Negative memories of gym class may impact adults’ lifestyle

(Reuters Health) – – Negative childhood experiences in physical education (PE) classes may have long-term effects on adult physical activity, a large study suggests.

FILE PHOTO: A primary school student runs during a physical education class in Taipei September 20, 2007. REUTERS/Nicky Loh

Researchers conducted an online survey of more than 1,000 adults, ages 18 to 45, across 46 states about their best and worst memories of their PE experiences, as well as their attitude about physical activity now. The 392 male and 636 female respondents were recruited by an internet service for monetary compensation.

“Memories of enjoyment of PE . . . were the most substantial correlates of present-day attitudes and intentions for physical activity,” the investigators report in the Translational Journal of the American College of Sports Medicine.

For example, they found, rarely being chosen first for team sports in gym class was “strongly related to the amount of time spent sitting on weekdays and on the weekend” in adulthood.

Thirty-four percent of respondents reported feeling embarrassed by their childhood PE experience.

The next most frequent “worst memory” theme was lack of enjoyment in PE activities, reported by 18 percent.

People’s best memories of PE class included receiving positive recognition from peers or teachers regarding their performance.

“The most surprising thing about our research was the vividness of (memories and the) emotional impact. This tells us these were transformative experiences,” senior author Panteleimon Ekkekakis of Iowa State University in Ames told Reuters Health by phone.

People’s gym-class memories “had some degree of influence on their self-perception and . . . the degree of their sedentariness,” said Ekkekakis.

However, he stressed, the association was only “modest at best.”

“We’re not saying the experiences are deterministic and that one negative experience is going to determine a person’s physical activity level for the rest of their life,” he said.

Christopher Hersl, vice president of programs and professional development at the Society of Health and Physical Educators (SHAPE America), who was not involved in the study, told Reuters Health by phone, “Our number one goal is to turn out children that are healthy, happy and productive. If our instructional practices are causing any of these things not to happen then we need to reconsider our practices.”

Carolyn Buenaflor, associate director of Cedars Sinai Healthy Habits, a community benefit program that partners with school districts within Los Angeles to provide nutrition education and physical activity programs, told Reuters Health by phone that children today might not have the same PE experiences as their parents did.

Buenaflor said many of the elimination games children and adolescents used to play in gym class have been replaced with non-elimination games. PE classes also play more group games than sports games where one student at a time shined or did not.

“Getting in front of the class and kicking the ball is not the best thing to foster enjoyment and physical exercise,” said Buenaflor, who was not involved in the research,

People’s recollections of past experiences may not be accurate, the authors acknowledge. And this kind of study can’t prove that early experiences affected later attitudes.

Still, they point out, “If improvements in PE experiences could inspire even small increases in (physical activity), millions could derive additional health benefits.”

It seems clear, they conclude, “that decades-old arguments concerning the focus on sport in PE programs and . . . fitness testing should be revisited. (With further research) it may be possible to transform PE into a professional field that closely adheres to the (evidence and) . . . that welcomes psychological best practices for the benefit of children and public health.”

SOURCE: Translational Journal of the American College of Sports Medicine, online August 22, 2018.

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Doctors should ask teens about gender identity, experts say

(Reuters Health) – – Doctors who treat adolescents should find ways to ask them about their gender identity during office visits, researchers say.

FILE PHOTO: A gender-neutral bathroom is seen at the University of California, Irvine in Irvine, California, U.S. September 30, 2014. REUTERS/Lucy Nicholson

These discussions could help doctors know whether youngsters might benefit from gender-affirming medical and psychosocial support, the researchers write in the Journal of Adolescent Health.

“Medical providers cannot provide potentially helpful services and referrals if they do not know that their patient is transgender,” said lead study author Dr. Carly Guss of Boston Children’s Hospital.

An estimated 150,000 U.S. adolescents identify as transgender, she said. Transgender youth face health disparities, including being at higher risk for depression, anxiety and suicide, compared to their cisgender peers.

“Asking all patients their gender identity and pronouns creates a gender-affirming environment,” Guss told Reuters Health by email.

Guss and colleagues surveyed the seven Leadership and Education in Adolescent Health (LEAH) programs across the U.S. that are funded by the Maternal and Child Health Bureau to provide interdisciplinary leadership training. The researchers asked whether and how the programs ask patients for information about gender identity and what barriers they face when documenting that information.

The seven programs – in Alabama, California, Indiana, Maryland, Massachusetts, Minnesota and Washington State – managed a total of 43 primary care and specialty clinics. Thirty-one clinics, or just over two-thirds, used a standardized questionnaire template for patients to enter information into the electronic health record. But only 22 of the 31 had a standardized gender identity question that “aimed to identify transgender or gender expansive youth.”

Four of the seven LEAH programs had a workflow for documenting a transgender youth’s name and preferred pronouns in electronic medical records, and four programs had a specialty gender clinic among their facilities, the researchers report.

At sites that did not regularly ask adolescent patients about gender, barriers to implementing a standardized question included concerns about confidentiality, a lack of trained providers, lack of a referral network, low numbers of transgender patients and not having a validated gender identity question.

“It was notable that there are still barriers to incorporating questions about gender identity into routine clinical care,” Guss said.

As a next step, Guss and colleagues want to know more about how doctors use gender identity information and how it can improve care. Doctors also need more training on how to sensitively engage transgender youth during medical visits, she said.

“In pediatrics and general medicine, there is very little attention and time spent on education around any LGBTQ issues, especially transgender care,” said Dr. Ilana Sherer, who wasn’t involved in the study.

Sherer, a founder of the Child and Adolescent Gender Center at Benioff Children’s Hospital in Oakland, California, teaches doctors how to talk about transgender and gender identity concerns.

“I suspect there is an attitude that transgender is uncommon and unusual and not something providers would need to know as much about, but we can’t even know unless we ask, and so many providers don’t know how to ask,” she said by email.

Researchers are also interested in youths’ perspectives on being asked about gender identity and the age at which gender identity should be asked and documented, said Diane Chen, a pediatric psychologist at the Ann and Robert H. Lurie Children’s Hospital in Chicago, who wasn’t involved in the study.

The general consensus is that by age 11, U.S. youth are generally able to answer gender identity questions without support, she said.

Asking about gender identity “also represents an important step to creating affirming, inclusive healthcare environments,” Chen said by email.

SOURCE: Journal of Adolescent Health, online August 13, 2018.

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China confirms sixth African swine fever outbreak in the country

BEIJING (Reuters) – China’s Ministry of Agriculture said on Sunday that 134 hogs had died from African swine fever in Xuancheng city of eastern Anhui province, bringing the total number of outbreaks in China over the past month to six.

Xuancheng city is around 70 km (45 miles) southeast of Wuhu city, where another African swine fever case in Anhui was reported last week.

Live hogs and animals that can be easily infected and products from them are banned from being transported into and outside the infected area, the ministry said.

Reporting by Judy Hua, Stella Qiu, Hallie Gu and Josephine Mason; Editing by Alison Williams

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China says has culled over 38,000 hogs due to African swine fever

BEIJING (Reuters) – China culled more than 38,000 hogs as of Sept. 1 due to African swine fever outbreaks, the agriculture ministry said on Sunday.

FILE PHOTO – Piglets are seen by a sow at a pig farm in Zhoukou, Henan province, China June 3, 2018. Picture taken June 3, 2018. REUTERS/Stringer

China, where pork is a staple meat, has reported five swine fever cases in five different provinces in a month, prompting authorities to cull hogs to contain the outbreak.

Epidemic culling and harmless treatment has basically finished in Liaoning, Henan, Jiangsu and Zhejiang provinces, where a total of 37,271 hogs were culled, while another 1,264 hogs were put down by Saturday in Anhui province.

Live hogs from provinces with outbreaks are banned from being transported outside and live hog markets in those provinces will be shut, the ministry said.

Live hogs from unaffected provinces cannot be transported through infected provinces, it added.

The ministry said on Wednesday it cannot rule out the possibility of new outbreaks as concerns grow over the deadly disease’s spread in the world’s largest hog herd.

Reporting by Judy Hua, Stella Qiu and Josephine Mason; Editing by Kim Coghill

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Exclusive: Brazil prosecutors hope to strike deal lifting glyphosate injunction

BRASILIA (Reuters) – Brazil federal prosecutors are negotiating with health authority Anvisa and the agriculture ministry to reach a deal that could lift an injunction against the popular weed-killer glyphosate, a prosecutor on the case told Reuters on Friday.

Prosecutors have requested a meeting next week to discuss a deal just as a ban on glyphosate products already on the market is expected to go into effect on Monday, Brasilia-based prosecutor Luciana Loureira Oliveira said by telephone.

The deal would lift injunctions on new and existing products provided that Anvisa issues a decision in the first quarter of 2019 on the chemical’s safety and the ministry agrees not to appeal the health regulator’s decision, she said.

Court documents say billions of dollars of agricultural trade could rest on whether glyphosate is ultimately allowed in Brazil, the world’s largest exporter of soy.

Brazilian farmers widely apply the herbicide to the oilseed and other crops with Monsanto SA, owned by Germany’s Bayer AG, being the largest supplier of glyphosate products in the country.

Monsanto is also facing legal backlash in the United States with hundreds of cases alleging glyphosate causes cancer.

The Brazilian federal prosecutors’ office has said that new evidence, including a study conducted in 2015 by an arm of the World Health Organization, indicates glyphosate could cause cancer and the country should reevaluate the chemical’s safety.

A Brazilian judge ruled earlier this month to halt the registration of new glyphosate-based products in the country and to suspend existing registrations after 30 days, to remain in effect until Anvisa issues a ruling on its safety.

That deadline is expected to lapse on Monday, Oliveira said, just as farmer’s are set to start planting the soy crop next month.

The Solicitor General’s office is appealing the decision with the backing of the agriculture ministry, but the court has yet to rule on the appeal.

A deal, subject to court approval, would shelve the injunction and allow glyphosate products to be used until Anvisa reaches a decision, Oliveira said.

Getting the ministry’s agreement to abide by the ruling would potentially avoid a long process of multiple layers of appeals within Brazil’s complex legal system, Oliveira said.

“We want to abbreviate this whole process that could still be very long,” she said.

Anvisa said it was taking necessary legal action in the case and could not comment on the prosecutor’s remarks. The ministry of agriculture’s press office declined to comment on the proposed deal.

A representative for Bayer and Monsanto said the companies maintain their previous statement that 40 years of use in practice and reviews by authorities around the world have shown that glyphosate is safe to use.

Reporting by Jake Spring in Brasilia; Editing by Brad Brooks, Matthew Lewis and Cynthia Osterman

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Fake, low quality drugs come at high cost

(Reuters Health) – About one in eight essential medicines in low- and middle-income countries may be fake or contain dangerous mixes of ingredients that put patients’ lives at risk, a research review suggests.

Researchers examined data from more 350 previous studies that tested more 400,000 drug samples in low- and middle-income countries. Overall, roughly 14 percent of medicines were counterfeit, expired or otherwise low quality and unlikely to be as safe or effective as patients might expect.

“Low-quality medicines can have no or little active pharmaceutical ingredient (and) can prolong illness, lead to treatment failure and contribute to drug resistance,” said lead study author Sachiko Ozawa of the University of North Carolina at Chapel Hill.

“Or it may have too much active ingredient and cause a drug overdose,” Ozawa said by email. “If it is contaminated or has other active ingredients, then the medication could cause poisoning, adverse drug interactions or avertable deaths.”

Much of the research to date on counterfeit or otherwise unsafe medicines has focused on Africa, and about half of the studies in the current analysis were done there.

Almost one in five medications tested in Africa were fake or otherwise potentially unsafe, researchers report in JAMA Network Open.

Another third of the studies were done in Asia, where about 14 percent of medicines tested were found to be counterfeit or otherwise unsafe.

Antibiotics and antimalarials were the most tested drugs in the analysis. Overall, about 19 percent of antimalarials and 12 percent of antibiotics were falsified or otherwise unsafe.

While fake or improperly made medicines undoubtedly harm patients, the current analysis couldn’t tell how many people suffered serious side effects or died as a result of falsified drugs.

Researchers did try to assess the economic impact of counterfeit or improperly made medicines and found the annual cost might run anywhere from $10 billion to $200 billion.

While the study didn’t examine high-income countries, drug quality concerns are by no means limited to less affluent nations, Ozawa said.

“Even in high-income countries, purchasing cheaper medicines from illegitimate sources online could result in obtaining substandard or falsified medicines,” Ozawa said. “Verify the source before you buy medications, and make policymakers aware of the problem so they can work to improve the global supply chain of medicines.”‘’

The study wasn’t a controlled experiment designed to prove whether or how counterfeit or poorly made medicines directly harm patients, however. And economic impact was difficult to assess from smaller studies that often didn’t include detailed methodology for calculating the financial toll.

The report “provides important validation of what is largely already known,” Tim Mackey of the Global Health Policy Institute in La Jolla, California, writes in an accompanying editorial. “It is important to note that although the study is comprehensive, its narrow scope means it only provides a snapshot of the entire problem, as it is limited to studies conducted in low- and middle-income countries and to those medicines classified as essential by the World Health Organization.”

SOURCE: JAMA Network Open, online August 10, 2018.

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Urological problems in men linked to depression and sleep disorders

Men who suffer from urological problems such as erectile dysfunction, urinary tract and bladder problems or infertility issues often also suffer from depression and sleep disorders. Physicians should therefore be aware of these risks so that they can refer their patients to relevant specialists and provide comprehensive and timely care of male patients. This is according to Arman Walia of the University of California Irvine in the US, in a study in the Springer Nature-branded IJIR: Your Sexual Medicine Journal.

As part of the study, 124 patients visiting a Men’s Health clinic in the US completed three urological questionnaires. These asked whether they had prostate issues or suffered from erectile disfunction, and whether these were age-related. They also filled in four other questionnaires about their general health and sleeping habits, including whether they suffered from insomnia, sleepiness or sleep apnea. Walia and his team evaluated these questionnaires together with information about the participants’ medical history and specific laboratory test results. The men involved in the study were on average 54 years old.

Overall, the study identified associations between urologic disease and sleep and mood complaints in patients presenting to a Men’s Health clinic. Depression, insomnia and sleep apnea were commonplace and were particularly prevalent in older patients, those who were overweight or suffered from lower urinary tract symptoms. These problems were also common among patients who had hypogonadism which is where the body does not produce enough of the male hormone testosterone.

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Three in every four participants were overweight, while 22.5 per cent suffered from hypertension, 15 per cent had heart problems, and 13.3 per cent were diabetic. Two in every five men were mildly to severely depressed or had prostate problems. One in every two patients suffered from sleep apnea or mild to severe erectile problems. Lower levels of male sex hormones were measured in four out of every five men.

“When addressing the entirety of a patient’s disease burden, a practicing urologist should take into account these associations while evaluating a patient, particularly because non-urologic disease may negatively impact urologic disease,” says Walia.

“Urologists are not specifically trained in sleep medicine or how to manage depression, and therefore should have an appropriate threshold for referral,” he notes. “This underscores the importance of screening for conditions, thereby preventing patients from slipping through the cracks and being able to more accurately identify those in need of further intervention.”


Posted in: Men’s Health News | Medical Research News

Tags: Bladder, Depression, Erectile Dysfunction, Health Clinic, Heart, Hormone, Hypogonadism, Infertility, Insomnia, Laboratory, Men’s Health, Prostate, Sleep, Sleep Apnea, Testosterone

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