Time for a Recess; Today, Play Like a Kid Again!

 

In our hectic, modern lives, many of us focus so heavily on work and family commitments that we never seem to have time for pure fun. Somewhere between childhood and adulthood, we’ve stopped playing. When we carve out some leisure time, we’re more likely to zone out in front of the TV or computer than engage in fun, rejuvenating play as we did when we were kids.

Just because we’re adults, that doesn’t mean we have to take ourselves so seriously and make life all about work. We all need to play.

Why should adults play?

Play is not just essential for kids; it can be an important source of relaxation and stimulation for adults as well. Playing with your romantic partner, friends, co-workers, pets, and children is a sure (and fun) way to fuel your imagination, creativity, problem-solving abilities, and emotional well-being.

Adult play is a time to forget about work and commitments, and to be social in an unstructured, creative way. Focus your play on the actual experience, not on accomplishing any goal. There doesn’t need to be any point to the activity beyond having fun and enjoying yourself.

Play could be simply goofing off with friends, sharing jokes with a coworker, throwing a Frisbee on the beach, dressing up at Halloween with your kids, building a snowman in the yard, playing fetch with a dog, a game of charades at a party, or going for a bike ride with your spouse with no destination in mind. By giving yourself permission to play with the joyful abandon of childhood, you can reap oodles of health benefits throughout life.

The benefits of play

While play is crucial for a child’s development, it is also beneficial for people of all ages. Play can add joy to life, relieve stress, supercharge learning, and connect you to others and the world around you. Play can also make work more productive and pleasurable.

You can play on your own or with a pet, but for greater benefits, play should involve at least one other person, away from the sensory-overload of electronic gadgets.

Play can:

Relieve stress. Play is fun and can trigger the release of endorphins, the body’s natural feel-good chemicals. Endorphins promote an overall sense of well-being and can even temporarily relieve pain.
Improve brain function. Playing chess, completing puzzles, or pursuing other fun activities that challenge the brain can help prevent memory problems and improve brain function. The social interaction of playing with family and friends can also help ward off stress and depression.
Stimulate the mind and boost creativity. Young children often learn best when they are playing—and that principle applies to adults, as well. You’ll learn a new task better when it’s fun and you’re in a relaxed and playful mood. Play can also stimulate your imagination, helping you adapt and problem solve.
Improve relationships and your connection to others. Sharing laughter and fun can foster empathy, compassion, trust, and intimacy with others. Play doesn’t have to be a specific activity; it can also be a state of mind. Developing a playful nature can help you loosen up in stressful situations, break the ice with strangers, make new friends, and form new business relationships.
Keep you feeling young and energetic. In the words of George Bernard Shaw, “We don’t stop playing because we grow old; we grow old because we stop playing.” Playing can boost your energy and vitality and even improve your resistance to disease, helping you feel your best.

Play and relationships

Play is one of the most effective tools for keeping relationships fresh and exciting. Playing together brings joy, vitality, and resilience to relationships. Play can also heal resentments, disagreements, and hurts. Through regular play, we learn to trust one another and feel safe. Trust enables us to work together, open ourselves to intimacy, and try new things.

By making a conscious effort to incorporate more humor and play into your daily interactions, you can improve the quality of your love relationships—as well as your connections with co-workers, family members, and friends.
Play helps develop and improve social skills. Social skills are learned in the give and take of play. During childhood play, kids learn about verbal communication, body language, boundaries, cooperation, and teamwork. As adults, you continue to refine these skills through play and playful communication.

Play teaches cooperation with others. Play is a powerful catalyst for positive socialization. Through play, children learn how to “play nicely” with others—to work together, follow mutually agreed upon rules, and socialize in groups. As adults, you can continue to use play to break down barriers and improve your relationships with others.
Play can heal emotional wounds. As adults, when you play together, you are engaging in exactly the same patterns of behavior that positively shape the brains of children. These same playful behaviors that predict emotional health in children can also lead to positive changes in adults. If an emotionally-insecure individual plays with a secure partner, for example, it can help replace negative beliefs and behaviors with positive assumptions and actions.
Fixing relationship problems with humor and play.  Play and laughter perform an essential role in building strong, healthy relationships by bringing people closer together, creating a positive bond, and resolving conflict and disagreements. In new relationships, play and humor can be an effective tool not just for attracting the other person but also for overcoming any awkwardness or embarrassment that arises during the dating and getting-to-know-you process. Flirting is a prime example of how play and humor are used in adult interactions. In longer-term relationships, play can keep things exciting, fresh, and vibrant, and deepen intimacy. It can also help you overcome differences and the tiny aggravations than can build up over time.

Play at work

Many dot-com companies have long recognized the link between productivity and a fun work environment. Some encourage play and creativity by offering art or yoga classes, throwing regular parties, providing games such as Foosball or ping pong, or encouraging recess-like breaks during the workday for employees to play and let off steam. These companies know that more play at work results in more productivity, higher job satisfaction, greater workplace morale, and a decrease in employees skipping work and staff turnover.

If you’re fortunate enough to work for such a company, embrace the culture; if your company lacks the play ethic, you can still inject your own sense of play into breaks and lunch hours. Keep a camera or sketch pad on hand and take creative breaks where you can. Joke with coworkers during coffee breaks, relieve stress at lunch by shooting hoops, playing cards, or completing word puzzles together. It can strengthen the bond you have with your coworkers as well as improve your job performance. For people with mundane jobs, maintaining a sense of play can make a real difference to the work day by helping to relieve boredom.

Using play to boost productivity and innovation.  Success at work doesn’t depend on the amount of time you work; it depends upon the quality of your work. And the quality of your work is highly dependent on your well-being.

Taking the time to replenish yourself through play is one of the best things you can do for your career. When the project you’re working on hits a serious glitch, take some time out to play and have a few laughs. Taking a pause for play does a lot more than take your mind off the problem. When you play, you engage the creative side of your brain and silence your “inner editor,” that psychological barrier that censors your thoughts and ideas. This can often help you see the problem in a new light and think up fresh, creative solutions.

Playing at work:

• keeps you functional when under stress
• refreshes your mind and body
• encourages teamwork
• increases energy and prevents burnout
• triggers creativity and innovation
• helps you see problems in new ways

Tips for managers and employers

It’s tempting to think that the best way to cope with an ever-increasing workload is to have your employees work longer and harder. However, without some recreation time, it’s more likely the work will suffer and your workers become chronically overwhelmed and burned out. Encouraging play, on the other hand, creates a more lighthearted work atmosphere that in turn encourages employees to take more creative risks.

  • Provide opportunities for social interaction among employees. Throw parties, put a basketball hoop in the parking lot, arrange a miniature golf tournament, stage an office treasure hunt.
  • Encourage creative thinking or just lighten the mood of meetings by keeping tactile puzzles on the conference room table.
  • Encourage workers to take regular breaks from their desks, and spend a few minutes engaged in a fun activity, such as a word or number game.

Playing with your children

Rolling on the floor with your baby or getting down on your knees to play with a young child is vitally important—both to your child’s development and to your own health.

Play is essential for developing social, emotional, cognitive, and physical skills in children. In fact, far from being a waste of time or just a fun distraction, play is a time when your child is often learning the most. Whether it’s an infant playing “peek-a-boo,” a toddler playing make-believe, or an older child playing a board game, play develops social skills, stimulates a child’s imagination and makes kids better adjusted, smarter, and less stressed.

As well as aiding your child’s development, play can also bring you closer together and strengthen the parent-child bond that will last a lifetime.
How to play with your child

While children need time to play alone and with other children, playing with their parents is also important. Here are some helpful tips to encourage play:

  • Establish regular play times. It may be for twenty minutes before dinner every night or every Saturday morning, for example. Remember, this time spent playing together is benefiting both of you.
  • Give your child your undivided attention. Turn off the TV and your cell phone and make the time to play with your child without distraction. Having your undivided attention makes your child feel special.
  • Get down to your child’s level. That may mean getting down on your knees or sitting on the floor. Match your child’s intensity during play—if your child is loud and energetic, be loud and energetic, too.
  • Embrace repetition. It may be boring to you, but it’s not to your child. Children learn through repetition. Let your child play the same game over and over. Your child will move on when he or she is ready.
  • Let your children take the lead. Become part of their game rather than trying to dictate the play. In pretend play, let your child call the shots, make the rules, and determine the pace of play. Ask questions and follow along—you’ll likely get drawn into imaginative new worlds that are fun for you, too.
  • Don’t force play or try to prolong a game. The best way to teach a new skill is to show children how something works, then step back and give them a chance to try. When your child is tired of an activity, it’s time to move on to something new.
  • Make play age-appropriate and consider safety. If a game is too hard or too easy, it loses its sense of pleasure and fun. Help your child find age-appropriate activities and understand any safety rules for play. Nothing ruins a fun game faster than a child getting hurt.

How to play more

Incorporating more fun and play into your daily life can improve the quality of your relationships, as well as your mood and outlook. Even in the most difficult of times, taking time away from your troubles to play or laugh can go a long way toward making you feel better.

It’s true what they say: laughter really is the best medicine. Laughter makes you feel good. And the good feeling that you get when you laugh and have fun remains with you even after the laughter subsides. Play and laughter help you keep a positive, optimistic outlook through difficult situations, disappointments, and loss.

Develop your playful side

It’s never too late to develop your playful, humorous side. If you find yourself limiting your playfulness, it’s possible that you’re self-conscious and concerned about how you’ll look and sound to others when you attempt to be lighthearted. Fearing rejection, embarrassment or ridicule when attempting to be playful is an understandable fear.

Adults are often worried that being playful will get them labeled as childish. But what is so wrong with that? Children are incredibly creative, inventive and are constantly learning. Wouldn’t you want to be childish if that is the definition? Remember that as a child, you were naturally playful; you didn’t worry about the reactions of other people. You can reclaim your inner child by setting aside regular, quality playtime. The more you play, joke, and laugh—the easier it becomes.

Try to clear your schedule for an afternoon or evening, for example, and then turn off your phone, TV, computer, and other devices. Give yourself permission to do whatever you want for the time you’ve allotted. Be spontaneous, set aside your inhibitions and try something fun, something you haven’t done since you were a kid, perhaps. And enjoy the change of pace.

Creating opportunities to play

Host a regular game night with friends or family.
Arrange nights out with work colleagues bowling, playing pool, miniature golf, or singing karaoke.
Schedule time in a park or at the beach to throw a Frisbee or fly a kite with friends.
Play with a pet. Puppies, especially, make very willing playmates. If you don’t have your own, borrow one from your local animal shelter.
Surround yourself with playful people. They’ll help loosen you up and are more likely to support your efforts to play and have fun.
Joke with strangers at a bus stop or in a checkout line. It’ll make the time pass quicker and you may even spark up new friendships.
Visit a magic store and learn some tricks. Or invest in art supplies, construction toys, or science kits and create something new.
Play with children. Goofing around with kids helps you experience the joy of play from their perspective. If you don’t have young children, arrange a play date with your grandkids, nephews, nieces, or other young relatives.

Adapted from these Resources and references

Play Science: The Patterns of Play – Learn about the different ways human beings play, the roles these different patterns of play serve, and how we benefit from them. (National Institute for Play)
Parent Handouts: Play – Information about why play matters and what you as a parent can do to encourage your child to play. (ParentingCounts.org)
Help guide.org. Authors: Lawrence Robinson, Melinda Smith, M.A., Jeanne Segal, Ph.D., and Jennifer Shubin. Last updated: March 2018.

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#emotionalwellbeing

Is Eating Chocolate Actually Good for You? Researchers Seem to Think So!

Despite a bad rap for causing weight gain and loosely being associated with acne, Chocolate is the ultimate comfort food for many.  Americans spend $10 billion annually on chocolaty treats.  For many, it is a sure-fire relief in times of stress, a reliable source of consolation in times of disappointment, and a mood-enhancer and romance-magnifier in more positive circumstances.

But is it at all healthy?  If you consume lots of it, obviously not; but the next time you savor a piece of chocolate, you may not have to feel so guilty about it. Countless studies document a host of medically proven ways in which chocolate — good chocolate, which is to say dark chocolate, with a cocoa percentage of around seventy per cent or more — really is good for us.

Fast facts on chocolate

  • Chocolate is made from tropical Theobroma cacao tree seeds.
  • Its earliest use dates back to the Olmec civilization in Mesoamerica.
  • After the European discovery of the Americas, chocolate became very popular in the wider world, and its demand exploded.
  • Chocolate consumption has long been associated with conditions such as diabetes, coronary heart disease, and hypertension.
  • Chocolate is believed to contain high levels of antioxidants.
  • Some studies have suggested chocolate could lower cholesterol levels and prevent memory decline.
  • Chocolate contains a large number of calories.
  • People who are seeking to lose or maintain weight should eat chocolate only in moderation.

Benefits

Chocolate receives a lot of bad press because of its high fat and sugar content. Its consumption has also been associated high blood pressure, coronary artery disease, and diabetes.

However, a review of chocolate’s health effects published in the Netherlands Journal of Medicine point to the discovery that cocoa – the key ingredient in chocolate –  contains biologically active phenolic compounds.  This has changed people’s views on chocolate, and it has stimulated research into how it might impact aging, and conditions such as oxidative stress, blood pressure regulation, and atherosclerosis.

It is important to note many of the possible health benefits mentioned below are gleaned  from single studies.

1)  Cholesterol

One study, published in The Journal of Nutrition, suggests that chocolate consumption might help reduce low-density lipoprotein (LDL) cholesterol levels, also known as “bad cholesterol.”

The researchers set out to investigate whether chocolate bars containing plant sterols (PS) and cocoa flavanols (CF) have any effect on cholesterol levels.

The authors concluded: “Regular consumption of chocolate bars containing PS and CF, as part of a low-fat diet, may support cardiovascular health by lowering cholesterol and improving blood pressure.”

2)  Cognitive function

Scientists at Harvard Medical School have suggested that drinking two cups of hot chocolate a day could help keep the brain healthy and reduce memory decline in older people.

The researchers found that hot chocolate helped improve blood flow to parts of the brain where it was needed.

Lead author, Farzaneh A. Sorond, said:

“As different areas of the brain need more energy to complete their tasks, they also need greater blood flow. This relationship, called neurovascular coupling, may play an important role in diseases such as Alzheimer’s.”

Another study, published in 2016 in the journal Appetite, suggests eating chocolate at least once weekly could improve cognitive function.

Flavanols are thought to reduce memory loss in older people, and the anti-inflammatory qualities of dark chocolate have been found beneficial in treating brain injuries such as concussion.

Research has shown that when elderly people were given specially prepared cocoa extracts which was high in flavanols, their cognitive function greatly improved. The only problem is that when it comes to eating chocolate, the percentage of those cocoa flavanols is much reduced due to the processing and the addition of eggs, sugar and milk.

3)  Heart disease

Lots of studies reveal that the flavonoids in chocolate can help your veins and arteries to stay supple. Over 7 studies followed 114,000 participants who were given a few servings of dark chocolate a week. The results showed that their risk of getting a heart attack was reduced by about 37% while the chances of getting a stroke were 29% less when they had a higher consumption of chocolate.

Research published in The BMJ, suggests that consuming chocolate could help lower the risk of developing heart disease by one-third.  Based on their observations, the authors concluded that higher levels of chocolate consumption could be linked to a lower risk of cardiometabolic disorders.

A 2014 study found that dark chocolate helps restore flexibility to arteries while also preventing white blood cells from sticking to the walls of blood vessels – both common causes of artery clogging.

4)  Stroke

Canadian scientists, in a study involving 44,489 individuals, found that people who ate chocolate were 22 percent less likely to experience a stroke than those who did not. Also, those who had a stroke but regularly consumed chocolate were 46 percent less likely to die as a result.

A further study, published in the journal Heart in 2015, tracked the impact of diet on the long-term health of 25,000 men and women.  The findings suggested that eating up to 100 grams (g) of chocolate each day may be linked to a lower risk of heart disease and stroke.

5)  Good for moms, fetal growth and development

Eating 30 g of chocolate every day during pregnancy might benefit fetal growth and development, according to a study presented at the 2016 Pregnancy Meeting of the Society for Maternal-Fetal Medicine in Atlanta, GA.

A Finnish study also found that chocolate reduced stress in expectant mothers, and that the babies of such mothers smiled more often than the offspring of non-chocolate-eating parents.

One of the complications of pregnancy, known as preeclampsia, can cause blood pressure can shoot up. Researchers have established that one of the chemicals in dark chocolate, theobromine, can stimulate the heart and help the arteries dilate. When pregnant women were given higher doses of chocolate, they had a 40% less chance of developing this complication.

6)  Athletic performance

Findings published in The Journal of the International Society of Sports Nutrition suggest a little dark chocolate might boost oxygen availability during fitness training.

Another magical flavanol in chocolate is epicatechin. Mice were given this substance and they were much fitter and stronger than those mice on water only. Researchers say that to get the best results from your workout you have to limit the amount to only about half of one square of chocolate a day! If you have too much, it could undo the beneficial effects.

7)   It’s mineral rich

Dark chocolate is packed with beneficial minerals such as potassium, zinc and selenium, and a 100g bar of dark (70 per cent or more) choc provides 67 per cent of the RDA of iron.  It has almost all of your RDA for copper and manganese, contains over half your magnesium RDA and delivers about 10% of fiber.

8)  It reduces cholesterol

Consumption of cocoa has been shown to reduce levels of “bad” cholesterol (LDL) and raise levels of “good” cholesterol, potentially lowering the risk of cardiovascular disease.

The Journal of Nutrition published an interesting article about the results of a study done to determine whether dark chocolate could have any effect on the LDL cholesterol levels. They found when subjects were given bars of dark chocolate with plant sterols and flavanols, they were getting lower scores on their cholesterol levels.

9)  It’s good for your skin

The flavanols in dark chocolate can protect the skin against sun damage.     One study conducted in London found that women who were given chocolate with a high flavanol content were able to withstand double the amount of UV light on their skins without burning, compared to those on lower doses.  Still, you are probably better off slapping on some sunscreen.

10) It can help you lose weight

Chocolate can help you lose weight. Really. Neuroscientist Will Clower says a small square of good choc melted on the tongue 20 minutes before a meal triggers the hormones in the brain that say, “I’m full”, cutting the amount of food you subsequently consume. Finishing a meal with the same small trigger could reduce subsequent snacking.

11) It may prevent diabetes

It sounds mad, but cocoa has been shown to improve insulin sensitivity. So dark chocolate – in moderation – might delay or prevent the onset of diabetes. One small study at the University of L’Aquila in Italy found that the right does of chocolate flavonoids can help the body’s metabolism and enhance insulin function.

12) Chocolate makes you feel better

Chocolate contains phenylethylamine (PEA), which is the same chemical that your brain creates when you feel like you’re falling in love. PEA encourages your brain to release feel-good endorphins. These Endorphins play a key role in helping to prevent depression and other mental malaise.

Some chocolate lovers also add certain kinds of chocolate may be good for the soul: this is chocolate for which the raw materials have been grown with care by farmers who are properly rewarded for their work; then processed by people who take time and care in their work and finished by chocolatiers who love what they do. It is not mass-produced, and it may not be cheap. But it could be good for you, heart and soul.

13) It may help people with Alzheimer’s disease

As we know, the nerve pathways to the brain get damaged when Alzheimer’s disease strikes, causing severe loss in certain mental functions. It is fascinating to read about how one extract from cocoa, called lavado, can actually reduce the damage done to these vital pathways.

Results of a lab experiment, published in 2014, indicated that a cocoa extract, called lavado, might reduce or prevent damage to nerve pathways found in patients with Alzheimer’s disease. This extract could help slow symptoms such as cognitive decline.

14) It can help to lower your blood pressure

You may not know it but having the right amount of NO (Nitric Oxide) in your body can help your arteries to relax. That will, in turn help to take some of the pressure off them and the result is a lower BP count. Just another benefit of the dark chocolate flavanols which help to produce this vital Nitric Oxide.

15) It can also help you see better

University of Reading researchers were curious to see if dark chocolate flavanols could actually improve vision as they knew it certainly improved blood circulation in general. They decided to do a small experiment and gave two groups of volunteers some white and dark chocolate. The dark chocolate groups were doing better on vision tests afterwards.

16) It may help reduce fatigue

If you suffer from Chronic Fatigue Syndrome you should try adding chocolate to your daily diet. One group of sufferers were given a daily dose of chocolate for two months. They were less tired and the best news of all is that they did not put on any extra weight.

17) It may help to lower your Body Mass Index

There has been a lot of emphasis on how chocolate can actually reduce your BMI (Body Mass Index) which is how you measure up as regards your height versus your weight. One study took 1,000 Californians and they found that those who ate chocolate more often during the week had a lower BMI. Overall diet and exercise regimes were not factors which influenced this result.

18) It may help reduce your chances of getting cancer

As we have mentioned, the cocoa flavanols in dark chocolate have both anti-inflammatory and antioxidant properties. These are important in keeping the actions of free radicals at bay. As we know, these are the protagonists when cancer starts to invade cells.

19) It may help your cough

Another marvelous effect of the theobromine chemical in chocolate is that it can calm a troublesome cough. Manufacturers are looking at this to produce safer cough syrups instead of using codeine which has some undesirable side effects.

20) It may help with blood circulation

Normally you take an aspirin to help prevent blood clotting and to improve circulation. Studies now show that chocolate can have a similar effect.

Light vs. dark chocolate

Chocolate’s antioxidant potential may have a range of health benefits. The higher the cocoa content, as in dark chocolate, the more benefits there are. Dark chocolate may also contain less fat and sugar, but it is important to check the label.

Manufacturers of light, or milk, chocolate, claim their product is better for health because it contains milk, and milk provides protein and calcium. Supporters of dark chocolate point to the higher iron content and levels of antioxidants in their product.

How do the nutrients compare?

Here are some sample nutrient levels in light and dark chocolate,

Nutrient Light (100 g) Dark (100 g)
Energy 531 kcal 556 kcal
Protein 8.51 g 5.54 g
Carbohydrate 58 g 60.49 g
Fat 30.57 g 32.4 g
Sugars 54 g 47.56 g
Iron 0.91 mg 2.13 mg
Phosphorus 206 mg 51 mg
Potassium 438 mg 502 mg
Sodium 101 mg 6 mg
Calcium 251 mg 30 mg
Cholesterol 24 mg 5 mg

The darker the chocolate, the higher the concentration of cocoa, and so, in theory, the higher the level of antioxidants there will be in the bar.

However, nutrients vary widely in commercially available chocolate bars, depending on the brand and type you choose. It is best to check the label if you want to be sure of the nutrients.

Risks and precautions

More research is needed to confirm eating chocolate can really improve people’s health.  In addition, chocolate bars do not contain only cocoa. The benefits and risks of any other ingredients, such as sugar and fat, need to be considered.

Weight gain: Some studies suggest that chocolate consumption is linked to lower body mass index (BMI) and fatness. However, chocolate can have a high calorie count due to its sugar and fat content. Anyone who is trying to slim down or maintain their weight should limit their chocolate consumption and check the label of their favorite product.

Sugar content: The high sugar content of most chocolate can also be a cause of tooth decay.

Migraine risk: Some people may experience an increase in migraines when eating chocolate regularly due to cocoa’s tyramine, histamine, and phenylalanine content. However, research is mixed.

Bone health: There is some evidence that chocolate might cause poor bone structure and osteoporosis. The results of one study, published in The American Journal of Clinical Nutrition, found that older women who consumed chocolate every day had lower bone density and strength.

Heavy metals: Some cocoa powders, chocolate bars, and cacao nibs may contain high levels of cadmium and lead, which are toxic to the kidneys, bones, and other body tissues.

In 2017, Consumer Lab tested 43 chocolate products and found that nearly all cocoa powders contained more than 0.3 mcg cadmium per serving, the maximum amount recommended by the World Health Organization (WHO).

Conclusion

All in all, eating chocolate can have both health benefits and risks. As with anything, moderation is key.  Research is continuing, and while experts have already found chocolate is good for the heart, circulation and brain, it has been suggested it may even greater benefit in such major heath challenges as autism, obesity and  diabetes.

If you are interested in speaking with a physician about the delicious benefits of chocolate or starting a workout to shed the unwanted effects of too much, find a doctor in the nation’s largest healthcare social ecosystem – HealthLynked.  Here, patients a connecting with physicians in unique ways to Improve HealthCare.

Ready to get Lynked?  Go to HealthLynked.com to sign up for Free!

 

Sources:

20 Health Benefits of Chocolate, Robert Locke

Health benefits and risks of chocolate, Natalie Butler, RD, LD

 

How is Lack of Sleep Ruining Your Health?

I used to say, “I will sleep when I am dead.”  That’s Old military humor meant as some form of motivation in those days we would go for an eternity without sleep.  What I did not know was that not sleeping can draw us closer to death every day.

Ongoing surveys indicate more people are sleeping less than six hours a night, and sleep difficulties visit 75% of us at least a few nights per week. A short-lived bout of insomnia is generally nothing to worry about. The bigger concern is chronic sleep loss, which can contribute to health problems such as weight gain, high blood pressure, and a weakening in the immune system – all which can cause even greater problems down the road.

Why Is Sleep Important?

Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety.

The way you feel while you’re awake depends in part on what happens while you’re sleeping. During sleep, your body is working to support healthy brain function and maintain your physical health. In children and teens, sleep also helps support growth and development.

Think of your body like a factory that performs a number of vital functions. As you drift off to sleep, your body begins its night-shift work:

  • Healing damaged cells
  • Boosting your immune system
  • Recovering from the day’s activities
  • Recharging your heart and cardiovascular system for the next day

Understanding the sleep cycle

Understanding what happens during sleep also means understanding the sleep cycle, which consists of  two recurring phases: REM (rapid eye movement) and NREM (non-REM or non-rapid eye movement). Both phases are important for different functions in our bodies.

NREM sleep typically occupies 75–80% of total sleep each night. Many of the health benefits of sleep take place during NREM sleep – tissue growth and repair occurs, energy is restored and hormones that are essential for growth and development are released.

REM sleep typically occupies 20–25% of total sleep each night. REM sleep, when dreaming occurs, is essential to our minds for processing and consolidating emotions, memories and stress. It is also thought to be vital for learning, stimulating the brain regions used in practicing and developing new skills.

If the REM and NREM cycles are interrupted multiple times throughout the night — either due to snoring, difficulties breathing or waking up frequently —we miss out on vital body processes.  This can affect our health and well-being the next day and long term.

What happens if you don’t get enough sleep?

If your body doesn’t get a chance to properly recharge – by cycling through REM and NREM – you’re already starting the next day at a disadvantage. You might find yourself:

  • Feeling drowsy, irritable or sometimes depressed
  • Struggling to take in new information at work, remembering things or making decisions
  • Craving more unhealthy foods, which could cause weight gain1

We have all heard about the importance of sleeping well, and we’ve all experienced the feeling of being refreshed after a good night’s sleep, or the feeling of fatigue after a poor night’s sleep. Even though we know this, in our busy society, many of us are not getting the quality sleep needed to truly receive its health benefits.

Here are a few reasons to catch more ZZZZs.

Healthy Brain Function and Emotional Well-Being

Sleep helps your brain work properly. While you’re sleeping, your brain is preparing for the next day. It’s forming new pathways to help you learn and remember information.

Studies show that a good night’s sleep improves learning. Whether you’re learning math, how to play the piano, how to perfect your golf swing, or how to drive a car, sleep helps enhance your learning and problem-solving skills. Sleep also helps you pay attention, make decisions, and be creative.

Studies also show that sleep deficiency alters activity in some parts of the brain. If you’re sleep deficient, you may have trouble making decisions, solving problems, controlling your emotions and behavior, and coping with change. Sleep deficiency also has been linked to depression, suicide, and risk-taking behavior.

Children and teens who are sleep deficient may have problems getting along with others. They may feel angry and impulsive, have mood swings, feel sad or depressed, or lack motivation. They also may have problems paying attention, and they may get lower grades and feel stressed.

Physical Health

Sleep plays a significant role in your physical health. For example, sleep is involved in healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke.

Sleep deficiency also increases the risk of obesity. For example, one study of teenagers showed that with each hour of sleep lost, the odds of becoming obese went up. Sleep deficiency increases the risk of obesity in other age groups as well.

Sleep helps maintain a healthy balance of the hormones that make you feel hungry (ghrelin) or full (leptin). When you don’t get enough sleep, your level of ghrelin goes up and your level of leptin goes down. This makes you feel hungrier than when you’re well-rested.

Sleep also affects how your body reacts to insulin, the hormone that controls your blood glucose (sugar) level. Sleep deficiency results in a higher than normal blood sugar level, which may increase your risk for diabetes.

Sleep also supports healthy growth and development. Deep sleep triggers the body to release the hormone that promotes normal growth in children and teens. This hormone also boosts muscle mass and helps repair cells and tissues in children, teens, and adults. Sleep also plays a role in puberty and fertility.

Your immune system relies on sleep to stay healthy. This system defends your body against foreign or harmful substances. Ongoing sleep deficiency can change the way in which your immune system responds. For example, if you’re sleep deficient, you may have trouble fighting common infections.

Daytime Performance and Safety

Getting enough quality sleep at the right times helps you function well throughout the day. People who are sleep deficient are less productive at work and school. They take longer to finish tasks, have a slower reaction time, and make more mistakes.

After several nights of losing sleep—even a loss of just 1–2 hours per night—your ability to function suffers as if you haven’t slept at all for a day or two.

Lack of sleep also may lead to microsleep. Microsleep refers to brief moments of sleep that occur when you’re normally awake.

You can’t control microsleep, and you might not be aware of it. For example, have you ever driven somewhere and then not remembered part of the trip? If so, you may have experienced microsleep.

Even if you’re not driving, microsleep can affect how you function. If you’re listening to a lecture, for example, you might miss some of the information or feel like you don’t understand the point. In reality, though, you may have slept through part of the lecture and not been aware of it.

Some people aren’t aware of the risks of sleep deficiency. In fact, they may not even realize that they’re sleep deficient. Even with limited or poor-quality sleep, they may still think that they can function well.

Drowsy drivers may feel capable of driving. Yet, studies show that sleep deficiency harms your driving ability as much as, or more than, being drunk. It’s estimated that driver sleepiness is a factor in about 100,000 car accidents each year, resulting in about 1,500 deaths.

Drivers aren’t the only ones affected by sleep deficiency. It can affect people in all lines of work, including health care workers, pilots, students, lawyers, mechanics, and assembly line workers.

As a result, sleep deficiency is not only harmful on a personal level, but it also can cause large-scale damage. For example, sleep deficiency has played a role in human errors linked to tragic accidents, such as nuclear reactor meltdowns, grounding of large ships, and aviation accidents

Get help

If you are shorting your sleep night after night, it places a tremendous strain on your nervous system, body and overall health. Damage from sleep deficiency can occur in an instant (such as a car crash), or it can harm you over time. For example, ongoing sleep deficiency can raise your risk for some chronic health problems. It also can affect how well you think, react, work, learn, and get along with others.

So, if you’re not sleeping well or aren’t feeling rested when you wake up in the morning, it’s important to talk to your doctor and ask if a sleep study is right for you.  To find a healthcare provider who is practiced in helping you get a good night’s rest, go to HealthLynked.com.  In our first of its kind healthcare ecosystem, you will find physicians and advice to help you stop counting sheep!

Sign up for Free and start taking control of your health today!

 

Is Workaholism Destroying Your Health and Your Career?

Our society is obsessed with the concept we all must be the best at what we do, and overworking or becoming a ‘workaholic’ sometimes seem the best means to achieving that goal. While researchers and psychologists have been arguing for decades about what constitutes “workaholism” and whether it is a disorder at all, the term started being thrown around in the 1970s.  Since then, mountains of evidence have piled up showing workaholics display many of the same characteristics as those addicted to drugs or alcohol, such as engaging in compulsive behaviors that are ultimately destructive.

Today, there are more ways to overwork yourself than ever, and few leaders will discourage it.  Surveys  consistently show at least one-third of Americans are chronically overworked. According to the current OECD Better Life Index, the United States ranks 30 out of 38 advanced nations in the category of “work-life balance”.  While refusing vacation time, eating lunch at your desk or never shutting off your work email might seem like smart ways to impress the boss, they also could have dire consequences for your health down the road.

The research is pretty cut and dry when it comes to the effects of workaholism on mental health. 32.7 percent of workaholics met ADHD criteria, compared to 12.7 percent of non-workaholics. 25.6 percent of workaholics met OCD criteria, compared to 8.7 percent of non-workaholics. 33.8 percent of workaholics met anxiety criteria, compared to 11.9 percent of non-workaholics. And 8.9 percent of workaholics met depression criteria, compared to 2.6 percent of non-workaholics.

Consider two more facts:

  • People who work eleven hours per day rather than eight have a 67% increased risk of developing heart disease.
  • Those who work more than 50 hours per week are three times more likely to develop an alcohol-abuse problem.

Those are some pretty damning numbers.   The problem is, workaholism is the rare mental health issue that can often have positive rewards in the short term — things like the praise of a happy boss or increased income. For these reasons, psychologist Bryan Robinson once called workaholism “the best-dressed mental health problem.”

So, if you’re trying to wean yourself off your work addiction but are just having a little difficulty, here are some things to keep in mind.

Not taking vacations hurts your career.

Almost three-quarters of American workers don’t use all their vacation time and less than half take the time to plan out their vacations each year, according to Project: Time Off –  sponsored by the U.S. Travel Association. As a result, they end up burning valuable time.

By forfeiting 658 million unused vacation days, workers cost the US economy an estimated $223 billion in total economic impact and 1.6 million jobs. That makes ditching vacation both one of the most costly and common ways Americans overwork themselves.

Workers that don’t take vacation were also found to be less productive and score lower on performance reviews.

According to a new study published in the Journal of Management, there is a significant difference between being engaged at work and being addicted to it. While the former is characterized by hard work because the employee is passionate about the job, the latter is often motivated by negative feelings like guilt, fear and compulsion.

Your brain needs breaks.

So, you are totally engaged, but do you leave time to take a much needed break or two during the day? Giving your brain some down time is essential to increasing productivity. A recent study found that the ideal work-to-break ratio should be 52 minutes of work followed by a 17-minute break.

The study is backed up by several others that have found giving your brain some time to relax and day dream increases productivity, problem-solving and creativity.

Eating lunch at your desk is bad for you.

For one, a lunch break is a perfect time to recharge your gray matter.  Also, the physical activity of getting up and away from your desk can help   improve productivity and stave off obesity.  A U.K. study found that people who ate more meals at work were more likely to be overweight.

What’s more, experts agree that grabbing lunch with co-workers and clients can be a great way to network and further your career.  It is also important to note skipping lunch altogether is maybe the worst thing you can do.

Constantly checking email wastes your life.

No matter what you tell yourself, constantly being on your work email isn’t helping your state of mind or your productivity. A 2012 study found  when workers were forced to take a five-day break from work email they  experienced less stress and became more efficient at completing work tasks. The hiatus even led to workers having “more natural, variable heart rates.”

Workers who answer emails late in to the evening were also more likely to be exhausted the next day and hence less engaged, two 2014 studies found.

You’re probably hurting your relationship.

Being addicted to work can cause serious rifts between partners in romantic relationships. Since workaholism can be thought of as being similar to substance addiction, workaholics often prioritize their job over their friends and family. For example, those addicted to work can leave a disproportionate amount of domestic duties to spouses who have a more balanced approach to their careers.

Marriages involving a workaholic are twice as likely to end in divorce, a 1999 study found. For those that stay together, the psychological damage can be considerable. Kids of workaholics have been found to experience greater levels of depression and anxiety than the children of alcoholics.

You can’t keep it up forever.

In short, workaholics burn out. What may begin as simply spending a few extra hours at the office every week can quickly spiral into much more destructive behavior because workaholics don’t take the time to give themselves a break, CNNMoney reports. All that nonstop activity can result in bad personal habits and ultimately lead to what one expert called “incapacitating ‘burnout.’”  What’s more, studies have shown that limiting workers to a 40-hour week is the best way to maintain long-term productivity.

It’s bad for your co-workers and employers.

Having workers who take on too much stress, as workaholics often do, isn’t just bad for the employee — it’s bad for companies and co-workers, too. Businesses lose an estimated $300 billion in productivity due to stress each year, according to the World Health Organization.

But that stress can also have collateral damage on co-workers. Since workaholics tend to be perfectionists, they can often put added , often unnecessary stress on their colleagues, according to experts.

And even worse for you.

In short, workaholism has been linked with a laundry list of disorders, including alcoholismsleep problems, heart disease, depression and anxiety, weight gainhigh blood pressure and even premature death.

Here are a few tips you can implement to begin a much healthier relationship with your work:

Make Relaxation Part of Your Day

Learning to work smarter, not longer, will increase productivity and help to eliminate the potential disastrous results from being overworked. Take a break for a few minutes at a time each day and relax periodically. You should relax by physically slowing down. Take deeper breaths, drink more water, take a walk outside. All of these things will help you to relax your body and your mind and will make you more productive.

Condense Your Workload

Give yourself a set amount of time to work each day and each week; then stick to it. You’ll find yourself becoming more productive during the time you actually work, because you have to get your stuff done faster. To help you stick with your new schedule, set appointments for 30 minutes after you’re supposed to be done. So, if you tell yourself you’re absolutely going to stop working at 5 p.m., set an appointment for 5:30 p.m. and stick to it. Make it a barber or beauty shop, or an appointment with your spouse or kids or workout partner. Whatever you do, stick to it.

Have Set Email and Social Media Times

Don’t allow yourself to be available to the world every minute of the day. Set times when you will check and respond to email. You really don’t need to be connected all the time. Now, take the time that you save from responding to email, and claim it by reducing your work hours. Also, now that you’re not being interrupted all the time, you can focus more.

Don’t Skip the Vacation

Taking the occasional vacation for a few days at a time can help you physically and emotionally recharge. If you can’t afford your dream vacation, more affordable mini vacations or stay-cations can be the answer. Take a day off to go hiking or sightseeing. Visit a relative within driving distance for the weekend. Pretend you’re a tourist in your own city and visit some attractions. Take the family camping.

Whatever your vacation idea, schedule it on your calendar and plan for it in advance. The payoff is greater balance between your personal and professional lives as well as delivering the emotional lift of something to look forward to. Your business will survive without you, so leave the laptop at home.

To avoid becoming one of the statistics from above, there are resources available for those who feel they may be losing the ability to balance their personal and work lives.   For example, Workaholics Anonymous is a 12-step program based on the one designed for recovering alcoholics. It’s just one of many ways people can learn to set clear boundaries between the office and the home, according to CNNMoney.

Finally, if you are looking for a health professional who might help you find a really great work life balance, you can find them using HealthLynked. It is the first of its kind medical network built as a social ecosystem with a Higher Purpose – Improving HealthCareGo to HealthLynked.com to sing up for free and find our additional resources on mental health information.

 

Why Being A Workaholic Is Awful For You AND Everyone Around You, Harry Bradford, Huffington Post

Being a Workaholic is Bad For Your Health, Scott And Heidi Shimberg, 28 May 2015

 

Why is it Important to Know My Family Health History?

Family Health History: Why It’s Important and What You Should Know
Why is it important to know my family history?

by Kimberly Holland

Family members share more than similar appearance. You may recognize that you have your father’s curly hair or your mother’s button nose. Thank goodness my kids got my wife’s food looks. What is not so easy to see is that your great-grandmother passed along an increased risk for both breast and ovarian cancer.

That’s why discovering and knowing your family health history is vitally important. Your medical history includes all the traits your family shares you can’t see. These traits may increase your risk for many hereditary conditions and diseases, including:

• cancer
• diabetes
• asthma
• heart disease and blood clots
• Alzheimer’s disease and dementia
• arthritis
• depression
• high blood pressure and high cholesterol

Whose history do I need?

The general rule for family health history is that more is better. First, you’ll want to focus on immediate family members who are related to you through blood. Start with your parents, siblings, and children. If they’re still alive, grandparents are another great place to start. They may know partial histories of many members of your family.

You can also gather information from your aunts and uncles, and other blood relatives. Once you move beyond this core circle of family, genetic makeups change so greatly that you may not be able to learn much about your own risk. Still, keep information handy for any family members you learn about during your search for medical history. It may be helpful down the road.

How can I gather this information?

Talking about health may not come naturally to you or your family. You can start the conversation by letting your family members know why you want to gather health information. Also, let them know that you’re willing to share information with them, so that you can all have more complete health histories. It may be easier to start out by having one-on-one conversations.

Get the right information

When you’re ready to gather family health history information, keep these things in mind:

Major medical issues: Ask about every major medical issue anyone in close relation to you has been diagnosed with. In this fact-finding stage, nothing is too small, though issues are only significant if the cause was genetic. Lyme disease, injuries, and other things caused by external factors can’t be inherited.
Causes of death: Find out the cause of death for any family members who’ve passed away. That might provide a clue to your family medical history, too.
Age of onset: Ask when each family member was diagnosed with each condition. This may help your doctor recognize the early onset of certain diseases.
Ethnic background: Different ethnicities have varying levels of risk for certain conditions. As best you can, identify your ethnic background to help spot potential health risks.
Environment: Families share common genes, but they also share common environments, habits, and behaviors. A complete family history also includes understanding what factors in your environment could impact your health.

5 questions to ask

Here are some questions you can ask to start the conversation:

  1. How old was my relative when they died, and what was the cause of death?
  2. Are there health problems that run in the family?
  3. Is there a history of pregnancy loss or birth defects in my family?
  4. What allergies do people in my family have?
  5. What is my ethnicity? (Some conditions are common among certain ethnicities.)

What should I do with this information?

Knowing your own health history is important, and sharing it with your doctor may be more important. That’s because your doctor can help you interpret what it means for your current lifestyle, suggest prevention tips, and decide on screening or testing options for conditions you may be more at risk for developing.

The genes you’re born with can’t be changed or altered. If you know your family history, you’re one step ahead of the game. You can take the initiative to adopt healthier lifestyle habits. For example, you could decide to stop smoking or drinking alcohol, or to start exercising regularly and maintaining a healthy weight. These lifestyle changes may reduce your chances for developing hereditary conditions.

Is incomplete information still useful?

Even a family health history that’s incomplete is still useful to your doctor. Share any information you have with them.

For example, if you know that your sibling was diagnosed with colon cancer at age 35, your doctor may suspect a possible genetic issue. They may then decide it’s important that you have regular colon cancer screenings before the recommended age of 50. Your doctor may also suggest you undergo genetic counseling or testing to identify any genetic risks.

What if I was adopted

Environment plays an important part in your health history, and you can get the details for this from your adoptive family. Learning more about your birth family’s health history may require a large investment of time and energy.

Ask your adoptive parents if they have any information about your birth parents. It’s possible family health history information was shared during the adoption process. If not, ask the agency that arranged the adoption if they retained any personal health history information for your birth parents. Understand your state’s statutes before you begin requesting adoption history information.

If all of these avenues come up short, you may need to make a choice about seeking out your birth parents. You may not wish to pursue that route, or you may be unable to connect with them. In that case, alert your doctor to your personal history. The two of you can then work to identify ways to screen for and detect your risk of certain conditions.

What if I’m estranged from my family?

If you’re estranged from only part of your family, you can try a few things to collect your family health history:

Talk to the family members you’re connected with. You may not need to reconnect with your whole family to collect your family health history.
Reach out via your doctor. Some medical offices may be able to send out questionnaires to family members asking for information in an official capacity. This may prompt people to respond.

Do some research. You may be able to discover the cause of death of your relatives from death certificates. Search online to find state-specific death records or check ancestry sites for this information. Obituaries, often available online or archived by public libraries, might also provide health information.

What about genetic testing and genetic predisposition?

Certain ethnic backgrounds and races may be predisposed to conditions for which a genetic test is useful. For example, women of Ashkenazi Jewish ancestry have an increased risk for breast cancer. A specific gene mutation is more common in these women than in other women. Genetic screening may help your doctor detect this gene mutation and prepare you for treatment options early.

Although genetic tests can help identify potential risks you may have inherited for a specific disease, they don’t guarantee you’ll develop that disease. Results may show you have a predisposition to several conditions. While you may never actually develop any of these, you might feel the added anxiety isn’t worth the knowledge. Seriously consider the benefits and concerns you may have with knowing your genetic risk factors before you do any testing.

How do I record the details?

Make sure you write down or electronically document the health information your relatives provide. You can use HealthLynked for this. Just complete one profile per family member whose medical records you are responsible for and have other family members complete and share their own with you.

Outlook

Knowing your health history helps you to be more proactive about your health. Share this information with your doctor so they can screen early for conditions you’re predisposed to and suggest lifestyle choices that can help reduce your risk.



Also talk to your doctor if you need more help figuring out how to uncover your health history or what questions you should ask. If you don’t have one you depend on today, you might find a great physician using the first of its kind social ecosystem designed specifically for everything described in the article.

Ready to get Lynked? Go to HealthLynked.com now to start compiling your medical history and sharing with those you choose, for Free, today!

Source

 

UV Exposure: Why Do We Ignore the Health Risks?

 

Published Thursday 17 July 2014

By Honor Whiteman

The sun is shining, so what are your plans? For many of us, the answer will be to hit the beach and soak up the rays. But while you are busy packing beachwear and towels, are you considering the dangers of sun exposure?

Exposure to ultraviolet (UV) radiation – from the sun, tanning beds, lamps or booths – is the main cause of skin cancer, accounting for around 86% of non-melanoma and 90% of melanoma skin cancers. In addition, excessive UV exposure can increase the risk of eye diseases, such as cataract and eye cancers.

The health risks associated with exposure to UV radiation have certainly been well documented, so much so that the World Health Organization (WHO) have now officially classed UV radiation as a human carcinogen.

This year alone, Medical News Today reported on an array of studies warning of UV exposure risks. One study, published in the journal Pediatrics, revealed that tanning bed use among youths can increase the risk of early skin cancer, while other research found that multiple sunburns as an adolescent can increase melanoma risk by 80%.

Furthermore, in response to reported health risks, the Food and Drug Administration (FDA) recently changed their regulation of tanning beds, lamps and booths. Such products must now carry a visible, black-box warning stating that they should not be used by anyone under the age of 18.

How does UV radiation cause damage?

UV radiation consists of three different wavebands: UVA, UVB and UVC. The UVC waveband is the highest-energy UV but has the shortest wavelength, meaning it does not reach the earth’s surface and does not cause skin damage to humans.

However, UVA has a long wavelength and accounts for 95% of solar UV radiation that reaches the earth’s surface, while UVB – with a middle-range wavelength – accounts for the remainder. Tanning beds and tanning lamps primarily emit UVA radiation, sometimes at doses up to 12 times higher than that of the sun.

Both UVA and UVB radiation can damage the skin by penetrating its layers and destroying cellular DNA. UVA radiation tends to penetrate deeper layers of skin, known as the dermis, aging the skin cells and causing wrinkles. UVB radiation is the main cause of skin reddening or sunburn, as it damages the outer layers of the skin, known as the epidermis.

Excessive UV exposure can cause genetic mutations that can lead to the development of skin cancer. The browning of the skin, or a tan, is the skin’s way of trying to stop further DNA damage from occurring.

Of course, it is not only the skin that can be subject to damage from UV radiation. Bright sunlight can penetrate the eye’s surfaces tissues, as well as the cornea and the lens.

Ignoring the risks of UV exposure

But regardless of the numerous studies and health warnings associated with UV exposure, it seems many of us refuse to take note.

A 2012 survey from the Centers for Disease Control and Prevention (CDC) found that 50.1% of all adults and 65.6% of white adults ages 18-29 reported suffering sunburn in the past 12 months, indicating that sun protection measures are not followed correctly, if at all.

A more recent study from the University of California-San Francisco stated that the popularity of indoor tanning is “alarming” – particularly among young people.

The study revealed that 35% of adults had been exposed to indoor tanning, with 14% reporting tanning bed use in the past year. Even more of a concern was that 43% of university students and 18% of adolescents reported using tanning beds in the past year.

Overall rates of tanning bed use, the researchers estimate, may lead to an additional 450,000 non-melanoma and 10,000 melanoma skin cancer cases every year.

It seems unbelievable that so many of us are willing to put our health at risk to soak up some sunshine. So why do we do it?

The desire for a ‘healthy tan’

A recent study published in the journal Cell suggested that UV radiation causes the body to release endorphins – “feel-good” hormones – which makes sun exposure addictive.

But Tim Turnham, executive director of the Melanoma Research Foundation, told Medical News Today that many people simply favor a tanned body over health:

“Despite elevated awareness of the dangers of UV radiation, people still choose to ignore the dangers in the pursuit of what they consider to be a ‘healthy tan.’ This is particularly an issue among young people who tend to ignore health risks in favor of enhancing their social status and popularity. We know that tanning appeals to people who are interested in being included, and this is a primary driver for teens – being part of the ‘in’ crowd.”

Anita Blankenship, health communication specialist at the CDC, told us that the desire for a tan is particularly common among young women.

“In the US, nearly 1 in 3 young white women ages 16-25 years engages in indoor tanning each year,” she said. “These young women may experience pressure to conform to beauty standards, and young people may not be as concerned about health risks.”

Turnham agreed, telling us that the indoor tanning industry specifically targets this population. “Aggressive marketing, deep discount and package deals are used routinely by tanning salons, who market their services preferentially to young women,” he said.

Blankenship added that the public are also presented with “conflicting messages” when it comes to the safety of excess UV exposure. She pointed out that a recent US report found that only 7% of tanning salons reported any harmful effects from tanning beds, booths or lamps, while 78% reported health benefits.

“It is important to monitor deceptive health and safety claims about UV exposure, as they may make it difficult for consumers to adequately assess risk,” she told us. “It is important for people to understand that tanned skin is damaged skin, and that damage can lead to wrinkles and early aging of the skin, as well as skin cancer including melanoma – the kind of skin cancer that leads to the most deaths.”

Progress has been made, but more needs to be done

This month is UV Safety Month – an annual campaign that aims to increase public awareness of the health implications caused by UV exposure.

With the help of such campaigns and an increase in studies detailing UV risks, many health care professionals believe there has been a change for the better in attitudes toward UV exposure.

Many health care professionals believe much progress has been made in increasing awareness of UV exposure risks in recent years, but more needs to be done.

“Certainly the scientific community, a number of federal agencies, and possibly the general public are more aware of the risk of UV exposure,” a spokesperson from the National Cancer Institute (NCI) told Medical News Today.

“Action and more coordinated efforts increased markedly about 4 years ago, when a number of epidemiological studies documented the harms of indoor tanning, the FDA held their scientific advisory committee meeting to discuss need for changing indoor tanning device regulations, and they also acted on their previous proposals to change sunscreen regulations.”

The spokesperson continued:

“We think these summaries acted as a catalyst for efforts to make the public and policy makers aware of the risks of indoor tanning, and also they gave a boost to efforts to increase awareness of outdoor sun exposure risks and encourage sun safe protective behaviors.”

In addition, some studies have indicated that many youngsters may even be moving away from the use of tanning beds. A recent Youth Risk Behavior Survey found that among high school students, indoor tanning activity decreased from 15.6% in 2009 to 12.8% in 2013.

Turnham told us that since sunless tanning – such as the use of spray tans – is on the increase, it may be that youngsters are using this as an alternative to tanning salons. But the NCI spokesperson said such an association needs to be investigated before any conclusions can be reached:

“We do not know if changes in indoor tanning are related to increases in use of spray-on and sunless tanning products and services,” they told us. “Some studies indicate that sunless products and services are used by people who continue to engage in indoor tanning, but it is an area we continue to research. We are hopeful that we will be able to measure this in an upcoming national survey supplement that is being developed by NCI and CDC.”

But despite widespread efforts to increase UV safety awareness, Turnham believes there is still a lot more that can be done to protect public health:

“Regulators could and should do much more to fight the ravages of UV exposure. We need federal legislation banning the use of tanning beds by minors. We need more funding for awareness and prevention efforts.”

He added that doctors can also play a role in increasing UV exposure awareness by warning patients of associated risks – something the US Preventive Services Task Force (USPSTF) recommend. They state that health care providers should counsel fair-skinned youths between the ages of 10 and 24 about the risks of indoor tanning and how to protect themselves against UV radiation from the sun.

However, Turnham noted that doctors do not have much time with each patient and proposes that signage in waiting areas warning of the risks of UV exposure may also be effective.

Protecting against UV radiation

Whether there will be further regulation for indoor tanning or an increase in awareness efforts is unclear. But one thing is certain: we can help ourselves to avoid the negative health implications associated with UV exposure.

The American Cancer Society notes young children need extra protection from the sun, as they spend more time outside and can burn easily.

The CDC recommend the following for protecting against UV radiation:

  • Stay in the shade if possible, particularly when the sun is at its strongest – usually around midday
  • Wear clothing that covers your arms and legs
  • Wear a wide-brimmed hat that provides shade for your head, face, ears and neck
  • Wear wrap-around sunglasses that protect against both UVA and UVB radiation
  • Use sunscreen with a minimum sun protection factor (SPF) of 15 that protects against UVA and UVB radiation, and reapply every 2 hours
  • Avoid indoor tanning.

In addition, the American Cancer Society notes young children need extra protection from the sun as they spend more time outside and can burn easily. They add that babies younger than 6 months should be kept out of direct sunlight and be covered with protective clothing. Sunscreen should never be used on an infants skin.

As  we embark on the glorious, sunny days of the summer season and enter into the Fourth of July Celebration, let’s do all we can to protect ourselves and our little ones from UV rays’ potential threats to our skin. Remember, UV rays are the major causes of several deadly skin cancers and sunscreen is one of the most easy and accessible ways to protect against them. So, get out those sunscreen tubes and cover your head with a hat and your eyes with some shades because sun protection is trending today and everyday!

And, if you do find an odd spot on your body’s biggest organ, you can use HealthLynked to find a great physician near you and get the help you need.  Simply go to HealthLynked.com and sign up for free, then Connect and collaborate through HealthLynked to heal your skin!

 

Genes linked with sunburn, skin cancer risk

 

May 8, 2018

Certain genes can determine which people are more at risk of getting sunburn and possibly develop skin cancer as a result..

In a trawl of the genetics of nearly 180,000 people of European ancestry in Britain, Australia, the Netherlands and United States, researchers found 20 sunburn genes.

Eight of the genes had been associated with skin cancer in previous research, according to findings published in the journal Nature Communications.

And in at least one region of the genome, “we have found evidence to suggest that the gene involved in melanoma risk… acts through increasing susceptibility to sunburns,” co-author Mario Falchi of King’s College London told AFP.

Sun exposure is critical for the body’s production of vitamin D, which keeps bones, teeth, and muscles healthy, and which scientists say may help stave off chronic diseases, even cancer.

But too much can be painful in the short-term, and dangerous for your health.

The new study, which claims to be the largest to date into the genetics of sunburn, helps explain why people with the same skin tone can have such different reactions to exposure to sunlight—some burn red while others tan brown.

It may also begin to explain factors in skin cancer risk.
“It is necessary to explore these genes in more detail, to understand the mechanism by which they contribute to propensity to burn,” said Falchi.

In future, the research may help identify people at risk, through genetic testing.

“People tend to ‘forget’ that sunburns are quite dangerous,” said Falchi.

“Given the rise in incidence in skin cancer, we hope that knowing there is a genetic link between sunburn and skin cancer may help in encouraging people to lead a healthy lifestyle.”

More information: Genome-wide association study in 176,678 Europeans reveals genetic loci for tanning response to sun exposure, Nature Communications (2018).
nature.com/articles/doi:10.1038/s41467-018-04086-y
Journal reference: Nature Communications

Millennials aren’t getting the message about sun safety and the dangers of tanning

Many millennials lack knowledge about the importance of sunscreen and continue to tan outdoors in part because of low self-esteem and high rates of narcissism that fuel addictive tanning behavior, a new study from Oregon State University-Cascades has found.

Lead author Amy Watson and her colleagues found that those with higher levels of self-esteem were less likely to tan, while those with lower self-esteem and higher levels of narcissism were more likely to present addictive tanning behavior. The motivation for the addictive tanning behavior was the perception of improved appearance.

“This study gives us a clearer understanding of actual consumer behavior,” said Watson, an assistant professor of marketing at OSU-Cascades. “The number of people still deliberately exposing their skin to the sun for tanning purposes is alarming. We need to find new ways to entice people to protect their skin, including challenging the ideal of tan skin as a standard of beauty.”

The findings were published recently in the Journal of Consumer Affairs. Co-authors are Gail Zank and Anna M. Turri of Texas State University.

Skin cancer is the most common type of cancer worldwide, with more than 3.5 million cases diagnosed annually. Melanoma cases among women rose sharply between 1970 and 2009, with an 800 percent increase among women 18 to 39.

In an effort to improve consumer education about the role of sunscreen in the prevention of skin cancer, the Centers for Disease Control and the Food and Drug Administration developed a new “Drug Facts” panel of information now required on all sunscreen bottles. The panel includes directions for sunscreen use and advice on other sun protection measures, among other information.

The researchers’ goal with the study was to gauge whether the information on this new label is effective at curbing tanning behavior and if new information is helping to increase consumer knowledge about how and when to use sunscreen and how much to use.

The study of 250 college students, most between 18 and 23 years old, measured their sun safety knowledge and included: questions about their beliefs regarding sunscreen effectiveness and ultraviolet light exposure danger; questions about tanning motivation and behavior; an assessment of tanning addiction; and personality questions relating to self-esteem, narcissism, appearance and addictive behavior.

The study participants, 47 percent male and 53 percent female, scored an average of 54 percent on an 11-question sun safety knowledge test, which included true/false statements such as: “On a daily basis I should use at least one ounce of sunscreen on exposed skin” (true); and “When applied correctly, SPF 100 is twice as effective as SPF 50” (false).

About 70 percent of the study participants reported purposefully exposing their skin to the sun to achieve a tan. About a third of the participants reported that having a tan is important to them, while about 37 percent said they feel better with a tan, and 41 percent indicated that having a tan makes them more confident in their appearance

The participants’ levels of tanning addiction were measured through questions such as “I get annoyed when people tell me not to tan,” and “I continue to tan knowing that it is bad for me,” and “I feel unattractive or anxious to tan if I do not maintain my tan.”

The researchers found that those with lower self-esteem and higher narcissism rates were also more likely to exhibit addictive tanning behavior. They found no evidence that increased knowledge about sun safety leads to lower levels of addictive tanning.

“What we found is that this knowledge doesn’t matter to the consumers,” Watson said. “That tactic to require sunscreen manufacturers to include this information is not effective.”

Sun safety and sunscreen messaging from the CDC is all statistics-based, emphasizing the likelihood of a skin cancer occurrence or diagnosis, Watson said. But that type of message isn’t resonating with millennials. The next step for Watson and her colleagues is to begin testing other types of messages to identify ways millennials would respond more positively to sun safety measures.

“People are starting to get the message about the dangers of using tanning beds, but a large number of people are still tanning outdoors, deliberately exposing their skin to the sun, because they think it’s attractive,” she said.

“We need to move away from the narrative where tan skin is associated with health and youth. That’s the opposite of reality. Because reality is tan skin is damaged skin.”

More information: Amy Watson et al, I Know, but I Would Rather Be Beautiful: The Impact of Self-Esteem, Narcissism, and Knowledge on Addictive Tanning Behavior in Millennials, Journal of Consumer Affairs (2018). DOI: 10.1111/joca.12179
Provided by: Oregon State University

Here comes the sun, and kid sun safety

(HealthDay)—Summer sun brings childhood fun, but experts warn it also brings skin cancer dangers, even for kids.

“Don’t assume children cannot get skin cancer because of their age,” said Dr. Alberto Pappo, director of the solid tumor division at St. Jude Children’s Research Hospital in Memphis, Tenn. “Unlike other cancers, the conventional melanoma that we see mostly in adolescents behaves the same as it does in adults.”

His advice: “Children are not immune from extreme sun damage, and parents should start sun protection early and make it a habit for life.”

So, this and every summer, parents should take steps to shield kids from the sun’s harmful UV rays.

Those steps include:

* Avoid exposure. Infants and children younger than 6 months old should avoid sun exposure entirely, Pappo advised. If these babies are outside or on the beach this summer, they should be covered up with hats and appropriate clothing. It’s also a good idea to avoid being outside when UV rays are at their peak, between 10 a.m. and 2 p.m.

* Use sunscreen. It’s important to apply a broad-spectrum sunscreen to children’s exposed skin. Choose one with at least SPF15 that protects against both UVA and UVB rays. Pappo cautioned that sunscreen needs to be reapplied every couple of hours and after swimming—even if the label says it is “water-resistant.”

However, sunscreen should not be used on infants younger than 6 months old because their exposure to the chemicals in these products would be too high, he noted.

* Keep kids away from tanning beds. Melanoma rates are rising among teenagers, partly due to their use of indoor tanning beds. Use of tanning beds by people younger than 30 boosts their risk for this deadly form of cancer by 75 percent, according to the International Agency for Research on Cancer.

* Get children screened. Early detection of melanoma is key to increasing patients’ odds of survival. Children with suspicious moles or skin lesions should be seen by a doctor as soon as possible, Pappo advised. Removing melanoma in its early stages also increases the chances of avoiding more invasive surgical procedures later on, he added.

More information: There are more sun-safety tips at the Skin Cancer Foundation.

The Beat Goes On | Heart Transplants Still a Marvel of Modern Medicine

On this day in 2001, a petite 44-year-old woman received a successful heart transplant at Ronald Reagan UCLA Medical Center, thanks to an experimental Total Artificial Heart designed for smaller patients.

The UCLA patient was the first person in California to receive the smaller Total Artificial Heart, and the first patient in the world with the device to be bridged to a successful heart transplant — that is, to go from needing a transplant to receiving one.

The 50cc SynCardia temporary Total Artificial Heart is a smaller investigational version of the larger 70cc SynCardia heart, which was approved for use in people awaiting a transplant by the Federal Food and Drug Administration in 2004 and has been used by more than 1,440 patients worldwide.

The 50cc device is designed to be used by smaller patients — including most women, some men and many adolescents — with end-stage biventricular heart failure, where both sides of the heart are failing to pump enough blood to sustain the body. The device provides mechanical support until a donor heart can be found

Nemah Kahala, a wife and mother of five, was transferred to UCLA from Kaiser Permanente Los Angeles Medical Center in March.  She was suffering from restrictive heart muscle disease and in critical condition.  Her heart failure was so advanced that repair surgery and other mechanical assist devices could not help.

Kahala was placed on a life support system called extra corporal membrane oxygenation, but this only works for about 10 days before a person’s organs begin to deteriorate.

With the clock ticking, doctors needed to buy time by replacing Kahala’s failing heart with an artificial heart while she waited for a heart transplant.  Her chest cavity was too small for her to receive the larger 70cc artificial heart.  However, under a one-time emergency use permitted under FDA guidelines, her doctors were able to implant the experimental 50cc device.

“Mrs. Kahala’s condition was deteriorating so rapidly that she would have not survived while waiting for a transplant,” said her surgeon, Dr. Abbas Ardehali, a professor of cardiothoracic surgery and director of the UCLA Heart and Lung Transplant Program. “We were grateful to have this experimental technology available to save her life and help bridge her to a donor heart.”

The artificial heart provides an immediate and safe flow of blood to help vital organs recover faster and make patients better transplant candidates.

After the two-hour surgery to implant the artificial heart, Kahala remained hospitalized in the intensive care unit and eventually began daily physical therapy to help make her stronger for transplant surgery.

Two weeks after the total artificial heart surgery, she was strong enough to be placed on the heart transplant list.  After a week of waiting, a donor heart was found.

“In addition to the high-tech medicine that kept her alive, Mrs. Kahala and her family exemplified how a solid support system that includes loved ones and a compassionate medical team practicing what we at UCLA have termed ‘Relational Medicine’ plays an important role in surviving a medical crisis,” said Dr. Mario Deng, professor of medicine and medical director of the Advanced Heart Failure, Mechanical Support and Heart Transplant program at UCLA.

Kahala was discharged from UCLA on April 18.

Since 2012, the UCLA Heart Transplant Program has implanted eight 70cc SynCardia Total Artificial Hearts. UCLA also participated in the clinical study of a 13.5-pound Freedom portable driver — a backpack-sized device that powers the artificial heart, allowing the patient to leave the hospital — that received FDA approval on June 26, 2014.

The FDA cautions that in the United States, the 50cc SynCardia temporary Total Artificial Heart is an investigational device, limited by United States law to investigational use.  The 50cc TAH is in an FDA-approved clinical study.

First Fully Contained Artificial Heart

On the same day, a patient was implanted with the world’s first self-contained mechanical heart after a 7-hour operation, a hospital in Louisville, Kentucky. The procedure was the first major advance in the development of an artificial replacement heart in nearly two decades.

The device, created by Danvers, Massachusetts-based Abiomed Inc., replaces the lower chambers of a patient’s failing heart with a plastic-and-metal motorized hydraulic pump which weighs 2 pounds (1 kg) and is about the size of a grapefruit.

It was the first artificial heart to be free of wires connecting it to the outside.

“This is the first time this has ever been done,” said Kathy Keadle, a spokeswoman at Jewish Hospital where the procedure was performed by University of Louisville surgeons Laman Gray and

Neither Abiomed nor hospital officials would disclose the name, sex or gender of the patients, all of whom are seriously ill.  The long-awaited surgery had been expected by June 30 but was delayed because the company had not completed patient screening.

Abiomed got U.S. Food and Drug Administration approval in February’s 2001 to test the device on as many as 15 patients, all of whom are too ill to be candidates for a heart transplant.  Unlike existing devices, which serve as a temporary solution to extend a patient’s life until a patient can secure a donor heart, the AbioCor heart is designed to be a fully functioning replacement heart.

The trial involved severely ill patients with less than 30 days to live, said John Thero, vice president and chief financial officer of Abiomed.

“This is not a bridge to transplant. There is a scarcity of donor hearts available,” Thero said in a telephone interview. “We are starting with patients who are at the ends of their lives. They are not candidates for transplant and are near death. Our goal is to provide them with a reasonable quality of life and an extension of life.”

Thero said the current candidates had a life expectancy of two months. “While the device is designed to eventually go much longer, if we were able to double someone’s life expectancy, we would be very pleased,” he said.

The 40,000 patients awaiting heart transplants far outnumber the number of hearts available, and a successful mechanical heart could fill a huge need.

Earlier versions of the artificial heart were bulky and provided limited benefit to patients.  In 1982, Dr. Barney Clark, 61, of Salt Lake City, Utah, received the first permanent artificial heart, known as Jarvik-7. He was bound to his bed by protruding cables, tubes and a noisy box-like air compressor during the 112 days that he survived with the artificial heart.

With the Jarvik-7 and other “bridge devices,” the outside connectors leave patients exposed to infection.  The AbioCor contains a small electric motor attached to an implanted battery and is designed to last for years. Patients could wear a battery pack or plug into an electrical outlet to recharge the heart’s battery.

A Brief History of Heart Transplant

Long before human-to-human transplantation was ever imagined by the public, scientists were conducting pioneering medical and surgical research that would eventually lead to today’s transplantation successes. From the late 1700s until the early 1900s, the field of immunology was slowly evolving through the works of numerous independent scientists. Among the notable breakthroughs were Ehrlich’s discovery of antibodies and antigens, Lansteiner’s blood typing, and Metchnikoff’s theory of host resistance.

Because of advances in suturing techniques at the end of the 19th century, surgeons began to transplant organs in their lab research. At the start of the 20th century, enough experimentation had taken place to know that xenographic (cross species) transplants invariably failed, allogenic transplants (between individuals of same species) usually failed, while autografts (within the same individual, generally skin grafts) were almost always successful. It was also understood that repeat transplants between same donor and recipient experienced accelerated rejection, and that graft success was more likely when the donor and recipient shared a “blood relationship.”

Alexis Carrel was a French surgeon and Nobel laureate whose experiments involved sustaining life in animal organs outside the body. He received the 1912 Nobel Prize in Medicine or Physiology for his technique for suturing blood vessels. In the 1930s, he collaborated with the aviator Charles Lindbergh to invent a mechanical heart that circulated vital fluids through excised organs. Various organs and animal tissues were kept alive for many years in this fashion.

Throughout the 1940s and 50s, small but steady research advances were made. In 1958, Dickinson Richards, MD, chairman of the Columbia University Medical Division, and Andre Cournaud were awarded the same Nobel Prize for their work leading to fuller understanding of the physiology of the human heart using cardiac catheterization.

In that same year, Keith Reemtsma, MD, a member of the faculty of Tulane University who later became chairman of the Department of Surgery at Columbia University Medical Center, showed for the first time that immunosuppressive agents would prolong heart transplant survival in the laboratory setting.

At this time, Norman Shumway, MD, Richard Lower, MD, and their associates at Stanford University Medical Center were embarking on the development of heart-lung machines, solving perfusion issues, and pioneering surgical procedures to correct heart valve defects. Key to their success was experimentation with “topical hypothermia,” the localized hyper-cooling of the heart which allowed the interruption of blood flow and gave the surgeons the proper blood-free environment and adequate time to perform the repairs. Next came “autotransplantation,” where the heart would be excised and resutured in place.

By the mid-1960s, the Shumway group was convinced that immunologic rejection was the only remaining obstacle to successful clinical heart transplantation. In 1967, Michael DeBakey, MD, implanted an artificial left ventricle device of his design in a patient at Baylor College of Medicine in Houston.

In 1967, a human heart from one person was transplanted into the body of another by a South African surgeon named Dr. Christiaan Barnard in Cape Town. In early December, Dr. Barnard’s surgical team removed the heart of a 25-year-old woman who had died following an auto accident and placed it in the chest of Louis Washkansky, a 55-year-old man dying of heart damage. The patient survived for 18 days. Dr. Barnard had learned much of his technique from studying with the Stanford group. This first clinical heart transplantation experience stimulated world-wide notoriety, and many surgeons quickly co-opted the procedure. However, because many patients were dying soon after, the number of heart transplants dropped from 100 in 1968, to just 18 in 1970. It was recognized that the major problem was the body’s natural tendency to reject the new tissues.

Over the next 20 years, important advances in tissue typing and immunosuppressant drugs allowed more transplant operations to take place and increased patients’ survival rates. The most notable development in this area was Jean Borel’s discovery of cyclosporine, an immunosuppressant drug derived from soil fungus, in the mid 1970s.

The cardiac transplant program at Columbia University Medical Center began in 1971 as part of an investigational surgery program initiated by Dr. Keith Reemtsma. At that time, Columbia University Medical Center was one of only a handful of medical centers in the nation actively engaged in cardiac transplant research. Columbia University Medical Center’s first cardiac transplant was performed by Dr. Reemtsma in 1977, when survival rates had begun to improve significantly. That patient survived for 14 months. Two additional transplants were performed that year. Initially Columbia University Medical Center accepted patients deemed too risky for transplantation by Stanford and the Medical College of Virginia, the only other medical centers in the country performing heart transplants.

Thanks to the persistence of pioneers in immunosuppression research, transplant patients have dramatically expanded life expectancies. The first immunosuppressant drugs used in organ transplantation were the corticosteroids. In 1983, Columbia University Medical Center became one of a small group of medical centers to initiate clinical trials of cyclosporine; approved for commercial use in November of that year, it is still the most commonly prescribed immunosuppressant used in organ transplantation. General information on the variety of medications that may be prescribed for you is found in the chapter on Medications in the section Care and Concerns after Your Operation.

In 1984, the world’s first successful pediatric heart transplant was performed at Columbia on a four-year-old boy. He received a second transplant in 1989 and lived until he succumbed to other health issues in 2006.

Also, in 1984, in Loma Linda, California, Leonard Bailey, MD, implanted a baboon heart into a 12-day-old girl who came to be known as “Baby Fae.” The infant survived for twenty days as the most famous recipient of xenographic transplantation. Throughout the decade of the 1980s and into the 90s, physicians continue to refine techniques for balancing dosages of immunosuppressant medications to protect the new heart yet allow the patient sufficient immunologic function to stave off infection. In 1994 a new drug, tacrolimus or FK-506, originally discovered in a fungus sample, was approved for immunosuppression in transplant patients. Newer formulations of cyclosporine now enable efficacy (effectiveness) at lower, less toxic dosages.

While research on transplantation issues continues, other techniques for the management and cure of heart disease are also under development. Some future directions include:

Coronary assist devices and mechanical hearts are being developed or perfected to perform the functions of live tissues. Artificial hearts have been under development since the 1950s. In 1966, Dr. DeBakey first successfully implanted a booster pump as a temporary assist device. Columbia’s cardiac surgeons have been instrumental in the development of a LVAD (left ventricular assist device) to function as a bridge-to-transplantation for those waiting for a new heart to become available. Columbia University Medical Center’s lead role in the REMATCH clinical trial helped to lead to approval for the the LVAD as a permanent, or destination, therapy as well.

In 1969, Dr. Denton Cooley implanted the first completely artificial heart in a human, again on a temporary basis. The first permanent artificial heart, designed by Dr. Robert Jarvik, was implanted in 1982. Numbers of patients have received Jarvik or other artificial hearts since, but surviving recipients have tended to suffer strokes and related problems.

There is a tremendous gap in the number of patients waiting for new hearts and the number of organs that actually become available. In addition to avoiding the immunosuppression and rejection complications of transplantation, success in clinical application of such mechanical devices can help resolve the issue of organ availability and thus, stakes are high to continue research in this arena.

Advances in immunosuppression have most recently involved the development and expanded use of polyclonal and monoclonal antibodies to counteract steroid-resistant rejection. Research continues into the management, reversal and avoidance of accelerated atherosclerosis in the transplanted heart, believed to be caused or aggravated by the required suppression of the body’s normal immunology. From the development of more powerful and specific immunosuppressants to new treatments for accelerated graft atherosclerosis, advances in the science of immunology appear to hold the key to expanding the success of heart transplantation in our treatment of end-stage cardiac disease.

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Sources

UCLAnewsroom.edu

Wired.com

Columbiasurgery.org

Title:  The Beat Goes On | Heart Transplants a Marvel of Modern Medicine

 

#heart,#transplant,#immunosuppression