Care and Connection

Loneliness Affects All Ages. Human beings are social creatures. Feeling like we’re part of a community helps us thrive. But we sometimes have a hard time making and keeping the relationships that sustain us. Many Americans report feeling lonely for long periods of time. Connections with others are important for your health.Social isolation and loneliness can both cause problems. “Isolation is about whether other people are physically there or not. Being lonely is about not feeling connected to others. You can feel lonely in a room full of people,” explains Dr. Steve Cole, an NIH-funded researcher at the University of California, Los Angeles, who studies loneliness.

Loneliness not only feels bad, it may also be harmful to your health. People who feel lonely are at higher risk of many diseases. These include heart disease, high blood pressure, and Alzheimer’s disease. Loneliness may also increase the risk of death for older adults.

Some of the increased risk of disease may come from changes in behavior. People who feel isolated may not have friends or family encouraging them to eat right, exercise, or see a doctor. New research suggests that loneliness can also directly harm our health.

“Lonely people have differences in their biology that make them more vulnerable to disease,” Cole explains. He and colleagues have studied how loneliness affects the immune system, your body’s disease fighting system. They found that loneliness may alter the tendency of cells in the immune system to promote inflammation. Heat, swelling, and redness caused by the body’s protective response to injury or infection. Inflammation is necessary to help our bodies heal from injury. But when it goes on too long, it may raise the risk of chronic diseases.

People who feel lonely may also have weakened immune cells that have trouble fighting off viruses. “So that leaves lonely people more vulnerable to a variety of infectious diseases,” Cole adds.

People often associate loneliness with getting older. But you can feel lonely at any age. A recent survey found that young Americans are more likely to feel lonely than older adults. Some research suggests that social media tools and resources are preventing younger people from connecting in real life, Cole says. However, more studies are needed to know whether this is true.

It can be hard for people to talk about loneliness, Cole explains. They may feel like something is wrong with them, even though feeling lonely happens to almost everyone at some point.

NIH-funded researchers are looking into ways to help people break the cycle of loneliness. Studies have shown that feelings of loneliness can be reduced by helping others, Cole says. Caregiving and volunteering to help others may therefore help people to feel less lonely.

Having a sense of purpose in life may be another way to fight the effects of loneliness. Research has found that having a strong sense of mission in life is linked to healthier immune cells. “And when you start to pursue a goal that’s important to you, you almost always have to cooperate with others to do that,” Cole says. “That helps bring people together.”

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To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Bionic Movements

Connecting Mind and MachineWhen you lose the use of a limb, even the simplest of daily tasks can turn into a challenge. High-tech devices can help restore independence. New technologies are even making it possible to connect the mind to an artificial limb. These artificial limbs are called bionic prosthetic devicesDevices that replace a body part..

“To get back some of that lost function, you need some sort of assistive tool or technology to either enhance recovery or restore the capability of the anatomy that’s missing now,” says Dr. Nick Langhals, who oversees NIH-supported prosthetic engineering research.

This fast-moving research aims to improve people’s lives by restoring both movement and feeling.

Prosthetic Control

Traditional prosthetic devices use a body-powered harness to control a hand device. These are easy to use. With a shrug of your shoulder, the prosthetic hand or hook opens. With the release of your shoulder, the prosthesis closes. Through the feel of the cable tension across your shoulders, you know whether the prosthesis is open or closed without looking at it.

Newer, motorized hands are not as easy to learn how to use. To close the device, you contract the remaining muscles in your arm. An electrical sensor placed over those muscles detects the contraction and tells the hand to close. Since the original muscles that controlled the hand are gone, the remaining muscles must be retrained. Learning how to open and close a prosthetic hand in this way takes some time. And you still need to watch the device to know what it’s doing.

To make motorized hands more intuitive to use, researchers are developing ways to detect the electrical signals in your brain and nerves. Special tissues that carry signals between your brain and other parts of your body to help control advanced bionic prosthetics. This can be done many ways, such as by implanting tiny sensors in the parts of the brain that control movement or by attaching small electrodes. Tools that are used to carry electricity to or from different parts of the body to the amputated nerves. Either way, the patients simply think about moving their hand and computers translate it into the movements of a bionic prosthetic hand.

Two-Way Communication

To regain a sense of wholeness, a person with a bionic limb needs to do more than control the device. They also need to “feel” what it’s doing. New bionic devices can send sensation from the device back to the brain. This allows a person with a bionic device to feel like they are using their own limb.

“The most important thing about the research that we’re doing is this sense of wholeness,” says Dr. Paul Marasco, a biomedical engineering researcher at Cleveland Clinic.

One way to help a person feel their prosthetic hand is to move the remaining sensory nerves from the amputated hand to the skin of the upper arm. You can then use small robots to press on the skin of the upper arm when the hand is touching something.

Marasco’s team devised a similar system to restore the feeling of movement, too. The bionic hand sends signals to a computerized control system outside of the body. The computer then tells a small robot worn on the arm to send vibrations to the arm muscle. These vibrations deep in the muscle create an illusion of movement that tells the brain when the hand is closing or opening.

Marasco’s team tested this feedback system with several people who had a hand prosthesis. The study participants were able to operate the bionic hand and know what position it was in just as well as with their natural hand. With this feedback system, they didn’t have to look at the bionic hand to know when it was open or closed, or when it was reaching for an object.

“We fool their brains into believing that the prosthesis is actually part of their body,” Marasco says. This advancement directly taps into the way that the brain senses movement, which helps improve the two-way communication between prosthetic device and mind.

Wearable Robots

Research teams are also trying to help people who have lost the use of their legs. By wearing a robotic device called an exoskeleton, some people with leg paralysis have been able to regain the ability to walk.

A group led by Dr. Thomas Bulea, a biomedical engineer at the NIH Clinical Center, created a wearable exoskeleton for children with cerebral palsy. Cerebral palsy is a brain disorder that makes it hard to stand up straight, balance, and walk. The motorized, robotic exoskeleton changes the way the children walk by helping them straighten their knees at key points during the walking cycle. While the exoskeleton can make walking easier, children must be able to navigate at least small distances on their own to use it.

“The ultimate goal really is to have a person wear this outside of our lab, or even outside of the clinical setting,” Bulea explains. “To do that you have to have a really robust control system that makes sure that the robot is behaving properly in all different kinds of environments.”

The team is now writing software so that the robotic device can be worn while navigating bumps in the terrain and other real-world conditions.

Finding the Right Device

“What I try to emphasize to people is that there are a lot of potential tools and technologies at our disposal to try and make people better, and they should explore them and consider embracing them,” Langhals says.

Many types of prosthetic devices are now in development. If you’d like to find a clinical study to help test one, you can search for one in clinicaltrials.gov, a database of both NIH-supported and other studies around the world.

If you’re interested in taking part in a study, talk with your doctor about the possible risks and benefits. See the Ask Your Doctor box for questions to ask.

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To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Twelve signs and symptoms of low testosterone

Positive Parenting | NIH News in Health

Building Healthy Relationships With Your KidsParents have an important job. Raising kids is both rewarding and challenging. You’re likely to get a lot of advice along the way, from doctors, family, friends, and even strangers. But every parent and child is unique. Being sensitive and responsive to your kids can help you build positive, healthy relationships together.

“Being a sensitive parent and responding to your kids cuts across all areas of parenting,” says Arizona State University’s Dr. Keith Crnic, a parent-child relationship expert. “What it means is recognizing what your child needs in the moment and providing that in an effective way.”

This can be especially critical for infants and toddlers, he adds. Strong emotional bonds often develop through sensitive, responsive, and consistent parenting in the first years of life. For instance, holding your baby lovingly and responding to their cries helps build strong bonds.

Building Bonds

Strong emotional bonds help children learn how to manage their own feelings and behaviors and develop self-confidence. They help create a safe base from which they can explore, learn, and relate to others.

Experts call this type of strong connection between children and their caregivers “secure attachment.” Securely attached children are more likely to be able to cope with challenges like poverty, family instability, parental stress, and depression.

A recent analysis shows that about 6 out of 10 children in the U.S. develop secure attachments to their parents. The 4 out of 10 kids who lack such bonds may avoid their parents when they are upset or resist their parents if they cause them more distress. Studies suggest that this can make kids more prone to serious behavior problems. Researchers have been testing programs to help parents develop behaviors that encourage secure attachment.

Being Available

Modern life is full of things that can influence your ability to be sensitive and responsive to your child. These include competing priorities, extra work, lack of sleep, and things like mobile devices. Some experts are concerned about the effects that distracted parenting may have on emotional bonding and children’s language development, social interaction, and safety.

If parents are inconsistently available, kids can get distressed and feel hurt, rejected, or ignored. They may have more emotional outbursts and feel alone. They may even stop trying to compete for their parents’ attention and start to lose emotional connections to their parents.

“There are times when kids really do need your attention and want your recognition,” Crnic explains. Parents need to communicate that their kids are valuable and important, and children need to know that parents care what they’re doing, he says.

It can be tough to respond with sensitivity during tantrums, arguments, or other challenging times with your kids. “If parents respond by being irritable or aggressive themselves, children can mimic that behavior, and a negative cycle then continues to escalate,” explains Dr. Carol Metzler, who studies parenting at the Oregon Research Institute.

According to Crnic, kids start to regulate their own emotions and behavior around age 3. Up until then, they depend more on you to help them regulate their emotions, whether to calm them or help get them excited.

“They’re watching you to see how you do it and listening to how you talk to them about it,” he explains. “Parents need to be good self-regulators. You’re not only trying to regulate your own emotions in the moment, but helping your child learn to manage their emotions and behavior.”

As kids become better at managing their feelings and behavior, it’s important to help them develop coping skills, like active problem solving. Such skills can help them feel confident in handling what comes their way.

“When parents engage positively with their children, teaching them the behaviors and skills that they need to cope with the world, children learn to follow rules and regulate their own feelings,” Metzler says.

“As parents, we try really hard to protect our kids from the experience of bad things,” Crnic explains. “But if you protect them all the time and they are not in situations where they deal with difficult or adverse circumstances, they aren’t able to develop healthy coping skills.”

He encourages you to allow your kids to have more of those experiences and then help them learn how to solve the problems that emerge. Talk through the situation and their feelings. Then work with them to find solutions to put into practice.

Meeting Needs

As children grow up, it’s important to remember that giving them what they need doesn’t mean giving them everything they want. “These two things are very different,” Crnic explains. “Really hone in on exactly what’s going on with your kid in the moment. This is an incredibly important parenting skill and it’s linked to so many great outcomes for kids.”

Think about where a child is in life and what skills they need to learn at that time. Perhaps they need help managing emotions, learning how to behave in a certain situation, thinking through a new task, or relating to friends.

“You want to help kids become confident,” Crnic says. “You don’t want to aim too high where they can’t get there or too low where they have already mastered the skill.” Another way to boost confidence while strengthening your relationship is to let your kid take the lead.

“Make some time to spend with your child that isn’t highly directive, where your child leads the play,” advises Dr. John Bates, who studies children’s behavior problems at Indiana University Bloomington. “Kids come to expect it and they love it, and it really improves the relationship.”

Bates also encourages parents to focus on their child’s actual needs instead of sticking to any specific parenting principles. It’s never too late to start building a healthier, more positive relationship with your child, even if things have gotten strained and stressful.

“Most importantly, make sure that your child knows that you love them and are on their side,” Metzler says. “For older children, let them know that you are genuinely committed to building a stronger relationship with them and helping them be successful.”

By being a sensitive and responsive parent, you can help set your kids on a positive path, teach them self-control, reduce the likelihood of troublesome behaviors, and build a warm, caring parent-child relationship.

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To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare.  Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Keeping Up in School? | NIH News in Health

Identifying Learning Problems

Reading, writing, and math are the building blocks of learning. Mastering these subjects early on can affect many areas of life, including school, work, and even overall health. It’s normal to make mistakes and even struggle a little when learning new things. But repeated, long-lasting problems may be a sign of a learning disability.Learning disabilities aren’t related to how smart a child is. They’re caused by differences in the brain that are present from birth, or shortly after.

These differences affect how the brain handles information and can create difficulties with reading, writing, and math.“Typically, in the first few years of elementary school, some children, in spite of adequate instruction, have a hard time and can’t master the skills of reading and writing as efficiently as their peers,” says Dr. Benedetto Vitiello, a child mental health expert at NIH. “So the issue is usually brought up as a learning problem.” In general, the earlier a learning disability is recognized and addressed, the greater the likelihood for success in school and later in life. “Initial screening and then ongoing monitoring of children’s performance is important for being able to tell quickly when they start to struggle,” explains Dr. Brett Miller, a reading and writing disabilities expert at NIH. “If you’re not actively looking for it, you can miss opportunities to intervene early.”

Each learning disability has its own signs. A child with a reading disability may be a poor speller or have trouble reading quickly or recognizing common words. A child with a writing disability may write very slowly, have poor handwriting, or have trouble expressing ideas in writing and organizing text. A math disability can make it hard for a child to understand basic math concepts (like multiplication), make change in cash transactions, or do math-related word problems.Learning difficulties can affect more than school performance. If not addressed, they can also affect health.

A learning disability can make it hard to understand written health information, follow a doctor’s directions, or take the proper amount of medication at the right times. Learning disabilities can also lead to a poor understanding of the benefits of healthy behaviors, such as exercise, and of health risks, such as obesity. This lack of knowledge can result in unhealthy behaviors and increased risk of disease.Not all struggling learners have a disability. Many factors affect a person’s ability to learn. Some students may learn more slowly or need more practice than their classmates. Poor vision or hearing can cause a child to miss what’s being taught. Poor nutrition or exposure to toxins early in life can also contribute to learning difficulties.

If a child is struggling in school, parents or teachers can request an evaluation for a learning disability. The U.S. Individuals with Disabilities Education Improvement Act requires that public schools provide free special education support to children, including children with specific learning disabilities, who need such services. To qualify for these services, a child must be evaluated by the school and meet specific federal and state requirements. An evaluation may include a medical exam, a discussion of family history, and intellectual and school performance testing.Many people with learning disabilities can develop strategies to cope with their disorder. A teacher or other learning specialist can help kids learn skills that build on their strengths to counter-balance their weaknesses. Educators may provide special teaching methods, make changes to the classroom, or use technologies that can assist a child’s learning needs.

A child with a learning disability may also struggle with low self-esteem, lack of confidence, and frustration. In the case of a math learning disability, math anxiety may play a role in worsening math abilities. A counselor can help children use coping skills and build healthy attitudes about their ability to learn.“If appropriate interventionsActions taken to prevent or treat a disorder or to improve health in other ways. are provided, many of these challenges can be minimized,” explains Dr. Kathy Mann Koepke, a math learning disability expert at NIH. “Parents and teachers should be aware that their own words and behavior around learning and doing math are implicitly learned by the young people around them and may lessen or worsen math anxiety.”

“We often talk about these conditions in isolation, but some people have more than one challenge,” Miller says. Sometimes children with learning disabilities have another learning disorder or other condition, such as attention deficit hyperactivity disorder (ADHD).“ADHD can be confused with a learning problem,” Vitiello says. ADHD makes it difficult for a child to pay attention, stay focused, organize information, and finish tasks. This can interfere with schoolwork, home life, and friendships. But ADHD is not considered a learning disability. It requires its own treatments, which may include behavior therapy and medications.“Parents play an important role in treatment, especially for children in elementary school,” Vitiello says. Medications and behavioral interventions are often delivered at home. Teachers can usually advise parents on how to help kids at home, such as by scheduling appropriate amounts of time for learning-related activities. Parents can also help by minimizing distractions and encouraging kids to stay on task, such as when doing homework. Effective intervention requires consistency and a partnership between school and home.

Many complex factors can contribute to development of learning disabilities. Learning disorders tend to run in families. Home, family, and daily life also have a strong effect on a child’s ability to learn starting from a very early age. Parents can help their children develop skills and build knowledge during the first few years of life that will support later learning.“Early exposure to a rich environment is important for brain development,” Mann Koepke says. Engage your child in different learning activities from the start. Before they’re even speaking, kids are learning. “Even if it’s just listening and watching as you talk about what you’re doing in your daily tasks,” she says.Point out and talk with children about the names, colors, shapes, sizes, and numbers of objects in their environment. Try to use comparison words like “more than” or “less than.” This will help teach your child about the relationships between things, which is important for learning math concepts, says Mann Koepke. Even basic things, like getting enough sleep and eating a healthy diet, can help children’s brain development and their ability to learn.NIH is continuing to invest in research centers that study learning challenges and their treatments, with a special focus on understudied and high-risk groups.

Although there are no “cures,” early interventions offer essential learning tools and strategies to help lessen the effects of learning disabilities. With support from caregivers, educators, and health providers, people with learning disabilities can be successful at school, work, and in their personal lives.

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To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Safeguarding Our Health | NIH News in Health

Vaccines Protect Us All

We share more than food and culture within our homes and communities. We can also spread disease. Luckily, we live in a time when vaccines can protect us from many of the most serious illnesses. Staying current on your shots helps you—and your neighbors—avoid getting and spreading disease.Vaccines have led to large reductions in illness and death for both kids and adults, says Dr. David M. Koelle, a vaccine expert at the University of Washington in Seattle. One study estimated that, among U.S. children born from 1994 to 2013, vaccines will prevent about 322 million illnesses, 21 million hospitalizations, and 732,000 deaths.

Vaccines harness your immune systemA collection of specialized cells and organs that protect the body against infectious diseases.’s natural ability to detect and destroy disease-causing germs and then “remember” the best way to fight these germs in the future. Vaccination, or immunization, has completely eliminated naturally occurring smallpox worldwide—to the point that we no longer need to get shots against this fast-spreading, deadly disease. Polio has been eliminated in the U.S. and most other nations as well, thanks to immunizations. Poliovirus can affect the brain and spinal cord, leaving people unable to move their arms or legs, or sometimes unable to breathe.

“These childhood diseases used to be dreaded problems that would kill or paralyze children,” says Koelle. “In the 1950s, it was a common occurrence for kids to be fine in the spring, get polio over the summer, and then have to go back to school in the fall no longer able to walk.”

Experts recommend that healthy children and teens get shots against 16 diseases (see Wise Choices box). With these shots, many disabling or life-threatening illnesses have significantly declined in the U.S., including measles, rubella, and whooping cough. But, unlike smallpox, these disease-causing germs, or pathogens, are still causing infections around the world.

“These days, the risks of not being vaccinated in a developed country, like the United States, may seem superficially safe because of low rates of infection due to vaccination and other advances in public health,” Koelle says. “But we live in an era of international travel where we can be exposed to mobile pathogens.” So even if you don’t travel, a neighbor or classmate could go overseas and bring the disease back to your area.

“When the rates of vaccination drop, there can be a resurgence of the disease,” explains Dr. Saad Omer, a global health researcher at Emory University in Atlanta. For instance, measles was completely eliminated in the U.S. in 2000. But since then, thousands of cases have occurred, mostly related to travel.

Omer and colleagues examined U.S. reports on measles outbreaks since 2000. “We found that measles cases have occurred mostly in those who are not vaccinated and in communities that have lower rates of vaccination. And that’s true for many vaccine-preventable diseases,” he says. Most of the unvaccinated cases were those who chose not to be vaccinated or not have their children vaccinated for non-medical reasons.

When enough people are vaccinated, the entire community gains protection from the disease. This is called community immunity. It helps to stop the spread of disease and protects the most vulnerable: newborns, the elderly, and people fighting serious illnesses like cancer. During these times, your immune system is often too weak to fend off disease and may not be strong enough for vaccinations. Avoiding exposure becomes key.

“There’s a huge benefit to all of us getting the recommended vaccines,” explains Dr. Martha Alexander-Miller, an immune system expert at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. “Number one, vaccines protect you. But they also limit the presence of disease-causing entities that are circulating in the community. So, you’re helping to protect individuals who may not be capable of protecting themselves, for example because they are too young to get vaccinated.”

When expectant moms are vaccinated, immune protection can pass through the placenta to the fetus. “Early on, the baby’s immune system is immature. So there’s a period of vulnerability where disease and death can occur,” Omer explains. “But the mother’s own antibodies—proteins formed by her immune system—can protect the baby.”

Doctors recommend that moms-to-be get both flu and Tdap (tetanus, diphtheria, and whooping cough) shots. A mother’s antibodies can help protect the newborn until they can receive their own vaccinations.

Some vaccines must be given before pregnancy. Rubella, for instance, can cause life-altering birth defects or miscarriage if contracted during pregnancy. There’s no treatment, but the measles, mumps, and rubella (MMR) vaccine offers prevention. Vaccines for many other common diseases that put newborns at risk are being studied.

“We’ve made amazing progress in the development of effective vaccines,” says Alexander-Miller. “Our ability to have such breakthroughs is the end result of very basic research that went on for years and years.” NIH-funded scientists continue to search for new ways to stimulate protection against various diseases.

Koelle studies how our bodies fight herpes viruses. There are eight related herpes viruses, but the body responds differently to each one. So far, we only have vaccines for one: varicella-zoster virus, which causes chickenpox and shingles.

Koelle’s team is comparing how our immune system responds to chickenpox and the herpes simplex viruses, which cause mouth and genital sores. “We’re hoping to harness the success that has been possible with the chickenpox vaccine and see if we can create a vaccine that would work for both chickenpox and shingles and also herpes simplex,” he says.

Researchers are also working to improve existing vaccines. Some vaccines require a series of shots to trigger a strong immune response. The protection of other vaccines can fade over time, so booster shots may be needed. Some, like the flu vaccine, require a shot each year because the virus changes so that the vaccine no longer protects against new strains. So keeping up with the latest flu vaccines is important.

Ask your doctor’s office whether your vaccinations are current. You may also find records of vaccinations at your state health department or schools. If you can’t find your records, ask your doctor if it’s okay to get a vaccine you might have received before.

Most side effects of vaccines are mild, such as a sore arm, headache, or low-grade fever.

“It can be easy to take vaccines for granted, because you’ll never know all the times you would’ve gotten really sick had you not been vaccinated,” says Alexander-Miller.

Help your community keep diseases at bay: Stay up-to-date with vaccines.

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To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Acne Breakouts | NIH News in Health

Controlling Problem Pimples

Zits. Pimples. Spots. Whatever you call it, acne can cause discomfort and embarrassment. This skin condition affects most people at some point during their lives. About 4 out of every 5 people experience acne outbreaks between the ages of 11 and 30.

Acne starts in the skin’s oil glands. The hair on our bodies comes out through canals from these glands called follicles. Oil glands make oils that emerge to the skin’s surface through the follicles’ openings, or pores, along with the hairs.

Sometimes hair, oil, and dead skin cells come together to plug a follicle. The plugged pore provides the right conditions for bacteria that normally live on the skin to thrive. When the body’s immune systemThe system that protects your body from invading viruses, bacteria, and other microscopic threats. attacks the bacteria, pain and swelling can result. That’s how a pimple forms.

Doctors don’t know why only some people get acne. They do know what raises the risk for acne. Increases in certain hormonesSubstances sent through the bloodstream to signal another part of the body to grow or react a certain way. can cause oil glands to get bigger and make more oil. These hormone levels go up during puberty. Because of this, acne is most common in adolescents and young adults. Hormone changes caused by pregnancy or by starting or stopping birth control pills can also trigger acne.

But people of all ages can get acne. For most, acne goes away by the time they reach their 30s. However, some people in their 30s, 40s, and 50s still get acne. Although acne is usually not a serious health threat, it can be upsetting, and severe acne can lead to permanent scarring.

There are things you can do to prevent acne, explains Dr. Edward Cowen, a skin specialist at NIH. He recommends that people with acne avoid skin products that contain petrolatum, a type of oil. Instead, he says, look for creams and lotions labeled “noncomedogenic.” These are less likely to clog pores. A lot of people think certain foods can cause acne breakouts. However, Cowen explains, research has not been able to confirm this in most cases. See the Wise Choices box for other tips.

While there are plenty of home remedies for acne, Cowen says, it’s better to start with proven over-the-counter treatments for mild acne. These products can contain benzoyl peroxide, resorcinol, salicylic acid, or sulfur.

People with severe acne should discuss prescription drug options with a doctor, he adds. These include antibiotics to kill bacteria or drugs called retinoids, which can be given as a topical to apply to the skin or as an oral medication.

NIH-funded scientists are conducting research to better understand why acne develops and to find better ways to treat the condition.

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To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

11 Ways Laughter IS the Best Medicine, and It IS Contagious !

Do you remember that last time you had a good, hearty, deep from your very soul laugh? For my family, it was last night while we enjoyed fireworks with friends over the lake in anticipation of the 4th of July celebration. Josh Billings said, “Laughter is the fireworks of the soul”; and great wisdom can be found in Proverb (17:22): “A cheerful heart is good medicine, but a broken spirit saps a person’s strength.”

There are tremendous health benefits found in laughing – it strengthens your immune system, triggers the release of endorphins that lift your mood, helps protect your heart, diminishes pain and protects you by reducing effects of stress.

One of the best feelings in the world is that deep belly laugh – to have one and even to hear it in others. While the ability to laugh is a powerful health resource, mentally, emotionally and physically. it can also bring people together and establish amazing connections. Everything from a slight giggle to a side-splitting guffaw can change the atmosphere of a room from chilly unfamiliarity to warm and family-like. Studies have shown a strong, positive bond is created when we laugh with one another.

So, when was the last time you found yourself laughing out loud? Hopefully, you are one of the fortunate ones that has enjoyed the delights of laughing recently – and the powerful preventive benefits its joy offers. There is so much to love about laughter and many ways it promotes wellness and wellbeing in everyday life, at home, work and at play.

What is laughter?

While the brain mechanisms behind laughing (and smiling) remain a mystery, it is often a spontaneous response to humor or other visual, auditory, or emotional stimuli. And, too, it can occur on command—as either voluntary or contrived.

When we laugh, air is forced through the vocal cords as a result of chest wall contractions, in particular from the diaphragm. It is often followed by a deep inspiration of air. Thus, laughter recruits a number of muscles—respiratory, laryngeal, and facial. And when “exuberant,” it can also involve the arms and legs.

When do humans begin laughing?

Our first laugh typically occurs between 3 to 4 months of age—even before we learn to speak! It is believed that a baby’s laugh serves as a way to communicate, bond, and, too, explore sound and vocalization.
There is already so much to love for laughter that it seems greedy to look for more, but that’s exactly what researchers Dr. Lee Berk and Dr. Stanley Tan at the Loma Linda University in California have done. These two doctors have researched the benefits of laughter and found amazing results.

1. Lowers blood pressure
People who lower their blood pressure, even those who start at normal levels, will reduce their risk of stroke and heart attack. So, grab the Sunday paper, flip to the funny pages, and enjoy your laughter medicine, or pull up the latest memes in social media. Of even better, watch your favorite funny movie.

2. Reduces stress hormone levels
By reducing the level of stress hormones, you’re simultaneously cutting the anxiety and stress that impacts your body. Additionally, the reduction of stress hormones may result in higher immune system performance. Just think: Laughing along as a co-worker tells a funny joke can relieve some of the day’s stress and help you reap the health benefits of laughter.

Psychologically, having a good sense of humor—and applying it by laughing—may permit us to have a better perspective on things by seeing situations in a “more realistic and less threatening light.” Physically, laughter can put a damper on the production of stress hormones—cortisol and epinephrine—as well as trigger the release of endorphins. Endorphins are our body’s natural painkillers and can boost our mood. And, too, it has been shown that a good LOL or ROTFL — texting slang for “laugh out loud” or “rolling on the floor laughing” — can relax our muscles for up to 45 minutes after.

3. Works your abs
One of the benefits of laughter is that it can help you tone your abs. When you are laughing, the muscles in your stomach expand and contract, similar to when you intentionally exercise your abs. Meanwhile, the muscles you are not using to laugh are getting an opportunity to relax. Add laughter to your ab routine and make getting a toned tummy more enjoyable.

4. Improves cardiac health
Laughter is a great cardio workout, especially for those who are incapable of doing other physical activity due to injury or illness. It gets your heart pumping and burns a similar number of calories per hour as walking at a slow to moderate pace. So, laugh your heart into health.

The American Heart Association states that laughter can help our hearts. Research shows that by decreasing stress hormones, we can see a decrease in blood pressure as well as artery inflammation and bad cholesterol levels. Elevated blood pressure forces our heart to work harder in order to generate the force needed to pump against the increased resistance. And inflammation and high cholesterol contribute to the development of fatty plaques that decrease blood flow to the heart, or, even, complete blockage that can cause a heart attack.

5. Boosts T-cells
T-cells are specialized immune system cells just waiting in your body for activation. When you laugh, you activate T-cells that immediately begin to help you fight off sickness. Next time you feel a cold coming on, add chuckling to your illness prevention plan.

6. Triggers the release of endorphins
Endorphins are the body’s natural painkillers. By laughing, you can release endorphins, which can help ease chronic pain and make you feel good all over.

7. Produces a general sense of well-being
Laughter can increase your overall sense of well-being. Doctors have found that people who have a positive outlook on life tend to fight diseases better than people who tend to be more negative. Smile, laugh, and live longer!

8. Improves bonding
There has been much written that laughter is not primarily about humor, but, instead, social relationships. When we laugh, we create a positive emotional climate and a sense of connection between two people. In fact, with romantic partners, shared laughter—when you laugh together—is an indicator of relationship well-being, in that it enhances closeness and perceptions of partner supportiveness.

9. Can shed pounds
In a study published in the International Journal of Obesity, researchers found that 15 minutes of genuine laughter burns up to 40 calories, depending on the individual’s body weight and laughter intensity. While this cannot replace aerobic physical activity, 15 minutes of daily LOL, over the course of a year, could result in up to 4 fewer pounds.

10. Enhances our ability to fight off germs
Laughter increases the production of antibodies—proteins that surveillance for foreign invaders—as well as a number of other immune system cells. And, in doing so, we are strengthening our body’s defenses against germs. Additionally, it is a well-known fact that stress weakens our immune system. And because laughing alleviates our body’s stress response, it can help dampen its ill-effects.

11. A natural pain-killer
The iconic Charlie Chaplin stated: “Laughter is the tonic, the relief, the surcease for pain.” Although Mr. Chaplin probably meant this figuratively, laughter can literally relieve pain by stimulating our bodies to produce endorphins — natural painkillers. Laughter may also break the pain-spasm cycle common to some muscle disorders. The best part: You do not need a prescription and there are no known side-effects.

Is it contagious?

Yes. The saying “laugh and the whole world laughs with you” is not just figurative, it is literal. When we hear laughter, it triggers an area in our brain that is involved in moving the muscles in our face, almost like a reflex. This is one of the reasons television sitcoms have laugh tracks—a separate soundtrack that contains the sound of audience laughter. We are more likely to find the joke or situation funny and chuckle, giggle, or guffaw.

How to use laughter to heal and uplift.

Laughter is a physical expression of pleasant emotions among human beings. It is preceded by what one sees, hears or feels. When shared, it serves to connect people and increases intimacy and is a good anti-stress medicine.

LOL or lol, has become a very popular element of internet communications and texting in expressing great amusement in a chat. As well, according to research, the smiling and “tears of joy” laughing emoji faces are tops in digital communications. Their usage is so widespread and so common, that we now actually have data that demonstrates that the use and placement of emojis carries an emotional weight which impacts our perception of the messages that frame these icons (understanding the mental states of others is crucial to communication). And yes, in today’s busy world we may be utilizing =D and LOL’s at every turn, but let’s lean in to the hilarious and enjoy the good, hearty health benefits of laughter.

And remember, know when not to laugh. Laughter at the expense of others or in hurtful situations is inappropriate.

Now, make a commitment to laugh more.

In his book, The Travelers Gift, Andy Andrews challenges the traveler to start each day with laughter within moments of waking. It changes your whole being, even if you only laugh for seven seconds. I have tried it. I have faked it, and even as I start with the fake laugh, I can’t stop after seven seconds.

Practice laughing by beginning with a smile and then enact a laugh. Although it may feel contrived at first, with practice, it will likely become spontaneous. At Laughter University (yes, there is one) they encourage at least 30 seconds. There is so much going on around us that is laughable!

We can also move towards laughter by being with those who laugh and return the favor by making them laugh. And, too, surround ourselves with children and pets. On average, children laugh 300 times a day! And we know that laughter is contagious. Studies have shown people are immensely happier just seeing a picture of a dog!

Even make an effort to find the humor in an unpleasant situation, especially with situations that are beyond our control.

For all this, you will be made glad. Laughter wipes away stress, decreases blood pressure, burns calories, alleviates pain, connects us to others, reinvigorates us with hope, helps ward off germs … (the list goes on) – and feels soooo good. LOL for better health, connection and joy!

Want to find a physician who tickles your funny bone or at least knows where it is? To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Sources:
Gaiam.com
laughteronlineuniveristy,com
Dr. Nina Radcliff, Laugh, giggle, be joyful — for lol; ‘The fireworks of the soul’. Washington Post

The Often Misunderstood Diagnosis of Post-Traumatic Stress Disorder

PTSD stands for Post-Traumatic Stress Disorder and is a condition that many veterans and non-veterans alike suffer; PTSD can occur when someone experiences or witnesses a traumatic event. This condition wasn’t always understood properly by the medical or military community, and Department of Defense press releases often point to earlier attempts to identify PTSD symptoms in the wake of service in World War 2, Vietnam, and other conflicts.

PTSD Awareness Day is observed today, Wednesday, June 27, 2018.

The History of PTSD Awareness Day

In 2010, Senator Kent Conrad pushed to get official recognition of PTSD via a “day of awareness” in tribute to a North Dakota National Guard member who took his life following two tours in Iraq.

Staff Sergeant Joe Biel died in 2007 after suffering from PTSD; Biel committed suicide after his return from duty to his home state. SSgt. Biel’s birthday, June 27, was selected as the official PTSD Awareness Day, now observed every year.

How Do People Observe Post-Traumatic Stress Disorder Awareness Day?

Much of what is done to observe PTSD Awareness Day involves encouraging open talk about PTSD, its’ causes, symptoms, and most important of all, getting help for the condition. When today, PTSD is often misunderstood by those lacking firsthand experience with the condition or those who suffer from it. PTSD Awareness Day is designed to help change that.

The Department of Defense publishes circulars, articles, and other materials to help educate and inform military members and their families about the condition. The Department of Veterans Affairs official site has several pages dedicated to PTSD, and when military members retiring or separating from the service fill out VA claim forms for service-connected injuries, illnesses, or disabilities, there is an option to be evaluated for PTSD as a part of the VA claims process.

What Is Post-Traumatic Stress Disorder?

The current American Psychiatric Association’s Diagnostic and Statistical Manual, DSM-IV, says PTSD can develop through a range of exposures to death or injury: direct personal involvement, witnessing it or, if it concerns someone close, just learning about it.  Post-traumatic stress disorder is a form of anxiety that can happen after experiencing or witnessing actual or near death, serious injury, war-related violence, terrorism or sexual violence.  While most people typically connect this disorder to military veterans or refugees, it can happen to anyone.

Almost no other psychiatric diagnosis has generated as much controversy.  The diagnosis is almost four decades old.  PTSD is not a sign of weakness, and people can be affected by PTSD even when they were not directly part of the traumatic event.

The specific nature of the trauma can and does vary greatly. Experts are quick to point out, while combat and combat-related military service can be incredibly challenging, and while witnessing or being a victim of an event that rips the fabric of daily life can be traumatic, not everyone responds the same way. Some may develop symptoms of PTSD, while others may be unaffected.

Post-Traumatic Stress Disorder: How Widespread Is It?

Some sources estimate that as many as 70% of all Americans have experienced a traumatic event sufficient to cause PTSD or PTSD-like symptoms. That does not mean that all 70% of Americans WILL suffer from PTSD. Using these statistics, some 224 million Americans have experienced a traumatic event. Of that number, some 20% will develop PTSD symptoms, roughly 44 million people.

Of that 44 million, an estimated eight percent experience active PTSD symptoms at any one time. An estimated 50% of all mental health patients are also diagnosed with Post-Traumatic Stress Disorder.

PTSD: Often Misunderstood and Misidentified

“Shell shock” and “combat shock” were earlier attempts to define and understand the symptoms of PTSD. Post-traumatic stress disorder was often stigmatized in popular culture after the Vietnam conflict, and many films and television shows featured antagonists or unsympathetic characters suffering from “Vietnam flashbacks” or other issues.

The misunderstanding of PTSD slowly began to change in 1980 when it was recognized as a specific condition with identifiable symptoms. It was then the disorder was listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

This manual is a diagnostic tool for mental health professionals and paraprofessional workers in the healthcare field and is considered a definitive reference. The addition of PTSD to the DSM was a highly significant development.

Today, the symptoms of Post Traumatic Stress Disorder are better understood, treatable, and recognized by the Department of Veterans Affairs as a service-connected condition. PTSD is not exclusive to veterans or currently serving members of the United States military, but a portion of those who serve are definitely at risk for PTSD.

What Are the Symptoms of Post-Traumatic Stress Syndrome?

Some PTSD symptoms may seem vague and non-specific, others are more readily identified specifically as evidence of PTSD. In this context “non-specific” means that the symptoms may be related to other mental health issues and not specifically limited to Post-Traumatic Stress Disorder.

In the same way, more “specific” symptoms may be manifest outside PTSD, but when looking for specific signifiers, these issues are common “red flags” that indicate PTSD may be the cause of the suffering rather than a different condition. This is often circumstantial, and there is no one-size-fits-all diagnosis for the condition.

Suicidal thoughts or self-destructive acts are often a result of PTSD or related symptoms. Anyone experiencing thoughts or urges to self-harm should seek immediate care to prevent the condition from getting worse in the short-term. (See below)

That said, more non-specific symptoms include varying degrees of irritability, depression, and suicidal feelings. More specific problems-especially where veterans and currently serving military members are concerned-include something known as “hypervigilance” or “hyperarousal”.

Other symptoms include repeatedly experiencing the traumatic event(s) in the form of flashbacks, nightmares, persistent memories of the event(s), and intrusive thoughts about the traumatic event(s).

These symptoms vary in intensity depending on the individual and are not ‘standardized”. They may come and go, or they may be persistent over a span of time. Sometimes PTSD sufferers can be high-functioning, other times they may be more debilitated by the condition.

Get Treatment For PTSD

Those who experience symptoms of PTSD or PTSD-like issues should seek help immediately. Department of Veterans Affairs medical facilities, private care providers, counselors, and therapists can all be helpful in establishing an initial care regimen or refer those suffering from PTSD to a qualified care provider.

The Department of Veterans Affairs has more information on help for PTSD on its’ official site including help finding a therapist.

Those experiencing suicidal feelings or self-destructive urges should get help immediately. The Suicide Crisis Hotline (1-800-273-8255) has a specific resource for veterans and the Department of Veterans Affairs offers a Veterans’ Crisis Hotline confidential chat resource.

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Adapted from https://militarybenefits.info/ptsd-awareness-day/

“Doing It My Way, Testing for HIV” | HIV Testing Day 2018

National HIV Testing Day (NHTD) is an annual observance encouraging people of all ages to get tested for HIV and to know their status.  Too many people are unaware they have HIV. At the end of 2014, an estimated 1.1 million persons aged 13 and older were living with HIV infection in the United States, including an estimated 166,000 (15%, or 1 in 7) persons whose infections had not been diagnosed.

Getting tested is the first step to finding out if you have HIV. If you have HIV, getting medical care, taking medicines regularly and changes in behavior help you live a longer, healthier life and will lower the chances of passing HIV on to others.

Testing is the only way for the Americans living with undiagnosed HIV to know their HIV status and get into care. CDC estimates that more than 90% of all new infections could be prevented by proper testing and linking HIV positive persons to care. HIV testing saves lives! It is one of the most powerful tools in the fight against HIV

How do I know if I am at risk to get HIV? 

Knowing your risk can help you make important decisions to prevent exposure to HIV.  Overall, an American has a 1 in 99 chance of being diagnosed with HIV at some point in his or her lifetime. However, the lifetime risk is much greater among some populations. If current diagnosis rates continue the lifetime risk of getting HIV is:

  • 1 in 6 for gay and bisexual men overall
  • 1 in 2 for African American gay and bisexual men
  • 1 in 4 for Hispanic gay and bisexual men
  • 1 in 11 for white gay and bisexual men
  • 1 in 20 for African American men overall
  • 1 in 48 for African American women overall
  • 1 in 23 for women who inject drugs
  • 1 in 36 for men who inject drugs

Your health behaviors also affect your risk. You can get or transmit HIV only through specific activities. HIV is commonly transmitted through anal or vaginal sex without a condom or sharing injection and other drug injection equipment with a person infected with HIV. Substance use can increase the risk of exposure to HIV because alcohol and other drugs can affect your decision to use condoms during sex. To learn more about your HIV risk and ways to reduce these risks, visit: https://wwwn.cdc.gov/hivrisk/

How do HIV, Viral Hepatitis, and STDs relate to each other? 

Persons who have an STD are at least two to five times more likely than uninfected persons to acquire HIV infection if they are exposed to the virus through sexual contact. In addition, if a person who is HIV positive also has an STD, that person is more likely to transmit HIV through sexual contact than other HIV-infected persons.

Hepatitis B virus (HBV) and HIV are bloodborne viruses transmitted primarily through sexual contact and injection drug use. Because of these shared modes of transmission, a high proportion of adults at risk for HIV infection are also at risk for HBV infection. HIV-positive persons who become infected with HBV are at increased risk for developing chronic HBV infection and should be tested. In addition, persons who are co-infected with HIV and HBV can have serious medical complications, including an increased risk for liver-related morbidity and mortality.

Hepatitis C Virus (HCV) is one of the most common causes of chronic liver disease in the United States. For persons who are HIV infected, co-infection with HCV can result in a more rapid occurrence of liver damage and may also impact the course and management of HIV infection.

How do I protect myself and others from HIV, Viral Hepatitis, and STDs? 

HIV Prevention

Your life matters and staying healthy is important. It’s important for you, the people who care about you, and your community that you know your HIV status.  Knowing give you powerful information to help take steps to keep you and others healthy. You should get tested for HIV, and encourage others to get tested too.

For people who are sexually active, there are more tools available today to prevent HIV than ever before. The list below provides a number of ways you can lower your chances of getting HIV. The more of these actions you take, the safer you can be.

  • Get tested and treated for other STDs and encourage your partners to do the same.All adults and adolescents from ages 13-64 should be tested at least once for HIV, and high-risk groups get tested more often.  STDs can have long-term health consequences.  They can also increase your chance of getting HIV or transmitting it to others. It is important to have an honest and open talk with your healthcare provider and ask whether you should be tested for STDs.  Your healthcare provider can offer you the best care if you discuss your sexual history openly.
  • Choose less risky sexual behaviors. Oral sex is much less risky than anal or vaginal sex for HIV transmission. Anal sex is the highest-risk sexual activity for HIV transmission. Sexual activities that do not involve the potential exchange of bodily fluids carry no risk for getting HIV (e.g., touching).
  • Use condoms consistently and correctly.
  • Reduce the number of people you have sex with.  The number of sex partners you have affects your HIV risk. The more partners you have, the more likely you are to have a partner with HIV whose viral load is not suppressed or to have a sex partner with a sexually transmitted disease. Both of these factors can increase the risk of HIV transmission.
  • Talk to your doctor about pre-exposure prophylaxis (PrEP). CDC recommends that PrEP be considered for people who are HIIV-negative and at substantial risk for being exposed to HIV.For sexual transmission, this includes HIIV-negative persons who are in an ongoing relationship with an HIV-positive partner. It also includes anyone who 1) is not in a mutually monogamous relationship with a partner who recently tested HIV-negative, and 2) is a gay or bisexual man who has had sex without a condom or been diagnosed with an STD in the past 6 months; or heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners). For people who inject drugs, this includes those who have injected drugs in the past 6 months and who have shared injection equipment or been in drug treatment for injection drug use in the past 6 months.
  • Talk to your doctor right away (within 3 days) about post-exposure prophylaxis (PEP) if you have a possible exposure to HIV. An example of a possible exposure is if you have anal or vaginal sex without a condom with someone who is or may be HIV-positive, and you are HIV-negative and not taking PrEP. Your chance of exposure to HIV is lower if your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral load is undetectable. Starting medicine immediately (known as post-exposure prophylaxis, or PEP) and taking it daily for 4 weeks reduces your chance of getting HIV.
  • If your partner is HIV-positive, encourage your partner to get and stay on treatment.  ART reduces the amount of HIV virus (viral load) in blood and body fluids. ART can keep people with HIV healthy for many years, and greatly reduce the chance of transmitting HIV to sex partners if taken consistently and correctly.

Hepatitis Prevention

The best way to prevent both Hepatitis A and B is by getting vaccinated.   There is no vaccine available to prevent Hepatitis C.  The best way to prevent Hepatitis C is by avoiding behaviors that can spread the disease, such as sharing needles or other equipment to inject drugs.

STD Prevention

The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do several things to lower your chances of getting an STD, including:

  • Get tested for STDs and encourage your partner(s) to do the same. It is important to have an honest and open talk with your healthcare provider and ask whether you should be tested for STDs.  Your healthcare provider can offer you the best care if you discuss your sexual history openly.
  • Get vaccinated. Vaccines are safe, effective, and recommended ways to prevent hepatitis A, hepatitis B, and HPV.
  • Be in a sexually active relationship with only one person, who has agreed to be sexually active only with you.
  • Reduce your number of sex partners.  By doing so, you decrease your risk for STDs. It is still important that you and your partner get tested, and that you share your test results with one another.
  • Use a condom every time you have vaginal, anal, or oral sex. Correct and consistent use of the male latex condomis highly effective in reducing STD transmission.

What puts me at risk for HIV, Viral Hepatitis, and STDs? 

Risks for HIV

The most common ways HIV is transmitted in the United States is through anal or vaginal sex or sharing drug injection equipment with a person infected with HIV. Although the risk factors for HIV are the same for everyone, some racial/ethnic, gender, and age groups are far more affected than others.

What puts me at risk for Hepatitis A?

Hepatitis A is usually spread when a person ingests fecal matter — even in microscopic amounts — from contact with objects, food, or drinks contaminated by the feces or stool of an infected person. Due to routine vaccination of children, Hepatitis A has decreased dramatically in the United States. Although anyone can get Hepatitis A, certain groups of people are at higher risk, including men who have sex with men, people who use illegal drugs, people who travel to certain international countries, and people who have sexual contact with someone who has Hepatitis A.

What puts me at risk for Hepatitis B?

Hepatitis B is usually spread when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact with an infected person or sharing needles, syringes, or other drug-injection equipment. Hepatitis B can also be passed from an infected mother to her baby at birth.

Among adults in the United States, Hepatitis B is most commonly spread through sexual contact and accounts for nearly two-thirds of acute Hepatitis B cases. Hepatitis B is 50–100 times more infectious than HIV.

What puts me at risk for Hepatitis C?

Hepatitis C is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. Hepatitis C was also commonly spread through blood transfusions and organ transplants prior to the early 1990’s. At that time, widespread screening of the blood supply began in the United States, which has helped ensure a safe blood supply.

STDs

Risks for  Genital Herpes

Genital herpes is a common STD, and most people with genital herpes infection do not know they have it.   You can get genital herpes from an infected partner, even if your partner has no herpes symptoms.  There is no cure for herpes, but medication is available to reduce symptoms and make it less likely that you will spread herpes to a sex partner.

Risks for Genital Human Papillomavirus (HPV)

HPV is so common that most sexually active people get it at some point in their lives. Anyone who is sexually active can get HPV, even if you have had sex with only one person. In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer. HPV is passed on through genital contact (such as vaginal and anal sex). You can pass HPV to others without knowing it.

Risks for Chlamydia

Most people who have chlamydia don’t know it since the disease often has no symptoms.  Chlamydia is the most commonly reported STD in the United States.  Sexually active females 25 years old and younger need testing every year. Although it is easy to cure, chlamydia can make it difficult for a woman to get pregnant if left untreated.

Risks for Gonorrhea

Anyone who is sexually active can get gonorrhea, an STD that can cause infections in the genitals, rectum, and throat. It is a very common infection, especially among young people ages 15-24 years. But it can be easily cured.  You can get gonorrhea by having anal, vaginal, or oral sex with someone who has gonorrhea. A pregnant woman with gonorrhea can give the infection to her baby during childbirth.

Risks for Syphilis

Any sexually active person can get syphilis. It is more common among men who have sex with men. Syphilis is passed through direct contact with a syphilis sore. Sores occur mainly on the external genitals, anus, or in the rectum. Sores also can occur on the lips and in the mouth. A pregnant women with syphilis can give the infection to her unborn baby.

Risks for Bacterial Vaginosis

BV is common among women of childbearing age. Any woman can get BV, but women are at a higher risk for BV if they have a new sex partner, multiple sex partners, use an intrauterine device (IUD), and/or douche.

Managing Your Appointments

HIV is a treatable condition. If you are diagnosed early, get on antiretroviral therapy (ART), and adhere to your medication, you can stay healthy, live a normal life span, and reduce the chances of transmitting HIV to others. Part of staying healthy is seeing your HIV care provider regularly so that he or she can track your progress and make sure your HIV treatment is working for you.

Your HIV care provider might be a doctor, nurse practitioner, or physician assistant. Some people living with HIV go to an HIV clinic; others see an HIV specialist at a community health center, Veterans Affairs clinic, or other health clinic; and some people see their provider in a private practice. Current guidelines recommend that most people living with HIV see their provider for lab tests every 3 to 4 months. Some people may see their provider more frequently, especially during the first two years of treatment or if their HIV viral load is not suppressed (i.e. very low or undetectable). Current guidelines say that people who take their medication every day and have had a suppressed viral load at every test for more than 2 years only need to have their lab tests done two times a year.

In addition to seeing your HIV care provider, you may need to see other health care practitioners, including dentists, nurses, case managers, social workers, psychiatrists/psychologists, pharmacists and medical specialists. This may mean juggling multiple appointments, but it is all part of staying healthy. You can help make this easier by preparing a plan for yourself.

Before Your Visit

For many people living with HIV, appointments with their HIV care provider become a routine part of their life. These tips may help you better prepare for your visits to your HIV care provider and get more out of them:

  • Start with a list or a notebook. Write down any questions you have before you go. (The Department of Veterans Affairs offers a useful list of sample questions you can bring with you.)
  • Make a list of your health and life goals so that you can talk about them with your HIV provider and how she/he can help you reach them.
  • Make a list of any symptoms or problems you are experiencing that you want to talk to your provider about.
  • Bring a list of all the HIV and non-HIV medications that you are taking (or the medications themselves), including over-the-counter medications, vitamins, or supplements. Include a list of any HIV medications you may have taken in the past and any problems you had when taking them.
  • Bring along a copy of your medical records if you are seeing a new provider who does not already have them. You have the right to access your medical records and having copies of your records can help you keep track of your lab results, prescriptions, and other health information. It can also help your new provider have a better understanding of your health history. The best way to do this is by using a global, portable personal health record like the one you will maintain here at HealthLynked.
  • Be prepared to talk about any changes in your living situation, relationships, insurance, or employment that may affect your ability to keep up with your HIV appointments and treatment or to take care of yourself. Your provider may be able to connect you with resources or services that may assist you.
  • Be on time. Most healthcare providers have full appointment schedules—if you are late, you throw the schedule off for everyone who comes after you. If you are late, there is a chance your provider will not be able to see you the same day.

During Your Visit

  • If your provider wants to run some lab tests during your visit, make sure you understand what the lab tests are for and what your provider will do with the results. If you don’t understand, ask your provider to explain it in everyday terms. Typically, you will be asked to give a sample (blood, urine) during your visit and your provider’s office will call you with your results in a few days. Keep track of your results and call your provider back if you have any questions.
  • Be honest. Your provider isn’t there to judge you, but to make decisions with you based on your particular circumstances. Talk about any HIV medication doses you have missed. Tell your provider about your sexual or alcohol/drug use history. These behaviors can put you at risk of developing drug resistance and getting other sexually transmitted infections (STIs) as well as hepatitis. Your provider will work with you to develop strategies to keep you as healthy as possible.
  • Describe any side effects you may be having from your HIV medications. Your provider will want to know how the HIV medications are affecting your body in order to work with you to solve any problems and find the right combination of medications for you.
  • Ask your provider about your next visit and what you should bring to that appointment.
  • Ask for a list of your upcoming appointments when you check out. Work with your case manager, if you have one, to develop a system to help you remember your appointments, such as a calendar, app, or text/e-mail reminders.

Asking Questions and Solving Problems

It’s important for you to be an active participant in your own health care and it’s your right to ask questions. You may need to direct your questions to different people, depending on what you need/want to know:

HIV care providers (doctors, nurse practitioners, physician assistants) can answer specific questions about a wide range of issues that affect your health. They can also help you find resources and solutions to problems you may have that affect your health, including:

  • Your prognosis (how your HIV disease is affecting your body)
  • How to manage any symptoms you may be experiencing
  • Medication issues, including medication changes, new medications, and how the HIV medications may interact with other medications you take.
  • Sexual health issues, including questions about any sexual symptoms you may be having, and how you can prevent or treat STIs, and how you can prevent transmitting HIV to your partner(s).
  • Family planning considerations, including your goals; birth control options for you and/or your partner, if relevant; your options for having children should you wish to do so; and, if you are an HIV-positive woman who is pregnant or considering getting pregnant, how you can reduce the risk of transmitting HIV to your baby
  • Substance use issues, including how alcohol/drug use can affect your HIV treatment and overall health, and whether you should be referred for substance abuse treatment
  • Mental health issues, including questions about any mental health symptoms you may be having, and whether you should be referred for mental health treatment
  • Referrals for other medical issues you may be experiencing
  • The meaning of lab test results
  • The need for surgical procedures, if relevant
  • Medication adherence strategies (tips for keeping up with your medication and ensuring you take it as scheduled and exactly as prescribed)
  • Any clinical trials or research studies that may be relevant for you
  • Information about resources and services that can help you with issues or challenges you may be having that affect your health.

Nurses and case managers often have more time to answer questions about what you discuss with your provider and to help identify solutions to problems that are affecting your health, particularly around:

  • Understanding your HIV treatment plan, including how many pills of each medicine you should take; when to take each medicine; how to take each medicine (for example, with or without food); and how to store each medicine
  • Understanding possible side effects from your HIV medication and what you should do if you experience them
  • Challenges you may have in taking your medications and/or keeping your medical appointments, and strategies for overcoming these challenges
  • Resources to help you better understand lab reports, tests, and procedures
  • Mental health and/or substance abuse treatment, housing assistance, food assistance, and other resources that exist in your community
  • Insurance and pharmacy benefits, and other aspects of paying for care
  • Understanding other medical conditions you may have
  • How to quit smoking and resources that are available to assist you
  • Information about resources and services that can help you with issues or challenges you may be having that affect your health.

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Aidsinfo.NIH.gov

14 Injections of Fact and Folklore Surrounding the first “Killed” Vaccine

Just 60 years ago, polio was one of the most feared killers in the U.S.

Every year, as the warmer months approached, panic over polio intensified. Late summer was dubbed “polio season.” Public swimming pools were shut down. Movie theaters urged patrons not to sit too close together to avoid spreading the disease. Insurance companies started selling polio insurance for newborns.

The fear was well grounded. By the 1950s, polio had become one of the most serious communicable diseases among children in the United States. In 1952 alone, nearly 60,000 children were infected with the virus; thousands were paralyzed, and more than 3,000 died. Hospitals set up special units with iron lung machines to keep polio victims alive.

Then in 1955, the U.S. began widespread vaccinations. By 1979, the virus had been completely eliminated across the country. Now polio is on the verge of being eliminated from the world. The virus remains endemic in only two parts of the globe: northern Nigeria and the border between Afghanistan and Pakistan.

On this day, June 23rd, 1995, the creator of the first ever “killed” vaccine, which started the US down the path of eliminating the disease, died. Dr. Jonas Salk was 80 years old. Here are a few facts about the medical genius and the disease he and his colleagues worked to eradicate.

Although polio was the most feared disease of the 20th century, it was hardly the top killer.
The first major polio epidemic in the United States hit Vermont in 1894 with 132 cases. A larger outbreak struck New York City in 1916, with more than 27,000 cases and 6,000 deaths. As the number of polio cases grew, the paralytic disease changed the way Americans looked at public health and disability.

Polio, while definitely on a meteoric rise in the 1950’s, was not the rampant killer it has been portrayed to be. During the 50s and 60s, 10 times as many children died in accidents and three times as many succumbed to cancer. Polio inspired such fear because it struck without warning, and researchers were unsure of how it spread from person to person. In the years following World War II, polls found the only thing Americans feared more than polio was nuclear war.

Salk was rejected by multiple laboratories after medical school.
After graduating from medical school at New York University and completing his residency training, Salk applied to laboratories to work in medical research. Rather than treat patients as a practicing physician, Salk hoped to work on the influenza vaccine, a research area he began studying in medical school.

Although he was rejected from multiple labs, perhaps due to quotas that discriminated against Jewish people, he didn’t get discouraged. “My attitude was always to keep open, to keep scanning. I think that’s how things work in nature. Many people are close-minded, rigid, and that’s not my inclination,” he revealed in his Academy of Achievement interview.

Franklin D. Roosevelt and Harry Truman proved instrumental in the vaccine’s development.
A year after his nomination as a Democratic vice presidential candidate, rising political star Franklin D. Roosevelt contracted polio while vacationing at his summer home on Campobello Island in 1921. The disease left the legs of the 39-year-old future president permanently paralyzed. In 1938, five years after entering the White House, Roosevelt helped to create the National Foundation for Infantile Paralysis, later renamed the March of Dimes Foundation, which became the primary funding source for Salk’s vaccine trials. Employing “poster children” and enlisting the star power of celebrities from Mickey Rooney to Mickey Mouse, the grassroots organization run by Roosevelt’s former Wall Street law partner Basil O’Connor was raising more than $20 million per year by the late 1940s.

In 1946, President Harry Truman declared polio a threat to the United States and called on Americans to do everything possible to combat it. “The fight against infantile paralysis cannot be a local war,” Truman declared in a speech broadcast from the White House. “It must be nationwide. It must be total war in every city, town and village throughout the land. For only with a united front can we ever hope to win any war.”

Science initially failed
Early attempts to develop a vaccine ran into numerous hurdles. A vaccine tested on 10,000 children by two researchers at New York University provided no immunity and left nine children dead. Other vaccine trials used “volunteers” at mental institutions.

Salk challenged prevailing scientific orthodoxy in his vaccine development.
While most scientists believed that effective vaccines could only be developed with live viruses, Salk developed a “killed-virus” vaccine by growing samples of the virus and then deactivating them by adding formaldehyde so that they could no longer reproduce. By injecting the benign strains into the bloodstream, the vaccine tricked the immune system into manufacturing protective antibodies without the need to introduce a weakened form of the virus into healthy patients.

Many researchers, such as Polish-born virologist Albert Sabin, who was developing an oral “live-virus” polio vaccine, called Salk’s approach dangerous. Sabin even belittled Salk as “a mere kitchen chemist.” The hard-charging O’Connor, however, had grown impatient at the time-consuming process of developing a live-virus vaccine and put the resources of the March of Dimes behind Salk.

Since Sabin and Cincinnati Children’s Hospital couldn’t gain political support in the U.S. for what he viewed as his superior vaccine, he moved testing to the Soviet Union instead.

Salk tested the vaccine on himself and his family.
After successfully inoculating thousands of monkeys, Salk began the risky step of testing the vaccine on humans in 1952. In addition to administering the vaccine to children at two Pittsburgh-area institutions, Salk injected himself, his wife and his three sons in his kitchen after boiling the needles and syringes on his stovetop. Salk announced the success of the initial human tests to a national radio audience on March 26, 1953.

The clinical trial was the biggest public health experiment in American history.
On April 26, 1954, six-year-old Randy Kerr was injected with the Salk vaccine at the Franklin Sherman Elementary School in McLean, Virginia. By the end of June, an unprecedented 1.8 million people, including hundreds of thousands of schoolchildren, joined him in becoming “polio pioneers.” For the first time, researchers used the double-blind method, now standard, in which neither the patient nor person administering the inoculation knew if it was a vaccine or placebo. Although no one was certain that the vaccine was perfectly safe—in fact, Sabin argued it would cause more cases of polio than it would prevent—there was no shortage of volunteers.

Salk did not patent his vaccine.
On April 12, 1955, the day the Salk vaccine was declared “safe, effective and potent,” legendary CBS newsman Edward R. Morrow interviewed its creator and asked who owned the patent. “Well, the people, I would say,” said Salk in light of the millions of charitable donations raised by the March of Dimes that funded the vaccine’s research and field testing. “There is no patent. Could you patent the sun?” Lawyers for the foundation had investigated the possibility of patenting the vaccine but did not pursue it, in part because of Salk’s reluctance.

Although a tainted batch of the Salk vaccine killed 11 people, Americans continued vaccinating their children.
Just weeks after the Salk vaccine had been declared safe, more than 200 polio cases were traced to lots contaminated with virulent live polio strains manufactured by the Cutter Laboratories in Berkeley, California. Most taken ill became severely paralyzed. Eleven died. In the haste to rush the vaccine to the public, the federal government had not provided proper supervision of the major drug companies contracted by the March of Dimes to produce 9 million doses of vaccine for 1955. Although the United States surgeon general ordered all inoculations temporarily halted, Americans continued to vaccinate themselves and their children. Outside of the “Cutter Incident,” not a single case of polio attributed to the Salk vaccine was ever contracted in the United States.

A rival vaccine supplanted Salk’s in the 1960s.
Once Sabin’s oral vaccine finally became available in 1962, it quickly supplanted Salk’s injected vaccine because it was cheaper to produce and easier to administer. Ultimately, both vaccines produced by the bitter rivals nearly eradicated the disease from the planet. According to the World Health Organization (WHO), there were only 416 reported cases of polio worldwide in 2013, mostly confined to a handful of Asian and African countries. Since Sabin’s live-virus vaccine, which is responsible for about a dozen cases of polio each year, is seen as the final obstacle to eliminating the disease in most of the world, the WHO has urged polio-free countries to return to Salk’s killed-virus vaccine.

Salk was the stepfather of Pablo Picasso’s Children
In 1970, Salk married Françoise Gilot, a French artist who had two children, Claude and Paloma, with Pablo Picasso. In an interview in 1980, Paloma remembered the fear people had of polio, and that as a child, she didn’t visit her father’s house in the South of France due to a polio outbreak. She also revealed that she got along well with her stepfather: “He’s very cute. He’s a wonderful person,” she said. After his death in 1995, Gilot continued her late husband’s legacy by working at the Salk Institute for Biological Studies.

Salk worked on cures for cancer and AIDS
After Salk developed the polio vaccine, he tried to develop vaccines for cancer, AIDS, and multiple sclerosis. Although he wasn’t ultimately successful, he did patent Remune, a vaccine for AIDS to delay the progression of HIV into AIDS. In 2001, six years after Salk died, Pfizer stopped funding clinical trials for Remune due to a lack of evidence that it worked.

Salk was much maligned by the medical community
At the University of Pittsburgh, Salk launched what was then the largest human trial in history and introduced new scientific rigor now used as the gold standard in development of new treatments and tests for pathology. When it was announced that his vaccine worked, Salk was hailed as a humanitarian hero. By 1957, new polio cases had fallen below 6,000.

While heads of state around the globe rushed to celebrate him, many in the medical community derided his efforts. According to Dr. Charlene Jacobs in a interview with the Oxford Press, this was for many reasons:

  1. He preferred the “killed” vaccine, which most in medicine feared would be too weak.
  2. He worked in secret and with a small team.
  3. They claimed he grabbed the limelight and failed to share credit with others.
  4. It appeared he pandered to the press, crossing an imaginary line medicine had set up between science and the media.

Salk won few awards for what is still considered one of the greatest medical breakthroughs
While nominated several times, he did not win the Nobel Peace prize, and he was blackballed from the Academy of Sciences. He won a great deal of social celebrity, for sure, but his insistence on using intuition as much as rigor left many wondering what he really was doing. His dismissal in actual scientific communities is attributed to envy by many who review the history of the time.

Over the years, polio was found to be a highly contagious disease that spread, not in movie theaters or swimming pools, but from contact with water or food contaminated from the stool of an infected person. Along with the vaccine, much was done to improve hygiene in the Americas, The U.S. recorded its last case of polio in 1979, among isolated Amish communities in several states. Then the effort to eradicate polio globally began in earnest. The Western Hemisphere reported its last case, in Peru, in 1991.

Both Salk’s and Sabin’s vaccines are still used today. Although Jonas Salk is credited with ending the scourge of polio because his killed-virus vaccine was first to market, Albert Sabin’s sweet-tasting and inexpensive oral vaccine continues to prevent the spread of poliomyelitis in remote corners of the world. While the later version, which requires just two drops in a child’s mouth, proved much easier to use in mass immunization campaigns, today, it is being marked as the final barrier to truly eliminating polio – it does occasionally infect patients. The complete return to Salk’s vaccine has been promoted by the World Health Organization (WHO) since 2000.

Advances in medicine sometimes come from great intuition complimented with heavy doses of experience and meaningful development. These three make a powerful elixir. HealthLynked could be that kind of breakthrough – a good mix of real world wisdom, a touch of intuition and a love of professional rigor.

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sources:

npr.org

pbs.org

Nytimes.com

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