Changed route of immunization dramatically improves efficacy of TB vaccine submitted by /u/Express_Hyena
[link] [comments] https://ift.tt/eA8V8J January 04, 2020 at 07:32AM https://ift.tt/1R552o9
Preparing for a Mental Health Crisis
Mental health issues can be very difficult to manage, but preparation is helpful and could be lifesaving. Just as other emergencies can be handled better with plans and necessary supplies in place (winter storms, power outages, and emergency childcare or health problems), you have control in quiet times to think of what you might need in a crisis, and you can decide on management plans that you approve of ahead of time. With many aspects of illness outside your control, this is one area that can give you confidence. You are the main person responsible for your care.
How can you create a crisis management plan? Write down emergency numbers. These can include the National Suicide Prevention hotline (1-800-277-8255) as well as any other contact information you or emergency personnel might need. This should include your doctor, employer (if you think your boss needs to be notified you will be missing work), and anyone responsible for your children. A list of medication and insurance cards in your wallet, as well as timely refills, is a good way to make check-ins quicker if you need medical care. Some people add a health directive, too. Information about this is available from your doctor.
What comforts you? Put a kit together with some of these items to use on days when you need them. Everything from a fidget gadget to a chocolate snack is worthy. These stress relievers have a basis in science. Fidgeting (or movement) can calm the nervous system, and a little chocolate is a well-known soother of the soul. You can even write encouraging notes to yourself, so you know this time will pass and you will feel better. Add a reminder to call or visit someone whose understanding will help you get through. If you tend to isolate, decide in what situations you want to avoid being alone. Watching a movie with a friend or making ice cream sundaes or birthday gifts can keep your mind occupied. You know what things work for you and what to skip. Music is often helpful. Exercise. You can add a few cards with lists of what has worked before or what you would like to try. Add these and items like a soft blanket and pillow to your kit.
Think about what you want family members and/or a trusted friend to do if you begin acting as if you are not your normal self. It isn’t always possible for a person to recognize danger signs, when it comes to behavior or mental disorders, so write out messages you think would help you if your contacts feel you may need help. These might serve as a check-in with yourself, so you can make a decision about where you are on the mental health spectrum. They are also good reminders when you are okay and can let others know that.
As you develop your plan, you can let them know what you’re doing, and what you would like them to do. Open discussion, while it may be embarrassing sometimes, is a powerful tool you can use to keep at least your primary contact informed. An example would be to ask someone to keep an extra key to your home in case they need to check on you. If you have bipolar disorder and know you might be hypomanic at times, giving someone permission to freeze your credit card might save you a huge amount of money. And on some days, a little extra care and comfort is a lot like a bowl of chicken soup. It might be enough to help you recover your equilibrium before a crisis really starts.
Research and learn all you can about your condition. Counselors can help with this and often encourage developing a good management plan. You can help your family members understand and develop a plan for their own reactions to sudden and often frightening crisis days by sharing this information and what you do to manage your life successfully. If there are areas or times you need help with, who better to call on than someone who loves you? The fear tactics of mental illness tell you otherwise, but don’t let that hold you back. If you are unsure about something, speak with your counselor or write it down in your journal and examine what truth or lies it holds.
It isn’t your fault that you must manage a medical condition. Your situation may be complicated (or even “invisible”), but you never deserve stigma or shame. Though diabetes or a broken arm might be easier for people to understand, remember that your brain is like any other part of your body. You are not alone but one in millions of people who are taking charge of their mental health each year.
Keep exercising as it’s good for your brain’s gray matter, suggests new study (n=2,013). Cardiorespiratory fitness is linked to increases in gray matter and total brain volume, associated with cognition, suggesting that exercise contributes to improved brain health and slows decline in gray matter.
Keep exercising as it’s good for your brain’s gray matter, suggests new study (n=2,013). Cardiorespiratory fitness is linked to increases in gray matter and total brain volume, associated with cognition, suggesting that exercise contributes to improved brain health and slows decline in gray matter.
https://ift.tt/39x5DyG January 03, 2020 at 04:53PM https://ift.tt/1R552o9
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Broadest ever therapeutic HPV vaccine to be tested in clinical trial - Treatment could clear up persistent infections and reduce risk of cervical cancer
Broadest ever therapeutic HPV vaccine to be tested in clinical trial - Treatment could clear up persistent infections and reduce risk of cervical cancer
https://ift.tt/37sJoYI January 03, 2020 at 05:07PM https://ift.tt/1R552o9
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submitted by /u/mvea [link] [comments] |
Why medical research keeps changing its mind
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Did you ever wonder why medical research seems to flip-flop so often? Eggs used to be terrible for your health; now they’re not so bad. Stomach ulcers were thought to be due to stress and a “type A personality” but that’s been disproven. I was taught that every postmenopausal woman should take hormone replacement therapy to prevent heart disease and bone loss; now it’s considered way too risky. It can make you question every bit of medical news you hear.
But maybe that’s not such a bad thing. Questioning what you read or hear is reasonable. And maybe medical reversals — when new research leads to a complete turnaround regarding a widespread medical practice or treatment — are not as common as they seem. Perhaps they get more attention than they deserve and drown out the consistent and “non-reversed” medical research that’s out there. For example, it seems unlikely that the health benefits of regular exercise, smoking cessation, or maintaining a healthy weight will ever be reversed.
A new study examines medical reversals
A remarkable new study explored the phenomenon of medical reversals to determine how common they are, and to identify what types of conditions were most involved.
Researchers collected more than 3,000 randomized controlled trials; these are considered the most reliable types of research because they randomly assign otherwise similar study subjects to different treatment groups and try to account (control) for factors other than the treatments that might affect the results. For example, a trial comparing two treatments to prevent heart attacks would need to have a similar proportion of people with high cholesterol or high blood pressure, because these can affect the risk of heart attack.
In this new study, the analysis was limited to three of the top medical journals in the world: JAMA (formerly known as the Journal of the American Medical Association), The Lancet, and the New England Journal of Medicine. For each medical reversal identified, the authors searched for later studies refuting the findings and only counted those that had stood the test of time (so far!).
Here’s what they found:
- Of 3,017 studies analyzed from the last 15 years, 396 came to conclusions that reversed prior treatments or practice recommendations. This represented about 13% of randomized controlled trials appearing in these journals and about 6% of their original research papers.
- The most common conditions were cardiovascular disease, preventive medicine, and critical care medicine (such as care received in an intensive care unit).
- Medications, procedures, and vitamins accounted for about two-thirds of the reversals.
Examples of medical reversals
Among the nearly 400 medical treatments or practices that were reversed during the years of this new study, here are some notable examples.
- Wearable technology for weight loss. When fitness trackers first became widely available, recommendations to use them to help with weight loss were common. But a study in 2016 found that they were no more effective (and perhaps less so) than a standard weight-loss program that did not use an activity tracker.
- Hormone replacement therapy (HRT). For more than 50 years, HRT was thought to prevent chronic disease, such as cardiovascular disease, in menopausal women. A number of more recent (and more powerful) studies have demonstrated that HRT provides no such benefits, and that some combinations of hormonal therapy may increase the risk of certain cancers, stroke, and blood clots. HRT may still be recommended for women with significant menopausal symptoms, such as hot flashes, but it is no longer prescribed to prevent chronic disease.
- Surgery for a meniscal (cartilage) tear with osteoarthritis of the knee for adults ages 45 and older. This combination of problems is common among middle-aged and older adults and is frequently detected when MRI scans are performed to evaluate knee pain. While surgery was often recommended and performed to remove or repair the torn meniscus, it was uncertain whether this was truly necessary. A study in 2013 found that initial treatment with physical therapy was just as effective as immediate surgery. Guidelines soon changed to advise nonsurgical treatment as the initial approach for most middle-aged or older patients with meniscal tears and osteoarthritis of the knee.
Medical myth or medical fact?
Myth and misconception are common in matters of health and medical practice. But it’s also true that medical fact is a moving target. Things we accepted as fact years ago sometimes turn out to be wrong, as these medical reversals demonstrate. Meanwhile, certain myths could turn out to have credence if well-designed research concludes as much.
The reason this study about medical reversals is so important is that it points out how vital rigorous research is, not only for new treatments or innovative procedures, but also to evaluate older, well-established ways of doing things.
What’s next?
Hearing medical experts flip-flop on their recommendations or conclusions about medical news seems common — but is 6% of original research or 13% of all randomized controlled trials “too high”? I’d argue that it’s not. In fact, rather than casting doubt on all research, this new study about medical reversals should serve as a measure of reassurance that skepticism is alive and well in the research community, and that “low-value medical practices” will be uncovered if the right research is designed, funded, and implemented.
You can bet that there will be more head-scratching, mind-bending medical reversals in the future. Just keep in mind that most of this is simply a reflection of how researchers are continuing to clarify what works in medicine — and what doesn’t. The best they can do is to keep at it. The best we can do is to consider medical news with a critical eye and to keep an open mind.
The post Why medical research keeps changing its mind appeared first on Harvard Health Blog.
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