Nicole Burke and Ryan Miller live on a farm with their 4-year-old daughter, eating a diet rich in homegrown vegetables and kombucha -- an organic tea fermented in a cocktail of yeast and bacteria.
Burke and Miller, from New Haven, VT, also brew and sell their own probiotic, using raw honey from their bee colony. They believe that a healthy dose of microbes contributes to their overall health.
“Research seems to show that the health of the microbiome is important,” says Miller. “And there is more going on there than we ever realized. It’s pretty exciting.”
Miller is right. Early research shows that a diverse and balanced microbiome -- the colony of microorganisms that make up the ecosystem of our body -- may be the key to good physical and mental health.
Americans have caught on, too. They spend more than $38 billion a year on probiotics in food, over-the-counter supplements, and creams in the hopes that these products will improve their gut bacteria and their health.
Doctors and consumers are using these lab-grown bacteria to boost their immune system, shorten a cold, and quell the symptoms of digestive disorders. Some doctors use probiotics -- available in many different strains -- to treat irritable bowel syndrome, antibiotic-induced diarrhea, and a stubborn infection that can be fatal in the elderly, C difficile. Some have even prescribed probiotics to treat obsessive-compulsive disorder.
Others are drinking kombucha, as well as other popular fermented foods like yogurt, kefir, sauerkraut, soft cheeses, and pickles in hopes they can boost levels of good bacteria in their digestive tract.
Can these products really improve your gut bacteria? And if they do, what does that mean for your health?
The Microbe-Body ConnectionOur bodies are home to trillions of microbes -- bacteria, viruses and fungi -- that live mostly in the intestine, communicating with the immune system and the brain.
But when things go awry, these germs can hurt us. Gut flora have been implicated in diabetes, asthma, rheumatoid arthritis, and even depression and autism, according to scientists who study the microbiome. Theories even suggest that gut flora may play a role in obesity.
Early research into probiotics, mostly in animals, shows promise in treating some diseases.
One type of bacterium, E.coli Nissle 1917, can “cure” salmonella. The food-borne infection causes 19,000 hospitalizations and 380 deaths a year, according to the CDC.
Studies show the same bacteria can cause remission in ulcerative colitis, leaky bowel syndrome, and Crohn’s disease.
There is also evidence that probiotics can lower deaths in premature babies with necrotizing enterocolitis. The disease is the most common infection in neonatal intensive care units and has a 50% mortality rate, according to the CDC.
Only a few dozen bacterial strains have been actually tested in human trials. Most of the studies on probiotics have been done on lactobacillus and bifidobacterium, which are the predominant class of bacteria in commercial products, according to the National Center for Complementary and Integrative Health.
Who Needs Probiotic Supplements?For healthy people, over-the-counter supplements may not be worth the cost, experts say.
“Buying probiotic supplements is not necessary for most healthy people, and can be expensive,” says Mark Swain, MD, of the Immunology and Gastrointestinal Research Group at the University of Calgary in Canada.
Experts also point out that probiotics, like other supplements, are not regulated by the FDA.
Not much is known about the safety of commercial probiotics, and there have been no long-term studies. So far, they show few side effects -- usually gas.
But because they contain live bacteria, they can cause dangerous infections in people with weakened immune systems, chemotherapy and organ transplant patients, as well as those who have had much of their gastrointestinal tract removed.
Purna C. Kashyap, MD, a gastroenterologist and researcher at the Mayo Clinic’s Center for Individualized Medicine, says he won’t prescribe probiotic supplements to his patients with digestive complaints.
“I can’t tell people to go out and spend money on probiotics without actually having the clinical data to back it up,” he says. “But if they are already taking them and perceive benefits I tell them it’s fine.”
Kashyap says there are plenty of good probiotic foods like yogurt, kombucha, and the pickled Korean dish kimchi that provide the same benefits.
“People don’t realize that yogurt has bacteria,” he said. “If they have a bottle [of probiotics], it feels like medication and they are doing something good.”
While probiotics may give the body a healthy boost as they “travel through” the digestive tract, studies haven’t proved that they can change the structure of the microbiome, says Mary Ellen Sanders, PhD, founding president of the International Scientific Association for Probiotics and Prebiotics.
Jack Gilbert, MD, faculty director at the Microbiome Center at the University of Chicago, says more testing is needed.
“We need a heavy dose of skepticism that only good science can provide,” he says.
“The key thing is probiotics are unregulated, so we need to rely on testing and trials to actually determine whether any of these commercial probiotics are beneficial,” says Gilbert, co-author of the book Dirt Is Good. “The jury is out right now on a lot of them.”
What About Prebiotics?On the other hand, some experts say that a prebiotic diet, rich in fiber and a variety of foods like fruits and vegetables, can act like a fertilizer of good bacteria, permanently increasing the diversity to keep them in balance.
Jerusalem artichokes, bananas, oatmeal, honey, maple syrup and legumes are good prebiotics, say experts. Lowering sugar, saturated fat, and alcohol is also helpful, and exercise is important: Research in Australia has shown athletes have a more diverse microbiome.
“A diet high in prebiotics, including things like onions, whole wheat bran, whole wheat flour, asparagus, and leeks" helps to keep our gut bugs healthy and happy by providing food for them, says the University of Calgary’s Swain.
“Also, it is not as simple as just eating healthy,” Gilbert says. “You must also consider activity: walking, being outside, interacting with animals and plants, and reducing overall stress in your life with mindfulness training.”
Getting an Early StartOther environmental factors and lifestyle choices may have longer-lasting effects on the microbiome, especially in children, says Marie-Claire Arrieta, PhD, co-author of the book Let Them Eat Dirt.
Arrieta, an assistant professor at the University of Calgary who studies the link between the gut and several immune diseases, says that the first 2 to 3 years seem to be the most important for developing a healthy microbiome.
Having a vaginal birth rather than a C-section, breastfeeding, getting a pet, avoiding unnecessary antibiotics, and eating a high-fiber diet and prebiotic foods can go a long way to creating and maintaining a healthy one, she says.
Which is why kombucha maker Ryan Miller says he feels good about raising his daughter in a natural setting, amid farm dirt, free-roaming chickens, and unprocessed food.
And her great-grandmother, a Vermont farmer, lived to be 99.
“There are other factors that affect your health, but the one thing you can control is your lifestyle and making sure your body gets all the nutrients it needs,” he says.
“I strongly believe that eating healthfully will go a long way.”
-This information has been brought to you by iMater Medical and provided by WebMD.
They’ve been called the ”must-have office toy” by Forbes.
Some teachers and parents love them; others loathe them.
Fidget spinners are toy-like devices that sit on a ball bearing and spin easily on your hand or a hard surface. By keeping your hands busy, they are supposed to ease stress, manage fidgeting and help people with ADHD (attention deficit-hyperactivity disorder) focus. Prices range from as little as a dollar to several hundred for the more elaborate designs.
Matthew Lorber, MD, a child psychiatrist at Lenox Hill Hospital, New York, says many parents of children with ADHD are asking his opinion about the popular toy and how it works. He shared the most common questions he hears with WebMD.
WebMD: How might fidget spinners help?
Lorber: If you are trying to focus on a task, but your hands are busy doing something else, it actually forces your brain to increase your efforts to focus on the task at hand. That’s how an ADHD mind works.
The prefrontal cortex is the ‘office manager’ of the brain. That part of the brain in those with ADHD has become ineffective in organizing information, inefficient in focusing.
If they are playing with a fidget spinner, or tapping with a pen or a pencil, it automatically forces their brain to work harder. The brain has to put more effort into not being distracted.
People with ADHD who tend to be hyperactive—not all are—would have the most benefit from fidget spinners. They have excess energy to begin with. It gives them an outlet to get that fidgety-ness out of their body.
WebMD: Is there any research backing fidget spinners?
Lorber: There have been some small scale studies that show people with ADHD do better on tasks if given some sort of outlet to get out their energy, to distract their hands. While fidget spinners specifically haven’t been studied, there have been studies that have shown in general that someone with ADHD with something to fidget with — such as tapping a pen — perform better on tasks.
WebMD: Bottom Line?
Lorber: There’s not really a negative side effect to trying it. The only side effect here is distracting other people around you. Potentially a fidget spinner could be used to decrease the need for ADHD medication, to take a lower dose.
I think it’s worth a try.
-This information has been brought to you by iMater Medicine and provided by WebMD.
May 1, 2017 -- Conventional wisdom has long held that salty foods boost our thirst and lead us to drink more water. But can salt also lead us to eat more, as well?
Researchers have begun to explore salt’s previously unknown role in hunger and weight gain. Several recent studies shed light on why salt may encourage us to overeat.
“Until now, we have always focused on the effect of salt on blood pressure,” says Jens Titze, MD, associate professor of medicine and of molecular physiology and biophysics at Vanderbilt University in Nashville. “We have to expand our conceptions of salt and diet.”
Salt and SpaceTitze was the lead researcher on a new study challenging the notion that salty foods make us thirsty. Instead, he found that people who eat high amounts of salt actually drink less water than those who have smaller amounts of salt in their diet. They also become hungrier. Over the long term, that boost in appetite could lead us to overeat and gain weight.
For the study, published last month, Titze and his colleagues gained access to a unique group of subjects: Ten Russian astronauts -- or cosmonauts -- preparing for the rigors of space travel to Mars. The space flight simulation, which lasted for months, provided a stable environment for the researchers to study how salt affected them.
Throughout the study, the cosmonauts' diet did not vary except in one key way: The researchers changed the amount of salt in their food. The study subjects began on a diet that included 12 grams of salt per day. That’s about twice the amount recommended by U.S. dietary guidelines. After several weeks, researchers reduced their salt to 9 grams per day. The cosmonauts ate 6 grams of salt daily during the final third of the study period.
What happened over the course of the study upended the researchers’ expectations: The cosmonauts drank more water as their salt intake dropped.
“We simply could not understand it,” says Titze.
Titze describes another surprise. The cosmonauts complained of hunger while on the high-salt diet.
“We said you can’t be hungry, you’re getting the same amount of food,” says Titze. “The only thing that’s changed is the amount of salt.”
Salt and Our HealthSodium, the main ingredient in salt, is an essential part of our diet, and not just for flavor. It keeps our muscles and nerves working properly, and it helps our bodies maintain the proper balance of fluids.
But when sodium levels rise too high, blood pressure often goes up as well. Over time, high blood pressure can have serious, life-threatening consequences. It can lead to stroke, heart attack, kidney disease, and other health problems.
To protect against high blood pressure, U.S. dietary guidelines recommend that we get less than 2,300 milligrams of sodium per day. That’s about a teaspoon of salt. According to the American Heart Association, the ideal target for most adults is no more than 1,500 milligrams daily.
Most adults, however, get far too much. The CDC estimates that the average American adult eats 3,400 grams every day.
In the last several years, scientists have begun to investigate whether salt affects obesity. Here’s what they have found:
While these studies show a link between salt and body fat, increased eating, and obesity, they don’t show that salt makes any of those things happen. More research needs to be done to fully understand salt’s role.
Lori Roman, president of the Salt Institute, said in an email that her nonprofit trade group “continues to follow the science closely as it develops.”
She says research shows that cattle ranchers use salt to cut their animals' appetites and limit how much feed they eat.
“This longstanding research and other research on humans would lead us to question any claims that salt might increase obesity,” Roman wrote. She added that Americans eat in the “normal range” when it comes to salt.
Salt and MiceIn the space flight simulation study, the authors did not understand why the cosmonauts drank less and became hungrier on the higher-salt diet, so they turned to mice to find out. This study revealed that when mice ate a high-salt diet, their livers produced a substance called urea, which helps keep the body's water in balance. But producing urea requires lots of energy, says Titze. In other words, it requires food, specifically protein. And that need could be what caused the astronauts’ hunger.
“The fact that they didn’t drink more but wanted to eat more was interesting,” says Vijaya Surampudi, MD, assistant professor of medicine and assistant director of the Weight Management Program at UCLA. “It means that there are mechanisms at work that we don’t yet understand.”
Mark Zeidel, MD, says the study raises important new questions and may shed light on what drives our appetites.
“What this study makes clear is that we need to better understand how things like appetite and thirst are controlled,” says Zeidel, a professor of medicine at Harvard Medical School and chairman of medicine at Beth Israel Deaconess Medical Center in Boston.
“The control of appetite is very, very complex.”
Future research will tell more about Titze's findings. In the meantime, Titze offers this advice: “If you’re on a diet and trying to reduce the amount of food you eat but you always feel hungry, start thinking of salt. Perhaps reducing it may help you.”
Cut Salt in Your DietLowering how much salt you eat can be tough, says Lauren Blake, a registered dietitian at Ohio State University’s Wexner Medical Center. Here are her tips:
-This Information has been brought to you by iMater Medicine and provided by WebMD.
Scholarships, loans, fellowships, grants—you’ve got a lot of options when it comes to paying for college. The specific options available depend on many unique things—your background, your academic performance, your financial need, your program of choice and the field that you choose to enter, to name a few. Scholarships are financial awards that are offered to students for various reasons, but most of the time these are merit-based, meaning they’re awarded based on academic ability or some other quality.
Loans are money you borrow with the intention of paying it back. If you’re considering loans, you might also consider service commitment programs and other other unique ways that health care professionals who have come before you have paid back loans.
Fellowships are generally short-term opportunities that focus on professional development. Fellowships generally provide a stipend that can help cover some life costs during your studies, but may not be enough on their own to cover all of your financial needs.
Grants are similar to scholarships—in fact, the terms are often used interchangeably. Most grants are need-based, though, so they’re awarded based on your financial ne
E-Cigs Cut Smokers’ Levels of Toxic Chemicals
Feb. 9, 2017 -- Die-hard smokers often turn to electronic cigarettes (e-cigarettes) to help them cut down on regular cigarettes or quit altogether.
A new study from the UK has found that e-cigarette users, compared with those who smoke regular cigarettes or use both, have dramatically lower levels of cancer-causing agents and toxins than those who smoke cigarettes alone.
"E-cigarettes are definitely safer than continuing smoking," says study author Lion Shahab, PhD, senior lecturer in health psychology at University College London. He says it is the first long-term look at exposure to e-cigarettes, battery-operated devices that heat up and vaporize nicotine, compared with regular tobacco cigarettes.
The study didn't look at whether e-cigarettes help people quit regular cigarettes.
Shahab focused on 181 people divided into five groups:
"We are aware it is difficult to stop smoking without support,” says Shahab. “Only half of smokers actually stop forever. For those who really struggle, we can't really leave them out in the cold.''
The focus, he says, is on harm reduction. ''E-cigarettes, I believe, because they are effective at delivering nicotine but reduce the cancer-causing chemicals, will help smokers who would not stop otherwise.”
In a 2015 report, Public Health England said e-cigarettes are 95% less harmful than smoking.
Public Health Response
The CDC says that e-cigarettes can benefit public health if adult smokers stop using tobacco completely and vape instead, says spokesman Joel London.
But, he points out: "Safer is not the same as safe.”
The benefits of e-cigarettes are reduced if the person smokes even a few regular cigarettes a day.
While the CDC acknowledges that e-cigarettes generally give out lower levels of dangerous toxins than combusted cigarettes, it notes, ''in addition to nicotine, e-cigarette aerosols can contain heavy metals, ultrafine particulate and cancer-causing agents like acrolein."
And they’re never good for young people, the CDC says.
"We don't know the long-term effects of e-cigarette use,” says London. “But we know that among youth, use of any tobacco product, including e-cigarettes, is not acceptable.'' (See graphic below about how e-cigarettes affect your body.)
Another study out this week showed that e-cigarette liquids can contain toxic and potentially cancer-causing metals.
E-Cigarettes as a Way to Help You Quit
The American Lung Association says it’s “concerned about the potential health consequences of electronic cigarettes” and calls claims they help smokers quit "unproven."
Research on smoking e-cigarettes to help you quit is mixed.
In one study, researchers polled more than 4,400 Arkansas residents and found that e-cigarettes did help some quit smoking. But most smokers who had smoked in the previous 5 years and who tried e-cigarettes did not quit. Of the more than 1,000 people who were current smokers or reported quitting in the past 5 years, more than half said they used e-cigarettes. Of those, 80% continued smoking.
Another recent study focused on smokers with chronic obstructive pulmonary disease (COPD) and found that those who used e-cigarettes reduced their use of regular cigarettes.
Many e-cigarettes also contain nicotine, the same addictive substance found in cigarettes, and the amount of nicotine found in them may vary, according to the American Lung Association.
''These findings haven't changed our stance on e-cigarettes, but have helped to address some unanswered questions about long-term safety,” says George Butterworth, tobacco policy manager for Cancer Research UK, which funded the study.
Cancer Research UK supports a ''balanced approach'' toward nicotine-containing products such as e-cigarettes, in the hope they will help people quit smoking, and invests in e-cigarette research to find out more, he says.
"Research into how e-cigarettes can help people quit smoking is hugely important," he says. "We support evidence-based policy and hope other organizations also develop their own positions based on the available evidence."
-This information has been brought to you by iMater Medical and information provided by WebMD
Colorectal Cancers on the Rise in Younger Adults
Three different doctors over 3 years dismissed Ashley Flynn’s complaints.
“I had blood in my stool, and each doctor pushed it off as if it were fissures or hemorrhoids or something else minor,” says Flynn, who lives outside Kansas City, KS.
But it wasn’t something minor. Flynn was only 24 when she was diagnosed in 2011 with stage 3 rectal cancer. She had surgery and chemotherapy beginning in late 2011 and has been cancer-free since August 2012.
Cases of colon and rectal cancer are on the rise in people under the age of 50, a group that’s rarely screened for them. According to a recent study, rates among younger people increased by more than 11% between 2004 and 2014.
In 2016, about 135,000 people will be diagnosed with colorectal cancer, which includes colon cancer and rectal cancer, according to the American Cancer Society. About one in seven of them will be under 50. Researchers at The University of Texas MD Anderson Cancer Center predicted last year that cases of colon cancer among people ages 20 to 34 will increase by 90% by 2030. They expect the number of rectal cancer diagnoses to more than double.
The problem appears to be particularly pronounced among certain minority groups, says Durado Brooks, MD, managing director of cancer control intervention at the American Cancer Society.
“African-Americans are about twice as likely as whites to be diagnosed before the age of 50,” Brooks says. “Young Alaska natives are diagnosed at 3 times the rate of whites. And this is not a uniquely American phenomenon. European nations and Australia are also seeing a rise.”
Although the overall number of young people with it remains small compared with older people, younger people are often diagnosed with more advanced disease that requires more aggressive treatment.
Flynn’s experience is typical for such cases in younger people, says Brooks.
“I hear often from young people with the disease that when they told their doctor they had rectal bleeding, their doctor told them, ‘You’re too young to have colorectal cancer screening,’ ” says Brooks. “That tendency for clinicians to disregard the possibility of colorectal cancer in younger people is one of the things we are working very hard to overcome.”
Overall, says Brooks, the outlook for many younger people is worse because of how late their cancer is diagnosed.
“But because they are younger, they do better,” Brooks says. “Someone diagnosed with stage 3 colorectal cancer in their 30s can tolerate more aggressive treatment and will therefore be more likely to do better than someone in their 80s who has stage 3 colorectal cancer along with other health problems.”
Dan Hawkins, an inventory supervisor in Salem, OR, learned he had stage 3 colon cancer in 2013, at age 29. He, too, had symptoms for several years before he was diagnosed with colon cancer.
“I didn’t have insurance, so I went to an urgent care clinic,” Hawkins says. “They told me not to worry about it.”
Two years later, when he could no longer ignore the pain that had started building in his groin, he went to the emergency room. That visit led to a colonoscopy, which revealed a tumor pressing against his prostate.
“I wish the first doctor I had seen had been more proactive and referred me to a specialist,” says Hawkins, who has been in remission since late 2013, after surgery and chemotherapy.
No Known Reason for Rising Number of CasesExperts don’t know why the rates of colorectal cancer are rising among young people, which began around 1990, says Yi-Qian Nancy You, MD, a colorectal cancer surgeon and researcher at the University of Texas MD Anderson Cancer Center in Houston.
You says that about a third of the cases can be attributed either to a genetic condition or family history of the disease. For the remaining two-thirds, it’s unclear.
“We don’t know if it’s diet or lack of exercise or other factors,” she says. “There’s no large-scale study focused on young people.”
Brooks points to changes in diet over the last few decades as a possible explanation.
“Younger people today eat a lot more fast food and processed food -- things we know are associated with colorectal and other kinds of cancers,” he says. “And the increasing obesity rate is a huge concern.”
Hormones and antibiotics used on livestock and found in meat and other animal products might reduce the ability of our gut bacteria to protect us from disease, says Brooks.
“There’s a lot of speculation about potential underlying causes,” he says.
Be an Advocate for Your HealthCurrent guidelines recommend testing for colorectal cancer starting at age 50. You says that screening should start much earlier if you have a family history of the disease or a genetic condition, such as Lynch syndrome, a disorder that increases your risk of colorectal and other cancers, or familial adenomatous polyposis (FAP), which causes benign growths that will eventually become cancerous.
“We need to identify those 15% who have a hereditary syndrome,” says You, “and we need to get people with a family history of the disease to show up and get screened.”
Your family history should go back two generations and include your parents, grandparents, aunts, and uncles. If anyone in your family had colorectal cancer, says You, get tested 10 years before the age at which the youngest person in your family got the disease. The American Cancer Society also suggests talking with your doctor about genetic counseling if you have a family history of colorectal cancer. A genetic counselor can help determine if you have genes that put you at increased risk of colorectal cancer.
“If you diagnose people with such a history or genetic syndrome, their whole families should be diagnosed very early and very aggressively,” says You.
Flynn and Hawkins, however, had no such risk factors. And for young people like them, it’s unlikely that testing guidelines will change any time soon.
“We have to do studies to find out what effect screening would have in young patients and in what age groups screening would be most effective,” says Matthew Kalady, MD, a colorectal surgeon and co-director of the Cleveland Clinic’s Comprehensive Colorectal Cancer Program.
Experts recommend that patients and primary care doctors recognize and take seriously the symptoms of colorectal cancer. The most common include:
Flynn, a pediatric oncology nurse practitioner, has a message for practitioners: “As a provider, you have to keep those rare cases on your mind so that the next time a 30-year-old comes in with rectal bleeding, you don’t push it off as fissures or hemorrhoids right away. Instead, maybe dive into the causes a little deeper.”
Now 29, Flynn, who married last summer, may be cancer-free, but she never expects to be worry-free. She wonders: What if the cancer comes back? But she tries not to live in fear. Hawkins, who goes in for checkups every 6 months now, must use a colostomy bag for the rest of his life.
“My life will never be what it was before,” he says. “However, as cancer survivors, we have to create a new normal.”
- This information has been brought to you by iMater Medical and the information provided by WebMD Health News Reviewed by Brunilda Nazario, MD on November 30, 2016
© 2016 WebMD, LLC. All rights reserved.
$25,000 - $58,000
YEARS TO COMPLETE
POST-HIGH SCHOOL EDUCATION
6 - 8
Psychometrists administer and score neuropsychological, psychological, personality and academic tests for patients with mild to severe traumatic brain injury, neurological diseases, psychological health issues or learning disabilities, or for psychological or neuropsychological research. The psychometrist is skilled in the administration and scoring of objective neuropsychological and psychological test batteries and management of the care, storage and inventory of neuropsychological and psychological test materials, as well as patient test data.
The psychometrist may only perform duties under the general supervision of licensed neuropsychologists and psychologists. The supervising neuropsychologist/ psychologist provides technical and clinical guidance and uses the assessments and reports that the psychometrist performs and prepares to assist in diagnosing and preparing treatment plans for patients or to recommend treatment to patients’ referring doctors. Psychometrists’ assessments and records are also used to further the advancement of the psychological or neuropsychological field by using the test data for research. The psychometrist must remain current on advances in the field to prepare the reports and to remain skilled in administering tests.
The psychometrist works closely for extended periods of time with patients for the purpose of testing issues of a behavioral, psychological and/or neurocognitive nature and may at times work with patients’ family members as well.
A senior or lead psychometrist may also function as a mentor, manager and evaluator of other psychometrists assigned to the facility.
Note: Thea Griffith, M.A., Psychometrist for the Baylor Memory Center in Baylor University Medical Center’s Department of Neurology, wrote this career description, which has been reviewed and approved by the Board of Certified Psychometrists.
Public Health Nurse