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Medicare tips on how to lower your surgery costs





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Tips on avoiding Alzheimer’s and where to turn when it’s a loved one

Deborah Kan was an executive producer with The Wall Street Journal when she got the agonising news that her mother had been diagnosed with Alzheimer’s – a progressive disease with no cure, with symptoms of memory loss and cognitive degeneration that gradually worsen.

In search of answers to her many questions, Kan turned to the internet, but that left her more frustrated. While she found a lot of information online, it was in bits and pieces, hard to understand and often contradictory.

Mental health app may be lifesaver as Asia braces for dementia spike

“I didn’t know who or what to believe,” says Kan, who has lived in Hong Kong since 2004.

“I had so many questions but there was no one place where I could get the answers. Dealing with a long-term illness in the family is difficult enough. Not knowing where to turn to get accurate information makes it even more tormenting.”

Putting her journalistic skills to use, she mapped the pathology of Alzheimer’s and then called researchers, doctors and caregivers to probe them on the disease.

“Over an eight-month period I did over a hundred interviews and got a wealth of information that wasn’t readily available anywhere else,” says Kan, adding she was “angry at the injustice that this type of information wasn’t available to the millions impacted by Alzheimer’s”.

Kan’s efforts to find answers led her to establish Being Patient, a pioneering website that aims to clarify the many complex and sensitive issues of Alzheimer’s for patients and families dealing with the disease.

“Our goal is to be a trusted, unbiased and accurate source of information on Alzheimer’s by providing editorially independent content on the prevention, treatment and challenges of the disease.”

Kan left her journalism career to start the website, which launched in July 2017.

Being Patient brings together patients and caregivers as well as doctors and researchers on a common platform.

It covers topics including disease diagnosis and management, brain health and fitness, genetic testing and detection, and patients’ and caregivers’ personal experiences.

A panel of expert advisers includes leaders in the field of Alzheimer’s research, patient care and advocacy.

It includes Dr Marwan Sabbagh, director of the Cleveland Clinic Lou Ruvo Centre for Brain Health, and Dr Pierre Tariot, director of Banner Alzheimer’s Institute in the US state of Arizona.

“With their guidance, we ensure that our coverage meets the highest standards of scientific accuracy and clearly explains the significance of the research for patients and caregivers,” Kan says.

Interviews with scientists and doctors cover topics such as the development of a new blood test that could help diagnose Alzheimer’s; whether there is a link between hormones and memory; and how artificial intelligence could help diagnosis and prevent cognitive decline.

A section devoted to brain health covers research on preventing Alzheimer’s and the link between diet, exercise, sleep and other lifestyle factors that affect dementia risk.

“It is important to think about your brain health in your forties and fifties, long before there is a problem,” says Kan, an avid runner who has gone back to learning the piano and taken up yoga and meditation to keep her brain healthy.

Valerie Schache, 66, an avid user of the site, was diagnosed with dementia in 2004. “I have looked at many websites and I find that Being Patient is at the cutting edge of research,” she says.

“Their coverage on developments in the early diagnosis and prevention of Alzheimer’s has helped me tremendously.”

The exchange of information is two ways, Kan explains. “We are connecting researchers to the caregivers, who are at the frontline of this disease and hold a wealth of information. At the same time we ask experts questions that patients and caregivers want answers to.”

The most read and shared section of the website is “Voices”, where patients and their caregivers share their experiences. Kan says she created the section because she realised the importance of addressing the emotional needs of those affected by Alzheimer’s.

One article published on the site that went viral is called “What I Wish I Knew Before My Mother’s Alzheimer’s Death.”

Written by Jasja De Smedt Kotterman, it is based on the final three months of Kotterman’s mother, who had struggled with the disease for eight years.

“What I couldn’t find is how someone dies from Alzheimer’s,” Kotterman writes. “What do these complications look like in an Alzheimer’s patient? What does it really mean for the patient and the family? I never found an answer until I watched it for myself.”

Kan says this is something everyone thinks about, but nobody had addressed. “You can see how these stories get shared over and over, because again, that’s serving a need for better information.”

She has coined it a “community-driven model” unique to health media, where assessing the information needs of the community drives the editorial initiative.

“I especially love that caregivers are recognised,” says Marie Temple, an Alzheimer’s caregiver. “A lot of people don’t realise what goes into caregiving and how difficult it is. I always read the posts on current research, or the Voices posts to see what similar experiences caregivers are having.”

Being Patient also offers a weekly newsletter on the latest research developments and has launched a widely followed Facebook page, which features “Brain Talks” – live interviews with leading researchers and doctors.

Kan is happiest when she gets messages from people telling her how much the website has helped them.

“The feeling that we have been able to inform, support and comfort people with this difficult disease is priceless,” she says.

“Other than caregivers and patients, I get emails almost every day from people like me with ageing parents. In addition to worrying about their own parents, they suddenly care about their [own] brains.

“We will not stop at Alzheimer’s. Our goal is to tackle major diseases from depression to diabetes and give people an information platform on long-term health conditions.”

How to Keep Your Brain Healthy

The human brain has an astonishing ability to adapt and change, even into old age, called neuroplasticity. With the right stimulation, the brain can form new neural pathways, alter existing connections and adapt in ever-changing ways.

Here are nine ways to harness the natural power of neuroplasticity and keep your brain healthy from the Being Patient website:

1. Get moving

If you have time to fit one brain-enhancing task into your week, make it exercise. Go for a brisk walk, jog or run. Aerobic exercise is particularly good for the brain.

2. Meditate

Meditation improves concentration and memory. People who meditate have more cell density in the hippocampus (associated with memory) and frontal lobes (associated with behaviour control).

3. Get your sleep

Adults need seven to nine hours of sleep every night. Get to bed and wake up at the same time every day, avoid all screens for at least an hour before bed, and cut back on caffeine.

4. Eat brain-boosting foods

Vegetables such as broccoli, spinach, tomatoes and berries, and omega-3 oils found in oily fish including salmon, tuna and sardines, improve memory and brain, as do green tea and proteins.

5. Learn a new language

Research suggests learning a new language at any age improves thinking skills and memory abilities.

6. Learn a musical instrument

Learning a new instrument changes brain waves in a way that rapidly improves listening and hearing skills.

7. Stimulate your mind

Read, take new courses and do word puzzles.

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8. Build social networks

Meaningful relationships and a strong support system are vital to emotional and brain health. Make it a point to see friends more often, join a club and volunteer.

9. Laugh

Laughter is good for the brain. Laugh at yourself, share your embarrassing moments, and spend time with fun, playful people.

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Your uncle’s genes may decide your longevity: Study


London: The key to longevity can probably be found in the genes of your long-living uncles and aunts and not just parents, finds a study. Researchers, from Netherlands’ Leiden University and US’ University of Utah, showed that an individual’s chances of dying is reduced, even if the parents themselves did not live to be extremely old, but aunts and uncles are among the top survivors in the family.

Top survivors refer to people in the top 10 per cent age-wise of a group of people born in a family within a given time period. “We observed the more long-lived relatives you have, the lower your hazard of dying at any point in life,” said lead author Niels van den Berg, doctoral student at Leiden University in the Netherlands.

“Longevity is heritable, but that primarily applies to persons from families where multiple members are among the top 10 per cent survivors of their birth cohort. The key to a long life can probably be found in the genes of these families,” said the paper published in the journal Nature Communications.

For the study, the team analysed the genealogies of nearly 314,819 people from over 20,360 families. The search for genes associated with human longevity has been ongoing for a long time but those genes turned out to be much more difficult to discover than genes for diseases.

The study has led us to be far stricter in selecting the people in whom you have to look for those genes, the researchers said.  According to Ken Smith, Professor at Utah, the findings underscore the importance of constructing high-quality family trees that “allow us to observe complete life-spans of individuals over generations and in diverse locations.

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Wellness gurus’ health tips: which to adopt and which to ignore

Thinking of getting into wellness? Here's a helpful guide
Thinking of getting into wellness? Here’s a helpful guide


Do you start your day with a visit to a hyperbaric oxygen chamber? Or do you prefer to stare at the sun while doing yoga?

These are among the rituals of four “wellness” obsessives who were profiled by The Times on 12 January.

The pursuit of good health is, of course, to be encouraged, but it’s hardly surprising that some of the measures they reported – such as Himalayan salt lamps and a device called the “HumanCharger” – raised a few eyebrows on social media.

Devotees of wellness clearly have a strong interest in the science of human health, and many of their habits have some basis in research. However, they could perhaps do with a little help at sifting evidence-based lifestyle advice from pseudoscientific guff.

For anyone hoping to improve their own health, we’ve picked out a few of the good bits from their daily routines – and a few you should probably ignore.

Don’t bother

Sun staring – “I sun-stare because the UV rays aren’t harmful to my retina the first hour after sunrise,” Dasha Maximov told The Times. Though fewer UV rays will hit your retina when the sun is not yet up, they are still harmful. Staring at the sun is not a good idea at any time.

HumanCharger – “It looks like an iPod and shines light into my ear to give me energy,” says photographer Alex Beer. Light therapy may be useful for all sorts of things, including depression and neurological diseases, but it works best through the eyes.

Himalayan salt lamp – This is said to add minerals to the air. Don’t believe a word of it.

Seawater supplements – Tim Gray, a digital marketing agency CEO, said he takes Quinton Isotonic – “a supplement that comes from plankton and contains enzymes that help me stay hydrated”. According to one website selling these products, they are 29 per cent sea water and 71 per cent spring water, so a 10 ml shot of it is unlikely to do anything much.

Brain-enhancing drugs – Gray also takes aniracetam, a drug he says “switches my brain on and gives me clearer thinking”. Though studies have found a benefit in patients with dementia, there is minimal evidence that the drug is helpful to people with normal cognitive function.

Staying hydrated – “I wake up and immediately rehydrate,” says Beer. Gray has a spreadsheet recording his hydration. Wellness enthusiasts seem to have a particular concern about staying hydrated, but the truth is if you just obey your thirst, you’ll be fine.

Ditching processed food – We’re told we must eschew processed food, but there’s no good reason to do so. They have helped us overcome hunger and reduce waste.


So-called superfoodsThese foods may be healthy, but they also have exceptionally good PR. Some small studies suggest quinoa may help lower cholesterol, but we don’t know for sure. Blueberries may reduce cardiovascular risk, but their much-touted antioxidants hardly get into the bloodstream. Coconut water is no better for hydration than water. The benefits of oily fish rich in omega-3 fatty acids are probably overstated.

Spices – Beer sometimes has turmeric before bed. It may be better at the start of the day: one study found that a turmeric breakfast led to improvements in working memory six hours later. But cinnamon – favoured by another person profiled – had no effect.

Supplements – All the wellness devotees espoused the benefits of supplements – Gray takes 15 a day. However, the results from a slew of studies on nutritional supplements for health has been underwhelming, and in some cases, taking high doses can be harmful. Taking supplements with food seems to be important to make sure the nutrients can be absorbed.

Probiotics – Two of those profiled mentioned taking shots of probiotics – live bacteria intended to boost the microbial communities in your gut. But there’s a lot of doubt about their usefulness. They seem to colonise the gut in some people, but not others. And when they do, they can actually be harmful.


Yoga and meditation – Yoga has well-established benefits for physical strength and psychological health. Mindfulness meditation can alleviate depression and anxiety, improve learning, and perhaps even slow ageing. There is also evidence that yoga and meditation can dampen the activity of genes associated with inflammation. To enhance their benefits further, you can even combine them with brain zapping.

Avoid blue light in the evening – There is growing evidence that exposure to blue light in the evening disrupts our circadian rhythms and affects the quality of sleep. Switching off screens before bed, or using an app to filter out blue light, may be helpful. “When I’m working on the computer, I use a program that dims the screen according to the sun’s timing in my location, and I wear blue-light-blocking glasses,” says Maximov.

Get plenty of sleep – Gray has analysed his sleep for four years and found that seven hours and forty-one minutes’ sleep is “the perfect amount for me”. Getting less than seven hours’ sleep raises your risk of obesity, heart disease, depression and early death.

More on these topics:

  • diet
  • health

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What is to be blamed for childhood cancer?

childhood cancer

Sydney: A team of researchers has thrown light on the community beliefs about what causes cancer in children, an area which remains understudied, finds the latest research.

“Few childhood cancers are attributed to genetics or environmental factors, so when children are diagnosed with cancer, families often wonder ‘why me/why us’?” said lead author Janine Vetsch, postdoctoral research candidate from UNSW Sydney in Australia.

For the study, the team examined the beliefs of more than 600 participants — parents and childhood cancer survivors — about the causes of childhood cancer, and compared them with beliefs of 510 members of the general population.

Findings, published in Acta Oncologica, revealed that more than seven out of 10 childhood cancer survivors and survivors’ parents believed that chance or bad luck caused the cancer. 

This led to most parents and survivors seem to understand that there is nothing they could have done to prevent the cancer, according to Vetsch. However, around one in five families did believe that environmental factors and genetics played a role, despite only limited available scientific evidence, results further showed.

“It looks like healthcare professionals are successfully helping most families arrive at that view,” said Vetsch. Such views could lead to stigma. Hence, it is important to increase community knowledge of childhood cancer causes in general. 

There is a need to encourage doctors to talk about the causes with affected families to address unhelpful misconceptions,” Vetsch suggested.

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Six-of-the-best winter health tips

AS WE approach mid winter, NHS Portsmouth has issued a ‘six of the best’ guide on how to stay warm and well.

Dr Linda Collie, a GP who is the chief clinical officer for NHS Portsmouth Clinical Commissioning Group, said: ‘It’s important we do what we can for ourselves to stay well throughout any colder spells.

 It’s particularly important to check on elderly relatives and neighbours during winter. Popping in to say ‘hello’ can make the world of difference, especially to people who live alone and may find it difficult to go out when it’s colder, particularly if the pavements get icy.’

The top six top tips are:

Add extra layers of clothing and heat your home to at least 18 celsius if you can.

Visit your pharmacy for advice if you are beginning to feel unwell. 

Dial 111 if you need help urgently or need advice to be directed to the best treatment. 

Make an appointment, then visit your GP if you need to. This winter more appointments are available at evenings and weekends.

When cold weather warnings are in place, people with long term health conditions such as asthma should take extra care to avoid the cold.

If you have a long-term condition, are pregnant or are 65 and over then take up your free flu vaccination .

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Five on-the-go dental health tips for busy professionals

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In a fast-paced business world, people often don’t have time to stop for lunch, let alone take care of their teeth. But dental professionals say it’s well worth carving out some minutes for your mouth during the busy day — every day.

“No matter how crazy your days are, you deserve excellent oral health and a beautiful, healthy smile,” says Dr. Nammy Patel, DDS, author of Age With Style: Your Guide To A Youthful Smile Healthy Living. “But consistently neglecting your teeth and gums during long days in the office can be very costly both from a health and a financial standpoint.

“Many people don’t realize there are lots of ways to take care of your teeth during the work hours, no matter how busy you are.” Below, Dr. Patel shares five on-the-go dental health tips:

1) Keep water close.

“Water neutralizes the acid in your mouth in addition to keeping you hydrated,” Dr. Patel says. “Too much acidity leads to enamel erosion, decay, cavities and gum disease.” She recommends drinking eight eight-ounce glasses per day, keeping a water bottle or water glass on your desk as a reminder.

2) Store oral essentials at your desk.

This means keeping a toothbrush, toothpaste and floss handy in a drawer. “After any meal or snack, our teeth and gums require attention to remove bacteria, and keeping these dental tools on hand will ensure you’re readily equipped,” Dr. Patel says. “Too many people go an entire work day without any oral care.”

3) Snack on naturally cleansing foods.

Eating on the run at work can lead to sugary snacks that compromise oral health. Dr. Patel recommends packing healthy items such as apples, carrots, celery and almonds.

“Not only are these foods full of great vitamins and minerals for your teeth and body, they also naturally cleanse your teeth,” she says. “Crunchy snacks like these help scrape away food or plaque stuck on your teeth.”

4) Sip beverages thoughtfully.

Patel says it’s not just what we drink at work that affects our teeth, but how we drink certain beverages. She recommends keeping a reusable straw in your desk.

“Whenever you opt for a beverage, use a straw to help limit the chance of tooth decay and staining,” Dr. Patel says. “Place the straw toward the back of your mouth to keep the liquid from coming into contact with your teeth.”

5) Relax your face.

The stress of a busy day causes tension in your head, neck and jaw. Consistent tension in the jaw can lead to TMJ.

“Take time at your desk to relax your jaw and face muscles,” Dr. Patel says. “Use your fingertips to gently massage your jaw, open and close your mouth a few times, and stretch your tongue forward to the top front teeth, and then up to the roof of your mouth.”

“Taking moments here and there for self-oral care throughout your busy day can make a big difference,” Dr. Patel says. “It just means a little more planning, and taken individually they are small things that can prevent major problems.”

Dr. Nammy Patel, DDS operates a practice called Green Dentistry in San Francisco and is the author of Age With Style: Your Guide To A Youthful Smile Healthy Living. A graduate of the University of California’s School of Dentistry, she is a leader in the movement to bring environmental sanity and well-being into the dental world.

— Information provided by News and Experts

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Undetectable levels of HIV is untransmittable, say experts


Washington DC: Officials from the National Institutes of Health have said that the results from years of clinical evidence that firmly established that the HIV Undetectable = Untransmittable (U=U) concept is scientifically sound. According to the experts, U=U means people living with HIV who are able to achieve and maintain an undetectable viral load, i.e., the amount of HIV in the blood, by taking and adhering to antiretroviral therapy (ART) as prescribed cannot sexually transmit the virus to others.

The results, published in Journal of the American Medical Association (JAMA), saw officials from NIH’s National Institute of Allergy and Infectious Diseases (NIAID) review the scientific evidence underlying the theory and discussing the implications of the widespread acceptance of the message.

The new commentary saw NIAID Director Anthony S. Fauci, M.D., and colleagues summarize results from large clinical trials and cohort studies validating U=U. The landmark NIH-funded HPTN 052 clinical trial showed that no linked HIV transmissions occurred among HIV affected heterosexual couples when the partner living with HIV had a durably suppressed viral load. Subsequently, the PARTNER and Opposites Attract studies confirmed these findings and extended them to male-male couples.

The NIAID officials note that the validation of the HIV treatment as a prevention strategy and acceptance of the U=U concept as scientifically sound have numerous behavioural, social and legal implications and can help control the HIV pandemic by preventing HIV transmission as it can reduce the stigma that many people with HIV face.

The success of U=U as an HIV prevention method depends on achieving and maintaining an undetectable viral load by taking ART daily as prescribed. However, there are multiple factors that can often make ART adherence difficult. To enhance the overall success of U=U, the authors emphasise the importance of implementing programmes that help patients remain in care and address the barriers to daily therapy. 

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Bullying, sexual abuse may trigger binge eating, smoking


Sydney: People who have suffered bullying or sexual abuse have a lower quality of life similar to those living with chronic conditions like heart disease, diabetes, depression or severe anxiety, a new study has found. The findings, led by University of Adelaide researchers, found that the victims of bullying and sexual abuse were three times more likely to be binge eaters than people who had never experienced these forms of abuse.

Anti-depressant use was up to four times more likely and smoking dependence was twice as frequent for such people. They are also far more likely to display harmful behaviour like smoking dependence and had a reduced quality of life.

“If a doctor finds a patient with multiple harmful behaviours — like smoking dependence and binge eating — who is depressed and has a lower quality of life, they should consider exploring whether these patients were victims of bullying and/or sexual abuse,” said David Gonzalez-Chica from the varsity.

“Identifying survivors of both forms of abuse is important to provide support and reduce more severe mental and physical consequences, such as suicide,” Gonzalez-Chica added.

The study, published in BMC Public Health journal, investigated around 3,000 Australians who took part in face-to-face interviews using self-labelling questions to measure the age of onset and duration of bullying and sexual assault and their outcomes during home interviews.

While 60-70 per cent of these forms of abuse occurred in childhood or adolescence, they were associated with worse outcomes later in life. If someone had two or more adverse outcomes (smoking dependence, binge eating, antidepressant use, and a lower quality of life) the probability they had suffered bullying and/or sexual abuse ranged between 60-85 per cent.

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High-fibre diet may lower risk of death, chronic diseases

High-fibre diet

Washington DC: A new study now finds that people who eat diets that have higher fibre content have a lower risk of death and chronic diseases such as stroke or cancer. The study, that was published in the journal The Lancet saw co-author of the study, Andrew Reynolds, a researcher at the University of Otago in New Zealand, state that fibre’s health benefits have been recorded by over 100 years of research, reported CNN.

The study finds that higher intakes of fibre “led to a reduced incidence of a surprisingly broad range of relevant diseases (heart disease, type 2 diabetes and colorectal cancer),” reduced body weight and total cholesterol, and reduced mortality, Reynolds wrote. Similar findings were shown with increasing whole-grain intakes.

The team was commissioned by the World Health Organization to inform future fibre intake recommendations. Speaking about the study, co-author Jim Mann, professor of human nutrition and medicine at the University of Otago said, “The health benefits of dietary fibre appear to be even greater than we thought previously.”

According to the study, 15 per cent to 30 per cent reduced the risk of death and chronic diseases in people who included the most fibre in their diets as compared to those with the lowest intake.

A fibre-rich diet was linked, on average, to a 22 per cent reduced the risk of stroke, a 16 per cent lower risk of Type 2 diabetes and colorectal cancer, and a 30 per cent reduced risk of death from coronary heart disease.

Based on the research, experts recommend 25 grams (0.88 ounces) to 29 grams (1.02 ounces) of fibre each day. Higher amounts are even more beneficial, according to the analysis.

The analysis found no dangers with high fibre intake. But it adds that for people with an iron deficiency, high levels of whole grains can further reduce iron levels.

The study further found small risk reduction in stroke and Type 2 diabetes for people adhering to a low-glycemic-index diet, which involves foods like green vegetables, most fruits, kidney beans and bran breakfast cereals. 

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