BEAUTIFUL LIFE IN STORIES

LIFE IS AWESOME

EDITOR’S POINT OF VIEW

DR. MAHESH BALDWA

MEDICO LEGAL WRITES

OUR REGULAR FEATURES

AUGUST 2017

Year : 2017 Pages :20 Volume : 96 : 525

THE DOCTOR’S PEOPLE

CURIOSITY IS THE SPARK BEHIND

THE SPARK OF EVERY GREAT IDEA.

TTHE FU URE BELONGS

TO THE CURIOUS

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recommended dose or formula, the method, route and duration of administration, side effects and contra-indications. The clinician should assess each patient individually and use their own knowledge, skill and experience to make a diagnosis and determine the best peri-operative or procedural anesthetic regime for each patient. Contributors are individually responsible for their respective opinions, views, information and figures assimilated in their respective chapters and are hereof individually responsible for the source of such information.

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7

BEAUTIFUL LIFE THROUGH STORIES

Point Of ViewEDITOR'S

Dear friends and colleagues,

Wishing you a happy Independence Day

Is it not true that India's healthcare system is suffering from a crisis of Compassion and empathy for their patients? Even though we all every

styear on July 1 celebrate as “Doctor's Day” across the length and breadth of India. It reminds me that way back in 1943, Sir Joseph W. Bhore was appointed the chairman of the health survey and development committee, which was formed by the British colonial rulers. The formation of this committee came in the wake of 'crisis of legitimating' failure of health services across the country by the British rulers, as after the end of the Second World War; there was a significant breakdown of health services across the country.

The committee submitted its recommendation in three volumes in 1946, a year before independence. It severely criticized the health status in British India and brought to light the dramatic comparisons between the values of important health statistics (like infant mortality and life expectancy) in England (and Wales) and in India. Most of the recommendations of the Bhore Committee had a preventive narrative. But there was also emphasis on the integration of preventive and therapeutic services at primary, secondary and tertiary levels meaning encompassing all levels of healthcare. The Bhore committee had borrowed the words of the famous Swiss medical historian, Professor Henry E. Sigerist, to say that the doctor should be a 'social physician protecting and guiding the people'. It appears to me, this was the heart and soul of the numerous recommendations of the committee. This describes the psyche of individual members of the health care delivery system most importantly towards doctor rather than pointing mistakes as to how to run the administrative machinery of health care.

The three months of rural posting (after MBBS) which was started following the recommendations of the Bhore committee with this very objective, is too little and inconsequential in evoking any sense of understanding in the minds of these budding doctors to take over as social physicians and community leaders. Even after 70 years it was recommended, the Indian doctor is yet to take over the mantle of a social physician and a leader protecting and guiding the people. In fact, the medical fraternity has hardly ever attempted to take a social reformation role seriously in independent India, barring a few exceptions. It seems there is a lack of will of the Indian doctor or a lack of understanding of the basic tenants of socialistic goals of the Indian healthcare system within the realms of the diverse fabric of Indian society.

I won't be wrong in concluding that medical students in India are kept away from this aspect of training where they can be sensitized to the needs of the poor, the underprivileged and the downtrodden of the society. So what seed one sows reaps the similar crop! Hence, Indian doctor never became social physician' or health leader. The materialistic lure, better job opportunities and poor understanding of the operational complexities of the Indian society, are some of the causes which prevent the development of 'social physicians/ health leaders' of masses residing in villages. It may be argued that to be a social physician as recommended by Bhore, it is not only necessary to be practicing in the rural hinterlands of the country and rightly so. The 'social physician leader' can evolve anywhere. A doctor should understand that the diseased are always more important than the disease. Any doctor having a sense of compassion and empathy towards the patients suffering anywhere in India makes him health leader

so social leadership is not attached the place of practice for a doctor that makes him/her a leader, but what makes him leader is quality of empathy and compassion towards suffering of patients anywhere in India. In a country that sees more than 1,500-2,000 trained doctors migrate to foreign soils every year, how do we arouse compassion and train them to fit into the role of a 'social physician' is the question, which unfortunately does not have a clear-cut answer. So from colonial 'crisis of legitimization' at the time of Bhore committee, we have landed into a 'crisis of compassion' towards Indian patient at present.

People like Dr. Binayak Sen, Dr. Abhay Bang and Dr. Rani Bang, the doctors at the Jan Swasthya Sahyog and Dr. Abhay Shukla, Dr Prakash Amte, Dr Mandakini Amte of Hemalkasa are some of the names, despite a reluctance of the Indian medical fraternity to serve its own people with the zest of a social activist, there are examples from India itself where doctors have taken over the role suggested by Bhore Committee. These are individuals who have gone beyond the precincts of conventional thinking and action and have taken up healthcare not only as a means of preventing and treating disease, but also as a weapon to fight for the rights of the weaker sections of the society, train them to stand for their cause and thus emerge as leaders for large segments of Indian populace. The practice of medicine gives an opportunity of changing the society from within. India's medical professionals should realize that beyond the lures of pharmaceutical industry and tons of capital, lies an unexplored horizon of hope. To evolve as social physicians of Bhore, along with the science of healing, we need to learn the art of compassion. In the words of Hippocrates, the father of medicine, wherever the art of medicine is loved, there is also a love of humanity.

A doctor should be a 'social physician protecting and guiding the people' most Indian doctors are yet to take over challenge of social change and leadership by compassion. Will some readers take lead after reading this article is a matter of conscience and compassion guided by empathy towards patients. Advance wishes for Ganesh Chaturthi. We are all in devotional and spiritual mode for these 10 days. Yours truly,

Dr. Mahesh BaldwaMBBS, MD, LLM, PhD, MBA

r M s aD ahe h Baldw

My life is coming to an end. Soon Death will tap its boney finger on my door… soon! Suffering has so withered my chest that no maiden's kisses can warm it. For the sins of my life, for my battle against Reason, harsh Fate has torn all the hair from my head, and not even Macassar oil will help it grow back! It's hard to die when you have done as many foolish things in life as I have. It's hard to die with the bitter knowledge that you have more sins on your soul than you had hairs on your head in your prime. It's hard to settle accounts with this earthly life when you have so many debts… it's hard, so very hard! Oh, what a wretch I am! What a fool! Why didn't I think before I acted? Why did it take me so long to know myself? My fellow man! Have pity on your poor neighbour, who realized so late that he was a fool and that his entire life purpose was to keep from doing foolish things. Have pity on your wretched neighbour, who did not know himself in time and acted against his purpose in life…

I blame no one for succumbing to temptation. No one planted these temptations in me; they took root on their own. I thank you, kind journalists. You tried to bring me to my senses; you proved to me in print the bitter truth that I came to understand so late and the ignorance that was the cause of such

unhappiness and sinfulness! My foolish vanity kept me from believing that I was a fool!

Not long before this moment I had intended to bequeath to the world the history of my follies, but the task of the historian is hard. It is hard to maintain objectivity about oneself, as you know from your own experience. With that in mind, I decided not to tear off the veil from my past life. I feel compelled, however, to lift up the veil a bit, since I think that my openness may be useful to humanity. Perhaps I am mistaken. Do not censure me for such a bold thought. Remember: I am a fool.

I think the tale of what happened to me in my youth and threw such a strong shadow on the rest of my life will be useful to someone. Be patient: I want to tell you about the greatest folly of my life.

Of all the passions that inflamed my tempestuous youth, envy was in first place, if only by mite. I suffered greatly from it. I do not wish, however, to unconditionally condemn this emotion. I must suppress my personal hatred for envy and first express my honest opinion of it. Envy is not a useless emotion, although it can be quite harmful. It stirs the blood and prevents the deadly stagnation of the soul; it awakens a person from the inaction that is so harmful to society; it may make someone do absolutely stupid things so extraordinarily boldly that they appear to be well-considered

acts. When a person is possessed by envy, it puts him under the great pressure of the powers to act - Reason and Will. I do not speak of the petty, everyday envy that you may meet at every step in London and Kaluga, on the Vyborg side of the Neva River or on Nevsky Prospekt, but I will speak of envy that is more worthy of attention.

There are people who envy Napoleon and Suvorov, Shakespeare and Baron Brambeus, Croesus and Sinebrychoff; there are others who envy Baucis and Philemon, Petrach and Laura, Peter and John, Stanislav and Anna; there is a third group that envies Manfred and Faust; and fourth that envies yet others… in a word, we all envy someone. You come across envy in the theater watching Hamlet, in the pastry shop reading the military newspaper “Russian Invalid,” at the ball dancing with a young beauty who will be forever out of reach of the person who envies her. Envy is especially pervasive in trade, service and literature.

But enough on where you might come across envy. I want to tell you where I felt it… I hold my left hand over my heart, gather up the remnants of my strength, and pray that kind Fate will not end my life before I can finish my instructive talk with my benevolent reader…

I was born on one of the streets of Vasilievsky Island to noble but poor parents. After I turned 18, I was orphaned and received an inheritance of ten thousand rubles. Obeyingmy father's death-bed advice, I lent it out to private investors, but since the returns

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weren't enough to live on, I had to give lessons… I bitterly complained about my fate, having to run sometimes as much as 10 Versts a day to make just five rubles. “So many people travel in carriages!” I thought. “How are they better than me?” Little by little, those complaints arose more and more often. Unhappy creature! I did not understand then how much I sinned against Providence when I dared to lament its good will. Whenever I saw a carriage my heart nearly burst from ire and envy. I hated anyone who owned one… Envy sucked my soul dry… No matter what I did, no matter where I went, the thought of a carriage never left me. I missed lessons, used vulgar language, committed follies — and the only reason was one thought. I cried out in sinful despair: “Why, cruel Fate, did you make me a poor man? What good deeds did so many people do to be blessed with a carriage? What transgressions did I commit to be sentenced to walk on foot my whole life?”

Inclement weather had an even more dreadful effect on me. When there was rain, mud, lightning and thunder outside, the same storm raged within me. A glance at my muddy boots conquered the resolve of my heart. Tears streamed down my face, my eyes flashed like lightning, and a tempest pounded in my head. “Terrible! How terrible not to own a carriage!” I said as I tiptoed across muddy streets. Suddenly I heard a sound far off. I peered into the distance. My fury turned me to stone: A carriage was passing me! I could not control myself! I was ready to leap into the maw of that monstrous four-seater. I was ready to devour that square bulk with my eyes, swallow up its repellent rattle, and clamp down with my teeth to stop it in its path. My blood boiled, my knees buckled: I couldn't walk as rain poured down on me, thunder cracked above my head, and fear of being late for my lesson burnt my heart by a stroke of lightning. The monstrosity rattled by me. I calmed down, but not for long. Once again, I heard the rattle in the distance — another monstrosity! But sometimes — the horror! — two, three, four of them all at once… there was truly no salvation! Clumps of mud flew up and hit my side, my leg, my arm, my face, my mouth… The horror of it! So many reasons to hate mankind! They force you to eat mud in public, so you don't dare to open your mouth! “Crash into pieces, you despicable tool of Satan!” I shouted, dashing out from under the horses' hooves.

The torture became unbearable. The love I felt for the sister of one of my students yielded to unfathomable feelings — for carriages. I say “unfathomable” because they were truly unfathomable. I loved carriages, which is why I envied their owners; I hated them and wished them every conceivable harm, since they were the source of all my suffering. Oh, how foolish I was! Once again, I say that my love almost turned to hatred because the object of my adoration rode in a carriage. I was tortured, I fulminated, I suffered like the Prisoner of Chillon, I cursed like Byron, and in my terrible despair, I didn't notice that I had failed to lend out my capital… To calm my heart, I needed to

take my revenge on mankind, and for that revenge I needed a carriage… I felt that owning one would make me happier, but the delight of having that beast on springs in my power, to have the right to smash it at the first flash of anger… Oh, that would be worth the sacrifice! I fought with myself for a long time. For a long time the spark of Reason, however, fading, saved me from the shameful moniker of “arrant fool.” But finally one terrible event decided my lot in life and helped Fate transform me into one of the “utter fools” that I have to honor to be…

One day when the weather was fair, I took a walk along Nevsky Prospekt. I was at ease because I hadn't seen any carriages for a long time. I thought about my love. There was nothing comforting about my love, but the promise of much pure pleasure in the present. My love was wealthy, meant to ride in a carriage and live in joy and luxury. I was a creature born to walk on foot, marked by a strange defect — envy of carriages! But the greatest obstacles in fools often turn into their illusory advantages: I persuaded myself that the obstacles meant nothing, that everything would be fine, and came to the most inane

conclusions that seemed completely plausible to my limited intellect. Suddenly it began to rain and the streets became muddy. My vision was sullied by more and more carriages. As was my won't, I thought that the owners smirked at me and the drivers purposely went out of their way to nearly trample this poor little pedestrian as they even shouted to fall, that is, “Fall and say good-bye to life!” Foolish, so foolish! But I must admit that such madness seemed plausible to me then. There I was crossing the street, when I saw a carriage in the distance. I turned to avoid falling under the horses' hooves… and suddenly a disgusting clump of mud flew up and hit me right in the face. I shook in horror and outrage. I wanted to wipe it off, but just then I heard a peal of laughter from inside the carriage… Good Lord! Who was laughing? I dropped my hands. I turned around and saw Lyuba, my dream, the object of my love. She stuck her head out the door and screamed with laughter. I can still hear her laughter in my ears! I can't recall what I said. I just remember that cluttered some dreadful nonsense… My fate was sealed. Like a madman I ran home. That clump of mud was still stuck to my face, and feeling it there kept my fury white-hot.

I sold everything I owned, took all my money and bought a carriage. Oh, what a fool I was!

After committing this enormous folly, I had a few hundred rubles left. Meanwhile, my expenses had soared: the cursed carriage needed a shed; the horses needed a stall and oats; the staff needed apartments and bread. I rented a small room with a big stable. The first trip I took in my carriage was to them - to give a lesson. The entire family and an officer, I didn't know greeted me with laughter. I turned hot and then cold. She, that devilish woman, laughed more than the others!

“Just imagine!” the mother told the officer.

“We just went out to buy a trousseau for our girl Lyuba…”

“Trousseau? For your daughter?” I repeated with a horrible foreboding.

“Yes,” Lyuba laughed. “We went to buy gowns and we weren't careful… ha ha ha!… and we splashed…”

Zumpt's Latin Grammar fell from my hands…

“I'll get my revenge!” I said as I ran from the room.

“Where to?” asked the footman.

“Wherever you want! Just drive as fast as you can to the muddiest streets and splash all the pedestrians!” I screamed at the coachman.

The coachman and footman rolled their eyes at me, thinking that I was mad… but I was merely a fool…

After that, my favorite past time was to gallop along the streets and watch the mud from my carriage hit passers by in the face. As soon as the weather was foul and the streets were muddy, I would order the carriage to be harnessed up and then gallop, gallop, gallop while taking indescribable pleasure watching the mud fly up from under the wheels and the horse’s hooves! I consoled myself with the thought that in avenging the insults inflicted upon me, I was muddying all of mankind. What a fool I was.

But no matter how I tried, I was never able to sling mud onto the faces of those who once inflicted that humiliation on me…

In the end, my capital ran out. I stopped eating so that I could feed my horses, but it was all for naught. The bitter moment came when I had to accept my poverty and realize that I could no longer afford the carriage. But I didn't sell it. In a fit of mindless fury at the mute instrument of my misery, I tore my carriage apart with my own hands. And in my poverty and despair, I consoled myself with the thought that I had wiped off the face of the earth at least one of those two-seated monstrosities that had splashed mud on so many people, including sinful me. Oh, how stupid I was!

What else can I say? I already told you that this event had a disastrous effect of the rest of my life. I destroyed the carriage and took to my bed. After a long illness, I finally got up from my sick bed, pale and emaciated, deeply disappointed, with a broken heart. I was still weak, but I thirsted for God's light and clean air, and so I went outside. On Nevsky Prospekt I fell under a carriage and lost my right leg.

Learn from my sad tale, all you who are fated to walk about on foot, and do not envy people riding in carriages. If my example will cure two or three envious wretches, I will be consoled that I did at least one wise thing at the end of my life. For a fool, that's a lot!

In my will I ask those who bury me to ensure that not a single carriage follows after my coffin. I recognize that my ill feeling is foolish, but I cannot be completely free of its influence. Such is the power of habit. But I am an old fool and may be forgiven.

Here in the city lives a prince whose left arm is like any other man's and whose right arm is a swan's wing.

He and his eleven brothers were turned into swans by their vituperative stepmother, who had no intention of raising the twelve sons of her husband's former wife (whose pallid, mortified face stared glassily from portrait after portrait; whose unending pregnancies had dispatched her before her fortieth birthday). Twelve brawling, boastful boys; twelve fragile and rapacious egos; twelve adolescence - all presented to the new queen as routine aspects of her job. Do we blame her? Do we, really?

She turned the boys into swans, and commanded them to fly away.

Problem solved.

She spared the thirteenth child, the youngest, because she was a girl, though the stepmother's fantasies about shared confidences and day-long shopping trips evaporated quickly enough. Why, after all, would a girl be anything but surly and petulant toward the woman who'd turned her brothers into birds? And so - after a certain patient lenience toward sulking silences, after a number of ball gowns purchased but never worn—the queen gave up. The princess lived in the castle like an impoverished relative, fed and housed, tolerated but not loved.

The twelve swan-princes lived on a rock far out at sea, and were permitted only an annual, day-long return to their kingdom, a visit that was both eagerly anticipated and awkward for the king and his consort. It was hard to exult in a day spent among twelve formerly stalwart and valiant sons who could only, during that single yearly interlude, honk and preen and peck at mites as they flapped around in the castle courtyard. The king did his best at pretending to be glad to see them. The queen was always struck by one of her migraines.

Years passed. And then… At long last…

On one of the swan-princes' yearly furloughs, their little sister broke the spell, having learned from a beggar woman she met

while picking berries in the forest that the only known cure for the swan transformation curse was coats made of nettles.

However. The girl was compelled to knit the coats in secret, because they needed (or so the beggar woman told her) not only to be made of nettles, but of nettles collected from graveyards, after dark. If the princess was caught gathering nettles from among the tombstones, past midnight, her stepmother would surely have accused her of witchcraft, and had her burned along with the rest of the garbage. The girl, no fool, knew she couldn't count, on her father, who by then harbored a secret wish (which he acknowledged not even to himself) to be free of all his children.

The princess crept nightly into local grave yards to gather nettles, and spent her days weaving them into coats. It was, as it turned out, a blessing that no one in the castle paid much attention to her.

She had almost finished the twelve coats when the local archbishop (who was not asked why he himself happened to be in a graveyard so late at night) saw her picking nettles, and turned her in. The queen felt confirmed in her suspicions (this being the girl who shared not a single virginal secret, who claimed complete indifference to shoes exquisite enough to be shown in museums). The king, unsurprisingly, acceded, hoping he'd be seen as strong and unsentimental, a true king, a king, so devoted to protecting his people from the darker forces that he'd agree to the execution of his own daughter, if it kept his subjects safe, free of curses, unafraid of demonic transformations.

Just as the princess was about to be burned at the stake, however, the swan-brothers descended from the smoky sky, and their sister threw the coats onto them. Suddenly, with a loud crackling sound, amid a flurry of sparkling wind, twelve studly young men, naked under their nettle coats, stood in the courtyard, with only a few stray white feathers wafting around them.

Actually there were eleven fully intact princes and one, the twelfth, restored save for a single detail—his right arm remained a swan's wing, because his sister, interrupted at her work, had to leave one coat with a missing sleeve.

It seemed a small-enough price to pay.

Eleven of the young men soon married, had children, joined organizations, gave parties that thrilled everyone, right down to the mice in the walls. Their thwarted stepmother, so raucously outnumbered, so unmotherly, retreated to a convent, which inspired the king to fabricate memories of abiding loyalty to his transfigured sons and helplessness before his harridan of a wife, a version the boys were

more than willing to believe.

End of story. “Happily ever after” fell on everyone like a guillotine's blade.

Almost everyone.

It was difficult for the twelfth brother, the swan-winged one. His father, his uncles and aunts, the various lords and ladies, were not pleased by the reminder of their brush with such sinister elements, or their unskeptical willingness to execute the princess as she worked to save her siblings.

The king's consort made jokes about the swan-winged prince, which his eleven f lawlessly formed brothers took up readily,insisting they were only meant in fun. The young nieces and nephews, children of the eleven brothers, hid whenever the twelfth son entered a room, and giggled from behind the chaises and tapestries. His brothers' wives asked repeatedly that he do his best to remain calm at dinner (he was prone to gesticulating with the wing while telling a joke, and had once flicked an entire haunch of venison against the opposite wall).

The palace cats tended to snarl and slink away whenever he came near.

Finally, he packed a few things and went out into the world. The world, however, proved no easier for him than the palace had been. He could only get the most menial of jobs. He had no marketable skills (princes don't), and just one working hand. Every now and then a woman grew interested, but it always turned out that she was briefly drawn to some Leda fantasy or, worse, hoped her love could bring him back his arm. Nothing ever lasted. The wing was awkward on the subway, impossible in cabs. It had to be checked constantly for lice. And unless it was washed daily, feather by feather, it turned from the creamy white of a French tulip to a linty, dispiriting gray.

c el gha

Mi ha Cunnin m

He lived with his wing as another man might live with a dog adopted from the pound: sweet- tempered, but neurot ic and untrainable. He loved his wing, helplessly. He also found it exasperating, adorable, irritating, wearying, heart-breaking. It embarrassed him, not only because he didn't manage to keep it cleaner, or because getting through doors and turnstiles never got less awkward, but because he failed to insist on it as an asset. Which wasn't all that hard to imagine. He could see himself selling himself as a compelling metamorphosis, a young god, proud to the point of sexy arrogance of his anatomical deviation: ninety percent thriving muscled man-flesh and ten percent glorious blindingly white angel wing.Baby, these feathers are going to tickle you halfway to heaven, and this man-part is going to take you the rest of the way.

Where, he asked himself, was that version of him? What dearth of nerve rendered him, as year followed year, increasingly paunchy and slack-shouldered, a walking apology? Why was it beyond his capacities to get back into shape, to cop an attitude, to stroll insouciantly into clubs in a black lizard skin suit with one sleeve cut off ?

Yeah, right, sweetheart, it's a wing, I'm part angel, but trust me, the rest is pure devil.

He couldn't seem to manage that. He might as well have tried to run a three-minute mile, or become a virtuoso on the violin. He's still around. He pays his rent one way or another. He takes his love where he can find it. In late middle age he's grown ironic, and cheerful in a toughened, seen-it-all way. He's become possessed of a world-weary wit. He's realized he can either descend into bitterness or become a wised-up holy fool. It's better, it's less mortifying, to be the guy who understands that the jokes on him, and is the first to laugh when the punch line lands.

Most of his brothers back at the palace are on their second or third wives. Their children, having been cosseted and catered to all their lives, can be difficult. The princes spend their days knocking golden balls into silver cups, or skewering moths with their swords. At night, they watch the jesters and jugglers and acrobats perform.

The twelfth brother can be found, most nights, in one of the bars on the city's outer edges, the ones that cater to people who were only partly cured of their curses, or not cured at all. There's the three-hundred-year-old woman who wasn't specific enough when she spoke to the magic fish, and found herself crying, “No, wait, I meant alive and young forever,” into a suddenly empty sea.

There's the crown, letted frog who can't seem to truly love any of the women willing to kiss him, and break the spell. There's the prince who's spent years trying to determine the location of the comatose princess he's meant to revive with a kiss, and has lately been less devoted to searching mountain and glen, more prone to bar-crawling, given to long stories about the girl who got away.

In such bars, a man with a single swan wing is considered lucky.

His life, he tells himself, is not the worst of all possible lives. Maybe that's enough. Maybe that's what there is to hope for - that it merely won't get any worse.

Some nights, when he's stumbled home smashed (there are many such nights), negotiated the five flights up to his apartment, turned on the TV, and passed out on the sofa, he awakes, hours later, as the first light greys the slats of the venetian blinds, with only his hangover for company, to find that he's curled his wing over his chest and belly; or rather (he knows this to be impossible, and yet…) that

the wing has curled itself, by its own volition, over him, both blanket and companion, his devoted resident alien, every bit as imploring and ardent and inconvenient as that mutt from the pound would have been. His dreadful familiar. His burden, his comrade.

It's a hard fact to accept, but your friends and co-workers lie to you regularly. The real challenge lies in how you respond once you catch someone in the act. “I'm not upset that you lied to me, I'm upset that from now on I can't believe you.” – Friedrich Nietzsche Even though most people lie a lot - roughly two to three times during a ten-minute conversation, studies show - you don't catch them nearly as often as you might think. Researchers from the University of California analysed the results of 253 studies and found that we only spot about half the lies we're told (53% to be exact). In other words, we're about as likely to identify a lie as we are to win a coin toss.

The scary thing is that people who are trained in detecting deception -judges, customs agents, law enforcement officers, and even CIA agents - don't fare much better. They can only spot a lie about 60% of the time.

When you do catch someone lying to you, it's usually a real whopper. These are the kinds of lies that are so insulting to be the recipient that it's hard to think straight. In these moments, you want to keep the conversation constructive, without letting the liar off the hook, which is a difficult thing to pull off.

And what about the times when you have a nagging sense that you're being lied to but aren't certain and don't want to come across as paranoid or accusatory? While too much skepticism is never healthy, a small dose can be a very good thing, especially since we're so poor at recognizing lies.

The question always becomes, what do you do with a lie? If you think someone is lying to you, do you call them on it? Do you tell someone else? Or do you just go along to get along?

There are actually several things you can do, and the right one, or the right combination, depends on the situation.

First, make certain you understand the rules

Before you decide what course of action to take, check the employee handbook and consider the recent history of similar situations. If you're going to call someone out, you need to know what you're getting yourself and the liar into. Know the severity of the

conversation with the liar in private or with others whom the lie affects.

In either case, it's important you have evidence that backs up your claim, or you very well may be called a liar yourself. Just make certain you are honest and direct with the person who lied. Don't go to others with the lie when you know it's better handled privately between you and the liar.

There are many times when reporting a lie is the right thing to do, both ethically and practically. Sometimes, not reporting a lie can cost you your job. However, there are a few things you need to think about before you take that step. First, question your motives.

Are you thinking of telling someone about the lie out of concern that either another employee or the company could be harmed, or are you just mad? If it's the latter, you run the risk of making yourself look petty; if it's the former, stick to the facts. Don't offer any hypotheses about why the person may be lying because that's just supposition on your part. Stick to what the person said, what the truth is, and any proof you have collected.

Not optional: Protect yourself

Whether you decide to call a lie or to let it go, once you know you're dealing with a liar, it's critical to take steps to protect yourself. One way to do that is to have a witness attest to what the liar said. Failing this, interact with the liar via email or text, both of which create a written record. Though if you're dealing with a particularly savvy liar, they're not going to commit to anything in writing.

In that case, document the conversation yourself: who, what, when, where, etc., and cap it off by sending your lying colleague an e-mail summarizing the conversation. That's not as good as having proof in the other person's words, but at least you'll be able to make the argument that your colleague had the opportunity to correct you.Bringing it all together

Some people tell infrequent lies to make themselves look good or to protect themselves. Others are pros. They've been doing it their whole careers, they're good at it, and they've learned how to avoid getting caught. That's why there's no single solution that works in every situation. The best thing to do is to carefully consider your options, thinking through the pros and cons of each course of action.

consequencesrfor lying, and make certain you follow propeprotocol for addressing it, or the entire thing could backfire on you.

Option #1: Do nothing

Nobody likes being lied to, and the natural reaction is to call the liar out, but that's not always the smartest thing to do, especially at work. Before you do anything, ask yourself, ‘'What's at stake besides my ego?' Carefully weigh the pros and cons before you take action.

Consider who, if anyone, should know about the lie and the implications it has for the company. Sometimes, the animosity you avoid by staying silent is worth more than the satisfaction you receive from speaking out. Other times, the lie is serious enough that people have to know.

Option #2: Deflect with humor

Some lies are too big to ignore completely, yet too small to make a big deal out of. When this happens, you can always make a joke of it. Playful comments that acknowledge the lie will usually do the trick. Whether it's “Hey, I think I just saw your nose grow a little bit” or “I need to get my prescription checked.

When I looked at the scorecard, it said you shot 112,” this strategy gives the liar a chance to admit their slip-up without fear of reprisal. The key to making this tactic work is to give the impression that the other person was kidding around or intentionally exaggerating and never expected to be believed.

Option #3: Play dumb

Another way to let someone save face and this is particularly appropriate for group settings -is to play dumb. Pretend you suddenly suffered a memory lapse or are confused about the facts. Ask lots of follow-up questions.

The more details you request, the more likely it is that the truth will come out. Drawing it out gives the liar a chance to admit that they “misspoke” and correct themselves without being called a liar.

Option #4: Call them on it

In situations where doing nothing isn't a good option, you can always call the liar out. You just need to think carefully about the best way to do this, and impulsively bashing them is never a smart move. You may choose to have a

WHEN YOU CATCH A LIAR

Life Is A e o w s me4 By Travis Bradberry

THINGS TO DO

REVEALS 4 RITUALS

THAT WILL MAKE YOU HAPPY

NEW NEUROSCIENCE

BY ERIC BARKER

You get all kinds of happiness advice on the internet from people who don't know what they're talking about. Don't trust them.

Actually, don't trust me either. Trust neuroscientists. They study that gray blob in your head all day and have learned a lot about what truly will make you happy.

UCLA neuroscience researcher Alex Korb has some insights that can create an upward spiral of happiness in your life. Here's what you and I can learn from the people who really have answers:

1) The Most Important Question To Ask When You Feel DownSometimes it doesn't feel like your brain wants you to be happy. You may feel guilty or shameful. Why?

Believe it or not, guilt and shame activate the brain's reward center.

Despite their differences, pride, shame, and guilt all activate similar neural circuits, including the dorsomedial prefrontal cortex, amygdala, insula, and the nucleus accumbens. Interestingly, pride is the most powerful of these emotions at triggering activity in these regions — except in the nucleus accumbens, where guilt and shame win out. This explains why it can be so appealing to heap guilt and shame on ourselves — they're activating the brain's reward center.

Know what Prozac does? Boosts the neurotransmitter serotonin. So does gratitude.

One powerful effect of gratitude is that it can boost serotonin. Trying to think of things you are grateful for forces you to focus on the positive aspects of your life. This simple act increases serotonin production in the anterior cingulate cortex.

I know, sometimes life lands a really mean punch in the gut and it feels like there's nothing to be grateful for. Guess what?

Doesn't matter. You don't have to find anything. It's the searching that counts.

It's not finding gratitude that matters most; it's remembering to look in the first place. Remembering to be grateful is a form of emotional intelligence. One study found that it actually affected neuron density in both the ventromedial and lateral prefrontal cortex. These density changes suggest that as emotional intelligence increases, the neurons in these areas become more efficient. With higher emotional intelligence, it simply takes less effort to be grateful.And gratitude doesn't just make your brain happy — it can also create a positive feedback loop in your relationships. So express that gratitude to the people you care about.But what happens when bad feelings completely overtake you? When you're really in the dumps and don't even know how to deal with it? There's an easy answer…

And you worry a lot too. Why? In the short term, worrying makes your brain feel a little better - at least you're doing something about your problems.

In fact, worrying can help calm the limbic system by increasing activity in the medial prefrontal cortex and decreasing activity in the amygdala. That might seem counterintuitive, but it just goes to show that if you're feeling anxiety, doing something about it-even worrying - is better than doing nothing.

But guilt, shame and worry are horrible l ong - t e rm so l u t i on s . So wha t do neuroscientists say you should do? Ask yourself this question:

What am I grateful for?

Yeah, gratitude is awesome… but does it really affect your brain at the biological level? Yup. You know what the antidepressant Wellbutrin does? Boosts the neurotransmitter dopamine. So does gratitude.

The benefits of gratitude start with the dopamine system, because feeling grateful activates the brain stem region that produces dopamine. Additionally, gratitude toward others increases activity in social dopamine circuits, which makes social interactions more enjoyable…

2) Label Negative Feelings You feel awful. Okay, give that awfulness a name. Sad? Anxious? Angry?

Boom. It's that simple. Sound stupid? Your noggin disagrees.…in one fMRI study, appropriately titled “Putting Feelings into Words” participants viewed pictures of people with emotional facial expressions. Predictably, each participant's amygdala activated to the emotions in the picture. But when they were asked to name the emotion, the ventrolateral prefrontal cortex activated and reduced the emotional amygdala reactivity. In other words, consciously recognizing the emotions reduced their impact.

Suppressing emotions doesn't work and can backfire on you.Gross found that people who tried to suppress a negative emotional experience failed to do so. While they thought they looked fine outwardly, inwardly their limbic system was just as aroused as without suppression, and in some cases, even more aroused. Kevin Ochsner, at Columbia, repeated these findings using an FMRI. Trying not to feel something doesn't work, and in some cases even backfires. But labeling, on the other hand, makes a big difference. To reduce arousal, you need to use just a few words to describe an emotion, and ideally use symbolic language, which means using indirect metaphors, metrics, and simplifications of your experience. This requires you to activate your prefrontal cortex, which reduces the arousal in the limbic system. Here's the bottom line: describe an emotion in just a word or two, and it helps reduce the emotion. Ancient methods were way ahead of us on this one. Meditation has employed this for centuries. Labeling is a fundamental tool of mindfulness.

In fact, labeling affects the brain so powerfully it works with other people too. Labeling emotions is one of the primary tools used by FBI hostage negotiators.

Okay, hopefully you're not reading this and labeling your current emotional state as “Bored.” Maybe you're not feeling awful, but you probably have things going on in your life that are causing you some stress. Here's a simple way to beat them…

3) Make That Decision

Ever make a decision and then your brain finally feels at rest? That's n o r a n d o m occurrence.

dopamine activity.

Want proof? No problem. Let's talk about cocaine.

You give 2 rats injections of cocaine. Rat A had to pull a lever first. Rat B didn't have to do anything. Any difference? Yup: rat A gets a bigger boost of dopamine.So they both got the same injections of cocaine at the same time, but rat A had to actively press the lever, and rat B didn't have to do anything. And you guessed it - rat A released more dopamine in its nucleus accumbens. So what's the lesson here? Next time you buy cocaine… whoops, wrong lesson. The point is, when you make a decision on a goal and then achieve it, you feel better than when good stuff just happens by chance.And this answers the eternal mystery of why dragging your butt to the gym can be so hard.

If you go because you feel you have to or you should, well, it's not really a voluntary decision. Your brain doesn't get the pleasure boost. It just feels stress. And that's no way to build a good exercise habit.

Interestingly, if they are forced to exercise, they don't get the same benefits, because without choice, the exercise itself is a source of stress.So make more decisions. Neuroscience researcher Alex Korb :We don't just choose the things we like; we also like the things we choose.Okay, you're being grateful, labeling negative emotions and making more decisions. Great. But this is feeling kinda lonely for a happiness prescription. Let's get some other people in here.

What's something you can do with others that neuroscience says is a path to mucho happiness? And something that's stupidly simple, so you don't get lazy and skip it? Brain docs have an answer for you…

sums it up nicely

Brain science shows that making decisions, reduces worry and anxiety - as well as helping you solve problems.

Making decisions includes creating intentions and setting goals - all three are part of the same neural circuitry and engage the prefrontal cortex in a positive way, reducing worry and anxiety. Making decisions also helps overcome striatum activity, which usually pulls you toward negative impulses and routines. Finally, making decisions, changes your perception of the world — finding solutions to your problems and calming the limbic system.

But deciding can be hard. I agree. So what kind of decisions should you make? Neuroscience has an answer…

Make a “good enough” decision. Don't sweat making the absolute 100% best decision. We all know being a perfectionist can be stressful. And brain studies back this up.

Trying to be perfect overwhelms your brain with emotions and makes you feel out of control.

Trying for the best, instead of good enough, brings too much emotional ventromedial prefrontal activity into the decision-making process. In contrast, recognizing that good enough is good enough activates more dorsolateral prefrontal areas, which helps you feel more in control…As Swarthmore professor

said in my interview with him: “Good enough is almost always good enough.”

So when you make a decision, your brain feels you have control. And, as I've talked about before, reduces stress. But here's what's really fascinating: Deciding also boosts pleasure.

Actively choosing caused changes in attention circuits and in how the participants felt about the action, and it increased rewarding

Barry Schwartz

a feeling of control

THAT WILL MAKE YOU

RITUALS HAPPY

4) Touch People

No, not indiscriminately; that can get you in a lot of trouble. But we need to feel love and acceptance from others. When we don't, it's painful. And I don't mean “awkward” or “disappointing.” I mean actually painful. Neuroscientists did a study where people played a ball-tossing video game. The other players tossed the ball to you and you tossed it back to them. Actually, there were no other players; that was all done by the computer program. But the subjects were told the characters were controlled by real people. So what happened when the “other players” stopped playing nice and didn't share the ball? Subjects' brains responded the same way as if they experienced physical pain. Rejection doesn't just hurt like a broken heart; your brain feels it like a broken leg.

In fact, as demonstrated in an FMRI experiment, social exclusion activates the same circuitry as physical pain… at one point they stopped sharing, only throwing back and forth to each other, ignoring the participant. This small change was enough to elicit feelings of social exclusion, and it activated the anterior cingulate and insula, just like physical pain would.

Relationships are very important to your brain's feeling of happiness. Want to take that to the next level? Touch people.

One of the primary ways to release oxytocin is through touching. Obviously, it's not always appropriate to touch most people, but small touches like handshakes and pats on the back are usually okay. For people you're close with, make more of an effort to touch more often.

Touching is incredibly powerful. We just don't give it enough credit. It makes you more

, increases improves your … heck, it even boosts

.

Touching someone you love actually reduces pain. In fact, when studies were done on married couples, the stronger the marriage,

persuasive team performanceflirting

math skills

,

them on the phone, they felt better. What about when they just texted? Their bodies responded the same as if they had no support at all.…the text-message group had cortisol and oxytocin levels similar to the no-contact group.

Author's note: I totally approve of texting if you make a hug appointment.

Okay, I don't want to strain your brain with too much info. Let's round it up and learn the quickest and easiest way to start that upward spiral of neuroscience-inspired happiness…

Sum Up

Here's what brain research says will make you happy:

So what's the dead simple way to start that upward spiral of happiness?

Just send someone a . If you feel awkward about it, you can send them this post to tell them why.

This really can start an upward spiral of happiness in your life. UCLA neuroscience researcher explains:Everything is interconnected. Gratitude improves sleep. Sleep reduces pain. Reduced pain improves your mood. Improved mood, reduces anxiety, which improves focus and planning. Focus and planning help with decision making. Decision making further reduces anxiety and improves enjoyment. Enjoyment gives you more to be grateful for, which keeps that loop of the upward spiral going. Enjoyment also makes it more likely you'll exercise and be social, which, in turn, will make you happier.

· Ask “What am I grateful for?” No answers? Doesn't matter. Just searching helps.

· Label those negative emotions. Give it a name and your brain isn't so bothered by it.

· Decide. Go for “good enough” instead of “best decision ever made on Earth.”

· Hugs, hugs, hugs. Don't text — touch.

thank you email

Alex Korb

the more powerful the effect.

In addition, holding hands with someone can help comfort you and your brain through painful situations. One FMRI study scanned married women as they were warned that they were about to get a small electric shock. While anticipating the painful shocks, the brain showed a predictable pattern of response in pain and worrying circuits, with activation in the insula, anterior cingulate, and dorsolateral prefrontal cortex. During a separate scan, the women either held their husbands' hands or the hand of the experimenter. When a subject held her husband's hand, the threat of shock had a smaller effect. The brain showed reduced activation in both the anterior cingulate cortex and dorsolateral prefrontal cortex - that is, less activity in the pain and worrying circuits. In addition, the stronger the marriage, the lower the discomfort-related insula activity.

So hug someone today. And do not accept little, quick hugs. No, no, no. Tell them your neuroscientist recommended long hugs.A hug, especially a long one, releases a neurotransmitter and hormone oxytocin, which reduces the reactivity of the amygdala.Research shows

increases happiness big time.

Don't have anyone to hug right now? No? (I'm sorry to hear that. I would give you a hug right now if I could.) But there's an answer: neuroscience says you should go get a massage.

The results are fairly clear that massage boosts your serotonin by as much as 30 percent. Massage also decreases stress hormones and raises dopamine levels, which helps you create new good habits… Massage reduces pain because the oxytocin system activates painkilling endorphins. Massage also improves sleep and reduces fatigue by increasing serotonin and dopamine and decreasing the stress hormone cortisol.

So spend time with other people and give some hugs. Sorry, texting is not enough.When you put people in a stressful situation and then let them, visit loved ones or talk to

getting five hugs a day for four weeks

MEDICAL NEWS UPDATES

A severe head injury, especially during

middle age, could dramatically boost the risk

for developing dementia later in life, new

research from Finland suggests.

The investigation tracked dementia risk

among people who had suffered a traumatic

brain injury [TBI] at 65 or younger. Ultimately,

the researchers determined that not only did

the risk go up for those who had a TBI, but the

worse the initial head injury, the greater the risk

of dementia.

"The study showed that 3.5 percent of

persons with moderate-to-severe TBI [were]

diagnosed with a neurodegenerative disease

[such as dementia] later in life," said study lead

author Dr. Rahul Raj. He's an associate

professor of experimental neurosurgery at

Helsinki University Hospital.

"This is substantially higher compared

to age-matched peers with no history of brain

injury," he noted.

By comparison, "only 1.6 percent of

persons with mild TBI were diagnosed with a

neurodegenerative disease," Raj added,

placing moderate-to-severe TBI patients at a

90 percent greater risk for dementia than mild

TBI patients.

The study authors pointed out that this

research could only show an association; it

could not prove a direct cause-and-effect link

between traumatic brain injury and dementia.

those who had a traumatic brain injury

between ages 41 and 50. Their odds of

dementia were nearly triple those of someone

with a mild injury.

For those who had a TBI between ages 51

and 60, the odds of dementia were doubled,

the study showed.

More people in the moderate-to-severe

group also ended up with dementia before the

age of 65, compared to those in the mild group

(40 percent versus 26 percent, respectively).

For TBI survivors, Raj said that "even after [a]

seemingly [full] recovery there is an underlying

elevated risk for dementia that probably won't

ever go away.

"Thus, until we have a specific treatment

for this, it is extremely important to minimize

other risk factors for dementia, such as high

blood pressure, high levels of cholesterol,

diabetes, tobacco smoking and alcohol

consumption," he noted.

Dr. Anton Porsteinsson is a professor of

psychiatry and director of the Alzheimer's

Disease Care, Research and Education

Program at the University of Rochester School

of Medicine in Rochester, N.Y. He said the

findings suggest the effects of a traumatic brain

injury can be "long-lasting or even permanent."

Why? Porsteinsson said a head injury likely

triggers a loss of "brain reserve," while spurring

on problematic shifts in overall brain chemistry.

"That the risk is highest in middle age is not

surprising," he added, "as the brain has less

ability to recover from injury at that time. And

this is also the time period where the processes

that may ultimately even decades later result in

Alzheimer's disease tend to start."

The upshot, said Porsteinsson, is that

"taking steps to minimize the risk of TBI is quite

relevant" among the middle-aged, "no less so

than in young athletes." The study was

published in the July 5 issue of PLOS Medicine.

In addition, a traumatic brain injury was

only linked to a higher risk for developing

dementia, not to a higher risk for other

neurological conditions, such as Parkinson's or

ALS (Lou Gehrig's disease).

The American Association of Neurological

Surgeons (AANS) says that about 1.7 million

Americans experience some form of traumatic

brain injury each year, often resulting from a fall,

a car accident or a firearm accident.

Among moderate-to-severe traumatic

brain injury patients, roughly one in three ends

up succumbing to their injury, Raj noted. One

in two survivors end up struggling with lifelong

disabilities. The AANS pegs the number of

Americans living with a TBI-induced disability at

more than 5 million.

The new study included more than 40,000

Finnish adults between 18 and 65 who had

been hospitalized with mild, moderate or

severe traumatic brain injuries. The injuries

occurred between 1987 and 2014. The

researchers followed the study participants for

about 11 years.

The roughly 20,000 mild TBI patients were

hospitalized for less than a day. None had

experienced a traumatic brain lesion such as

brain bruising, swelling, bleeding or a blood

clot.

More than 20,000 moderate-to-severe

traumatic brain injury patients had been

hospitalized for a minimum of three days. All

had been diagnosed with some form of serious

brain lesion.

There was no significant difference

between the two groups in terms of age,

educational background or income.

Though above-average dementia risk was

seen among all TBI patients, the moderate-to-

severe group faced a substantially higher risk

than the mild group.

The largest jump in risk was seen among

Dementia Risk Years LaterSource : HealthDay News

Severe Head Injury May Raise

Sleep Problems: An Early Warning Sign of Alzheimer's?

Trouble getting enough sleep may be

linked to a bigger risk of Alzheimer's disease for

some people, new research suggests.

The results of the small study hint that

people with a higher-than-normal risk of

Alzheimer's disease who had worse sleep

quality, more sleep problems and daytime

sleepiness had more markers for Alzheimer's

disease in their spinal fluid than those who

didn't have sleep issues.

The markers found by researchers

included signs of the proteins amyloid and tau,

and brain cell damage and inflammation, all

linked to potential Alzheimer's.

Amyloid is a protein that folds and forms

plaques. Tau is a protein that forms tangles.

Plaques and tangles are found in the brains of

those with Alzheimer's disease and are

considered a hallmark of the disease.

"This study and others in the field suggest

that sleep may be a modifiable risk factor for

Alzheimer's disease," said senior researcher

Barbara Bendlin. She's an associate professor of

medicine at the University of Wisconsin School

of Medicine and Public Health.

"This will require studies that directly test

whether modifying sleep has a beneficial effect

on the brain," Bendlin said.

So, if you're someone who's always tossing

and turning at night, does that mean you're

I

Although a strong association between sleep

problems and Alzheimer's markers was seen in

most people, not everyone with sleep difficulty

had these markers in their spinal fluid, Bendlin

said.

For example, there was no association

seen between people who had sleep apnea

and markers for Alzheimer's in their spinal fluid.

Other factors - such as the use of drugs to aid

sleep, education, depression and weight --

didn't change the association between poor

sleep and markers for Alzheimer's disease, the

researchers found.

One thing that could have thrown the

findings off is that the participants reported their

own sleep problems. It's possible that people

misreported their sleep issues or didn't

remember them correctly, the researchers

said.

One specialist said that the association

between sleep and amyloid has been seen in

mice, but its effect on people isn't clear.

"There is a positive feedback loop involving

sleep and amyloid," said Dr. Sam Gandy,

director of the Center for Cognitive Health at

Mount Sinai Hospital in New York City.

In mice, the worse the sleep, the more

amyloid builds up. The more amyloid builds

up, the worse the sleep, he said.

It's not known if this occurs in the same way in

humans, Gandy said.

"Since our ability to slow progression of

Alzheimer's is still quite limited, this is an

important area for research so that we might

be able to exploit sleep regulation

therapeutically," he said.

Bendlin said it's important to identify

modifiable risk factors for Alzheimer's because

delaying Alzheimer's disease in people by as

little as five years could reduce the number of

cases in the next 30 years by nearly 6 million

and save $367 billion in health care costs.

The report was published online July 5 in

the journal Neurology.

destined to a future with Alzheimer's disease?

Not necessarily. Bendlin said these findings

cannot prove that poor sleep causes

Alzheimer's disease. "We found an association,"

she said. "But that does not mean cause and

effect."

It's possible changes in the brain associated

with Alzheimer's could affect sleep, as opposed

to the other way around, Bendlin added.

People with markers -- signs -- of

Alzheimer's in their spinal fluid aren't

necessarily predestined to develop the

condition either, she said.

"We found relationships between sleep

and levels of proteins related to Alzheimer's

disease, but the proteins that we were

measuring haven't yet been shown to predict

future dementia when measured in cognitively

healthy people," Bendlin said.

The study included 101 people and their

average age was 63. At the time of testing, all of

the study volunteers had normal thinking and

memory skills. But they were considered at risk

for Alzheimer's either because they had a

parent with the disease or they carried a gene

that increases the risk for Alzheimer's called

apolipoprotein E, or APOE.

The study volunteers gave a sample of

spinal fluid to be tested for markers of

Alzheimer's disease.

They also answered questions to judge

the quality of their sleep. Examples included:

"During the past four weeks, how often did you

get the amount of sleep you needed?" Or "Did

you get enough sleep to feel rested upon

waking in the morning?" Bendlin said.

Source : HealthDay News

Bingeing on chocolate, pastries and soda

during pregnancy might have an unintended

downside -- setting kids up for asthma and

allergies, new research suggests.

The study of more than 9,000 mother-

child pairs in Britain can't prove cause-and-

effect. However, the researchers found that

children born to the 20 percent of mothers

with the highest sugar intake during pregnancy

were 38 percent more likely to have an allergy

by the age of 7, and 73 percent more likely to

have two or more allergies.

The children were assessed at age 7 for

common allergies such as dust mites, cat and

grass.

Compared to children born to women in

the lowest category of sugar intake, these kids

also had double the odds for allergic asthma,

the researchers found.

The British team stressed that the

association remained even after they factored

out the kids' own daily sugar intake.

Dr. Jennifer Wu is an obstetrician/gynecologist

at Lenox Hill Hospital in New York City. She

agreed that "with the rise in allergies, anything

that can be done to decrease risks should be

explored. Further studies with larger numbers

are needed, but already doctors should start to

have conversations with their patients about

diet."

The British researchers said more study is

planned.

"The first step is to see whether we can

replicate these findings in a different cohort of

mothers and children," Shaheen said. "If we

can, then we will design a trial to test whether

we can prevent childhood allergy and allergic

asthma by reducing the consumption of sugar

by mothers during pregnancy. In the

meantime, we would recommend that

pregnant women follow current guidelines and

avoid excessive sugar consumption."

The study was published July 5 in the

European Respiratory Journal.

“We cannot say on the basis of these

observations that a high intake of sugar by

mothers in pregnancy is definitely causing

allergy and allergic asthma in their offspring,"

lead researcher Seif Shaheen, a professor at

Queen Mary University of London, said in a

university news release.

"However, given the extremely high

consumption of sugar in the West, we will

certainly be investigating this hypothesis further

with some urgency," he said.

Two experts agreed the findings are

intriguing, but they added that more study is

needed.

While the findings need to be confirmed

in subsequent trials, "the data is exciting in that it

suggests that we may be able to control,

through maternal diet during pregnancy, the

outcomes of allergies and allergic asthma in

unborn children," said Dr. Sherry Farzan. She's

an allergy specialist at Northwell Health in

Great Neck, N.Y.

Could a Sweet Tooth in

Source : HealthDay News

Pregnancy Spur Allergies in Kids?

Go to People With Mental IllnessHalf of Opioid PrescriptionsSource : HealthDay News

Americans with mental health disorders

receive a troubling percentage of the nation's

opioid prescriptions, a new study finds.

"Despite representing only 16

percent of the adult population, adults with

mental health disorders receive more than half

of all opioid prescriptions distributed each year

in the United States," study lead author

Of the 115 million prescriptions written for

these painkillers each year in the United States,

60 million are for adults with mental illness,

according to the researchers.

Matthew Davis, assistant professor at the

University of Michigan School of Nursing, said

in a university news release.

Prescription opioids include drugs such

as OxyContin and Vicodin. Widespread use of

opioids for pain has led to an epidemic of

addiction in the United States. Forty lives are

lost to prescription drug overdose every day,

according to the U.S. Centers for Disease

Control and Prevention.

Study co-author Brian Sites said that

"because of the vulnerable nature of patients

with mental illness -- such as their susceptibility

for opioid dependency and abuse -- this finding

warrants urgent attention to determine if the

risks associated with such prescribing are

balanced with therapeutic benefits." Sites is an

anesthesiologist at Dartmouth-Hitchcock

Medical Center in Lebanon, N.H.

also a major risk factor for overdose and other

opioid - related harms.

The study is scheduled to be published

online July 6 in the Journal of the American

Board of Family Medicine.

About 39 million Americans have been

diagnosed with a mental illness. Among these

people, more than 7 million (18 percent) are

prescribed opioids each year. In adults without

mental illness, just 5 percent are prescribed

opioids, the study authors said.

The researchers said the link between

mental illness and opioid prescribing is

particularly concerning because mental illness is

An inexpensive over-the-counter

antioxidant/zinc supplement that may help

preserve vision in older people is also cost

effective, a new study suggests.

The combo pill has been dubbed the

"Age-Related Eye Disease Study (AREDS)"

supplement, based on trial in which it was

studied previously.

Dr. Aaron Lee, a researcher on the new

trial, said his team found AREDS was "greatly

cost-effective for the treatment of age-related

macular degeneration, specifically in people

definitively showed a benefit in preventing the

disease or its progression.

"Despite this being routine practice among

many retinal specialists in the U.S., the benefits

remain uncertain," said Dr. Alfred Sommer,

professor of ophthalmology at Johns Hopkins

University School of Medicine in Baltimore.

According to the American Macular

Degeneration Foundation (AMDF), age-

related macular degeneration causes damage

to the macula, a small spot near the center of

the retina. It's the part of the eye needed for

sharp, central vision. Over time, vision can

become blurry, and eventually patients can lose

their eyesight.

The two basic types of macular

degeneration are called wet and dry. About 10

percent to 15 percent of the cases of macular

degeneration are the wet type.

who have active wet, age-related macular

degeneration in one eye and dry in the other."

Lee is assistant professor of ophthalmology at

the University of Washington in Seattle.

Macular degeneration is a progressive

disease that's a major cause of vision loss in

older Americans.

The new study suggests the AREDS

supplement may delay the need for more

expensive treatment of the "wet" form of the

illness, especially, Lee said.

Exactly how the supplements work to

slow progression of the eye malady isn't

known, he added, but "the current formulation

of the supplements contain antioxidants that

are thought to be protective of the retina from

damage that results in wet age-related macular

degeneration."

Still, at least one U.S. eye expert challenged

the idea that the AREDS supplement

Supplement May Help Source : HealthDay News

Against Vision-Robbing Disease in Seniors

In wet macular degeneration, blood

vessels grow under the retina and macula.

These new vessels may bleed and leak fluid,

causing the macula to bulge or lift up from its

normally flat position, thus distorting or

destroying central vision. Vision loss may be

rapid and severe.

Approximately 85 percent to 90 percent

of the cases of macular degeneration are the

dry type. Dry age-re lated macular

degeneration does not involve any leakage of

blood. Instead, the macula may deteriorate

and waste products from cells in the eye can

build up. Loss of vision can occur, according to

the AMDF.

The prior AREDS trial showed that the

supplements, which combine antioxidant

vitamins with zinc and copper, are inexpensive

and effective in slowing the progression of age-

related macular degeneration.

AREDS supplements are sold under

brand names such as Preser Vision and Pro-

Optic. Costs range from about $25 to $40 for

120 pills - a two-month supply.

Over the course of a lifetime, the researchers found that these patients would need nearly eight fewer injections of anti-VEGF therapies into their eye, Lee said.

That could lead to thousands of dollars in savings per patient over time, the British team concluded. But Sommer, who reviewed the new findings, did have some caveats. Sommer noted that "it is now, in fact, common practice for ophthalmologists in the U.S. to recommend that their patients who fit this profile take this supplement."

He added, "If one believes the supplement does work in the group in which it appeared to, then the whole issue is cost, since no evidence has ever been reported that shows harm."But does ARDS actually work?

According to Sommer, no large-scale study has been done to test that out. And the AREDS trial researchers used to tout these supplements was small, so that any positive results might still be a chance occurrence, he noted. Sommer's conclusion: "Despite this being routine practice among many retinal specialists i n t he U.S . , t he bene f i t s rema in uncertain."Therefore, "any analysis of the cost for the benefits are somewhat meaningless when viewed from this perspective," he said.

The study was published Aug. 23 in the British Journal of Ophthalmology.

That's a much lower price tag than expensive

prescription drugs called anti-VEGF therapies,

which are currently used to treat wet macular

degeneration. Plus, anti-VEGF drug therapy

involves getting a needle in the eye, and the

drugs can also have side effects. One possible

side effect is an increased risk of inflammation of

the inside of the eye, and another possibility is

stroke, Lee noted.

So, to calculate the cost-effectiveness of AREDS supplements, Lee and colleagues looked at the use of the supplements in people over 55 years of age. The AREDS trial had concluded that a daily supplement combining high-dose antioxidants and zinc lowered the risk of developing wet age-related macular degeneration and slowed its progression. Lee's team looked at two formulas of available supplements. Formula 1 has high doses of vitamins C and E, beta carotene, zinc and copper. Formula 2 has lutein and zeaxan thin instead of beta carotene.

The researchers used a statistical model with information from the AREDS trial, along with data from more than 90,000 people with macular degeneration in the United Kingdom.The investigators found that both formulations were cost effective for treating patients with early stage disease, but they were even more cost effective for those with the condition in only one eye.

Hinder Infertility Treatments?Do Flame RetardantsSource : HealthDay News

Researchers have linked higher exposure

to a type of flame retardant to a greater

likelihood that in-vitro fertilization won't work.

"Couples undergoing IVF and trying to

improve their chances of success by reducing

their exposure to environmental chemicals

may want to opt for products that are flame

retardant-free," said senior study author Russ

Hauser. He is a professor of reproductive

physiology at the Harvard T.H. Chan School of

Public Health in Boston.

The study is said to be the first to look at

possible connections between pregnancy and

exposure to organophosphate f lame

retardants, also known as PFRs. These are

suggested that PFRs disrupt hormones in

animals, and can enter the air and dust indoors.

For the new study, the researchers analyzed

urine samples from 211 women who were

undergoing in-vitro fertilization at the

Massachusetts General Hospital Fertility

used in the manufacturing of polyurethane

foam products, and are found in upholstered

furniture, baby supplies and gym mats.

"These findings suggest that

exposure to PFRs may be one of many risk

factors for lower reproductive success," study

first author Courtney Carignan, a research

fellow at Harvard, said in a school news

release. "They also add to the body of evidence

indicating a need to reduce the use of these

flame retardants and identify safer alternatives."

PFRs first appeared in polyurethane foam

products as an alternative to another flame

retardant that was believed to be unsafe, the

researchers said. However, evidence has

Center between 2005 and 2015. After adjusting their statistics to

compensate for other factors, the investigators

found that women whose urine showed signs

of more exposure to the flame retardants were

10 percent less likely, on average, to achieve

successful fertilization. They were also 31

pregnancy and birth. It's also not clear what role

flame retardant exposure may play in male

fertility.

Funded by the U.S. National Institute of

Environmental Health Sciences, the study was

published online Aug. 25 in the journal

Environmental Health Perspectives.

percent less likely to have an embryo

implanted, 41 percent less likely to become

pregnant and 38 percent less likely to give birth

to a live child, the study authors said.

The study doesn't prove that exposure

to flame retardants caused a lower likelihood of

Common Treatment for Early Source : HealthDay News

Because testosterone can help prostate

tumors grow, men with prostate cancer are

often given hormone-suppressing treatment.

But new research suggests that delivering the

treatment in prostate cancer's early stages may,

in turn, hike a man's odds for another illness --

heart failure.

The treatment in question is known as

androgen-deprivation therapy.

The take-home message from the new

study is that "patients with localized prostate

cancer should be followed to minimize the

health effects of androgen-deprivation therapy

on the cardiovascular system," said study

author Reina Haque. She's a researcher with

the Kaiser Permanente Southern California

Department of Research & Evaluation.

Haque's advice? "Patients should consider

[heart-healthy] lifestyle changes, and physicians

should actively monitor the patient's health for

early signs of heart disease," she said in a Kaiser

Permanente news release.

A prostate cancer expert who reviewed the

study agreed.

"This new data is important in deciding

what treatment should be undertaken, if any,

for early stage disease," said Dr. Elizabeth

Kavaler, a urology specialist at Lenox Hill

Hospital, in New York City.

Haque's research team noted that, in

recent years, there's been an expansion in use

of hormone-suppressing treatment for

prostate cancer. The treatment was previously

These men were also three times more likely

to develop "conduction disorder," which occurs

when electrical impulses to the heart are

interrupted. One urologist experienced in the

treatment of prostate cancer said that "there

are two issues we need to look at to understand

this report properly."

Dr. Nachum Katlowitz directs urology at

Staten Island University Hospital in New York

City. He said that, first of all, it's important to

remember that "all treatments have risk.”

“If androgen-deprivation therapy

increases the risk of dying from cardiovascular

disease, but decreases the risk of dying

from prostate cancer, then we use it," he

reasoned. "We watch for potential side effects.

And sometimes, in select patients, the risk is

greater than the benefit -- so we do not [advise

the therapy]."

Secondly, Katlowitz said, the findings

come as little surprise, since physicians have

long known that the suppression of

testosterone can raise a man's odds for

common heart disease risk factors.

restricted to advanced prostate tumors, but

now it's being given to a growing number of

men with early stage prostate cancer that has

not spread to other parts of the body.

However, the safety and effectiveness of

androgen-deprivation therapy for these men

hasn't been investigated, the study authors said.

In the new study, Haque and colleagues

assessed outcomes for more than 7,600 men

with early stage prostate cancer. The

investigators tracked the men for up to 12

years, starting when they were diagnosed

between 1998 and 2008. The researchers

factored in certain heart risk factors - things such

as overweight/obesity, history of smoking,

diabetes, high blood pressure or if they

required heart medications.

Initially, the men in the study were not

undergoing any form of treatment but were

being closely watched by their doctor to

monitor the progression of their disease. But

nearly 30 percent of the men did go on to

receive androgen-deprivation therapy, the

researchers said. Many of these men were

younger than 60.

The study found the men with early stage

prostate cancer who did not already have heart

disease, but who received hormone-depleting

treatments had an 81 percent higher risk for

heart failure.

Meanwhile, those who already had heart

disease when they received the anti-hormone

treatment also had a greater risk for heart

rhythm problems, including a 44 percent

increased risk of an irregular heartbeat.

Prostate Cancer May Carry Heart Risk

"To summarize, yes, androgen-deprivation

therapy has risk," he said, but so does the

option of not providing the treatment in men

with prostate cancer. “It is up to the doctor

working with the patient to decide if the

benefits are worth the risks and side effects,"

Katlowitz concluded.

Study author Haque agreed.

"The findings allow men with localized

prostate cancer to consider the positive and

negative effects of androgen-deprivation

therapy and discuss it with their physicians," she

said. "If they move forward with the therapy,

patients should work with their physicians to

adjust their lifestyle to reduce the risk of

cardiovascular disease."The study was

published Aug. 24 in the British Journal of

Cancer.

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