Trajectory: Major surgery is associated with a small, long-term change in the average cognitive trajectory, according to a study published online Aug. 7 in The BMJ.

Recommendations Developed for Management of Lyme Disease: The Infectious Diseases Society of America, the American Academy of Neurology, and the American College of Rheumatology have released a draft of their joint clinical practice guidelines for the management of Lyme disease. The authors note that for prevention of tick bites and tick-borne infections, wearing protective clothing, checking for ticks, bathing after outdoor activities, drying clothing, and limiting pet exposure are recommended. Repellents to prevent tick bites include permethrin-treated clothing; attached ticks should be removed promptly. Following a tick bite, testing for Borrelia burgdorferi is not recommended in an Ixodes tick, and asymptomatic patients should not be tested for exposure to Borrelia burgdorferi following an Ixodes tick bite. Prophylactic antibiotic treatment should be given to adults and children within 72 hours of removal of an identified high-risk tick. A single dose of oral doxycycline is recommended within 72 hours of tick removal during observation for high-risk Ixodes bites. Erythema migrans skin lesions are the most common clinical manifestation of Lyme disease. Clinical diagnosis is recommended over laboratory testing for patients with lesions compatible with erythema migrans. The public comment period for these draft guidelines has been extended for an additional 30 days, and the deadline for comment is Sept. 9, 2019.

Diabetes over treatment seriously endangers health: People with diabetes, particularly those with type 1 diabetes, may have an increased risk of hypoglycemia (low blood sugar) if they receive too much glucose lowering therapy. New research now warns that many people with diabetes face that risk. Mayo Clinic Proceedings

OTHER
Trouble Driving at Night? Yellow Lenses Won't Help: Night-driving" glasses that promise to dim the glare of headlights may not work as advertised, a new study finds. The glasses, featuring yellow-tinted lenses, have been marketed for years as a way to ward off blinding headlights and make night driving easier. The problem: There's no scientific evidence they work. Now a new study, published online Aug. 1 in JAMA Ophthalmology, offers a buyer-beware message. In driving simulation tests, researchers found that yellow lenses did not improve people's performance over clear lenses -- including when they were faced with oncoming headlights.

Brand-Brand Competition Has Not Cut Prices in Pharma Market: Brand-brand competition in the U.S. pharmaceutical market has not lowered drug list prices, according to a review published online July 30 in PLOS Medicine. 

New Opioid Rx Rules Coming for U.S. Employees' Health Plans: Tighter rules on opioid painkiller prescriptions for U.S. government employees will be implemented in the fall, the Trump Administration says. The new Federal Employee Health Benefits Program rules are meant to prevent over prescribing of the potentially addictive drugs to patients who might require them for only a short period of time, the Associated Press reported. Patients with intractable pain from cancer and other conditions will still be able to get opioid painkillers.AP 

Do electronic devices affect our ability to grasp complex ideas? In today's world, it seems pretty much everyone uses smartphones and tablets on a daily basis. But our brains may not thank us for it, according to new research showing that overuse of electronic devices correlates with a poorer understanding of complex, scientific texts. Scientific Reports