Sunday, November 30, 2014

No more Ebola cases in Mali after patient cured: president

Mali's President Ibrahim Boubacar Keita (front) checks on measures preventing the spread of Ebola in Kouremale, at Mali's border with Guinea November 17, 2014. REUTERS/Joe Penney

Mali's President Ibrahim Boubacar Keita (front) checks on measures preventing the spread of Ebola in Kouremale, at Mali's border with Guinea November 17, 2014.

DAKAR (Reuters) - Mali has no more confirmed cases of Ebola after the last patient known to be suffering from the virus was cured, President Ibrahim Boubacar Keita said on Saturday.

Mali has registered eight cases of Ebola - seven of them confirmed and one probable - after the virus spread from neighboring Guinea, the World Health Organization (WHO) said this week.

Six of these people infected have died, the WHO said. A further 285 people who came into contact with them are being monitored but have shown no sign of the disease.

"At this moment, there are no cases of infection (in Mali)," Keita told a summit of francophone nations in Senegal.

"The suspected case turned out to be negative and the day before yesterday we had the good news of the first cured case of Ebola so I can now say zero cases in Mali," he said.

The death toll in the world's worst Ebola epidemic has risen to 5,689 out of 15,935 cases reported in eight countries by Nov. 23, according to the WHO.

All but 15 deaths have been in Guinea, Sierra Leone and Liberia - and the three countries have reported 600 new cases in the past week, the WHO's latest update says.

Cuban doctor with Ebola 'improving' in Geneva hospital

HAVANA (Reuters) - The Cuban doctor who contracted Ebola while treating patients in Sierra Leone is improving with each day and eating normally, though he is still weak, a Swiss hospital said on Friday.

Felix Baez, 43, arrived at University Hospitals of Geneva (HUG) a week ago for treatment of the disease that has killed more than 5,600 people since March, mostly in Sierra Leone, Liberia and Guinea.

Baez is one of 256 Cuban doctors and nurses sent to West Africa to treat patients, a commitment that has won wide international praise for the poor, Caribbean island. "Today, Dr. Felix Baez is still weak and is recovering gradually. He is eating normally and his general condition is improving every day. He is in daily contact with his family," the statement said.

On Tuesday, the hospital had reported a significant decrease in the amount of the virus in his blood. Cuban officials previously said his fever was reduced before traveling from Freetown to Geneva on Nov. 20 and that he had lost his appetite.

Baez has been treated in a special room in an isolated area of the hospital by a team of five specialists employing strict safety protocols. He is the first Cuban known to have contracted Ebola in this outbreak, the worst on record with about 16,000 cases reported.

Some 165 Cuban doctors and nurses have gone to Sierra Leone for six-month missions, with another 53 in Liberia and 38 in Guinea.

Exclusive: U.S. CEOs threaten to pull tacit Obamacare support over 'wellness' spat

Cathey Park of Cambridge, Massachusetts shows her cast signed by U.S. President Barack Obama after he spoke about health insurance at Faneuil Hall in Boston October 30, 2013. REUTERS/Kevin Lamarque

Cathey Park of Cambridge, Massachusetts shows her cast signed by U.S. President Barack Obama after he spoke about health insurance at Faneuil Hall in Boston October 30, 2013.

NEW YORK (Reuters) - Leading U.S. CEOs, angered by the Obama administration's challenge to certain "workplace wellness" programs, are threatening to side with anti-Obamacare forces unless the government backs off, according to people familiar with the matter.

Major U.S. corporations have broadly supported President Barack Obama's healthcare reform despite concerns over several of its elements, largely because it included provisions encouraging the wellness programs.

The programs aim to control healthcare costs by reducing smoking, obesity, hypertension and other risk factors that can lead to expensive illnesses. A bipartisan provision in the 2010 healthcare reform law allows employers to reward workers who participate and penalize those who don't.

But recent lawsuits filed by the administration's Equal Employment Opportunity Commission (EEOC), challenging the programs at Honeywell International and two smaller companies, have thrown the future of that part of Obamacare into doubt.

The lawsuits infuriated some large employers so much that they are considering aligning themselves with Obama's opponents, according to people familiar with the executives' thinking.

"The fact that the EEOC sued is shocking to our members," said Maria Ghazal, vice-president and counsel at the Business Roundtable, a group of chief executives of more than 200 large U.S. corporations. "They don't understand why a plan in compliance with the ACA (Affordable Care Act) is the target of a lawsuit," she said. "This is a major issue to our members."

"There have been conversations at the most senior levels of the administration about this," she added.

Business Roundtable members are due to meet Obama in a closed-door session on Tuesday, where they may air their concerns.

It is not clear how many members of the group, whose companies sponsor health insurance for 40 million people, are considering any action. It is also not clear if the White House can stop the EEOC from challenging wellness programs.

A threat of a corporate backlash comes at a time when Obama faces criticism even from his Democrats' ranks that he had devoted too much political capital to healthcare reform.

Such action could take the form of radical changes in health benefits that employers offer. It could also mean supporting a potentially game-changing challenge to Obamacare at the Supreme Court next year and expected Republican efforts to eviscerate the law when they take control of Congress in 2015.

CARROTS AND STICKS

Obamacare allows financial incentives for workers taking part in workplace wellness programs of up to 50 percent of their monthly premiums, deductibles, and other costs. That translates into hundreds and sometimes thousands of dollars in extra annual costs for those who do not participate.

Typically, participation means filling out detailed health questionnaires, undergoing medical screenings, and in some cases attending weight-loss or smoking-cessation programs.

One of the arguments presented in the lawsuit against three employers is that requiring medical testing violates the Americans with Disabilities Act.

That 1990 law, according to employment-law attorney Joseph Lazzarotti of Jackson Lewis P.C. in Morristown, N.J., largely prohibits requiring medical tests as part of employment.

"You can't make medical inquiries unless it's consistent with job-necessity, or part of a voluntary wellness program," he said.

The lawsuits are based on the view that it is no longer voluntary if employees face up to $4,000 in penalties for non-participation, loss of insurance or even their jobs.

Employers, however, see the lawsuits as reneging on the administration's commitment to an important part of the healthcare reform.

On Nov. 14, Roundtable president John Engler sent a letter to the Labor, Treasury and Health and Human Services cabinet secretaries who oversee Obamacare asking them to "thwart all future inappropriate actions against employers who are complying with" the law's wellness rules, and warning of "a chilling effect across the country."

Asked for a response to the letter, an administration official told Reuters that it supported workplace health promotion and prevention "while ensuring that individuals are protected from unfair underwriting practices that could otherwise reduce benefits based on health status."

UNDERMINING OBAMACARE

In practical terms, large corporations have several ways to undermine Obamacare if they decide to.

One is to support legal challenges to the subsidies given to low-income individuals who buy health insurance on the federal exchange established under the law. Neither the Business Roundtable nor any of its CEO members have done this so far. The Supreme Court is expected to hear oral arguments in the case in 2015.

Another option is to make top executives available for hearings on repealing or diluting Obamacare. "We never did this before," said the person familiar with the executives' thinking. "But they could turn up the noise. I don't think the White House would want the CEOs turning on them and supporting these efforts on the Hill."

The nuclear option would be to radically change employer-sponsored health insurance. Large corporations are highly unlikely to eliminate it, but they might give workers a fixed amount of money to buy coverage on a private insurance exchange. That would allow employers, almost all of which pay workers' medical claims out of their earnings, to cap their healthcare spending.

Surgeon who died of Ebola eulogized at Maryland service

LANDOVER HILLS, Md. (Reuters) - Martin Salia, a surgeon from Sierra Leone who died in a Nebraska hospital earlier this month after contracting Ebola in his homeland, was remembered as a humanitarian and a hero at his funeral in Maryland on Saturday.

The 44-year-old doctor was born and raised in Sierra Leone and lived as a permanent resident of the United States with his wife and two sons in New Carrollton, Maryland, outside of Washington, D.C.

He returned to Sierra Leone in August to help treat victims of Ebola, a deadly virus that has killed at least 5,689 people, mainly in West Africa in its latest outbreak.

"By dedicating himself to promoting the health of others, Martin reflected the essential American belief that we have obligations to one another," President Barack Obama said in a statement read by a White House representative during the services at a Roman Catholic church in Landover Hills.

Salia was the second person to die in the United States while being treated for Ebola. Several others have survived after aggressive treatment at hospitals in Nebraska, Atlanta, New York and Maryland.

Salia's treatment was delayed when his first two tests for Ebola falsely showed no presence of the virus in his blood. A third test came back positive.

By the time the doctor arrived at Omaha's Nebraska Medical Center on a specially equipped airplane arranged by the U.S. State Department, two weeks had elapsed since he contracted Ebola.

The medical staff reported his kidneys were failing and his breathing labored. The blood transfusions and experimental drugs they gave him were too late to save him. He died Nov. 17 and was cremated.

"The greatest heroes are the people who choose to face danger," Ron Klain, the White House's Ebola Response Coordinator, said as he eulogized Salia. "We need more people like Martin Salia."

Earlier this week, the World Health Organization said Ebola deaths in Sierra Leone were rising even while the disease is being brought under control in neighboring countries of Liberia and Guinea.

Bockari Stevens, Sierra Leone's ambassador to the United States, called for more international aid to help his country control the epidemic. 

"We are losing too many people," he said at the funeral.

(Editing by Frank McGurty and Lisa Shumaker)

Thursday, November 27, 2014

Breast cancer recurrence risk down since 1980s

The world's largest awareness ribbon made of flowers is seen from above during the UAE leg of the Avon Walk around the world for Breast Cancer Awareness walkathon in Zaabeel park in Dubai, November 16, 2007. REUTERS/Jumana El Heloueh

The world's largest awareness ribbon made of flowers is seen from above during the UAE leg of the Avon Walk around the world for Breast Cancer Awareness walkathon in Zaabeel park in Dubai, November 16, 2007.

(Reuters Health) - Rates of breast cancer recurrence fell by half or more between the 1980s and the early 2000s - likely due to improved treatments and increased screenings, according to a new study from Canada.

The analysis of data on Canadian breast cancer patients offers reassurance that breast cancer survival is improving and also provides updated data to researchers, said the study’s lead author, Dr. Karen Gelmon from the BC Cancer Agency in Vancouver, British Columbia.

“It gives some contemporary numbers to people designing trials testing adjuvant treatments,” she said.

An earlier study, published in the 1990s and based on data from 1978 to 1988, found that women whose breast cancers fed off the hormone estrogen (so-called estrogen-receptor positive breast cancers) had a consistent risk of the cancer recurring over time. For breast cancers not driven by estrogen, recurrence risk was high for five years after successful treatment, but then dropped below the risk of those with estrogen-receptor (ER)-positive cancers.

In the new study, published in the Journal of Clinical Oncology, Gelmon's team compared data on 7,178 women treated for early to moderately-advanced breast cancer during two different periods: 1986 to 1992, and 2004 to 2008.

The researchers matched the cancer characteristics of each patient from the first period to a patient from the second period, including estrogen-receptor status as well as the presence of another protein on cancer cells, HER2.

The HER2 molecule helps drive cancer-cell growth. Tumors with HER2 tend to be more aggressive than HER2-negative ones, the researchers note.

Starting in the 1990s, drugs targeting molecules on cancer cells like HER2 became available. Together with improved early detection of less-advanced cancers, which gives such drugs a better chance of working, the targeted therapies have been credited with improving overall cancer survival

In the new study, the overall risk of breast cancer recurrence for women in the later group was about 50 percent lower than for women in the earlier group, for each year after being cancer-free.

Like the 1990s study, the new analysis found a high risk of recurrence within the first five years among women with cancers that were not driven by estrogen. Among women treated in the 2000s, that early increased risk was less dramatic, however.

Specifically, the risk of recurrence after one year was about 11 percent among women from the earlier period with cancers not driven by estrogen, compared to about a 6 percent risk among women with the same type of cancer in the later period.

“It showed we were doing better, but the peaks are still there,” Gelmon said.

The researchers also found that HER2-positive cancers saw some of the greatest reductions in recurrence risk.

For example, the risk of recurrence in the second year of being cancer-free among women whose tumors were HER2-positive and ER-negative fell from about 23 percent in the earlier period to about 9 percent in the most recent period.

The new study can't show why recurrence rates improved, but the researchers say it’s most likely a result of screening leading to early detection and more “comprehensive and appropriate” treatments targeting specific cancer types.

For example, they also saw large increases in the use of chemotherapy, and of drugs targeting estrogen-driven cancers, among the most recent patients.

Drugs targeting HER2-positive cancers were not available in the earlier time period.

“I think the most important thing is (the study) validates all these things we’ve been doing all these years,” said Dr. Marleen Meyers, an oncologist and breast cancer expert at the NYU Langone Medical Center’s Perlmutter Cancer Center in New York City.

Meyers, who wasn’t involved in the new study, also called the findings reassuring.

“I think we continue to learn,” she said. “I think this is very good, very positive information for women.”

SOURCE: bit.ly/1vOlzpm Journal of Clinical Oncology, online November 24, 2014.

U.S. government says 462,125 people signed up for 2015 Obamacare plans

(Reuters) - Open enrollment for the second year of Obamacare individual health coverage brought in 462,125 people who chose their health plans in its first week, nearly half of whom were first-time customers, the U.S. government said on Wednesday.

The U.S. Department of Health and Human Services has set a goal of 9 million people for 2015 individual plans. This new coverage was introduced in 2014 for the first time as part of President Barack Obama's national healthcare law, often called Obamacare.

After fixing the technology issues that last year contributed to a rocky start for enrollment in the program, more than 7 million people were enrolled in 2014 plans.

"It's still early and we have a long way to go, but we're off to a solid start," Secretary Sylvia Burwell said during a press conference to discuss the first week's data for the 2015 enrollment period that opened on Nov. 15.

Of the 462,125 people who selected one of the health plans sold on Healthcare.gov, 52 percent were individuals who had enrolled in a 2014 plans. The balance were new customers, including people in Oregon and Nevada who are using the federally run exchange for the first time.

The federal exchange covers 35 states and the remaining states and Washington D.C. run their own exchanges and release their data separately. Oregon and Nevada moved their customers to Healthcare.gov because of technology problems.

Enrollment for 2015 coverage closes on Feb. 15 and current customers who do not actively sign up again by Dec. 15 will be automatically re-enrolled.

Between Nov. 15 and Nov. 21, the website experienced no outages and its peak number of concurrent users was 55,000, HHS said. The site was built to withstand 250,000 concurrent users based on the government's expectation for 9 million people to seek coverage for 2015.

Healthcare.gov had 3,741,725 unique users and 1,032,129 applications were submitted, the agency said.

Cigarette smoking by U.S. adults reaches record low: CDC

A woman smokes a cigarette in this illustration picture taken in Paris, October 8, 2014.  REUTERS/Christian Hartmann

A woman smokes a cigarette in this illustration picture taken in Paris, October 8, 2014.

ATLANTA (Reuters) - Cigarette smoking among U.S. adults last year touched its lowest on record, a drop spurred by higher prices, smoke-free policies and anti-smoking campaigns, the Centers for Disease Control and Prevention said on Wednesday.

About 17.8 percent of American adults smoked cigarettes in 2013, down from 20.9 percent in 2005 and 42.4 percent in 1965, when the U.S. government began keeping records on smoking, the federal health agency said.

While the continuing decline is encouraging, Brian King, a senior scientific advisor with the CDC's Office on Smoking and Health, said the rate is not on track to meet the federal goal of cutting adult cigarette smoking to 12 percent by 2020.

"We need to accelerate the magnitude of the decline," he said.

Tobacco use remains the leading cause of preventable disease in the United States, causing 480,000 premature deaths annually, according to the CDC.

In addition to the overall decline in adult smokers, those who continue to smoke daily are cutting back, the CDC study found. U.S. smokers consumed an average of 14.2 cigarettes per day in 2013, down from 16.7 in 2005.

The CDC said increased access to medications and programs that help smokers quit also have contributed to the drop in smoking rates.

The U.S. Midwest has the highest adult cigarette smoking rate, and the West has the lowest, according to the study.

Lesbians, gays and bisexual adults smoke about 50 percent more cigarettes than heterosexual people, the CDC said.

The agency also expressed concern over the increased use of electronic cigarettes - battery-powered cartridges that produce a nicotine-laced vapor for the "smoker" to inhale - and hookahs, or water pipes.

The use of e-cigarettes by high school students tripled from 2011 to 2013 to 4.5 percent, according to a CDC survey released last week.

The potential risks and benefits of e-cigarettes are subject to a fierce debate, with a lack of long-term scientific evidence on their safety.

(Editing by Jonathan Kaminsky, G Crosse and Colleen Jenkins)

U.S. approves GSK's purchase of Novartis vaccine business: companies

WASHINGTON (Reuters) - GlaxoSmithKline won U.S. antitrust approval to buy Novartis AG's vaccine business, with the exception of influenza vaccines, the two companies said on Wednesday.

The deal is part of a three-way transaction unveiled in April, which includes Britain's GSK buying the vaccines business of Novartis, the Swiss company purchasing GSK's cancer drugs, and the two groups tying up in consumer healthcare.

The U.S. Federal Trade Commission had previously announced on Wednesday that it approved the consumer health care joint venture on the condition that Novartis sell its Habitrol nicotine patch.

Novartis and Glaxo, which has Nicoderm CQ, are two of only three companies that sell nicotine patches to U.S. retailers, the FTC said.

Wednesday, November 26, 2014

Four illnesses you are likely to hear about this summer

Summer is a time for fun in the sun, but those warm, sticky days can also bring an explosion of illnesses. The most common types of illness during summer are often the most unfortunate - gastroenteritis, ear infections, asthma attacks and red rashes to name just a few.  
 
When you’re having loads of fun in the sun and surf, it can be easy to forget the potential ill effects of summer. With that in mind, here are four illnesses to look out for this summer.
  • Asthma Attacks – summer can be a dangerous time for kids and adults with asthma. More air pollution, high pollen levels and increased mould growth due to high humidity can cause a spike in asthma attacks. Symptoms of an asthma attack can include difficulty breathing, wheezing, coughing, shortness of breath and difficulty performing normal daily activities. If you are prone to asthma attacks, keep a close eye on pollen and air pollution. The severity of an asthma attack can escalate rapidly, so it's important to seek a doctor if any of these symptoms occur.
  • Food Poisoning – as the temperature increases, so does the rate of food poisoning. The Food Safety Information Council estimates there are 5.4 million cases of food poisoning a year (including 120 deaths), 1.2 million visits to doctors, 300,000 prescriptions for antibiotics and 2.1 million days of lost work each year. The reason for the outbreak increase in summer is because the bacteria that causes food poisoning grows faster in hot and humid weather. Food poisoning is also one of those illnesses that can be prevented by, frequently washing your hands, wiping cooking surfaces, not allowing foods and utensils to become cross contaminated and cooking foods to their proper temperature and promptly refrigerating leftovers. 
  • If you are suffering from food poisoning, avoid solid foods until nausea and vomiting ends and drink clear fluids to prevent dehydration. If your symptoms are lasting more than 3 days or you have severe belly pain, fever or signs of dehydration, such as dry mouth, dizziness, fatigue or increased heart rate, it is best to call a doctor for treatment. 
  • Swimmers ear and ear infections – next to the common cold, ear infections and swimmers ear are the most common illness in children. Ear infections occur when fluid or other debris gets trapped in the middle ear and becomes infected. The signs and symptoms of an ear infection include pain in the middle ear, your child may not want to eat or they could have trouble sleeping. A child who might have an ear infection should visit a doctor, as they may need antibiotics. To see other treatment options, see one of our earlier posts on the topic here.
  • Heat rash – this is a harmless but very itchy skin rash that can appear all over the body. It is caused by the sweat blocking the sweat ducts in heat and high humidity and results in tiny red spots, an irritating itch, a prickling sensation and occasionally mild swelling. If this occurs, it is best to keep your body cool and drink plenty of water to prevent dehydration and an application of a medicated powder can also help. The rash usually disappears after a few hours and it is unlikely that you will need further treatment. 
If you need an after hours doctor home visit from National Home Doctor Service  during summer to treat these or any other ailments, call 13 SICK.  Home Doctor is available for home visits from 6pm weeknights, 12 noon on Saturdays, all day Sundays and public holidays. To find out if we cover your area, simply type your postcode in our suburb locator here.
 

Banish the Blues Exercise Eat well Sleep Have fun! Talk

By Abi Gold, Family and Parenting Expert, Juggle Family and Parenting Consultancy

Practical tips for staying positive from Abi Gold, Family and Parenting Expert at Juggle Family and Parenting Consultancy.

We all get a little low sometimes, but that's ok, because life does tend to serve us the occasional curve ball. But we soon buck up, and before we know it, we're back to our old selves again. But what if we can't shake off the sadness, control the worry or find joy any more? And how do we keep the blues at bay?
Exercise releases 'feel good' hormones that give you an instant pick-me-up.  Find something you enjoy doing, make it part of your day, and if you can, do it with company, to get the maximum benefit.  Being outside will also give you a lift.
Your mind needs regular nourishment to help it to maintain a positive outlook on life, so fill up on foods rich in Omega-3 fatty acids, like salmon, walnuts and soy beans, and eat plenty of complex carbohydrates, like wholemeal bread and oats, fresh fruit and vegetables.
Tiredness can put a real dampener on your happiness, so prioritise a good night's sleep, to feel energised and better able to cope.  Find a bedtime routine that helps you to wind down, like taking a hot bath, lighting candles or burning incense.  Try to avoid stress and work before bed, avoid caffeine in the evenings, and stick to a regular bedtime.
Surround yourself with happy people who make you feel happy, do things that you enjoy and that challenge you, and smile and laugh lots. Think happy thoughts, make an effort to see positives wherever possible, and seek out good company as soon as you start to feel down. 
We all need someone to confide in, and talking about how we feel is a great way to manage stress and find solutions.  If you're feeling low, find someone to open up to, after all, a problem shared is a problem halved.
 
Everyone has good days and bad days, but seeking out happiness and choosing to be positive are the first steps to being happy most of the time.  So pass the message on, and have a happy day!

Video games and ageing – an unexpected match

There might be a new target market for video games,  and it may not be who you think! Whilst the impact of video games is widely debated, new research has found that video games can help with one of life’s inevitable processes  - the ageing process. For example..
 
Do you know video games may help rejuvenate ageing brains?
 
Ageing is a daunting process, not least because some of the first things to be affected are also the most useful - memory and motor skills to name a couple. We also know that designing activities to reverse the mental effects of ageing is tricky. But the idea that some form of regular mental activity - doing a crossword, for example—can postpone mental decline is not new. Now researchers have found another - playing certain types of video games could help the older people stay sharper for longer.
 
But how exactly do video games help the brain power of older people?
 
Cognitive neuroscientists, particularly in the United States, have been researching and conducting experiments with volunteers aged 60 to 85 to answer this question. 
 
The experiments uncovered some remarkable insights including:
  • Sixty-year-olds who played a custom-designed video game for 12 hours over the course of a month, improved their ability to multitask to levels better than those achieved by 20-year-olds playing the game for the first time
  • Playing games on a TV or Wii system that encourage physical activity may also make an older person less likely to fall - even just a few sessions with the Wii led to improved balance, coordination, and strength
  • Swerving around cars while simultaneously picking out road signs in a video game can improve the short-term memory and long-term focus of older adults
  • People aged 80+ began to show neurological patterns of people in their 20s
  • Improved sustained attention of older people in games where they had to remain vigilant and react quickly to a change on the screen
 
What does this mean for me, my older relatives or the older people I care for?
 
We aren’t suggesting that people over a certain age should rush out and buy a gaming console. What studies like this demonstrate is the importance of regularly participating in activities that challenge our brains by making us think, make decisions and be in control of various situations. Whether that is through video games, smartphone apps, crosswords, puzzles, board games or sudokus - there should be an activity for everyone to find and enjoy.
 
At National Home Doctor Service, we are passionate about providing quality health and medical care, particularly for older people, including those living in aged care facilities. If you or the older people you care for are in need of medical attention after hours, National Home Doctor Service is on hand to help.
 
National Home Doctor Service is a bulk-billing, after hours, doctor home visiting service. We are available for home visits from 6pm weeknights, 12 noon on Saturdays, all day Sundays and public holidays. We also provide a report of each visit to your GP within 24 hours after treatment to ensure follow up and continuity of care. 
 
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Monitoring the health of transgender and other gender minority populations: Validity of natal sex and gender identity survey items in a U.S. national cohort of young adults

Background

A barrier to monitoring the health of gender minority (transgender) populations is the lack of brief, validated tools with which to identify participants in surveillance systems.

Methods

We used the Growing Up Today Study (GUTS), a prospective cohort study of U.S. young adults (mean age = 20.7 years in 2005), to assess the validity of self-report measures and implement a two-step method to measure gender minority status (step 1: assigned sex at birth, step 2: current gender identity). A mixed-methods study was conducted in 2013. Construct validity was evaluated in secondary data analysis of the 2010 wave (n = 7,831). Cognitive testing interviews of close-ended measures were conducted with a subsample of participants (n = 39).

Results

Compared to cisgender (non-transgender) participants, transgender participants had higher levels of recalled childhood gender nonconformity age < 11 years and current socially assigned gender nonconformity and were more likely to have ever identified as not completely heterosexual (p < 0.001). No problems with item comprehension were found for cisgender or gender minority participants. Assigned sex at birth was interpreted as sex designated on a birth certificate; transgender was understood to be a difference between a person's natal sex and gender identity. Participants were correctly classified as male, female, or transgender.

Conclusions

The survey items performed well in this sample and are recommended for further evaluation in languages other than English and with diverse samples in terms of age, race/ethnicity, and socioeconomic status.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.


Tuesday, November 25, 2014

'Dramatic improvement' in Ebola outlook in Liberia: U.S. general

A man walks by a mural with health instructions on treating the Ebola virus, in Monrovia, November 18, 2014. REUTERS/James Giahyue

A man walks by a mural with health instructions on treating the Ebola virus, in Monrovia, November 18, 2014.

DAKAR (Reuters) - A U.S. general in the force helping Liberia fight the Ebola epidemic reported on Monday a dramatic improvement in the situation there and confirmed the cancellation of two planned treatment facilities.

Brigadier General Frank Tate, deputy commanding general of U.S. Operation United Assistance, said the drop in the number of cases in the country was all the more encouraging given recent improvements in reporting capacity.

He said new daily cases have fallen to around 20 from close to 80 when the operation was announced in September. Ebola is still spreading in other parts of West Africa.

"It's a dramatic improvement," he told Reuters on the airstrip of a temporary U.S. logistics base in Dakar as dozens of U.S. soldiers boarded a Monrovia-bound Hercules aircraft.

"It was decided between USAID (U.S. Agency for International Development) and the Liberian government that two of the 17 Ebola Treatment Units was no longer necessary. They were canceled," he said.

Elsewhere in West Africa, the disease is still spreading, especially in neighboring Sierra Leone which recorded 533 new cases in the week to Nov. 16. At least six people have died from Ebola in Mali, whose government is now monitoring hundreds of contacts linked to Guinean imam whose symptoms went undetected.

Tate's comments echoed other positive signs from Liberia, once the epicenter of the worst known Ebola outbreak in history that has killed more than 5,459 people. Already, the United States has decided to trim the number of troops in Liberia from 4,000 to a maximum of 3,000 in December.

Liberian President Ellen Johnson Sirleaf decided this month not to renew a state of emergency there and set a national target of no new cases by December 25.

But Tate warned that authorities need to remain vigilant.

"We can by no means declare victory. We have to continue pressure on this disease in Liberia as well as in Guinea and Sierra Leone and work on border security," he said.

Tate said the United States had no current plans to shift resources to other Ebola-hit countries. "If it became necessary and those orders came to us, we maintain the capability," he said.

China considers tougher tobacco controls: Xinhua

Girls stand next to a ''No Smoking'' sign at a park downtown Shanghai April 27, 2014. REUTERS/Carlos Barria

Girls stand next to a ''No Smoking'' sign at a park downtown Shanghai April 27, 2014.

SHANGHAI (Reuters) - China, the world's biggest tobacco market, is considering a draft regulation that would ban indoor smoking, limit outdoor smoking and end tobacco advertising, the state-run Xinhua news agency has reported.

The draft, published by the legislative affairs office of the State Council, or cabinet, and open for public consultation, included plans to curtail smoking scenes in films and TV shows, Xinhua said in a report published late on Monday.

China faces a smoking-related health crisis, with more than 300 million smokers and hundreds of millions more exposed to second-hand smoke each year. However, cigarettes are part of China's social fabric and advocates of tougher smoking regulations have faced difficulty pushing through controls.

The government's heavy dependence on tobacco taxes has been a major impediment to anti-smoking efforts. Last year, the tobacco industry contributed more than 816 billion yuan ($131.70 billion) to government coffers, an annual rise of nearly 14 percent.

Sources told Reuters in September that intense lobbying by the powerful state tobacco monopoly had resulted in the weakening of controversial legislation that had meant to introduce a complete advertising ban.

The draft regulation would ban indoor smoking in public places and outdoor spaces in kindergartens, schools, colleges, women's and children's hospitals and in fitness venues, Xinhua said. The draft also prohibits selling cigarettes to minors through vending machines.

It urged civil servants, teachers and medical staff to take the lead in tobacco control, saying teachers and medical workers would not be allowed to smoke in front of students or patients.

Bayer resumes efforts to sell diabetes device unit: sources

The logo of German drugmaker Bayer is seen in Leverkusen April 26, 2014. REUTERS/Ina Fassbender

The logo of German drugmaker Bayer is seen in Leverkusen April 26, 2014.

FRANKFURT (Reuters) - German drugmaker Bayer AG is considering a fresh attempt to sell its diabetes device business as it sharpens its focus on margin-rich healthcare sectors, two people familiar with the matter told Reuters on Tuesday.

Bayer is overhauling its structure with plans to list its plastics business on the stock market to free up money for investments and acquisitions in healthcare, veterinary drugs and crop protection products.

It already tried to find a buyer for the Contour blood glucose meter business, which has annual sales of 722 million euros ($897 mln), in 2012 as the industry grappled with increased competition and reimbursement pressure.

But it failed to generate sufficient interest from potential bidders such as French drugmaker Sanofi, sources said at the time.

Two sources told Reuters on Tuesday that Bayer has mandated Credit Suisse to find a buyer for the business and is expecting tentative bids in the first quarter of 2015.

Bloomberg earlier cited sources as saying the diabetes device business, thought to be worth 1 billion to 2 billion euros, might attract bids from private equity firms such as Cinven Ltd, EQT Partners AB and Triton Advisers Ltd.

Bayer and Credit Suisse declined to comment on the matter.

Draft U.S. legislation would curb FDA medical software oversight

SAN FRANCISCO (Reuters) - A draft U.S. bill is circulating in Washington D.C. that would curb the U.S. Food and Drug Administration's regulatory oversight over electronic medical records and some clinical support software, according to a copy of the legislation seen by Reuters.

The Medical Electronic Data Technology Enhancement for Consumers’ Health Act or Medtech Act would limit the FDA's jurisdiction over medical technology that it classifies as posing low risks to patient safety. It builds on previous efforts in the U.S. Senate and House of Representatives.

The bill is being developed by Republican Senator of Utah Orrin Hatch and Democratic Senator of Colorado Michael Bennet and proposes that some software should not be regulated as medical devices. This includes software for administrative support of hospitals, according to a copy of the draft bill.

The FDA is currently working in concert with other federal agencies to propose a strategy for a risk-based regulatory framework for health IT that balances innovation and patient safety.

The FDA declined to comment on pending or proposed legislation.

Some industry experts say the bill would bring clarity to the health IT sector, which is still a regulatory gray area.

"The lack of clear regulation makes it very difficult to plan for the future," said Dan Haley, vice president of government affairs for electronic medical-records company AthenaHealth.

"The act takes a straightforward and clean approach and as a result is less likely to have unintended consequences," added Bradley Merrill Thompson, an FDA-specialist with the Washington D.C.-based legal firm Epstein Becker & Green.

Merrill Thompson said the bill would retain FDA oversight over medium-risk or high-risk software, and technology that serves as an accessory to a medical device. But the bill does not propose any specific body or agency that would be charged with determining levels of risk.

AthenaHealth, IBM and other IT companies publicly declared support for the PROTECT Act, a previous effort to prevent FDA from regulating some health technology. The PROTECT act was introduced in February of 2014.

It not yet clear if or when the law will be formally introduced in Congress.

Mali confirms eighth Ebola case, monitoring 271 people

Children watch as health workers spray disinfectants at a mosque in Bamako November 14, 2014. REUTERS/Joe Penney

Children watch as health workers spray disinfectants at a mosque in Bamako November 14, 2014.

BAMAKO (Reuters) - Mali said on Monday that another person had tested positive for the Ebola virus, bringing the total number of cases in the West African nation to eight.

Mali is the sixth West African country to be hit by the worst outbreak on record of deadly haemorrhagic fever that has killed some 5,459 since the first case was recorded early this year in neighboring Guinea.

The Malian government did not provide further details about the new case and how the person contracted the disease, but it came after another case was confirmed on Saturday.

It said both cases were at an Ebola treatment center.

The government said in a situation report that 271 people who may have come in contact with Ebola cases were being monitored.

Of the six previously known cases of the disease in Mali, all have died, the World Health Organization said on Friday.

Sunday, November 23, 2014

Top Heart Rate Monitors for iPhone

iPhone is unlike any other smart phone. Not only it lets you make phone calls and have a lot of fun with the apps available on iTunes, you can also use it to become more healthy and even lose weight. There are lots of cool applications to choose from in the health and fitness categories. Take heart rate monitors. You can not only track/monitor your heart rate with these apps but also how much you are burning on an everyday basis. A great way to get on the right track and stay on it.

Here are the Top best heart rate monitor apps for iPhone:

iRunXtreme: iRunXtreme is a highly sophisticated application that lets you monitor your heart rate using your iPhone microphone. As easy as that!

164

Fitview: Fitview is a complete tracking application for every aspect of your health. You can track your body sugar, heart rate, and … Very useful for the methodical types among us.

 

FitnessBuilder: FitnessBuilder is perhaps the only application you need to get yourself in shape. It’s a complete guide (w/ videos) to take your workout to the next level. Allows you to track your HR and calories burned as well.

165

12 Fitness Calculators: 12 Fitness Calculators provides you with everything you need to keep track of your progress when it comes to fitness and weight loss.

166

Heart Rate Monitor: HRM is another cool iPhone app that monitors your heart beat by using your iPhone’s microphone.

 

iHeart: iHeart is a pulse reader that lets you figure out your pulse rate by holding your iPhone in your hands. Can’t get any easier than this. Not too shabby.

112

iPulse: iPulse is a decent heart rate monitor that not only counts your heart rate but also comes with a log system to help you keep track of your activities.

171

iNewLeaf: a sophisticated app that helps you keep track of your workout and track your progress easily. You can also keep track of how many calories you are burning and how much fat you are carrying. Good choice for those who live an active lifestyle.

13

Vitalsview: whether you want to track your body fat, your heart rate or blood pressure, you can do it all with Vitalsview.

169

Gym Tracker: a wonderful utility application for every gym addict. It lets you keep track of your heart rate, exercises, and all other relevant information. It can also help you take your workout to the next level.

17

 

 

Top Heart Rate Monitors for iPhone

iPhone is unlike any other smart phone. Not only it lets you make phone calls and have a lot of fun with the apps available on iTunes, you can also use it to become more healthy and even lose weight. There are lots of cool applications to choose from in the health and fitness categories. Take heart rate monitors. You can not only track/monitor your heart rate with these apps but also how much you are burning on an everyday basis. A great way to get on the right track and stay on it.

Here are the Top best heart rate monitor apps for iPhone:

iRunXtreme: iRunXtreme is a highly sophisticated application that lets you monitor your heart rate using your iPhone microphone. As easy as that!

164

Fitview: Fitview is a complete tracking application for every aspect of your health. You can track your body sugar, heart rate, and … Very useful for the methodical types among us.

 

FitnessBuilder: FitnessBuilder is perhaps the only application you need to get yourself in shape. It’s a complete guide (w/ videos) to take your workout to the next level. Allows you to track your HR and calories burned as well.

165

12 Fitness Calculators: 12 Fitness Calculators provides you with everything you need to keep track of your progress when it comes to fitness and weight loss.

166

Heart Rate Monitor: HRM is another cool iPhone app that monitors your heart beat by using your iPhone’s microphone.

 

iHeart: iHeart is a pulse reader that lets you figure out your pulse rate by holding your iPhone in your hands. Can’t get any easier than this. Not too shabby.

112

iPulse: iPulse is a decent heart rate monitor that not only counts your heart rate but also comes with a log system to help you keep track of your activities.

171

iNewLeaf: a sophisticated app that helps you keep track of your workout and track your progress easily. You can also keep track of how many calories you are burning and how much fat you are carrying. Good choice for those who live an active lifestyle.

13

Vitalsview: whether you want to track your body fat, your heart rate or blood pressure, you can do it all with Vitalsview.

169

Gym Tracker: a wonderful utility application for every gym addict. It lets you keep track of your heart rate, exercises, and all other relevant information. It can also help you take your workout to the next level.

17

 

 

Saudi Arabia tackles MERS virus, still hunting source

LONDON, (Reuters) - (This story corrects to make clear that the finding that 97 percent of cases were hospital-acquired was from a study of an outbreak in Jeddah, paragraph 10)

Saudi Arabia has not yet traced the source of a mysterious camel virus, leaving many questions about a disease that has killed 346 people in the Kingdom.

The lack of scientific evidence about how camels contract the virus, which causes an often fatal illness called Middle East Respiratory Syndrome (MERS) in people, echoes wider concerns about the threat posed to human health by animal-borne pathogens, including the Ebola virus.

There is no cure or vaccine for MERS -- a severe respiratory disease which causes cough, fever, breathing problems and can lead to pneumonia and kidney failure.

Yet studies of both camels and people infected with MERS in Saudi Arabia have given preliminary results that are helping authorities curb the disease's spread, according to the scientist overseeing the work.

"Coming into close contact with the nasal secretions of camels is a major risk factor," said Tariq Madani, head of the scientific advisory board of the Saudi health ministry command and control center (CCC) set up in June to handle the outbreak.

"The main transmission is actually human to human," he told Reuters in a telephone interview.

MERS was first identified in humans in 2012 and is caused by a coronavirus from the same viral family as the one that caused a deadly outbreak of SARS in China in 2003. Some 808 people in Saudi Arabia are known to have been infected with it since it was discovered, and 346 of them have died.

The World Health Organization and leading global health specialists have criticized Saudi Arabia for failing to properly investigate the causes of MERS.

Critics said Saudi delays contributed to the virus taking hold and spreading via travelers to some 20 countries around the world.

Madani, who was appointed after the former Saudi health minister and his deputy lost their jobs amid discontent about their handling of the outbreak, said an analysis of a large outbreak in Jeddah in 2014 showed most people were infected in hospital. 

"We found out that 97 percent of the cases were healthcare associated," he said. "And 3 percent of them were primary cases who probably acquired the infection from contact with camels."

Tighter infection controls in hospitals have contributed to a significant drop in cases recently, but he warned sporadic primary cases will still pop up.

Tests of nasal and rectal swabs from camel imports arriving from the Horn of Africa -- the source of the majority of camels traded and farmed in Saudi -- found no traces of the MERS virus, Madani said, with 71 animals tested so far.

"Until now the camels we have examined have proven to be negative -- and this is really very unexpected," he said.

Asked whether this suggested the camels were being infected within Saudi Arabia's borders, Madani said it was too early to reach conclusions, but said tests on imported camels will continue alongside studies of wild animals such as bats and monkeys that may also be harboring the virus.

Meanwhile, studies of 12 camels with which MERS patients had contact showed six had the virus circulating in their noses, but tests of their milk and urine were virus-free -- suggesting the risk to humans from drinking camel milk is far lower than from direct contact with nasal secretions.

Another study found that among a group of 36 workers in a camel slaughterhouse, 58 percent had MERS antibodies -- indicating they had been infected with it at some point.

"None of them recalls having a severe infection or pneumonia," Madani said. "And this indicates that you get some sort of immunity as a result of repeated exposure to camels and the virus."

(Editing by Anna Willard)

Mali records new Ebola case, linked to dead nurse

Children watch as a health worker sprays disinfectants outside a mosque in Bamako November 14, 2014.  REUTERS/Joe Penney

Children watch as a health worker sprays disinfectants outside a mosque in Bamako November 14, 2014.

BAMAKO (Reuters) - Mali has recorded a new case of Ebola in the capital Bamako after the friend of a nurse who died of the hemorrhagic fever earlier this month tested positive for the disease, health and medical officials said on Saturday.

The nurse contracted the disease after treating an imam from neighboring Guinea, who died after being incorrectly diagnosed with kidney problems. This allowed Ebola to spread to five other people in the West African nation's second outbreak.

"Of two suspected cases tested, one was negative and the other positive. The latter was placed in an isolation center for intensive treatment," a statement from the health ministry said, adding that another 310 contact cases were being monitored.

Two Malian medical officials, who asked not to be named, confirmed the relationship between the new case and the deceased nurse.

A total of 5,459 people have died in the worst Ebola outbreak on record, according the World Health Organization (WHO). Guinea, Sierra Leone and Liberia account for all but 15 of them.

Of the six previously known cases of the disease in Mali, all have died, the WHO said on Friday.

Saturday, November 22, 2014

Predictors of onset of cannabis and other drug use in male young adults: results from a longitudinal study

Background

The use of cannabis and other illegal drugs is particularly prevalent in male young adults and is associated with severe health problems. This longitudinal study explored variables associated with the onset of cannabis use and the onset of illegal drug use other than cannabis separately in male young adults, including demographics, religion and religiosity, health, social context, substance use, and personality. Furthermore, we explored how far the gateway hypothesis and the common liability to addiction model are in line with the resulting prediction models.

Methods

The data were gathered within the Cohort Study on Substance Use Risk Factors (C-SURF). Young men aged around 20 years provided demographic, social, health, substance use, and personality-related data at baseline. Onset of cannabis and other drug use were assessed at 15-months follow-up. Samples of 2,774 and 4,254 individuals who indicated at baseline that they have not used cannabis and other drugs, respectively, in their life and who provided follow-up data were used for the prediction models. Hierarchical logistic stepwise regressions were conducted, in order to identify predictors of the late onset of cannabis and other drug use separately.

Results

Not providing for oneself, having siblings, depressiveness, parental divorce, lower parental knowledge of peers and the whereabouts, peer pressure, very low nicotine dependence, and sensation seeking were positively associated with the onset of cannabis use. Practising religion was negatively associated with the onset of cannabis use. Onset of drug use other than cannabis showed a positive association with depressiveness, antisocial personality disorder, lower parental knowledge of peers and the whereabouts, psychiatric problems of peers, problematic cannabis use, and sensation seeking.

Conclusions

Consideration of the predictor variables identified within this study may help to identify young male adults for whom preventive measures for cannabis or other drug use are most appropriate. The results provide evidence for both the gateway hypothesis and the common liability to addiction model and point to further variables like depressiveness or practising of religion that might influence the onset of drug use.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.


Friday, November 21, 2014

Association between physical and mental health-related quality of life and adverse outcomes; a retrospective cohort study of 5,272 Scottish adults

Background

Health-related quality of life (HRQoL) is associated with adverse outcomes in disease-specific populations. This study examines whether it is also independent predictor of incident cancer, coronary heart disease (CHD) and mortality in the general population.

Methods

The records of adult participants in the Scottish Health Survey 2003 were linked with hospital admissions, cancer registrations and death certificates. Cox proportional hazard models were used to explore the associations between quintiles of physical and mental component summary score (PCS and MCS respectively) of the SF-12 and adverse outcomes. Higher quintiles of both PCS and MCS indicate better health status.

Results

Among the 5,272 study participants, the mean PCS score was 49 (standard deviation (SD) 10.3). Participants were followed-up for a mean of 7.6 years. On survival analysis the lowest quintile of PCS was a strong predictor of all-cause death (hazard ratio (HR) 2.81, 95% CI 1.76, 4.49), incident cancer (HR 1.63, 95% CI 1.10, 2.42), and CHD events (HR 1.99, 95% CI 1.00, 3.96), compared to the highest quintile. This association was independent of adiposity and other confounders. The mean MCS score 52 (SD 8.8). MCS quintile was not associated with incident cancer and CHD, and the association between MCS and all-cause death (HR 1.33, 95% CI 1.01, 1.75) became non-significant after adjustment for adiposity.

Conclusion

Physical HRQoL is a significant predictor of a range of adverse outcomes, even after adjustment for adiposity and other confounders. This study highlights the importance of perceived health in the general population.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.


The Origin of the Baby New Year

Every year it's the same thing. Some diapered little baby is paraded around wearing a sash with the new year written on it. Who hasn't been to a New Year's Party that ended that way, huh? Okay, me neither. But the Baby New Year is still an iconic image that even popped up in a really bad sequel to Rudolph the Red-Nosed Baby. Usually in concert with the Baby New Year there is also a wizened old man with a ZZ Top beard. But this article isn't about that. It's about that naked baby.

 

 

The use of an infant as a symbol of the start of the new cycle that begins with the passage of the year dates back to ancient Greece. The festival of Dionysus, who was the god of wine, song and merriment let us not forget, was a big thing for the Greeks. No doubt the festival of Dionysus often ended long after the womenfolk had been sent to bed and each male reveler had left his male Greek friends behind to unsteadily walk home to the little woman.

Before these parties got down to the good stuff, however, it was the custom of the time to parade a newborn baby around in a basket. The baby was a symbol and a herald for fertility of the crops. (Probably just the crops since Greek style doesn't produce much in the way of offspring.

None so's you want to keep, anyway.) Across that big lake, the Egyptians were also fond of holding a ceremony of rebirth that involved the use of a young baby. In fact, there was a specific ceremonial ritual involving a young man and an older bearded man carrying a baby inside a basket that was discovered on the lid of a sarcophagus that is now on display in a museum.

The symbol of a Baby New Year was ubiquitous throughout the pagan religions so it should come as no surprise that the Catholic Church disallowed it for centuries. Finally, thanks to a fact that Bush seems incapable of grasping---that it is next to impossible to kill an idea that people cleave to with all their might---the Catholic Church gave in and allowed infants to be used in New Year celebrations. Okay, they made one adjustment. The Baby New Year was transformed from a pagan symbol into a symbol of the Baby Christ.

The contemporary image of the Baby New Year comes to us, like the Christmas tree, courtesy of those fun-loving, always-with-the-joke Germans. It was the Germans, you see, who first slapped a diaper on the Baby New Year. The newly diapered Baby New Year first cropped up in German woodcarving illustrations in the 1300s. When the German immigrants poured into Pennsylvania they brought with them the Christmas tree, Groundhog Day and our current image of the Baby New Year.

 


With gene mutations, second breast cancer risk rises over time

(Reuters Health) – Women who are genetically susceptible to breast cancer and develop it in one breast are at higher than average risk for a tumor in the other breast, and that risk may increase as time goes on, according to a new analysis.

Mutations in the BRCA 1 or 2 genes increase the risk for several types of cancer and account for 5 percent to 10 percent of breast cancers, according to the National Cancer Institute.

Researchers from Spain reviewed 20 studies of the risk of cancer in the second breast of BRCA 1 and 2 carriers.

For breast cancer patients with the BRCA 1 mutation, the risk of a cancer in the opposite breast rose from 15 percent at five years after diagnosis to 27 percent at 10 years and 33 percent at 15 years.

For the BRCA 2 mutation, the risk increased from nine percent at five years to 19 percent at 10 years to 23 percent at 15 years.

For women with neither mutation, the risk of cancer in the opposite breast stayed low at 3 percent and 5 percent at the five and 10 year marks, according to results in the journal The Breast. There wasn’t enough data to estimate the 15-year risk in this group, the authors write.

Even though the risk for cancer of the second breast is much higher for BRCA carriers, it still means there is a 70 to 80 percent chance that they won’t develop breast cancer 10 to 15 years later, said Dr. Katharine Yao, who wasn’t involved with the new study but directs the breast surgical program at NorthShore University HealthSystem in Chicago.

“(Women) should be concerned but also realize that we have very effective ways to monitor the breast with breast MRI and mammograms which detect cancer at an early stage (small size, node negative) and at a stage that is easily treatable and has a good prognosis,” Yao told Reuters Health by email.

The new data have been known for some time, said Dr. Todd Tuttle, a surgeon at the University of Minnesota in Minneapolis who was not involved in the review.

“I think most of these women should strongly consider contralateral prophylactic mastectomy because their risk of contralateral breast cancer is so high,” Tuttle told Reuters Health by email.

“However, there are some groups of patients who may not benefit from that procedure including those patients who have a high stage first cancer and those who have other considerable medical problems,” he said.

A study Tuttle led earlier this year found that for women without the mutation, removing the other breast does not extend life (see Reuters story of August 15, 2014 here: reut.rs/1AlZUUu).

Though it doesn’t appear to extend life, the extra mastectomy does help avoid future breast imaging and maintain aesthetic symmetry, so some women without the mutations may still prefer it, he said.

In another study in February of this year, women with stage I or II breast cancer and BRCA mutations did survive longer with double vs single mastectomy.

For women who do not have the BRCA mutations, “patients do often overestimate their contralateral breast cancer risk and do not realize how low it really is,” Yao said.

SOURCE: bit.ly/1uNf1Wx The Breast, online November 7, 2014.

Appeals court order keeps Mississippi's sole abortion clinic open

JACKSON Miss. (Reuters) - Mississippi's sole abortion clinic will remain open after a federal appeals court refused on Thursday to reconsider its decision to block a state law that would have closed it.

The law, passed in 2012, required doctors at the clinic to have admitting privileges at local hospitals, a standard they could not meet.

A three-member panel of the 5th U.S. Circuit Court of Appeals in July upheld a lower court ruling blocking the law as a legal challenge continues. On Thursday, the appeals court denied Mississippi's request for a reconsideration of the injunction by the full court.

"This is definitely good news," said Diane Derzis, who owns the Jackson Women's Health Organization, the only abortion clinic in Mississippi. "We've been waiting so long. It's a true Thanksgiving."

Mississippi is among several states that have passed laws requiring abortion doctors to have admitting privileges at a hospital within 30 miles of their clinics.

Abortion rights campaigners say the laws, some of which are under court review, impose medically unnecessary requirements targeting providers of the procedure.

Anti-abortion advocates have countered that they are intended to protect women's health, though some have also said they would likely shutter clinics.

"There are a lot of places women can go if they want an abortion," said Tanya Britton, a board member of Pro-Life Mississippi. "They can go to Louisiana. They can go to Arkansas. They can go to Alabama."

Many hospitals refused to consider the admitting privileges applications of doctors working for the Jackson Women's Health Organization, which nearly closed as a result. 

A federal district court judge in 2012 issued a temporary injunction blocking the law because it would have forced women seeking abortions to go out of state. The same judge issued a second injunction in 2013 that remains in effect with Thursday's order.

Advocates who brought the suit against Mississippi's law expect it to move forward at the trial court in 2015.

The state has the option of asking the U.S. Supreme Court to lift the injunction, with a spokeswoman for the Mississippi Attorney General's Office saying it is considering its options.

'Kissing disease' outbreak closes Oklahoma school district

OKLAHOMA CITY (Reuters) - A small Oklahoma school district has ordered all of its students to stay away from classes until December due to an outbreak of mononucleosis, officials said on Thursday.

Woodland Public Schools in Fairfax, about 100 miles northeast of Oklahoma City, said it made the decision so as not to put the nearly 200 students in the district at risk of the contagious disease.

"The closure is due to a high infection frequency of mononucleosis in our community," the school board said.

During the closure, all school buildings will be disinfected to curb the spread of the virus, it said. 

The Mayo Clinic said the virus that causes the so-called "kissing disease" is transmitted through saliva, and people can be exposed through a cough or sneeze, or by sharing a glass or food utensils with someone who has "mono".

Symptoms include fatigue, sore throat and fever, it said.

Bird flu outbreak hits second Dutch farm, exports to remain frozen

Police tape and warning signs are seen outside a duck farm in Nafferton, northern England November 17, 2014. REUTERS/Phil Noble

Police tape and warning signs are seen outside a duck farm in Nafferton, northern England November 17, 2014.

AMSTERDAM (Reuters) - A second Dutch farm was hit by an outbreak of bird flu, the government said on Thursday, prompting the destruction of 43,000 chickens and prolonging restrictions on trade in the world's leading egg-exporting country.

A three-day, nationwide ban on the transportation of all poultry, eggs and related farm products was extended until Sunday, a statement said.

The measures have already caused up to 100 million euros ($125 million) in losses for farmers, said Gert-Jan Oplaat, president of the poultry farmers' association. Industry groups say an extension could bankrupt smaller producers.

Infections have also been discovered on farms in Germany and Britain.

The infection announced on Thursday was of the H5 strain, the government said, but it was unclear if it was the highly-contagious H5N8 virus discovered last week at a farm 20 km (12 miles) away.

As in the previous outbreak, authorities imposed a 10 km (6 miles) exclusion zone around the farm in Ter Are, in the central Netherlands, and were testing four nearby farms for the virus.

The first case in the Netherlands was reported last weekend in the village of Hekendorp, prompting the culling of 150,000 laying hens.

Tests show that bird flu viruses found in Germany, the Netherlands and Britain are similar to one that devastated poultry flocks in South Korea earlier this year, the World Organization for Animal Health (OIE) said on Wednesday

"They are very, very close, which reinforces the theory of a transmission through migrating birds," OIE Director General Bernard Vallat told Reuters, adding that genetic analyses had pegged similarities at 99.8 percent.

The German and the first Dutch outbreak are of the H5N8 strain, which is highly contagious in birds. H5N8 has never been found in humans, unlike H5N1, which has killed 400 people mostly in Asia and the Middle East since 2003 and caused a global scare.

There can be no exports of poultry products as long as the transportation ban is in place and the latest measures could lead to a supply shortage.

About 2,000 Dutch businesses, with more than 100 million chickens, export more than 6 billion eggs a year. The Netherlands is also the EU's leading exporter of poultry meat.