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Importance of Wearing a Medical Alert Bracelet with Diabetes
Medical alert bracelets enable rapid identification of patients with a number of illnesses, including diabetes, which can make them unable to communicate their illness to others, according to Shamai Grossman, M.D., Director of the Cardiac Emergency Center and Clinical Decision Unit at Beth Israel Deaconess Medical Center. (Beth Israel Deaconess Medical Center is clinically affiliated with the Joslin Diabetes Center).
How They’re Beneficial for People with Diabetes
Medical alert bracelets can be extremely important for people with diabetes. Should you have a low blood glucose reaction and suddenly become confused or unresponsive, the bracelet allows immediate identification of the problem to both bystanders and paramedics. The sooner the low blood glucose reactions can be identified, the sooner they can be treated.
Emergency department personnel also use medical alert bracelets to rapidly identify people with diabetes, particularly when they may not be able to express that they have diabetes on their own. On arrival to an emergency department, one of the routine parts of the evaluation of the critically ill, unconscious, or disoriented patients is to remove their clothing to inspect the body for a cause of their sudden alteration, Grossman says. In these situations, medical alert bracelets can be invaluable as a time saver.
Information People with Diabetes Should Put on a Medical Alert Bracelet
The message on your medical alert bracelet should be concise and to the point. “Diabetes” should be engraved boldly on one side. The other side of the bracelet can have other information such as “insulin dependent” or “medication controlled,” he says. Other important information can include:
- An emergency contact number
- The name of your physician
- A referral to another place for more information, for example “see wallet card for a full medical history”
Where to Purchase a Medical Alert Bracelet
Medical alert bracelets can be purchased online through multiple Web sites, or can be ordered through many surgical supply stores. Although attractive medical alert jewelry is now readily available, Grossman cautions that the more elaborate the setting, the more difficult it will be to inform people of your diabetes.
Page last updated: March 29, 2015
| 10 |
Schools are having a difficult time meeting new federal requirements for leaner student lunches championed by First Lady Michelle Obama and in some cases are adding less healthy foods to meet calorie limits, investigators have found.
The problems are so widespread that the Government Accountability Office is recommending that the Agriculture Department ease or change some requirements to avoid the unexpected consequences of Mrs. Obama's signature effort to address childhood obesity.
“Because of the meat and grain maximums, some districts made menu decisions that are inconsistent with the goal of improving children’s diets, as they added desserts and condiments that increased the amount of sugar, salt or fat in lunches in order to comply with the required calorie minimums,” the GAO reported in the first substantial review of how school districts are implementing school lunch requirements under child nutrition laws passed by Congress in 2010.
GAO, the investigative arm of Congress, spot checked several school districts and found schools, food distributors and students are all facing challenges.“School districts faced several challenges implementing the new lunch requirements in school year 2012-2013, according to the eight districts GAO visited and food service and industry officials GAO interviewed from across the country,” the watchdog agency said.
One of the biggest complications for schools is staying within the new law’s meat, grain and calorie limits, which affect the types of food a school is able to serve and the portion sizes food suppliers are able to produce.
The regulations are even leading some schools to substitute healthy food for less-healthy options to meet the requirements:
•Shredded cheese is being replaced with processed cheese sauce because the sauce is not considered a meat alternative.
•Pudding, gelatin, ice cream, butter and ranch dressing are added to meals to meet minimum calorie requirements.
•Whole grain chips are replaced with potato chips because potatoes aren’t considered a grain.
The meat and grain limits have been temporarily suspended, but are slated to start again next year. The GAO recommended the regulations be removed permanently.
The Agriculture Department agreed that a permanent decision is needed, and said it is launching its own review of the new lunches policies.
“USDA also expressed concern that the findings in the testimony did not reflect a nationally representative sample of school districts,” the report said.
Meanwhile, some students haven't been accepting of the new regulations. The GAO said lunch items such as sub rolls, tortillas and peanut butter and jelly sandwiches are being cut back or abolished completely, while food suppliers were forced to create a hamburger patty small enough to stay under the meat maximum requirements. Whole-grain pasta and legumes are replacing the foods. \
Such changes led some schools to report a significant decrease in students who ate lunches, and at one school students even led a 3-week boycott of school meals, the GAO said.
Some student athletes reported the new lunches left them hungry, and teachers have complained that students were significantly more tired during the last two periods of the day because of the new lunches.
The way schools determine what amount of meat, grains, vegetables and total calories each student should receive is by dividing them into three groups based on grade level — kindergarten through fifth grade, sixth grade through eighth grade, and ninth grade through 12th grade. Under the current rules, height and weight are never taken into consideration.
USDA said that while it faces challenges in providing nutrition based on height and weight, a child’s age was still one of the most important factors in determining their food requirements, a statement echoed by nutritional experts.
Healthy eating advocates say the new regulations will help fight childhood obesity, which the Centers for Disease Control and Prevention say has doubled in the last 30 years - and tripled among teenagers.
Mrs. Obama recently visited a school in Alexandria, Va., to show off the final product of the school lunch revamping she helped crusade.
“That's why as a mom myself, I am so excited that schools will now be offering healthier choices to students and reinforcing the work we do at home to help our kids stay healthy,” the first lady said.
The GAO said that many of the early problems are growing pains and will be resolved over time. Investigators noted many students had positive things to say about the greater number of vegetables and smaller portion sizes, and they expect that number to grow over time.
| 10 |
Over time, the sun's ultraviolet (UV) light harms fibers in the skin called elastin. When these fibers break down, the skin begins to sag and stretch. It also bruises and tears more easily, taking longer to heal.
Spending too much time in the sun can also give your skin freckles, rough texture, white spots, a yellowing of the skin, and discolored areas of the skin (which doctors call "mottled pigmentation"). It can also widen small blood vessels under your skin.
9 Ways to Protect Your Skin
- Wear sunscreen every day, in all weather and in every season. It should have a sun protection factor (SPF) of 30 and say "broad-spectrum" on the label, which means it protects against the sun's UVA and UVB rays. Put it on at least 15 minutes before going outside. Use 1 ounce, which would fill a shot glass.
- Reapply sunscreen at least every 2 hours or more often if you're sweating or swimming.
- Wear sunglasses with total UV protection.
- Wear wide-brimmed hats, and long-sleeved shirts and pants.
- Avoid being out in the sun as much as possible from 10 a.m. to 2 p.m.
- Check your skin regularly so you know what's normal for you and to notice any changes or new growths.
- Choose cosmetics and contact lenses that offer UV protection. You still need to use sunscreen and wear sunglasses with broad-spectrum sun protection.
- If you're a parent, protect your child's skin and practice those habits together.
- Don't use tanning beds.
| 10 |
Are you unhealthy and unhappy? Has your weight gone up and down? Have you experimented with crash diets trying to find your healthy weight? A healthy life is what many people strive for, and it expands your lifespan.
1Basics of your diet: You need to incorporate many different things into your diet.
- Healthy fruits such as apples, watermelon, mangos, grapes, pineapple, kiwi
- Vegetables such as cauliflower, bell peppers, lettuce, spinach, beets, etc.
- Whole grains and oats that can be whole grain bread, cereal, oatmeal, rice, spaghetti, etc.
- Healthy fats and dairy such as cheese, yogurt, olive oil, vinegar, etc.
- And protein such as turkey, fish, beans, etc.
2Eat in a normal routine: have 3 healthy and balanced meals a day incorporating the food groups above. Allow 2-3 healthy snacks. A good way to look at it is to make sure everything you put into your body nourishes it. don't eat too little at a meal or too much simply eat till you are full.
3Avoid cravings for unhealthy foods: Some examples of substitutes would be trail mix instead of chips; naturally flavored water or tea for soda; or baked pretzels instead of crackers.
5Sleep well and take a daily vitamin.Ad
We could really use your help!
motor driven systems?
- Do fun things for exercise, like dancing or swimming.
- Feel free to bring a friend to exercise with you.
- Find healthy fruits and veggies that you love. Seek for other foods that are healthy and taste great.
- Have fun with feeling good. See how great your body feels after your healthy habits kick in.
- Have fun with your food; learn new recipes, and explore new foods and tastes.
- Be patient, and avoid stress.
- Get busy and be satisfied with feeling full and not over eating.
- Remember to love your body. Besides, being super skinny usually isn't even attractive, and is just unhealthy.
- If you want, you can try shape up shoes for walking around; just for a little boost or some help.
- Don't overdo the exercise.
- Don't starve yourself.
Categories: Building Muscle & Strength
In other languages:
Thanks to all authors for creating a page that has been read 118,246 times.
| 10 |
Making the Call for Help: Warning Signs of Diabetes Disaster
Whether it's the flu season or a time of year when variables collide that can send your glucose on a wild roller coaster ride, you need to know when to call for help. Knowing when to tap into the safety net of your healthcare providers can prevent an unnecessary trip to the hospital, or worse (use your imagination).
The top 7 reasons to call your doctor and why.
1. Low glucose. Hypoglycemia (glucose less than 70) is dangerous and the number one diabetes-related emergency. If left untreated, glucose levels can plummet and cause seizures, coma, and, in the worse case, stop you from ever having to pay taxes again. Hypoglycemia is a possible side effect associated with taking pills that make the pancreas release more insulin (like Glyburide, Glipizide, Prandin, Glucotrol), or injecting the hormone insulin itself. Example of triggers for hypoglycemia include more activity than usual (watch for lows hours after finishing exercise), less food intake, alcohol consumption (especially the morning after drinking), taking the wrong amount or type of insulin (accidentally injecting the morning dose in the evening), and glucose values coming down from the 300-400 range into the target range where medications then become more effective. If you have a low, treat it, then let your doctor know about it. Medications may be reduced or changed to prevent lows from happening again. (Treat lows with 15 grams of carbohydrate — 4 oz. Juice or 3 glucose tablets — followed by retesting glucose in 15 minutes, more juice if needed, then eat). If you have a severe hypoglycemic episode (less than 45) that doesn't respond to repeated doses of 15 grams of carbohydrate, call 911.
2. High glucose. Hyperglycemia (glucose more than 200), where most of your readings are more than 250 for two days in a row, can lead you into troubled waters. Hyperglycemia can occur related to stress, illness, infection, a dietary indiscretion, pain, outdated insulin (most insulin needs to be discarded after 28 days; some insulin pens after 2 weeks — check with your CDE or pharmacist), and the flu. Left untreated, hyperglycemia can spiral upwards, dehydrating the body and putting a person at risk for ketosis, a dangerous, life-threatening situation. Treating hyperglycemia starts with staying hydrated. Unless you have developed a plan with your physician on how to handle highs (by taking extra insulin or adjusting oral medications), your best bet is to get a dial tone and call the doctor. Tell the receptionist you need to talk to your doctor or whomever is on-call today. Tell them it is urgent. Tell them you have a diabetes crisis and you want to avoid the Emergency Room. One of the biggest pitfalls is this last step where people know they are in trouble and can't get through to their doctor. Be persistent.
3. Illness. You can be healthy for years but the minute a cold or the flu finds you, or if you have nausea, vomiting, diarrhea, or an infection, your diabetes control can go right out the window. Check your glucose at least every four hours. As a guide, if your glucose if more than 180, continue your regular dose of medication. If it's less than 180, you may need less medicine, based on the recommendation of your healthcare provider. Communicate any health issues immediately. Small problems are much easier to manage. Don't play the waiting game. It can save you a lot of time, hassle, and suffering if you pick up the phone sooner rather than later.
4. Chest discomfort or shortness of breath. It has been said that diabetes is heart disease. If you notice any change in your ability to walk up a flight of stairs, or have odd sensations going on in your chest, jaw, neck, or arm, please don't keep it to yourself, unless your objective is to avoid paying any more taxes! Do you know your blood pressure and cholesterol values? Has your doctor suggested you take a baby aspirin a day? Do you have a family history of heart disease? Do you smoke? Know your risks and minimize accordingly.
5. Medication issues. Medications are like the Goldilocks and the Three Bears story: you might need to try a few before you find the medication that is just right! It may take time to figure out what's best for your body. Many people (25-50 percent) do not take their medications correctly. People stop their medications all the time because they don't like the way they feel, they are too expensive, etc. Some medications take weeks to reach full effect. Let your doctor in on how you feel. Even though a particular drug has a great track record, you may not tolerate it. Ask your doctor to try a different type. Pharmaceutical companies have programs to help offset the expense. Ask your friendly pharmacist to point you in the right direction with drug company-sponsored, low cost programs. Medications come and go. You may need some now, then not later and vice-a-versa. It's such a vital link to managing diabetes as is having a conversation with your doctor about what is working or not.
6. Painful anything. No pain, no gain is bologna. Pain is a red flag. If you have pain during urination, painful muscles, or any kind of painful condition, please share that information with your physician. Pain raises blood glucose and blood pressure. If your doctor is not taking your concerns seriously, talk to someone who will. The underlying cause of pain needs to be explored for its impact on quality of life, and for its interference with diabetes control.
7. Tune up time. Certain tests done on a regular basis assure you are on a path of health. Every 3 months, have the A1C test, and blood pressure test. Every 6 months, trot off to the dentist. Once a year, get your cholesterol checked as well as your urine microalbumin/creatinine level (big words for kidney function specific to diabetes), have an eye exam, and get your feet checked. Don't forget about the flu shot. Unless you are a dietitian, you should see one to get a refresher about food choices. And while you're there, see the nurse to look at overall blood glucose patterns.
An ounce of prevention will take you far. Your healthcare team is just a phone call away. It may be one of the best calls you make.
Read Theresa's bio here.
Read more of Theresa Garnero's columns.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
Sweet and Spicy BLT Chinese Sesame Broccoli Kasha with Zucchini and Onions Cheesy Artichoke Dip Celery Root Puree Thick Mushroom Soup Beefy Bean Dip Ham & Dried Fruit Spread Grilled Mahi Mahi with Tomato Vinaigrette Mushroom Barley Soup
Because I wear my Dexcom on my arm, I’ve slowly adjusted to the fact that people will ask me about it. Sometimes it’s the rude and inquisitive “What’s that?” and sometimes it’s somewhat sincere curiosity “Is that a (insert random type of medical device that they assume)?” Sometimes it bothers me more than others depending on how they ask and how they respond once I’ve told them what it is. I have limits to how much myth-busting I want to do in everyday conversation and how much rudeness I can...
| 10 |
Avoiding trans fats doesn’t just mean staying away from junk food.
Whole food sources of fat such as nuts, seeds, and avocadoes are likely superior.
Not all fats are bad though, there are good fats.The monounsaturated fats in nuts and avocados. There are great fats. The Omega-3 fats in flax seeds. And then there are the bad fats, the saturated fats found primarily in meat and dairy. And finally, the killer fats, the trans fats which are found in only two places, hydrogenated oils and meat and dairy. Trans fats are basically only found in one place in nature, in animal fats. Now thanks to better living through chemistry though, the food industry found a way to create these toxic fats synthetically by hardening vegetable oil in a process called hydrogenation, which rearranges their atoms to make them behave more like animal fats. This may be good for shelf life, but not good for human life. The most prestigious scientific body in the United States, the National Academy of Sciences, released a damning report on trans fats and concluded that the only safe intake of trans fats was zero. The Academy said that the tolerable upper daily limit of intake was zero. If the National Academy of Sciences is saying the only safe intake of trans fats is zero, and about one fifth of American trans fat intake is coming from animal products. Did they recommend that everyone should only eat vegan? No they didn't, but why not? They were challenged on it and one of the authors of the report, a nutritional epidemiologist at the Harvard School of Public Health responded "We can't tell people to stop eating all meat and all dairy products. Well, we could tell people to be vegetarians..." he added, "If we were truly basing this on science we would, but it is a bit extreme." Amazing. Wouldn't want scientists to base anything on science, would we?
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by veganmontreal.
To help out on the site please email [email protected]
Some recent videos on the beneficial fats in plant foods:
And learn more about the negative effects of saturated fats in these videos:
Some recent videos on the most damaging fat of all, Trans-fats:
Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. And check out theother videos on fat. Also, there are 1,449 other subjects covered in the rest of my videos--please feel free to explore them as well!
If you haven't yet, you can subscribe to my videos for free by clicking here.
Milling whole wheat into white flour may cause as much as a 300-fold decrease in phytonutrient content.
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| 10 |
WASHINGTON (Reuters) - People with fat in their thighs and backsides may live longer because the fat traps harmful fatty particles and actively secretes helpful compounds, according to a report published on Tuesday.
Many studies have shown that people who accumulate fat around the abdomen and stomach are more likely to die of heart disease and other causes than bottom-heavy people, but the reasons are not clear.
This may be because several different mechanisms are involved, said Konstantinos Manolopoulos of Britain's University of Oxford.
"It is the protective role of lower body, that is, gluteofemoral fat, that is striking," Manolopoulos wrote in the International journal of Obesity.
"The protective properties of the lower-body fat depot have been confirmed in many studies," he added.
Fat on the bottom and thighs appears to store excess fatty acids, said Manolopoulos, who reviewed published scientific studies for his report.
Pear-shaped people also appear to have lower levels of compounds called inflammatory cytokines -- signaling chemicals involved in the body's response to infection that also can play a role in heart disease and diabetes when they are inappropriately active.
Fat on the legs may also absorb fats from the diet, keeping them from overwhelming the body when people overeat, Manolopoulos said.
Cholesterol levels reflect a tricky balance between high density lipoprotein, the HDL or "good" cholesterol that removes harmful fats from the blood, and low-density lipoprotein, the "bad" LDL cholesterol that can harden and block the arteries.
Fat in the thighs may also be more stable, he said, with studies showing abdominal fat breaks down quickly during fasting or stress, releasing potentially harmful components from the fat.
"The exact regulatory mechanisms of fatty acid release and storage and their effect on short- and long-term fatty acid metabolism remain to be analyzed," Manolopoulos wrote.
Leg fat may also be better at producing hormones such as leptin, which are made by fat and affect appetite and metabolism -- although Manolopoulos said this is poorly understood.
Understanding all this could lead to better drugs for treating obesity and related disease such as diabetes and heart disease, Manolopoulos said.
(Reporting by Maggie Fox, Editing by Sandra Maler)
| 10 |
Vitamin D and B12 aren't linked in the sense that one causes the other but is relatively common for someone to fall short on both of these vitamins. For example, people who don't eat any animal products (vegans) typically need supplemental vitamin D and B12 either from fortified foods or supplements. Both of these vitamins are found primarily found in animal foods, although plant-based products can be fortified with D such as soy milk. Sunlight is another source of vitamin D.
Another example would be someone who had gastric bypass surgery -- they are at higher risk for vitamin D and B12 deficiencies. People with excess weight tend to have lower levels of vitamin D and additional B12 is needed after this type of surgery because absorption occurs in the stomach.
A third example is someone who is elderly. They absorb less vitamin B12 from food and do not make as much vitamin D from the sun. Work with your healthcare provider or a registered dietitian to make sure you are getting enough of both of these vitamins.
This answer should not be considered medical advice...This answer should not be considered medical advice and should not take the place of a doctor’s visit. Please see the bottom of the page for more information or visit our Terms and Conditions.
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| 10 |
||This article does not have any sources. (June 2014)|
A glucose meter is a medical tool that measures glucose in human blood. It is an important part of blood glucose checking for people with diabetes mellitus or hypoglycemia. A drop of blood is placed on a test strip. The meter reads the strip and displays the blood sugar levels.
| 10 |
The first 12 months of life is the fastest growth period in a human’s life – a baby’s weight can triple by twelve months of age. Making sure your baby is fed properly is critical for normal growth and development. Breast milk is preferable as the sole source of nutrition up until about 6 months, or infant formula if you are unable to breastfeed.
The Dietary Guidelines for Children and Adolescents developed by the National Health and Medical Research Council (NHMRC) state that at 6 months of age, your baby needs additional iron from food and is physically ready to take on the challenge of learning to eat. Breast milk or formula, however, continues to be the most important source of nutrition. By about 12 months, your baby should be eating foods similar to those eaten by the whole family. This includes breads and cereals, fruit, vegetables, legumes, dairy foods, meat, fish and eggs.
When should food be first offered?
What foods should be offered first?
When can dairy foods be offered?
What should the food texture be like?
How much food should be offered?
Should low fat foods be offered?
What about fruit juice?
What about lactose intolerance?
Growing from infants to toddlers
Published: April 2009
|Infant Nutrition_Printable PDF.pdf||187.26 KB|
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| 10 |
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School has been back in session and the first seasonal colds are beginning to appear in classrooms. As a person living with type 1 diabetes, I was reminded forcibly how these colds can wreak havoc on my blood glucose (BG) control.
I learned all the “sick day” rules when I was a kid. As a woman and a mom, I don’t have time to be sick. A reminder of the sick day rules could be beneficial.
When sick, the body attempts to fight it. The body releases hormones that increase insulin resistance. This means that usually the BG raises inducing hyperglycemia.
However, if nausea, vomiting and diarrhea are involved, there is a chance that the BG can fall inducing hypoglycemia.
Check BG levels more frequently during a sick day. Drinking plenty of fluids is essential.
For people with diabetes, this can actually help flush out the sugar and ketones in the blood.
Additional insulin or medication might need to be given. Be aware of hidden sugars in over-the-counter medications.
The American Diabetes Association recommends that you “prepare a plan for sick days in advance. Work with your doctor, or a diabetes educator. The plan will include when to call your diabetes team, how often to measure blood sugar and urine ketones, what medicines to take, and how to eat. Also, attach to your plan a list of phone numbers for your doctor, diabetes educator, and dietitian.
You do not need to call your team every time you have a sniffle. But you will probably want to call if certain things happen. For example:
• “you've been sick or have had a fever for a couple of days and aren't getting better
• “you've been vomiting or having diarrhea for more than 6 hours
• “you have moderate to large amounts of ketones in your urine
• “your glucose levels are higher than 240 even though you've taken the extra insulin your sick-day plan calls for
• “you take pills for your diabetes and your blood sugar level climbs to more than 240 before meals and stays there for more than 24 hours
| 10 |
Your body requires “fuel” to perform tasks and power chemical reactions that make it possible for you to think, make your heart beat, help you to digest your food or move from one place to another. These raw materials are commonly known as nutrients, and minerals are some of the most important nutrients necessary for a healthy body. Minerals are needed for many crucial bodily functions and are usually derived from food.
read more about calcium and minerals » | find answers to your vitamins questions »
Your diet may not be providing all of the nutrients required for good health due to unhealthy choices, health care problems, or a busy schedule. In these cases, mineral supplements may aid your body in acquiring the materials that it needs to function optimally.
Why Do I Need Calcium?
Calcium is a vital component of teeth and bones and is essential to their development. Calcium makes teeth and bones strong enough to resist breakage. Postmenopausal women are often advised to increase their calcium dosage, as changes in estrogen levels weaken their bones. Other populations at risk for developing calcium deficiencies include people who are lactose intolerant and cannot consume dairy products and vegans who do not include dairy in their diets.
Is Chromium Good For Diabetes?
Another essential mineral is chromium which has been shown to play an important role in regulating blood glucose. Chromium is thought to help cells absorb glucose and assists with cellular response to insulin, the chemical that balances blood sugar levels. Some older adults become deficient in chromium, and scientists believe that those with diabetes may benefit from chromium supplements though more research is needed to confirm this fact.
Am I Getting Enough Iron?
The mineral iron is an essential component of hemoglobin which is a protein in the blood that helps to transport oxygen throughout the body. The National Institute of Health (NIH) estimates that up to 80 percent of people in the world don't get enough iron from their diets. In addition, the NIH states that approximately 30 percent of the world’s population is anemic, which means that their hemoglobin production is very deficient. Symptoms of anemia include fatigue, easy bruising and shortness of breath, all of which many doctors believe may be alleviated through iron supplementation.
What Does Magnesium Do?
Magnesium plays many different roles in the human body. The mineral helps the body regulate its temperature, move muscles, transport messages across the nervous system and metabolize nutrients at the cellular level. Deficiencies in magnesium may occur in individuals who take certain medications, diabetics, those with digestive issues and the elderly.
Unsure which mineral supplement is right for you? Consult with your doctor. He or she can discuss your symptoms with you and help develop a plan that will include the best supplement to address your needs. drugstore.com has a wide variety of mineral supplements to meet your needs. From multiminerals that combine more than one essential nutrient to single mineral supplements, our minerals are all affordably priced and produced by reputable manufacturers. Shop our collection now to find the right supplement to help you improve your daily nutrition.
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| 10 |
Public health agencies play major roles in shaping the way healthcare is delivered to populations around the country and the world. In many cases, these agencies work with partners to ensure that underserved and disadvantaged groups have access to adequate care and education. With diabetes, most underserved groups are disproportionately affected by the disease and face much greater mortality and morbidity rates. In order to combat the disadvantages faced by these populations, it is critical for public agencies to:
- Find effective ways to provide greater access to care
- Develop programs that cater to specific cultural, ethnic, and socio-economic needs and conditions
- Utilize technology to manage cost
- Demonstrate quality outcomes that can scale
Improve the quality of life of the citizens they represent
Over the last several years, Joslin has worked on programs with the largest healthcare agencies in the U.S. to bring diabetes care to critical populations. National agencies include:
- Veterans Health Administration
- Department of Defense
- Indian Health Service Center for Medicare Services
- The USDA Extension Service
In each case, Joslin is lending its expertise to develop programs that increase access for patients and provide them with new levels of care and education for diabetes. Our Joslin Vision NetworkTM (JVN), for example, is a proven retinal imaging device and clinical service deployed in over 50 sites within the Indian Health Service network that has screened thousands of Native American patients for diabetic retinopathy - the leading cause of new-onset vision loss in working age adults. Images are obtained through the JVN camera workstation by a remote technician and then sent to a reading center in Phoenix established by Joslin and the IHS. Joslin-trained readers evaluate images and render summaries and treatment guides in order to triage patients to care and pre-empt the progression of disease.
With the Department of Defense and the Veterans Health Administration, Joslin has developed the Comprehensive Diabetes Management Program (CDMP) software tool to allow nurses to perform more complete and efficient care management and education. The tool is being implemented in select DoD and VHA sites and will expand in the near future.
Joslin also works with the Cooperative State Research, Education and Extension Service (CSREES), a branch of the USDA that has a long experience working with clients in underserved areas, particularly in areas of nutrition. These two groups have developed a diabetes program outside of the usual medical care system that can be delivered by leaders without a diabetes background to access underserved patients. "On the Road to Living Well with Diabetes" Program, which is delivered to small groups, includes on-site testing of blood pressure, portable device A1C measurements, and sometimes microalbumin and cholesterol. The program includes a series of colorful low-literacy flip charts and a 20-page booklet that describes in easy-to-understand terms six tests that all people with diabetes should have, why these tests are important and what the results mean in terms of people’s overall diabetes care.
Joslin is also working with state and local agencies to help address the growing problem of diabetes in urban and minority communities. Its initiatives in the state of Mississippi and New York City are arming healthcare workers with more advanced risk stratification and care management tools and providing education vehicles to help reach patients.
For more information on how Joslin can provide health solutions in partnership with your agency, please contact
Page last updated: March 27, 2015
| 10 |
Make 'simple food swaps' for good health, families told
- 2 January 2014
- From the section Health
A new public health campaign in England is urging families to make simple foods swaps such as switching to diet drinks.
People who sign up to the Smart Swaps campaign will receive money-off vouchers towards their groceries.
Critics say this latest in a long line of government health drives puts the onus on consumers and not food manufacturers who should cut salt and sugar levels in their products.
A two-litre bottle of pop can contain the equivalent of 52 lumps of sugar.
Swapping sugary drinks to diet, sugar free options or milk could save a family up to three quarters of a 1kg bag of sugar over four weeks, according to the Change4Life Smart Swaps campaign.
Other swaps include:
- Switching from full fat cheese to reduced fat cheese
- Swapping butter for lower fat spreads
- Picking low sugar cereals, such as plain porridge or whole wheat/grain products, over sugary ones
- Drinking 1% fat or skimmed milk rather than whole or semi-skimmed
Prof Kevin Fenton of Public Health England said: "Swapping like-for-like food in your diet could help you cut out surprising levels of saturated fat, sugar and ultimately calories."
Public Health England has set aside £840,000 worth of vouchers, provided by commercial food stores, for those who sign up to the campaign.
Malcolm Clark of the Children's Food Campaign says the government should be putting more pressure on food manufacturers.
"These good messages risk being undermined unless there is real change in what is sold and promoted to us in store. The supermarkets should be the ones doing the swapping: permanently replacing promotions on unhealthy products with those for healthier items.
"There is nothing smart about Public Health England partnering with the food industry without expecting more in return."
| 10 |
To prevent childhood obesity.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Measures to Prevent Childhood Obesity Act of 2012''.
SEC. 2. FINDINGS.
Congress finds the following: (1) Obesity is related to more than 30 chronic conditions, including diabetes, cancer, cardiovascular disease, and arthritis. (2) Obesity has become a major health concern for millions of Americans, as 1 in 3 adults and nearly 1 in 5 children have obesity, according to the Centers for Disease Control and Prevention. (3) Left unchecked, nearly 50 percent of Americans will be obese by 2030, according to a recent study. (4) Rates of obesity among children and adolescents have nearly tripled since 1980, according to the Centers for Disease Control and Prevention. (5) The Centers for Disease Control and Prevention estimates that more than 75 percent of health care costs are due to chronic conditions. (6) A recent study conducted by researchers at Cornell University and Lehigh University concluded that obesity accounts for nearly 21 percent of health care costs in America. (7) Direct medical spending on obesity could exceed $300,000,000,000 annually by 2018, according to an analysis conducted by McKinsey and Company. (8) Obesity has become a threat to national security and is the leading medical reason for applicants failing to qualify for military service, according to a report issued by Mission:Readiness. (9) A report issued by the Trust for...
| 10 |
The glucose challenge test measures your body's response to sugar (glucose). The glucose challenge test is done during pregnancy to screen for gestational diabetes — diabetes that develops during pregnancy.
The glucose challenge test is done in two steps. First you drink a sugary solution. One hour later, your blood sugar level is measured. The results of the glucose challenge test indicate whether you might have gestational diabetes.
If the test results are above normal, you'll need to have further testing to determine the diagnosis.
April 17, 2013
- Coustan DR, et al. Screening and diagnosis of gestational diabetes mellitus. http://www.uptodate.com/index. Accessed Aug. 1, 2012.
- Van Leeuwen M, et al. Glucose challenge test for detecting gestational diabetes mellitus: A systematic review. BJOG: An International Journal of Obstetrics and Gynaecology. 2012;119:393.
- Evensen AE. Update on gestational diabetes mellitus. Primary Care. 2012;39:83.
- Position statement: Standards of medical care in diabetes — 2012. Diabetes Care. 2012;35:S11.
- The American College of Obstetricians and Gynecologists Committee on Obstetric Practice. Committee Opinion No. 504: Screening and diagnosis of gestational diabetes mellitus. Obstetrics & Gynecology. 2011;118:751.
- What I need to know about gestational diabetes. National Diabetes Information Clearing House. http://diabetes.niddk.nih.gov/dm/pubs/gestational/#5. Accessed Aug. 1, 2012.
- Routine prenatal care. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/prenatal_care_4/prenatal_care__routine__full_version__2.html. Accessed Sept. 14, 2012.
- Castro MR (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 24, 2012.
| 10 |
"Jan. 29, 2013 -- The American Academy of Pediatrics has issued the first-ever guidelines for the management of type 2 diabetes in children and teens.
Type 2 diabetes is rising rapidly among children and teens because of soaring obesity "...
The following adverse reactions are discussed in more detail elsewhere in the labeling:
- Cardiac Failure [see WARNINGS AND PRECAUTIONS]
- Major Adverse Cardiovascular Events [see WARNINGS AND PRECAUTIONS]
- Edema [see WARNINGS AND PRECAUTIONS]
- Weight Gain [see WARNINGS AND PRECAUTIONS]
- Hepatic Effects [see WARNINGS AND PRECAUTIONS]
- Macular Edema [see WARNINGS AND PRECAUTIONS]
- Fractures [see WARNINGS AND PRECAUTIONS]
- Hematologic Effects [see WARNINGS AND PRECAUTIONS]
- Ovul ati on [see WARNINGS AND PRECAUTIONS]
Clinical Trial Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.
In clinical trials, approximately 9,900 patients with type 2 diabetes have been treated with AVANDIA.
Short-term Trials of AVANDIA as Monotherapy and In Combination With Other Hypoglycemic Agents: The incidence and types of adverse events reported in short-term clinical trials of AVANDIA as monotherapy are shown in Table 3.
Table 3: Adverse Events (≥5% in any Treatment
Group) Reported by Patients in Short terma Double-blind Clinical Trials With AVANDIA as Monotherapy
|Preferred Term||Clinical Trials With AVANDIA as Monotherapy|
N = 2,526 %
N = 601 %
N = 225 %
N = 626 %
|Upper respiratory tract infection||9.9||8.7||8.9||7.3|
|a Short-term trials ranged from 8 weeks to 1
b Includes patients receiving glyburide (N = 514), gliclazide (N = 91), or glipizide (N = 21).
Overall, the types of adverse reactions without regard to causality reported when AVANDIA was used in combination with a sulfonylurea or metformin were similar to those during monotherapy with AVANDIA.
Events of anemia and edema tended to be reported more frequently at higher doses, and were generally mild to moderate in severity and usually did not require discontinuation of treatment with AVANDIA.
In double-blind trials, anemia was reported in 1.9% of patients receiving AVANDIA as monotherapy compared with 0.7% on placebo, 0.6% on sulfonylureas, and 2.2% on metformin. Reports of anemia were greater in patients treated with a combination of AVANDIA and metformin (7.1%) and with a combination of AVANDIA and a sulfonylurea plus metformin (6.7%) compared with monotherapy with AVANDIA or in combination with a sulfonylurea (2.3%). Lower pre-treatment hemoglobin/hematocrit levels in patients enrolled in the metformin combination clinical trials may have contributed to the higher reporting rate of anemia in these trials.
In clinical trials, edema was reported in 4.8% of patients receiving AVANDIA as monotherapy compared with 1.3% on placebo, 1.0% on sulfonylureas, and 2.2% on metformin. The reporting rate of edema was higher for AVANDIA 8 mg in sulfonylurea combinations (12.4%) compared with other combinations, with the exception of insulin. Edema was reported in 14.7% of patients receiving AVANDIA in the insulin combination trials compared with 5.4% on insulin alone. Reports of new onset or exacerbation of congestive heart failure occurred at rates of 1% for insulin alone, and 2% (4 mg) and 3% (8 mg) for insulin in combination with AVANDIA [see BOXED WARNING, WARNINGS AND PRECAUTIONS].
In controlled combination therapy trials with sulfonylureas, mild to moderate hypoglycemic symptoms, which appear to be dose related, were reported. Few patients were withdrawn for hypoglycemia ( < 1%) and few episodes of hypoglycemia were considered to be severe ( < 1%). Hypoglycemia was the most frequently reported adverse event in the fixed-dose insulin combination trials, although few patients withdrew for hypoglycemia (4 of 408 for AVANDIA plus insulin and 1 of 203 for insulin alone). Rates of hypoglycemia, confirmed by capillary blood glucose concentration ≤ 50 mg/dL, were 6% for insulin alone and 12% (4 mg) and 14% (8 mg) for insulin in combination with AVANDIA. [See WARNINGS AND PRECAUTIONS]
Long-term Trial of AVANDIA as Monotherapy: A 4- to 6-year trial (ADOPT) compared the use of AVANDIA (n = 1,456), glyburide (n = 1,441), and metformin (n = 1,454) as monotherapy in patients recently diagnosed with type 2 diabetes who were not previously treated with antidiabetic medication. Table 4 presents adverse reactions without regard to causality; rates are expressed per 100 patient-years (PY) exposure to account for the differences in exposure to trial medication across the 3 treatment groups.
In ADOPT, fractures were reported in a greater number of women treated with AVANDIA (9.3%, 2.7/100 patient-years) compared with glyburide (3.5%, 1.3/100 patient-years) or metformin (5.1%, 1.5/100 patient-years). The majority of the fractures in the women who received rosiglitazone were reported in the upper arm, hand, and foot. [See WARNINGS AND PRECAUTIONS] The observed incidence of fractures for male patients was similar among the 3 treatment groups.
Table 4: On-therapy Adverse Events [≥5 Events/100
Patient-Years (PY)] in any Treatment Group Reported
in a 4-to 6-Year Clinical Trial of AVANDIA as Monotherapy (ADOPT)
N = 1,456
PY = 4,954
N = 1,441
PY = 4,244
N = 1,454
PY = 4,906
|Upper respiratory tract infection||4.3||5.0||4.7|
Long-term Trial of AVANDIA as Combination Therapy (RECORD): RECORD (Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycemia in Diabetes) was a multicenter, randomized, open-label, non-inferiority trial in subjects with type 2 diabetes inadequately controlled on maximum doses of metformin or sulfonylurea (glyburide, gliclazide, or glimepiride) to compare the time to reach the combined cardiovascular endpoint of cardiovascular death or cardiovascular hospitalization between patients randomized to the addition of AVANDIA versus metformin or sulfonylurea. The trial included patients who have failed metformin or sulfonylurea monotherapy; those who failed metformin (n = 2,222) were randomized to receive either AVANDIA as add-on therapy (n = 1,117) or add-on sulfonylurea (n = 1,105), and those who failed sulfonylurea (n = 2,225) were randomized to receive either AVANDIA as add-on therapy (n = 1,103) or add-on metformin (n = 1,122). Patients were treated to target HbA1c ≤ 7% throughout the trial.
The mean age of patients in this trial was 58 years, 52% were male, and the mean duration of follow-up was 5.5 years. AVANDIA demonstrated non-inferiority to active control for the primary endpoint of cardiovascular hospitalization or cardiovascular death (HR 0.99, 95% CI: 0.85-1.16). There were no significant differences between groups for secondary endpoints with the exception of congestive heart failure (see Table 5). The incidence of congestive heart failure was significantly greater among patients randomized to AVANDIA.
Table 5: Cardiovascular (CV) Outcomes for the RECORD
N = 2,220
l N = 2,227
|Hazard Ratio||95% CI|
|CV death or CV hospitalization||321||323||0.99||0.85-1.16|
|CV death, myocardial infarction, or stroke||154||165||0.93||0.74-1.15|
There was an increased incidence of bone fracture for subjects randomized to AVANDIA in addition to metformin or sulfonylurea compared with those randomized to metformin plus sulfonylurea (8.3% versus 5.3%) [see WARNINGS AND PRECAUTIONS]. The majority of fractures were reported in the upper limbs and distal lower limbs. The risk of fracture appeared to be higher in females relative to control (11.5% versus 6.3%), than in males relative to control (5.3% versus 4.3%). Additional data are necessary to determine whether there is an increased risk of fracture in males after a longer period of follow-up.
AVANDIA has been evaluated for safety in a single, active-controlled trial of pediatric patients with type 2 diabetes in which 99 were treated with AVANDIA and 101 were treated with metformin. The most common adverse reactions (>10%) without regard to causality for either AVANDIA or metformin were headache (17% versus 14%), nausea (4% versus 11%), nasopharyngitis (3% versus 12%), and diarrhea (1% versus 13%). In this trial, one case of diabetic ketoacidosis was reported in the metformin group. In addition, there were 3 patients in the rosiglitazone group who had FPG of approximately 300 mg/dL, 2+ ketonuria, and an elevated anion gap.
Decreases in mean hemoglobin and hematocrit occurred in a dose-related fashion in adult patients treated with AVANDIA (mean decreases in individual trials as much as 1.0 g/dL hemoglobin and as much as 3.3% hematocrit). The changes occurred primarily during the first 3 months following initiation of therapy with AVANDIA or following a dose increase in AVANDIA. The time course and magnitude of decreases were similar in patients treated with a combination of AVANDIA and other hypoglycemic agents or monotherapy with AVANDIA. Pre-treatment levels of hemoglobin and hematocrit were lower in patients in metformin combination trials and may have contributed to the higher reporting rate of anemia. In a single trial in pediatric patients, decreases in hemoglobin and hematocrit (mean decreases of 0.29 g/dL and 0.95%, respectively) were reported. Small decreases in hemoglobin and hematocrit have also been reported in pediatric patients treated with AVANDIA. White blood cell counts also decreased slightly in adult patients treated with AVANDIA. Decreases in hematologic parameters may be related to increased plasma volume observed with treatment with AVANDIA.
Changes in serum lipids have been observed following treatment with AVANDIA in adults [see CLINICAL PHARMACOLOGY]. Small changes in serum lipid parameters were reported in children treated with AVANDIA for 24 weeks.
Serum Transaminase Levels
In pre-approval clinical trials in 4,598 patients treated with AVANDIA (3,600 patient-years of exposure) and in a long-term 4- to 6-year trial in 1,456 patients treated with AVANDIA (4,954 patient-years exposure), there was no evidence of druginduced hepatotoxicity.
In pre-approval controlled trials, 0.2% of patients treated with AVANDIA had elevations in ALT >3X the upper limit of normal compared with 0.2% on placebo and 0.5% on active comparators. The ALT elevations in patients treated with AVANDIA were reversible. Hyperbilirubinemia was found in 0.3% of patients treated with AVANDIA compared with 0.9% treated with placebo and 1% in patients treated with active comparators. In pre-approval clinical trials, there were no cases of idiosyncratic drug reactions leading to hepatic failure. [See WARNINGS AND PRECAUTIONS]
In the 4- to 6-year ADOPT trial, patients treated with AVANDIA (4,954 patient-years exposure), glyburide (4,244 patient-years exposure), or metformin (4,906 patient-years exposure), as monotherapy, had the same rate of ALT increase to >3X upper limit of normal (0.3 per 100 patient-years exposure).
In the RECORD trial, patients randomized to AVANDIA in addition to metformin or sulfonylurea (10,849 patient-years exposure) and to metformin plus sulfonylurea (10,209 patientyears exposure) had a rate of ALT increase to ≥3X upper limit of normal of approximately 0.2 and 0.3 per 100 patient-years exposure, respectively.
In addition to adverse reactions reported from clinical trials, the events described below have been identified during post-approval use of AVANDIA. Because these events are reported voluntarily from a population of unknown size, it is not possible to reliably estimate their frequency or to always establish a causal relationship to drug exposure.
In patients receiving thiazolidinedione therapy, serious adverse events with or without a fatal outcome, potentially related to volume expansion (e.g., congestive heart failure, pulmonary edema, and pleural effusions) have been reported [see BOXED WARNING, WARNINGS AND PRECAUTIONS].
There are postmarketing reports with AVANDIA of hepatitis, hepatic enzyme elevations to 3 or more times the upper limit of normal, and hepatic failure with and without fatal outcome, although causality has not been established.
There are postmarketing reports with AVANDIA of rash, pruritus, urticaria, angioedema, anaphylactic reaction, Stevens-Johnson syndrome [see CONTRAINDICATIONS, and new onset or worsening diabetic macular edema with decreased visual acuity [see WARNINGS AND PRECAUTIONS].
Read the Avandia (rosiglitazone maleate) Side Effects Center for a complete guide to possible side effects
CYP2C8 Inhibitors And Inducers
An inhibitor of CYP2C8 (e.g., gemfibrozil) may increase the AUC of rosiglitazone and an inducer of CYP2C8 (e.g., rifampin) may decrease the AUC of rosiglitazone. Therefore, if an inhibitor or an inducer of CYP2C8 is started or stopped during treatment with rosiglitazone, changes in diabetes treatment may be needed based upon clinical response. [See CLINICAL PHARMACOLOGY]
Read the Avandia Drug Interactions Center for a complete guide to possible interactions
Last reviewed on RxList: 5/27/2014
This monograph has been modified to include the generic and brand name in many instances.
Additional Avandia Information
Avandia - User Reviews
Avandia User Reviews
Now you can gain knowledge and insight about a drug treatment with Patient Discussions.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Find out what women really need.
| 10 |
If you have clients who experience severely itchy skin, perhaps they are not getting enough omega-6 fatty acids in their diets. Recommend that they talk to their physician or a dietician for a possible solution.
University of Illinois scientists have learned that a specific omega-6 fatty acid may be critical to maintaining skin health.
"In experiments with mice, we knocked out a gene responsible for an enzyme that helps the body to make arachidonic acid. Without arachidonic acid, the mice developed severe ulcerative dermatitis. The animals were very itchy, they scratched themselves continuously, and they developed a lot of bleeding sores," said Manabu Nakamura, a U of I associate professor of food science and human nutrition.
When arachidonic acid was added to the animals' diet, the itching went away, he said.
Nakamura's team has been focusing on understanding the function of omega-3 and -6 fatty acids, and doctoral student Chad Stroud developed a mouse model to help them understand the physiological roles of these fats. By knocking out genes, they can create deficiencies of certain fats and learn about their functions.
"Knocking out a gene that enables the body to make the delta-6-desaturase enzyme has led to some surprising discoveries. In this instance, we learned that arachidonic acid is essential for healthy skin function. This new understanding may have implications for treating the flaky, itchy skin that sometimes develops without an attributable cause in infants," he said.
Nakamura explained that our bodies make arachidonic acid from linoleic acid, an essential fatty acid that we must obtain through our diets. It is found mainly in vegetable oils.
Scientists have long attributed healthy skin function to linoleic acid, which is important because it provides the lipids that coat the outer layer of the skin, keeping the body from losing water and energy, which would retard growth, the scientist said.
But skin function seems to be more complicated than that. These itchy mice had plenty of linoleic acid. They just couldn't convert it to arachidonic acid because the gene to make the necessary enzyme had been knocked out, he noted.
Arachidonic acid is also essential to the production of prostaglandins, compounds that can lead to inflammatory reactions and are important to immune function. Common painkillers like aspirin and ibuprofen work by inhibiting the conversion of arachidonic acid to prostaglandins.
"We usually think of inflammation as a bad thing, but in this case, prostaglandins prevented dermatitis, which is an inflammatory reaction. We measured prostaglandin levels in the animals' skin, and when we fed arachidonic acid to the knockout mice, they resumed making these important chemical compounds," he said.
Nakamura cautioned that there are still things they don't understand about the function of this omega-6 fatty acid. "This new knowledge is a starting point in understanding the mechanisms that are involved, and we need to do more research at the cellular level."
The study was published in a recent issue of the Journal of Lipid Research. Co-authors are Chad K. Stroud, Takayuki Y. Nara, Manuel Roqueta-Rivera, Emily C. Radlowski, Byung H. Cho, Mariangela Segre, Rex A. Hess, and Wanda M. Haschek, all of the U of I, and Peter Lawrence, Ying Zhang, and J. Thomas Brenna of Cornell University. Funding was provided in part by a USDA National Needs Fellowship Award and a grant from the National Institutes of Health.
From ScienceDaily.com, April 14, 2010
| 10 |
Fat in Formula for Brainier Babies?
Smarter Baby Formula
Nov. 28, 2001 -- All agree that when it comes to feeding babies, breast milk is best. Infant formula manufacturers even market their products by claiming they are as close as possible to mother's milk.
But in the United States, at least, commercial baby formulas are missing key ingredients of breast milk, which studies suggest help improve both visual and cognitive development. That could all change within the next year, however, if the FDA approves the addition of two essential fatty acids to infant formulas.
The fats docosahexaenoic acid (DHA) and arachidonic acid (AA) are already available in commercial infant formulas in 60 countries. And proponents say adding the fats found in breast milk to formulas in this country is a no-brainer.
"Pediatricians who are educated about DHA have been trying to get it into infant formula for the last decade," says California pediatrician Bill Sears, MD, who has written more than 30 books on infant development and parenting.
"The science is overwhelming that it is beneficial in terms of cognitive development. But even without the science it would be obvious because nature makes very few mistakes. And there is a large amount of DHA in breast milk."
Sears points out that an infant's brain triples in size during the first year of life, and that the brain is 60% fat. The natural conclusion, he says, is that one of the most important nutrients for the human brain is fat.
"If the formula companies are going to make the claim that they are close to mother's milk, then wouldn't it make sense to put in the fat that mother's milk has?," he says.
Last May, the FDA officially affirmed the safety of DHA and AA for use in infant formulas, but it still must approve specific requests by formula manufacturers to put the oils in their products.
"I would be very surprised if we don't see formula on the shelves with DHA and AA within the next year," says Angela Tsetsis, director of marketing for Martek Biosciences of Columbia, Md., which manufacturers the algae-derived fatty acid oils.
| 10 |
Drinking soda ups your blood pressure
By David Liu, PHD
Wednesday, May 2, 2012 (foodconsumer.org) It has been known that drinking sugar-sweetened beverages or commonly known as soft drinks or sodas may increase risk of hypertension or high blood pressure. A new study confirms the association.
Lisa Cohen of University of Maryland Medical Center in Baltimore, MD and colleagues found that drinking one serving of sugar-sweetened beverages per day was associated with 13 increased risk of hypertension.
They also found drinking artificially sweetened beverages, once a day was associated with 14 percent increased risk of high blood pressure.
The association was stronger for carbonated beverages compared to non-carbonated beverages, and for colas, compared to non-cola beverages.
Specifically, high intake of fructose from sugar sweetened beverages was correlated with increased risk for hypertension while high intake of fructose from other sources was correlated with reduced risk.
The findings were derived from an analysis of data from three large, prospective cohorts, the Nurses' Health Studies I including 88,540 women and II including 97,991 women and the Health Professionals' Follow-Up Study including 37,360 men.
The study was released in Journal of General Internal Medicine.
High hypertension is linked to heart disease. The Centers for Disease Control and Prevention says that 33 percent of adult Americans suffer this condition, which kills nearly 30,000 people in the U.S. each year.
Bing drinking, eaing fructose, high fat diet, low vitamin D, obesity, diabetes, arsenic exposure, poor sleeping, air pollution increase the risk of hypertension while garlic, vitamin C, arginine, beet juice, blueberries, and vegetarian diet can lower blood pressure.
(Send your news to [email protected], Foodconsumer.org is part of the Infoplus.com ™ news and information network)
- Elevated cholesterol and triglycerides may increase the risk for prostate cancer recurrence
- Stillbirth may increase women's long term risk for depression
- Vinegar may help fight diabetes mellitus
- Supermarket Guru to Showcase Hottest 2015 Food Trends at Midwinter Leadership Forum
- Killing you softly. And secretly
| 10 |
A broad range of scientific research has demonstrated that an adequate intake of calcium plays an important role in building and maintaining optimum bone mass, and a recent meta-analysis published online in the British Medical Journal should not cause consumers to doubt the value of calcium supplements for maintaining bone health.
"Adequate calcium intake is vital to building and maintaining healthy bones, and to preventing osteoporosis—which is caused by a failure to build adequate bone mass or by bone loss that occurs as we age. Most people do not get enough calcium from diet alone, and this is where a calcium supplement can be important to consumers of all ages," said Andrew Shao, Ph.D., senior vice president, scientific & regulatory affairs, Council for Responsible Nutrition. "The results from this meta-analysis does not undermine the value calcium supplements offer to those concerned with maintaining or increasing bone density, as years of research shows these products do."
The authors of the meta-analysis examined the effects of calcium supplements on the risk of cardiovascular events, concluding there is an increased risk, and calling for a reassessment of the role of calcium supplements for osteoporosis. According to CRN, these conclusions are dramatically overstated, considering the limitations of meta-analysis, in general, and this meta-analysis, specifically.
For example, the analysis could have potentially included over 300 scientific studies on calcium supplementation's effect on bone, but only 15 randomized clinical trials were deemed "eligible for analysis."
Further, seven of the 15 trials evaluated had no, or incomplete, data on cardiovascular outcomes, and only five of the 15 studies accounted for almost all of the cardiovascular outcomes. Further, because the researchers chose to exclude any trials administering calcium plus vitamin D, many large, important trials—including the Women's Health Initiative, which found calcium plus vitamin D had no effect on the risk of coronary heart disease or stroke—were not included.
"The authors characterize these findings as though all of the selected studies suggest increased risk. In fact, the opposite is true: most of the studies do not suggest increased risk," says Dr. Shao. "Bone health is one of the most common reasons why healthcare professionals recommend calcium supplements; there are other health benefits that may be associated with calcium supplementation, such as reduction of colon cancer risk. This is not even considered by the authors. It's unfortunate that these researchers are making sweeping judgments about the value of calcium supplements by only assessing a handful of handpicked studies."
Dr. Shao also pointed out that none of the original studies included in the meta-analysis were designed to evaluate cardiovascular outcomes. Additionally, the data on cardiovascular events was never previously published, so the meta-analysts had to track the information down separately, in some cases, 10 even 20 years after the original study was published.
"Meta-analysis can be a useful tool for scientific evaluation, but we have to recognize its limitations, and keep in mind that its findings are based on a collection of past studies that may have different designs, doses and study populations," says Dr. Shao. "This analysis should not dissuade consumers, particularly young women, from taking calcium supplements. They should talk with their doctors about their current and long-term needs and determine how much calcium they are getting from their diets, and supplement accordingly—likely in combination with vitamin D."
Explore further: Physician/Pharmacist model can improve mean BP
| 10 |
One in three Americans who have diabetes are unaware that they have the disease. It is a disease that affects seven percent of the population, or 20.8 million people in the United States. Diabetes is a disease in which the body doesn’t produce or properly use insulin.
Greg Sanchez, 41, was one of those people who was completely unaware that he had diabetes until he ended up in Urgent Care.
“I was very dehydrated because I was urinating 25 to 30 times a day,” said Sanchez. “My doctor tested me for diabetes and the results really surprised me.”
“He may have had diabetes for more than 12 years and was never diagnosed until now,” said Dustin Lillie, MD, Medical Director, UC San Diego Scripps Ranch Clinic.
“Dr. Lillie worked with me, taking a great deal of time to put together a treatment plan I could follow,” said Sanchez. “I email him my blood sugar levels weekly and he emails me back with suggestions about what to change or do differently with my diet and exercise program.”
Weight gain is one of the risk factors and side effects of diabetes and Sanchez had gained more than 25 pounds in the past six months.
“Diabetes and obesity sometimes go hand-in-hand and are reaching epidemic numbers in Americans,” said Lillie.
“Keeping your weight under control is one of the most important ways to head off or control diabetes,” said Sanchez. “I’m working on losing weight.”
Now when Sanchez visits the grocery store his 15 year-old-son Chris joins him and counsels him on what foods to buy.
“My son is now aware that he could develop diabetes because it is hereditary; so he watches what I eat from diabetic chocolate to a wheat bun instead of white bread,” said Sanchez.
Now Sanchez feels things are falling back into place and he is feeling better.
There are two types of diabetes: Type 1 and Type 2.
In Type 1 diabetes, the body does not produce insulin. Insulin is necessary for the body to be able to use sugar and sugar is the basic fuel for cells in the body. Insulin takes the sugar from the blood into the cells.
In Type 2 diabetes, the body is insulin resistant so it doesn’t properly use insulin. Most Americans are diagnosed with diabetes Type 2.
Diabetes is most common in African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders.
Symptoms of diabetes Type 2 include:
- Frequent urination
- Excessive thirst
- Extreme hunger
- Unusual weight loss
- Increased fatigue
- Blurry vision
Working with your physician can help to keep your diabetes under control. The most common ways to help manage diabetes is through weight loss, staying active and exercise, and eating low-fat meals rich in fruits, vegetables and whole grain foods.
Diagnosis and management of diabetes is important because left untreated, Type 1 and Type 2 diabetes can lead to heart attack, stroke, kidney disease, blindness, or limb amputation.
Working together with your doctor, you can take control of your health, your weight and diabetes.
# # #
Media Contact: Eileen Callahan, 619-543-6163, [email protected]
| 10 |
At face value, it seems to make sense. After all, we know that a calorie deficit is required for weight loss. That means consuming fewer calories than your body burns. For healthy and sustainable weight loss, most experts recommend consuming 250 – 500 fewer calories than your body burns. By skipping a meal, we can easily create that calorie deficit. Right?
It’s not that simple. Skipping a meal has other consequences.
For one, researchers have found that meal skippers tend to overeat on their next meal due to their extreme hunger. In total, they still tend to eat the same amount of calories. According to researchers, this cycle of starvation and then overindulgence can result in some potentially risky metabolic changes that, over time, could even result in diabetes.
Beyond the metabolic impact and intense hunger pangs, skipping meals and is also absolutely miserable. If you’ve ever spent time fasting, you’ve likely experienced difficulty focusing, moodiness, drops in productivity, sluggishness and so on. And if you’re lacking energy and focus, it becomes much harder to power through a workout; thus, it can put your results at risk.
Rather than skipping meals, cut calories by making your existing meals smarter and healthier. Trim down your portions and opt for more vegetables, lean meats and healthy cooking methods.
P.S. To look and feel great through the foods you eat, download Davey Wavey’s Insanely Easy Guide to Eating Smarter.
| 10 |
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Research, links, discussions –
everything you need to know to help your pediatric patients and their families !
Updates March 2015
The proposed “soda ban” in New-York made waves and brought fame to Mayor Michael Bloomberg in recent months. The idea is simple – one can not buy soda drinks larger than 16 oz. While you can buy 3 or 4 of those if you are eager to gulp large amount of sugar, it is a measure to curb consumption of sugary drinks in hopes of reducing obesity.
Authors of a paper in Journal of Pediatrics suggest another reason to avoid large soda cups, or any soda at all. Among almost 3000 families children in the Fragile Families and Child Wellbeing Study is a prospective birth cohort study, 43% consumed at least one serving of soda per day. After adjusting to demographics, consuming any soda drinks daily was associated with an aggressive behavior. The effect was ‘dose-dependent’ and children with 4 or more soda drinks were almost 5 times more likely (4.7; 95% CI, 3.2-6.2) to score high on aggressive behavior scale and the attention problems subscale. Can soda be ‘the source for all evil’ ?
Once in a while medicine is reinvented – check out this solar autoclave, activated by nanoparticles. Humble idea that crosses borders and bring medical sterile equipment everywhere.
A group from Philadelphia reported recently in Pediatrics, that among over 1500 parents interviewed online, the time parents spent watching the ‘tube’ was strongly predicting their child’s television time. This was a better predictor than access to television in the home, access to television in the child’s bedroom, rules-at-home or parent-child co-viewing. The findings were consistent to children in all age groups.
Children’s excessive television viewing is associated with several negative phenomena in childhood, including obesity. Since ‘the apple doesn’t fall far from the (screen) tree’, educating parents about their own viewing habits is a must by those providing care for children.
Psychologists from Missouri investigated three groups of boys and their video gaming patterns. Parents of boys with autism spectrum disorder, ADHD and typical development were surveyed. Interestingly, boys with autism spent almost twice the daily time playing video compared to developmentally typical boys (2.1 hours a day). Both autism and ADHD was associated with greater in-room video game access and greater problematic video game use (yes, there is a score for that, based on measures associated with behavioral addiction model).
The findings are of interest, since hyperactivity and impulsivity are associated with criminal involvement in the future, and ‘problematic gaming’ may be a prelude for future problems. As for boys with autism – spending a long time on a game console may be part of their potential social skills deficiency.
Children will eat anything. They also tend to choke on anything. A descriptive study based on data from the National Electronic Injury Surveillance System–All Injury Program reveal that a staggering number of children 0-14 years (over 110,000) were treated in emergency departments in the US over the period 2001-9 for chocking on food. The average age was 4.5 years.
What is most concerning is that a third of children were in their first year of life. Hard candy, other candies, meat and bone were the most common food associated with choking. 1/10 needed hospitalization.
The investigators suggested surveillance, food labeling and redesign as important strategies, but the likely most effective path should be educating their parents.
The rise of probiotics is of interest to many pediatricians. Seen in previous decades as a complementary medicine substrate with little to no proof of effectiveness, probiotics slowly gained press as well as scientific evidence of value in some conditions and as part of well being of children.
In a meta-analysis published by reviewers from a few US states, published in Pediatrics, the effect of probiotics on atopy and asthma in children was reviewed. Bottom line : while not significantly reducing asthma or wheezing episodes, probiotics are effective in reducing total immunoglobulin E, reducing the risk of atopic sensitization when administered pre-natally for positive result on skin prick test and/or elevated specific IgE to common allergens, and also post-natally for skin prick test. The star was Lactobacillus acidophilus, with an increased risk of atopic sensitization.
Few pediatricians are great business movers and shakers. Business organizations are starting to be better pediatricians, or at least to provide pediatric services. Large chains like Walgreens started offering immunizations and nurse practitioners in hundreds of locations. Time covered a recent JAMA paper shedding more light on the phenomenon and how families take advantage of pediatric retail clinics for minor health issues. Who said you need a full-fledged pediatrician for a runny nose ?
While pediatricians and the American Academy of Pediatrics are concerned, effortless access, perception of who needs to see our children and smart marketing will win. Retail pediatrics is here to stay.
In the days of high tech ‘i’ devices and computer running everything, a collaboration between investigators in the US and Zambia went back to the …. plastic bag. They randomized 104 premature Zambian newborns (26-36 weeks gestation or 1-2.5 kg birth weight) to be put in a plastic bag or not at birth, along with standard warming (blanket or radiant warmer). The ‘plastic-bag babies’ were warmer at 1 hour post delivery (0.4 degrees). Incubator manufacturers be on guard. Read in Pediatrics.
Pediatricians from Cincinnati Children’s asked over 250 parents, mostly African Americans and Medicaid insured, if they use technology. Well, the answer was yes, they do ! 80% had internet at home and 71% had smartphone. That allowed them to be connected to email (91%), Facebook (78%) and Twitter (27%). Parents were connected and eager to receive practical clinical information, if ‘approved by their child’s medical provider’. Time to connect those patients to reliable information online. Read in Pediatrics.
Persistent cough in children makes everyone anxious and mostly…. tired. The child, the parents and the pediatrician. The authors of a recent paper in the journal Cough (very appropriate journal for the topic) from the UK and Malaysia explain the ‘prolonged acute cough’ phenomenon – not really acute, not truly chronic. From post bronchiolitis to post pertussis, this paper help organize a differential diagnosis. Yet, the cure for cough is still just being patient. Read full text.
Emergency physicians at Boston Children’s Hospital followed patients 11-22 years old after acute concussion until symptom resolution. Those with previous concussion suffered twice as long (24 days compared to 12 days). Those with a previous concussion in the same year – suffered triple the agony (35 days).
A group from Columbus, Ohio, reviewed the ‘National Electronic Injury Surveillance System’ and found an average of almost 20,000 TV related injuries annually among children. This number represents only those that needed to visit a hospital, so the true figure is probably much higher. The vast majority (65%) are children under 5 years of age. The most concerning finding was the colossal increase in number of injuries over the last two decades, especially of devices falling from dressers and the like.
In an ongoing effort to discover the environmental aspects of obesity, a group from Kaiser Permanente, Oakland, published in PLOS one a paper on the association of urine Bisphenol-A (BPA) and obesity. Available in all plastic products, and found to be in 92% of children, the group examined over 1300 students in grades 4 to 12 from three schools in china.
After adjustment of the analysis to known confounders, urine BPA level was associated with more than two-fold increased risk of having weight >90th percentile among girls 9–12 years old (adjusted odds ratio of 2.32). No such association was found in boys.
While supporting previous findings, it is not clear why the correlation was observed only in girls. It seems that with multitude of risks, BPA should be avoided.
With the first pediatric auditory brain stem implant in the US, little Grayson can now hear voices. Sanjay Gupta and CNN on the unique implant and the amazing story of Grayson and his foster parents
The New York Times piece by Dr Mark Offit, head of infectious diseases at CHOP (Children’s Hospital of Philadelphia) on why we should not take vitamins. The well-oiled marketing machine, and the culture of mega-vitamins have always been pushing aside meta-analyses and scientific evidence. Will Dr Offit’s upcoming book on alternative medicine be the trigger to sensible parenting when it comes to vitamins ? Clinical Pediatrics conference prediction: NO. The Katy Perry effect (read the article to understand why) is still heard loud and clear.
Resuscitation is one of the most scary experienced to health care providers. They are rare and stressful. Simulation, the new version of ‘mock codes’ are becoming more and more high-fidelity and the research behind them gaining momentum. Not the least important is the debriefing after the simulated scenario: “so what did we learn here”. A group from 14 centers led by Dr Cheng from Canada published in JAMA Pediatrics a report on the use of a standardized script to facilitate team debriefings after a simulation session of a resuscitation. Scripted debriefing improved knowledge and leadership skills for subsequent simulations.
Despite confusion and disbelief among parents who do not understand why 11 year old girls need a vaccine for sexually transmitted diseases, HPV vaccine, now marketed for four years or so, is already making a significant (and surprising) impact.
Markowitz and others from the Centers for Disease Control and Prevention (CDC) report in the Journal of Infectious Diseases that among girls 14–19 years of age, HPV prevalence decreased 56% from 11.5% in 2003–2006 to 5% in 2007–2010, when serotypes covered by the vaccine are tested. Even one dose (and not 3 as recommended) had a significant impact. A total of more than 2000 girls were involved in the study throughout the years covered.
Now with two approved vaccines available, and more boys vaccinated, it will be interesting to see further reduction in HPV and likely cervical cancer.
Seeing in the office a rash such as erythema multiforme (EM) on a child, the care givers are worried and push to get ‘something’ – would you give systemic steroids ? A recent review paper by Chan suggests we hold on. The recommendation is to hold treatment for EM-minor (and consider topical steroids), and that systemic steroids for EM-major remains controversial.
Most children probably do not finish the course of antibiotics they receive from their pediatrician. Furthermore, how come we give all children the same length of treatment. Shouldn’t we treat them based on personalized regimen – their age ? severity of symptoms ? clinical improvement ? Interesting BMJ article.
After a decade of revisions the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is now released by the American Psychiatric Association.
Expect a lots of changes and mental health “shift” in pediatrics.
Be part of the ‘inner circle’ – here is a recipe to make ethics your friend and not your foe – at least by these UK based authors.
So how many of your patients come out of the emergency department and know exactly what the nurse, physician assistant or emerg doc told them ? probably very few. Limited health providers’ time and level of understanding by patients and families have always been a problem. A group from Augusta, Georgia, report in Pediatric Emergency Care their effort to improve discharge instructions for common pediatric conditions such as fever, vomiting or diarrhea and wheezing. They randomized families to regular discharge or to watching a 3 minute video with some discharge instructions. Of more than 436 caregivers, parents receiving video discharge instructions scored a post discharge questionnaire significantly higher in the emergency (12 vs 9) and 2 to 5 days after discharge (11 vs 8). At follow-up, 29% of the written and 42% of the video groups rated their discharge instructions as being extremely helpful. In the age of YouTube and Vimeo, watching the “tube” is probably better the written instructions.
The fear of botulism is the fundamental cause of recommending no honey be given to infants in their first year of life. A group from a county hospital pediatric clinic in Houston, Texas, asked parents about the practice of cleaning pacifiers with Honey. Surprisingly, 11% of about 400 families use this ‘method’. This is a group of children with a ‘potential’ for severe illness. One of the challenges is likely the level of awareness to the risks. Only about 20% of all parents were aware of botulism as a risk. As always, knowledge is power. Read Pediatrics.
Protocols, advice, interesting reminders about treating sepsis
A group from Boston determined recently that changing adult prescription drugs resulted in pediatric medication exposures and poisonings. The findings were among all age groups, mostly among 0 to 5 years old, and opioids were the biggest ‘offenders’. These poisoning reports were not benign. Emergency department visits were highest for events related to hypoglycemics (60%) and beta-blockers (60%); serious injuries and hospitalizations occurred with opioids (27% and 35%) and hypoglycemics (20% and 50%). Read in Pediatrics.
Which are your 10 best medical advancement in the last decade ? Here is CNN’s list.
Patients may diagnose themselves, using technology, and prescribe themselves medications without ever seeing the doctor. Sounds far-fetched until learning that the Food and Drug Administration (FDA) is seriously considering this option.
Pediatric research established the connection between viral infection (such as respiratory syncytial virus) and asthma. In a recent New England Journal of Medicine issue the Dutch RSV Neonatal Network reported a randomized, double-blind, placebo-controlled trial and found that premature infants that were given palivizumab (monoclonal antibody for respiratory syncytial virus) had a significant 61% decrease in the total number of wheezing days during their first year of life, compared to not receiving the (extremely expensive) regimen. Reduced wheezing persisted after the prophylaxis period. Is this the future of asthma prevention ? time will tell.
Read NEJM paper and Editorial.
A group from Australia followed children from early life to 8 years of age and found the correlation that pediatricians intuitively think about. Weight gain from 0-18 months is significantly associated with later childhood overweight and obesity. More importantly, it is also correlated with excess central adiposity, higher systolic blood pressure, higher inflammatory markers (CRP) and greater carotid artery wall thickness. Read in pediatrics.
What was known as one of the risk factors for sudden infant death syndrome (SIDS) is now curved in “stone”. Sharing a bed with a baby increased their risk of SIDS fivefold, even without any other known risk factor such as smoking at home and alcohol use. The trend of co-sleeping is abundant in many countries, so advice from the pediatric provider is important. While the rate of SIDS declined in the last decade to 1 in 2000 babies, the decline has plateaued. BMJ Open. Picture: rubyblossom on flickr.
So a group from Ireland had to find an answer to the question – how do children like their hospital glove – ‘Jedward’ or ‘Mohawk’ ?
First a clarification on ‘Jedward’ for those not watching The X Factor TV show. The name relates to the twin performers John and Edward Grimes, known by the name Jedward, who have a unique hair do. ‘Mohawk’ needs no explanation.
Distracting kids during a procedure is important and in the age of iPad and video on demand, some clinicians are still looking for low-cost, easy to use bed-side distractions. So to answer the ‘Jedward’ or ‘Mohawk’ was provided by the Irish investigators who randomized children arriving to their hospital and 75 picked the ‘Jedward’ version and 61 the ‘Mohawk’ version of the glove-baloon.
One thing is for sure – never let the kids play with the glove – this is a choking hazard !
Nice review on the management of Asthma. Full text in Paediatric Child Health.
In a world wide effort to improve quality of life and reduce mortality of premature babies younger than 28 week gestation, three international randomized, controlled trials, compared oxygen saturation of 85-89%, to a level of 91-95% on disability-free survival at 2 years of age.
Lower oxygen saturation was associated with reduced rate of retinopathy of prematurity (relative risk 0.79) but was also associated with an increased rate of necrotizing enterocolitis (relative risk 1.31).
But more importantly, when a trial stops early, such as this one, the message is clear – there is no need for more research. In this large trail, now in the New England Journal of Medicine, interim analysis showed an increased rate of death at 36 weeks in the group with a lower oxygen saturation.
While past recommendations were against pacifier use in children that breastfeed, a recent PRETx review in Canadian Family Physician suggests that breastfeeding cessation is more a parental decision than use of pacifiers. Free full-text.
Routine penicillin prophylaxis and conjugate vaccines are making a difference. This time it is for children with Sickle Cell Disease. While up to 5% were shown to be bacteremia in the past, a recent study from Boston Children’s reports 18 years’ worth of data, and only 9 out of over 1100 children with febrile episodes had bacteremia. There was no morbidity or mortality, even in children discharged from the emergency. Pediatrics is getting closer to the vision of managing children outside the hospital. The paper in Pediatrics.
The Centers for Disease Control and Prevention’s 2011 national Youth Risk Behavior Survey continues to provide alarming data on generation “young”. Among over 8500 adolescents 16 years old or over (US national representative sample), almost half report texting while driving during a 30 days period. Risky in itself, the authors from Atlanta found that these students are more likely to engage in additional risky motor-vehicle behaviors. Now in Pediatrics. t
Tell your adolescent patients, or just text them the link for this YOUTUBE video from “Responsible Young Drivers” : http://www.youtube.com/watch?feature=player_embedded&v=emu25nWf2Do
A group from University of California San Francisco reports randomizing newborn babies who lost 5% or more of their birth weight at 1-2 days of life to continue just breastfeeding or receive some additional formula. For those receiving supplementation – rate of formula use at 1 week was lower and rate of breastfeeding at 3 months was higher. The bottle may have just been what these babies needed – a bridge to better breastfeeding. Read in Pediatrics.
The last recommendation you may expect from the pediatrician is to prescribe children with more video gaming. A study from Australia, now in Journal of Pediatrics, may suggest just that.
Active console games (exergaming) on Xbox 360–Kinect in a small group of children (15) induced significant increase in heart rate and increased energy expenditure, but only if the game was ‘high intensity’ such as 200m Hurdles. Low intensity game like bowling did not ‘do the trick’. Well, this actually make sense. An even better recommendation for children and their parents ? do the actual 200m hurdles outside !
In a meta-analysis published in Pediatrics by a group from Greece, eating frequent meals was associated with lower body weight. The author reviewed 1707 papers and ended summarizing 11 studies with over 18000 children. The findings were true especially in boys.
Fever – the essence keeping pediatric medicine awake at night. With advanced vaccination, invasive testing in the non-verbal febrile child is diminishing slowly. But Urinary Tract Infection is still a culprit. In Annals of Emergency Medicine a good review of past search for UTI and the shifting paradigm for testing less. The authors from New York conclude that it is reasonable to withhold or delay testing for urinary tract infection if signs of other sources are apparent or if the fever has been present for fewer than 4 to 5 days. In the “fever without a source” we still need to “chase” UTI.
Children account for 20% of US emergency department visits, yet specialized peds emergency is far from perfect. A group from Boston, Massachusetts called over 200 randomly selected Emergency Departments and found lack of progress compared to a decade ago. Only a third had pediatric departments, only 1/8 had intensive care units and only a tenth had a separate pediatric ED. Most EDs treated only mild-to-moderate cases of childhood bronchiolitis and asthma and only half were able to care for children with acute appendicitis. In case of Emergency our children may be in trouble. Read International Emergency Medicine.
‘Best news ever’ for parents cleaning their children’s pacifiers by putting it in their mouth ! Of 184 infants 18 and 36 months of age whose parents sucked on their pacifiers to clean them during the first 6 months of life had only a 1/3 of the risk of developing eczema at 18 months of age, compared to children whose parents did not cleaning the pacifiers this way. So possibly saliva stimulate baby’s immune system. Forget hot water, soap or alcohol rub to pacifiers – start sucking on them to clean. See Pediatrics.
More and more evidence is available that chronic fatigue syndrome (CFS) affects children and not only adults as thought before. Among close to 550 adolescents in a specialized UK clinic, the rate of depression among children with CFS the prevalence of depression is close to 29%. As one would expect, this high rate, much more significant than in the population of adolescents, was associated with the amount of disability.
Among 91 adolescents 13-15 who completed a week long random surveys on their activities (primary, secondary, and tertiary attention), watching TV as a primary activity was associated with higher BMI. The amount of time spent watching television was unrelated to BMI.
Could it be commercials seen on the screen ? preferring energy-dense, nutritionally questionable foods ? eating while distracted by TV ? asks the authors from Boston Children’s.
Another interesting finding was that duration of use or extent of attention paid to video games or computers was not associated with BMI. It would have been interesting to determine if “computer time” means active engagement (compared to watching streamed video) that suppressed the desire to eat. Read more in Pediatrics.
Why pediatrics is so exciting and pediatricians so contradictory with their advice …… a great post by Claire McCarthy, MD, a Boston Children’s Hospital pediatrician, on the different pieces of advice we give parents. This one started from discussing sleep advice, but the issue is true for all aspects of parents’ advice.
Will you be satisfied with a drop of almost 50% in the rate of CT scans for children with suspected appendicitis ? we will. Less radiation (and reduced risk of cancer in the future), reduced cost and likely even shorter wait for operation ?
All a group from South Carolina had to do was to sit down and create clinical practice guideline. Pre-guidelines as many as 90% of children had a CT scan, and after implementation – only 48%. Ultrasound rate increased significantly but the no-imaging group also tripled. Published in Pediatric Emergency Care.
Maybe others just need to ‘sit’ and create guidelines.
A brave girl. An impossible diagnosis. A 12 year old with an emotional story about Familial Adenomatous Polyposis, a colon resection and how genetic testing changed her life, for now at least. Sanjay Gupta in Everyday Health.
Look for errors at home as well as in the hospital and clinic setting. After reviewing almost 1000 medications in the homes of children with cancer, a group from Massachusetts School of Medicine report 3.6 errors/100 patients and 36 errors/100 patients with potential for injury. Still lots to do, even at home !
Food allergy increases in the US. 8% have allergy and 30% of them more than one allergy. Dr. Wayne Shreffler from Massachusetts General and Dr. Ruchi Gupta from Chicago on this interesting NPR’s Radio show. GoEpiGo !
Compliance with anti-acne meds seems very low. In a study led by a pharmacist from University of Michigan, reviewing prescription databases of over 24000 patients (90% under 18 years old), average adherence rate to acne drugs was only 11.7%. Patients were less adherent to antibiotics and topical retinoids. The use of oral antibiotics dramatically reduced acne-related outpatient visits (by half) and reduced acne-related total health care cost by half !
Why are they not filling the script ?
Our (childrens’) life by YouTube. In a new paper in Pediatrics, investigators from Miami are concerned about the “Cinnamon Challenge” seen over 50,000 times on YouTube, and resulted in adolescents needing ER visits and hospitalizations. The video calls to try and swallow a tablespoon of cinnamon powder in 60 seconds with no water. The main problem with cinnamon is that it is a caustic powder that neither dissolve nor biodegrade in the lungs. Extensive cough, vomiting, nosebleed, and chest tightness were among the more serious symptoms.
Children want to know. Children need to know. And they usually have three questions on their mind, even if they do not articulate them well. Parents, teachers and pediatric health care providers must de-stress and allow children to understand the news. Psychology Today provides some practical advice to helping children cope with the stress.
Zinc supplementation made a huge difference to the lives of millions of children in developing countries. Zinc is a safe and effective measure to shorten diarrhea-related illness in children and to possibly reduce other complications – including death !. Read in Canadian Family Physician.
In a New York based randomized clinical trial, almost 300 premature babies in a neonatal intensive care unit were monitored while listening to lullabies. Cardiac and respiratory function was improved and even feeding behaviors and sucking patterns were better. But maybe more important, the music significantly decreased parental stress perception. Read the Pediatrics paper.
Sleep was shown over the years to improve physical and mental health. In a large cohort from Philadelphia, published in pediatrics, investigators report that the BMI of adolescents 14-18 years of age can benefit from sleep.
Follow-up on almost 1400 adolescents from ninth to twelfth grade found that the largest increase in BMI observed at the 90th BMI percentile. Each additional hour of sleep was associated with decreases in BMI at percentiles 10th to 90th. Increasing sleep from 7.5 to 10 hours per day at age 18 predicted a reduction in the proportion of adolescents with BMI >25 by 4%.
The challenge of getting adolescents off their computer and social media outlets, and have them sleep more is yet to be addressed.
While the season of bronchiolitis in North America is almost over, effort to find supportive therapy for the viral induced illness are continuing. In pediatrics, a group from the UK, reported an RCT looking at Heliox (21% oxygen + 79% helium) and Airox (21% oxygen + 79% nitrogen) for over 300 infants with bronchiolitis.
Length of treatment required to alleviate hypoxia and respiratory distress was not different between the two groups. When heliox was given via a nasal cannula – treatment was ineffective.
Following the decade-old Institute of Medicine (IOM) report determining no causal relationship between vaccines and autism, a new study in the Journal of Pediatrics challenges the belief that “too many vaccines too soon” may be associated with autism.
Comparing 256 children with autism spectrum disorder compared with 752 children without autism spectrum disorder, the amount of antigens from vaccines received on one day of vaccination and the amount of antigens from vaccines received in total during the first two years of life was not different.
“vaccine phobia” will continue to affect many parents’ decision making when it comes to vaccinating children, but the this study may provide health care providers with more tools to explain the safety of vaccines.
Two-thirds of parents say they don’t always follow the advice they get from their child’s doctor, according to a new poll from the University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health. Enhancing health literacy will also increase compliance. We can tell them what they need to know, answer parents’ questions and refer them to resources.
We know very little on treating functional gastrointestinal disorders in children and keep on learning how little we know. This recent Canadian Family Physician Journal review paper from the PRETx program (www.pretx.org) reflects on the use of antidepressants. Not enough evidence for their effectiveness.
Kids Play – AEDs are easy to use and can save lives. High school students can use them effectively the first time they see them. Read Contemporary Pediatrics with a nice summary on AEDs.
The American Academy of Pediatrics came out this month with an updated Clinical Practice Guideline for the ‘The Diagnosis and Management of Acute Otitis Media’. Bottom line – make the correct diagnosis (redness and effusion are not otitis), reduce pain as part of treatment, antibiotics for severe otitis in everyone 6 month and older, antibiotics for non-severe bilateral otitis in 6-23 month of age, choose observation (and reassessment) or treatment for non-severe unilateral otitis in 6-23 month of age or any otitis in older children.
Amoxicillin still the drug of choice. Give antibiotics with lactamase coverage for recurrent infections, recurrent purulent conjunctivitis and non-responders to Amox.
A must read for everyone treating children !
Zed et al in Journal of Pediatrics reviewed papers with medication-related ED visits and hospital admissions. 0.5%-3.3% ended up in emergency department, 0.16%-4.3% had to be admitted, and up to two thirds were preventable !
From wrong prescription to overdose, allergic reaction and adverse drug reactions – all were documented well. The biggest offenders : antibiotics, CNS drugs, analgesics, hormones, cardiovascular and respiratory drugs and even vaccines.
In a finely designed study, Martin et al found breastfeeding does not promote reduced obesity later in life. In a cluster-randomized controlled trial in Belarus, with over 17 000 breastfeeding mother-infant pairs in 31 hospitals, child adiposity and circulating insulin-like growth factor (IGF)-I were not affected by exclusivity breastfeeding. Children may still be overweight or obese.
Read the CNN piece on enhancing attention using stimulants in healthy children. The American Academy of Neurology position paper againt the common practice of prescribing stimulants (and other drugs) to boost cognitive function in healthy children and teens.
Based on a New England Journal of Medicine paper on the known risk for prolonged QT interval and torsades de pointes – a new FDA warning is published. Should an ECG be done on every child on Azithro ?
They cry – so lets treat them. While tolerated, PPIs in infants and children who cry do not show efficacy. They can cause gastro, pneumonia and other complications. Read this PRETx update in Canadian Family Physician.
Celiac Disease and Immunization
Probiotics and Allergic Rhinitis
Smart Phone for Otitis Rescue
Children Still Suffer
Physicians and Drug Reps
Geographic Variability of Food Allergy
The ‘First Dinner’
Localized Purpuric Rash
The Benefits of Friends (the real ones….)
The Best Children’s Hospitals in the US
Anaphylaxis Following Immunization
Children Grow Online
Boxing for Children – a Health Issue ?
CT scans induce radiation exposure and Cancer
Baby Genome for a Price
Free Med School ?
Hypertonic Saline for Wheezing
The Clinical Picture of a Perforated appendix
Biomarker for Head Injury
Music and the Brain
Cancer and Folic Acid
Internet Exposure in Childhood
Nebulizers or Pressurized MDIs for Asthma
Marketing Breast Milk Substitutes
Nighttime wakening post maternal Java
Hypertension on the Rise
Analgesia for Vaccinations
Time Magazine challenges Attachment parenting
Prolonged Pregnancy and ADHD
Overweight and Diabetes
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November 12, 2009 |
Jerusalem, November 12, 2009 — How a specific gene within the pancreas affects secretion of insulin has been discovered by researchers from the Hebrew University of Jerusalem, in collaboration with Japanese and American universities. Their work opens the way for a new understanding of possible paths to battle diabetes and diabetes-related health problems, which are on the rise all over the world.
Blood glucose levels are tightly regulated by secretion of insulin from beta cells in the pancreas. Defective insulin secretion results in poorly regulated blood glucose levels and diabetes.
The work of the multi-national research team explored the role of LKB1, a gene involved in many cellular functions, whose role in the pancreas was not examined before. Specifically, they studied the implications of beta cell-specific loss of the LKB1 gene, using a mouse model system. They were able to show that eliminating this gene from beta cells causes the production and secretion of more insulin than normal beta cells, resulting in an enhanced response to increases in blood glucose levels.
The findings have potentially great implications for those suffering from diabetes (excessive blood sugar) due to insufficient production of insulin in the pancreas.
Since it was shown that LKB1 negatively regulates both insulin content and secretion, the way has now been opened to possible development of a novel therapy that would limit the presence of this gene in pancreas beta cells, thus enhancing insulin secretion.
The researchers involved in the project, whose findings were published recently in the journal Cell Metabolism, were led by Dr. Yuval Dor of the Institute for Medical Research Israel-Canada of the Hebrew University-Hadassah Medical School and included students Zvi Granot, Avital Swisa, Judith Magenheim and Miri Stolovitch-Rain, as well as scientists from Kobe University in Japan, and American researchers from the University of Pennsylvania, Washington University in St. Louis and Massachusetts General Hospital in Boston.
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With summer right around the corner, everyone should be thinking about sun protection. In fact, those of us who spend many hours outside during the early spring should already be ahead of the curve.
Still, many people misunderstand both the dangers and the necessary steps to protect their skin from sun damage, which includes skin cancer and acute damage like sunburn and sun poisoning.
There's No 'Safe' Tan
Probably the biggest misconception people have about sun care is that suntans are healthy. The fact is, a suntan is the body's response to damage. When the sun's rays are absorbed by the skin, cells called melanocytes produce melanin, a pigment that gives the skin color. The added melanin offers increased protection for future exposure.
However, it's important to emphasize that if skin tans, damage has already occurred. Moreover, sunburn is a severe response to excessive sun exposure, which exceeds the skin's melanin production response.
What Harm Is a Little Burn?I often hear, "I got a little sunburn, but it's no big deal." Unfortunately, while tans and burns are signs of damage, each time we burn we greatly increase our risk for skin cancer—one blistering sunburn doubles your risk for malignant melanoma, the most dangerous and ever-increasing form of skin cancer.
Athletes in particular should keep in mind that sunburns and acute sun poisoning can cause headaches, nausea, fever and fatigue. Nevertheless, a 'healthy tan' is often popular, particularly among cyclists, who often pride themselves on their tan lines.
Have Sunscreen, Will Tan
Another common misconception is that wearing sunscreen will prevent tanning. In fact, those of us who spend long hours in the sun will tan no matter how much sunscreen we use. Rather than going without sunscreen for a few days to get tan, use it liberally because even the strongest broad spectrum sunscreens can't block 100 percent of UVB rays, and are even less effective against UVA rays. You'll still tan through sunscreen, so there's no reason to avoid using it.
Liberal use of sunscreen is the least we can do to protect ourselves, but proper use is critical! Apply 1 ounce (about 2 tablespoons) of at least SPF 30 sunscreen to all exposed skin at least 20 minutes before going outside to allow it time to 'soak' in and offer the best protection. Be sure to get all the easily-missed areas like behind ears and knees, as well as below your waist band. Apply a little extra on the nose and forearms, which get the most exposure. Reapply every two hours, regardless of SPF.
Sunscreen, Clothing, Ergogenic Aids?
The human body can be considered a near-perfect black radiator, absorbing 97 percent of radiant energy directed at it, regardless of skin color. So while it may sound implausible, wearing both sunscreen and clothing can actually enhance performance by reducing the amount of radiant energy absorbed by the skin; even small increases in body temperature can adversely affect performance.
Additionally, wearing sunscreen on covered areas during hot and sunny days can be beneficial too, since those great wicking fabrics are also great at letting more sun in.
Sun Block or Sweat Block?
While use of sunscreen can reduce radiant heat absorption, many athletes are concerned that sunscreen will also hamper sweating. However, data from a 2000 research study published in the Journal Sports Medicine and Physical Fitness showed that use of sunscreen doesn't affect thermoregulation—in fact, it may actually enhance overall body cooling. This data, while preliminary, should convince those who believe sunscreen will compromise their performance to start protecting their skin.
More: Sun Protection 101
Managing Your Risk
Because of training and racing, many athletes are unable to avoid the sun during certain times of the day. While it's best to avoid the peak sun hours between 10 a.m. and 4 p.m., many competitions take place during this time. In order to adequately acclimatize to hot weather, an athlete must train intensely during these hot parts of the day, making use of sunscreen all the more important.
The bottom line is that we all need to do the best we can to reduce our risk while maximizing our performance. The most important thing to understand is that sunscreen doesn't hurt performance, it can actually improve your performance by protecting against burns and keeping you cooler in the heat.
Stay in shape in a fitness class.
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[News release] Losing 30 minutes of sleep per day may promote weight gain and adversely affect blood sugar control
….At 12 months, for every 30 minutes of weekday sleep debt at baseline, the risk of obesity and insulin resistance was significantly increased by 17% and 39%, respectively….
From the 9 December 2014 McGill University press release
Extract of Irish potatoes, rich in polyphenols, reduces weight gain to a surprising extentPublished: 9Dec2014
Take a look in your pantry: the miracle ingredient for fighting obesity may already be there. A simple potato extract may limit weight gain from a diet that is high in fat and refined carbohydrates, according to scientists at McGill University.
The results of their recent study were so surprising that the investigators repeated the experiment just to be sure.
Investigators fed mice an obesity-inducing diet for 10 weeks. The results soon appeared on the scale: mice that started out weighing on average 25 grams put on about 16 grams. But mice that consumed the same diet but with a potato extract gained much less weight: only 7 more grams. The benefits of the extract are due to its high concentration of polyphenols, a beneficial chemical component from the fruits and vegetables we eat.
“We were astonished by the results,” said Prof. Luis Agellon, one of the study’s authors. “We thought this can’t be right – in fact, we ran the experiment again using a different batch of extract prepared from potatoes grown in another season, just to be certain.”
The rate of obesity due to over-eating continues to rise in Canada, affecting 1 in every 4 adults. Obesity increases the risk of cardiovascular disease and cancer. According to this study, potato extracts could be a solution for preventing both obesity and type 2 diabetes.
Extract derived from 30 potatoes
“The daily dose of extract comes from 30 potatoes, but of course we don’t advise anyone to eat 30 potatoes a day,” says Stan Kubow, principal author of the study, “as that would be an enormous number of calories.” What the investigators envisage instead is making the extract available as a dietary supplement or simply as a cooking ingredient to be added in the kitchen.
Popularly known for its carbohydrate content, the potato is also a source of polyphenols. “In the famous French diet, considered to be very healthy, potatoes – not red wine – are the primary source of polyphenols,” says Kubow. “In North America, potatoes come third as a source of polyphenols – before the popular blueberries.”
A low-cost solution
“Potatoes have the advantage of being cheap to produce, and they’re already part of the basic diet in many countries,” Kubow explains. “We chose a cultivated variety that is consumed in Canada and especially rich in polyphenols.”
Tel Aviv University research shows fat mass in cells expands with disuse
Over 35 percent of American adults and 17 percent of American children are considered obese, according to the latest survey conducted by the Centers for Disease Control and Prevention. Associated with diabetes, heart disease, stroke, and even certain types of cancer, obesity places a major burden on the health care system and economy. It’s usually treated through a combination of diet, nutrition, exercise, and other techniques.
To understand how obesity develops, Prof. Amit Gefen, Dr. Natan Shaked and Ms. Naama Shoham of Tel Aviv University’s Department of Biomedical Engineering, together with Prof. Dafna Benayahu of TAU’s Department of Cell and Developmental Biology, used state-of-the-art technology to analyze the accumulation of fat in the body at the cellular level. According to their findings, nutrition is not the only factor driving obesity. The mechanics of “cellular expansion” plays a primary role in fat production, they discovered.
By exposing the mechanics of fat production at a cellular level, the researchers offer insight into the development of obesity. And with a better understanding of the process, the team is now creating a platform to develop new therapies and technologies to prevent or even reverse fat gain. The research was published this week in the Biophysical Journal.
Getting to the bottom of obesity
“Two years ago, Dafna and I were awarded a grant from the Israel Science Foundation to investigate how mechanical forces increase the fat content within fat cells. We wanted to find out why a sedentary lifestyle results in obesity, other than making time to eat more hamburgers,” said Prof. Gefen. “We found that fat cells exposed to sustained, chronic pressure — such as what happens to the buttocks when you’re sitting down — experienced accelerated growth of lipid droplets, which are molecules that carry fats.
“Contrary to muscle and bone tissue, which get mechanically weaker with disuse, fat depots in fat cells expanded when they experienced sustained loading by as much as 50%. This was a substantial discovery.”
The researchers discovered that, once it accumulated lipid droplets, the structure of a cell and its mechanics changed dramatically. Using a cutting-edge atomic force microscope and other microscopy technologies, they were able to observe the material composition of the transforming fat cell, which became stiffer as it expanded. This stiffness alters the environment of surrounding cells by physically deforming them, pushing them to change their own shape and composition.
“When they gain mass and change their composition, expanding cells deform neighboring cells, forcing them to differentiate and expand,” said Prof. Gefen. “This proves that you’re not just what you eat. You’re also what you feel — and what you’re feeling is the pressure of increased weight and the sustained loading in the tissues of the buttocks of the couch potato.”
The more you know …
“If we understand the etiology of getting fatter, of how cells in fat tissues synthesize nutritional components under a given mechanical loading environment, then we can think about different practical solutions to obesity,” Prof. Gefen says. “If you can learn to control the mechanical environment of cells, you can then determine how to modulate the fat cells to produce less fat.”
The team hopes that its observations can serve as a point of departure for further research into the changing cellular environment and different stimulations that lead to increased fat production.
March 19, 2014
American Heart Association
Kids whose parents are demanding but not emotionally responsive are about one-third more likely to be obese than kids whose parents set healthy boundaries, are affectionate and discuss behavior. Researchers compared kids whose parents are generally affectionate, have reasonable discussions about behavior with their child and set healthy boundaries (authoritative) with those whose parents were strict about limits without much dialogue or affection (authoritarian).
The same kinds of impulsive behavior that lead some people to abuse alcohol and other drugs may also be an important contributor to an unhealthy relationship with food, according to new research from the University of Georgia.
In a paper published recently in the journal Appetite, researchers found that people with impulsive personalities were more likely to report higher levels of food addiction — a compulsive pattern of eating that is similar to drug addiction — and this in turn was associated with obesity.
“The notion of food addiction is a very new one, and one that has generated a lot of interest,” said James MacKillop, the study’s principal investigator and associate professor of psychology in UGA’s Franklin College of Arts and Sciences. “My lab generally studies alcohol, nicotine and other forms of drug addiction, but we think it’s possible to think about impulsivity, food addiction and obesity using some of the same techniques.”
More than one-third of U.S. adults are obese, according to the Centers for Disease Control and Prevention, putting them at greater risk for heart disease, stroke, type 2 diabetes and certain types of cancer. The estimated annual medical cost of obesity was $147 billion in 2008 U.S. dollars, and obese people pay an average of $1,429 more in medical expenses than those of normal weight.
MacKillop and doctoral students Cara Murphy and Monika Stojek hope that their research will ultimately help physicians and other experts plan treatments and interventions for obese people who have developed an addiction to food, paving the way for a healthier lifestyle.
The contemporary food industry has created a wide array of eating options, and foods that are high in fat, sodium, sugar and other flavorful additives and appear to produce cravings much like illicit drugs, MacKillop said. Now they will work to see how those intense cravings might play a role in the development of obesity.
“Modern neuroscience has helped us understand how substances like drugs and alcohol co-opt areas of the brain that evolved to release dopamine and create a sense of happiness or satisfaction,” he said. “And now we realize that certain types of food also hijack these brain circuits and lay the foundation for compulsive eating habits that are similar to drug addiction.”
From the 30 December 2013 EurkAlert
According to new study of normal-weight and overweight or obese individuals published in the Journal of the Academy of Nutrition and Dietetics
Philadelphia, PA, December 30, 2013 – Obesity rates in the United States increased from 14.5% of the population in 1971-1974 to 35.9% of the population in 2009-2010. It’s believed that one contributing factor to expanding waistlines is the reported increase in energy intake. Research suggests that the ability to control energy intake may be affected by the speed at which we eat, and a high eating rate may impair the relationship between the sensory signals and processes that regulate how much we eat.
In order to learn more about the relationship between eating speed and energy intake, a team of researchers in the Department of Kinesiology at Texas Christian University took a look at how eating speed affects calories consumed during a meal in both normal weight subjects as well as overweight or obese subjects. The investigators also collected data on feelings of hunger and fullness before and after the fast-paced and slow-paced meals and water consumption during the meals. Their results are published in the Journal of the Academy of Nutrition and Dietetics.
While previous studies have reviewed the relationship between eating speed and body weight, most of those studies were conducted with normal-weight individuals. In this new study, investigators asked a group of normal-weight subjects and a group of overweight or obese subjects to consume two meals in a controlled environment. All subjects ate one meal at a slow speed, for which they were instructed to imagine that they had no time constraints, take small bites, chew thoroughly, and pause and put the spoon down between bites, and a second meal at a fast speed, for which they were instructed to imagine that they had a time constraint, take large bites, chew quickly, and not pause and put the spoon down.
At the conclusion of the study, researchers found that only normal-weight subjects had a statistically significant reduction in caloric consumption during the slow compared to the fast meal: 88 kcal less for the normal weight group, versus only 58 kcal less for the overweight or obese group.
“Slowing the speed of eating led to a significant reduction in energy intake in the normal-weight group, but not in the overweight or obese group. A lack of statistical significance in the overweight and obese group may be partly due to the fact that they consumed less food during both eating conditions compared to the normal-weight subjects,” explained lead author Meena Shah, PhD, professor in the Department of Kinesiology at Texas Christian University. “It is possible that the overweight and obese subjects felt more self-conscious, and thus ate less during the study.”
Despite the differences in caloric consumption between the normal-weight and overweight and obese subjects, the study found some similarities. Both groups felt less hungry later on after the slow meal than after the fast meal. “In both groups, ratings of hunger were significantly lower at 60 minutes from when the meal began during the slow compared to the fast eating condition,” added Dr. Shah. “These results indicate that greater hunger suppression among both groups could be expected from a meal that is consumed more slowly.”
Also, both the normal weight and overweight or obese groups consumed more water during the slow meal. During the fast condition, participants across the study only consumed 9 ounces of water, but during the slow condition, that amount rose to 12 ounces. “Water consumption was higher during the slow compared to the fast eating condition by 27% in the normal weight and 33% in the overweight or obese group. The higher water intake during the slow eating condition probably caused stomach distention and may have affected food consumption,” said Dr. Shah.
With obesity rates continuing to rise among the adult population in the United States, information about how different weight groups approach and consume food will be helpful in crafting strategies to lower energy intake, but for now, Dr. Shah suggested, “Slowing the speed of eating may help to lower energy intake and suppress hunger levels and may even enhance the enjoyment of a meal.”
Yes to Calories on Menus, No to Soda Limits
Most Americans (69%) see obesity as a very serious public health problem, substantially more than the percentages viewing alcohol abuse, cigarette smoking and AIDS in the same terms. In addition, a broad majority believes that obesity is not just a problem that affects individuals: 63% say obesity has consequences for society beyond the personal impact on individuals. Just 31% say it impacts the individuals who are obese but not society more broadly.
Yet, the public has mixed opinions about what, if anything, the government should do about the issue. A 54% majority does not want the government to play a significant role in reducing obesity, while 42% say the government should play a significant role. And while some proposals for reducing obesity draw broad support, others are decidedly unpopular.
(The survey was conducted before the Food and Drug Administration’s proposal last Thursday to severely restrict trans fats nationwide.) 1
- When should we start addressing obesity in America? (consumersresearch.org)
- Roadmap to treat adults affected by obesity, overweight (medicalnewstoday.com)
All people have trillions of bacteria living in their intestines. If you place them on a scale, they weigh around 1.5 kg. Previously, a major part of these ‘blind passengers’ were unknown, as they are difficult or impossible to grow in laboratories. But over the past five years, an EU-funded research team, MetaHIT, coordinated by Professor S. Dusko Ehrlich at the INRA Research Centre of Jouy-en-Josas, France and with experts from Europe and China have used advanced DNA analysis and bioinformatics methods to map human intestinal bacteria.
-The genetic analysis of intestinal bacteria from 292 Danes shows that about a quarter of us have up to 40% less gut bacteria genes and correspondingly fewer bacteria than average. Not only has this quarter fewer intestinal bacteria, but they also have reduced bacterial diversity and they harbour more bacteria causing a low-grade inflammation of the body. This is a representative study sample, and the study results can therefore be generalised to people in the Western world, says Oluf Pedersen, Professor and Scientific Director at the Faculty of Health and Medical Sciences, University of Copenhagen.
Oluf Pedersen and Professor Torben Hansen have headed the Danish part of the MetaHIT project, and the findings are reported in the highly recognised scientific journal Nature.
The gut is like a rainforest
Oluf Pedersen compares the human gut and its bacteria with a tropical rainforest. He explains that we need as much diversity as possible, and – as is the case with the natural tropical rainforests – decreasing diversity is a cause for concern. It appears that the richer and more diverse the composition of our intestinal bacteria, the stronger our health. The bacteria produce vital vitamins, mature and strengthen our immune system and communicate with the many nerve cells and hormone-producing cells in the intestinal system. And, not least, the bacteria produce a wealth of bioactive substances which penetrate into the bloodstream and affect our biology in countless ways.
-Our study shows that people having few and less diverse intestinal bacteria are more obese than the rest. They have a preponderance of bacteria which exhibit the potential to cause mild inflammation in the digestive tract and in the entire body, which is reflected in blood samples that reveal a state of chronic inflammation, which we know from other studies to affect metabolism and increase the risk of type 2 diabetes and cardiovascular diseases, says Oluf Pedersen.
-And we also see that if you belong to the group with less intestinal bacteria and have already developed obesity, you will also gain more weight over a number of years. We don’t know what came first, the chicken or the egg, but one thing is certain: it is a vicious circle that poses a health threat, says the researcher.
Take care of your intestinal bacteria
The researchers thus still cannot explain why some people have fewer intestinal bacteria, but the researchers are focusing their attention at dietary components, genetic variation in the human host, exposure to antimicrobial agents during early childhood and the chemistry we encounter daily in the form of preservatives and disinfectants.
A French research team reports a study in the same issue of Nature showing that by maintaining a low-fat diet for just six weeks, a group of overweight individuals with fewer and less diverse intestinal bacteria may, to some extent, increase the growth of intestinal bacteria, both in terms of actual numbers and diversity.
-This indicates that you can repair some of the damage to your gut bacteria simply by changing your dietary habits. Our intestinal bacteria are actually to be considered an organ just like our heart and brain, and the presence of health-promoting bacteria must therefore be cared for in the best way possible. Over the next years, we will be gathering more knowledge of how best to do this,” says Oluf Pedersen, whose research team is studying, among other things, the impact of dietary gluten on gut bacteria composition and gut function.
Towards innovative early diagnostics and treatment options
Obesity and type 2 diabetes are not just a result of unfortunate combinations of intestinal bacteria or lack of health-promoting intestinal bacteria, Oluf Pedersen emphasises. There are likely many causal factors at play. But the MetaHit researchers’ contribution opens a new universe in which we begin to understand how gut bacteria in direct contact with the surrounding environment have a decisive impact on our health and risk of disease.
-At present we cannot do anything about our own DNA, individual variation in which also plays a crucial role in susceptibility for lifestyle diseases. But thanks to the new gut microbiota research, we now can start exploring interactions between host genetics and the gut bacteria- related environment which we may be able to change. That is why it is so exciting for us scientist within this research field– the possibilities are huge, says Oluf Pedersen.
-The long-term dream is to map and characterize any naturally occurring gut bacteria that produce appetite-inhibiting bioactive substances and in this way learn to exploit the body’s own medicine to prevent the obesity epidemic and type 2 diabetes, says Oluf Pedersen.
“as Americans live longer, they are living longer with illness.”
“The top driver of disease is a bad diet.”
- Disease and death in America: A poor bill of health | The Economist (dralfoldman.com)
- Disease and death in America: A poor bill of health | The Economist (policyabcs.wordpress.com)
- America’s Health Report Card Shows Improvement Needed (voanews.com)
- Higher BMI Increases Risk Of Gallstones, Especially In Women (medicalnewstoday.com)
- United States losing ground to other countries in health outcomes (eurekalert.org)
- U.S. health “mediocre” compared to other wealthy countries (cbsnews.com)
- Embracing disease, not eradicating it. (watsonfor13.wordpress.com)
Originally posted on THE POLICY THINKSHOP "Think Together":
Health insurance coverage to help you fix decades of high cholesterol will probably not save your life. This is the problem that America faces as it is found to be sick because of health behaviors it does not want to change. We have the freedom to act very unhealthy and to get sick. How much will increasing insurance coverage really improve our health?
“THE Affordable Care Act, or Obamacare, faces an immediate problem. The deadline for its insurance expansion is January 1st, but each week brings some new obstacle. Even if Obamacare overcomes these, a long-term challenge will remain: the law may not improve Americans’ health. And that health is dismal, as illuminated in vivid new detail on July 10th.
Christopher Murray and his colleagues at the University of Washington have new research on which ailments plague Americans, and why. Dr Murray is due to present his findings at the…
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Interesting, thoughtful take on current movements focusing on food environments (schools, neighborhoods) before there is enough evidence.
Originally posted on Weight Maven:
Social policy researcher Helen Lee thinks food activism is leading public health astray (emphasis mine):
Much of the American public health and medical establishment came to believe that one of the most powerful ways to overcome the [obesity] epidemic was to radically remake our school and neighborhood food environments, reducing access to unhealthy foods and increasing access to healthy ones.
But in their rush to condemn corporate agribusiness, food marketers, and neighborhood food environments, public health advocates have too often allowed their policy and ideological preferences to race ahead of the science. This has fostered a reductive story about obesity that appeals to liberal audiences but doesn’t comport particularly well with much of what we know about why people choose to eat unhealthy foods, what the health consequences of being overweight or obese actually are, or why health outcomes associated with obesity are so much worse among some populations than…
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As an aside, I stopped participating in alumni band during football homecoming.
Just don’t want to be part of this sport which in increasingly unhealthy in the short and long run.
You’ve probably watched the Super Bowl as I have many times, faithfully, elevating the occasion to some kind of macabre family tradition. It is a spectacle of athletic agility, drama, and struggle; the pinnacle of American sporting contests. Despite the heavy onslaught of commercialism, faux halftime culture, and evident violence on the field, we suspend our awareness that this event may not be a magical moment worth our time and validation, even as its winners call out to some magical Disney kingdom.
Here are 7 points to consider:
7. Obesity and cardiovascular disease. Up to 45% of youth participating in football are overweight or obese. The nature of the sport favors, and increasingly demands, a large body size. The physique acquired in adolescence often persists into adulthood.
According to a 2007 study of 653 boys ages 8-14 playing football in Michigan, 20% were overweight and another 25% were obese, as defined by body mass index.Studies have shown that linemen have high early mortality rates, and for all professional players who have played 5 years or more, life expectancy is less than 60.
6) MRSA infections and abscesses. Quarterbacks Tom Brady and Peyton Manning have suffered from it.
- CTE Continued (Buckeye Surgeon)
CTE is an abbreviation for Chronic Traumatic Encephalopathy (Head Trauma)
Search the blog with CTE for other related postings by this Ohio physician
- Super Bowl XLVII and sex trafficking (multiplyjustice.net)
Originally posted on Johns Hopkins University Press Blog:
Guest post by Maxwell J. Mehlman
In a November article for the New England Journal of Medicine, Harvard law professors Michelle Mello and Glenn Cohen argue that in upholding the Affordable Care Act’s individual insurance mandate as a tax the Supreme Court “has highlighted an opportunity for passing creative new public health laws.” As a bioethicist who writes extensively on the question of coercive public health this troubled me on several fronts. In this case, Mello and Cohen give an example of the laws that they have in mind: higher taxes on people whose body-mass index falls outside of the normal range, who do not produce an annual health improvement plan with their physician, who do not purchase gym memberships, who are diabetic but fail to control their glycated hemoglobin levels, and who do not declare that they were tobacco-free during the past year.
Some of these suggestions seem ineffectual…
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Pregnant women who are highly exposed to common environmental chemicals — polyfluoroalkyl compounds (PFCs) — have babies that are smaller at birth and larger at 20 months of age, according to a study from Emory University’s Rollins School of Public Health published online in the August 30 edition ofEnvironmental Health Perspectives.
PFCs are used in the production of fluoropolymers and are found widely in protective coatings of packaging products, clothes, furniture and non-stick cookware. They are persistent compounds found abundantly in the environment and human exposure is common. PFCs have been detected in human sera, breast milk and cord blood…
The researchers found that even though girls with higher exposure were smaller than average (43rd percentile) at birth, they were heavier than average (58th percentile) by 20 months of age. The authors say this path may lead to obesity at older ages.
“Previous animal and human research suggests prenatal exposures to PFCs may have harmful effects on fetal and postnatal growth,” says lead researcher Michele Marcus, MPH, PhD, a professor of epidemiology in Emory’s Rollins School of Public Health and the assistant program director at Kaiser Permanente’s Center for Health Research.
“Our findings are consistent with these studies and emerging evidence that chemicals in our environment are contributing to obesity and diabetes and demonstrate that this trajectory is set very early in life for those exposed.”
According to Marcus, a recent study in Denmark found that women exposed to PFCs in the womb were more likely to be overweight at age 20. And experimental studies with mice have shown that exposure in the womb led to higher levels of insulin and heavier body weight in adulthood….
- Chemical exposure in the womb from household items may contribute to obesity (engineeringevil.com)
- Chemical exposure in the womb from household items may contribute to obesity (scienceblog.com)
- Chemical exposure in the womb from household items may contribute to obesity (eurekalert.org)
- Chemical exposure in the womb from household items may contribute to obesity (medicalxpress.com)
- Child obesity link to magnetic field exposure in the womb (nyrnaturalnews.com)
- Exposure To Magnetic Fields In The Womb Associated With Increased Risk Of Obesity In Childhood (medicalnewstoday.com)
- Exposure To Chemical In Drinking Water In The Womb And Early Childhood May Affect Vision (medicalnewstoday.com)
- Diesel Exhaust Exposure In The Womb A Possible Risk Factor For Obesity (medicalnewstoday.com)
- Exposure to environmental chemicals in the womb reprograms the rodent brain to disrupt reproduction (medicalxpress.com)
- Widely Used Pesticide Harms Boys’ Brains (eastbayexpress.com)
Most of America’s urban cores were designed for walking but offer little in the way of supermarkets, healthy restaurants and other amenities for residents to walk to, according to a study led by a Michigan State University scholar.
The study is one of the first to show that poor residents living in declining urban neighborhoods want healthy food choices – evidenced by their willingness to travel long distances to find them. Past research has generally assumed that poor people will shop at whatever store is closest.
But compared with suburban residents, the urban poor are more overweight and must travel farther to find healthy food and access personal services, said Igor Vojnovic, associate professor of geography and lead author on the study…
..Other findings included:
- Fast food restaurants were more plentiful in poor neighborhoods. In addition, residents there reported that 55 percent of all dining-out experiences were at fast food eateries, compared with only 13 percent for those in the suburbs.
- Poor urban residents had to go nearly twice as far as suburbanites to shop at supermarkets.
- The urban poor made about five trips per month to convenience stores (which aren’t known for stocking healthy foods) compared with only one trip per month for suburbanites…
During the past 30 years, urban planners and business investors have largely ignored poor communities, instead focusing policy, research and investment efforts on wealthier neighborhoods, Vojnovic said. As a result, little is known about resident behaviors in declining communities, even as the number of poor people increases in the United States, he said.
The current study shows that the fundamental principles in city planning and design that have been developed around wealthy communities do not necessarily hold in poor neighborhoods.
Meanwhile, some have advocated an “obesity tax” on unhealthy foods to help pay for the health-care system overhaul or as a policy to curtail obesity. But Vojnovic said such a tax would disproportionately burden the urban poor and noted that this population has little power to influence the location decisions of healthy food suppliers.
- Urban poor plagued by ‘burdens of place’ (scienceblog.com)
- Urban poor need to hunt for healthy food (futurity.org)
- Urban poor need to hunt for healthy food (holykaw.alltop.com)
- Kinder Work Schedules May Reduce Obesity (theepochtimes.com)
- Obesity and Your Dental Health (topdentists.com)
- Overtime Shifts May Increase Obesity Rates Among Nurses (medicalnewstoday.com)
- AMA and Mercy Aligned in Educating Kids about the Dangers of Obesity (prweb.com)
- Fat of the land: how urban design can help curb obesity (healthycities.wordpress.com)
- Study: Junk food laws may help curb kids’ obesity (rep-am.com)
The New Science Behind America’s Deadliest Diseases – WSJ.com (16th July 2012)
What do heart disease, diabetes, Alzheimer’s, stroke and cancer have in common? Scientists have linked each of these to a condition known as chronic inflammation, and they are studying how high-fat foods and excess body weight may increase the risk for fatal disorders.
Inflammation is the body’s natural response to injury and outside irritants. But when the irritants don’t let up, because of a diet of high-fat foods, too much body fat and smoking, for example, the immune system can spiral out of control and increase the risk for disease. Experts say when inflammation becomes chronic it can damage heart valves and brain cells, trigger strokes, and promote resistance to insulin, which leads to diabetes. It also is associated with the development of cancer.
Much of the research on chronic inflammation has focused on fighting it with drugs, such as cholesterol-lowering statins for heart disease. A growing body of research is revealing how abdominal fat and an unhealthy diet can lead to inflammation. Some scientists are investigating how certain components in foods might help. Dietary fiber from whole grains, for instance, may play a protective role against inflammation, a recent study found. And dairy foods may help ease inflammation in patients with a combination of risk factors…
…A substance known as C-reactive protein, measured with a simple blood test, is an indicator of inflammation in the body. A report published in Archives of Internal Medicine in 2007, which analyzed results of 33 separate studies, found that losing weight can lower C-reactive protein levels. For each one kilogram, or 2.2 pounds, of weight loss, whether by dieting, exercise or surgery, the mean reduction in C-reactive protein among participants was 0.13 milligram per liter…
..At a meeting in Quebec City last week on abdominal obesity and its health risks, experts in cardiology, endocrinology, nutrition and related specialties presented a wide range of new research linking obesity to inflammation-related diseases…
- What do heart disease, diabetes, Alzheimer’s, stroke and cancer have in common? (warmsouthernbreeze.wordpress.com)
- A.M. Vitals: Inflammation and Disease (blogs.wsj.com)
- Diet, Deadly Ailments Linked to Inflammation (pochp.wordpress.com)
- The silent killer: Modern lifestyle promotes Leaky Gut and low-level chronic inflammation (theaveragejoenewsblogg.com)
- Inflammation and food (therealfoodchannel.com)
- A.M. Vitals: Anticipation on Alzheimer’s (blogs.wsj.com)
San Diego, CA, April 10, 2012 – The neighborhoods in which children and adolescents live and spend their time play a role in whether or not they eat a healthy diet, get enough exercise or become obese, concludes a collection of studies in a special theme issue of the American Journal of Preventive Medicine.
Each of the six studies uses the latest concepts and methods in geographic information systems (GIS)-based research to determine how the geographic location affects physical health. A study titled “Spatial Classification of Youth Physical Activity Patterns” shows, for example, that while rural youth get the largest proportion of their physical activity while at school, urban and suburban youth are most active when commuting. Not only does this finding suggest that the walk to school might be just as important to some children’s health as is the physical education they receive as part of the school curriculum, it is also important given that adolescent health behaviors are predictive of behaviors in adults.
Another study by researchers in the United Kingdom concludes that adolescents in rural areas ate fast food more often when fast-food outlets were easily accessible, whereas the opposite was true for adolescents living in urban areas. The researchers, led by Lorna J. Fraser of the University of Leeds, conclude that although the need continues to exist for nutritional education regarding fast food, placing restrictions on the location of fast-food outlets may not decrease consumption of fast food in the same ways in all areas.
Brian E. Saelens and Lawrence D. Frank, along with their colleagues, authored two papers for the theme issue. “Obesogenic Neighborhood Environments, Child and Parent Obesity: The Neighborhood Impact on Kids Study” evaluated child and parent weight status across neighborhoods in Seattle and San Diego and ultimately found evidence that GIS-based definitions of obesogenic neighborhoods that consider both physical activity and the availability of healthy food options were strongly related to childhood obesity.
In a second study, the researchers used GIS-based measures to determine the ‘walkability’ and proximity to healthy food of certain neighborhoods in the San Diego and Seattle regions. The study recommends that such measures be used to study physical activity, nutrition and obesity outcomes.
In a paper titled “Obesogenic Environments in Youth: Concepts and Methods from a Longitudinal National Sample,” Janne Boone-Heinonen and colleagues describe the challenges inherent to longitudinal neighborhood environment research, as well as the insights they gained and the advances and remaining gaps in study design. The researchers note that understanding which neighborhood environment features influence weight gain in various age groups is essential to effectively prevent and reduce childhood obesity.
Two commentaries included in the theme issue examine the ways that computer-based GIS systems—which transform geospatial data into visual representations of the real world—can help prevent childhood obesity. “Thinking About Place, Spatial Behavior, and Spatial Process in Childhood Obesity” by Stephen A. Matthews, outlines the content of the theme, concluding that although GIS is not a panacea, it “offers an important means of better understanding and dealing with some of the most pressing problems of our time, and provides valuable tools for researchers and policymakers alike.”
The second commentary, providing a perspective from the Robert Wood Johnson Foundation, notes that while GIS is still in the relatively early stages of application in the field, it might one day enhance understanding of the complex and dynamic connections between people, their health and their physical and social environments.
Report Finds Reducing Average Body Mass Index Rates by Five Percent Could Lead to Billions in Health Care Savings
The Trust for America’s Health (TFAH) has released a new report, Bending the Obesity Cost Curve, which finds that reducing the average body mass index by just five percent in the United States could lead to more than $29 billion in health care savings in just five years, due to reduced obesity-related costs.
- Increasing Body Mass Index Lowers Quality of Life in Obese Individuals (ahrq.gov)
- Investments in Public Health and Prevention Save Lives and Money (jflahiff.wordpress.com)
- What Is A Healthy Weight? (medicalnewstoday.com)
“Your “healthy” weight cannot simply be calculated from a general source – people’s healthy weight, orideal weight, depends on several factors, including their age, sex, body type, bone density, muscle-fat-ratio, overall general health, and height.
Over the last few decades, using BMI (body mass index) was seen as an excellent means for calculating a person’s healthy weight. However, BMI, as you will see later on in this article, is at best, a ballpark calculation with several limitations…
…Health care professionals and sports scientists say measuring a person’s body fat percentage is the ideal way of gauging their level of fitness and general health, because it is the only one that includes the person’s true body composition. [my emphasis]
(Unfortunately, at this time, the only ways to measure body fat percentage are rather hi-tech according to this article. Three ways noted are based on air displacement, infrared rays, and X-rays)
Sugar should be controlled like alcohol and tobacco to protect public health, according to a team of UCSF researchers, who maintain in a new report that sugar is fueling a global obesity pandemic, contributing to 35 million deaths annually worldwide from non-communicable diseases like diabetes, heart disease and cancer.
Non-communicable diseases now pose a greater health burden worldwide than infectious diseases, according to the United Nations. In the United States, 75 percent of health care dollars are spent treating these diseases and their associated disabilities….
Sugar, they argue, is far from just “empty calories” that make people fat. At the levels consumed by most Americans, sugar changes metabolism, raises blood pressure, critically alters the signaling of hormones and causes significant damage to the liver — the least understood of sugar’s damages. These health hazards largely mirror the effects of drinking too much alcohol, which they point out in their commentary is the distillation of sugar.
Worldwide consumption of sugar has tripled during the past 50 years and is viewed as a key cause of the obesity epidemic. But obesity, Lustig, Schmidt and Brindis argue, may just be a marker for the damage caused by the toxic effects of too much sugar. This would help explain why 40 percent of people with metabolic syndrome — the key metabolic changes that lead to diabetes, heart disease and cancer — are not clinically obese.
“As long as the public thinks that sugar is just ‘empty calories,’ we have no chance in solving this,” said Lustig, a professor of pediatrics, in the division of endocrinology at the UCSF Benioff Children’s Hospital and director of the Weight Assessment for Teen and Child Health (WATCH) Program at UCSF.
“There are good calories and bad calories, just as there are good fats and bad fats, good amino acids and bad amino acids, good carbohydrates and bad carbohydrates,” Lustig said. “But sugar is toxic beyond its calories…
…”We’re not talking prohibition,” Schmidt said. “We’re not advocating a major imposition of the government into people’s lives. We’re talking about gentle ways to make sugar consumption slightly less convenient, thereby moving people away from the concentrated dose. What we want is to actually increase people’s choices by making foods that aren’t loaded with sugar comparatively easier and cheaper to get.”..
- Societal control of sugar essential to ease public health burden (eurekalert.org)
- Is There a Growing Concern About Fructose?(Food, Facts, and Fads)
In the 1800s and early 1900s, the average American took in about 15 grams of fructose (about half an ounce), mostly from eating fruits and vegetables. Today we average 55 grams per day (73 grams for adolescents)…
…HFCS produced significantly higher fructose levels in the blood than the sugar-sweetened drinks. The HFCS drinks also increased uric acid levels implicated in blood pressure. In this study, the HFCS drinks also resulted in a 3 mm Hg greater rise in systolic blood pressure….
…Another recent study found that teens that consume large amounts of fructose in foods and beverages show evidence of heart disease and diabetes risk in their blood…
…The Institute of Medicine (IOM) also found that diets with more than 25% of caloric intake from added sugars from processing were associated with significantly decreased levels of essential nutrients (e.g., calcium, magnesium, and zinc) in some population groups….
- Public Health Burden Could Be Eased By Societal Control Of Sugar (medicalnewstoday.com)
Drinking Large Amounts of Soft Drinks Associated With Asthma and COPD (ScienceNewsToday)
- Sugar Should Be Regulated Like Alcohol And Tobacco Say Scientists (medicalnewstoday.com)
- UCSF scientists declare war on sugar in food – San Francisco Chronicle (sfgate.com)
- Sugar: Should Feds Make It A Controlled Substance? (aarp.org)
- Tax and regulate sugar like alcohol and tobacco, urge scientists (junkscience.com)
- Tax and regulate sugar like alcohol and tobacco, urge scientists (guardian.co.uk)
- Should Sugar Be Supervised or Treated As Toxic? (tellsworld.wordpress.com)
- Why Banning Sugar Will Not Solve Obesity (drsharma.ca)
- Sugar as harmful as tobacco, alcohol, experts say (smh.com.au)
- Sugar tax needed, say US experts (bbc.co.uk)
- Report calls for ‘toxic’ sugar to be regulated like alcohol, though not everyone agrees (theprovince.com)
- Tax ‘toxic’ sugar, doctors urge (talesfromthelou.wordpress.com)
Soda’s Evil Twin – The Dangers of Fruit Drinks (Infographic) [With Added Item on Environmental Degradation by Soda Manufacturer Processes]
America’s Health Rankings Finds Preventable Chronic Disease on the Rise; Obesity, Diabetes Undermining Country’s Overall Health
- Nation made no progress in improving health in 2011 after three years of gains
- Modest decreases in smoking and preventable hospitalizations
- Dramatic increases in obesity and diabetes, combined with still-too-high levels of tobacco use, are putting more people at risk for preventable illness and higher health expenditures
- The Rankings indicates that every person that quit smoking in 2011 was offset by a person becoming obese
- 2011 is the first year no state had an obesity prevalence under 20 percent
- United Health Foundation launches “Take Action for Change” Facebook campaign to incent healthy behavior
Washington, D.C., Dec. 6, 2011 – United Health Foundation’s 2011 America’s Heath Rankings® finds that troubling increases in obesity, diabetes and children in poverty are offsetting improvements in smoking cessation, preventable hospitalizations and cardiovascular deaths. The report finds that the country’s overall health did not improve between 2010 and 2011 – a drop from the 0.5 percent average annual rate of improvement between 2000 and 2010 and the 1.6 percent average annual rate of improvement seen in the 1990s…..
- United Health Foundations Americas Health Rankings (bespacific.com)
- New Ways Calories Can Add Up to Weight Gain(wsj.com) “t isn’t so much what you eat, the study suggests, but how much you eat that counts when it comes to accumulating body fat.”
- Glimmer of Hope in U.S. Obesity Picture(Medical News Today)
- iOverweight people have a weight thermostat that is turned up too high (KevinMD.com)
- Prevalence of Obesity in the United States, 2009–2010 (full text reports)
+ More than one-third of adults and almost 17% of youth were obese in 2009–2010.
+ There was no change in the prevalence of obesity among adults or children from 2007–2008 to 2009–2010.
+ Obesity prevalence did not differ between men and women.
+ Adults aged 60 and over were more likely to be obese than younger adults.
- Vermont keeps title of healthiest state, report shows – Reuters (reuters.com)
- America’s Health Rankings 2011: Which state scored worst? (cbsnews.com)
- Obesity And Diabetes Undermining America’s Overall Health (medicalnewstoday.com)
- Cough-cough, puff-puff. Oklahoma looks a little sick (newsok.com)
- Tennessee moves up 3 slots in U.S. health ranking (knoxnews.com)
- America’s Health Report Card: Needs Improvement (webmd.com)
- Report: America’s Health Deteriorated In 2011 (thinkprogress.org)
- America’s Health Rankings 2011 Released (aa47.wordpress.com)
Exercise helps us to eat a healthy diet
|IMAGE: Exercise helps us to eat a healthy diet.Click here for more information.|
A healthy diet and the right amount of exercise are key players in treating and preventing obesity but we still know little about the relationship both factors have with each other. A new study now reveals that an increase in physical activity is linked to an improvement in diet quality.
Many questions arise when trying to lose weight. Would it be better to start on a diet and then do exercise, or the other way around? And how much does one compensate the other?
“Understanding the interaction between exercise and a healthy diet could improve preventative and therapeutic measures against obesity by strengthening current approaches and treatments,” explains Miguel Alonso Alonso, researcher at Harvard University (USA) who has published a bibliographical compilation on the subject, to SINC.
The data from epidemiological studies suggest that tendencies towards a healthy diet and the right amount of physical exercise often come hand in hand. Furthermore, an increase in physical activity is usually linked to a parallel improvement in diet quality.
Exercise also brings benefits such as an increase in sensitivity to physiological signs of fullness. This not only means that appetite can be controlled better but it also modifies hedonic responses to food stimuli. Therefore, benefits can be classified as those that occur in the short term (of metabolic predominance) and those that are seen in the long term (of behavioural predominance).
According to Alonso Alonso, “physical exercise seems to encourage a healthy diet. In fact, when exercise is added to a weight-loss diet, treatment of obesity is more successful and the diet is adhered to in the long run.”
The authors of the study state how important it is for social policy to encourage and facilitate sport and physical exercise amongst the population. This should be present in both schools and our urban environment or daily lives through the use of public transport or availability of pedestrianised areas and sports facilities….
- Exercise can make it easier to eat healthy (news.bioscholar.com)
- Exercise helps people eat healthier: study (vancouversun.com)
- Exercise ‘makes people eat better’ (thehindu.com)
- Obesity Gene’s Effect Reduced By Exercise (medicalnewstoday.com)
Exercise may encourage healthy eating by changing parts of the brain that influence impulsive behaviour, according to a new review of the available literature by researchers from Spain and the US published in Obesity Reviews. The researchers conclude that in a society where we are surrounded by temptations and triggers that facilitate over-eating and excess, the part of the brain responsible for “inhibitory control” undergoes “relentless strain” (they note it has limited capacity anyway), and doing exercise on a regular basis enhances it.
“By enhancing the resources that facilitate ‘top-down’ inhibitory control, increased physical activity may help compensate and suppress the hedonic drive to over-eat,” they write. ……
- Exercise can make it easier to eat healthy (news.bioscholar.com)
- It’s Not Too Late to Improve Your Health: Tips for Healthy Eating and Physical Activity for Seniors (prweb.com)
Protein, not sugar, stimulates cells keeping us thin and awake, new study suggests
A new study has found that protein and not sugar activates the cells responsible for keeping us awake and burning calories. The research, published in the 17 November issue of the scientific journal Neuron, has implications for understanding obesity and sleep disorders.
Wakefulness and energy expenditure rely on “orexin cells”, which secrete a stimulant called orexin/hypocretin in the brain. Reduced activity in these unique cells results in narcolepsy and has been linked to weight gain.
Scientists at the University of Cambridge compared actions of different nutrients on orexin cells. They found that amino acids – nutrients found in proteins such as egg whites – stimulate orexin neurons much more than other nutrients….
…”To combat obesity and insomnia in today’s society, we need more information on how diet affects sleep and appetite cells. For now, research suggests that if you have a choice between jam on toast, or egg whites on toast, go for the latter! Even though the two may contain the same number of calories, having a bit of protein will tell the body to burn more calories out of those consumed.”
- Weight Gain Likely In Narcoleptics (medicalnewstoday.com)
- Sleep hormone restores vigor and reverses apathy in sickness, Oregon scientists report (oregonlive.com)
- Hormone fights fat with fat: Orexin prevents obesity in mice by activating calorie-burning brown fat (sciencedaily.com)
- What makes us feel ‘bad’ when sick and how to treat it (news.bioscholar.com)
- Why You Don’t Want to Wake Up – Interrupted Sleep Interrupts Memory (pt5.psychologytoday.com)
- Is Light Keeping You Awake? (psychologytoday.com)
This four-part Series critically examines what we know about the global obesity pandemic: its drivers, its economic and health burden, the physiology behind weight control and maintenance, and what science tells us about the kind of actions that are needed to change our obesogenic environment and reverse the current tsunami of risk factors for chronic diseases in future generations. …Series Papers**The global obesity pandemic: shaped by global drivers and local environmentsBoyd A Swinburn, Gary Sacks, Kevin D Hall, Klim McPherson, Diane T Finegood, Marjory L Moodie, Steven L GortmakerHealth and economic burden of the projected obesity trends in the USA and the UKY Claire Wang, Klim McPherson, Tim Marsh, Steven L Gortmaker, Martin BrownQuantification of the effect of energy imbalance on bodyweightKevin D Hall, Gary Sacks, Dhruva Chandramohan, Carson C Chow, Y Claire Wang, Steven L Gortmaker, Boyd A SwinburnChanging the future of obesity: science, policy, and actionSteven L Gortmaker, Boyd A Swinburn, David Levy, Rob Carter, Patricia L Mabry, Diane T Finegood, Terry Huang, Tim Marsh, Marjory L Moodie
- Half of UK men could be obese by 2030 (guardian.co.uk)
- Government-led efforts targeting eating habits of children needed to curb worldwide obesity epidemic (eurekalert.org)
- The diabetes pandemic: 1 in 4 US adults now has diabetes (casesblog.blogspot.com)
- Obesity deterrents by governments called for (cbc.ca)
- Shocking report says half of Americans will be obese by 2030 (cbsnews.com)
Elida Martinez, a 32-year veteran of school kitchens in Greeley, Colo., mixing beans with cheese and seasonings for burritos.
GREELEY, Colo. — The idea of making school lunches better and healthier has gathered steam in many parts of the nation in recent years, but not equally for every child. Schools with money and involved parents concerned about obesity and nutrition charged ahead, while poor and struggling districts, overwhelmed by hard times, mostly did not.
This midsize city in northern Colorado, where 60 percent of the 19,500 students qualify for free or reduced-price meals, is trying to break the mold. When classes start on Thursday, the district will make a great leap forward — and at the same time back to the way it was done a generation ago — in cooking meals from scratch…
Read the article at http://www.nytimes.com/2011/08/17/education/17lunch.html?_r=1&ref=health
- The Challenges of Serving Healthy School Lunches (foodservicewarehouse.com)
- Popular Back to School Lunch Ideas (homeandgardenideas.com)
- Hurried School Lunches Making Kids Fat (patspapers.com)
- Can Your School Afford Healthier Cafeteria Food? (timesoftexas.com)
Eating out, and the amount we spend on it, especially on fast foods, has been rising steadily for decades, and parallels the increase in daily calorie intake that is contributing to the growing obesity crisis. But is that about to change? Official figures, which take years to emerge, don’t appear to show it, but some more recent findings suggest the tide could be starting to turn, although for surprising reasons…
More Tips for Healthy Eating Out
Here are some more tips, based on information from the University of Wisconsin, on how to be kind to your waistline and your health when eating out, without spoiling the fun and enjoyment of good food.
- Do your research first: find out who is offering healthy, low fat meals.
- Eat something, like a piece of fruit, or drink a glass of water with a squeeze of lemon, about half an hour before, so you are not starving when you order, which can affect your choices.
- If you can’t control your portions, avoid restaurants that offer buffet or “all you can eat” menus.
- Eat half the entrée and ask them to wrap the rest for you to take home.
- Order one meal with two plates, one for you, one for your dining partner.
- Have an appetizer as a main course.
- Don’t eat everything: skip the bits you like less.
- Prefer spinach, watercress, dark green leaf salads (they are more nutritious) to those where the only leaf is pale iceberg lettuce.
- Avoid thick sauces made with butter or cream: ask the waiter if you are not sure. Go for stock-based sauce, or cooked in own juices instead.
- Instead of french fries, have baked potato, a side salad, or some steamed vegetables.
- Skip the mayonnaise and rich sauces in sandwiches and ask for extra tomatoes, onions, lettuce, mustard instead.
- Eat less at another meal in the day – but don’t skip meals, as this can lead to binge eating.
- Watch the alcohol and sweetened drinks: they are also rich in calories.
- Look for low fat, grilled, flame-cooked, broiled and steamed main dishes instead of battered, tempura, breaded, fried foods.
- Choose hard rolls, plain bread sticks, french bread or wholemeal buns and avoid dishes made with pastries, croissants and biscuits.
- Choose soups that are broth-based rather than cream or milk-based.
- Have extra vegetable toppings on your pizza instead of meat and extra cheese.
Authorities in the field of foodaddiction at the University of Florida say new research indicates that overeating andobesity problems might be effectively tackled if people would limit their food choices.
Editorializing in the August edition of the American Journal of Clinical Nutrition, Nicole M. Avena, Ph.D., a research assistant professor, and Mark S. Gold, M.D., chairman of the UF College of Medicine’s department of psychiatry, suggest modern living presents many delicious possibilities for people at mealtime – too many for people who respond to food as if it were an addictive drug…
We Can! is a national education program designed to give parents and communities ways to help kids stay at a healthy weight, can help your family avoid excess pounds. From the US National Heart, Lung, and Blood Institute.
Get tips on choosing low-calorie snacks, getting active, and cooking fun, healthy meals.
The home page has links to
- Healthy Midnight Snacks (everydayhealth.com)
- Michelle Obama: ‘Let’s Move’ Initiative Battles Childhood Obesity (abc news, Feb 2010)
- How to Eat Healthy and Lose Weight (womenandweight.com)
- Urban Design that Fights Obesity and Promotes Physical Activity (Crossroads – Lehigh Valley perspectives on promoting smart growth and effective governance. )
- Study gives clues to how obesity spreads socially (Science Daily May 5, 2011)
Shared ideas about acceptable weight or body size play only a minor role in spreading obesity among friends, according to the findings published in the article “Shared Norms and Their Explanation for the Social Clustering of Obesity.”
“Interventions targeted at changing ideas about appropriate body mass indexes or body sizes may be less useful than those working more directly with behaviors, for example, by changing eating habits or transforming opportunities for and constraints on dietary intake,” wrote lead author Daniel J. Hruschka, and co-authors Amber Wutich, Alexandra Brewis and Benjamin Morin, all with ASU’s School of Human Evolution and Social Change.”
- Fight Childhood Obesity as a Family (everydayhealth.com)
The Mayo Clinic staff have vetted materials on nutrition and healthy eating in the following areas
- Nutrition Basics with overviews on healthy diets, healthy cooking, and nutritional supplements
- In Depth coverage of topics in Nutrition basics as the new dietary guidelines, carbohydrates, dietary fats, specific diets (as the Mediterranean diet), and menu options
- Multimedia links to images, interactive graphics, videos, and slideshows
- Expert blog with tips by registered dieticians and nurses on topics like kitchen organization, meal planning, and ideas for healthy salads
- Resources with links to Web sites on nutrition, cooking, menus, and shopping strategies
- Web Site of the Week: Nutrition and healthy eating (alleganylibrarydirector.wordpress.com)
- Whole Grains, Fiber, Protein And Almonds Help Manage Hunger Pains (Medical News Today, April 2011)
- Live Well & Live Longer With Foods For Healthy Aging(Medical News Today, April 2011)”The tips below provide a starting point that can help you focus on foods for key parts of the body that are important to healthy aging:– Bones: String cheese is not just for the young. Add calcium to your diet by snacking on a stick of string cheese when hunger strikes.
— Muscles: For a quick and easy snack, look for a nutrition bar with added soy protein or add a packet of soy or whey protein to your favorite smoothie.
— Eyes: Punch up your intake of the eye-popping nutrients lutein and zeaxanthin by making a spinach salad with slices of oranges. Many multivitamin and mineral dietary supplements also include lutein.
— Heart: Popcorn is a great source of whole grains. Keep a few mini-bags in your desk drawer to heat up for a quick, low-calorie snack at the office. Also, try spicing up your popcorn with garlic powder and cinnamon, or rosemary and parmesan cheese.
— Mind: Salmon or tuna that is canned in water or in a shelf-stable pouch can make easy and affordable meals; add a few tablespoons of olive oil, season with pepper and thyme to enjoy on top of whole grain crackers or wrap with tomatoes in a lettuce leaf.”
- Kitchen organization: Control the clutter in your kitchen (mayoclinic.com)
- Meal planning 101: Tips and tricks (mayoclinic.com)
New research in the FASEB Journal suggests that a gene called CMAH has been lost during the course of recent evolution, and may lead to an increased risk of Type 2 diabetes in humans
From the February 25 2011 Eureka news alert
As if the recent prediction that half of all Americans will have diabetes or pre-diabetes by the year 2020 isn’t alarming enough, a new genetic discovery published online in the FASEB Journal. *** provides a disturbing explanation as to why: we took an evolutionary “wrong turn.” In the research report, scientists show that human evolution leading to the loss of function in a gene called “CMAH” may make humans more prone to obesity and diabetes than other mammals.
“Diabetes is estimated to affect over 25 million individuals in the U.S., and 285 million people worldwide,” said Jane J. Kim, M.D., a researcher involved in the work from the Department of Pediatrics at the University of California, San Diego in La Jolla, CA. “Our study for the first time links human-specific sialic acid changes to insulin and glucose metabolism and therefore opens up a new perspective in understanding the causes of diabetes.”
In this study, which is the first to examine the effect of a human-specific CMAH genetic mutation in obesity-related metabolism and diabetes, Kim and colleagues show that the loss of CMAH’s function contributes to the failure of the insulin-producing pancreatic beta cells in overweight humans, which is known to be a key factor in the development of type 2 diabetes. This gene encodes for an enzyme present in all mammalian species except for humans and adds a single oxygen atom to sialic acids, which are sugars that coat the cell surface.
To make their discovery, the researchers used two groups of mice. The first group had the same mutant CMAH gene found in humans. These mice demonstrated that the CMAH enzyme was inactive and could not produce a sialic acid type called NeuSGc at the cell surface. The second group had a normal CMAH gene. When exposed to a high fat diet, both sets of mice developed insulin resistance as a result of their obesity. Pancreatic beta cell failure, however, occurred only in the CMAH mutant mice that lacked NeuSGc, resulting in a decreased insulin production, which then further impaired blood glucose level control. This discovery may enhance scientific understanding of why humans may be particularly prone to develop type 2 diabetes. Results may also suggest that conventional animal models may not accurately mirror the human situation.
“The diabetes discovery is an important advance in its own right. It tells us a lot about what goes wrong in diabetes, and where to aim with new treatments,” said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, “but its implications for human evolution are even greater. If this enzyme is unique to humans, it must also have given us a survival advantage over earlier species. Now the challenge is to find the function of CMAH in defending us against microbes or environmental stress or both. This evolutionary science explains how we can win some and lose some, to keep our species ahead of the extinction curve.”
Related articles and Web sites
- Food Processing and Obesity (education.com)
- How Can an Unhealthy Diet Cause Diabetes? (brighthub.com)
- Diabetes (MedlinePlus) has links to overviews, basic information, health check tools, research findings, reference materials, and more
The Library of Congress Science Reference Services has recently published these two research guides
Health Effects of Obesity
This guide includes
A complete listing of all Science Reference guides with links may be found here.
This guide is a review of the literature and vetted online resources on the subject of smell. It is designed, as the name of the series implies, to put the reader ‘on target.’ This and other recent Tracer Bullets are available in print and also online from Science Reference Services at: http://www.loc.gov/rr/scitech/tracer-bullets/tbs.html
From the US Centers for Disease Control and Prevention (CDC) Web site “Communities Putting Prevention to Work”
CDC’s Communities Putting Prevention to Work program was developed to highly impact the nation’s health by reducing chronic diseases related to obesity and tobacco using a prescribed set of effective strategies to build public health policies, strengthen the community environment to support health, and establish successful and sustainable interventions over the long term.
The Communities Putting Prevention to Work program is focused on preventing chronic disease by producing sustainable, positive and improved health outcomes through the implementation of programmatic efforts through policy, systems, and environmental level change.
Communities of the Communities Putting Prevention to Work program are funded under a 2-year cooperative agreement to implement evidence and practice based MAPPS (Media, Access, Point of decision information, Price, and Social support services) strategies that are expected to have lasting healthful effects in the years following the end of the 2-year funding period.
Highlights from this Web site
Tools and Resources for community planning , including both general information and specific resources on the topics of physical activity, nutrition, obesity, and tobacco
MAPPS Strategies which give advice on how to change individual behaviors through avenues as the media, social support services, and signage (as billboards)
Media Resource Center has specific resources related to physical activity, nutrition, obesity and tobacco
| 10 |
Fifty-one percent of public school students were eligible for a free or reduced-price lunch in 2012-13, according to a Southern Education Foundation report. That means low-income students are a majority, some have reported.
Qualifying for a subsidized lunch is a very unreliable measure of poverty. It both undercounts and overcounts the poor, explains Kevin Drum on Mother Jones. But, mostly, it overcounts.
A family of four earning $44,000 a year, less than 185 percent of the poverty line, would qualify for the reduced-price lunch. That’s about 7 percent of the total. Forty-four percent get a free lunch because family income is under $31,000.
. . . lots of poor kids, especially in the upper grades, don’t participate in school lunch programs even though they qualify. They just don’t want to eat in the cafeteria. So there’s always been a bit of undercounting of those eligible.
On the other hand, a new program called the Community Eligibility Provision, enacted a couple of years ago, allows certain school districts to offer free meals to everyone without any proof of income. Currently, more than 2,000 school districts enrolling 6 million students are eligible, and the number is growing quickly. For example, every single child in the Milwaukee Public School system is eligible.
A few school districts — typically those with affluent students — are dropping out of the school lunch program because students don’t want to pay for the new smaller, healthier meals.
Instead of fooling with inaccurate school lunch data, why not ask about family income directly (and parental education while we’re at it)?
Child poverty increased in the recession, but is now trending down, writes Alex Tabarrok on Marginal Revolution The National Center for Education Statistics estimates 21 percent of school-age children were in families living under the poverty line in 2012. Child Trends estimates 20 percent in 2013.
| 10 |
Faculty: Maryellen Maguire-Eisen, RN, MSN
Release Date: 02/10/2015
“I am able to make patients aware because of my membership with DNA.”
The National Council for Skin Cancer Prevention (NCSCP) initiated "Don't Fry Day" in 2009 to educate the public about sun protection and skin cancer prevention. Members of the Dermatology Nurses' Association participate annually in "Don't Fry Day" by reinforcing sun safety facts to the people in their communities.
List some important sun safety tips you share with members of your community.
What is the best way to educate people on the dangers of the sun?
| 10 |
March 28, 2015
Squamous Cell Carcinoma
News & Features
The small pilot study reached no conclusion about the exact increase in risk that marathoners face, however.
Sunshine restores the soul and fosters the formation of vitamin D, but no one is safe from its damaging ultraviolet rays.
Dr. A. Bernard Ackerman, a dermatologist, spends much of his time diagnosing the potentially deadly cancer melanoma and other skin diseases. But when he returned from a recent trip to Israel, he was, well, deeply tanned.
MEN over 50 are twice as likely as women to develop skin cancer and, even more sobering, to die from it, according to the American Cancer Society. Experts say the reason lies not in men's skin -- but in their brains. Hatless, sunscreenless, heedless, men have made fewer changes in the decades of...
New findings that aspirin may prevent colon cancer have bolstered a growing area of research into whether humble aspirin or drugs like it will work against a range of malignancies. It will be years before the question is answered. Until then, experts say, people should be wary of taking the drugs...
THE great 20th-century love affair with the sun is finally cooling. At least it is for many former sun worshippers. For a while, sunbathers were in denial, like smokers of filtered cigarettes. They thought that if they avoided sunburn, if they shielded themselves from ultraviolet B, or UV-B,...
JUST when dermatologists and cancer specialists had Americans convinced that sunscreens could protect them from skin cancer and wrinkles, a scientist at Memorial Sloan-Kettering Cancer Center in New York concluded after a review of available research that sunscreens might not prevent melanoma, the...
MELANOMA, the least common but most feared form of skin cancer, does not just happen out of the blue. Because of changes in fashion and behavior that occurred more than a half-century ago, someone born today is more than 12 times as likely to develop melanoma as someone born in midcentury. The main...
THE doctor could tell the patient had once been an attractive woman. But now, though only in her 50's, her face was etched with wrinkles, her features gaunt-looking with prominent underlying bones and her skin shriveled and gray with purplish blotches. Diagnosis: smoker's face. Dr. Douglas...
ALTHOUGH most Americans work indoors, they spend much of their leisure time outdoors -- running, walking, cycling, swimming, skating, skiing, playing golf and tennis, going to ball games and, of course, sunbathing. In the process many expose their skin and eyes to a heavy dose of harmful...
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| 10 |
Hip Replacement Surgery
Hip arthritis typically occurs in adults aged 45 and older, when the cartilage that cushions the joint breaks down and eventually wears away. Characterized by pain and stiffness, severe cases can be profoundly debilitating.
If conservative treatments for hip joint pain fail to bring relief; if pain is impacting normal daily functioning and the ability to get a good night’s sleep, total hip replacement surgery (arthroplasty) may be recommended.
The surgery is most often performed under regional anesthesia. The surgeon removes damaged cartilage and bone, then positions new metal, plastic or ceramic joint surfaces to reconstruct the joint.
An artificial joint is comprised of two basic components: the ball (made of a highly polished strong metal or ceramic material) and the socket (a durable cup of plastic or ceramic). Special surgical cement is frequently used to secure the artificial joint in place.
Sometimes in younger, more active patients, a non-cemented type of prosthesis is used. This prosthesis is designed so that the bone will grow into and integrates with the porous surface of the implant. In some cases, a combination of a cemented ball and a non-cemented socket is used.
Specialty: Joint Replacement
Comments are closed.
| 11 |
Training errors are the most common cause of overuse
injuries. These errors involve rapid acceleration of the intensity,
duration, or frequency of activity. Overuse injuries also happen in
people who are returning to a sport or activity after injury and try to
make up for lost time by pushing themselves to achieve the level of
participation they were at before injury. Proper technique is critical
in avoiding overuse injuries, as slight changes in form may be the
culprit. For this reason, coaches, athletic trainers, and teachers can
play a role in preventing recurrent overuse injuries.
Some people are more prone than others to overuse injuries.
Imbalances between strength and flexibility around certain joints
predispose individuals to injury. Body alignment, such as knock-knees,
bowlegs, unequal leg lengths, and flat or high arched feet, also impact
overuse injuries. Many people also have weak links due to old injuries,
incompletely rehabilitated injuries, or other anatomic factors.
Other factors include equipment, such as the type of running shoe or
ballet shoe, and terrain — hard versus soft surface in aerobic dance or
This answer should not be considered medical advice...This answer should not be considered medical advice and should not take the place of a doctor’s visit. Please see the bottom of the page for more information or visit our Terms and Conditions.
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Seniors can stay physically fit by staying active. Cardiovascular exercises, strength training exercises, and stretching exercises are all great ways for older adults to maintain a healthy body.
Cardiovascular exercise can be any activity that elevates your heart rate for an extended period of time. A brisk walk, riding a bicycle, or doing yard work can all be considered cardiovascular in nature. As time goes on, it becomes increasingly important to exercise your heart and lungs on a regular basis. Start with 5-10 minutes of an aerobic activity that you enjoy, 2-3 times per week, and gradually increase your time and frequency as your endurance improves.
Strength training, whether it be body-weight, exercise bands, dumbbells, etc., will build strength and keep your muscles in good working condition. As we age, our muscles deteriorate rapidly without stimulation. You can slow the degeneration process dramatically with a strength training exercise program. You don't need to lift heavy weights to feel the positive effects. Performing light-weight resistance training exercises 2-3 times per week will leave you feeling fresh and invigorated.
Stretching is important too. The natural aging process causes us to gradually lose muscular flexibility, agility, and mobility. Stretching your muscles on a regular basis can keep you feeling loose and limber. Ideally, you should stretch several times per day, particularly before and after exercise.
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Original Editor - Joris De Pot
Clinically Relevant Anatomy
The hamate bone is a triangular bone located in the distal carpal row and is situated on the ulnar side. He is composed of a body and a hook. Hamate fractures constituted about 2% of all carpal fractures. They are classified as type I fractures involving the hook and type II fractures involving the body. Type I fractures are more common than type II fractures.
The hamate is bordered proximally by the pisiform and the lunate in the proximal carpal row, radially by the capitate, and distally by the bases of the fourth and fifth metacarpals.
The Guyon canal carries the ulnar artery and nerve, for this reason hook fractures should suggest a high probability of ulnar artery and nerve damage.
Mechanism of Injury / Pathological Process
Hamate fractures are most often seen in racquet, club or bat sports.
Racquet sports, like tennis, cause impact of the grip against the hook of the hamate of the dominant hand where as in golf, baseball and hockey the club will impact against the hamate in the non-dominant hand.
Type I fractures involving the hook of the hamate can occur via several different mechanisms:
- Repeated micro trauma
- Direct trauma
- Indirect trauma
Repeated micro trauma to the hook in sports involving swinging clubs, bats, or racquets can result in a hook stress fracture. These are usually occurring in the non-dominant hand.
Direct trauma can be applied during sports when the butt of the club rests on the hamate and the force of the swing is then transmitted directly to the bone. A fall onto the outstretch hand or fall on the hand while holding an object but is also seen in particular sporting activities.
Indirect trauma can be applied to the hook through its muscular and ligamentous attachments. This can occur either when falling on a hyperextended wrist or during power grips.
Type II fractures involving the body of the hamate always requires a direct force. These fractures are typically associated with high-energy, direct-force trauma or contusion injuries.
Point tenderness on the hypothenar and weak grip are characteristics of hamate fractures. Patients typically present with pain and tenderness over the hamate. Ulnar and median neuropathy can also be seen, as well as rare injuries to the ulnar artery. Displaced hamate fragments and hematoma as well as nonunion of the hook of the hamate can lead to neuropathy of the deep branch of the ulnar nerve, lesion of the median nerve, or even rupture of deep flexor tendons IV and V. Decreased sensation or weakness may be due to ulnar or median nerve injury. The fracture fragments may injure the nerves directly or swelling and inflammation may injure them indirectly.
With a fracture of the hook of the hamate there might be pain on the dorso-ulnar aspect of the wrist.
An oblique x-ray view or a carpal tunnel view should be considered as part of the initial diagnostic investigations. It can help with diagnosis and give further important information to aid appropriate management. Usually they are negative, a CT scan of the wrist in the “praying position” is the imaging modality of choice. A high density CT scan with the wrists in the “praying position” allows comparison between the two wrists. It is reported to have a sensitivity of 100%, specificity of 98.4%, and accuracy of 97.2% and is the radiographic technique of choice in the diagnosis of hook of the hamate fractures.
Fractures of the body of the hamate are difficult to diagnose. AP (anteroposterior), lateral and oblique views are more useful for diagnosis of body fractures than for hook fractures. The oblique and lateral views are the most useful. When routine films are negative and when a fracture is highly suspected, a CT scan should be taken. Assessments of the degree of angulations, reduction and articular incongruence or subluxation are the important imaging findings.
The hook of the hamate pull test (HPPT) is a clinical test for diagnosing a hook of hamate fracture.
Management / Interventions
Conservative option for nondisplaced fractures is a short-arm cast. The cast should immobilize the metacarpophalangeal joints of the fourth and fifth fingers and be a thumb spica to decrease micrononuinion at the hook. 2 Cast should be worn for 6-8 weeks to prevent nonunion. If pain is still present after cast removal, then excision for nonunion is the treatment of choice.
In the most studies, surgical treatment (fragment excision and open reduction and internal fixation (ORIF)) of a hamate fracture has a higher success rate than after conservative treatment.
Depending on the injury passive and active exercises are explained and exercised. As the healing of the tissue progresses and the function of the involved joint improves, coordination exercises, exercises against resistance and exercises to restore strength are incorporated into the exercise program.
During the first days after injury arises an edema in the hand. This edema is usually located on the dorsum of the hand. As a result, the function of the hand is negatively affected. In extreme swelling the hand must be positioned higher than the elbow.
In an intra-articular injury ice will immediately be applicated after the trauma, surgery or exercise to the involved joint to avoid post-traumatic arthritis.
During the rehabilitation physiotherapist uses passive mobilizations to normalize the ROM and the rolling and sliding motion of the involved joint. These mobilizations may include traction, translation and angular mobilizations.
In intra-articular lesions tractions can be performed to obtain pain relief. If in the last phase of the revalidation there is still capsular retraction, traction and translations can be carried out. During rehabilitation after plaster immobilization of the wrist there will be some stiffness of the capsule in the wrist. Here, traction and translations are performed. The patient is also encouraged to mobilize as much as possible the involved joints in question to optimize the functionality of the member in question as quickly as possible. Patients are encouraged to actively mobilize the adjacent joints to avoid stiffening.
After an injury, the balance between phasic and tonic muscles restored. In the hand wrist and finger flexors are tonic muscles. With a hand or wrist injury these muscles show an elevated tone and have the tendency to shorten. The flexors of the hand should be stretched and (as pain and swelling allows) excentric trained.
To start building progressive resistance exercises, the fracture has to be sufficiently consolidated. The exercises consist of concentric and eccentric muscle activity, closed and open chain exercises. Resistance exercises are necessary to regain a good functionality of the hand.
Low-intensity ultrasound has been reported to be useful in promoting fracture healing, it accelerates the normal fracture repair process.
Ultrasound treatment might be useful for nonunion caused by a repeated stress, the ultrasound is a treatment for nonunion of the hook of the hamate and is an option in various treatment methods.
Differential diagnosis includes:
• Flexor/extensor carpi ulnaris tendon injury
• Metacarpal/carpal bone fracture or contusion
• Triangular fibrocartilaginous complex tear
• Ulnar artery thrombosis
• Ulnar nerve neuropathy
• Carpal tunnel syndrome
Decision between casting and surgery is based on the lifestyle demands of the patient. The athlete who does not want to risk healing a nonunion after casting may opt for surgery to minimize the time away from sport. Similarly, a patient with a job that requires repetitive grabbing, gripping or lifting may elect for excision to reduce the risk of an extended period of time away from work.
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- ↑ 1.0 1.1 1.2 Rainer Schmitt; Ulrich Lanz; Diagnostic imaging of the hand; THIEME; 2008
- ↑ Rosemary Prosser,W. Bruce Conolly; Rehabilitation of the hand and upper limb; 2003
- ↑ 3.0 3.1 Amy Powell et al.; http://emedicine.medscape.com/article/97813-overview; Updated: May 13, 2008
- ↑ 4.0 4.1 Vishal H Borse, James Hahnel, Adnan Faraj; Lessons to be learned from a missed case of Hamate fracture: a case report; Journal of Orthopaedic Surgery and Research; 2010 Aug 27;5:64. (B)
- ↑ 5.0 5.1 5.2 Philip Robinson; Essential radiology for sports medicine; Springer; 2010
- ↑ 6.0 6.1 Hirano K, Inoue G. Classification and treatment of hamate fractures. Hand Surg. 2005; 10(2-3):151-7. (A2)
- ↑ 7.0 7.1 7.2 7.3 7.4 Guha AR, Marynissen H. Stress fracture of the hook of the hamate. Br J Sports Med. Jun 2002; 36(3):224-5. (B)
- ↑ 8.0 8.1 8.2 8.3 Mark D. Bracker; The 5-minute Sports Medicine Consult; Wolters Kluwer; 2011
- ↑ Kenneth A. Egol, Kenneth J. Koval, Joseph D. Zuckerman; Handbook of fractures; Wolters Kluwer; 2010
- ↑ Robert E. Carroll, Jeffrey F. Lakin; Fracture of the hook of the hamate: radiographic visualization.; Iowa Orthop J.; 1993;13:178-82. (A1)
- ↑ Thomas W. Wright, Michael W. Moser, Deenesh T. Sahajpal; Hook of the hamate pull test; J Hand Surg Am. 2010 Nov; 35 (11): 1887-1889. (B)
- ↑ Scheufler O, Radmer S, Erdmann D, Exner K, Germann G, Andresen R.; Current treatment of hamate hook fractures; HANDCHIRURGIE MIKROCHIRURGIE PLASTISCHE CHIRURGIE;2006 Oct;38(5):273-82. (A2)
- ↑ Scheufler O, Andresen R, Radmer S, Erdmann D, Exner K, Germann G.; Hook of hamate fractures: critical evaluation of different therapeutic procedures.; PLASTIC AND RECONSTRUCTIVE SURGERY; 2005 Feb; 115(2): 488-497. (A2)
- ↑ 14.0 14.1 Hiroyuki Fujioka, Juichi Tanaka, Shinichi Yoshiya, Masaya Tsunoda, Kenji Fujita, Nobuzo Matsui, Takeshi Makino, Masahiro Kurosaka; Ultrasound treatment of nonunion of the hook of the hamate in sports activities; Knee Surg Sports Traumatol Arthrosc.; (2004) 12 : 162–164. (B)
- ↑ Dr. Louise M. van Dongen et al.; Handboek voor handrevalidatie theorie en praktijk; Bohn Stafleu Van Loghum; 2002
- ↑ Eric Van den Kerckhove et al.; De kinesitherapeutische behandeling van hand- en polsletsels Oefentherapie en ondersteunende technieken; Standaard uitgeverij; 2009
- ↑ Hiroyuki Fujioka et al; Treatment of ununited fracture of the hook of hamate by low-intensity pulsed ultrasound: a case report; J Hand Surg Am.; (2000) 25: 77-79. (A1)
Evidence Based Practice
Learn about Evidence Based Practice in this month's members learn topic with book chapters from Practical Evidence-Based Physiotherapy 2012 & Evidence-Based Practice Across the Health Professions 2013
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Knee cap pain can be caused by a number of things. It may be that the problem is with the kneecap bone itself, with the cartilage that lines it, or tightness/weakness in the surrounding muscles causing it to move incorrectly.
The kneecap aka patella is a small triangle shape bone that sits inside the quadriceps tendon. It rests in a groove on the femur (thigh bone) known as the patellar/trochlear groove and glides up and down in this groove as the knee moves.
The back surface of the kneecap is lined with the thickest layer of cartilage in the whole body. This is because such large forces go through it. For example when you squat, a force equivalent to eight times your body weight goes through the kneecap.
But why do we have kneecaps? The knee cap is functionally important because it increases the leverage at the knee joint. This increases the strength of the knee by approximately 30% with extension activities like kicking. Problems with the patella tend to cause front knee pain.
Here you will find a summary of the most common causes of knee cap pain. To find out more about each one, including detailed information on symptoms, causes, diagnosis and treatment options, click on the relevant links below:
Chondromalacia is a common cause of knee cap pain,
especially in young adults and adolescents. Thinning of the cartilage that lines the back of the knee cap results in pain at the front. It
tends to be worse when you first get up from sitting or when climbing
stairs. It can also cause a
grinding/grating sensation. It is
usually caused by muscle tightness and weakness, overuse or altered
biomechanics in the leg
Find out More: Chondromalacia
Runner's knee is a very common cause of patellar pain. It can affect anyone from athletes to office workers, despite the name! It is caused by patella maltracking, a problem with how the kneecap moves, usually due to muscle tightness, weakness or abnormal biomechanics e.g. foot position.
Symptoms tend to come on gradually over time. Typically people experience an achy pain around the front of the knee and under the patella. It tends
to be worse after prolonged activity or inactivity and when coming down
stairs. It is also known as anterior
knee pain or patellofemoral pain syndrome.
Find out More: Runner's Knee
More commonly known as Jumper's Knee, this usually results in knee cap pain just below the patella. It is caused by damage to the patella tendon from repetitive activities like jumping and kicking. The most defining symptom is pain when pressure is applied just below the knee on the tendon. The knee cap pain also tends to be worse with and after activity and first thing in the morning.
Find out More: Jumper's Knee
A patella dislocation occurs when the knee cap is forced out of the patellar groove, usually after a fall, car accident, or less commonly after twisting the knee awkwardly. There is usually a visibly deformity with a large bulge to the side of the knee, most commonly the outer side. There tends to also be lots of swelling. It is a medical emergency and needs relocating (putting back in place) by a doctor as soon as possible. It is usually accompanied by damage to the ligaments that hold the knee cap in place which can make you prone to dislocating again in the future.
Find out More: Kneecap Dislocation
This is when the kneecap gets broken and tends to occur due to a fall
from a height or a massive force through the bone. Depending on the severity of the injury, the
leg may be put in a brace/cast to prevent movement for a few weeks while the
bone heals, or surgery may be required to fix the fragments back together. If the injury is severe, part or all of the
kneecap may be removed.
Find out More: Patella Fractures
Arthritis often causes knee cap pain. Osteoarthritis is when there is wear and tear
in the bones and cartilage, which can affect any of the knee bones. Patellofemoral arthritis
leads to a narrowing of the space between the kneecap and the groove it sits in
on the femur. The knee cap
pain is usually worse with any activities that put pressure through the patella
such as squatting, climbing stairs and kneeling.
It also sometimes produces a cracking or grating noise/sensation when
you move your knee.
Find out More: Arthritis
To find out more about these common causes of knee cap pain, including causes, symptoms, diagnosis and treatment options, click on the links above.
If none of these are sounding quite like your pain, visit the knee pain diagnosis section for help working out what is wrong with your knee.
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Physicians have recognized scoliosis, the abnormal curvature of the spine, since the time of Hippocrates, but its causes have remained a mystery -- until now. For the first time, researchers have discovered a gene that underlies the condition, which affects about 3 percent of all children.
The new finding lays the groundwork for determining how a defect in the gene -- known as CHD7 -- leads to the C- and S-shaped curves that characterize scoliosis. The gene's link to scoliosis was identified by scientists at Washington University School of Medicine in St. Louis, working in collaboration with investigators at the University of Texas Southwestern Medical Center and Texas Scottish Rite Hospital for Children, both in Dallas, Rutgers State University of New Jersey and the University of Iowa. The group published its results in May in the American Journal of Human Genetics.
"Hopefully, we can now begin to understand the steps by which the gene affects spinal development," says Anne Bowcock, Ph.D., professor of genetics, of medicine and of pediatrics. "If we understand the genetic basis of the condition, we can theoretically predict who is going to develop scoliosis and develop treatments to intervene before the deformity sets in. It may take many years to accomplish these goals, but I think it will eventually happen."
The researchers have traced a defect in CHD7 to idiopathic scoliosis, the form of the condition for which there is no apparent cause. It is the most common type of scoliosis, occurs in otherwise healthy children and is typically detected during the growth spurt that accompanies adolescence.
Although scientists have known for years that scoliosis runs in families, its pattern of inheritance has remained unclear. That's because the condition is likely caused by several different genes that work in concert with one another -- and the environment -- to cause scoliosis. Bowcock predicts that scientists will soon find other genes involved in the disease.
The CHD7 gene is thought to play a critical role in many basic functions in the cell. The researchers zeroed in on the gene after finding that it is missing or profoundly disrupted in a rare syndrome called CHARGE. Babies born with the syndrome often die in infancy. Those that survive have heart defects, mental retardation, genital and urinary problems, ear abnormalities and deafness, among other problems. They also develop late-onset scoliosis.
"This led us to consider that milder variations of CHD7 may be involved in other types of scoliosis," Bowcock said.
The researchers, led by Carol Wise, Ph.D., at Scottish Rite Hospital, collected data on 52 families with a history of scoliosis in at least two members -- the one who sought treatment and another from earlier generation. The patients had an average spinal curvature of 40 degrees and did not have any illnesses, such as Marfan syndrome or cerebral palsy, which can also involve scoliosis. The researchers performed genome-wide scans that spelled out the 6 billion letters of genetic code in the affected family members and analyzed the data.
They found that patients with scoliosis very often had a defect in the gene's non-coding region, meaning that the error did not disrupt production of the CHD7 protein. The researchers speculate that this particular mutation alters the binding of a molecule that controls whether the gene is turned on. In this case, they think the gene is turned off more often than it should be, which reduces the amount of CHD7 protein produced.
"The change in the amount of the protein produced is subtle, which correlates with the onset of scoliosis, which typically happens very gradually," explains Michael Lovett, Ph.D., professor of genetics and pediatrics. "This particular defect was so highly associated with scoliosis that it is either the real McCoy or is very closely linked to the defect that causes the condition."
The researchers will continue to look for genetic variations involved in scoliosis by studying additional families with the condition.
Severe scoliosis is typically treated by surgery or by wearing an orthopedic brace, which straightens the curvature over time. Most minor spinal curves can be monitored by a doctor and do not progress to the point where treatment is necessary.
Source: Washington University
Explore further: Facebook app encourages individuals to get in touch with their DNA
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If you're a rock climbing enthusiast, you can reap some significant health benefits by regularly participating in this type of exercise. Rock climbing can provide you with both emotional and physical health perks. However, if you do participate in rock climbing, make sure you have proper training and follow safety precautions.
Calorie Expenditure Perks
Rock climbing is an excellent calorie-burning exercise, which can help you achieve or maintain a healthy body weight. Harvard Health Publications reports that a 155-pound person burns about 818 calories hourly during a rock-climbing ascent and 596 calories per hour while rappelling. If you're overweight or obese, burning just 500 calories more than you eat daily can help you shed 1 pound per week.
Chronic Disease Prevention
Rock climbing on a regular basis is an excellent way to reduce your risk for chronic diseases, such as heart disease, high blood pressure, high blood cholesterol and diabetes. The Centers for Disease Control and Prevention defines rock climbing as vigorous-intensity physical activity. Therefore, you only need to participate in 1.25 to 2.5 hours of this intense exercise weekly to reap health benefits, according to the 2008 Physical Activity Guidelines for Americans.
Strength and Toning Benefits
Because you're working a number of different muscle groups when you rock climb, you'll increase your strength and muscle definition by rock climbing regularly. A review published in 2011 in the Journal of Human Kinetics reports that elite rock climbers often have low body mass indexes, low body fat percentages, and increased handgrip strengths.
Rock climbing on a regular basis may help improve your mood or decrease bouts of depression. A review published in 2008 in Annals of General Psychiatry found that a variety of different exercises, including rock climbing, help improve the moods of people suffering from depression. Authors of this review report that in addition to rock climbing, other exercises that have been effective for improving depressed moods include aerobic dancing, jogging, swimming, walking, yoga and tai chi.
Rock climbing is an adventure sport that comes with a high risk of stress-related injuries and falls, especially if you're an inexperienced climber. A study published in 2008 in the American Journal of Preventative Medicine found that the many rock climbing injuries seen in emergency rooms were due to sprains, fractures and strains, often in lower extremities, and that the majority of these injuries occurred during falls related to rock climbing. Therefore, despite the numerous potential health benefits that can occur from regular rock climbing, it's important to be aware of injury risks and always follow safety precautions.
An experienced health, nutrition and fitness writer, Erin Coleman is a registered and licensed dietitian and holds a dietetics degree from the University of Wisconsin-Madison. She also has worked as a clinical dietitian and health educator in outpatient settings. Erin's work is published on popular health websites, such as TheNest.com and J
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Latest Flexor retinaculum of the hand Stories
By Newey, Martyn Clarke, Malcolm KEYWORDS Carpal tunnel syndrome / Nurse-led service / Return to work This article describes the condition known as carpal tunnel syndrome and reviews a carpal tunnel service that was started in Leicester in 1999.
The pisiform bone (pisiforme or lentiform bone) is a small knobbly, pea-shaped bone of the wrist. It is found in the proximal row of the carpus, located where the ulna joins the carpus (wrist). This bone only articulates with the triquetral. The pisiform bone is typically known by its small size, and by presenting a single articular facet. It is situated on a plane anterior to the other carpal bones and is spheroidal (spherical) in form. Pisiform is derivative of the Latin word “pisum”...
- The governor of a province or people.
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Superior angle of scapula
|Superior angle of scapula|
Posterior surface of left scapula. Superior angle shown in red.
Bones of human back. Superior angles shown in red.
|Latin||Angulus superior scapulae|
|Anatomical terms of bone|
The superior angle of the scapula (or medial angle) is formed by the junction of the superior and medial borders of the scapula. The superior angle of scapula is located at approximate the level of the second thoracic verterbra.
Left scapula seen from behind
(superior angle labeled as medial angle at upper right)
Anterior surface of left scapula. Superior angle labelled at top left.
- Gray, Henry (1918). Anatomy of the Human Body, 20th ed. / thoroughly rev. and re-edited by Warren H. Lewis. Philadelphia: Lea & Febiger. p. 206.
|Wikimedia Commons has media related to Superior angle of the scapula.|
|This human musculoskeletal system article is a stub. You can help Wikipedia by expanding it.|
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The initial deadline for injured patients to register for the Stryker Rejuvenate hip lawsuit settlement has been extended to March 30,... read more
Hip Implant/Replacement Loosening
The parts of an artificial hip replace the natural ball and socket hip joint. The ball, which rotates within the hip socket, is attached to the thigh bone by a metal stem. The stem is inserted into a canal the surgeon makes in the femur or thigh bone.
Loose Stem Hip Replacement
A stem can be fit into the canal tightly so it holds the implant in place. Or, a stem can be inserted into the canal and held in place by epoxy-cement. Stems loosen over time, especially in more active or heavy patients because wear causes the cement to crack or fracture.
An implant might also become loose if the friction between the metal ball at the top of the femoral stem and the polyethylene acetabular cup (the artificial hip socket) causes debris to shed from the cup. Particles of debris which are shed from the cup or the cement holding the implant in place trigger an inflammatory response. Inflammation of the surrounding tissue and bone can cause bone loss around the implant. Eventually, bone loss can cause the implant to loosen.
Symptoms of a Loose Hip Implant
When a hip implant loosens, it begins to move a little bit. Symptoms of a loosened hip replacement include:
- Increasing and lasting pain that develops slowly over years (the pain usually is in the entire hip and or in the thigh when the femoral component comes loose)
- Stiffness in the joint
- Changes on X-rays
- Problem putting weight on the joint
- Reduced range of motion
When a hip implant fails, revision surgery is needed. Revision surgery is more complicated and the results are usually not as successful as the original surgery. This is because:
- The bones are damaged from the complications involving the loss of the original implant
- The surgery is more difficult to perform
- Revision surgery takes longer and requires more blood than the primary surgery
- Aspiration of the joint may be required to be sure there is no infection
- The risk of complications is greater
- Because of the loss of bone, bone grafts are often required
Problems with some hip implants are occurring much sooner than usual, sometimes within three to five years after hip replacement surgery. Implants normally can last from 15 to 20 years.
If you or someone you love has required revision surgery due to a loose implant, we may be able to help you recover compensation for your pain and suffering as well as the cost of revision surgery and lost wages. Contact a hip implant lawyer for more information.
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Less Than 3 Hours a Week Offers Protection Close to Longer Workouts
A new study shows that walking briskly for less than three hours a week reduces the risk almost as much as longer workouts.
Researchers looked at 74,000 women enrolled in the ongoing Women's Health Initiative. They found that exercising a mere 1 1/4 to 2 1/2 hours each week -- walking briskly or similar exercise -- reduced the risk of breast cancer by 18% compared with inactive women. That protective effect is only slightly less than the 22% reduced risk observed in women who exercise at least 10 hours a week.
You Don't Have to Be an Athlete
"This is great news for women who don't want to be athletes," says lead researcher Anne McTiernan, MD, PhD, of the Fred Hutchinson Cancer Research Center in Seattle. "Even modest exercise can reduce their risk of breast cancer."
The benefits of exercise on breast cancer are well established, with more than 30 studies showing that women who regularly engage in physical activity have significantly less breastcancer. But most of those studies show protection resulting from more vigorous levels of activity -- typically starting at the often-recommended 30 minutes per day.
But this new study, published in this week's edition of TheJournal of the American Medical Association, shows that even moderate intensity exercise done regularly -- say, walking at a 20-minute-per-mile pace -- may offer significant breastcancer protection.
"Some of the older studies made it look like women had to do vigorous activity in order to reduce their risk," McTiernan tells WebMD. "But it looks like light, brisk walking done a few days a week may also offer significant benefit."
Even for Those at Highest Risk
There is a caveat, though: This lower risk is more likely to occur in women who are thin, average, or only slightly overweight -- especially as they reach middle age and beyond. Modest or even more intense exercise alone plays little, if any, role in reducing cancer risk in the obese, she says.
"Exercise works in reducing breast cancer risk by reducing body fat, which itself is a risk factor," says McTiernan, a longtime breast cancer researcher who authored Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast Cancer. "But if body fat levels are not low enough, even if women are overcompensating with exercise, they're not getting the same benefit. They also need to diet in order to lose that body fat."
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Benefits of Regular ExerciseBY: Raja Vikram | Category: Health | Submitted: 2010-03-17 07:07:54
Exercise is an physical activity which maintains physical fitness and good health. There are different ways of Exercise to perform. The exercise can be Playing, Gym workout,yoga, out door sports, jogging, and so on which leads to the development of physical system and total health . So from Regular exercise there are good number of benefits. Because of these exercises there are lot of benefits excluding the Health benefits. Where we will get good self-confidence and our expectancy level increases . Apart from this we will be having a different look to ourselves.
1. Improves Cardiovascular health : As we know most of the people are badly getting hit by Heart and Lungs problems. So if the regular exercise is performed like swimming and cycling then it helps the heart and lungs system to be more stronger.
2. Bone gets stronger: Because of the regular exercises like jogging,walking, playing makes the bone more stronger and keeps us healthy .
3. Stops from gaining weight : Regular exercise helps us in two ways , that is by maintaining a constant body weight will keeps the health more stronger. By doing regular exercise and perfect diet patterns we can maintain the exact weight which is required . Because of this there will be a balance in the body. We can perform a bit faster and Stronger even if we gets old. Not only loosing weight, we can maintain ourselves from gaining weight also. which is more important if we look at both ways of weight .
4. Changes the Brian Mood: from the Studies it is shown that , By doing regular exercise the depression levels, Stress goes off. Due to the Endorphins levels are low we feel stress, but due to the regular exercise the endorphins increases and we became stress free. So which is very much required for this generation. Because of this we look more fresh and younger. we can easily fight back with the mentally stress problems.
5. Increase Immune system (resistance) : Due to the regular exercise our body becomes fit and flexible. So that we can fight with any kind of diseases. That means the immunity system of our body Increases and it gives us resistance to protect from the Infections like flu and cold.
So because of the regular exercise there are so many benefits. Excluding the above benefits we can have benefits like Good Sleep, pain resistance increases, Controls Diabetics and Hypertension, and so on. The way that we are growing in terms of technology ,the same way the health problems are also growing. So to keep ourselves fit and to do the daily activities we have to do regular exercise. We should think of the present and future trend, and we should keep ourselves stronger by performing regular exercise .
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March 26, 2015,
- American Podiatric Medical Association
- American Orthopaedic Foot and Ankle Society
- American College of Foot and Ankle Surgeons
- American Academy of Podiatric Sports Medicine
- American Physical Therapy Association
- American Diabetes Association
- National Diabetes Education Program
- Arthritis Foundation
- Podiatry Network
The American Podiatric Medical Association offers the following tips for preventing foot pain:
- Don't ignore foot pain -- it's not normal. If the pain persists, see a doctor who specializes in podiatry.
- Inspect feet regularly. Pay attention to changes in color and temperature. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin. Peeling or scaling on the soles of feet could indicate athlete's foot. Any growth on the foot is not considered normal.
- Wash feet regularly, especially between the toes, and dry them completely.
- Trim toenails straight across, but not too short. (Cutting nails in corners or on the sides increases the risk for ingrown toenails.)
- Make sure shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest, and replace worn out shoes as soon as possible.
- Select and wear the right shoe for specific activities (such as running shoes for running).
- Alternate shoes. Don't wear the same pair of shoes every day.
- Avoid walking barefoot, which increases the risk for injury and infection. At the beach or when wearing sandals, always use sunblock on your feet, as you would on the rest of your body.
- Be cautious when using home remedies for foot ailments. Self-treatment can often turn a minor problem into a major one.
- It is critical that people with diabetes see a podiatric physician at least once a year for a checkup. People with diabetes, poor circulation, or heart problems should not treat their own feet, including toenails, because they are more prone to infection.
Skin Creams and Foot Baths
Skin creams can help maintain skin softness and pliability. A pumice stone or loofah sponge can help get rid of dead skin.
Taking a warm footbath for 10 minutes two or three times a week will keep the feet relaxed and help prevent mild foot pain caused by fatigue. Adding 1/2 cup of Epsom salts increases circulation and adds other benefits. Taking footbaths only when the feet are painful is not as helpful.
Proper Walking and Foot Exercises
In addition to wearing proper shoes and socks, walking often -- and properly -- can prevent foot injury and pain. The head should be erect, the back straight, and the arms relaxed and swinging freely at the side. Step out on the heel, move forward with the weight on the outside of the foot, and complete the step by pushing off the big toe.
Exercises specifically for the toe and feet are easy to perform and help strengthen them and keep them flexible. Helpful exercises include the following:
- Raise and curl the toes 10 times, holding each position for a count of five.
- Put a rubber band around both big toes and pull the feet away from each other. Count to five. Repeat 10 times.
- Pick up a towel with the toes. Repeat five times.
- Pump the foot up and down to stretch the calf and shin muscles. Perform for 2 or 3 minutes.
Preventing Foot Problems in Childhood
Early Development. The first year of life is important for foot development. Parents should cover their babies' feet loosely, allowing plenty of opportunity for kicking and exercise. Change the child's position frequently. Children generally start to walk at 10 - 18 months. They should not be forced to start walking early. Wearing just socks or going barefoot indoors helps the foot develop normally and strongly and allows the toes to grasp. Going barefoot outside, however, increases the risk for injury and other conditions, such as plantar warts.
Shoes. Children should wear shoes that are light and flexible, and since their feet tend to perspire, their shoes should be made of materials that breathe. Replace footwear every few months as the child's feet grow. Footwear should never be handed down. Protect children's feet if they participate in high-impact sports.
- Risk Factors
- Corns and Calluses
- Ingrown Toenails
- Forefoot Pain
- Heel Pain
- Flat Feet
- Abnormally High Arches
- Tarsal Tunnel Syndrome
- Foot Injury
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April 2, 2001 -- Eric Taylor suffered from back pain for almost 30 years. He tried physical therapy, pain relievers, anti-inflammatory medicines, and surgery, but nothing worked. His doctor told him he could have steel rods placed in his spine or put up with the pain for the rest of his life.
Nighttime back pain is a special type of lower back pain that could indicate a serious problem with your spine.
In the U.S., between 60% and 80% of the population experiences some form of low back pain. It's the second most common reason people see their doctor. But as debilitating as back pain can be, most instances of it are manageable, and people who get adequate rest and proper exercise often see improvement within a matter of weeks.
With nighttime back pain, however, people can't get the...
Taylor sought an alternative. A friend told him about a new procedure called vertebral axial decompression (VAX-D) that might relieve pain without surgery. Taylor thought, why not?
"As long as it was nonsurgical and noninvasive, I was open to it," says Taylor, a 54-year-old attorney in St. Louis. "I was ready."
Nearly 70% of all people will suffer from low-back pain at some point in their lives, according to the CDC. It is the most common work-related injury, the Occupational Safety and Health Administration (OSHA) reports. There is little, however, that can be done. Bed rest is the most prescribed remedy, followed by exercise, muscle relaxants, pain medication, physical therapy, chiropractic intervention, and surgery. These and other methods often fail to provide long-term relief. But researchers say there is new hope: The VAX-D therapeutic table.
Approved by the FDA in 1996, the device was designed by Allan E. Dyer, MD, PhD, a former Canadian deputy health minister who helped develop the heart defibrillator. Treatment using the table is said to relieve lower back pain by applying tension to the spinal column to decompress the intervertebral discs.
A study published in April 1998 in The Journal of Neurological Research found that VAX-D is effective in relieving pain in 71% of cases. The majority of the 778 patients -- cases reviewed from 22 centers across the country -- reported a reduction in pain to a level of 0 or 1 on a 0 to 5 scale (with 5 being the highest level of pain). About 1% of patients reported an increase in pain, while 7% experienced no change. About 4% of the patients had had previous lumbar disc surgery. The researchers suggest that postsurgical patients who still have persistent pain should try VAX-D before considering further surgery.
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Osteoarthritis Topic Guide
Hip Pain There are many causes of hip pain such as arthritis, trauma, strains, sprains, and other conditions that cause referred hip pain. Hip pain can be sharp, sudden, gradual, or may come and go. Diagnosis and treatment of hip pain will depend upon the cause.
Expert Views and News
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Peripheral neuropathy is a disorder of the peripheral nerves resulting from different causes, such as diabetes mellitus and alcoholism, leading to pain, numbness or weakness of the limbs and other problems. Vitamin B is commonly used to treat peripheral neuropathy but it is not clear if it helps. This review of 13 trials on diabetic and alcoholic peripheral neuropathy with a total of 741 participants showed only one study that suggested possible short-term benefit from eight-week treatment with benfotiamine (a derivative of vitamin B1) with slightly greater improvement in vibration perception threshold compared to placebo. Vitamin B complex when given in a higher dose administered for four weeks was more efficacious than a lower dose in reducing pain and other clinical problems based on another study. Two to eight weeks of treatment with vitamin B was less efficacious than alpha-lipoic acid, cilostazol or cytidine triphosphate in short-term improvement of clinical and nerve test findings. All these findings require confirmation in larger studies before they can be accepted as definite. Vitamin B is generally well-tolerated with only a few reports of mild side effects.
There are only limited data in randomised trials testing the efficacy of vitamin B for treating peripheral neuropathy and the evidence is insufficient to determine whether vitamin B is beneficial or harmful. One small trial in alcoholic peripheral neuropathy reported slightly greater improvement in vibration perception threshold with oral benfotiamine for eight weeks than placebo. In another small study, a higher dose of oral vitamin B complex for four weeks was more efficacious than a lower dose in reducing symptoms and signs. Vitamin B administered by various routes for two to eight weeks was less efficacious than alpha-lipoic acid, cilostazol or cytidine triphosphate in short-term improvement of clinical and nerve conduction study outcomes. Vitamin B is generally well-tolerated.
Vitamin B is frequently used for treating peripheral neuropathy but its efficacy is not clear.
The objective of this review was to assess the effects of vitamin B for treating generalised peripheral neuropathy.
We searched the Cochrane Neuromuscular Disease Group Trials Register (searched August 2005), MEDLINE (January 1966 to September 2005), EMBASE (January 1980 to September 2005), Philippine databases (searched September 2005) and reference lists of articles. We also contacted manufacturers and researchers in the field.
Randomised and quasi-randomised trials where vitamin B was compared with placebo or another treatment in generalised peripheral neuropathy.
Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information.
Thirteen studies involving 741 participants with alcoholic or diabetic neuropathy were included. In the comparison of vitamin B with placebo, two small trials showed no significant short-term benefit in pain intensity while one of the trials showed a small significant benefit in vibration detection from oral benfotiamine, a derivative of thiamine. In the larger of two trials comparing different doses of vitamin B complex, there was some evidence that higher doses resulted in a significant short-term reduction in pain and improvement in paraesthesiae, in a composite outcome combining pain, temperature and vibration, and in a composite outcome combining pain, numbness and paraesthesiae. There was some evidence that vitamin B is less efficacious than alpha-lipoic acid, cilostazol or cytidine triphosphate in the short-term improvement of clinical and nerve conduction study outcomes but the trials were small. There were few minor adverse effects reported.
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Here are two easy ways to get a quick measure of heart health.
(1) Go to the National Institutes of Health's online risk-assessment calculator (hp2010.nhlbihin.net/
atpiii/calculator.asp) to learn your odds of having a heart attack within the next ten years.
(2) How quickly your heart recovers from exercise is also a good indicator. Give yourself this simple test, based on a study published in The New England Journal of Medicine.
Step 1: Run for ten minutes at a moderate to vigorous pace (fast enough that it's difficult to carry on a conversation). Immediately after stopping, check your heart rate (count beats per minute with a watch or use a heart-rate monitor).
Step 2: After the initial reading, wait one minute and calculate your heart rate again.
Step 3: Do the math. Your heart rate should have dropped by at least 25 beats per minute. If it didn't, you should see a cardiologist and make some lifestyle changes. In the NEJM study, participants whose heart rate dropped fewer than 25 beats per minute were more likely to suffer heart attacks.
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Like many aspects of growth in young children, healthy development of the spine can vary slightly from child to child with small curves constituting a normal part of spine anatomy. But if curves are observed by a parent, teacher, school nurse, or physician, evaluation for early onset scoliosis is advisable.
Scoliosis is diagnosed as several types:
The vast majority of scoliosis cases are due to unknown causes and can develop during infancy, childhood or adolescence. Patients with syndromic scoliosis often have curves in the spine early in life. As children with this condition grow, the curvature can progress and worsen. It’s important for a pediatric orthopedic surgeon to monitor the condition closely, because in some cases the curvature may eventually need to be treated.
Pediatric orthopaedists use physical examination and x-rays to diagnose early onset scoliosis. An initial x-ray is taken to determine the magnitude, location, and direction of the curve. Based on that x-ray, a determination is made regarding the type of scoliosis present, as well as its possible cause, and a treatment strategy is instituted.
X-ray showing curvature of the spine in a patient with scoliosis
At HSS, in children younger than ten years of age, an MRI of the entire spine is often recommended to ensure that there are no other problems affecting the spinal cord. Children with congenital scoliosis should be assessed for the presence of any cardiac or kidney problems associated with their condition.
Idiopathic Scoliosis: The most frequently seen form of the condition, idiopathic scoliosis may first be recognized during a routine pediatrician’s visit or in a school screening. While children with idiopathic scoliosis may not experience any pain, parents may see cosmetic signs of the condition, such as a shoulder that appears higher than the other or protruding ribs on one side, owing to a twisting aspect of the spine.
Patients with idiopathic scoliosis are further categorized by age: infantile scoliosis, affecting children from birth to three years of age; juvenile scoliosis from 3 to 9 years of age; and adolescent scoliosis, from 10 to18 years of age. Adolescent idiopathic scoliosis is seen more frequently in girls than in boys.
Syndromic Scoliosis: Children with syndromic scoliosis should also be evaluated by a geneticist and neurologist to determine which one of the disorders mentioned above, or others, could be the cause of the spine curvature. Sometimes these patients may have respiratory and cardiac conditions, related to the syndrome or secondary to severe spinal curvatures. Due to this risk, it is also important for these patients to be evaluated by a pediatric pulmonologist and cardiologist.
Congenital Scoliosis: Children with congenital scoliosis should be assessed for the presence of any cardiac or kidney problems associated with their condition.
Treatment decisions must take into account the age of the patient, the type of scoliosis, the size of the deformity, and the anticipated progression of the curve, according to John S. Blanco, MD, Associate Attending Orthopaedic Surgeon at Hospital for Special Surgery (HSS). “The period from birth to five years is crucial, because it is during this time that the lungs grow dramatically,” explains Dr. Blanco. If the chest cavity is constricted owing to scoliosis or other spinal deformities, lung growth can be significantly restricted and serious pulmonary complications may develop.
Treatment decisions must take into account the age of the patient, the type of scoliosis, the size of the deformity, and the anticipated progression of the curve. The period from birth to five years is crucial, because it is during this time when the most dramatic lung growth occurs. If the chest cavity is constricted owing to scoliosis or other spinal deformities, lung growth can be significantly restricted and serious pulmonary complications may develop.
For all patients with scoliosis, the goals of treatment are to slow or prevent progression of the curve and to achieve cosmetic improvement where possible. Based on all the information available, the pediatric orthopaedist may recommend one or more of the following:
For patients with smaller curves, those greater than 10 degrees and up to 20 degrees, the pediatric orthopaedist may recommend careful monitoring of the condition with physical examinations and follow-up x-rays taken at three to four month intervals. If the curve progresses, additional treatment measures are introduced.
For curves in the range of 20-40 degrees, bracing can be an effective means of controlling some forms of early onset scoliosis, such as idiopathic scoliosis and some syndromic forms of the condition. (However, bracing is not appropriate for neuromuscular or congenital scoliosis.) Moreover, it must be emphasized that bracing does not correct the curve. Bracing is intended to prevent progression.
Casting: The Risser Cast
A renewed interest in casting for early onset scoliosis has occurred. Casting can produce good results in children with infantile idiopathic scoliosis and those with syndromic scoliosis. Popularized recently by British physician Dr. Min Mehta, the technique employs a series of body casts to correct the curve called the Risser Cast. Extending from just under the arm pit - some also have “straps” that go over the shoulders - to the curve of the waist area, Risser casts remain on the patient for six weeks at a time. The cast is then changed to increase the amount of correction.
“The theory behind the technique is that by keeping the child in the cast around the clock, you actually help the spine start growing in a more normal way,” says Dr. Blanco. This process continues for several months to years, usually with a two- or three-day interval between castings to allow the patient to bathe and to address any skin problems that may develop.
“Because the cast remains on at all times, except for these brief breaks, the technique offers an advantage over braces which are removed for bathing and changing clothes,” says Dr. Blanco. Braces can be effective in arresting progression of a curve, but can’t correct it. “With casting, in the right patient, complete correction of the deformity is possible.” he adds. Presently, casting for the treatment of scoliosis is only available at a few centers in the United States.
The prognosis for patients with early onset scoliosis has improved significantly over the last ten years, according to Dr. Blanco. “We have lots of tools to treat the condition. It’s a matter of finding which one is best for the individual patient.” However, he stresses, when considering where to seek treatment, it’s important to look for an institution where a high volume of procedures are performed, there is a good medical support team in place, and the anesthesiology staff have experience working with patients with early onset scoliosis.
X-ray images showing a spinal curve in excess of 40 degrees (top)
and the same patient undergoing treatment with growing rods (bottom)
Growing Rod Technique
Growing rods are expandable devices that are attached to the top and base of the spine using screws or hooks. Every six months the orthopaedic surgeon lengthens the rod by about one centimeter, which is the amount of growth expected in the spines of young children.
While the initial surgery to attach the growing rods lasts two or more hours, subsequent adjustments are brief procedures involving only a small incision and, in otherwise healthy children, may not require an overnight stay in the hospital. When the device has reached its full extension, the child may require another surgery to introduce a new longer set of growing rods.
X-ray images showing a spinal curve in excess of 40 degrees (top)
and the same patient undergoing treatment with a VEPTR device (bottom)
The VEPTR Technique
The VEPTR (Vertical Expandable Prosthetic Titanium Rib) technique works to straighten the spine and separate the ribs, to prevent respiratory problems. For children with chest wall deformities, such as those seen in congenital scoliosis, the VEPTR device is usually the best option since bracing is ineffective in this population.
In contrast to growing rods, the VEPTR is attached to the patient’s ribs. It not only helps to straighten the spine, but also separates the ribs to prevent deterioration of breathing function that can develop with untreated scoliosis. As with growing rods, small adjustments are made to the VEPTR every six months to allow for growth.
While most patients with growing rods or VEPTR devices will eventually undergo a fusion to permanently maintain the correction, Dr. Blanco notes that the creator of the original VEPTR device, Robert Campbell, MD, has patients who have finished growing and continue functioning well with the VEPTR in place and no formal fusion performed.
Some families of children in whom growing rods or VEPTR devices are placed have concerns about the risks associated with repeat surgeries, according to Dr. Blanco. However, he says, even children with multiple medical problems can tolerate these procedures well in the hands of experienced specialists.
In spinal fusion, two or more vertebrae are fused together with bone grafts and internal devices, such as metal rods, to stabilize the spine or correct a deformity. Sophisticated fusion techniques and new instrumentation to surgically correct progressive curves, enhances the recovery of patients. Such techniques include new endoscopic procedures that allow specialists to access the spine through the chest cavity, and perform the fusion with three or four small incisions.
The next advances in the treatment of early onset scoliosis - as well as for other forms of scoliosis - may grow out of genetic research that seeks to predict which curves are going to progress. One Utah-based group has developed a DNA analysis of saliva that is showing promise in this area.
Genetic counseling can also benefit patients with syndromic or neuromuscular types of early onset scoliosis that run in families. While it won’t affect the course of treatment for the individual patient, counseling can help parents understand and anticipate what other organ systems may be affected and alert them to the possible need for other children in the family to be evaluated.
Learn more about pediatric orthopedic surgery in the HSS Guide to Pediatric Scoliosis.
To find out more about the treatment of early onset scoliosis at HSS, please visit the Physician Referral Service or call 1.877.606.1555.
Reviewed and Updated: 12/12/2012 00:00:00
Summary by Nancy Novick
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When it comes to fitness, a lot of people think the only way to improve is to do more, more, more. But one way to enhance your workout makes do with "less": interval training.
Interval training alternates short bursts of intense activity with periods of "active recovery," which means more moderate forms of that same activity. Elite athletes use the technique to improve their speed, endurance, and overall fitness. But moderate or beginning exercisers can use the same trick to burn more calories, improve cardiovascular endurance, and get a bracing workout in a relatively short time.
Interval training draws on the body's two forms of energy production: aerobic and anaerobic. In the aerobic state, the body uses oxygen to convert stored carbohydrates into energy. This is the method you use while walking, jogging, riding a bike, or even playing a leisurely game of golf. If you keep working aerobically long enough, or make more strenuous demands, such as sprinting or jumping, the anaerobic process kicks in. The body then makes energy from glycogen stored in the muscles. This is highly inefficient and produces lactic acid, contributing to muscle fatigue. After you stop the high-intensity activity, your body returns to the aerobic state and breaks down lactic acid.
Most people can't keep up anaerobic activity for very long without feeling out of breath and tired, and quite sore later. One step to increasing fitness is to train the body to delay the switch from aerobic to anaerobic for as long as possible. This is where interval training can help. Pushing the body to work hard for short periods can build your aerobic capacity because the body builds new capillaries and does a better job of transporting oxygen to the muscles.
Take running, for instance. Even a trained runner would find it nearly impossible to sprint for two minutes straight. But adding six 20-second sprints to a routine jog is akin to a two-minute sprint without the fatigue and shortness of breath.
Interval training can also be as easy as slow walking and then resting, or slow walking and then jogging for a few feet. It depends on your fitness level. If your exercise routine is getting stale, interval training can end the doldrums. It's also great for people with limited time.
Talk to your health care provider before starting or expanding a fitness program. It is important to monitor your heart rate while interval training.
Interval training can work with any type of aerobic exercise. You should add higher-intensity periods gradually, keep them brief, and always keep the pace comfortable.
Start gradually by varying the pace until you get accustomed to it. Tuning into the way your body responds to new demands is crucial to interval training.
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Clavicle (collarbone) Fractures are very common injuries. If a Clavicle Fracture is not significantly displaced (moved) or angled (bent), then it can be treated in a sling for 6 weeks. For people who do a lot of deskwork, a ‘figure-8’ brace that leaves the arms free may be preferred.
If a Clavicle Fracture is shortened 1.5 cm or more, significantly displaced (so that there’s no bony contact), significantly angled (bent) or comminuted (in many pieces), then it will probably do better if it is surgically repaired, especially in an active individual. This is because if the Clavicle Fracture is allowed to heal in a shortened or otherwise unsatisfactory situation, shoulder pain, stiffness, dysfunction, decreased endurance, and weakness can occur, especially during overhead activities or activities requiring shoulder strength. And once a Clavicle Fracture is healed in a shortened or otherwise unacceptable position, the muscles of the shoulder and the shoulder blade may contract and become permanently too short, or stretch to become permanently too long, depending on how the Clavicle Fracture healed. This can lead to permanent weakness and loss of endurance, even if the Clavicle Fracture is treated at a later time. As with most injuries, the best chance to obtain a good result is early after the injury occurs.
Surgical repair of a Clavicle Fracture is performed as an outpatient, same-day, surgery. The best way to fix most serious clavicle fractures is by using specially molded plates that conform to the Clavicle. After surgery, computer use and deskwork can be performed the following day. Showering is fine 3 days after surgery, at which point elbow, wrist and hand motion may begin. Active using the shoulder should be avoided for 4-6 weeks, and during that time a sling should be worn in public for protection. Clavicles often take 3 months to heal. A CT (cat) scan is often ordered 6-12 weeks after surgery to ensure that the bone is healed. Most patients usually do very well following Clavicle Fracture Repair.
Smoking greatly increases the risk of Clavicle Fractures not healing (i.e. going on to ‘non-union’), whether or not surgery is performed, and so quitting smoking is very helpful.
An unhealed Clavicle Fracture (Clavicle Non-union), is a more difficult problem to fix. Clavicle Non-unions usually involve some degree of shortening and deformity, which may be difficult to fully correct. In order to fix a Clavicle Non-union, it is often necessary to take bone from the iliac crest (the rim of bone above the hip). Taking bone graft from the iliac crest is somewhat painful, although with newer instruments this can be done using a minimally invasive technique, so it’s not as bad as it used to be. A specialized plate is used to stabilize the Clavicle Nonunion. Roughly 3-4 months after surgery, a CT scan will be ordered to confirm that the Clavicle Nonunion has healed.
In conclusion, most Clavicle Fractures usually don’t require surgical fixation, but when they do, modern techniques and equipment help produce an excellent result in the vast majority of cases.
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As we grow older, several changes occur throughout our bodies, including in the neck, back and spine. Intervertebral discs are natural shock absorbers between the bony vertebrae. Discs have two main components, an outer fibro-elastic containment rim and an inner soft gelatinous core. When axial loading pressure occurs along the spinal column, the central gelatinous core of the disc squeezes outward against the fibro-elastic containment rim of the disc. The elastic recoil of the containment wall pushes the gelatinous core back into position, reestablishing the height and shape of the disc. As a person ages, natural daily activity causes repeated loading of the disc. Small tears may develop in the fibers of the fibro-elastic outer containment wall. This causes some loss of the disc’s outer containment wall elasticity or recoil. The outer disc containment wall can no longer push the central core material back into shape as effectively. The outer containment wall sags, and is said to bulge or collapse. If the tears in the outer wall are large, inner disc core material may extrude into the area surrounding the disc. This condition is a herniated disc.
Conservative treatment options
Trauma may rapidly disclose longstanding degenerative changes. Except in the case of trauma, degenerative changes usually occur gradually. They may cause localized discomfort in areas of mild inflammation, but this pain seldom requires a health professional’s intervention. If, however, a bulging or herniated disc compresses an adjacent nerve, symptoms may continue to progress and may become more severe. More severe symptoms precipitate a consult with a physician. Following a physician’s proper diagnosis, a conservative treatment regimen may be prescribed. A conservative, non-operative treatment may include any of the following:
- Cutaneous stimulation – Also called hot/cold therapy. Alternating compresses of hot and cold can activate the healing process. Heat increases circulation, and cold reduces inflammation.
- Exercise – Gentle, low-impact exercise helps patients maintain a healthy body weight and strengthen bones and muscles without putting too much pressure on the joints. Consult your physician about exercises like swimming, hiking, walking, step aerobics, exercise ball therapy, recumbent stationary bikes or elliptical trainers.
- Medication – Pain medication can be found over the counter or obtained with a physician’s prescription. Medication for neck and back pain comes in a variety of forms, from oral analgesics or non-steroidal anti-inflammatory drugs to lidocaine patches and injections of corticosteroids.
- Alternative treatments –While not always accepted in the medical community, alternative treatments like chiropractic medicine, acupuncture and massage have helped some patients achieve temporary relief from pain.
Conservative and alternative treatments will help most degenerative disc disease patients achieve pain relief. However, some require more aggressive treatments, such as surgery. To find out more about the benefits of outpatient minimally invasive procedures for neck and/or back pain, contact Laser Spine Institute. We can also provide a review of your MRI or CT scan to ascertain whether you could be a candidate for our effective procedures.
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-- Robert Preidt
TUESDAY, Jan. 28, 2014 (HealthDay News) -- Spinal cord injury
rates in the United States are rising, and the leading cause now
appears to be falls suffered by seniors rather than traffic
crashes, according to a new study.
The findings suggest that programs to prevent falls in elderly
people could significantly reduce the number of spinal injuries in
the nation, the researchers said.
They analyzed data from more than 43,000 adults with spinal cord
injuries who were treated in hospital emergency rooms between 2007
and 2009. The incidence rate among people aged 18 to 64 dipped from
about 52 people per million in 2007 to about 50 per million in
2009, according to a Johns Hopkins Medicine news release.
The rate of spinal injuries among people 65 and older rose from
about 79 people per million to nearly 88 per million during that
time, according to the study, which was published in the Jan. 23
issue of the
Journal of Neurotrauma.
"We are seeing a changing face in the epidemiology of spinal cord injury," study co-leader Dr. Edward Hammond, a research associate at the International Center for Spinal Cord Injury at the Kennedy Krieger Institute in Baltimore, said in the news release.
Falls accounted for 41.5 percent of spinal cord injuries during
the study period, followed by traffic crashes at 35.5 percent. The
researchers also found that fall-related spinal cord injuries
accounted for 30 percent of all injuries among seniors in 2009,
compared to 23.6 percent in 2007.
A previous study found that the average age of adults with
spinal cord injuries was 41 between 2000 and 2005. It was 51 in the
current study, according to the news release.
The researchers also found that seniors with spinal cord
injuries are four times more likely than younger patients to die
from those injuries in the emergency room. Older patients also are
six times more likely to die after being admitted to the hospital
with a spinal injury.
The precise reason spinal cord injuries are more likely to be
caused by falls than traffic crashes is unclear, the researchers
said. It might be a combination of the overall aging of the U.S.
population, the more active lifestyles of seniors and increased
crash protection provided by airbags and seatbelt laws, they
The researchers also found that spinal cord injuries are a
growing financial burden on the health care system. From 2007 to
2009, emergency-room charges alone for spinal cord injuries totaled
$1.6 billion. Those charges increased 20 percent over the study
period -- well above the rate of inflation, they said.
"We have demonstrated how costly traumatic spinal cord injury is and how lethal and disabling it can be among older people," study co-leader Dr. Shalini Selvarajah, a postdoctoral surgical research fellow at the Johns Hopkins University School of Medicine, said in the news release. "It's an area that is ripe for prevention."
The U.S. National Library of Medicine has more about
spinal cord injuries.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.
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WebMD Health News
Laura J. Martin, MD
Nov. 7, 2011 (Chicago) -- While most sports don't seem to raise the risk of kneearthritis, some sports do seem to be particularly hard on the knees.
Overall, athletes don't have a greater risk for knee osteoarthritis, says researcher Jeffrey Driban, PhD, assistant professor of rheumatology at Tufts Medical Center in Boston.
That's true regardless of whether you participate in recreational or elite-level sports, he tells WebMD.
But both elite and non-elite soccer players were at increased risk of knee osteoarthritis (OA), a new study showed.
So too were competitive long-distance runners, weight lifters, and wrestlers.
There weren't enough data to draw conclusions about nonprofessionals who engage in these sports. In addition, the risk to women is unclear as most research has been on male elite athletes, Driban says.
The researchers found no increased risk of OA with basketball, boxing, cross-country skiing, ice hockey, orienteering, shooting, throwing, and track and field.
The study was presented here at the American College of Rheumatology's annual meeting.
Osteoarthritis, or OA, is characterized by progressive damage to the joint cartilage, the cushioning material at the end of bones.
Nearly 6.5 million Americans between the ages of 35 and 84 will be diagnosed with knee osteoarthritis in the next decade, according to another study presented at the meeting.
Interestingly, other recent studies have not found an increased risk of osteoarthritis in long-distance runners.
Still some experts urge caution. To reduce the risk of OA, consider non-contact, low-impact sports such as doubles tennis, swimming, and cycling, suggests Scott Zashin, MD, clinical associate professor of medicine at the University of Texas Southwestern Medical School in Dallas.
If you like to jog, try to run on a soft surface to limit trauma to the knees, he says.
If you're going to participate in high-risk sports like soccer, or if you already have knee injuries, be sure to maintain a healthy weight, Driban says. Other than aging, obesity is the biggest risk factor for osteoarthritis.
The reviewed studies compared knee osteoarthritis rates among sport participants after they retired to those of people of similar age who didn't participate in those sports.
Among the findings:
These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES:American College of Rheumatology's 75th Annual Scientific Meeting, Chicago, November 2011.Jeffrey Driban, PhD, assistant professor of rheumatology, Tufts Medical Center, Boston.Scott Zashin, MD, clinical associate professor of medicine, University of Texas Southwestern Medical School, Dallas.
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|South Texas Orthopaedics and Sports Medicine
495 10th Street
Floresville, TX 78114 USA
The tibia, or shinbone, is the most common fractured long bone in your body. The long bones include the femur, humerus, tibia, and fibula. A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle.
Because it typically takes a major force to break a long bone, other injuries often occur with these types of fractures.
The lower leg is made up of two bones: the tibia and fibula. The tibia is the larger of the two bones. It supports most of your weight and is an important part of both the knee joint and ankle joint.
The tibia can break in several ways. The severity of the fracture usually depends on the amount of force that caused the break. The fibula is often broken as well.
Common types of tibial fractures include:
Stable fracture: This type of fracture is barely out of place. The broken ends of the bones basically line up correctly and are aligned. In a stable fracture, the bones usually stay in place during healing.
Displaced fracture: When a bone breaks and is displaced, the broken ends are separated and do not line up. These types of fractures often require surgery to put the pieces back together.
Transverse fracture: This type of fracture has a horizontal fracture line. This fracture can be unstable, especially if the fibula is also broken.
Oblique fracture: This type of fracture has an angled pattern and is typically unstable. If an oblique fracture is initially stable or minimally displaced, over time it can become more out of place. This is especially true if the fibula is not broken.
Spiral fracture: This type of fracture is caused by a twisting force. The result is a spiral-shaped fracture line about the bone, like a staircase. Spiral fractures can be displaced or stable, depending on how much force causes the fracture.
Comminuted fracture: This type of fracture is very unstable. The bone shatters into three or more pieces.
Open fracture: When broken bones break through the skin, they are called open or compound fractures. For example, when a pedestrian is struck by the bumper of a moving car, the broken tibia may protrude through a tear in the skin and other soft tissues.
Open fractures often involve much more damage to the surrounding muscles, tendons, and ligaments. They have a higher risk for complications and take a longer time to heal.
Closed fracture: With this injury, the broken bones do not break the skin. Although the skin is not broken, internal soft tissues can still be badly damaged. In extreme cases, excessive swelling may cut off blood supply and lead to muscle death, and in rare cases, amputation.
High-energy collisions, such as an automobile or motorcycle crash, are common causes of tibial shaft fractures. In cases like these, the bone can be broken into several pieces (comminuted fracture).
Sports injuries, such as a fall while skiing or running into another player during soccer, are lower-energy injuries that can cause tibial shaft fractures. These fractures are typically caused by a twisting force and result in an oblique or spiral type of fracture.
The most common symptoms of a tibial shaft fracture are:
- Inability to walk or bear weight on the leg
- Deformity or instability of the leg
- Bone "tenting" the skin or protruding through a break in the skin
- Occasional loss of feeling in the foot
It is important that your doctor knows the circumstances of your injury. For example, if you fell from a tree, how far did you fall? It is just as important for your doctor to know if you sustained any other injuries and if you have any other medical problems, such as diabetes. Your doctor also needs to know if you take any medications.
After discussing your symptoms and medical history, your doctor will do a careful examination. He or she will assess your overall condition, and then focus on your leg. Your doctor will look for:
- Obvious deformity such as angulation or shortening (the legs are not the same length)
- Breaks in the skin
- Contusions (bruises)
- Bony prominences under the skin
- Instability (some patients may retain a degree of stability if the fibula remains intact or the fracture is incomplete)
After the visual inspection, your doctor will feel along your leg to see if there are abnormalities of the tibia. If you are awake and alert, your doctor will test your sensation and muscle strength by asking you to move your toes and see if you can feel different areas over your foot and ankle.
Other tests that may help your doctor confirm your fracture include:
X-rays can show if the bone is broken and whether there is displacement (the gap between broken bones). They can also show how many pieces of bone there are. X-rays are also useful for identifying the involvement of the knee or ankle joint, and the presence of a fibula fracture.
Computed tomography (CT) scan
After reviewing your x-rays, your doctor may recommend a CT scan of your leg. This is often done if there is a question of the fracture extending into either the knee or ankle joint. A CT scan shows a cross-sectional image of your limb. It can provide your doctor with valuable information about the severity of the fracture.
In planning your treatment, your doctor will consider several things, including:
- The cause of your injury
- Your overall health
- The severity of your injury
- The extent of soft tissue damage
Nonsurgical treatment may be recommended for patients who:
- Are poor surgical candidates due to their overall health problems
- Are less active, so are better able to tolerate small degrees of angulation or differences in leg length
- Have closed fractures with only two major bone fragments and little displacement (gap)
Initial treatment. Most injuries cause some swelling for the first few weeks. Your doctor may initially apply a splint to provide comfort and support. Unlike a full cast, a splint can be tightened or loosened, and allows swelling to occur safely. Once the swelling goes down, your doctor will consider a range of treatment options.
Cast and functional brace. One proven nonsurgical treatment method is to immobilize the fracture in a cast for initial healing. After weeks in the cast, it can be replaced with a functional brace made of plastic and fasteners. The brace will provide protection and support until healing is complete. The brace allows you to take it off for hygiene issues and for physical therapy.
Your doctor may recommend surgery for your fracture if it is:
- An open fracture with wounds that need monitoring
- Extremely unstable because of many bone fragments and large degrees of displacement
- Not healed with nonsurgical methods
Intramedullary nailing. The current most popular form of surgical treatment for tibial fractures is intramedullary nailing. During this procedure, a specially designed metal rod is inserted from the front of the knee down into the marrow canal of the tibia. The rod passes across the fracture to keep it in position.
Intramedullary nails come in various lengths and diameters to fit most tibia bones. The intramedullary nail is screwed to the bone at both ends. This keeps the nail and the bone in proper position during healing.
Intramedullary nailing allows for strong, stable, full-length fixation. The technique also makes it more likely that the position of the bone obtained at the time of surgery will be maintained when compared with casting or external fixation.
Intramedullary nailing is not ideal for fractures in children and adolescents because care must be taken to avoid crossing the bone's growth plates.
Plates and screws. Tibial shaft fractures were once routinely treated with plate and screw constructs. These tools are reserved for fractures in which intramedullary nailing may not be possible or optimal, such as certain fractures that extend into either the knee or ankle joints.
During this type of procedure, the bone fragments are first repositioned (reduced) into their normal alignment. They are held together with special screws and metal plates attached to the outer surface of the bone.
External fixation. In this type of operation, metal pins or screws are placed into the bone above and below the fracture site. The pins and screws are attached to a bar outside the skin. This device is a stabilizing frame that holds the bones in the proper position so they can heal.
While external fixation has yielded some reasonable results, having implants outside the body has proven to be somewhat unpopular with many patients and physicians.
How long it takes to return to daily activities varies with different types of fractures. Some tibial shaft fractures heal within 4 months, yet many may take 6 months or longer to heal. This is particularly true with open fractures and fractures in patients who are less healthy.
- Early motion. Many doctors encourage leg motion early in the recovery period. For example, if soft tissue injury is present with a fracture, the knee, ankle, foot, and toes may be mobilized early in order to prevent stiffness.
- Physical therapy. While you are wearing your cast or splint, you will likely lose muscle strength in the injured area. Exercises during the healing process and after your cast is removed are important. They will help you restore normal muscle strength, joint motion, and flexibility.
- Weightbearing. When you begin walking, you will most likely need to use crutches or a walker.
It is very important to follow your doctor's instructions for putting weight on your injured leg to avoid problems. In some cases, doctors will allow patients to put as much as weight as possible on the leg right after surgery. However, you should always follow the specific directions given by your surgeon.
Fracture pain usually stops long before the bone is solid enough to handle the stresses of everyday activities. If the bone is not healed and you put weight on it too soon, it could fail to heal. If that occurs, you may need a secondary surgical procedure, such as bone grafting or revision fixation.
A tibial shaft fracture can cause further injury and complications.
- Sharp fragments may cut or tear adjacent muscles, nerves, or blood vessels.
- Excessive swelling may lead to compartment syndrome, a condition in which the swelling cuts off blood supply to the leg. This can result in severe consequences and requires emergency surgery once it is diagnosed.
- Open fractures can result in long-term deep bony infection or osteomyelitis, although prevention of infection has improved dramatically over the past generation.
Surgical complications include:
- Malalignment, or the inability to correctly position the broken fragments
- Nerve injury
- Vascular injury
- Blood clots (these may also occur without surgery)
- Nonunion (failure of bone to heal)
- Angulation (with treatment by external fixation)
Certain factors are often associated with difficulties in fracture healing. Open fractures, in which the bone fragments are displaced enough to exit the skin, typically sustain greater injury and are at increased risk for infection. This may stall or prevent healing. These fractures are more likely to require secondary surgical procedures.
Fractures that are directed straight across the bone are typically the result of higher energy mechanisms (as opposed to the spiral-type fractures seen with low-energy twisting injuries). They also have increased injury to the tissues that are required for healing, and are associated with a greater occurrence of secondary surgeries.
These two factors are beyond the surgeon's control. A third and more controllable factor is getting the major fragments in line with each other and pushed together with surgery.
In addition, your general health may have an effect on healing. Smoking and corticosteroid use affect both bone and skin healing, so it is important to tell your doctor if you use these.
Bone morphogenetic proteins (BMPs) make up a new class of proteins that has been identified with factors that promote bone healing. Some of these proteins have been isolated and are now available for use as adjuncts to healing. Studies are ongoing to determine the ultimate value of these proteins, but early reports have been favorable.
The American Academy of Orthopaedic Surgeons
9400 West Higgins Road
Rosemont, IL 60018
| 11 |
Exercise and depression
Exercise is an important component of depression treatment (Current Psychiatry, June 2004). Exercise:
- helps metabolize cortisol, which is directly toxic to CNS neurons. Lowering cortisol levels improves neuronal connections.
- raises endorphin levels, which increases global feelings of well-being and activates reward centers in the brain.
- raises core body temperature, which promotes deeper and more restful sleep, during which serotonin is replenished.
Common reasons patients resist exercise include:
Lack of energy associated with a depressive episode. When I explain the benefits of exercise, however, patients are more likely to consider it.
Self-consciousness. Physically inactive patients are often reluctant to exercise in public, so help them choose an acceptable regimen and location.
Time management. I tell patients that exercise will increase their energy, making them more efficient. I also mention that exercise is a lifelong necessity for maintaining health.
I work primarily with young adults in a university health center. The key to getting students to exercise is to start very slowly—5 to 10 minutes of brisk walking three to five times weekly—then add 5 minutes per week until they are exercising about 30 minutes at a time.
I also preach persistence and patience, since the patient must exercise for 6 to 8 weeks to see a benefit. In the interim, I may help them choose a regular time to exercise, then encourage them to reward themselves by purchasing new walking shoes or exercise clothes if they are still exercising after 2 weeks. If a patient cannot follow a self-imposed schedule, participation in a fitness class may be more effective.
Linda L. Keeler MD
Counseling and Psychological Services
University of Kansas, Lawrence
The article, “Exercise for depression: Here’s how to get patients moving” shows the value of exercise in relieving depressive symptoms.
The authors summarize the evidence clinicians need for recommending that an exercise program may be just as effective as psychotherapy or pharmacotherapy for treating depression.
I plan to use the article to educate trainees in medicine, psychiatry, psychology, and social work. Thanks for publishing such a balanced, health-oriented discussion.
Stanley E. Harrris, MD, DFAPA
Clinical professor of psychiatry and the behavioral sciences
Keck School of Medicine
University of Southern California
| 11 |
What is an infection in a joint (s) with bacteria, virus and/or fungus that causes cartilage damage?
Septic (infectious, bacterial) arthritis
What is the term for an increase in the density of a bone?
DJD stands for what?
Degenerative joint disease
List a few radiographic signs of hip dysplasia
shallow acetabulum, flattened femoral head <half of the femoral head inside the acetabulum
What is an osseous (bony) outgrowth seen radiographically?
Osteophyte/ bone spur
What immobility and consolidation of a joint due to disease, injury, or surgical procedure?
What is destruction of a bone, seen as reduced density?
What is luxation or a dislocation?
Complete loss of contact between articular surface of a joint
Why are articular fractures difficult to treat?
Must achieve anatomical reduction and rigid skeletal fixation to perfectly align cartilage surface ( no step defect) or DJD will occur rapidly
Partial loss of contact between articular surfaces of a joint
What is possible sequela to Salter type 5 fracture? (Compression)
Angular limb deformity ( valgus and varus deviation of bones from the axis of of the limb past the joint
What is valgus and varus? how do you remember which is which?
VaLgus: lateral deviation of bones past joint
Varus: medial deviation
"L" in valgus =lateral
What results from twisting or overstretching a joint, causing a ligament to tear or separate from its bony attachment?
What is inflammation of a bursa?
What would be seen in the right side heart (pulmonic circulation) problems?
Blood backs up into the body ( caudal vena cava, filling the abdomen with fluid and into the jugular vein, resulting in a jugular pulse or distention on some species.
What would be seen with problems on the left side?
Blood backs up into the lungs (congestion) resulting in coughing and dyspnea ( difficult breathing)
What is the cranial part of the heart silhouette in a lateral radiograph?
right ventricle (passes from right to left around the cranial side of the heart)
What is an ectopic cilia?
misplaced eyelash that may contract and scratch the cornea
Describe the external ear canal?
Passes ventrally and then horizontally to reach the ear drum
What is capillary refill time?
Time it takes the mucosa (e.g gums) blanched by finger pressure to return to a normal pink color
How is a SQ injection performed?
Tent the skin at the junction of the neck and back and slip the needle into the subQ tissue
What are the clinical significance of the umbilicus?
How are anal glands expressed?
Thumb in one ischiorectal fossa and fingers in the other. Push forward (cranial to the anal sacs) squeeze, and pull caudally to express the contents of the sac into a paper towel held in your gloved hand
What is the clinical importance of a prepucial discharge?
What happens when dogs or cats nails are cut too short?
"Quicked" = pain and bleeding
What is it called when one or both testicles do not descend into the scrotum?
What is an onychectomy and how is regrowth prevented?
Declaw, dorsal aspect of the ungual crest must be removed
Want to see the other 38 Flashcards in Clinical ?JOIN TODAY FOR FREE!
| 11 |
Broken bones (or fractures) are a common injury in kids, especially after a fall. No matter where the break is or how small it may seem, all broken bones need to be checked out by a doctor.
Minor breaks often happen in the fingers and toes, and sometimes in the arm. More serious breaks may involve bones in the head, neck, leg, or pelvis. If the part of the body looks different, it's a sign the break might be serious. For example, if a child's arm is bent in an odd way or there's a large bump in the bone, the break may be serious.
Possible signs of a broken bone are:
If you think a child has a minor broken bone:
If it seems like a child has a serious broken bone:
To help prevent broken bones:
Reviewed by: Kate M. Cronan, MD
Date reviewed: January 2014
|American Red Cross Babysitter's Training Course Designed for 11- to 15-year-olds, the babysitter's training course can help you care for children and infants, make good decisions, solve problems, be a good leader, and more.|
|Babysitting: Emergency Contact Sheet The best time to prepare for an emergency is before it happens. If you're a teen babysitter, be sure parents have filled out a sheet like this and posted it near each phone.|
|Broken Bones Bones are tough stuff - but even tough stuff can break. Find out what happens when a bone fractures.|
|Babysitting Center Need advice on starting a babysitting business or tips on caring for kids? Want to test your babysitting knowledge and hear how other babysitters do it? This babysitting center for teens is the place for you.|
|Babysitting: Emergencies At most babysitting jobs the worst thing that happens is a fight over the last ice pop. But what do you do if there's really an emergency? Get some tips in this article for teen babysitters.|
|Babysitting: Dealing With Falls What should you do if a child you're babysitting falls? Our tip sheet can help you be prepared.|
|3 Things Every Responsible Babysitter Should Know It's extremely unlikely that you'll face an emergency while babysitting. But knowing you're capable of handling problems allows you to relax and focus on the kids.|
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
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Our online community that provides inspirational stories and helpful information.
| 11 |
Medicine intake, lack of movement for a long period, insect bites and unusual vitamin levels are some of the common causes of numbness and tingling in a particular part of the body, states Healthline. Persistent numbness and tingling without any apparent cause may indicate an injury or a disease.Know More
Numbness and tingling are called paresthesia, and can occur in various parts of the body, particularly in hands, arms, feet and legs, says Healthline. Radiation therapy, seafood toxins, inadequate blood supply to the affected body part and migraine headache are possible causes of paresthesia. People with diabetes, a damaged nerve in the neck or nerve pressure may also experience paresthesia.
One of the possible diseases associated with paresthesia is multiple sclerosis, an autoimmune illness that affects the brain and spinal cord, explains Healthline. Another likely disease that causes paresthesia is encephalitis or brain inflammation. It is essential to see a healthcare professional if a person suffers paresthesia after a head, neck or back injury. Immediate medical attention is also necessary if the individual becomes immobile, loses consciousness, experiences difficulty in thinking or suffers pain.
When individuals feel numbness and tingling, they may lack sensation and may not feel pain or temperature changes in the affected area, notes Healthline. Thus, it is important to be extra cautious to prevent accidental injuries.Learn more in Pain & Symptoms
Nausea after eating can occur as a result of gastritis, food poisoning, ulcers or bulimia, according to WebMD. Gastroesophageal reflux disease often causes people to become nauseous after eating foods that aggravate the production of stomach acids, notes Healthline.Full Answer >
Some medical conditions associated with hot ears include eczema, tinnitus, earwax blockage, cellulitis, Meniere's disease, abscess and labyrinthitis. Some other possible causes include exposure to loud noise, aspirin poisoning or a foreign object in the ear canal.Full Answer >
Consistent, excessive body heat can be attributed to several factors. The most notable factors include body metabolism, convection, conduction and radiation, according to the Chicago Tribune.Full Answer >
Bloating causes a feeling of fullness or uncomfortable tightness in the abdomen, according to Healthline. Bloating can also cause visible distension or swelling of the belly. Additional symptoms of bloating include intestinal gas and stomach pain.Full Answer >
| 11 |
The Achilles tendon connects the calf muscles to the heel bone. A rupture occurs when there is a tearing or separation of the tendon fibers.
Achilles tendon rupture can be caused by:
- Overworking an inflamed tendon
- Injury from an accident or fall
Factors that may increase your chance of getting Achilles tendon rupture include:
- Achilles tendonopathy
- Recent increase in activity level
- Weak or inflexible calf muscles
- Previous Achilles tendon rupture
- Involvement in sports that involve running, jumping, twisting, or lunging
- Improper footwear
- Certain medications, such as quinolone antibiotics or corticosteroids, which weaken the tendon
- Collagen vascular diseases, such as rheumatoid arthritis, lupus, and scleroderma
Symptoms may include:
- Popping or snapping noise when the injury occurs
- Sudden, extreme pain at the back of the heel
- Swelling near your heel
- Inability to push off from the ball of the foot
- Inability to walk on the affected leg
You will be asked about your symptoms and medical history. A physical exam will be done.
Images may be taken of the affected area. This can be done with:
Talk with your doctor about the best treatment plan for you. Treatment options may include the one or more of the following:
You will need time to heal. RICE and immediate medical care are often the pain part of treatment:
- Rest—Activities will need to be restricted.
- Ice—Ice therapy may help relieve swelling.
- Compression—Used for a limited time, compression bandages can provide gentle pressure to help move fluids out of the area.
- Elevation—Keeping the area elevated can help fluids drain out or prevent fluids from building up.
Crutches or a walker may be advised to protect the healing tendon.
Prescription or over-the-counter medication may be advised to reduce pain.
Surgery is the most common treatment for this condition. An incision is made in the lower leg and the tendon is sewn back together. A cast, splint, walking boot, or brace is worn for 6-8 weeks. One of the benefits of surgery is that it lowers the risk of re-rupturing the tendon. Surgery may also be a better option if you are physically active.
The other option is to allow your tendon to heal without surgery. In this case, you also need to wear a cast, splint, walking boot, or brace for 6-8 weeks. You also may have different exercises to do. If you are less active or have a chronic illness that prevents surgery, this option may be better for you.
A physical therapist will assess the tendon. An exercise program will be created to help recovery and to stregthen the muscles.
To help reduce your chance of getting Achilles tendon rupture, take the following steps:
- Do warm-up exercises before an activity and cool down exercises after an activity.
- Wear proper footwear.
- Maintain a healthy weight.
- Rest if you feel pain during an activity.
- Change your routine. Switch between high-impact activities and low-impact activities.
- Strengthen your calf muscle with exercises.
- Reviewer: Teresa Briedwell, PT, DPT
- Review Date: 03/2015 -
- Update Date: 02/28/2014 -
| 11 |
The airwalk is a popular dance move that is related to the moonwalk. While you move backwards when you do the moonwalk, you'll actually move forward while doing the airwalk. In order to do it, all you have to do is move your feet forward in a circular motion, lifting the toe of each foot in the air and then placing it down on the ground as you advance. All it takes is a bit of practice.
Part 1 of 2: Getting the Basics Down
1Stand with your feet side by side. They should be about hip's distance apart, as if you're walking as you normally would. The airwalk is all about your feet, so you don't have to worry about what to do with your arms or the rest of your body quite yet. If you've never tried this before, some people recommend that you sit with your feet apart to master the movements of your feet before standing.
- To get a stronger sense of what your feet are doing, you can practice in front of a mirror or even film yourself or ask a friend to watch you.
2Move one foot straight in the air in front of the other foot. Let the foot hover there straight, without pointing your toes, at about a 45 degree angle from the ground, with your toes above your heel. Lift the foot up in the air, with your toes leading, as if you were stepping over a barrier that is about half a foot tall, except that your foot won't hit the ground when you step over it and will pull back instead.
3As your weight transfers to the toes of that foot, glide it back to its original position. Your legs should be straight and you shouldn't bend your knees at all when you do this. Just glide the foot back to where it started, with the heel dragging it back until it naturally touches the ground. Think of it as rocking your weight forward before you transition to the other foot.
4When the first foot moves back to its original position, the other foot should point up on its toes. When you do the airwalk, you should never have both feet be flat on the ground at the same time. When one foot is moving back, the other should be preparing to move forward. It can take a little while to get into the rhythm. Just remember what we said about it being like riding a bicycle — when you're riding a bike, your feet are always in constant motion, too. If you stop one of them, then you'll stall.
5Move the other foot up and forward and repeat. Now, just do what you did with the other foot — lift your other foot forward, with the toe leading, as if you were stepping over a short barrier, and then drag it back, as if a string were attached to your heel and was slowly dragging it back. As the forward foot moves back, the other foot should prepare to move forward by lifting up on its toes.
6Keep moving forward. Just keep doing the airwalk by raising one foot at a time and moving forward for as long as you like. You can start by practicing in place and then slowly moving forward, so you're moving forward at a much slower pace than you would if you were walking, as if you're walking on air or are having to move forward in a low-gravity situation.
- When you move forward, try to form a "V" shape with your feet as they transition. So, when the foot that is up in the air moves back to meet the other, the heel of that foot should land where the toe of the other foot is pointed, so they create a "V" together as the pointed foot moves forward, and so on. This will keep you moving forward at the same pace.
7Practice. It can take some practice to get this move down, but it'll be worth it. It can also be easier to learn the moonwalk first, before you get the airwalk down, since some people think the airwalk is a little bit trickier. Once you master the airwalk, you can work on airwalking and then transitioning to the moonwalk and back to the airwalk again. You can also work on gliding, which will use somewhat similar techniques, except you'll be moving from side to side.
- As you get more comfortable with the airwalk, you can wave your shoulders a bit, and get your arms into it. Just move your arms forward and back, just as you would if you were walking forward normally, except at a slower pace to sync up with your feet.
- Remember to keep the movement as fluid as possible, so it looks like you're walking on air.
Part 2 of 2: Adding Variations
1Tap your toes with each step. Once you've got the airwalk down, you can add this small variation to make the movement more interesting. All you have to do is take the foot that is pointed on its toes, ready to move forward, move it forward, tap its toes on the ground, and then do the normal airwalking move, where the foot moves forward with the toes leading up above the heel. Then, move the foot back and do the same with the other foot, tapping its toes on the ground in front of it before it also moves forward.
2Tap your heel and toe with each step. Another thing you can do is to tap the heel of each foot, and then its toe, before you take a step forward. If you've mastered being able to tap each toe once before you move forward, then you should be able to tap the heel and then the toe of each foot as it takes a step without a problem. Watch yourself in the mirror to make sure that you've got the rhythm down.
3Do the airwalk along with the moonwalk. Once you become a master at the airwalk, you can work on walking forward for about thirty seconds or so, and then transitioning into the moonwalk, so you walk backwards to the place where you started. Then you can go right back into the airwalk, moving forward again, and then move backward using the moonwalk whenever you feel like it.
- The trickiest part will be the transition, and you have to work on not stalling or stopping, but transitioning right from moving forward to moving backward, and vice versa.
We could really use your help!
New Era hats?
Harvard Business School?
- If you Learn to do the moonwalk 1st the airwalk is easier.
- Stay away from ledges as head injuries may be possible.
- Make sure when popping your foot down it's popped and not just skidding to a stop as though it was a car to give it more of an illusionary sight.
Things You'll Need
- Smooth surface
- Socks, dance shoes, or trainers
Categories: Street Dance
In other languages:
Thanks to all authors for creating a page that has been read 12,454 times.
| 11 |
Rising Food Prices and Household Welfare: Evidence from Brazil in 2008
Food price inflation in Brazil in the twelve months to June 2008 was 18 percent, while overall inflation was 5.3 percent. This paper uses spatially disaggregated monthly data on consumer prices and two different household surveys to estimate the welfare consequences of these food price increases, and their distribution across households. Because Brazil is a large food producer, with a predominantly wage-earning agricultural labor force, our estimates include general equilibrium effects on market and transfer incomes, as well as the standard estimates of changes in consumer surplus. While the expenditure (or consumer surplus) effects were large, negative and markedly regressive everywhere, the market income effect was positive and progressive, particularly in rural areas. Because of this effect on the rural poor, and of the partial protection afforded by increases in two large social assistance benefits, the overall impact of higher food prices in Brazil was U-shaped, with the middle-income groups suffering larger proportional losses than the very poor. Nevertheless, since Brazil is 80 percent urban, higher food prices still led to a greater incidence and depth of poverty at the national level.
|Date of creation:||May 2011|
|Date of revision:|
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"The Distributional Impacts of Indonesia's Financial Crisis on Household Welfare: A "Rapid Response" Methodology,"
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8564, National Bureau of Economic Research, Inc.
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- Jed Friedman & James Levinsohn, 2001. "The Distributional Impacts of Indonesia's Financial Crisis on Household Welfare: "A Rapid Response Methodology"," William Davidson Institute Working Papers Series 387, William Davidson Institute at the University of Michigan.
- Jed Friedman & James Levinsohn, 2001. "The Distributional Impacts of Indonesia's Financial Crisis on Household Welfare: A 'Rapid Response' Methodology," Working Papers 482, Research Seminar in International Economics, University of Michigan.
- Ferreira, Francisco H. G. & Leite, Phillippe G. & Ravallion, Martin, 2007.
"Poverty reduction without economic growth ? explaining Brazil's poverty dynamics, 1985-2004,"
Policy Research Working Paper Series
4431, The World Bank.
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- Anton Korinek & Johan Mistiaen & Martin Ravallion, 2006.
"Survey nonresponse and the distribution of income,"
Journal of Economic Inequality,
Springer, vol. 4(1), pages 33-55, April.
- Fabio Veras Soares & Sergei Suarez Dillon Soares & Marcelo Medeiros & Rafael Guerreiro Osório, 2006. "Cash Transfer Programmes in Brazil: Impacts on Inequality and Poverty," Working Papers 21, International Policy Centre for Inclusive Growth.
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| 12 |
2007–08 world food price crisis
|Parts of this article (those related to price projections for 2009–10) are outdated. (February 2011)|
World food prices increased dramatically in 2007 and the 1st and 2nd quarter of 2008 creating a global crisis and causing political and economical instability and social unrest in both poor and developed nations. Although the media spotlight focused on the riots that ensued in the face of high prices, the ongoing crisis of food insecurity has been years in the making. Systemic causes for the worldwide increases in food prices continue to be the subject of debate. After peaking in the second quarter of 2008 prices fell dramatically during the Late-2000s recession but increased during 2009 and 2010, peaking again in early 2011 at a level slightly higher than the level reached in 2008. However a repeat of the crisis of 2008 is not anticipated due to ample stockpiles.
Initial causes of the late-2006 price spikes included droughts in grain-producing nations and rising oil prices. Oil price increases also caused general escalations in the costs of fertilizers, food transportation, and industrial agriculture. Root causes may be the increasing use of biofuels in developed countries (see also food vs fuel), and an increasing demand for a more varied diet across the expanding middle-class populations of Asia.
These factors, coupled with falling world-food stockpiles all contributed to the worldwide rise in food prices.
- 1 Drastic price increases
- 1.1 World population growth
- 1.2 Increased demand for more resource intensive food
- 1.3 Effects of petroleum and fertilizer price increases
- 1.4 Declining world food stockpiles
- 1.5 Financial speculation
- 1.6 Effects of trade liberalization
- 1.7 Effects of food for fuel
- 1.8 Biofuel subsidies in the US and the EU
- 1.9 Idled farmland
- 1.10 Agricultural subsidies
- 1.11 Distorted global rice market
- 1.12 Crop shortfalls from natural disasters
- 1.13 Soil and productivity losses
- 1.14 Rising levels of ozone
- 2 Rising prices
- 3 Effects on farmers
- 4 Unrest and government actions in individual countries and regions
- 5 Projections
- 6 After the crisis
- 7 Actions by governments
- 8 Food price decreases
- 9 See also
- 10 References
- 11 External links
Drastic price increases
Between 2006 and 2008 average world prices for rice rose by 217%, wheat by 136%, corn by 125% and soybeans by 107%. In late April 2008 rice prices hit 24 cents (U.S.) per U.S. pound, more than doubling the price in just seven months.
World population growth
Although some commentators have argued that this food crisis stems from unprecedented global population growth, others point out that world population growth rates have dropped dramatically since the 1980s, and grain availability has continued to outpace population.
In order to prevent price growth, food production should outpace population growth, which was about 1.2% per year. But there was a temporary drop in food production growth: for example, wheat production during 2006 and 2007 was 4% lower than that in 2004 and 2005.
Increased demand for more resource intensive food
The head of the International Food Policy Research Institute, stated in 2008 that the gradual change in diet among newly prosperous populations is the most important factor underpinning the rise in global food prices. Where food consumption has increased, it has largely been in processed ("value added") foods, sold in developing and developed nations. Total grain utilization growth since 2006 (up three percent, over the 2000–2006 per annum average of two percent) has been greatest in non-food usage, especially in feed and biofuels.
One kilogram of beef requires seven kilograms of feed grain. These reports, therefore, conclude that usage in industrial, feed, and input intensive foods, not population growth among poor consumers of simple grains, has contributed to the price increases. Rising meat consumption due to changes in lifestyle can in turn lead to higher energy consumption due to the higher energy-intensity of meat products, for example, one kilogram of meat uses about 19 times as much energy to produce it as the same amount of apple.
Although the vast majority of the population in Asia remains rural and poor, the growth of the middle class in the region has been dramatic. For comparison, in 1990, the middle class grew by 9.7 percent in India and 8.6 percent in China, but by 2007 the growth rate was nearly 30 percent and 70 percent respectively. The corresponding increase in Asian affluence also brought with it a change in lifestyle and eating habits, particularly a demand for greater variety, leading to increased competition with western nations for already strained agricultural resources. This demand exacerbates dramatic increases in commodity prices such as oil.
Another issue with rising affluence in India and China was reducing the 'shock absorber' of poor people who are forced to reduce their resource consumption when food prices rise. This reduced price elasticity and caused a sharp rise in food prices during some shortages. In the media, China is often mentioned as one of the main reasons for the increase in world food prices. However, China has to a large extent been able to meet its own demand for food, and even exports its surpluses in the world market.
Effects of petroleum and fertilizer price increases
Starting in 2007, the prices of fertilizers of all kinds increased dramatically, peaking around the summer of 2008 (see graphs by the International Fertilizer Industry Association). Prices approximately tripled for ammonia, urea, diammonium phosphate, muriate of potash (KCl), and sulfuric acid (used for making phosphate fertilizer), and then fell just as dramatically in the latter part of 2008. Some prices doubled within the six months before April 2008. Part of the cause for these price rises was the rise in the price of oil, since the most fertilizers require petroleum or natural gas to manufacture. Although the main fossil fuel input for fertilizer comes from natural gas to generate hydrogen for the Haber–Bosch process (see: Ammonia production), natural gas has its own supply problems similar to those for oil. Because natural gas can substitute for petroleum in some uses (for example, natural gas liquids and electricity generation), increasing prices for petroleum lead to increasing prices for natural gas, and thus for fertilizer.
Costs for fertilizer raw materials other than oil, such as potash, have themselves been increasing as increased production of staples increases demand. This is causing a boom (with associated volatility) in agriculture stocks.
The major IFPRI Report launched in February 2011 stated that the causes of the 2008 global food crisis were similar to that of the 1972–74 food crisis, in that the oil price and energy price was the major driver, as well as the shock to cereal demand (from biofuels this time), low interest rates, devaluation of the dollar, declining stocks, and some adverse weather conditions. Unfortunately the IFPRI states that such shocks are likely to recur with several shocks in the future; compounded by a long history of neglecting agricultural investments.
Declining world food stockpiles
In the past, nations tended to keep more sizable food stockpiles, but more recently, due to a faster pace of food growth and ease of importation, less emphasis is placed on high stockpiles. For example, in February 2008 wheat stockpiles hit a 60-year low in the United States (see also Rice shortage). Data stocks are often calculated as a residual between Production and Consumption but it becomes difficult to discriminate between a de-stocking policy choices of individual countries and a deficit between production and consumption.
Commodity index funds
Goldman Sachs' entry into the commodities market via the Goldman Sachs Commodity Index has been implicated by some in the 2007–2008 world food price crisis. In a 2010 article in Harper's magazine, Frederick Kaufman magazine accused Goldman Sachs of profiting while many people went hungry or even starved. He argued that Goldman's large purchases of long-options on wheat futures created a demand shock in the wheat market, which disturbed the normal relationship between supply and demand and price levels. He argues that the result was a 'contango' wheat market on the Chicago Mercantile Exchange, which caused prices of wheat to rise much higher than normal, defeating the purpose of the exchanges (price stabilization) in the first place. however, a report by the Organisation for Economic Co-operation and Development – using data from the Commodity Futures Trading Commission – showed tracking funds (of which Goldman Sachs Commodity Index was one) did not cause the bubble. For example the report points out that even commodities without futures markets also saw price rises during the period. Some commodities without futures markets saw their prices rise as a consequence of the rising prices of commodities with futures markets: the World Development Movement states there is strong evidence that the rising price of wheat caused the price of rice to subsequently rise as well.
Effects of trade liberalization
Some theorists, such as Martin Khor of the Third World Network, point out that many developing nations have gone from being food independent to being net food importing economies since the 1970s and 1980s International Monetary Fund (and later the World Trade Organisation's Agreement on Agriculture) free market economics directives to debtor nations. In opening developing countries to developed world food imports subsidised by Western governments, developing nations can become more dependent upon food imports if local agriculture does not improve.
While developed countries pressured the developing world to abolish subsidies in the interest of trade liberalization, rich countries largely kept subsidies in place for their own farmers. In recent years United States government subsidies have been added to push production toward biofuel rather than food and vegetables .
Effects of food for fuel
One systemic cause for the price rise is held to be the diversion of food crops (maize in particular) for making first-generation biofuels. An estimated 100 million tons of grain per year are being redirected from food to fuel. (Total worldwide grain production for 2007 was just over 2000 million tons.) As farmers devoted larger parts of their crops to fuel production than in previous years, land and resources available for food production were reduced correspondingly.
This has resulted in less food available for human consumption, especially in developing and least developed countries, where a family's daily allowances for food purchases are extremely limited. The crisis can be seen, in a sense, to dichotomize rich and poor nations, since, for example, filling a tank of an average car with biofuel, amounts to as much maize (Africa's principal food staple) as an African person consumes in an entire year.
Brazil, the world's second largest producer of ethanol after the U.S., is considered to have the world's first sustainable biofuels economy and its government claims Brazil's sugar cane based ethanol industry has not contributed to the 2008 food crises. A World Bank policy research working paper released in July 2008 concluded that "...large increases in biofuels production in the United States and Europe are the main reason behind the steep rise in global food prices", and also stated that "Brazil's sugar-based ethanol did not push food prices appreciably higher". An economic assessment published in July 2008 by the OECD disagrees with the World Bank report regarding the negative effects of subsidies and trade restrictions, finding that the effect of biofuels on food prices are much smaller.
A report released by Oxfam in June 2008 criticized biofuel policies of rich countries and concluded that, of all biofuels available in the market, Brazilian sugarcane ethanol is "far from perfect" but it is the most favorable biofuel in the world in term of cost and GHG balance. The report discusses some existing problems and potential risks and asks the Brazilian government for caution to avoid jeopardizing its environmental and social sustainability. The report also says that: "Rich countries spent up to $15 billion last year supporting biofuels while blocking cheaper Brazilian ethanol, which is far less damaging for global food security." (See Ethanol fuel in Brazil)
German Chancellor Angela Merkel said the rise in food prices is due to poor agricultural policies and changing eating habits in developing nations, not biofuels as some critics claim. On 29 April 2008, U.S. President George W. Bush declared during a press conference that "85 percent of the world's food prices are caused by weather, increased demand and energy prices", and recognized that "15 percent has been caused by ethanol". On 4 July 2008, The Guardian reported that a leaked World Bank report estimated the rise in food prices caused by biofuels to be 75%. This report was officially released in July 2008.
Since reaching record high prices in June 2008, corn prices fell 50% by October 2008, declining sharply together with other commodities, including oil. As ethanol production from corn has continued at the same levels, some have argued this trend shows the belief that the increased demand for corn to produce ethanol was mistaken. "Analysts, including some in the ethanol sector, say ethanol demand adds about 75 cents to $1.00 per bushel to the price of corn, as a rule of thumb. Other analysts say it adds around 20 percent, or just under 80 cents per bushel at current prices. Those estimates hint that $4 per bushel corn might be priced at only $3 without demand for ethanol fuel." These industry sources consider that a speculative bubble in the commodity markets holding positions in corn futures was the main driver behind the observed hike in corn prices affecting food supply.
Second- and third-generation biofuels (such as cellulosic ethanol and algae fuel, respectively) may someday ease the competition with food crops, as can grow on marginal lands unsuited for food crops, but these advanced biofuels require further development of farming practices and refining technology; in contrast, ethanol from maize uses mature technology and the maize crop can be shifted between food and fuel use quickly.
Biofuel subsidies in the US and the EU
The World Bank lists the effect of biofuels as an important contributor to higher food prices. The FAO/ECMB has reported that world land usage for agriculture has declined since the 1980s, and subsidies outside the United States and EU have dropped since the year 2004, leaving supply, while sufficient to meet 2004 needs, vulnerable when the United States began converting agricultural commodities to biofuels. According to the United States Department of Agriculture, global wheat imports and stocks have decreased, domestic consumption has stagnated, and world wheat production has decreased from 2006 to 2008.
In the United States, government subsidies for ethanol production have prompted many farmers to switch to production for biofuel. Maize is the primary crop used for the production of ethanol, with the United States being the biggest producer of maize ethanol. As a result, 23 percent of United States maize crops were being used for ethanol in 2006–2007 (up from 6 percent in 2005–2006), and the USDA expects the United States to use 81 million tons of maize for ethanol production in the 2007–2008 season, up 37 percent. This not only diverts grains from food, but it diverts agricultural land from food production.
Nevertheless, supporters of ethanol claim that using corn for ethanol is not responsible for the worst food riots in the world, many of which have been caused by the price of rice and oil, which are not affected by biofuel use but rather by supply and demand.
However, a World Bank policy research working paper released in July 2008 says that biofuels have raised food prices between 70 to 75 percent. The study found that higher oil prices and a weak dollar explain 25–30% of total price rise. The "month-by-month" five-year analysis disputes that increases in global grain consumption and droughts were responsible for price increases, reporting that this had had only a marginal effect and instead argues that the EU and US drive for biofuels has had by far the biggest effect on food supply and prices. The paper concludes that increased production of biofuels in the US and EU were supported by subsidies and tariffs on imports, and considers that without these policies, price increases would have been smaller. This research also concluded that Brazil's sugar cane based ethanol has not raised sugar prices significantly, and suggest to remove tariffs on ethanol imports by both the US and EU, to allow more efficient producers such as Brazil and other developing countries to produce ethanol profitably for export to meet the mandates in the EU and the US.
The Renewable Fuel Association (RFA) published a rebuttal based on the version leaked before the formal release of the World Bank's paper. The RFA critique considers that the analysis is highly subjective and that the author "estimates the effect of global food prices from the weak dollar and the direct and indirect effect of high petroleum prices and attributes everything else to biofuels."
An economic assessment report also published in July 2008 by the OECD agrees with the World Bank report regarding the negative effects of subsidies and trade restrictions, but found that the effect of biofuels on food prices are much smaller. The OECD study is also critical of the limited reduction of GHG emissions achieved from biofuels produced in Europe and North America, concluding that the current biofuel support policies would reduce greenhouse gas emissions from transport fuel by no more than 0.8 percent by 2015, while Brazilian ethanol from sugar cane reduces greenhouse gas emissions by at least 80 percent compared to fossil fuels. The assessment calls on governments for more open markets in biofuels and feedstocks to improve efficiency and lower costs.
According to the New York Times on 9 April 2008, the United States government pays farmers to idle their cropland under a conservation program. This policy reached a peak of 36,800,000 acres (149,000 km2) idled in 2007, that is 8% of cropland in United States, representing a total area bigger than the state of New York.
The global food crisis has renewed calls for removal of distorting agricultural subsidies in developed countries. Support to farmers in OECD countries totals 280 billion USD annually, which compares to official development assistance of just 80 billion USD in 2004, and farm support depresses global food prices, according to OECD estimates. These agricultural subsidies lead to underdevelopment in rural developing countries, including the least developed countries; meanwhile subsidised food increases overconsumption in developed countries. The US Farm Bill brought in by the Bush Administration in 2002 increased agricultural subsidies by 80% and cost the US taxpayer 190 billion USD. In 2003, the EU agreed to extend the Common Agricultural Policy until 2013. Former UNDP Administrator Malloch Brown renewed calls for reform of the farm subsidies such as the CAP.
Distorted global rice market
Japan is forced to import more than 767,000 tons of rice annually from the United States, Thailand, and other countries due to WTO rules, although Japan produces over 100% of domestic rice consumption needs with 11 million tons produced in 2005 while 8.7 million tons were consumed in 2003–2004 period. Japan is not allowed to re-export this rice to other countries without approval. This rice is generally left to rot and then used for animal feed. Under pressure, the United States and Japan are poised to strike a deal to remove such restrictions. It is expected 1.5 million tons of high-grade American rice will enter the market soon.
Crop shortfalls from natural disasters
Several distinct weather- and climate-related incidents have caused disruptions in crop production. Perhaps the most influential is the extended drought in Australia, in particular the fertile Murray-Darling Basin, which produces large amounts of wheat and rice. The drought has caused the annual rice harvest to fall by as much as 98% from pre-drought levels.
Australia is historically the second-largest exporter of wheat after the United States, producing up to 25 million tons in a good year, the vast majority for export. However, the 2006 harvest was 9.8 million. Other events that have negatively affected the price of food include the 2006 heat wave in California's San Joaquin Valley, which killed large numbers of farm animals, and unseasonable 2008 rains in Kerala, India, which destroyed swathes of grain. These incidents are consistent with the effects of climate change.
The effects of Cyclone Nargis on Burma in May 2008 caused a spike in the price of rice. Burma has historically been a rice exporter, though yields have fallen as government price controls have reduced incentives for farmers. The storm surge inundated rice paddies up to 30 miles (48 km) inland in the Irrawaddy Delta, raising concern that the salt could make the fields infertile. The FAO had previously estimated that Burma would export up to 600,000 tons of rice in 2008, but concerns were raised in the cyclone's aftermath that Burma may be forced to import rice for the first time, putting further upward pressure on global rice prices.
Stem rust reappeared in 1998 in Uganda (and possibly earlier in Kenya) with the particularly virulent UG99 fungus. Unlike other rusts, which only partially affect crop yields, UG99 can bring 100% crop loss. Up to 80% yield losses were recently recorded in Kenya.
As of 2005 stem rust was still believed to be "largely under control worldwide except in Eastern Africa". But by January 2007 an even more virulent strain had gone across the Red Sea into Yemen. FAO first reported on 5 March 2008 that Ug99 had now spread to major wheat-growing areas in Iran.
These countries in North Africa and Middle East consume over 150% of their own wheat production; the failure of this staple crop thus adds a major burden on them. The disease is now expected to spread over China and the Far-East. The strong international collaboration network of research and development that spread disease-resistant strains some 40 years ago and started the Green Revolution, known as CGIAR, was since slowly starved of research funds because of its own success and is now too atrophied to swiftly react to the new threat.
Soil and productivity losses
Sundquist points out that large areas of croplands are lost year after year, due mainly to soil erosion, water depletion and urbanisation. According to him "60,000 km2/year of land becomes so severely degraded that it loses its productive capacity and becomes wasteland", and even more are affected to a lesser extent, adding to the crop supply problem.
Additionally, agricultural production is also lost due to water depletion. Northern China in particular has depleted much of its non-renewables aquifers, which now impacts negatively its crop production.
Urbanisation is another, smaller, difficult to estimate cause of annual cropland reduction.
Rising levels of ozone
One possible environmental factor in the food price crisis is rising background levels of ground-level tropospheric ozone in the atmosphere. Plants have been shown to have a high sensitivity to ozone levels, and lower yields of important food crops, such as wheat and soybeans, may have been a result of elevated ozone levels. Ozone levels in the Yangtze Delta were studied for their effect on oilseed rape, a member of the cabbage family that produces one-third of the vegetable oil used in China. Plants grown in chambers that controlled ozone levels exhibited a 10–20 percent reduction in size and weight (biomass) when exposed to elevated ozone levels. Production of seeds and oil was also reduced. The Chinese authors of this study also reported that rice grown in chambers that controlled ozone levels exhibited a 14 to 20 percent reduction in biomass yield when exposed to ozone levels over 25 times higher than was normal for the region.
From the beginning of 2007 to early 2008, the prices of some of the most basic international food commodities increased dramatically on international markets. The international market price of wheat doubled from February 2007 to February 2008 hitting a record high of over US$10 a bushel. Rice prices also reached ten-year highs. In some nations, milk and meat prices more than doubled, while soy (which hit a 34-year high price in December 2007) and maize prices have increased dramatically.
Total food import bills rose by an estimated 25% for developing countries in 2007. Researchers from the Overseas Development Institute have suggested this problem will be worsened by a likely fall in food aid. As food aid is programmed by budget rather than volume, rising food prices mean that the World Food Programme (WFP) needs an extra $500 million just to sustain the current operations.
To ensure that food remains available for their domestic populations and to combat dramatic price inflation, major rice exporters, such as China, Brazil, India, Indonesia, Vietnam, Cambodia and Egypt, imposed strict export bans on rice. Conversely, several other nations, including Argentina, Ukraine, Russia, and Serbia either imposed high tariffs or blocked the export of wheat and other foodstuffs altogether, driving up prices still further for net food importing nations while trying to isolate their internal markets. North Korea suffered from the food crisis to such extent that a North Korean official was quoted in June '08 with saying "Life is more than difficult. It seems that everyone is going to die". This nation however is solely relying on food assistance to cope with the crisis.
In developed countries
|This section requires expansion. (May 2008)|
A May 2008 national survey found that food banks and pantries across the U.S. were being forced to cut back on food distribution as 99 percent of respondents reported an increase in the number of people requesting services. Rising food and fuel prices, inadequate food stamp benefits, unemployment, underemployment, and rent or mortgage costs were factors reported as forcing an average of 15–20 percent more people. Compounding this issue, USDA bonus foods have declined by $200 million and local food donations were down nationally about 9 percent over the same period. According to the California Association of Food Banks, which is an umbrella organization of nearly all food banks in the state, food banks are at the "beginning of a crisis."
Effects on farmers
If global price movements are transmitted to local markets, farmers in the developing world could benefit from the rising price of food. According to researchers from the Overseas Development Institute, this may depend on farmers' capacity to respond to changing market conditions. Experience suggests that farmers lack the credit and inputs needed to respond in the short term. In the medium or long term, however, they could benefit, as seen in the Asian Green Revolution or in many African countries in the recent past.
Relationship with 2008 Chinese milk scandal
As grain prices increased, China's numerous small-holding milk farmers, as well as producers of feed for cattle, were unable to exist economically. As a result, they turned to putting additives into the feed and milk, including melamine, in order to boost the measured level of protein. Hundreds of thousands of children became ill, China's milk exports virtually ended, executives and officials were arrested and some executed, and companies went bankrupt.
Unrest and government actions in individual countries and regions
The price rises affected parts of Asia and Africa particularly severely with Burkina Faso, Cameroon, Senegal, Mauritania, Côte d'Ivoire, Egypt and Morocco seeing protests and riots in late 2007 and early 2008 over the unavailability of basic food staples. Other countries that have seen food riots or are facing related unrest are: Mexico, Bolivia, Yemen, Uzbekistan, Bangladesh, Pakistan, Sri Lanka, and South Africa.
10,000 workers rioted close to the Bangladeshi capital Dhaka, smashing cars and buses and vandalising factories in anger at high food prices and low wages. Dozens of people, including at least 20 police officials, were injured in the violence. Ironically, the country achieved food self-sufficiency in 2002, but food prices increased drastically due to the reliance of agriculture on oil and fossil fuels.
Economists estimate 30 million of the country's 150 million people could go hungry.
One of the earlier food riots took place in Burkina Faso, on 22 February, when rioting broke out in the country's second and third largest cities over soaring food prices (up to a 65 percent increase), sparing the capital, Ouagadougou, where soldiers were mobilized throughout strategic points. The government promised to lower taxes on food and to release food stocks. Over 100 people were arrested in one of the towns. Related policy actions of the Burkinabe government included:
- The removal of customs duty on rice, salt, dairy-based products and baby foods
- The removal of value added tax on durum wheat, baby foods, soap and edible oils
- Establishing negotiated prices with wholesalers for sugar, oil and rice
- Releasing food stocks
- Strengthening of community grain banks
- Food distribution in-kind
- Reduction of electricity cost, partial payment of utility bills for the poor
- Enacting special programs for schools and hospitals
- Fertilizer distribution and production support.
A ban was also imposed on exportation of cereals.
Cameroon, the world's fourth largest cocoa producer, saw large scale rioting in late February 2008 in Douala, the country's commercial capital. Protesters were against inflating food and fuel prices, as well as the attempt by President Paul Biya to extend his 25-year rule. Protesters set up barricades, burned tires, and targeted businesses that they believed belonged to the Biya family, high members of the ruling party, the government, or France. It became the first protest in the nation's history in which minute- by-minute events were covered by social media. By 27 February, a strike was taking place in thirty-one cities, including Yaoundé, Douala, Bamenda, Bafoussam, Buea, Limbe, Tiko, Muea, Mutengene, and Kumba. At least seven people were killed in the worst unrest seen in the country in over fifteen years. This figure was later increased to 24. Youths were mobilized in ways that had not been seen since the days of the villes mortes. Part of the government response to the protests was a reduction in import taxes on foods including rice, flour, and fish. The government reached an agreement with retailers by which prices would be lowered in exchange for the reduced import taxes. As of late April 2008, however, reports suggested that prices had not eased and in some cases had even increased.
On 24 April 2008, the government of Cameroon announced a two-year emergency program designed to double Cameroon's food production and achieve food self-sufficiency.
On 31 March, Côte d'Ivoire's capital Abidjan saw police use tear gas and a dozen protesters injured following food riots that gripped the city. The riots followed dramatic hikes in the price of food and fuel, with the price of beef rising from US$1.68 to $2.16 per kilogram, and the price of gasoline rising from $1.44 to $2.04 per liter, in only three days.
In Egypt, a boy was killed from a gunshot to the head after Egyptian police intervened in violent demonstrations over rising food prices that gripped the industrial city of Mahalla on 8 April. Large swathes of the population have been hit as food prices, and particularly the price of bread, have doubled over the last several months as a result of producers exploiting a shortage that has existed since 2006 · .
|This section requires expansion. (June 2008)|
On 12 April 2008, the Haitian Senate voted to dismiss Prime Minister Jacques-Édouard Alexis after violent food riots hit the country. The food riots caused the death of 5 people. Prices for food items such as rice, beans, fruit and condensed milk have gone up 50 percent in Haiti since late 2007 while the price of fuel has tripled in only two months. Riots broke out in April due to the high prices, and the government had been attempting to restore order by subsidizing a 15 percent reduction in the price of rice. As of February 2010, post-earthquake Port-au-Prince is almost entirely reliant on foreign food aid, some of which ends up in the black markets.
India has banned the export of rice except for Basmati which attracts a premium price.
The ban has since been removed, and India now exports a variety of rice.
In April 2008, the Latin American members of the United Nations' Food and Agriculture Organization (FAO) met in Brasília to confront the issues of high food prices, scarcities and violence that affect the region.
The President of Mexico, Felipe Calderón, with industry representatives and members of the Confederation of Industrial Chambers (Concamin), agreed to freeze prices of more than 150 consumer staples, such as coffee, sardines, tuna, oil, soup or tea, among others, until the end of December 2008. The measure was carried out in an attempt to control inflation, which stood at an annual rate of 4.95%, the highest increase since December 2004.
Mexican baking company Grupo Bimbo's CEO, Daniel Servitje, announced in the 19th Plenary Meeting of the Mexico–China Business Committee that Bimbo agreed to freeze their product prices, despite a 20% rise in production costs. Bimbo is one of the most important baking companies worldwide, having recently expanded to China. Bimbo has also acquired five bakeries in the United States and Canada.
In mid February, rioting that started in the Mozambican rural town of Chokwe and then spread to the capital, Maputo, has resulted in at least four deaths. The riots were reported in the media to have been, at least in part, over food prices and were termed "food riots." A biofuel advocacy publication, however, claimed that these were, in fact, "fuel riots", limited to the rise in the cost of diesel, and argued that the "food riot" characterization worked to fan "anti-biofuels sentiment."
The Pakistan Army has been deployed to avoid the seizure of food from fields and warehouses. This hasn't stopped the food prices from increasing. The new government has been blamed for not managing the countries food stockpiles properly.
Once the world's top rice producer, Myanmar has produced enough rice to feed itself until now. Rice exports dropped over four decades from nearly 4 million tons to only about 40,000 tons last year, mostly due to neglect by Myanmar's ruling generals of infrastructure, including irrigation and warehousing. On 3 May 2008 Cyclone Nargis stripped Myanmar's rice-growing districts, ruining large areas with salt water. U.N. Food and Agriculture Organization estimates that these areas produce 65 percent of Myanmar's rice. Worries of long-term food shortages and rationing are rife. The military regime says nothing about the rice crisis, but continues to export rice at the same rate. "...at least the next two harvests are going to be greatly affected and there'll be virtually no output from those areas during that time. So we're likely to see considerable food and rice shortages for the next couple of years. The damage to the economy is going to be profound." said economist and Myanmar expert Sean Turnell, of Australia's Macquarie University. (interviewed in "The Irriwaddy", Tuesday, 27 May 2008)
In Panama, in response to higher rice prices the government began buying rice at the high market price and selling rice to the public at a lower subsidized price at food kiosks.
In the Philippines, the Arroyo government insisted on 13 April that there would be no food riots in the country and that there could be no comparison with Haiti's situation. Chief Presidential Legal Counsel, Sergio Apostol stated that: "Haiti is not trying to solve the problem, while we are doing something to address the issue. We don't have a food shortage. So, no comparison..." Comments by the Justice Secretary, Raul Gonzalez, the following day, that food riots are not far fetched, were quickly rebuked by the rest of the government.
On 15 April, the Philippines, the world's largest rice importer, urged China, Japan, and other key Asian nations, to convene an emergency meeting, especially taking issue with those countries' rice export bans. "Free trade should be flowing", Philippine Agriculture Secretary Arthur Yap stated. In late April 2008, the Philippines government requested that the World Bank exert pressure on rice exporting countries to end export restrictions.
The Russian government pressured retailers to freeze food prices before key elections for fear of a public backlash against the rising cost of food in October 2007. The freeze ended on 1 May 2008.
On 31 March 2008, Senegal had riots in response to the rise in the price of food and fuel. Twenty-four people were arrested and detained in a response that one local human rights group claimed included "torture" and other "unspeakable acts" on the part of the security forces. Further protests took place in Dakar on 26 April 2008.
Riots in Somalia occurred on 5 May 2008 over the price of food, in which five protesters were killed. The protests occurred amid a serious humanitarian emergency due to the Ethiopian war in Somalia.
The Christian Science Monitor, neweurasia, and other media observers are predicting that a nascent hunger crisis will erupt into a full famine as a consequence of the energy shortages. UN experts announced on 10 October that almost one-third of Tajikistan's 6.7 million inhabitants may not have enough to eat for the winter of 2008–09.
Food riots in southern Yemen that began in late March and continued through early April, saw police stations torched, and roadblocks were set up by armed protesters. The army has deployed tanks and other military vehicles. Although the riots involved thousands of demonstrators over several days and over 100 arrests, officials claimed no fatalities; residents, however, claimed that at least one of the fourteen wounded people has died.
The UN (FAO) released a study in December 2007 projecting a 49 percent increase in African cereal prices, and 53 percent in European prices, through July 2008. In April 2008, the World Bank, in combination with the International Monetary Fund, announced a series of measures aimed at mitigating the crisis, including increased loans to African farmers and emergency monetary aid to badly affected areas such as Haiti. According to FAO director Jacques Diouf, however, the World Food Programme needs an immediate cash injection of at least $1700 million, far more than the tens of million-worth in measures already pledged. On 28 April 2008, the United Nations Secretary-General Ban Ki-moon established a Task Force on the Global Food Security Crisis under his chairmanship and composed of the heads of the United Nations specialized agencies, funds and programmes, Bretton Woods institutions and relevant parts of the UN Secretariat to co-ordinate efforts to alleviate the crisis.
After the crisis
2013 research concluded that the spike was the result of an unusual combination of circumstances and prices in the future will be higher than before the spike, depending on oil prices, climate change, and future diets. The impacts of the spike on poor people were concentrated in low-income countries and may have been less severe than once thought, thanks to rising rural wages in some countries. The researchers called on developing countries to ensure good data on the key indicators of distress and to strengthen social protection, and on those involved in international development to continue increasing focus on reducing child malnutrition and stimulating agricultural development.
Actions by governments
On 2 May 2008 U.S. President George W. Bush said he was asking Congress to approve an extra $770 million funding for international food aid. On 16 October 2008, former US president Bill Clinton scolded the bipartisan coalition in Congress that killed the idea of making some aid donations in cash rather than in food.
The release of Japan's rice reserves onto the market may bring the rice price down significantly. As of 16 May, anticipation of the move had already lowered prices by 14% in a single week.
On 30 April 2008 Thailand announced the creation of the Organization of Rice Exporting Countries (OREC) with the potential to develop a price-fixing cartel for rice. This is seen by some as an action to capitalise on the crisis.
In June 2008 the Food and Agriculture Organization hosted a High-Level Conference on World Food Security, in which $1.2 billion in food aid was committed for the 75 million people in 60 countries hardest hit by rising food prices.
On 23 October 2008, Associated Press reported the following:
"Former President Clinton told a U.N. gathering Thursday [16 Oct 2008] that the global food crisis shows "we all blew it, including me", by treating food crops "like color TVs" instead of as a vital commodity for the world's poor.... Clinton criticized decades of policymaking by the World Bank, the International Monetary Fund and others, encouraged by the U.S., that pressured Africans in particular into dropping government subsidies for fertilizer, improved seed and other farm inputs as a requirement to get aid. Africa's food self-sufficiency declined and food imports rose. Now skyrocketing prices in the international grain trade – on average more than doubling between 2006 and early 2008 – have pushed many in poor countries deeper into poverty."
We need the World Bank, the IMF, all the big foundations, and all the governments to admit that, for 30 years, we all blew it, including me when I was President. We were wrong to believe that food was like some other product in international trade, and we all have to go back to a more responsible and sustainable form of agriculture.
Food price decreases
In December 2008, the global economic slowdown, decreasing oil prices, and speculation of decreased demand for commodities worldwide brought about sharp decreases in the price of staple crops from their earlier highs. Corn prices on the Chicago Board of Trade dropped from US$7.99 per bushel in June to US$3.74 per bushel in mid-December; wheat and rice prices experienced similar decreases. The UN's Food and Agriculture Organization, however, warned against "a false sense of security", noting that the credit crisis could cause farmers to reduce plantings. FAO convened a World Summit on Food Security at its headquarters in Rome in November 2008, noting that food prices remained high in developing countries and that the global food security situation has worsened.
By early 2011 food prices had risen again to surpass the record highs of 2008. Some commentators saw this as the resumption of the price spike seen in 2007–08. Prices had dropped after good weather helped increase grain yields while demand had dropped due to the recession.
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Amid fears of a repeat of the price surge experienced in 2008, FAO expects supplies of major food crops in 2010/11 to be more adequate than two years ago, mainly because of much larger reserves.
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- "As Prices Rise, Farmers Spurn Conservation Program" New York Times 9 April 2008. In England thousands of acres of land were "set-a-side" in hope to encourage wild birds and insects. This has had detrimental effects on the amount of food in England. Stockpiles of grain is virtually nil, which has made the price of bread excel over the past couple of months.
- Food crisis set to weigh on CAP Reform, EurActiv, 20 May 2008
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- Crops lost due to unseasonal rains in Kerala The Economic Times, 8 April 2008.
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Two die after clashes in Egypt industrial town Gamal: Reuters, 8 April 2008.
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The difference between the subsidised and market price of bread [in Egypt] is exploited at every stage of production and sale, by importers, millers, warehousers, traders, bakers and consumers alike.
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- Feeding Nine Billion
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First for the county!
Specimen produced a pinkish-orange spore print. Gathered with a permit from the refuge headquarters.
Tree Volvariella. A sort of eye-catching, white, shaggy mushroom growing from a rotting log.
The Pluteaceae are a family of small to medium-sized mushrooms which have free gill attachment and pink spores. Members of Pluteaceae can be mistaken for members of Entolomataceae, but can be distinguished by their angled spores and attached gills. The four genera in the Pluteaceae include the widely distributed Volvariella and Pluteus, the rare Chamaeota, and Volvopluteus, newly described in 2011 as a result of molecular analysis. The Dictionary of the Fungi (10th edition, 2008) estimates...
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One of the most exciting things for any plant enthusiast is to erect a greenhouse. This is the ideal place to grow plants regardless of the prevailing environmental conditions or season. If you want to have a greenhouse, you can consider building a greenhouse or buying a greenhouse kit. Whether you are building a greenhouse or buying one, there are some important factors that you must consider before choosing a greenhouse. Here are some tips on how to choose a greenhouse.
Location: The first thing is to choose the perfect greenhouse location and decide the right size. A greenhouse operates by trapping solar energy and then converting it into thermal energy. Therefore, you should erect it on an area that receives maximum sunlight. Ensure that the location is not blocked by large trees, buildings and other structures. When it comes to size, you can go for a mini or large version, based on the size and plan of your area.
Style: There are many types of greenhouse structural styles. There are two basic styles of greenhouse for your garden; free-standing and lean-to unit. The lean-to unit is attached to a garage or house. The major advantage of this style is that you will not worry about accessibility to electricity and water. If you opt for a free-standing greenhouse, consider the construction cost as well as availability of water. The most popular type of free-standing greenhouse is the span roof type.
Foundation: The greenhouse requires a strong foundation. A poured concrete foundation or any other permanent foundation is the best if you want to support units with heavy frame materials such as glass and fibreglass. For smaller types, wood foundation can do. However, choose pressure treated redwood, cypress and cedar which are highly resistant to decay and moisture.
Frame Material: A perfect frame should have great strength and offer insulation. You can choose aluminium, resin, PVC or wooden greenhouses. Wood offers great insulation but can promote disease infestation and mould growth. Aluminium is less expensive than wood and have great strength but can fail when it comes to insulation. Finally, the PVC offers great insulation, but scores low with regards to strength.
Covering or Glazing: This is usually chosen depending on heat retention, durability, reliability, budget and light penetration. Glass maintains good humidity levels and reduces heat loss but is fragile, expensive and requires a solid foundation. While plastic is less expensive, it would require replacement after every 1-2 years.
Watering System: With regards to the irrigation of plants in the greenhouse, you can either water manually or install an automatic irrigation system. Watering by hand may be used in smaller greenhouses, but not larger ones. The automatic systems have a mechanical evaporation sensor. Although the cost of setting up this system is a bit high, it can benefit busy people.
Type of Ventilation: Proper ventilation is very important for efficient working of a greenhouse. Roof vents help to remove warm air from the greenhouse. On the other hand, side vents tap cool air outside to support better growth of the plants. (447)
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You know this story. A butterfly in Brazil flaps its wings, and a few weeks later Texas has tornadoes instead of clear skies.
It’s called the butterfly effect, and science fiction writers love it. In Back to the Future, Marty McFly almost erases himself from existence after travelling back to 1955 in a DeLorean. In It’s a Wonderful Life, George Bailey changes the fate of his town when he wishes he had never been born. In chaos theory, a small change in a system—like the flap of a distant butterfly’s wing—can dramatically change the system ... leading to a tornado in Texas.
The idea seems far-fetched, especially since so many pop culture examples rely on time travel or meddlesome angels who are trying to earn their wings.
But mathematicians insist that it is real. If you let them, they will sit you down in a coffee shop and tell you all about the butterfly effect and chaos theory and topological mixing. Just insist that they buy the coffee. And remember that the work of a mathematician glorifies God by revealing the beauty of creation.
Beyond The High Calling of math, what does the butterfly effect have to do with the rest of us?
We are the butterflies.
I don’t care how much you love your job; sometimes you don’t love it. Sometimes you crawl out of bed and wonder why. How could today possibly matter? How could a few more keystrokes at the computer mean anything?
The butterfly effect fascinates us because we want to find meaning in our actions. We want to be the self-aware butterfly in Brazil, flapping our wings just so and creating tornadoes wherever we please.
There’s no doubt about it. You are a small factor in the world. Don’t get down about it. I’m small, too. But even the smallest actions can create ripples that change the world. We can’t anticipate the ripples, but we can still flap our wings knowing that our actions might help create a storm of activity.
This means we need to take our actions seriously. A butterfly was made to flap its wings, suck nectar, and migrate thousands of miles with its brood.
What were you made to do? You can’t predict the effects of your actions, but you can take them seriously. You can develop your talents. You can work with diligence and faithfulness and integrity.
If you want to change the world, take heart. Your small actions can have tremendous impact.
But I find another truth at work in this mathematic parable. The Brazilian butterfly never experiences the Texas tornado. It doesn’t know the end of the story, and neither do we.
My wife is an actor in the Texas Hill Country. She’s a bit of a local celebrity in our small town of 20,000 people. Last year, she went from comic farce to Shakespeare to The Wizard of Oz. I’m very proud of her work, and she has had a busy year.
Some performances are as exciting as you would expect for her—a full house holding its breath as she flies through a tornado somewhere over the rainbow. Other performances can feel like a failure, when fewer than 30 people show up on a Thursday night for a heart-wrenching drama.
A few years ago, we had lunch with a motivational speaker. He asked my wife, “Do you ever dream of Broadway? Do you ever wonder if you could make it there?”
She explained that she preferred to serve her local community.
But he wouldn’t relent. “Don’t you wonder if you’re good enough? I think you are! Don’t you want to dream bigger than this small town theater?”
My wife was very upset by the conversation. We have friends who have chosen to act in New York. We have friends who have chosen the film scene in LA. And we choose to flap our wings in Kerrville, Texas.
Who knows if our small actions in our small town will lead to larger ripples? We don’t control that. Grandiosity doesn’t motivate us to be good stewards of the talents God gave us. No. We flap our wings because God gave us wings. Simply taking flight is reward enough. Simply serving the immediate good of our local community is reward enough. It has to be.
Let God worry about distant storms. I need to roll up my sleeves, and do the work on my desk.
| 12 |
The management information systems department, or MIS, in the UA's Eller College of Management...
Engaging the Public in Sustainability
For more than 80 years, the Arizona Cooperative Extension has used classes, seminars, workshops and other methods to bring research-based information to farmers and ranchers throughout the state.
Sustainability is a theme that runs throughout the work of the University of Arizona's Cooperative Extension program.
For more than 80 years Cooperative Extension has used classes, seminars, workshops and other methods to bring research-based information to farmers and ranchers throughout Arizona.
"Cooperative Extension agents work with producers to be economically viable while engaging the public and also helping to insure we have a minimal negative impact on the environment," said Rick Gibson, Pinal County's Cooperative Extension director.
Arizona growers have been able to dramatically reduce their use of toxic substances by implementing integrated pest management (IPM), said Peter Ellsworth, state IPM coordinator and director of the Arizona Pest Management Center.
"IPM represents the sustainable option for pest control," said Ellsworth, Extension specialist and UA professor of entomology. "It really is the world standard for science-based sustainable management of pests.
"It's amazing how few pesticides are even needed anymore and how the (agricultural) industry has continually improved its pest management programs," he said.
The number of pesticide spray applications for all insect pest problems during the period from 2006 to 2009 was 1.5 per crop per season, down from 10 to 12 per crop per season in the 1990s, he said.
"Our ultimate goal is to manage the entire agro-ecosystem so there is a better balance that requires fewer disruptive interventions, and IPM is the way to get to that point," Ellsworth said.
One example is multi-state research the UA is leading on crop placement, both on the farm scale and wider scale.
Monitoring and manipulating the proximity of different types of crops can help prevent pest problems because some pests move from crop to crop if fields are close enough, he said. And because fewer pesticides are being used, beneficials - insects that benefit crops by eating pests or providing pollination services - are reemerging in fields.
A new instructional tool - similar to a video game - is in the works to show farmers how they can benefit by focusing on crop placement, and working with neighboring farmers to reduce pest problems and boost beneficials on a multi-farm scale.
"We are currently working on developing a game training simulation, essentially a virtual farm, so we can go to grower communities and sit them down with our laptops and look at different scenarios," he said. "We will show them a virtual world, a virtual farm, and how bugs spread throughout a system and at what scale, and demonstrate the economic impact."
Growers playing the game can arrange crops on their virtual-farm randomly or the way they normally do, then see the economic consequences of pest damage. Then trainers will run them through the same exercises after they have an interaction with their neighbors to discuss strategies for crop placement throughout the community. They can see the benefit of looking at the spatial aspect of planting, and a cost reduction report will be offered at the end of the exercise, he said.
"If there is enough communication and cooperation there can be a reduction of risk from the pest insects over a broad landscape," he said.
IPM has already meant big savings for Arizona farmers.
"We estimate growers adopting our IPM programs in cotton alone saved over $212 million since 1996," Ellsworth said. "We are making agriculture more efficient. Everything we are doing is making our growers more sustainable."
Cooperative Extension's Erin Taylor works with immigrants, primarily from Africa and Asia, who are trying to set up farming operations in Arizona.
Many of the people in the International Rescue Committee program are refugees who came to the United States to escape civil wars and persecution, said Taylor, area assistant agent for field crops in Maricopa County.
A lot of them have some kind of farming roots and want to farm here," she said. "We teach a more modern way of farming. A lot of them never used any kind of equipment. They used oxen, cows or horses or did it by hand. We're helping them learn to use planting equipment, rototillers, more modern drip irrigation."
Economic sustainability for the farms is one of the major challenges the immigrants taking part in the program face, she said. The biggest hurdle is teaching the farmers the business aspect of their agricultural endeavors.
"The program helps them get started, but they haven't learned the business end to make it sustainable: how to sell their product, take the money, set aside money for next year's crops, and use the rest to live off of. They don't understand how it works," Taylor said. "That is the hardest part. We are working with them on financial classes and farm planning classes."
About 120 people join the refugee agriculture program each year. Many fail, but three to five successful farming operations emerge each year, resulting in about 15 success stories during the three years Taylor has been involved in the program.
Participants typically begin by working half to a full acre, and then expand when successful. One project farm near Eloy, Ariz. is 50 acres. "They start small and slowly are building their business," she said.
| 12 |
Fungus Among UsLook into our eyes. Look deep into our eyes. There are no such things as molds. All molds are actually fungi. That's a bunch of fungus. This surprised us when we first learned about it. We always heard about mold in the shower or mold on the bread. Mold is actually a type of fungus. It has a shape called a zygote to be exact. While yeasts are single celled fungi, molds are multicellular fungi. Bread takes one kind of fungus (yeast) to make it rise. If you leave the bread out, another type of fungus comes in (bread mold) to break it down. It's not amazing, but it's true!
MushroomsLet's look at Club Fungi first. Mushrooms! Everyone knows about these fungi. So what is a mushroom or a puffball? Bunches of strands living underground are called hyphae (pronounced hi-fah). Those strands are the basic fungus in action, decomposing leaves, or rotting bark on the ground. When it's time to reproduce, they develop a stalk and cap. The mushroom that you see popping out of the ground. It's only one part of the fungus. On the bottom of that cap are a set of gills that have little clubs with fungus spores.
ZygotesWe already talked a little about mold. That is only one example of the Zygote Fungi. These have hyphae-like mushrooms but they reproduce in a different way. When it's time to make more fungi, they create a stalk and release something called zygospores (thus the name zygote). When your bread gets old and green or black, you are seeing a type of zygote fungus in action. If you wait long enough, you will see the stalks develop and the zygotes released.
Single CellsLet's finish up by looking at Sac Fungi, simple, single celled fungi. Yeast is used to make several types of food for humans. We need yeast to make breads. We also use them to make alcohol. It's a whole process called fermentation. Sugars are broken down in an environment without oxygen. It's called anaerobic fermentation. And voila, alcohol. Even though they are single celled, you may find them in colonies. They reproduce very quickly and hang out together. It takes a lot of them (because they are so small) to get a lot of work done.
- Protozoa I
- Protozoa II
- Good Microbes
- Bad Microbes
- Humans and Microbes
- More Topics
Bats in Crisis (US-NPS Video)
Useful Reference MaterialsEncyclopedia.com:
Books on Amazon.com:
- Modern Biology (Rinehart and Holt)
- Campbell Biology: Concepts and Connections (Reese, Taylor, Simon, and Dickey)
- Prentice Hall: Biology (Miller and Levine)
- Clinical Microbiology Made Ridiculously Simple (Gladwin and Trattler)
- Microbiology: A Systems Approach (Cowan)
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| 12 |
|University of California, Berkeley|
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|Jepson eFlora: Taxon page
Key to families | Table of families and genera
Indexes to all accepted names and synonyms:
| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z |
Annual to shrub. Leaf: generally simple, generally alternate, generally petioled; stipules 0; blade entire to deeply lobed. Inflorescence: various. Flower: bisexual; calyx lobes generally 5; corolla ± radial, cylindric to rotate, lobes generally 5; stamens 5, on corolla tube, alternate lobes; ovary superior, generally 2-chambered, style 1. Fruit: berry, loculicidal or septicidal capsule, [(drupe)], 2–5-chambered.
75 genera, 3000 species: worldwide, especially ± tropics; many alien weeds in California; many cultivated for food, drugs, or ornamental (potato, tomato, peppers, tobacco, petunia); many TOXIC. [Hunziker 2001 Genera Solanacearum. Koeltz Scientific Books] Nicandra physalodes (L.) Gaertn. is a waif. —Scientific Editor: Thomas J. Rosatti.
Unabridged references: [Hunziker 2001 Genera Solanacearum: The Genera of Solanaceae Illustrated, Arranged According to a New System by A.T. Hunziker. Koeltz Scientific Books, Königstein, Germany]
Key to Solanaceae
Annual or perennial herb, sticky-glandular, aromatic. Leaf: ± odd-1–2-pinnate. Inflorescence: raceme; pedicels jointed. Flower: often nodding; parts generally 5; sepals free ± to base; corolla yellow, ± rotate or lobes reflexed; anthers > filaments, tube-like around style, tapered, opening by slits from tip (except sterile part); stigma exserted from anthers. Fruit: berry, green to red, fleshy. Seed: coat gelatinous.Key to Lycopersicon
± 6 species: western South America, Central America. (Greek: wolf peach, from supposed toxic properties) [Peralta et al. 2008 Syst Bot Monogr 84:1–186] Recently included in Solanum.
Unabridged references: [Muller 1940 USDA Misc Publ 382; Peralta, I. E., D.M. Spooner & S. Knapp. 2008. Taxonomy of wild tomatoes and their relatives (Solanum sect. Lycopersicoides, sect. Juglandifolia, sect. Lycopersicon: Solanaceae). Syst Bot Monographs 84: 1–186]
Erect or reclining, often fleshy, from taproot. Leaf: 10–20 cm. Inflorescence: few-flowered; peduncle 1.5–4 cm; bracts generally 0. Fruit: 3–12 cm wide, spheric, compressed, or pear-shaped, yellow-green to red.
Disturbed areas, abandoned fields, roadsides; < 100 m. Great Central Valley, San Francisco Bay Area, South Coast; native to South America. Summer–fall [Online Interchange]
Previous taxon: Lycopersicon
Next taxon: Lycopersicon peruvianum
Citation for the whole project: Jepson Flora Project (eds.) 2013. Jepson eFlora, http://ucjeps.berkeley.edu/IJM.html, accessed on Apr 2 2015
Citation for this treatment: [Author of taxon treatment] 2013. Lycopersicon, in Jepson Flora Project (eds.) Jepson eFlora, http://ucjeps.berkeley.edu/cgi-bin/get_IJM.pl?tid=32229, accessed on Apr 2 2015
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|Geographic subdivisions indicated for the distribution of Lycopersicon esculentum|| Markers link to CCH specimen records. If the markers are obscured, reload the page [or change window size and reload]. Yellow markers indicate records that may provide evidence for eFlora range revision or may have georeferencing or identification issues.
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(Note: any qualifiers in the taxon distribution description, such as 'northern', 'southern', 'adjacent' etc., are not reflected in the map above, and in some cases indication of a taxon in a subdivision is based on a single collection or author-verified occurence).
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List of apple cultivars
||This article includes a list of references, but its sources remain unclear because it has insufficient inline citations. (January 2009)|
Over 7,500 cultivars of the apple are known. The following is a list of the more common and important cultivars, with the year and place of origin (where documented) and an indication of whether the apples are for cooking, eating, or making cider. Those varieties marked agm have gained the Royal Horticultural Society's Award of Garden Merit.
Table of apples
|Common name||Image||Origin||First developed||Comment||Use|
|Adams Pearmain||England||1826||A dessert apple. Similar flavour to Russet, first introduced under the name "Norfolk Pippin".||Eating|
|Aia Ilu||Estonia||1946||Apple is large in size, weighing 250–300 g. It is yellow, juicy, and bittersweet with a weak aroma.||Eating|
|Airlie Red Flesh (Newell-Kimzey red flesh, Aerlie's Red Flesh)||Oregon, US||c. 1961||A large, conic apple. Light yellow-green skin strewn with white dots, occasionally with a faint red-orange blush. Light pink to deep red flesh is crisp, sweet and mildly tart.||Eating|
|Akane||Japan||1970||Jonathan × Worcester Pearmain. Tangy taste.||Eating|
|Åkerö||Sweden||15th century||Apple is egg-shaped, medium to large in size, sweet and aromatic. Best in November, keeps well till February. Oldest cultivar in Northern Europe, grown mostly in Sweden and Estonia.||Eating|
|Alkmene agm||Germany||1930||Cox's Orange Pippin × Doktor Oldenburg||Eating|
|Allington Pippin||Lincolnshire, UK||1880s||A versatile English dessert apple raised by horticulturalist Thomas Laxton some time before 1884. Exhibited as Brown's South Lincoln Beauty, the name was changed to Allington Pippin by Bunyard Nursury in 1896. A cross of Cox's Orange Pippin and King of the Pippins. A small apple, aromatic, with a pineapple-like flavour, keeps its shape when cooked.||Eating, Cooking, Dessert|
|Ambrosia||British Columbia, Canada||1980s||Medium to large in size, mostly red coloration with yellow patches. Has cream-coloured flesh with a sweet, crisp, aromatic flavour and low acidity. Ambrosia trees are hardy and no major disadvantages have yet been identified.||Eating|
|Anna||Israel||1965||Colour is yellow with a red blush. This variety does not grow well in the cold and prefers heat and humidity.||Eating|
|Annurca||Campania, Italy||1876 (documented)||Very old apple; possibly one of the oldest of all. Believed to be older than first mention in Pasquale's Manuale di Arboricultura, 1876.||Eating|
|Antonovka||Kursk, Russia||17th century||A very old Russian variety, often planted at dachas. Apples are large, yellow-green and bracingly tart to eat out of hand, but superb for cooking, as they keep their shape. Extremely tolerant of cold weather, and because it produces a single, deep taproot (unusual among apple trees), Antonovka is propagated for use as a rootstock. Antonovka rootstock provides a cold-hardy (to -45 °C), well-anchored, vigorous, standard-sized tree.||Cooking, Cider|
|Apollo||Cox’s Orange Pippin × Geheimrat Dr. Oldenburg||Eating|
|Ariane||Angers, France||2002||Scab resistant. Developed at the National Institute of Agricultural Research in France.||Eating|
|Arkansas Black||Arkansas, US||c. 1870||Hard and crunchy; stores well. Very deep red, appearing black from a distance.||Eating|
|Arthur Turner agm||England||large golden cooker: prone to mildew but scab resistant||Cooking|
|Ashmead's Kernel agm||England||c. 1700||Small, very sweet and very tart.||Eating|
|Aurora Golden Gala||British Columbia, Canada||2003||Dessert apple; medium size, sweet, juicy, crisp, firm, very long storage life.||Eating|
|Autumn Glory||Washington, US||2011||Red over golden background. Very sweet, firm flesh with a subtle "cinnamon" flavour. Produced by Domex Superfresh Growers in Washington's Yakima Valley.||Eating|
|Bailey||New York||c. 1840||Red apple with considerable white flecks. Has some russeting.||Eating|
|Baldwin||Massachusetts, US||c. 1740||Sweet to subacid flavour. Also known as "Woodpecker". Very old variety for North America. Makes lots of juice.||Cooking, Eating|
|Ballyfatten||County Tyrone, Northern Ireland||c. 1740||A large, round apple with firm, dry, sweet, slightly tart white flesh. Excellent keeper. Scab and canker resistant.||Cooking, Eating|
|Beacon||Minnesota, US||1936||Lively, juicy flavour; good for baking. Does not keep very well.||Cooking, Eating|
|Beauty of Bath||England||1864||Deep red flush and streaks of red with a little russet. Early maturing but short season. Formerly grown commercially in England for local markets. Good flavour in its home climate if it is eaten soon after picking. Poor flavour if distributed long distances and stored for weeks, so now rare.||Eating|
|Belle de Boskoop agm||Boskoop, Netherlands||1856||Bright red, fairly large, early in season (end of August to early September).||Cooking (applesauce)|
|Ben Davis||Southeastern US||Noted for keeping well prior to refrigerated storage, but flavour has been compared with cork.||Eating|
|Beverly Hills||California, US||1997||Slightly tart flavour. Likes warm weather.||Eating|
|Birgit Bonnier||Sweden||A cross between Cortland (apple) and Lord Lambourne.|
|Bismarck||Victoria, Australia||1870||Medium sized fruit with a green and red skin, sharp in flavour and not a common apple.||Cooking|
|Blenheim Orange agm||England||c. 1740||Has greenish-yellow to orange skin streaked with red. Distinctive nutty flavour excellent for cooking. The vigorous tree is slow to come into crop but then produces heavily.||Cooking, Eating|
|Bloody Ploughman||Carse of Gowrie, Scotland||c. 1800||A medium-sized, very dark red, heavily ribbed apple. Crisp, mildly sweet white flesh, sometimes pink-streaked. It is reputed to have got its name from a ploughman who was caught stealing apples near Megginch Castle and was shot by the gamekeeper. His wife got the bag of apples and threw them on the compost heap where a seedling then grew and - voila - Bloody Ploughman.||Eating|
|Bottle Greening||Green Mountains, US||c. 1800||Produces large fruit. Has thick skin, but juicy.||Eating, Cider|
|Braeburn||New Zealand||1952||Chance seedling. The fruit is widely sold commercially in the UK.||Eating|
|Bramley (Bramley's Seedling) agm||Nottinghamshire, UK||1809||The fruit is the most widely sold cooker in the UK. Large sized fruits with waxy skin, green with a red flush. A favourite ingredient in many traditional British puddings.||Cooking|
|Bravo de Esmolfe||Esmolfe, Penacova, Portugal||18th century||A small, juicy and sweet apple, considered one of the best Portuguese apples||Eating|
|Breedon Pippin||England||1801||Sweet flavour. Originally raised by a parson in Berkshire. Rare.||Eating|
|Brina||Italy||1998||Resistant to scab. Spreading habit with intermediate vigour; full flowering season is medium-late, production is heavy, fruit is medium or medium-large, with smooth skin; white lenticels, no russet, excellent taste characteristics. Ripens first week of October (Trentino).||Eating|
|Calville Blanc d'hiver||France||1598||Noted for unusual looks (somewhat lumpy on the side) but excellent reward when tried. Noted for having unusually high vitamin C content. Apple of choice for tarte tatin in France.||Cooking|
|Cameo||Washington State, US||1980s||Existence owed to freak accidental crossing of two most popular apples in world: Red and Golden Delicious. Retains prongs on bottom of latter parent but has flavour more resembling Golden.||Eating|
|Carolina Red June||Tennessee, US||c. 1810||Has unusual habit of blossoming twice, and producing two crops per year. Very popular Civil-War-era Southern apple. Does beautifully in humid weather. Good choice for backyard gardener in subtropical climate.||Cooking, Eating|
|Carter's Blue||Alabama, US||1840s||Medium to large, roundish oblate; skin green or greenish yellow washed with dull red with darker red broken tripes, covered with a heavy bluish bloom. Crisp, juicy, sugary, aromatic, mild subacid. Foliage also has a blue hue. Ripens September and keeps until November. Once widely grown in the American South, then thought extinct. Reintroduced to America in 1994 after being discovered at the National Fruit Trust in Kent England, where it had been added in 1947 from a collection in Rhone, France, after it had been acquired around 1860 from the Fruitland Nursery in Augusta, Georgia.||Eating, Cooking|
|Champion, Shampion or Sampion||Czech Republic||circa 1960||A cross between Golden Delicious and a Cox Orange Pippin. Attractive colour. This tree bears attractive fruit, extra-large sized, deep red, juicy, and crisp. Keeps fresh for a long time. Starts bearing at a young age. Harvest time is October.||Eating, Juice|
|Catshead||England||1600s||Sharp flavour. Lumpy shape and electric green colouring. Known to have been a variety planted in early Virginia by settlers as well as native England. Extremely rare in native UK; occasionally still found growing in southern US.||Cooking|
|Charles Ross||Berkshire, UK||1890s||Has been an AGM winner. Orange to red. Best cooked early in season. Good flavour, and sweet when eaten later in season.||Multi-purpose|
|Chelmsford Wonder||Essex, UK||c. 1870||A large long keeping yellow-skinned apple with diffuse orange pink flush. . Still grown in Essex orchards including Lathcoats Farm Shop.||Multi-purpose|
|Chiver's Delight||Histon, Cambridgeshire, UK||1920s||Medium to large oblate apple. Red flush over greenish yellow skin. Crisp, juicy, sweet white flesh. Flavour can be variable but at its best is very well balanced. Grown by Chivers (now a brand of Premier Foods) for apple sauce.||Multi-purpose|
|Claygate Pearmain agm||UK||Suitable for northerly, cold, wet climates: rich, nutty flavour||Dessert|
|Clivia||Germany||Geheimrat Dr. Oldenburg × Cox's Orange Pippin||Eating|
|Cornish Gilliflower||Cornwall, UK||1813||Discovered as accidental seedling. Shy bearer.||Eating|
|Cortland||New York||1890s||Pale crisp flesh. Ripens in October in state of origin. Classic red coloration, nice crunch.||Eating|
|Court Pendu Plat||France||1613||Extremely old variety, may date from as early as Roman times. Popular during the Victorian era. Yellow to light green, flushed with red.||Eating|
|Cox's Orange Pippin||England||1829||One of the most celebrated apples in the UK, valued for its aromatic "orange" colour and flavour. The fruit is widely sold commercially. Mainly grown in UK, Belgium and the Netherlands but also grown for export in New Zealand.||Eating|
|Cripps Pink ('Pink Lady')||Australia||1970s||Crisp, very sweet and slightly tart. Light red, pink and light yellow-green striped skin.||Cooking, Eating|
|Crimson Gold||California||1944||A golf ball sized applecrab hybrid developed by Albert Etter who named it Little Rosybloom for its cute size and attractive ruby red flush. He died before completing the patent papers. Fruit was later rediscovered and renamed. Very crispy and keeps texture in backing.||Eating, Baking etc.|
|Criterion||New York||1898||One of parents believed to be Ben Davis, but very tart unlike parent. Dark red skin underlaid with stripes.||Cooking, Eating|
|D'Arcy Spice||Tolleshunt D'Arcy, Essex, UK||1785||A medium-sized apple with yellow-green skin, a red blush where exposed to the sun and covered with an spotty ochre russet. White flesh is aromatic, firm and crisp with noticeable hints of anise and clove.||Eating|
|Delblush||France||Delbard 1979||Tentation delblush
, Golden Delicious × Grifer
|Delcorf agm||France||Delbard 1960||Delbarestivale delcorf,
Golden Delicious × Stark Jonagrimes
|Delfloga||France||Delbard 2008||Delbardivine delfloga,
Royal Gala Tenroy × Florina, scab resistant
|Delflopion||France||Delbard||Sampion × Florina, scab resistant||Eating|
|Delrouval||France||Delbard 1995||Cybèle delrouval,
Delcorf × Akane
|Deltana||France||Delbard 2010||Delbard Celeste deltana,
(Golden Delicious × Grive Rouge) × Florina, scab resistant
|Devonshire Quarreden||England, France?||1685 (documented)||Possible French parentage or ancestry. Crimson red peel. Juicy.||Eating|
|Discovery agm||Essex, UK||1949||Possibly from an open-pollinated Worcester Pearmain, or could well be a Worcester × Beauty of Bath. Sharp, sweet flavour. Fruits are sold commercially in the UK.||Eating|
|Dorsett Golden||Bahamas||1964||Grown from chance seedling of Golden Delicious. One of the most southerly apples grown in North America.||Eating|
|Dougherty/Red Dougherty||Australia, New Zealand||Red Doughtery is a recent mutation discovered in New Zealand from the old Australian Doughtery||Eating|
|Duchess of Oldenburg||Russia||18th century||Has red stripes with splashes of green. Excellent resistance to freezing temperatures.||Cooking, Eating|
|Dudley Winter||Castle Hill, Maine, US||19th century||A medium-sized oblate apple with greenish-yellow skin covered with red stripes over a solid red blush. Flesh is firm but tender, juicy, aromatic and quite tart, becoming milder as it ages. Good for fresh eating and cooking; rated by many as one of the best for apple pies and sauces. Tree is a natural semi-dwarf, very hardy and bears heavily annually.||Cooking, Eating|
|Dummellor's Seedling agm also known as Dumelow's Seedling||Shackerstone, Leicestershire, UK||18th century||Large, roundish-oblate apple with pale greenish-yellow skin strewn with large russet dots, occasionally covered with a delicate pinkish-orange blush. Yellow-tinted white flesh is aromatic, firm, crisp, tart, and very juicy. One of the most widely grown culinary apples of Victorian England, esteemed for its fine flavour and good keeping qualities.||Cooking|
|Early Victoria||Essex, UK||1899 (introduced)||Possibly from Lord Grosvenor × Keswick Cod. Also called Emmeth Early. Ripens in late July. Pale yellow fruit.||Eating|
|Edward VII agm||Worcestershire, UK||1908 (introduced)||A large oblate-round apple with yellow-green skin and pinkish-brown blush. Suitable for more northerly, cold, wet climates. White flesh is sharp and pleasant. Extraordinary keeper; apple ripens in autumn and will keep until Easter. Possibly Blenheim Orange × Golden Noble.||Cooking|
|Egremont Russet agm||Sussex, UK||1872||Brown russeting, nutty flavour. Excellent keeper.||Eating|
|Ein Shemer||Israel||1963||Zabidani × Golden Delicious. This variety ripens in June. Tastes tart, does not do well in cold weather. (Not the same as Anna (apple))||Eating|
|Ellison's Orange agm||Lincolnshire, UK||1911||Cox's Orange Pippin × Calville Blanc. Rich aniseed flavour.||Eating|
|Elstar agm||Netherlands||1950s||Golden Delicious × Ingrid Marie. Medium-sized, mostly red with yellow showing. Often used in desserts due to its intense honey flavour.||Cooking, Eating|
|Emneth Early agm||UK||Suitable for northerly, cold, wet climates. A biennial crop that needs thinning.||Cooking|
|Empire||New York||1966||Lovely white subacid flesh. Tangy taste. Ruby red colour.||Eating|
|Enterprise||Illinois, US||1993||Classic North American red apple. Stores well up to six months. Makes very good candy apple.||Eating|
|Envy||New Zealand||2009||Sweet and crispy, takes 4–8 hours after cutting to start browning. Royal Gala × Braeburn.||Eating|
|Epicure||UK||1909||Yellowish apple with reddish blush. Good clean taste.||Eating|
|Esopus Spitzenburg||Esopus, New York||c. 1750||Grown by Thomas Jefferson at Monticello. Named for creek near which first seedling found. Heirloom variety still available at farmstands in Northeast and portions of Virginia. Difficult to grow for inexperienced planters.||Cooking, Eating|
|Falmenco||UK||1950 - 1999||A columnar ornamental tree with delicious fruit||Eating|
|Falstaff agm||UK||A good pollinator.||Dessert|
|Fiesta agm||Kent, UK||1972||Sometimes called Red Pippin. Claims both UK and US heritage: parents are Cox's Orange and Idared. Has flavour similar to the former but storage, colouring, and cold tolerance of the latter.||Eating|
|Fireside||Minnesota, United States||1943||Very fragrant. Yellow with red striping. Sweet apple, very popular in upper Midwest.||EatingFiesta_Apfelsorte.JPG|
|Florina||Anger, France||(Querina), scab resistant||Eating|
|Flower of Kent||Kent, UK||18th century||This is the variety that inspired Sir Isaac Newton to consider gravity.||Eating|
|Fortune agm (Laxton's Fortune)||1904||Cox's Orange Pippin × Wealthy||Eating|
|Fuji||Japan||1930s||Red Delicious × Ralls Genet. Dark red, conic apple. Sweet, crisp, dense flesh is very mildly flavoured. Keeps very well. One of the most widely grown apple varieties in the world.||Eating|
|Gala, Royal Gala agm||New Zealand||1970s||A small to medium-sized conic apple. Thin, tannic skin is yellow-green with a red blush overlaid with reddish-orange streaks. Flesh is yellowish-white, crisp and grainy with a mild flavour. Cross of three of the world's best known apples: Kidds Orange Red (a cross of Red Delicious and Cox's Orange Pippin) × Golden Delicious. One of the most widely available commercial fruit.||Eating|
|Garden Royal||Sudbury, Massachusetts, US||1800s||A medium-sized roundish-oblate, sometimes slightly conical apple. Greenish-yellow skin is striped and splashed with bright red, dull or grayish toward the stem; dots few, light and gray; cavity deep, basin shallow, slightly uneven. Flesh yellow, very tender, juicy, rich, mildly subacid and aromatic. Poor keeper. Upright habit, productive bearer, some biennial tendency.||Eating|
|Gascoyne's Scarlet||Kent, England||1871||large red fruit||Eating|
|Geheimrat Dr. Oldenburg||Germany||1897||Created at the Höheren Lehranstalt für Obstbau of Geisenheim in the Rheingau; Minister von Hammerstein × Baumanns Renette.||Eating|
|George Cave||Essex, UK||1923||Pale green-yellow fruit with red flush. Early harvest.||Eating|
|George Neal agm||Kent, UK||1904||Pale green to yellow colour, will keep nicely until late autumn.||Cooking|
|Glockenapfel||Switzerland||17th century||A medium-sized green-yellow elongate bell-shaped apple, sometimes takes on a reddish blush. Tart and juicy, stores well, taste improves with age. Excellent culinary variety; renowned for its use in Strudel.||Cooking, Eating|
|Gloster||Germany||1969||Conical shape. Somewhat tart, ruby red colour like parent Red Delicious. Good choice for backyard gardening.||Eating|
|Ginger Gold||Virginia, US||1960s||Tangy flavour, crunchy texture, pale green-yellow colour. Noted for being an extremely early bearer (Europe by September 1, California late July, Eastern US in August).||Cooking, Eating|
|Golden Delicious agm||Clay County, West Virginia, US||1914||One of the most popular varieties in the world. Due to its regular size, even colour and storage qualities the fruit is widely sold commercially. Uniform light green-yellow coloration, very sweet. A good pollinator.||Eating|
|Golden Noble agm||England||1820||Tree is short and stocky. Produces mint green fruit with blush of pink.||Eating|
|PRI 1956-6 × Ed Gould Golden. Resistant to scab. Moderate vigour, spreading habit and medium-late blooming season; fruit is moderately large (207 g) and symmetric, skin is smooth, no russeting. Ripens some days after Golden Delicious; fruit is very attractive; large, good storage ability.||Eating|
|Golden Russet||New York||1845 (documented)||A medium-sized heavily russeted light green apple, occasionally with a reddish blush. Crisp, fine-grained flesh is rich, sugary and very sweet. Excellent dessert apple, keeps very well. Makes extraordinary cider, known as the "Champagne of cider apples."||Cider, Eating|
|Golden Spire||Lancashire, UK||1850||An old Northern English variety. Unusually tall and oblong with a tart flavour.||Cider, Eating|
|Golden Supreme||Idaho, US||1960||Eating|
|Gradirose||Languedoc-Roussillon, France||2004||Created by Pépinières Grard. Early dessert apple with pink blush. Ripens in September and stores well. Very productive.||Eating|
|Gragg (aka Red Gragg, Winter Queen)||North Carolina, US||1860||Originated on the farm of James Gragg in Caldwell County, NC about 1860. Valued by North Carolina growers for its fine cooking qualities, crispness and long storage ability. The conical shaped fruit is red in colour with moderately conspicuous dots. Ripens in October and is a great keeper.||Cooking, Eating|
|Granny Smith||Australia||1868||This is the apple once used to represent Apple Records. A favourite variety, widely sold in the UK. Also noted as common pie apple. Lime green colouring. Extremely tart.||Cooking, Eating|
|Gravenstein||Gråsten, Jutland, Denmark||17th century||A medium-sized early yellow-green apple, often with red stripes. Crisp, sweet, tart flavour. Exceptional cooking apple, especially for applesauce and pies. Poor keeper; becomes soft quickly. German immigrants introduced this variety to California's San Joaquin Valley in the mid-19th century. Has many sports.||Cooking, Eating|
|Green Cheese||North Carolina or Georgia, US||18th century||A very old southern apple thought to have originated in North Carolina or Georgia but its true origin is uncertain. The fruit is medium to large, oblate to oblique in shape. The skin is deep green in colour, turning pale yellow when fully ripe. The yellowish flesh is sweet, crisp, tender and juicy.||Eating|
|Greensleeves agm||Kent, UK||1966||Golden Delicious × James Grieve; good garden apple, with a pleasant but unexceptional flavour. Likely named for famous Renaissance era song.||Eating|
|Grenadier agm||England||1862 (documented)||Possibly one of the strangest of all British apples: it is ribbed and lumpy with a tough coat, looking as though it has taken a beating. Grenadier cooks down to cream-coloured puree with a superb apple flavour. Makes an excellent apple jam. Poor keeper. Reliably heavy annual bearer.||Cooking|
|Grimes Golden||Brooke County, West Virginia, US||1804||A medium-sized roundish to slightly oblong apple. Greenish-yellow skin, ripening to a clear yellow, stem cavity sometimes russeted, covered with yellow or russet dots. The yellowish-white flesh is crisp and tender, with a rich, spicy, sugary-sweet flavour. A good all-purpose dessert and cooking apple, Grimes also makes a strong single-variety cider. Excellent keeper. Grimes Golden is the parent of the ubiquitous Golden Delicious. Relatively rare among apples, Grimes Golden is self-fertile. Original tree discovered near a known orchard of John Chapman (Johnny Appleseed).||Cider, Cooking, Eating|
|Haralson||Minnesota, US||1923||Red colour and large, moderately conspicuous dots. Crisp and juicy with a tart flavour. Excellent choice for pies.||Cooking, Eating|
|Harrison Cider Apple||New Jersey, US||1770||Yellow skin, sometimes red-blush, black spots, small size, sweet, rich and dry.||Cooking, Cider|
|Hawaii||1945 (introduced)||Noted for pineapple-like taste.||Eating|
|Heyer 12||Very cold-tolerant.||Eating|
|Honeycrisp||Minnesota, US||1960||Has excellent eating and keeping qualities. Mottled red and yellow colour. Very crisp white flesh is slightly tart with a strong honey-like sweetness. Quality varies from apple to apple. Developed by the University of Minnesota and best suited to cool climates.||Eating|
|Honeygold||Minnesota, US||1969||Sweet tasting fruit. Tree has very showy, light pink blossoms in spring.||Eating|
|Howgate Wonder||Isle of Wight, UK||1960||Usually a big apple. Makes a lot of juice.||Cooking|
|Idared agm||Moscow, Idaho, US||1942||A medium-sized deep red apple. Crisp white flesh is tart and juicy, and can be somewhat bland if eaten out of hand, however, Idared is an exceptional cooking apple. Flesh keeps is shape, and the flavour becomes much stronger with cooking. An excellent keeping apple, Idared remains hardy and durable in proper storage for as long as 8 months. Idared is a cross between Jonathan and Wagener developed at the University of Idaho.||Cooking|
|Irish Peach||Kilkenny, Ireland||19th century||Excellent for baking. Early harvest. More difficult to find within land of origin due to primary use for export to UK. Hardy, tastes very good straight off tree.||Cooking, Eating|
|James Grieve agm||Edinburgh, Scotland||1893||Good taste, but poor keeper (bruises easily).||Cooking, Eating|
|Jazz (Scifresh)||New Zealand||2007 (launched)||Bright red round apple with subtle yellow under-striping. Tart to sweet, dense and very crunchy with effervescent texture. From sweet Royal Gala × firm, tart Braeburn. Widely sold commercially in the UK.||Eating|
|Jonagold agm||New York||1968||Popular in Europe and land of origin. Several highly coloured strains are available. Widely sold commercially in the UK.||Eating, Cooking|
|Jonathan||New York||1820s||Tart taste. Mostly red apple with patches of lime green. Does well in cooler areas; some frost resistance.||Cooking (Pie), Eating|
|Junaluska||North Carolina, US||c. 1815||Battle of Horseshoe Bend, believed to have planted original tree. Extremely russeted and ugly apple but very hardy tree with superior taste to commercial varieties.||Cooking, Cider, Eating|
|Junami||Switzerland||c. 2010||A cross between Ideared and Maigold with Elstar. Beautifully round, fresh and fruity taste with a crunchy bite.||Cooking, Eating|
|Jupiter agm||North Carolina, US||c. 1815||A large, round, slightly conic apple. Light yellow-green skin with a red-orange blush and stripes. Strong apple flavour is well-balanced between sweet and sharp. Cross of Cox's Orange Pippin and Starking Delicious (a sport of Red Delicious), apple retains Cox's flavour, but tree is easier to grow.||Eating|
|Kanzi (Nicoter)||Belgium||1991||Gala × Braeburn. Crunchy, juicy, sweet, slightly tangier than Gala.||Eating|
|Karmijn de Sonnaville||Wageningen, Netherlands||1949||Yellow ground colour when ripe, with red flush, and russet depending on the season. Large apple, though shape can be irregular.||Cooking (Apple Juice), Eating|
|Katy||Sweden||1947||Medium-sized early eating apple with red skin and pale cream flesh. Well suited to Northern European climate.||Eating|
|Kerry Pippin||County Antrim, Ireland||c. 1805||Pale to golden yellow flesh. Delightful spicy taste. Well suited to Ireland's moist, cool climate.||Eating|
|Kidd's Orange Red agm||New Zealand||1924||Cox's Orange Pippin × Delicious. Yellow skin with orange red flush. Chewy rather than crunchy.||Eating|
|King of the Pippins agm||UK||Suitable for more northerly (southerly in the Southern Hemisphere) areas with higher rainfall||Eating, cooking|
|King Russet agm||UK||Russetted form of 'King of the Pippins'||Eating|
|Knobbed Russet||Sussex, England||1819||Green and yellow, with rough and black russet. Unusually irregular, warty and knobbly surface.||Cider, Eating|
|Lady Alice||Washington, US||1978||Medium-sized, roundish oblate with thin yellow-green skin with an orange blush and bright red stripes. Crisp yellowish-white flesh is sweet with hints of honey and almond. Don Emmons purchased a neglected orchard of Red Delicious near Gleed, Washington, in 1978. While cultivating between trees, a disc from the plow hit the base of a tree. The injury caused a new shoot to grow from the rootstock (likely a seedling grown from a pip). The shoot was allowed to grow and bear fruit which Mr. Emmons named for his mother, Alice.|
|Lane's Prince Albert agm||England||1841||Green with orange blush. Makes a good apple crumble for Christmas: peak ripening happens in winter.||Cooking|
|Laxton's Epicure agm||UK||Aromatic sweet fruit, tendency to biennial habit, bruises easily.|
|Laxton's Fortune See 'Fortune'|
|Laxton's Superb||England||1897||Wyken Pippin × Cox's Orange Pippin. Classic old Victorian, British apple. Green with dull red flush. Firm texture, but not very good juice producer.||Eating|
|Liberty||New York||1978||Very disease-resistant. Very similar appearance to McIntosh, relatively short storage life in air.||Eating|
|Limelight||Kent, England||2000||Greensleeves type; abundant cropping and a compact tree. A pale green apple with a smooth finish and occasional pink blush. Crisp flesh and disease resistant tree.||Eating|
|Liveland Raspberry apple||Livland Governorate||Old||Eating|
|Lodi||Ohio, US||1911||Fruit pale yellow flushed with deeper yellow. Resistant to scab. Tangy taste.||Eating|
|Lord Derby||Cheshire, England||c. 1850||Yellowish green apple. Acid flavour, likes cooler weather.||Cooking|
|Lord Lambourne agm||England||1921||James Grieve apple × Worcester Pearmain. Round shape. Orange flush with hint of russet. Strong acid flavour. Good for domestic cultivation.||Eating|
|Macoun||New York||1923||Cold-tolerant. Crunchy. Does very well in salads.||Eating|
|Maiden's Blush||Burlington, New Jersey, US||19th century||A thin-skinned, flattened apple. Pale yellow-green skin has a telltale crimson blush on the side that faced the sun. White flesh is crisp with a sharp flavour that mellows with storage. Heavy annual bearer. Good cooker. Excellent variety for drying because the flesh remains white and bright.||Cooking, Eating|
|Malinda||Vermont, US||1860||Small, conical with sheep's nose; deep, rich yellow with red spots possible. Dry, dense, substantive flesh; mild, pear-like flavour. Tree good in climates with heavy snowfall.||Cooking, Eating|
|Mantet||Manitoba, Canada||1929 (introduced)||Amber fruit washed with red. Summer apple. Does not do well in warm climates.||Eating|
|Manks Codlin||Isle of Man||First fruited in 1815.||Pale yellow medium sized fruit with occasional flush of red. Hardy. Heavy producing.||Cooking|
|Margil||London||1750s||Small, highly flavoured apple held in very high esteem by connoisseurs. Medium to small in size, slightly conical in shape, dull green skin with an orange-red blush, some russeting. The yellow flesh is firm, crisp, sugary, and as pomologist Robert Hogg said, "with a powerful and delicious aromatic flavour." The very small tree is weak and slender and bears light crops. Because it flowers early, it is susceptible to frost damage. It keeps well. Introduced to Brompton Park Nursury from Versailles by Henry Wise in the early 18th century.||Eating|
|May Queen||Worcester, England||1800s||Large, oblate, often russetted yellow apple with bright red blush and stripes. Crisp, greenish-yellow flesh, rich, nutty flavour. Similar texture to Ribston Pippin, and in a good year, its equal in flavour. In bad years it can be rather dry and harsh. Excellent keeper. Heavy annual bearer.||Eating|
|McIntosh||Ontario, Canada||1811||A popular, cold-tolerant eating apple in North America.||Cooking (applesauce), Eating|
|Melrose||Ohio, US||1944||Flavour improves in storage. Coarse flesh.||Eating|
|Merton Charm agm||UK||Semi-weeping habit, heavy crops of small fruit unless thinned|
|Merton Worcester||England||1956||Cox's Orange Pippin × Worcester Pearmain. Developed at John Innes Institute.||Eating|
|Miller's Seedling||Berkshire, England||1848||Sweet apple. Tree prefers chalky soils.||Eating|
|Mollie's Delicious||New Jersey, US||1966||Conical shape, pinkish red colour. Lasts long in refrigeration. Good aftertaste.||Eating|
|Mother (American Mother)||Massachusetts, US||1840||Medium-sized yellow apple with crimson stripes and darker red blush. White flesh is rich, sweet and juicy. The fruit has a balsamic aroma with a suggestion of vanilla. Cropping can be a bit irregular, if not completely biennial. A late flowering variety that avoids frost. Some resistance to scab.||Eating|
|Muscadet de Dieppe||Normandy, France||c. 1750||Commonly used in making Calvados brandy.||Cider|
|Mutsu||Aomori Prefecture, Japan||1930||Known as "Crispin" in the UK. Golden Delicious × Indo.||Eating|
|My Jewel||Watsonville, California||c. 1940||Originated as a chance seedling, a cross between Winter Banana (with a banana flavour) and Golden Delicious. Yellow colour. October harvest. Still used in cider blends by Martinelli's)||Eating, Cooking, Cider|
|Newell-Kimzey ( Airlie Red Flesh)||Airlie, Oregon||1961||A medium to medium -large, conic apple. Light yellow-green skin with white dots, occasionally with red-orange blush on one side.Light pink to deep red flesh is crisp, sweet and moderately tart.||Eating, pies|
|Newtown Pippin (Albemarle Pippin)||Queens County, New York||1759||Best known colonial apple in North America. Known favourite of Ben Franklin and Thomas Jefferson. Medium to large, often irregularly shaped apple. Greenish-yellow, dotted, often russeted. Tough skin, flesh cream to greenish-white, very quickly browning. Texture is crisp, moderately fine-grained subacid to tart, sprightly. Biennial habit, slow to come into bearing. Good keeper, improves with storage. Prized for its clear juice in cider making. Two sports, Green Newtown Pippin and Yellow Newtown Pippin, differ only in skin colour.||Cooking, Eating, Cider|
|Newton Wonder agm||England||1870s||Very good cooker. Prolific bearer, can be harvested in winter.||Cooking|
|Nickajack||North Carolina, United States||c. 1810||Native American origin, believed to be originally grown by Cherokee along banks of Nickajack Creek. Only grown in Appalachians, favourite of later settlers for desserts. Rusty red colour with sweet, crisp taste.||Cooking, Eating|
|Norfolk Royal||England||c. 1850||Crisp, sharply sweet and well-flavoured. Available as a russet or smooth.||Eating|
|Northern Spy||New York||c. 1800||Tart, firm, stores very well. Noted for being excellent choice for making American-style apple pie. Sometimes used as a rootstock.||Cider, Cooking, Eating|
|Opal||Czech Republic||1999||Firm, fine to medium grained, medium juicy, full flavoured, sweet, mild-subacid. Golden Delicious × Topaz.||Eating|
|Orin||Japan||1952||Sweet and distinctive fragrance. Notes of pineapple. Medium hardness. Golden Delicious × Indo.||Eating|
|Orleans Reinette||Orleans, France||1776||Reliable bearer. Extraordinary complex flavour, similar to Blenheim Orange, but not related.||Eating|
|Ozark Gold||Missouri, US||1970||Light green with pink blush. Has taste with notes of honey.||Eating|
|Pacific Rose||New Zealand||1995||Extremely crisp, sweet apple. Also grows well in California.||Eating|
|Pam's Delight||Bedfordshire, England||1958||A medium-sized apple with a red blush. Flesh is crisp, juicy and sweet-tasting. Alfred Hull, a retired clerk planted some apple pips in pots which he placed on his bathroom windowsill. He planted the most vigorous in his garden. His daughter, Pam, teased her father by telling him that he should dig the tree up as it did not look as if it was capable of producing fruit. Unfortunately, Pam developed Hodgkin's Disease, and Alfred told her that if his tree, which had become a family joke, ever bore fruit she would be the recipient of the first apple. Seven years after he planted the pip, the tree produced its first blossom, and from that, a single apple. He proudly presented it to Pam that October. Sadly, her illness became more severe, and she died, at the age of 28 the following April, just as the tree blossomed fully for the first time. That year the tree produced twenty two pounds of apples. In 1968, Brogdale Farm accepted Pam's Delight for full commercial trials. Later that year it was included in the National Register. As of 2011[update], Pam's Delight is available from East of England Apples and Orchard Group.||Eating|
|Paula Red||Kent County, Michigan, US||1960s||Firm white flesh; McIntosh mutation.||Eating|
|Peasgood's Nonsuch agm||England||1858||A very large yellowish-green apple, deepening to orange-yellow, flushed and striped red with some russet patches. Flesh is sweet and juicy. Good eating and superb for cooking. Large, hardy and heavy cropping tree. Apples can weigh up to half a kilogram, and are famously large enough to make a pie from a single apple.||Cooking, Eating|
|Pink Pearl||California, US||1944||Noted for having bright pink flesh. Sweet. Possibly has crab apple in its ancestry.||Eating|
|Pinova||Germany||1986||Bred in Germany over an 18-year period. Marketed as "Piñata" in the United States. Fragrant smell, thin skin and balanced sweet and tart flavour profile. From Clivia × Golden Delicious.||Cooking, Eating|
|Pitmaston Pineapple||Moseley, Worcester, England||1785||Pitmaston Pineapple is a dessert apple known since 1785. Small oblong apples with a yellow-green russeted skin. Tender flesh is an intense nutty, honeyed flavour with, as the name suggests, tropical undertones and some balancing acidity. Trees are biennial but produce heavy crops in the 'on' year.|
|Pixie agm||England||1947||Resistant to scab and mildew. Very small apple.||Eating|
|Pristine||USA||Resistant to most diseases||Eating|
|Prima||USA||1958||Resistant to scab and most diseases||Eating|
|Porter's||US||Smallish, squat, deep golden yellow colour with red blush and firm, white, fine-grained aromatic sweet flesh.||Eating, Cooking or Cider.|
|Pott's Seedling||England||Pale green to yellow colour and white flesh.||Cooking|
|Pound Sweet||Manchester, Connecticut, US||1834||Amber coloration. Used mostly for making apple butter. Russets. Does well in moderate cold. Suitable to areas with snowy winters.||Cooking|
|Rajka||Czech Republic||Scab-resistant cross of Rezista × Rome||Eating|
|Red Astrachan||Russia||c. 1800||Extremely resistant to frost.||Cooking|
|Red Delicious||Iowa, US||c. 1870||Unmistakable for its acutely conic shape, dark red colour and telltale bumps on bottom. Flavour is sweet and mild, bordering on bland. Poor choice for cooking or cider. Original seedling known as "Hawkeye." Rights bought by Stark Brothers in 1893. First marketed as "Delicious" or "Stark's Delicious," name changed to "Red Delicious" in 1914 when Stark bought the rights to Mullin's Yellow Seedling, changing that apple's name to "Yellow Delicious". Red Delicious has many sports and ranks as the world's most prolific apple.||Eating|
|Red Prince||Weert, Netherlands||1994||Medium-sized, conic, uniform deep red skin. White flesh is crisp, sweet and juicy, with hints of cherry and almond. Excellent keeper. Chance seedling (a natural cross of Jonathan and Golden Delicious) discovered in 1994. Marketed throughout Europe, in 2001, Global Fruit in Ontario became exclusive growers of the variety in North America.||Eating, Cooking|
|Rev. W. Wilks||England||1908||Pastel green with a light pink flush. Very disease-resistant.||Cooking|
|Rhode Island Greening||Newport, Rhode Island, US||1650s||Extremely old variety for United States, second only to Roxbury Russet in age. Very tart. Grass-green colour with some possible russeting near stem.||Cider, Cooking|
|Ribston Pippin agm||Knaresborough, North Yorkshire, England||1708||An irregularly-shaped and sometimes lopsided apple, usually round to conical and flattened at the base with distinct ribbing. Skin is yellow with an orange blush and red streaked with russet dots. Yellow flesh is firm, fine-grained, and sweet with a pear-like flavour. The original Ribston Pippin sprouted in 1708 from one of three apple pips sent from Normandy to Sir Henry Goodricke of Ribston Hall at Knaresborough. The original tree stood until 1835. It then sent up a new shoot and, on the original roots, lived until 1928. Ribston Pippin is thought to be a parent of Cox's Orange Pippin.||Eating|
|Rome Beauty||Rome, Ohio, United States||19th century||Rounded, deep red, and very glossy. Crisp, juicy white flesh is mild as a dessert apple, but develops an extraordinary depth and richness when cooked. Good keeper.||Cooking|
|Rosemary Russet agm||UK||Regular cropper. Fruit sweet and sharp, like 'Ashmead's Kernel'.|
|Royal Gala See Gala|
|Rubens (Civni)||Italy||1985||Sweet and crunchy; Gala × Elstar.||Eating|
|St. Edmund's Pippin agm||Suffolk, England||1870s||Unusual in fact that it has scaly russet patches mixed with smooth. Has vanilla/pear taste. Usually a light yellow-green.||Eating|
|Santana||Wageningen, Netherlands||1978||Scab resistant.||Eating.|
|Saturn||Kent, England||1980||Scab resistant.||Eating.|
|Smokehouse||Mill Creek, Pennsylvania, US||1837||A medium to small apple. Greenish-yellow with flushed red-orange stripes. The yellowish-white flesh is crisp and tender with a spicy-sweet flavour that tastes like cider. Excellent all-purpose apple. Unusual in that it also makes excellent cider. Seedling discovered growing next to the smokehouse on William Gibbons' farm in Mill Creek, PA. Bears fruit from young age.||Eating, Cooking, Cider.|
|Snow apple (Fameuse)||Quebec, Canada||17th century||Tender, aromatic, distinct flavour. A parent of McIntosh.||Cider, cooking, eating|
|Sonya||New Zealand||2000||Cross between a Red Delicious and Gala. Coppery coloration. Crisp.||Eating|
|Spartan||British Columbia, Canada||1926||Good all-purpose, medium sized apple. Has a bright red blush and may have background patches of greens and yellows. Popular across border in United States as well.||Cooking, Eating|
|Splendour/Splendor||New Zealand||1948||Descendant of Red Dougherty x Golden Delicious, ancestor of Pacific Rose and Aurora Golden Gala||Eating|
|Stark Earliest||US||1938||Does nicely in fruit salads. Red striping on light background. Ripens in summer.||Eating|
|Stayman||US||1866||Dullish red skin often covered with a light russet. Tart, wine-like flavour. Stores well. Particularly known for tangy cider.||Cider, Cooking, Eating|
|Streifling Herbst||Netherlands or Western Europe||Sour sweet. Popular in Eastern Europe||Eating, juice, jam, compote, dried|
|Sturmer Pippin||Sturmer, Essex, England||c. 1800||A medium-sized, bright greenish-yellow apple with a reddish-brown blush, often on one face only. White-fleshed and crisp. One of the best English keeping apples, with proper storage Sturmer Pippin lasts 4 to 5 months. Flavour is sprightly, more sharp than sweet when first picked, but improves dramatically in storage, becoming sweeter and richer, while maintaining its crisp texture. This keeping ability made it ideal for long journeys, as such, it was brought to Australia where it is still widely grown. Parent of Granny Smith.||Eating|
|Summerfree||Italy||1998||Resistant to scab. Spreading habit with moderate vigour, fruit is large, average weight of 175 g, skin is smooth, ripens 1–2 days before Gala, good storage ability.||Eating|
|Sunset agm||England||1918||Easy to grow. Has very similar flavour to Cox's Orange Pippin. Won't do well in heat.||Eating|
|Suntan agm||UK||Fruits ripen orange-red, flavour is sharp and intense|
|Sweet Sixteen||Minnesota, US||1973||Large fruit, some russeting near top. Moderately acidic taste.||Eating|
|SweeTango||Minnesota, US||2009||Juicy and sweet, and viewed as a successor to the Honeycrisp by many growers.||Eating|
|Teser||USA||1944||Resistant to scab.||Eating|
|Tolman Sweet||US||1822||Very sweet apple. Once used to make dried fruit for winter.||Cider, Cooking|
|Tom Putt||Trent, Dorset, England||18th century||Small to medium, flat and irregularly shaped apple. Green, usually covered entirely with a bright red blush. Crisp, sharp flavour. An excellent cooker and ideal single-variety cider apple. Softens during storage. Tree is vigorous and precocious. Scab-resistant. Seedling found by a Rev. Tom Putt of Trent, Somerset, England in the late 1700s. Triploid.||Cider, Cooking|
|Topaz||Czech Republic||1990||Rubin × Vanda, scab-resistant, sharp flavour.||Cider, Cooking, Eating|
|Twenty Ounce||New York||1840||Huge: apple weighs over one pound, or nearly 500 g. Green overlaid with broad red striping. Excellent cooker. Nice juice qualities.||Cider, Cooking, Eating|
|Tydeman's Early Worcester||England||1929||Mclntosh × Worcester Pearmain. Crimson over yellow background colour.||Eating|
|Tydeman's Late Orange||England||1930||Good storage qualities, but loses fragrance with age.||Eating|
|Wagener||New York||1795||Antique American variety, known since Colonial times. Tree is scab-resistant. Green with red flush, crispy, subacid and sweet. Keeps very well. Very versatile in kitchen; not only does it cook well, but makes a good single-variety cider. Wagener is a parent of Idared, to which it imparts its keeping and cooking qualities.||Cider, Cooking, Eating|
|Warner's King agm||Kent, England||c. 1700||Oblong and light green. Very tart. Do not attempt to eat out of hand.||Cooking|
|Westfield Seek-No-Further||Westfield, Massachusetts, US||18th century||A medium-sized conic to truncate-conic apple. Greenish-yellow, dull skin, flushed orange with carmine stripes, russet dots and patches. Shaded fruit are often irregularly russeted all over, with little colour showing. Flesh is light buttery-yellow, firm but tender, and moderately fine-grained. Flavour is nicely balanced, a honey-like sweetness balanced with a lemon-like citric acidity, rich, notes of pear and vanilla. Vigorous grower, some disease resistance.||Eating|
|Wealthy||Minnesota, US||1860||Cherry Red × Sops of Wine.
Pretty reddish pink coat. Believed at one time Minnesota was too cold to grow apples until "Wealthy" was cultivated. Now a parent to many apples for resistance to temperatures below freezing. Still available in upper Midwest.
|White Transparent||Latvia||1850||Very pale green skin with an almost white flesh, it is very sharp in taste. Fruit bruises easily and goes soft once harvested.||Cooking|
|Winesap||United States||1817||Sweet with tangy finish. Reddish blush flecked with some green.||Cider, Eating|
|Winston (Winter King) agm||England||c. 1935||Cox Orange × Worcester Pearmain. Originally called Winter King because of its extraordinary keeping ability, renamed during World War II for Winston Churchill.|
|Wijcik McIntosh||British Columbia, Canada||Mid 1960's||Mutation of McIntosh apple that first showed columnar ornamental properties||Eating, Cooking, Ornamental|
|Wolf River||Wisconsin, US||1881||Apple very large, some growing to size of large grapefruit. Red with yellow blush. Once very popular commercial apple in United States but presently relegated to upper Midwest if grown for profit. Occasionally can be found growing wild in backcountry thickets or abandoned land in Shenandoah Valley. Named for area where found. Feral trees can be brought back with care and pruning.||Cooking, Eating|
|Worcester Pearmain agm||Worcestershire, England||1873||Crisp and sweet strawberry flavour when ripe. Best if eaten early in season (September).||Eating|
|Wyken Pippin||England or Netherlands||Old||Small flattened golden apple with delicious flavor||Eating|
|York Imperial agm||York, Pennsylvania, US||1820||Tart yet sweet, preserves well, lop-sided shape||Cider, Cooking, Eating|
|Common name||Origin||First developed|
|Baldwin||Wilmington, Massachusetts, US||c. 1740|
|Brown Snout||Herefordshire, England||c. 1850|
|Dabinett||Somerset, England||late 19th century|
|Dymock Red||Gloucestershire, England|
|Foxwhelp||Gloucestershire, England||c. 1600|
|Kingston Black||Near Taunton, Somerset, England||late 19th century|
|Newtown Pippin||Queens County, New York, US||c. 1750|
|Redstreak||Herefordshire, England||c. 1630|
|Roxbury Russet||Massachusetts, US||c. 1640s|
|Stoke Red||Rodney Stoke, Somerset, England||early 20th century|
|Tremlett's Bitter||Exe Valley, UK||c. 1820|
|Vista Bella||Rutgers University, US||1944|
|Yeovil Sour||Yeovil, Somerset||c. 1824|
Selection of rootstock cultivars can be difficult: vigorous roots tend to give trees that are healthy but grow too tall to be harvested easily without careful pruning, while dwarfing rootstocks result in small trees that are easy to harvest from, but are often shorter-lived and sometimes less healthy. Most modern commercial orchards use one of the "Malling series" (aka 'M' series), introduced or developed by the East Malling Research Station from the early 20th century onward. However, a great deal of work has been done recently introducing new rootstocks in Poland, the U.S. (Geneva), and other nations. The Polish rootstocks are often used where cold hardiness is needed. The Geneva series of rootstocks has been developed to resist important diseases such as fireblight and collar rot, as well as for high fruit productivity.
- Elzebroek, A.T.G.; Wind, K. (2008). Guide to Cultivated Plants. Wallingford: CAB International. p. 27. ISBN 1-84593-356-7.
- "RHS Plant Selector - Malus domestica 'Alkmene'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Arthur Turner'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Ashmead's Kernel'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Belle de Boskoop'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Blenhein Orange'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Bramley'". Retrieved 23 May 2013.
- Calhoun, Creighton Lee, Jr. "Old Southern Apples", Blacksburg, Virginia 1995, MacDonald and Woodward, (ISBN 9-780939-923373), page 59
- "RHS Plant Selector - Malus domestica 'Claygate Pearmain'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Delcorf'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Discovery'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Dummellor's Seedling'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Edward VII'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Egremont Russet'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Ellison's Orange'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Elstar'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Emneth Early'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Falstaff'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Fiesta'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Fortune'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'George Neal'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Golden Delicious'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Golden Noble'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Greensleeves'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Grenadier'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Idared'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'James Grieve'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Jonagold'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Jupiter'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Kidd'sOrange Red'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'King of the Pippins'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'King Russet'". Retrieved 23 May 2013.
- Story of Lady Alice
- "RHS Plant Selector - Malus domestica 'Lane's Prince Albert'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Laxton's Epicure'". Retrieved 23 May 2013.
- "RHS Plant Selector - Malus domestica 'Lord Lambourne'". Retrieved 23 May 2013.
- [Santa Cruz Sentinel, June 27, 2006: "Life changes after encounter with fairy-tale horses"]
- "RHS Plant Selector - Malus domestica 'Newton Wonder'". Retrieved 26 May 2013.
- Story of Pam's Delight
- "RHS Plant Selector - Malus domestica 'Peasgood Nonesuch'". Retrieved 26 May 2013.
- "RHS Plant Selector - Malus domestica 'Pixie'". Retrieved 26 May 2013.
- Red Prince apples
- "RHS Plant Selector - Malus domestica 'Ribston Pippin'". Retrieved 26 May 2013.
- "RHS Plant Selector - Malus domestica 'Rosemary Russet'". Retrieved 26 May 2013.
- "RHS Plant Selector - Malus domestica 'St Edmund's Pippin'". Retrieved 26 May 2013.
- [Santana details "RHS Plant Selector - Malus domestica 'Santana'"]. Retrieved 26 May 2013.
- "RHS Plant Selector - Malus domestica 'Sunset'". Retrieved 26 May 2013.
- "RHS Plant Selector - Malus domestica 'Suntan'". Retrieved 26 May 2013.
- "RHS Plant Selector - Malus domestica 'Warner's King'". Retrieved 26 May 2013.
- "RHS Plant Selector - Malus domestica 'Winston'". Retrieved 26 May 2013.
- "RHS Plant Selector - Malus domestica 'Worcester Pearmain'". Retrieved 26 May 2013.
- "RHS Plant Selector - Malus domestica 'York Imperial'". Retrieved 26 May 2013.
Khanizadeh, S. and J. Cousineau. 1998. "Our Apples/ Les Pommiers de Chez Nous", A Description of Over 250 Apple Cultivars Grown in Eastern and Central Canada Including 400 Coloured Photographs of the Fruits, Flowers and Leaves. Publisher Shahrokh Khanizadeh, 260 p. Ed: S. Khanizadeh. ISBN 0-660-60543-0.
Two of the most comprehensive publications on apple cultivars are: Khanizadeh, S. and J. Cousineau. 1998. "Our Apples/ Les Pommiers de Chez Nous", A Description of Over 250 Apple Cultivars Grown in Eastern and Central Canada Including 400 Coloured Photographs of the Fruits, Flowers and Leaves. Publisher Shahrokh Khanizadeh, 260 p. Ed: S. Khanizadeh. ISBN 0-660-60543-0.
- The New Book of Apples (ISBN 0-09-188398-9) by Dr Joan Morgan of The National Fruit Collection and Alison Richards.
- Directory of Apple Cultivars (ISBN 1-874275-40-8) by Martin Crawford of The Agroforestry Research Trust
- For Cider apples - "Cider Apples, The New Pomona" [ISBN 978.0.9568994.2.2] by Liz Copas
- Apples (ISBN 0-393-03690-1) by Roger Yepsen. Text of apple history and descriptions with full-color watercolor illustrations of 90 apple varieties by Yepsen. W.W. Norton and Company, New York and London.
- "Old Southern Apples" (ISBN 9-780939-923373) by Creighton Lee Calhoun, Jr.
||This article's use of external links may not follow Wikipedia's policies or guidelines. (August 2010)|
- Apple Journal
- Apple flavours and descriptions from OrangePippin.com
- Smithsonian article on U.S. heirloom variety situation
- PRI (Purdue Univ., Rutgers State Univ. of New Jersey, and the Univ. of Illinois) breeding program, responsible for many new varieties
- Online southeast U.S. variety list
- New apple varieties
- Old Italian varieties of apple
- Tree Guide - Early Harvest Apple
- Goldspur - a green apple cultivar
| 12 |
regression analysis. Here, we also discuss the advantages and disadvantages of green revolution. Furthermore, we intend to throw light on the plight of Indian farmers, and the problems faced by agricultural sector in India.
In spite of Agriculture being the backbone of our country’s...
Industrial Revolution, commencing in the 18th century. By the end of the 20th century, East Asia had become one of the most recently industrialised regions of the world.
1 Description 2 History of industrialisation 2.1 Industrial revolution in Europe
Green Innovation Management in the Automotive
Auto industry is one of the first ones introducing “green” products to customers. It is because this...
Green Marketing: Leads to Product Innovation
Prof. Manjusha Kadam, Faculty of marketing
Novel Institute of Management Studies
Affiliated to AICTE approved by university of pune
Mail id : [email protected]
Ph : 9226787839
All of mankind has limited resources on the earth, with...
Britain in 2000
Green Belts Another feature, linked to the above, that must be contemplated, is the Green Belt. They are a man-made feature of the natural environment in the sense that they are areas, typically...
next year or next decade, it's now." Report from the UN Office for the Coordination of Humanitarian Affairs (OCHA): HYPERLINK "http://en.wikipedia.org/wiki/Environmental_issue" \l "cite_note-1"
"Climate disasters are on the rise. Around 70 percent of disasters are now climate related – up from around...
emerged as a significant threat to even the most industrialized nations as Mother Nature nearly negated the benefits derived from the 20th century’s Green Revolution.
As Western Europe became dependent on outside sources to provide sustenance to its population, tensions within the European Union reached...
the future. Its story is built on innovation and seeing where others fail to see. Always at the cutting edge - with colour, with its sales outlet revolution, with an absolutely unique production and commercial network and with a universal form of communication, creating both a phenomenon and cultural...
Research Associate, Department of Commerce,
V.H.N. Senthikumara Nadar College (Autonomous),
The industrial revolution of the eighteen and nineteenth centuries led to great increase in production and income. Technology innovation led to greatly increase output at...
sector. This is very much true not only for India but for most countries across the globe. Milk and milk products
are perhaps one of the very few consumption items common in all cultures around the world. The advent of
white revolution and operation flood has changed the scenario drastically...
Unemployment has become a major economic issue in India. With
many losing their jobs, and many not given the opportunity to obtain a job, India’s
unemployment rate had increases to 7.8 %( 2006 est.). With 1,129,866,154 (July 2007
est.) people living in India, 25% are below the poverty line. As apposed...
India and China are two countries that have experienced a rapid growth in population over the past few decades. Each of the two countries has a population in excess of one billion people and combined they represent over one-third of the world's population. As the population of these two countries has...
lobe. For the neck there is the adigai which consists of a choker and pendant, and a longer chain with a broad padakkam or pendant designed in red, green, and pearly stones with peacock or floral designs set in a half-moon like frame. An undulating bangle, vanki; for the upper arm, gold bangles for the...
India is the second most populous country in the world. Majority of its population live in villages & earn their livelihood through farming. Agriculture is the backbone of Indian Economy. The agriculture sector in India contributed 14.6% to the GDP in 2011-12 and is the...
globally from 2.4% to 1.8% for the oil and gas producers like BP.
On the supply side, the most noticeable phenomenon remains the American shale revolution. In 2012, the US recorded the largest oil and natural gas production increases in the world, and saw the largest gain in oil production in its history...
the rising tide of youth unemployment to forget about a steady job for life, saying such is "monotonous [anyway and] it's
Leader Party Alliance Leader since Seats won Popular vote Percentage
Beppe Grillo Five Star Movement Five Star...
and universal version of a primordial faith that was revealed many times before through prophets including Adam, Noah, Abraham, Moses, and Jesus.” (Wiki Islam)They argue that the previous messages and revelations have been partially misinterpreted or altered over time. Consequently, they consider the...
As an environmental activist
she has co-ordinated, supported and learned from grassroots networks on a wide range of issues across India.
Advocates ‘tree hugging’, the tactic of hugging trees to prevent them being cut down.
Supports ‘Navdanya’ (meaning 9 seeds): “Conserving seed is...
area or country. For instance, when McDonalds established itself in India, they had to consider the religious beliefs such as not selling beef. Many Indians follow a religious faith in which they worship cows. The selling of beef in India would thus result in a cultural disaster.
A developing trend around...
1. Is the Nuclear deal good for India : YES IT IS
2. Is the nuclear deal a windfall for the Congress party : YES IT SEEMS TO BE :
3. Are the finance ministry measures confidence building measures
4. Will Obama’s Anti-outsourcing stand spell doom to India
5. Has reservation in professional...
“The direct model has been a revolution, but it’s not a religion.” Michael Dell
"Consumers is a market by itself... We recognize that while we have been delivering products to consumers, we never had the strategy or organization to go after this market”
THE URGE TO CHANGE
The move to finally dip...
|Home Hardware Software Storage Networking Internet Mobile Web 2.0 Cloud Green Security DSE Regs |
|INTRO VIDEOS GLOSSARY ABOUT THE AUTHOR INFO FOR EDUCATORS SITE...
The economic development in India followed socialist-inspired policies for most of its independent history, including state-ownership of many sectors; India's per capita income increased at only around 1% annualised rate in the three decades after Independence. Since the mid-1980s, India has slowly opened up...
India is an agricultural country. About seventy percent of our population depends on agriculture. One-third of our National income comes from agriculture. Our economy is based on agriculture. The development of agriculture has much to do with the economic welfare of our country.Our agriculture remained...
Since the infrastructure of such cities was built to support a larger population, its maintenance can become a serious concern.
A shrinking city is a densely populated urban area with a minimum population of 10,000 residents that has faced...
CARBON CREDIT MANAGEMENT IN INDIA
The phenomenon of change in atmospheric conditions due to air polluting gases is
called as global warming. Carbon-dioxide is one of the Green House Gases causing
global warming. Green House Gases also includes some other gases like methane,
independence in 1947, India chose to be a federal state, with significant power to the state governments in response to the diversity in socio-economic conditions across the country. Over the last 60 years, the number of states and their boundaries has changed frequently and India now has 35 states and...
to efficient management
4. Is the Nuclear deal good for India
5. Is the nuclear deal a windfall for the Congress party
6. Are the finance ministry measures confidence building measures
7. Will Obama’s Anti-outsourcing stand spell doom to India
8. Has reservation in professional courses worked
system of agricultural production has undergone a drastic change from the basis of natural resources to scientific bases, which involved technology revolution in the agricultural sector. The traditional variety of seeds was not able to yield maximum productivity from the land with dependence on uncertain...
|http://www.greenpeace.org.uk/climate/solutions/renewable-energy for UK |
| | |Describe trends in global energy demand; role of India and |Graphs of trends in global energy use type |renewable energy potential |
| 12 |
Whether Brazil continues to reduce its deforestation could depend on the outcome of a vote on its forest protection law in Brazil's lower house in March and sign-off from the president. Above: the home of Brazil's Congress, Congresso Nacional do Brasil (Photo credit and thanks to Flickr user JorgeBRAZIL)
Brazil has made great strides in reducing Amazon deforestation in recent years, bringing rates down about 80% over the last six years. But President Dilma Rousseff is already showing signs of backsliding on her environmental commitments in just her first year in office.
It’s a trend environmental groups have been following since Rousseff was sworn in last January, and one New York Times reporter Alexei Barrionuevo captures well in his recent story, "In Brazil, Fears of a Slide Back for Amazon Protection."
With global emissions from deforestation contributing about 15% of greenhouse gas emissions – as much as all the world’s cars, trucks, ships and airplanes combined – a lot is at stake in next month’s vote on a forest protection law in Brazil’s House of Representatives.
Whether Brazil, home to about 40% of the world’s remaining tropical forests, continues to reduce deforestation or not could depend on the outcome of the vote, and President Rousseff’s sign-off.
Forest Code enforcement and new protected areas slashed deforestation in 2000s under Marina Silva
Brazil’s law regulating deforestation on private land, the Forest Code, has been around since 1965; until relatively recently, it was hardly enforced and rarely obeyed.
That changed under former Environment Minister Silva. In 2003 she launched a national Plan for the Prevention and Control of Amazon Deforestation that ramped up law enforcement and established 600,000 square kilometers – an area the size of France – of new protected areas. These indigenous lands, parks, and forest-land reserves were located in the areas most affected by the expansion of agriculture.
Coupled with a temporary decline in agriculture commodity prices, the Plan brought deforestation way down, and persuaded policy makers that Brazil could commit not only to a national deforestation target, but to an overall national emissions reduction target as well.
Brazil made just such a commitment at the 2009 Copenhagen climate conference, pledging to reduce its emissions 36–39% below business-as-usual emissions by 2020 — the first emissions reductions target taken by any major developing country. And Brazil is ahead of schedule to meet this 2020 target, having already reduced about 1 billion tons of carbon dioxide below its 1996–2005 baseline – on the order of what the EU has pledged to do by 2020.
However, while the deforestation plan was supposed to have a carrot (positive incentives for conservation) in addition to the stick (cracking down on illegal deforestation), so far it’s pretty much been all stick and no carrot: lots of law enforcement, but no incentives to keep the forests standing.
Farmers lash back
Many large-scale farmers in Brazil historically had railed against the Forest Code as being too restrictive, but were too busy cutting down trees to plant cattle pasture and soybeans to do much about it. Since the Code was rarely enforced, they didn’t much care.
An aerial view of Mato Grosso shows the stark distinctions between protected forests and land that has been cleared for cattle pasture or agriculture.
But they started to take notice when government, under Minister Marina Silva, began enforcing the Code and fining them for violations.
They also noticed when the environmental group Greenpeace mobilized big European soy importers to declare a moratorium on soy imports from land deforested after 2006, and when national supermarket chains, prodded by Brazil’s Attorney General, called for deforestation-free beef in 2009. Most people in urban Brazil agree that Amazon deforestation should stop, and support such measures.
For many of the large-scale farmers in Brazil and their powerful block of congressional representatives – the “ruralistas” – the solution to their not being in compliance with the law when government started enforcing it was to weaken the law.
So for the past two years, the ruralistas have been making a concerted push to radically weaken the Forest Code.
Last June, the ruralistas pushed a revised Forest Code through the lower house of Congress that amounted to a license to deforest. The bill, sponsored by a ruralista-friendly member of the Communist party, would fix the ruralistas’ problem by giving an amnesty for past illegal deforestation, and could open up new land for clearance.
Environmentalists and the Brazilian scientific community strongly contested the House bill. President Rousseff had promised during the presidential campaign to veto a new Forest Code that would increase deforestation or amnesty past illegal deforestation, but her administration was a belated and ineffective participant in the House debate.
In December, the Senate passed somewhat improved amendments to the Code, which, however, still includes an amnesty for some past illegal deforestation.
This bill now returns to the House for a final vote in March.
The amnesty for deforestation that has plagued these bills is unfair to the few farmers who made the effort to comply with the law, and could give all farmers the bad idea that if one new law granting amnesty for illegal deforestation is good, two – or more – are better. If farmers think that an amnesty now means that future illegal deforestation will eventually be amnestied too, they will take the new Code as a license to deforest. Penalties for scofflaws, and a clear pathway to legality with positive incentives, especially for small famers, would be much better.
Environmentalists are calling on Dilma to keep her campaign promise and veto the amnesty.
Deforestation: the price of progress? Not really.
For years, the ruralistas have insisted with increasing vehemence that the current Forest Code is an enormous, unfair obstacle to the growth of Brazilian agriculture. (They also often claim that environmentalists who support the Forest Code are no more than a front for foreign agriculture interests trying to protect themselves against Brazilian competition).
But there is solid evidence that while deforestation rates were falling to the lowest levels on record, Brazil and Amazon states were getting richer and agriculture production was growing to record levels.
A vivid example is Brazil’s biggest agricultural state, Mato Grosso.
Deforestation (red line in Fig. 1 above) in Brazil's state of Mato Grosso plummeted as production of soybeans (green) and cattle (blue) increased substantially from 2001-2010. (PNAS)
The state had the highest deforestation rate in the Amazon from 2000–2005, but over the next five years (2006-2010) saw deforestation fall more than 70% below historic levels. At the same time, agriculture production reached an all-time high, according to a recent article in the leading scientific journal Proceedings of the National Academy of Sciences. In “Decoupling of deforestation and soy production in the southern Amazon during the late 2000s,” Marcia Macedo, Ruth DeFries and others also show in great detail that in recent years, while soy prices and production picked up substantially, deforestation kept going down.
Ruralista rhetoric to the contrary, Brazil and Amazon states have shown decisively that, so far, they have the wherewithal to reduce deforestation substantially while they grow their economies and their agriculture sectors.
Brazil should encourage – not undercut – global action against climate change
However, as the Times story correctly notes, Forest Code amendments threaten to usher in open season on forests. The government has watered down environmental licensing for big infrastructure projects like dams and roads and has rolled back protected areas in the Amazon by a form of executive fiat. Brazil’s Congress is also considering a bill that would give it a veto over recognizing new indigenous lands.
Brazil is home to about 40% of the world's tropical forests and a pioneer in policies to Reduce Emissions from Deforestation and forest Degradation (REDD+), which could provide the positive economic incentives needed to maintain Brazil's progress in continuing to curb deforestation.
Perhaps most critically, there has been little progress on providing the carrot – positive economic incentives to keep deforestation going down and to restore degraded forests – that Brazil needs in order to sustain the progress it made during the last decade into the future.
One candidate for the carrot is Reducing Emissions from Deforestation and Forest Degradation (REDD) – the concept that reducing deforestation is good for the atmosphere and needs international compensation. Brazil was one of the pioneers of this idea in the international climate talks, and consequently created the Amazon Fund, to which Norway has committed $1 billion if the country continues to meet its 2020 target.
Brazil’s National Climate Change Policy also calls for the creation of a Brazilian emissions reductions market. But the federal government has made little headway on creating its own carbon market and has been reluctant to look at linking up with international carbon markets to pay for reducing deforestation. Both could go a long way to creating the incentives needed to grow the economy and sustainably expand agriculture and forestry, while stopping deforestation and restoring degraded forests.
What all of this means is that Brazil still leads the world in reducing carbon emissions because of its success in reducing Amazon deforestation – but risks reversing the trend if it approves a general amnesty for illegal deforestation. President Rousseff should listen carefully to Brazil’s world-class scientific community on how to balance environmental protection and development priorities, in the Forest Code and more broadly.
As Brazil prepares to host the Rio+20 Conference on Sustainable Development, it will find no lack of major developed countries to criticize for foot-dragging, omission, or outright obstruction on global environmental issues. Ambitious new commitments on environment and development are unlikely under the specter of economic crisis in the EU and anemic growth in the U.S. Blaming richer countries for tepid results is one possible outcome.
But if President Rousseff musters the political will to kill the deforestation amnesty and save the Forest Code, Brazil could do much better in Rio+ 20. It might find ways to use its world-leading achievement in reducing emissions from deforestation to chart the way to both more ambitious commitments and effective actions from other major economies going forward, and for funding for a sustainable low-carbon development strategy.
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Tulip Tulipa batalinii 'Bright Gem' 1 2 3 4 5 6 7 8 9 10 11 Tulip (Tulipa batalinii 'Bright Gem') Genus: Tulipa This named variety of the species has soft sulfur-yellow flowers up to 3 inches across. The spring blossoms sit 4-6 inches high, surrounded by wavy-edged, gray-green foliage that reaches 8-10 inches tall. Species tulips prefer sharp drainage and plenty of room to grow. Most do well in rock gardens, small displays, and containers. Noteworthy Characteristics: Tulips originate in regions with cold winters and dry summers. (They require a cold treatment in order to bloom.) They are invaluable for early spring color in bedding schemes, parterres, cottage gardens, and mixed borders. This species is also suitable for rock gardens. Care: Provide fertile, well-drained soil in full or afternoon sun. In autumn, plant to a depth of two and a half times the height of the bulb; in regions warmer than Zone 8, bulbs will need a cold treatment (40° to 45°F for 8-10 weeks). Many tulips only last and bloom reliably for one season, but this species will naturalize. Propagation: Impractical for home gardeners. Problems: Bulb and root rot, gray mold, slugs, snails, aphids, nematodes, voles. Overview Height 6 in. to 12 in. Spread 6 in. to 12 in. Growth Habit Clumps Growth Pace Moderate Grower Light Full Sun to Part Shade Moisture Dry to Medium Maintenance Moderate Characteristics Fragrant Flowers, Showy Flowers, Showy Foliage Bloom Time Spring Flower Color Yellow Uses Beds and Borders, Container, Cut Flower, Ground Covers, Naturalizing, Suitable as Annual Style Cottage Garden, Herb Garden, Meadow Garden, Rock Garden Seasonal Interest Spring Interest Type Bulbs Related Plants to Tulipa batalinii 'Bright Gem' 1 2 3 4 5 6 7 8 9 10 11 Wild jonquil Narcissus jonquilla 1 2 3 4 5 6 7 8 9 10 11 Daffodil Narcissus 'Quail' 1 2 3 4 5 6 7 8 9 10 11 Grape hyacinth Muscari comosum 'Plumosum' 1 2 3 4 5 6 7 8 9 10 11 Grape hyacinth Muscari aucheri 'Blue magic' View the discussion thread.
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At the same time that demand for food is soaring along with the world's population, the soil's ability to sustain and enhance agricultural productivity is becoming increasingly diminished and unreliable.
Fortunately, it's not too late to restore our soil resources. What it will take, say the editors and contributors to a new book, Soil Management: Building a Stable Base for Agriculture, is rediscovering the value of soil management and following practices that are firmly grounded in science. The book is published by the American Society of Agronomy (ASA) and Soil Science Society of America (SSSA).
Soil management concepts have been in place since the beginning of agriculture. However, "our personal concern," say the editors, Jerry L. Hatfield and Thomas J. Sauer of the USDA-Agricultural Research Service, "is that we have not focused enough on how to improve our soils and management practices." This concern led them to assemble in the book the latest scientific knowledge about the physical, biological, and chemical processes taking place in soils, which together form the foundation of effective soil management.
Individual chapters cover diverse issues of global relevance, including water dynamics in soils, gas exchange, soil biology, pesticide movement, and wind erosion. The book also emphasizes the mounting challenges of enhancing productivity while simultaneously achieving environmental protection, and managing soils in a changing climate.
"The management of soil is fundamental to life," say SSSA president Charles Rice and ASA president Newell Kitchen. "This book speaks to a priority message of our sciences."
While the book is well suited to scientists, it also uses accessible language, allowing students, soil science professionals, and other science-literate readers to benefit from its integration of management issues, soil research and long-term conservation efforts. The editors hope the volume will spark renewed interest in the critical, but somewhat neglected, topic of soil management.
Explore further: Block cropping pitted against integration method
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Avocado trees whether grown from seed or purchased from a nursery will need to proper care to thrive. This is a guide about caring for an avocado tree.
Here are questions related to Caring for an Avocado Tree.
My avocado tree started growing brown on the leaves. How would I check if it's root bound?
By DeBushe 03/18/2013
The only way I know of to check if a plant is root bound is to pull the whole thing out of the pot and look.
Avocado trees are just that, trees. They prefer to be in the ground. I had one in my back yard (California coastal valley) that was about 30 feet tall and put out hundreds of avocadoes.
The older leaves do turn brown, dry up and fall off. This is natural.
I have a mature 10 ft 8 yr old avocado tree and the leaves are turning yellow and the 30+ fruit on the tree are red skinned, but turn brown when picked and stored. It's close to another avocado tree which has the normal dark green leaves. It receives normal fertilizer annually. We are 200 meters from sea. Other avocado trees nearby in the settlement are normal. Is my tree dying or can it be saved? Thanks for any help.
By Allan M
By judy 04/05/2012
Beware fertilizing avocado trees too often. In So Cali they grow perfectly fine with very little...sometimes no fertilizer.
I currently have 5 avocado trees no taller than 1 foot. It seems, no matter how hard I try I can't keep them alive past 1 year. The leaves have fallen off all 5 plants. I only water them every 10-14 days. As we speak the soil is comfortably moist. It's so aggravating because I literally can grow anything. Perhaps I'm paying them too much attention?
By Lorelei N.
By Da S.02/11/2015
I don't have the answer, I just wanted to comment that I have the same problem. For the first time I had one that bushed out! It was so beautiful and now, the black stem is starting from top down and I want to cut it and stop it but the last 3 I did that and nothing stopped it. I have no answers anywhere, one site said it was s disease from not watering enough, but I made sure this one was moist. I have one left, and it's super tall and scrony. I haven't touched this one at all, no trimming in fear I can't get it to grow. :( Have you heard why they do this, what are we doing wrong?
I recently planted a 5yr old avocado tree that was beginning to flower. I (thought) I did everything I was supposed when planting, including fresh soil and deep watering, but since I planted the tree all the leaves have died and turned brown, but the branches are still green. It has been about three weeks since planting. I have sprinklers set to twice a week, but if am wondering if it is not getting enough water from them. I have deep watered only twice since planting. The tree sits on the north east end of my yard and gets plenty of sun after about 10am. Does it sound like the tree can recover? If so, what do I need to do?
By Shawn H.
By brenda lambert10/26/2014
My tree is 3 feet tall & in a pot and turning brown, should I plant it. Should the seed be visible when I plant it? How cold is to cold for it?
My avocado tree has leaves that are turning brown. There is very little new growth. Please help.
By Joyce C
By April 04/09/2012
Is your plant inside or outside? If potted, have you checked to make sure it isn't root bound?
I read your answer in ASK, but I do not have leaves or branches on my avocado plant only 1 high stem w/leaves. Can I cut the top back or the leaves further down, or just let it keep growing taller w/o branching out? This is all new to me, please help.
Don't cut the top as that will stunt the upward growth of the plant. You can prune off the lower leaves, and that might encourage it to grow more upwards, and then hopefully start to branch. If you prune the lower leaves/branches it forces the plant to put more energy into the stuff on top.
Hope this helps!
Please help me I am in desperate need of assistance. I live in East Lansing, Michigan and have been growing an indoor Avocado plant since this summer. Everything seemed to be going very well until recently.
Firstly, let me say that I do not know the type of seed nor have I ever pruned my tree (I don't know how to or if I should). Right now, my plant is a little taller than 1 foot. It is pretty straight up (spindly) and gets a good amount of sunlight.
Here is the problem: recently, I have noticed that almost all of the leaves have fallen off. There are still a few leaves at the top and there even appears to be new leaves sprouting from the very top. Some of the larger leaves literally fell off at the slightest touch. Is this simply a natural phase my plant is going through or are there any measures I should be taking to improve my plant's health.
I would be really upset if it died and would really appreciate any help you can provide. I do not give it plant food, but I do have it planted in potting soil containing time release plant food. How often should I completely change all the soil and how do I do that without damaging the tree?
So, in sum, why is my plant so ugly (for lack of a better word)? why are all the leaves falling off? What kind of soil and/or plant food would you recommend? Should I change the soil? If so, how do I do it? And finally, should I prune it? If so, how do I do it?
Hardiness Zone: 6a
By attys from East Lansing, MI
By Kathy Klahn 10/02/2009
I think you may have over watered it. If that is the case it probably will not make it, sorry. I would not feed it either we have never fed ours and we have about 30 trees(my hubby just can;t throw those seeds away!). Let it dry out a little between watering, then water completely till it runs out the bottom, but do not let it sit in water.
I usually cut mine back at about a foot high down to 6" or so. Avocados do not like to be repotted, that is why they suggest to first pot it in a fairly large pot. Remember It is really easy to start a new one if yours does not make it and fairly inexpensive. Think guacamole, yum. Just google starting avocado trees and you will get lots of help.
Hope this helps, good luck!
My 3 year old avocado's new leaves are browning.
Hardiness Zone: 7a
Jamie from Hampton, VA
By LuvMyGingerKids 02/25/2008
Contact your local nursery -- they'll have the answer! =D
I have a 9 year old avocado tree and every year when the tree blooms, all the leaves turn brown and fall off and all the buds dry up, turn brown, and fall off. The branches are always green and as everything browns and falls off there is new growth, leaves and branches and such. Only once did it bear a few avocados. I believe there were 8 of them though only two made it to full maturity. The raccoons may have gotten the rest. The tree is a dwarf tree that we bought at a nursery and planted in our backyard. We have no idea why this happens and it does not make much sense to us because the tree continues to look healthy and grow. We have tried different fertilizers and nothing seems to help. It's about 12ft tall now.
By Alison H.
Our avocado tree is dropping its fruit too early. They are small, milky once ripened, and tasteless. We have watered, but not fertilized her for a few years. Help?
My avo-tree is now seven years old and is bearing fruit for the second year, why is it loosing so many brown leaves during springtime?
My tree is 15 feet high. I planted him from a seed. He had for the first time after 6 years 40 avocados, 2nd time 70, 3d time 90. This year I don't know yet, but he loses a lot of brown leafs. Did I water him too much? Please let me know what I have to do. Thanks.
By Ruth S.
I have no idea how old the male tree is, but it is well over 30 feet. I live in Orlando Florida and the tree gets plenty of water and sunlight. It has been very healthy till about 3 weeks ago. Now the leaves are turning brown. We did have a frost in January and some cold weeks with temps around 45 for lows, but other than that nothing has changed. My female is still green and very healthy. What can I do for the male?
By Teri H. from Orlando, FL
I have a tree which is ten year old. It is not flowering. So I assume it is not old enough for flowering. Is there anything to do for that, like pruning or something else? My place is a hilly region with a tropical climate.
By P Thomas from Trichur, Kerala, India
I have a 5 ft tree in a pot. It has branches growing about 8 inches above the soil. It looks like where it was grafted. Are these suckers and what is the best way to get rid of them?
My avocado tree is about 12 years old. It's planted in the ground, in Orlando. Each branch is turning brown and looks like the tree is slowly dying. It gets adequate water and fertilizer. I am not sure why it's dying. Is the root rotten?
By Sabrina b
Can you tell me if I need to feed my avocado? It is about 15 inches; high, also the leaves are drooping, but are very green.
Why would a 7 month old avocado plant's leaves turn dark brown and fall off? Then new leaves come on and do the same. It's in a 5 gal. bucket with good drainage. What am I doing wrong?
i have grown an avocado plant from the stone in the fruit. Once I planted it, it grew really quickly for some time, and then just stopped. I moved it into a better sun position and it grew some more. It's still in the same spot, but it hasn't visibly grown for months now, not even sprouting new leaves. It still looks healthy. Its presently about a foot tall. Its an indoor plant, also. What's going on? Do I have a plant that's afraid to grow or something? =)
My tree is about three years old and is flowering right now, but is losing leaves from the top down. I have not watered much during the wet months. Is this normal?
By Conor from Los Angeles, CA
Should I cut back my avocado? It's 2 feet tall with 9 leaves on the very top, but none anywhere else. The ones further down on the stem don't grow at all and just fall off. Should I cut it back to 6 or 8 inches and hope for the best?
By Mary Ann D
I have a 40+ year old avocado tree. It has always done very well, but this year the avocados are smaller than usual and seemed to have stop growing. The tree looks fine. I tried to pick one to see if it would ripen, but no luck.
By Billie O
I am growing an avocado plant. We had regular soil in the pot, but then we bought Miracle Gro soil and distributed it in 7 avocado plants. Then we read the bad side of using the Miracle Grow; it said not for potting. Will it affect the avocado plant in any way?
I have grown an avocado tree. I would like to know what people mean by pinching back so as to get a rounder fuller tree. Do I pinch the top off the tree or just the leaves?
Hardiness Zone: 4a
By Martha from Dexter, NY
Do you have knowledge about this guide topic? Feel free to share a solution!
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Hardiness Zone: 8b
Janell from Aloha Oregon
Avocados are self thinning and if not pruned regularly, they can grow tall and spindly as house plants. If your plant is still losing leaves, too much water or not enough sun are the two most common culprits. I've never grown an avocado plant, but theoretically, pruning a mature avocado plant should encourage branches to sprout from below the cut. This should create a stronger, bushier, more compact plant. If you don't want to cut back the main stem, partially cut back a few branches higher up to encourage new growth further down the trunk. Keep in mind that by cutting back main branches, you will stimulate growth all over and can expect to see several new stems emerge below the cuts. You may want to let these emerging stems grow out a bit and then periodically pinch or prune some of them back in order to reshape your plant. Avoid pruning in late summer or early fall.
This is a tough one, as I would hate to see anything slow down a 9 ft. tall avocado tree. I'm not sure how a 9 ft. tall avocado will respond to being pruned. Is it tall and spindly or have you pruned it back before to encourage branching from below? I'm going to assume since it has grown so tall in just two years time that you may have never pruned it before. If you have a fair number of strong, leafy side branches I wouldn't worry about cutting it back far enough to fit it indoors.
If the plant consists primarily of one stem, you might want to let the top bend at the ceiling and cut a few of the side branches back to try to encourage more branching. If new branches start to emerge, you can safely cut back the top. You don't say what zone you're in, but if you live in 9b or above you probably won't have to keep it indoors long enough to worry about causing a permanent change in its appearance. As long as there are enough leaves left on the plant to maintain food production and the plant is in good overall health, I wouldn't worry too much about cutting it back. Clearly you have a knack for growing avocado plants. If something should happen to this one as a result of you cutting it back, you might consider keeping any future plants to ceiling height with regular pruning.
About The Author: Ellen Brown is our Green Living and Gardening Expert. Click here to ask Ellen a question! Ellen Brown is an environmental writer and photographer and the owner of Sustainable Media, an environmental media company that specializes in helping businesses and organizations promote eco-friendly products and services. Contact her on the web at http://www.sustainable-media.com
The idea is to keep the plant warm, but not in darkness. It gets it's health from the leaves, so they will be the final determination if you are able to save the plant. Whatever you do, use caution that you do not set up a fire hazard for yourself and the plant.
It takes several years before it will produce fruit, I understand, but I'd encourage you to use Sea Kelp, if it were mine, for this season. It should keep it healthy throughout the year. If you know of anyone who'd let you borrow a space in their greenhouse, that would be the ideal.
I sort of believe that unless there are branches and leaves well below the 6 foot height, you might actually kill the tree by cutting it back since you may also bring it inside, which causes plants to suffer some degree of shock. (I have so little sunlight that I know I'd kill one. )
If it's pot is really deep, perhaps you could gain a foot and a little more by transplanting gently to a less deep pot, and lightly trim it's roots, "very gently" with scissors?
If no one has a greenhouse, look for a friend with a higher ceiling, although I have visions of the plant getting scorched by the heat that rises naturally to the ceiling.
This is a tough call for you, having raised it from seed, as I once did as a young girl, then somehow did something wrong and lost it years ago. Most likely I forgot to water it back then.
As I say this, there is one more possibility that sounds strange, but might work. Is the plant flexible enough to try bending it over towards an east or south window, just for the winter? (We get many months of growing season here in Texas, so it might not work if your season is short there). I thought I'd help you exhaust all options. I'm not an expert, only gardened inside/out for best of 35 years and also lived in Hawaii for three years, a plant's paradise. God bless you in your efforts. (09/28/2006)
If you wish to own a tree that bears fruit go to Home Depot and for the low price of $23.95 buy a Hass avocado. These trees will usually bear fruit within a year. The trees are about 2 years old and will start fruit soon enough. Your trees do not fruit, because they are not grafted from the the original parent plants. So to answer all questions, feel free to cut and shape your tree as much as you want. (07/29/2009)
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The avocado tree is a tropical plant that thrives outdoor only in warm climates (zones 9, 10 and 11 in the United States). And, unfortunately, it takes a tree planted from seed, 5 to 13 years to bear fruit.
As an indoor plant, it is unlikely your tree will live that long...although it is possible. If your plant did survive that long, you would need a very high ceiling since avocado trees grow quite tall. The point here is that your objective, as related to this article, needs to be a beautiful indoor plant, not eatable avocados.
Of course, if you live in a frost free location and are willing to wait for your tree to mature, you can use these tips to start an avocado plant indoor and transplant it to your yard. Eventually you will have avocados to eat.
Avocado leaves, bark, skin and pit are documented to be harmful to animals. Cats, dogs, cattle, rabbits, birds, fish and horses can be severely harmed or even killed when they consume them.
Negative effects in humans seem to be primarily in allergic individuals.
Source: ASPCA and wikipedia.org
In light of the above caution, if you have a dog in the house be sure the plant is out of the dog's reach. As for cats, you would need to be very vigilant since cats have the ability to climb and have a tendency to chew on house plants.
Avocado plants may be started from the seed in an ordinary avocado you buy from the store. There are several popular methods to start the seed.
Pierce the seed with toothpicks around the middle of the seed (or you can use forks) and then suspend it (pointed end up) over a glass or jar of water. Keep the bottom of the seed submerged in water.
Remove the outer (brown) skin from the seed, then put it in a zipper-type plastic bag with two tablespoons of water. Seal and place the bag in a warm location out of direct sunlight and wait. After about 3 to 4 weeks, there should be enough root growth to plant in soil. Transplant and place in a sunny spot and keep moist.
Cut about 1/4 inch off the pointed end of the seed and plant directly in soil with just the tip of the cut end exposed.
In two to six weeks, you should have a young avocado plant. However, not all avocado seeds will germinate. If your seed has not sprouted in six weeks, start over with a new seed and try again.
Use a 1 or 2 gallon pot to start your plant (or transplant if started in water). Be sure the pot has several drainage holes in the bottom. Use a light potting soil that drains well. Cactus mix works well and is available at most garden centers.
Avocados like full sun, so after your plant emerges, place in a sunny window.
The biggest cause of failure in growing avocado indoors (as well as most other plants) is over watering. Avocado plants will not tolerate wet roots. They will die if over watered. A moisture gauge is a wise investment. These devices have a probe that is pushed into the soil and a gauge that tells you if your plant needs water. Many are available at garden centers and are not expensive.
Lacking a moisture gauge, as a general rule, water your plant about every 6 weeks. When you water, place the plant in the sink and water slowly until the water runs out the drainage holes in the bottom of the pot. When the water stops draining, repeat the procedure again.
Fertilize lightly each time you water. There are fertilizers available which are designed specifically for avocado (containing zinc). But, if unavailable, you may use any general purpose house plant fertilizer.
After your plant is about a foot tall, pinch it back to half to encourage a rounder and fuller plant. Once your plant has filled it's pot with roots, transplant it to a larger pot.
With a little care and attention you can have a beautiful indoor plant that is unique and will last for years.
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Euphorbia is the largest genus of the family Euphorbiaceae with about 1600 species. All species of Euphorbia exude a milky juice when broken, and Euphorbia hirta's local name "gatas-gatas" derives from this.
Gatas-gatas is a slender-stemmed,
annual hairy plant with many branches from the base to the top,
the branches simple or forked and ascending or spreading, up to 40 centimeters tall, reddish or purplish in color. Leaves
are opposite, elliptic-oblong to oblong-lanceolate, distichous,
1 to 2.5 centimeters long, usually blotched with purple in the middle, toothed
at the margin. Involucres are numerous, purplish to greenish in color,
borne in dense, axillary, stalkless or short-stalked clusters or crowded cymes, about
1 millimeter in length. Capsules are broadly ovoid, hairy, three-angled,
about 1.5 millimeters long.
- Abundant throughout the Philippines, in waste
places, open grasslands, etc.
- Studies have isolated gallic acid, quercetin, triacontane,
cetyl alcohol, phytosterol, phytosterolin (phytosterol glucoside); jambulol, melissic, and a mixture of acids consisting chiefly of palmitic,
oleic, and linoleic acid.
- Phytochemicals screenings have yielded alkaloids, essential oil, phenols, sterol, flavones
and fatty acids.
- Yields flavonoids: euphorbianin, leucocyanidol, camphol, quercitrin and quercitrol.
- Study has suggested that some of the constituents of the plant are similar to those of the jambul (Syzygium cumini) seeds.
- Dried leaves yielded a moisture content of 9.70%, protein 13.5% ±0.15, fat 1.13% ±0.06, ash 3.13% ±0.06, crude fiber 3.57% ±0.06, and carbohydrate 69.5% ±0.20. Vitamin content showed ascorbic acid 26.1 mg/100g, thiamine 0.60, riboflavin 1.20, and niacin 0.70. (37)
- Considered anti-asthmatic,
antibacterial, antidote, antifertility, antifungal, antimalarial, anti-spasmodic, anthelmintic, antidysenteric, diuretic, expectorant, pectoral, hemostatic, sedative, soporific.
Parts used and preparation
- Called gatas-gatas because
of the healing property of the milky juice.
- In the Philippines, leaves are mixed with Datura metel leaves and flowers in the preparation of "asthma-cigarettes."
- Latex is prescribed for asthma.
- Entire plant prescribed as an antidote; considered hemostatic, sedative, and soporific.
- Decoction used to allay the dyspnea of asthmatics.
- Fluid extract of tincture is used in asthma, chronic bronchitis, and emphysema, also in pulmonary cardiac disease and angina pectoris.
- Used for acute and chronic dysentery.
- Tincture is used as anthelmintic. Also used for ringworm.
- Juice used for colics.
- Juice used as ophthalmic drops for conjunctivitis or ulceration of the
cornea. Stem sap used in the treatment of styes.
- Leaf poultice used for swellings and boils.
- Infusion or tea of the plant, 4 glasses daily, for bronchitis and labored
breathing, asthma, chronic dysentery.
- Used for boils and wounds.
- Decoction of dry plant used for skin disease.
- Decoction of fresh plant used as gargle for the treatment of thrush.
- Decoction of the root used to allay vomiting, chronic diarrheas, and
- Root decoction also beneficial for nursing mothers deficient in milk:
4-5 glasses of tea.
- The same root decoction as an enema for constipation.
- Root used for snake bites.
- Used in sores, wounds, boils. As ear drop for pustular swellings in
- Leaves are mixed with Datura metel leaves and flowers to make the "asthma-cigarette."
- Latex also prescribed for asthma.
- Superficial bleeding: Crush leaves and apply on affected part, as local
- In Australia and elsewhere, used for asthma and pectoral complains.
- In Brazil, decoction used for gonorrhea and asthma.
- In Africa and Australia,
used to treat hypertension and edema.
- In India, used
for treatment of syphilis; sap applied to warts. Also for affections of children, especially bowel and chest complaints. The milky juice is dropped into eyes for conjunctivitis and corneal ulcerations.
- Plant decoction: 25 gms of the whole plant to a pint of boiling
water; boil for 3-4 minutes; drink 3-5 glasses a day. Externally as
- In traditional Indian medicinal systems, leaves used in the treatment of coryza, cough, asthma, bronchial infections, bowel complaints, helminthic infestations, wounds, kidney stones and abscesses.
- Santals use the root to allay vomiting; also, used by nursing mothers with deficient milk supply.
- In the Gold Coast, ground and mixed with water and used as an enema for constipation.
- In La Reunion, used as astringent in chronic diarrheas and dysentery.
- Roots used for intermittent fevers.
interests from the folk medicine grapevine
- Dengue and anecdotal reports of "cures" from the use of tawa-tawa has created a flurry of queries, web blogs, and sustained media interest.
- Tea Making Procedure:
Take 5 to 6 full whole Tawa Tawa plants
- Cut off the roots
- Wash and clean
- Fill a boiling pot with clean water
- Boil the Tawa Tawa for 1 (one) minute in a slow rolling boil
- Let the dengue fever victim drink only the Tawa Tawa water for 24 hours
- Sip 1 to 1.5 glasses of Tawa Tawa water every hour.
- Another Decoction Preparation: Cut roots off 5 to 6 gatas-gatas plants.
Rinse. Put the tawa-tawa into a pot of boiling water for one minute.
Cool. Drink the decoction, 1 to 1 1/2 glasses, every hour for 24 hours.
(Also see: Papaya)
• Anti-Diabetic / Lipid Effect: Study of ethanolic extracts of leaf, flower and stem on streptozotocin-induced diabetic mice showed significant reduction in blood glucose levels. Biochemical effects showed significant decreases in serum cholesterol with elevation of HDL. Results showed EH has antidiabetic action and suggests further study for isolation of responsible compound. (15)
Activities And Toxicological Potentials Of Crude Ethanolic Extracts
Of Euphorbia hirta: The study showed the ethanolic
extract to inhibit the growth of test isolates except Salmonella typhi.
The antibacterial effect was attributed to the presence of alkaloids,
tannins and flavonoids which have been shown to have antibacterial properties.
The results support its use in traditional medicine. (2)
• Antibacterial: Study on the antibacterial effect of compounds extracted from C sinensis and the methanol extract of E hirta against dysentery causing Shigella spp showed the extracts to be non-cytotoxic and effective antibacterial agents.
• Antibacterial: Methanolic extract inhibited the growth of S. aureus, E. coli, and B. subtilis. Phytochemical screening yielded terpenes, tannins, alkaloids and flavonoids.
• Diuretic: Euphorbia
hirta leaf extracts increase urine output and electrolytes in rats:
Study suggests that the active components in the water extract of E.
hirta leaf had similar diuretic effect as that of acetazolamide. The
results validate its traditional use as a diuretic by the Swahilis and Sukumas. (3)
• Anti-Allergic: Inhibition
of early and late phase allergic reactions by Euphorbia hirta L:
Study demonstrated that E. hirta possessed significant activity to prevent
early and late phase allergic reactions. (4)
• Anthelmintic: Anthelmintic
efficacy of the aqueous crude extract of Euphorbia hirta Linn in Nigerian
dogs: Extract of E. hirta Study reduced the fecal egg count of the helminths
and suggests a potential as an anthelmintic agent. (5)
• Antihypertensive / ACE Inhibition:
Angiotensin converting enzyme inhibiting
and anti-dipsogenic activities of Euphorbia hirta extracts:
Study showed the extract from leaves and stems inhibited the activity
of angiotensin-converting enzyme (ACE). (6)
• Anxiolytic / Sedative:
Euphorbia hirta showed an activity profile different from that of benzodiazepines.
Study showed a central depressant and sedating effect with no hypnotic
or neuroleptic effects. (7)
• Anxiolytic / Sedative: Study validated the traditional use of E. hirta as a sedative with anxiolytic properties.
• Antidiarrheal: Study investigated the antidiarrheal
activity of Euphorbia hirta extract. An active flavonoid
constituent, quercitin, was isolated and showed anti-diarrheic activity. (9)
• Antibacterial / Antifungal: The ethanol extract was analyzed for antimicrobial activity against S aureus, B cereus, S typhi, K pneumonia, P aeruginosa and fungus species A niger, A fumigatus, A flavus and R oryzae. Study of leaves isolated tannins, flavonoids, alklaloids, glycosides, proteins, sterols and saponins. Antimicrobial activity was attributed to one of these constituents. Leaves collected from August to December showed more significant antimicrobial activity. (11)
• Galactogenic: E hirta study in female guinea pigs increased the development of mammary glands and induced secretion.
• Antifertility: E hirta has been shown to decrease sperm motility, density of cauda epididymal and testis sperm suspension with 100% infertility.
• Anti-Malarial / Flavonol Glycosides: Study of aerial parts isolated flavonol glycosides afzelin, quercitin and myricitrin. The three compounds showed inhibition of proliferation of Plasmodium falcifarum. (12)
• Anticancer / Antiproliferative: (1) Studies of extracts of E hirta have shown selective cytotoxicity against several cancer line. (2) Extracts screened showed anti-proliferative activities against normal mouse fibroblast cells. (3) Study of a methanol extract of leaves of E. hirta on Hep-2 cells from human epithelioma of larynx showed anti-proliferative activity.
• Antioxidant: Study of various extracts of leaves showed potent in vitro antioxidant activity. Total antioxidant activity was higher in an acetone extract compared to alcohol extract. (30) Studies of methanol and water extracts showed antioxidant activities comparable to that of green and black teas.
• Anti-Inflammatory: n-hexane extract of aerial parts and its main triterpene constituents showed significant and dose-dependent anti-inflammatory activity.
• Anti-Inflammatory / iNOS Protein Inhibition: An extract of Euphorbia hirta and its component beta-amyrin are able to block most of the iNOS protein functions and NO induction, and presents a potential as a new selective NO inhibitor for the treatment of arthritis inflammation. (20)
• Platelet Effect / Dengue Treatment: Study of decoction of tawa-tawa leaves on Sprague-Dawley rats showed an increase in platelet counts without notable effects on RBC and WBC counts. The increase was attributed to stimulation of platelet production in the bone marrow. (18)
• Anti-Arthritic: Euphorbia hirta possibly affects cartilage degeneration through matrix metalloproteinases(MMP-13) pathways and tissue inhibitors of matrix metalloproteinases (TIMP-1) pathways, displaying dose-dependent effects on their levels. Results suggest a viable alternative to treatment of arthritis. (19)
• Anti-Tumor: The antitumor activity of the aerial part of E. hirta was evaluated against EL-4 cell line (S.C.) in Swiss albino mice. There was a significant enhancement of mean survival time and reduction of solid tumor mass of EF-treated tumor bearing mice. (21)
• Antiviral / Anti-HIV1 / Anti-HIV2 / SIV: Antiretroviral activities of extracts of E. hirta were investigated in vitro on MT4 human T lymphocyte cell line. A dose-dependent inhibition of RT activity was observed for all three viruses. A 50% methanolic extract exhibited a higher antiretroviral effect than an aqueous extract. Study concludes that tannins are probably responsible for the high antiretroviral activity. (23)
• Acute Toxicity Study: Study evaluated the acute toxicity of Euphorbia hirta plant material in Swiss mice. Results showed no toxicity at a dose of 10 g/kbw. E. hirta was found safe, with no delayed toxic signs in all experimental groups. (27)
• Sub-Chronic Toxicity Study: Study evaluated the in vivo toxicity of methanolic extracts of E. hirta in Sprague Dawley rats. Results showed long-term oral administration of E. hirta extract for 90 days did not cause sub-chronic toxicity. (28)
• Safety of Tawa-tawa Decoction: Study evaluated the safety and antibacterial activity of the traditional decoction preparation of tawa-tawa. Results were negative for any antibacterial potential, and suggests that tawa-tawa decoction for oral intake is safe for oral use without risk of altering the normal flora of microorganisms in the gastrointestinal tract. (29)
• Comparative Antimicrobial Activity / Latex: Study showed antimicrobial activity varies with species and plant material used, and E. hirta possess stronger antibacterial activity than E. thymifolia. Most of the organisms used in the study were causative agents of diarrhea and dysentery, for which both plants can be used as treatment. (31)
• Antifungal / Inflorescence: Study showed an ethyl acetate extract of inflorescence of E. hirta possessed possible antifungal activity targeting cell membrane leakage of cellular proteins caused by Aspergillus flavus. (32)
• Molluscicidal / Latex: Study evaluated the toxic effects of binary and tertiary combinations of EH latex powder with other plant molluscicidal compounds against freshwater snails Lymnaea acuminata and Indoplanorbis exustus in pond. The combinations showed significant time and dose dependent effect against both snails. At higher doses, they were also lethal to freshwater fish Channa punctatus. (33)
• Green Synthesis of Silver Nanoparticles / Antifungal: Study presents the cost effective and environment friendly synthesis from 1mM AgNO3 through the leaf extract of E. hirta as reducing and capping agent. Green synthesized silver nanoparticles showed antifungal activity against Candida albicans, C. kefyr, and A. niger. (34)
• Anti-Ulcer Activity: Study evaluated an ethanolic extract of E. hirta aerial parts for anti-ulcer activity in various gastric ulcer models like pylorus-ligation, indomethacin, HCl/EtOH induced ulcerated rats. Findings suggest gastroprotective potential, partly related to anti-secretory action and gastric mucus secretion. (35)
• Immunomodulatory: Study showed an ethanol extract to inhibit polysorbate 80 induced degranulation of isolated peritoneal mast cells in vitro, indicative of mast cell stabilizing activity. Therefore, the anti-inflammatory activity may be attributed to its ability to stabilize mast cell membrane, inhibiting the release of inflammatory mediators. (36)
• Proximate Composition and Vitamin Content: In a study of dried leaves of various plants for proximate composition and vitamin level, E. hirta showed a moisture content of 9.70%, protein 13.5% ±0.15, fat 1.13% ±0.06, ash 3.13% ±0.06, crude fiber 3.57% ±0.06, and carbohydrate 69.5% ±0.20. Vitamin content showed ascorbic acid 26.1 mg/100g, thiamine 0.60, riboflavin 1.20, and niacin 0.70. (37)
• Platelet Effect: Study evaluated the thrombogenic or platelet increasing property of E. hirta orally administering the extract to mice (4 control, 4 subject). Results showed no significant difference in platelet counts. (38)
• Immunosuppressive Effect: Euphorbia hirta showed a decrease of delayed hypersensitivity (DTH) response and dose-related decrease in primary antibody response. Results suggest EH is a potent and non-toxic immunosuppressor, with potential for development of potent immunosuppressor. (39)
• Anti-Biofilm Property: Crude methanol extract of E. hirta showed interesting and potential anti-biofilm inhibition and eradication activity against Pseudomonas aeruginosa. Results suggest promising anti-infective phytotherapeutical and pharmaceutical industry applications. (40)
• Cytotoxicity / Genotoxicity: Study evaluated the cytotoxicity and genotoxicity of E. hirta in MCF-7 cell line model. The extract showed significant cytotoxicity in the brine shrimp lethality assay, and exhibited genotoxicity effects against MCF-7 DNA in a time-dependent manner. (41)
Tea, candied or capsules in the local market.
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49th Shelf helps you find Canadian books learn more
Helaine Becker’s knack for turning great information into great fun is right at home in the insect world — a micro-universe full of feats of strength and tales of adventure! Through witty text and wacky illustrations young readers will learn to identify and classify insects from the everyday to the rare and fantastic. The Insecto-files brings bug facts to life with simple, insightful (and cruelty-free!) entomological experiments. Found throughout the book, each experiment can be safely performed at home without special equipment, unusual ingredients, or following fussy directions. Want to “speak” to fireflies and “sing” to crickets? Make your own bursting bug bombs? Break up an ant picnic? Through experiments like these, The Insecto-files feeds into kids’ natural curiosity and love of wacky fun, allowing them to actively learn about bugs on their own terms. Each experiment is accompanied by a “What’s Going On?” feature, so that kids can see that within each activity is a fascinating lesson in bug behavior. Readers will also encounter real-life insect inspectors along the way and learn about their zany experiments, all in the name of science!
What separates Becker's book from other insect-focused books is that Becker doesn't just provide fascinating insect facts; she also supplies child-friendly activities or experiments with virtually every two-page 'chapter'.
Extremely interactive and thought inspiring with questions and experiments that made us want to try them; amazing support illustrations.
The Insecto-files is jammed with interesting facts presented in kid-friendly language, with illustrations that vary between scientifically accurate and comic-book funny…[fascinating details] capture the imagination and give opportunities for further discussion and reading.
A book packed with fun experiments and fascinating facts about bugs…with 33 experiments listed and indexed and a good list of scientific concepts covered in the book, there is much of interest for would-be entomologists.
Along with the wealth of information about insects, there are fun activities and cute, charming pictures that will appeal to even the biggest of bug fearers.
This book provides children with a fountain of knowledge and insight into the insect world...colorful and comic illustrations will draw the children to the text surrounding them to discover even more.
A mix of colorful cartoons and realistic drawings of insects provides entertaining and educational visual appeal in this blend of energy, irreverence and information.
Readers are hooked from the introduction. The collection of original experiments and activities encourages kids in an entertaining way to think, do, and learn.
This edition is not currently available in bookstores. Check your local library or search for used copies at Abebooks.
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In Western Australia, the wet season occurs between December and March and the dry season between May and October. The reversals of prevailing winds in the two season drives the shift from wet to dry and back.
In April and May, fires usually burn themselves out within a few days due to the fact that even though there are dry spots that may catch fire, the wet area around them will keep the fires from burning out of control. The worst time for fire is late in the dry season, when vegetation has dried to tinder and blazes tend to be uncontrollable, intense, and dangerous.
The Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA's Aqua satellite acquired this image of dozens of fires in both Western Australia and the Northern Territory on April 28, 2013.
Although smoke plumes are visible, MODIS actually detects the fires by sensing thermal infrared energy radiating from the land surface. The heat is invisible in images like this, but the locations where MODIS detected fire are labeled with red outlines.
Prescribed burns in this area are part of a program managed by the Australian government and by conservation groups. The Ecofire effort, ongoing since 2007, has the goal of reducing destructive late-season out of control fires by increasing the number of early-season fires. The early fires tend to burn in a patchwork pattern that makes it easier for vegetation to reestablish itself afterwards.
As traditional lifestyles have been replaced by modern ways of living, the number of early season fires has decreased and the number of destructive, later fires has increased. The intent of Ecofire is to return the landscape to a burning regime that mirrors what happened in the past. For tens of thousands of years, aboriginal people in the region engaged in a practice known as "fire-stick farming." People intentionally lit fires in the early-season to encourage the growth of grasslands and to make it easier to locate and track animals for hunting.
Explore further: Magnitude-4.2 quake shakes central California; no damage
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I am always in search for brightly and special coloured animals, especially pink animals. I was therefore stunned to find there exist brightly coloured pink insects. Yes, pink insects! In the family of katydids which consists of more than 6400 species, a rare colour morph exists which is bubblegum pink!
Normally katydids are green and somewhat leaf-shaped, allowing them to blend in nicely with the foliage. They are so well camouflaged that they are very hard to see. However, their song, by which it got its name, makes them easy to recognize: “Katy did, Katy did, Katy didn’t”. As most insects, they ‘sing’ by running one wing along the teeth at the bottom of the other wing, a method called stridulation.
So why would a normally green insect be pink?
The pink coloration of the katydids is the result of a condition called erythrism, an unusual reddish pigmentation, and is similar to albinism where the condition is due to recessive genes. (mutation? recessive genes? Learn more about it here.) The same apparently is true for pink katydids, however still very little scientific data exists on this beautiful variant.
Although most people would probably say a pink insect looks nicer than a green one, it gives it a real disadvantage in its natural habitat of green plants and trees. It is just too easy for a predator to detect. However, the pink insects have one safe haven: pink and red flowers. So if it manages to find those before being spotted by a hungry predator, it might live another day to sing its characteristic song: “katy did katy did”.
Update: I recently received an email from a father and his son who found a bright red katydid in the North Cumberland Wildlife Management Area. I had never heard of a completely red katydid before, but I expect that the reddish pigmentation resulting from the erythrism is even stronger in the individuals they found. The Audubon Insectarium New Orleans now keeps a couple specimen for further study. Thanks to Shawn Philips for bringing this up!
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Practical findings from Horticultural Development Council trial, plus summaries of academic research and scientific trials, compiled by Dr Ken Cockshull.
Daffodil rust is a physiological disorder that results in loss of stem and leaf quality through rust-like lesions, making some cut flowers unmarketable. Industry surveys have indicated the extent of the problem and the most susceptible varieties.
Southern green shieldbug, Nezara viridula, is widely distributed across tropical and subtropical regions of the world where it is a serious pest of many important food crops.
"Identifying chemical growth regulators will provide growers with another option to control the growth of vigorous plant species and so meet required height specifications," says J&A Growers' Jamie Dewhurst.
The wood pigeon Columba palumbus is a major agricultural pest in the UK, feeding on a range of arable crops including peas, brassicas and leafy salads. HDC project FV 426 reviewed the evidence for damage levels, the efficacy and cost-effectiveness of deterrents and other management techniques and emerging controls.
The apple fruit rhynchites has increased in apple and pear orchards and if not controlled can give rise to corky scars on fruit. It can be controlled but requires treatment during or after blossom, which is undesirable. A sensitive monitoring trap is needed to direct insecticide treatments.
Mushroom yield, flushing pattern and quality are determined by nutrition.
Impatiens downy mildew, which is caused by Plasmopara obducens, is a foliar disease that is specific to impatiens.
Root diseases pose a serious threat to tomato production, with an increased risk where irrigation run-off is recycled. HDC project PC 281 used the molecular diagnostic method T-RLFP to begin to understand the diversity of microorganisms on tomato roots.
Codling moth is still the most important apple pest found in the UK and its control poses a major challenge for all growers.
HDC Project FV 364 investigated how cabbage root fly larvae (Delia radicum) locate brassica plants and tested potential treatments not involving conventional insecticides.
The production of quality container-grown hardy nursery plants requires accurate management of plant nutrition throughout the whole life of the crop.
Low light levels induce the growth of longer, weaker stems and petioles in plants, a condition known as etiolation. Such plants show reduced shelf life and may fail to meet buyer specifications and customer expectations. Etiolation can be an issue in pot herb production, so the HDC commissioned project PE 015 to investigate practical solutions.
Reports that earwigs are declining in some apple and pear orchards have raised concern for pest control and is it thought that this problem could be linked to the use of certain crop-protection products.
Infection of compost by Trichoderma aggressivum can result in up to 100 per cent crop loss in mushrooms.
Each season, strawberry growers expect to contend with certain flower and leaf pests, but they can never be quite sure when the pests will strike.
Gardeners + Garden Labourers
UK Mission Enterprise England, Surrey, Chertsey
Sahara Forest Project London (Central), London (Greater), Cambridge
Plantarea Manager - J122
Group Plant Buyer
Squires Garden Centre Farnham, Surrey
Lotus Landscapes Ltd. Laleham, Staines
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“We are very optimistic that is possible to reduce deforestation in the Amazon and develop this region for the people living there. But we know that this is just the beginning. We are inspired to go on build a global monitoring system covering 1 billion hectares of tropical forest that has tremendous worth for carbon, environment services, and cultural values.”
Sub-Issue: Arresting Deforestation Deforestation in the Brazilian Amazon is driven primarily by cattle and soy producers clearing new fields and pastures. Although Brazil’s Forest Code requires 80 percent of private lands in the Amazon to remain forested, most landowners operate with seeming impunity, knowing that the state is not equipped to monitor what happens on their lands, and rarely collects fines for illegal deforestation.
The Skoll Awardees: Adalberto (Beto) Veríssimo and Carlos Souza, Jr., are recognized leaders in tropical forest conservation, having developed, through the Amazon Institute of People and the Environment (Imazon), a deforestation monitoring system that makes it possible to know, in almost real time, where deforestation occurs. Beto co-founded Imazon in 1990, determined to find a role as an honest broker and provider of information at a time when those who wanted to save the forest and those determined to exploit it were almost literally at war. Carlos joined the team two years later, pioneering a key innovation: using state-of-the-art remote sensing and mapping to detect deforestation. This enables agencies to identify and prosecute illegal clearing, and creates strong incentives for the ranchers and producers to find alternatives – such as diversified wood products with less waste. Imazon also publishes cutting-edge scientific reports in accessible formats and works with national and international media outlets to keep information on deforestation up to date and bring public pressure on decision-makers At the time of the Award, the Brazilian government had achieved 80 percent reduction in deforestation over five years. Rigorous new limits to deforestation were enacted, and the government had committed to stop illegal logging, focusing on hotspot regions identified by Imazon.
Impact since joining the portfolio in 2010:
- Worked with Google to develop Google Earth technology’s capacity to track deforestation; Global Forest Watch platform launched in 2014 with World Resources Institute makes it possible to monitor tree cutting worldwide.
- Projects in development include tools to track fishing vessels and monitor sea level change.
- In Brazil, partnership with public prosecutors facilitates enforcement of conservation laws in 75 million hectares of conservation and indigenous lands.
LEARN MORE ABOUT THEIR WORK:
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The choppers swoop in, dumping insecticide over a plague-stricken village in Madagascar's stunning central highlands.
"The goal is to break the invasion," explains Tsitohaina Andriamaroahina, head of a UN mission to end a locust plague threatening the crops of 13 million farmers on this island nation.
In their countless billions, the insatiable hordes cloud the skies as they spread across two thirds of Madagascar, affecting an area roughly the size of Germany or Japan.
Columns of thick black smoke rise from the rolling grasslands surrounding the village of Amparihibe, 200 kilometres (125 miles) west of the capital Antananarivo, as desperate farmers set fires to disperse the crop-eating swarms.
The airborne locust bombers use the tell-tale smoke signals to help them target the insects on daily patrols using three helicopters and an airplane operating from mobile air bases.
"When we fly on a scouting mission, we look at several things: the wind direction, smoke, the position of the sun. All of that shows us where the swarms are," explained Hasibelo Rakotovao, one of the team members.
The 90 people in the joint operation between the UN's Food and Agriculture Organisation and Madagascar's anti-locust agency have already sprayed 500,000 litres (132,000 gallons) of pesticide over one million hectares of land.
Once the insects have been spotted, a technical team arrives before sunrise in a truck carrying pesticide containers which will be attached to the helicopter.
The team moves quickly—they can only spray at dawn, when the locusts are immobile on the ground, their wings weighed down by the morning dew.
The pesticide only affects insects, according to the mission, neutralising their nervous system.
Villagers then collect the grasshoppers and feed them to their pigs.
"We help one another among neighbours but we aren't enough. We are up to our knees in locusts and can't cope anymore," said Marie Louise Rasoamampionona, a 50-year-old small-scale farmer.
"We have to start bushfires because there's no other way to chase away the locusts."
'New invasions loom'
The swarms have multiplied uncontrollably in recent years because of government inaction during politically turbulent times which saw foreign aid to the country suspended.
The airborne operation under way now is seen as the only solution to the plague, but it is far from over and the FAO still needs $14 million to see the project through over the next two years.
Despite the efforts from the air which have annihilated hundreds of swarms in the past few weeks, local people say they have already been hard hit by rice shortages.
"The locusts cause farmers a lot of suffering, because rice is our livelihood," said Ranaivo, a peasant farmer from Amparihibe.
"If it is destroyed, we are lost, what will we eat? If we only eat cassava, it doesn't give us enough energy to work. Rice is essential."
Even if the current plague is brought under control, environmental degradation points to more problems in the future.
Increased deforestation heightens the risk of swarms, meaning that new locust invasions loom on the horizon.
Around 200,000 hectares of forest is chopped out every year, and 90 percent of Madagascar's rainforest has been lost already.
"Deforestation has very heavy consequences," explained mission head Andriamaroahina.
"When people cut down the forests, it creates more grasslands, which attract locusts."
Explore further: Climate change costing soybean farmers
| 12 |
A recent image captured by NASA's Aqua satellite provides a stark reminder of how Northern California continues to grapple with a series of wildfires, many of them sparked by lightning, while the southern part of the state enjoys relative calm.
As the entire state continues to suffer under unrelenting, severe drought conditions, major wildfires have largely been absent from Southern California since a series of blazes tore through San Diego County in May -- one of which was allegedly the result of arson.
Northern California, on the other hand, has been taking the brunt of the wildfire season -- a fact that was put into perspective via the large, drifting plume of smoke visible from space. But the tax to the state's firefighting resources has come mainly in the sheer volume of fires, not total acreage burned.
So far this year, the California Department of Forestry and Fire Protection has responded to 4,294 wildfires, more than the year-to-date average of 3,311, according to a weekly drought brief.
Despite the uptick, combined with a crippling drought across the West, none of the fires have detonated into catastrophe like the Rim fire did in 2013, scorching more than 250,000 acres.
By contrast, the Happy and July complex fires, among the largest, have scorched more than 58,000 acres combined in Northern California.
Meanwhile, the only active wildfire of any significance -- the Tecolote fire in Angeles National Forest -- is 90% contained at 294 acres, according to the U.S. Forest Service.
Copyright © 2015, Los Angeles Times
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Temporal range: Early Devonian–Recent
|Class:||Entognatha (but see text)|
Springtails (Collembola) form the largest of the three lineages of modern hexapods that are no longer considered insects (the other two are the Protura and Diplura). Although the three orders are sometimes grouped together in a class called Entognatha because they have internal mouthparts, they do not appear to be any more closely related to one another than they all are to insects, which have external mouthparts.
Some DNA sequence studies suggest that Collembola represent a separate evolutionary line from the other Hexapoda, but others disagree; this seems to be caused by widely divergent patterns of molecular evolution among the arthropods. The adjustments of traditional taxonomic rank for springtails reflects the occasional incompatibility of traditional groupings with modern cladistics: when they were included with the insects, they were ranked as an order; as part of the Entognatha, they are ranked as a subclass. If they are considered a basal lineage of Hexapoda, they are elevated to full class status.
Collembolans are omnivorous, free-living organisms that prefer moist conditions. They do not directly engage in the decomposition of organic matter, but contribute to it indirectly through the fragmentation of organic matter and the control of soil microbial communities. The word "collembola" is from the Greek colle meaning glue and embolon meaning piston or peg.
Members of Collembola are normally less than 6 mm (0.24 in) long, have six or fewer abdominal segments and possess a tubular appendage (the collophore or ventral tube) with eversible vesicles, projecting ventrally from the first abdominal segment. The Poduromorpha and Entomobryomorpha have an elongated body, while the Symphypleona have a globular body. Collembola lack a tracheal respiration system, which forces them to respire through a porous cuticle, to the notable exception of Sminthuridae which exhibit a rudimentary, although fully functional, tracheal system.
Most species have an abdominal, tail-like appendage, the furcula, that is folded beneath the body to be used for jumping when the animal is threatened. It is held under tension by a small structure called the retinaculum and when released, snaps against the substrate, flinging the springtail into the air. All of this takes place in as little as 18 milliseconds.
Springtails also possess the ability to reduce their body size by as much as 30% through subsequent ecdyses (molting) if temperatures rise high enough. The shrinkage is genetically controlled. Since warmer conditions increase metabolic rates and energy requirements in organisms, the reduction in body size is advantageous to their survival.
Systematics and evolution
Traditionally, the springtails were divided into the orders Arthropleona, Symphypleona and occasionally also Neelipleona. The Arthropleona were divided into two superfamilies, the Entomobryoidea and the Poduroidea. But actually, these two and the Symphypleona form three lineages, each of which is equally distant from the other two. Thus, the Arthropleona are abolished in modern classifications, and their superfamilies are raised in rank accordingly, being now the Entomobryomorpha and the Poduromorpha. Technically, the Arthropleona are thus a partial junior synonym of the Collembola. The term "Neopleona" is essentially synonymous with Symphypleona + Neelipleona.
The Neelipleona were originally seen as a particular advanced lineage of Symphypleona, based on the shared global body shape. But the global body of Neelipleona is realised in a completely different way than in Symphypleona. Subsequently, the Neelipleona were considered as being derived from the Entomobryomorpha. But analysis of 18S and 28S rRNA sequence data suggests that they form the most ancient lineage of springtails, which would explain their peculiar apomorphies.
Springtails are attested to since the Early Devonian. The fossil from , Rhyniella praecursor, is the oldest terrestrial arthropod, and was found in the famous Rhynie chert of Scotland. Given its morphology resembles extant species quite closely, the radiation of the Hexapoda can be situated in the Silurian, or more.
Fossil collembola are rare. Instead, most are found in amber. Even these are rare and many amber deposits carry few or no collembola. The best deposits are from the early Eocene of Canada and Europe, Miocene of Central America, and the mid-Cretaceous of Burma and Canada. They display some unusual characteristics: first, all but one of the fossils from the Cretaceous belong to extinct genera, whereas none of the specimens from the Eocene or the Miocene are of extinct genera; second, the species from Burma are more similar to the modern fauna of Canada than are the Canadian Cretaceous specimens.
There are about 3,600 different species.
Springtails are cryptozoa frequently found in leaf litter and other decaying material, where they are primarily detritivores and microbivores, and one of the main biological agents responsible for the control and the dissemination of soil microorganisms.
In sheer numbers, they are reputed to be one of the most abundant of all macroscopic animals, with estimates of 100,000 individuals per square meter of ground, essentially everywhere on Earth where soil and related habitats (moss cushions, fallen wood, grass tufts, ant and termite nests) occur. Only nematodes, crustaceans, and mites are likely to have global populations of similar magnitude, and each of those groups except mites is more inclusive: though taxonomic rank cannot be used for absolute comparisons, it is notable that nematodes are a phylum and crustaceans a subphylum. Most springtails are small and difficult to see by casual observation, but one springtail, the so-called snow flea (Hypogastrura nivicola), is readily observed on warm winter days when it is active and its dark color contrasts sharply with a background of snow.
In addition, a few species routinely climb trees and form a dominant component of canopy faunas, where they may be collected by beating or insecticide fogging. These tend to be the larger (>2 mm) species, mainly in the genera Entomobrya and Orchesella, though the densities on a per square meter basis are typically 1–2 orders of magnitude lower than soil populations of the same species. In temperate regions, a few species (e.g. Anurophorus spp., Entomobrya albocincta, Xenylla xavieri, Hypogastrura arborea) are almost exclusively arboreal. In tropical regions a single square meter of canopy habitat can support many species of Collembola.
The main ecological factor driving the local distribution of species is the vertical stratification of the environment: in woodland a continuous change in species assemblages can be observed from tree canopies to ground vegetation then to plant litter down to deeper soil horizons. This is a complex factor embracing both nutritional and physiological requirements, together with behavioural trends and probable species interactions. Some species have been shown to exhibit negative or positive gravitropism, which adds a behavioural dimension to this still poorly understood vertical segregation.
As a group, springtails are highly sensitive to desiccation, because of their tegumentary respiration. although some species with thin, permeable cuticles have been shown to resist severe drought by regulating the osmotic pressure of their body fluid. The gregarious behaviour of Collembola, mostly driven by the attractive power of pheromones excreted by adults, gives more chance to every juvenile or adult individual to find suitable, better protected places, where desiccation could be avoided and reproduction and survival rates (thereby fitness) could be kept at an optimum. Sensitivity to drought varies from species to species and increases during ecdysis. Given that springtails are moulting repeatedly during their entire life (an ancestral character in Hexapoda) they spend much time in concealed micro-sites where they can find protection against desiccation and predation during ecdysis, an advantage reinforced by synchronized moulting. The high humidity environment of many caves also favours springtails and there are numerous cave adapted species, including one, Plutomurus ortobalaganensis living 1,980 metres (6,500 ft) down the Krubera Cave.
The horizontal distribution of springtail species is affected by environmental factors which act at the landscape scale, such as soil acidity, moisture and light. Requirements for pH can be reconstructed experimentally. Altitudinal changes in species distribution can be at least partly explained by increased acidity at higher elevation. Moisture requirements, among other ecological and behavioural factors, explain why some species cannot live aboveground, or retreat in the soil during dry seasons, but also why some epigeal springtails are always found in the vicinity of ponds and lakes, such as the hygrophilous Isotomurus palustris. Adaptive features, such as the presence of a fan-like wettable mucro, allow some species to move at the surface of water (Sminthurides aquaticus, Sminthurides malmgreni). Podura aquatica, a unique representative of the family Poduridae (and one of the first springtails to have been described by Linnaeus), spends its entire life at the surface of water, its wettable eggs dropping in water until the non-wettable first instar hatches then surfaces.
In a variegated landscape, made of a patchwork of closed (woodland) and open (meadows, cereal crops) environments, most soil-dwelling species are not specialized and can be found everywhere, but most epigeal and litter-dwelling species are attracted to a particular environment, either forested or not. As a consequence of dispersal limitation, landuse change, when too rapid, may cause the local disappearance of slow-moving, specialist species, a phenomenon the measure of which was recently called colonisation credit.
Relationship with humans
Springtails are well known as pests of some agricultural crops. Sminthurus viridis, the lucerne flea, has been shown to cause severe damage to agricultural crops, and is considered as a pest in Australia. Also Onychiuridae are known to feed on tubers and to damage them to some extent. However, by their capacity to carry spores of mycorrhizal fungi and mycorrhiza-helper bacteria on their tegument, soil springtails play a positive role in the establishment of plant-fungal symbioses and thus are beneficial to agriculture. They also contribute to controlling plant fungal diseases through their active consumption of mycelia and spores of damping-off and pathogenic fungi. It has been suggested that they could be reared to be used for the control of pathogenic fungi in greenhouses and other indoor cultures.
Various sources and publications have suggested that some springtails may parasitize humans, but this is entirely inconsistent with their biology, and no such phenomenon has ever been scientifically confirmed, though it has been documented that the scales or hairs from collembolans can cause irritation when rubbed onto the skin. They may sometimes be abundant indoors in damp places such as bathrooms and basements, and incidentally found on one's person. More often, claims of persistent human skin infection by springtails may indicate a neurological problem, such as Morgellons Syndrome, or delusory parasitosis, a psychological rather than entomological problem. Researchers themselves may be subject to psychological phenomena. For example, a publication in 2004 claiming that springtails had been found in skin samples was later determined to be a case of pareidolia; that is, no springtail specimens were actually recovered, but the researchers had digitally enhanced photos of sample debris to create images resembling small arthropod heads, which then were claimed to be springtail remnants. However, Steve Hopkin reports one instance of an entomologist aspirating an Isotoma species and in the process accidentally inhaling some of their eggs, which hatched in his nasal cavity and made him quite ill until they were flushed out.
Ecotoxicology laboratory animals
Springtails are currently used in laboratory tests for the early detection of soil pollution. Acute and chronic toxicity tests have been performed by researchers, mostly using the parthenogenetic isotomid Folsomia candida. These tests have been standardized. Avoidance tests have been also performed. They have been standardized, too. Avoidance tests are complementary to toxicity tests, but they also offer several advantages: they are more rapid (thus cheaper), more sensitive and they are environmentally more reliable, because in the real world Collembola move actively far from pollution spots. It may be hypothesized that the soil could become locally depauperated in animals (and thus improper to normal use) while below thresholds of toxicity. Contrary to earthworms, and like many insects and molluscs, Collembola are very sensitive to herbicides and thus are threatened in no-tillage agriculture, which makes a more intense use of herbicides than conventional agriculture. The springtail Folsomia candida is also becoming a genomic model organism for soil toxicology. With microarray technology the expression of thousands of genes can be measured in parallel. The gene expression profiles of Folsomia candida exposed to environmental toxicants allow fast and sensitive detection of pollution, and additionally clarifies molecular mechanisms causing toxicology.
Sexual reproduction occurs through the clustered or scattered deposition of spermatophores by male adults. Stimulation of spermatophore deposition by female pheromones has been demonstrated in Sinella curviseta. Mating behaviour can be observed in Symphypleona. Among Symphypleona, males of some Sminthuridae use a clasping organ located on their antenna. Many collembolan species, mostly those living in deeper soil horizons, are parthenogenetic, which favours reproduction to the detriment of genetic diversity and thereby to population tolerance of environmental hazards. Parthenogenesis (also called thelytoky) is under the control of symbiotic bacteria of the genus Wolbachia, which live, reproduce and are carried in female reproductive organs and eggs of Collembola. Feminizing Wolbachia species are widespread in arthropods and nematodes, where they co-evolved with most of their lineages.
- Texella reddelli, a predator of Collembola
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- Sara Cristofoli & Grégory Mahy (2010). "Colonisation credit in recent wet heathland butterfly communities". Insect Conservation and Diversity 3 (2): 83–91. doi:10.1111/j.1752-4598.2009.00075.x.
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- ISO 11267 (2014). "Soil quality. Inhibition of reproduction of Collembola (Folsomia candida) by soil contaminants". Geneva: International Organization for Standardization.
- Christine Lors, Maite Martínez Aldaya, Sandrine Salmon & Jean-François Ponge (2006). "Use of an avoidance test for the assessment of microbial degradation of PAHs" (PDF). Soil Biology and Biochemistry 38 (8): 2199–2204. doi:10.1016/j.soilbio.2006.01.026.
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|Wikimedia Commons has media related to Collembola.|
- Checklist of the Collembola of the World
- Maps of Collembola (Britain and Ireland)
- Maps from 2006 of UK Collembola, plus Photolibrary
- General information on Collembola
- Tree of Life
- General information on Collembola
- A small lecture from the late Steve Hopkin
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Stewardship warns growers of increased leatherjacket threat
“Leatherjacket grubs are larger than usual for the time of year, so farmers need to be alert for any damage; particularly on establishing grass leys where they are following grass, but also to late drilled and spring cereal crops,” comments Brent Gibbon of Dow AgroSciences. “Hatched leatherjackets are vulnerable to desiccation, particularly when young, however the wet winter will have kept the soil moist and aided their survival.”
The stewardship initiative is urging growers to monitor fields known to have a history of leatherjacket damage, “Look out for large numbers of rooks and jackdaws feeding on the larvae,” notes Brent. “Cereals following established grass leys, a grassy stubble or spring barley are high risk crops. Permanent grassland and newly sown leys are also more likely to suffer yield damages from this pest, so growers need to be aware,” warns Brent.
“Chlorpyrifos is an effective insecticide, which following months of feeding by the pest can help prevent further damage, thus protecting the yield. It is vital that farmers firstly, have a strong knowledge of their land’s pest and disease history, and secondly look for indicators of leatherjackets in their crops, before treating.
“In recently planted crops, checking the top soil gives a good idea of pest activity; using a trowel, lift a few clods of soil working across the fields, a couple of inches deep to see if there are any grubs. Once the crops start germinating look for signs of damage around the base of the plant and the root. Be sure to treat at the first sign of activity,” advises Brent.
When applying chlorpyrifos for treatment of leatherjackets, growers should use LERAP rated 3 star nozzles and adopt a 20 metre no-spray buffer zone near to watercourses or a 1 metre near to dry ditches. “It is vital that growers adopt the stewardship guidelines when applying chlorpyrifos in order to help secure a future for this key insecticide,” concludes James.
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| 12 |
Corn research studies conducted at the North Plains Research Field near Etter are showing that maximum irrigation and high plant populations dont always produce the most economical or water-use efficient yields.
Dr. Brent Bean, Texas AgriLife Extension Service agronomist, along with Jake Becker, Texas AgriLife Research technician and graduate student, are studying new drought-tolerant corn hybrids under different seeding and irrigation rates.
The Texas High Plains Water District, along with Pioneer and Syngenta seed companies, are helping fund this study.
The goal of the study is to determine how to best manage these new drought-tolerant corn hybrids under limited irrigation.
All of the major seed companies are working on drought tolerance, and we are looking at what is considered the first generation of these new drought-tolerant hybrids, Bean said.
The study compares the new drought-tolerant hybrids to conventional hybrids. It is important that these new hybrids yield well under reduced irrigation, but also have the ability to not limit yield when favorable conditions are present, he said.
We have four hybrids from each of the companies, and will be comparing each companys drought-tolerant hybrids to their conventional hybrids, Bean said. It is not our intention to compare the two company hybrids against each other; in fact, they are being conducted in separate trials.
Becker said Pioneers drought-tolerant hybrids are being sold under the brand AquaMax, while Syngentas drought-tolerant hybrids are under the Artesian brand.
In the study, the hybrids are being grown at irrigation levels ranging from 40 percent to 100 percent evapotranspiration levels, he said.
Evapotranspiration is the loss of water from the soil both by evaporation and by transpiration from the plants. The irrigation levels are adjusted to replace that water loss on a percentage basis, Bean said.
You can really see the effects of the different irrigation levels in ear length, number of rows of kernels and overall pollination, Becker said.
The amount of irrigation water applied to meet the various percentages of evapotranspiration were: 40 percent, 14.13 inches; 50 percent, 16.29 inches; 65 percent, 20.33 inches; 75 percent, 23 inches; and 100 percent, 29.71 inches.
There was a clear height difference between all the levels, with the exception of 75 percent and 100 percent evapotranspiration, Becker said, and he didnt expect there to be a big yield difference between those two levels.
As for the other levels, he said so far all are producing ears with kernels. The 50 percent level has short plants, but it still pollinated and is producing ears. The 65 percent level showed better pollination, longer cob length and more kernels, as expected.
This research is just getting started, but this years data should provide us with good information on the performance of these new drought-tolerant hybrids under limited irrigation and the extreme weather conditions experienced this summer, Becker said.
Explore further: Pet foods contain animal contents not explicitly identified on labels
| 12 |
Bumblebees prefer stripes and red flowers, research suggests
- 12 October 2010
- From the section Science & Environment
Gardeners are being encouraged to grow striped flowers to encourage bumblebee populations, after research suggested the insects are most attracted to them.
Stripes on petal veins direct bumblebees to the flower's "central landing platform" and entrance to gather nectar and pollen.
Researchers also found that red flowers were also attractive to bees.
Bees play a key role in agriculture by pollinating crops.
The scientists say that growing especially inviting plants could be a way for people to help stem what has been called a "catastrophic" decline in UK bumblebee populations.
Stripes and spots
The research was to understand how pollinator decline can been halted, as a reduction in numbers can be "economically damaging and risks our food security", scientists say.
Professor Cathie Martin from John Innes Centre in Norwich said red and striped flowers were visited significantly more frequently than white or pink blooms. More flowers were visited per plant as well, she said.
Researchers from New Zealand also analysed how the stripy patterns were formed along the veins of the common snapdragon.
"Complex colour patterns such as spots and stripes are common in nature but the way they are formed is poorly understood," said Dr Kathy Schwinn of the New Zealand Institute for Plant and Food Research.
"We found that one signal comes from the veins of the petals and one from the skin of the petals, the epidermis. Where these signals intersect, the production of red anthocyanin pigments is induced."
Anthocyanins are plant pigments which colour red, purple and blue fruits and flowers.
| 12 |
(PhysOrg.com) -- In an important breakthrough, plant biologists at The University of Queensland have identified a hormone that plays a key role in determining the size and shape of plants.
The discovery of the hormone strigolactone could have enormous impact on the forestry and horticultural industries, and is expected to lead to the ability to custom design the shape of plants.
Taller plants can be produced by boosting strigolactone, and bushier plants can be grown by suppressing the hormone, UQ Associate Professor Dr. Christine Beveridge said.
In the case of fruit-producing trees where the yield comes from the branches, repression of the chemical that is, to create more branches can give a better harvest.
A number of factors work together to determine plant shape and size, but the discovery of strigolactone's role in inhibiting branch development was important, Dr. Beveridge said, and paved the way for understanding the regulatory framework behind plant development.
It is interesting that strigolactone uses a long-distance signaling process to determine plant shoot branching, Dr. Beveridge said.
Strigolactone's capacity to have an impact on shoot branching will be conducive to obtaining a desired shape in plants and is sure to prove beneficial in crop production.
Dr. Beveridge, who is a Future Fellow of the Australian Research Council, said in the forestry industry the hormone could be manipulated to inhibit branch production and contribute to better stem growth and wood production.
Researchers from the University of Western Australia (UWA) have detected a structurally similar chemical called karrikins in smoke that affects the sprouting of dormant seeds after fire.
Through research done under a UQ-UWA Bilateral Research Collaboration Award, a gene called MAX2 was found to control the functioning of both strigolactone and karrikins.
Dr. Beveridge said despite the similarity in the structure of the two hormones and their similar response systems, karrikins did not affect shoot branching.
Current promising leads with these hormones on their chemistry and on other aspects of plant development could result in improvements in the propagation of endangered and economically important plant species and in weed eradication and reforestation.
UQ's main commercialisation company, UniQuest, is currently working towards commercialisation opportunities for this technology.
Explore further: Too many targets: Scientists create model to analyze ceRNA regulation, validate results with synthetic gene circuits
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For the Juniors - Farm to Table
This series of six programs looks at what happens to certain foods before they reach the supermarket shelves.
For the Juniors aims to stimulate children's curiosity and imagination, widen their horizons and encourage them to explore their environment, present enjoyable experiences which relate broadly to the lives and interests of the children and raise issues. This series of six programs looks at what happens to certain foods before they reach the supermarket shelves.
Why doesn't all honey look and taste the same? Where does honey come from? Why do bees make honey? These are some of the questions answered in this program .
The program looks at how bees live in communities in which every bee has a very special job to do. The queen is in charge and other bees make sure she is well looked after and that her eggs and her young bees are also well cared for. Some of the worker bees go out to collect nectar from flowers and when they return other worker bees turn it into honey and store it in the honey comb. This is food for the colony when there are no flowers around. Bee keepers - apiarists - collect this stored honey, separate it from the honey comb and sell it. The program also looks at how apiarists farm their bees.
23 July 2014
This program shows how milk gets from the cow to the table.
To produce milk cows need lush green grass and a calf, as they produce milk as food for their calves. While the calves are drinking their mother's milk the cow continues to produce milk. Dairy farmers take the calves away but milk the cows so the cows bodies thinks they are still feeding their calves, but they are really producing milk for the farmer to sell. The program shows how the farmer milks his cows and how it is then pasteurised and homogenised before being put into containers ready for sale.
30 July 2014
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Reviewed June 2012
What is the official name of the ABCB11 gene?
The official name of this gene is “ATP-binding cassette, sub-family B (MDR/TAP), member 11.”
ABCB11 is the gene's official symbol. The ABCB11 gene is also known by other names, listed below.
What is the normal function of the ABCB11 gene?
The ABCB11 gene provides instructions for making a protein called the bile salt export pump (BSEP), which is found in the liver. Bile salts are a component of bile, which is used to digest fats. Bile salts are produced by liver cells and then transported out of the cell by BSEP to make bile. The release of bile salts from liver cells is critical for the normal secretion of bile.
Does the ABCB11 gene share characteristics with other genes?
The ABCB11 gene belongs to a family of genes called ABC (ATP-binding cassette transporters). It also belongs to a family of genes called ATP (ATPases).
A gene family is a group of genes that share important characteristics. Classifying individual genes into families helps researchers describe how genes are related to each other. For more information, see What are gene families? (http://ghr.nlm.nih.gov/handbook/howgeneswork/genefamilies) in the Handbook.
How are changes in the ABCB11 gene related to health conditions?
- benign recurrent intrahepatic cholestasis - caused by mutations in the ABCB11 gene
Mutations in the ABCB11 gene can cause benign recurrent intrahepatic cholestasis type 2 (BRIC2). People with BRIC2 have occasional episodes of impaired bile secretion that lead to severe itching (pruritus) and yellowing of the skin and whites of the eyes (jaundice). On occasion, people with BRIC2 have later been diagnosed with a more severe condition called progressive familial intrahepatic cholestasis type 2 (described below) when their symptoms worsened.
Affected individuals have a mutation in both copies of the ABCB11 gene. Mutations in the ABCB11 gene that cause BRIC2 lead to a 40 to 50 percent reduction of bile salt transport. The resulting buildup of bile salts in the liver leads to the signs and symptoms of BRIC2. It is unclear what causes the episodes to begin or end.
- progressive familial intrahepatic cholestasis - caused by mutations in the ABCB11 gene
More than 100 mutations in the ABCB11 gene have been found to cause a severe form of liver disease called progressive familial intrahepatic cholestasis type 2 (PFIC2) that usually leads to liver failure. Development of this condition requires a mutation in both copies of the ABCB11 gene. Mutations in the ABCB11 gene that cause PFIC2 result in a 70 percent reduction to complete absence of bile salt transport out of the liver. The lack of transport causes bile salts to build up in liver cells, leading to liver disease and its associated signs and symptoms.
Mutations that lead to the production of a short, nonfunctional protein or cause no protein to be produced tend to be associated with severe liver disease that appears earlier in life. People with no functional BSEP protein also seem to be at a greater risk of developing a type of liver cancer called hepatocellular carcinoma.
- intrahepatic cholestasis of pregnancy - associated with the ABCB11 gene
Women with a change in the ABCB11 gene are at risk of developing a condition called intrahepatic cholestasis of pregnancy. Affected women typically develop impaired bile secretion (cholestasis) and pruritus during the third trimester of pregnancy, and these features disappear after the baby is born. A common variation (polymorphism) in the ABCB11 gene is found more often in women who develop this condition than women who do not. This variation leads to a change in a single protein building block (amino acid) in the BSEP protein. Specifically, the amino acid valine is replaced by the amino acid alanine at position 444 of the protein (written as V444A). This change leads to a reduction in the amount of BSEP protein in liver cells. In rare cases, an uncommon change (a mutation) in one copy of the ABCB11 gene is found in women with intrahepatic cholestasis of pregnancy. A single mutation in this gene increases the risk of developing intrahepatic cholestasis of pregnancy. These mutations likely reduce the amount or function of the BSEP protein.
In women with either type of genetic change, enough BSEP function remains for sufficient bile secretion under most circumstances. Studies show that the hormones estrogen and progesterone (and products formed during their breakdown), which are elevated during pregnancy, further reduce the function of BSEP, resulting in impaired bile secretion and the signs and symptoms of intrahepatic cholestasis of pregnancy. Many factors, however, likely contribute to the risk of developing this complex disorder.
Where is the ABCB11 gene located?
Cytogenetic Location: 2q24
Molecular Location on chromosome 2: base pairs 168,922,801 to 169,034,889
The ABCB11 gene is located on the long (q) arm of chromosome 2 at position 24.
More precisely, the ABCB11 gene is located from base pair 168,922,801 to base pair 169,034,889 on chromosome 2.
See How do geneticists indicate the location of a gene? (http://ghr.nlm.nih.gov/handbook/howgeneswork/genelocation) in the Handbook.
Where can I find additional information about ABCB11?
You and your healthcare professional may find the following resources about ABCB11 helpful.
Educational resources - Information pages
- Madame Curie Bioscience Database: Fat Absorption and Lipid Metabolism in Cholestasis (http://www.ncbi.nlm.nih.gov/books/NBK6420/)
- Madame Curie Bioscience Database: Genetics of Cholestatic Disorders (http://www.ncbi.nlm.nih.gov/books/NBK6475/)
- The Human ATP-Binding Cassette (ABC) Transporter Superfamily: ABCB Genes (http://www.ncbi.nlm.nih.gov/books/NBK3/)
- Gene Reviews - Clinical summary (http://www.ncbi.nlm.nih.gov/books/NBK1297)
Genetic Testing Registry - Repository of genetic test information
- GTR: Genetic tests for ABCB11 (http://www.ncbi.nlm.nih.gov/gtr/tests/?term=8647%5Bgeneid%5D)
You may also be interested in these resources, which are designed for genetics professionals and researchers.
- PubMed - Recent literature (http://www.ncbi.nlm.nih.gov/pubmed?term=%28%28ABCB11%5BTIAB%5D%29%20OR%20%28BSEP%29%29%20AND%20%28%28Genes%5BMH%5D%29%20OR%20%28Genetic%20Phenomena%5BMH%5D%29%29%20AND%20english%5Bla%5D%20AND%20human%5Bmh%5D%20AND%20%22last%201800%20days%22%5Bdp%5D)
- OMIM - Genetic disorder catalog (http://omim.org/entry/603201)
Research Resources - Tools for researchers
- Atlas of Genetics and Cytogenetics in Oncology and Haematology (http://atlasgeneticsoncology.org/Genes/GC_ABCB11.html)
- HGNC Gene Family: ATP binding cassette transporters / subfamily B (http://www.genenames.org/genefamilies/ABC)
- HGNC Gene Symbol Report (http://www.genenames.org/cgi-bin/gene_symbol_report?q=data/hgnc_data.php&hgnc_id=42)
- NCBI Gene (http://www.ncbi.nlm.nih.gov/gene/8647)
What other names do people use for the ABCB11 gene or gene products?
- bile salt export pump
- progressive familial intrahepatic cholestasis 2
- sister p-glycoprotein
See How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.
What glossary definitions help with understanding ABCB11?
amino acid ;
hepatocellular carcinoma ;
liver cancer ;
liver failure ;
You may find definitions for these and many other terms in the Genetics Home Reference
- OMIM: ATP-BINDING CASSETTE, SUBFAMILY B, MEMBER 11 (http://omim.org/entry/603201)
- Davit-Spraul A, Gonzales E, Baussan C, Jacquemin E. Progressive familial intrahepatic cholestasis. Orphanet J Rare Dis. 2009 Jan 8;4:1. doi: 10.1186/1750-1172-4-1. Review. (http://www.ncbi.nlm.nih.gov/pubmed/19133130?dopt=Abstract)
- Dixon PH, van Mil SW, Chambers J, Strautnieks S, Thompson RJ, Lammert F, Kubitz R, Keitel V, Glantz A, Mattsson LA, Marschall HU, Molokhia M, Moore GE, Linton KJ, Williamson C. Contribution of variant alleles of ABCB11 to susceptibility to intrahepatic cholestasis of pregnancy. Gut. 2009 Apr;58(4):537-44. doi: 10.1136/gut.2008.159541. Epub 2008 Nov 5. (http://www.ncbi.nlm.nih.gov/pubmed/18987030?dopt=Abstract)
- Geenes V, Williamson C. Intrahepatic cholestasis of pregnancy. World J Gastroenterol. 2009 May 7;15(17):2049-66. Review. (http://www.ncbi.nlm.nih.gov/pubmed/19418576?dopt=Abstract)
- Jansen PL, Sturm E. Genetic cholestasis, causes and consequences for hepatobiliary transport. Liver Int. 2003 Oct;23(5):315-22. Review. (http://www.ncbi.nlm.nih.gov/pubmed/14708891?dopt=Abstract)
- Kagawa T, Watanabe N, Mochizuki K, Numari A, Ikeno Y, Itoh J, Tanaka H, Arias IM, Mine T. Phenotypic differences in PFIC2 and BRIC2 correlate with protein stability of mutant Bsep and impaired taurocholate secretion in MDCK II cells. Am J Physiol Gastrointest Liver Physiol. 2008 Jan;294(1):G58-67. Epub 2007 Oct 18. (http://www.ncbi.nlm.nih.gov/pubmed/17947449?dopt=Abstract)
- Lam P, Pearson CL, Soroka CJ, Xu S, Mennone A, Boyer JL. Levels of plasma membrane expression in progressive and benign mutations of the bile salt export pump (Bsep/Abcb11) correlate with severity of cholestatic diseases. Am J Physiol Cell Physiol. 2007 Nov;293(5):C1709-16. Epub 2007 Sep 13. (http://www.ncbi.nlm.nih.gov/pubmed/17855769?dopt=Abstract)
- Lam P, Soroka CJ, Boyer JL. The bile salt export pump: clinical and experimental aspects of genetic and acquired cholestatic liver disease. Semin Liver Dis. 2010 May;30(2):125-33. doi: 10.1055/s-0030-1253222. Epub 2010 Apr 26. Review. (http://www.ncbi.nlm.nih.gov/pubmed/20422495?dopt=Abstract)
- Meier Y, Pauli-Magnus C, Zanger UM, Klein K, Schaeffeler E, Nussler AK, Nussler N, Eichelbaum M, Meier PJ, Stieger B. Interindividual variability of canalicular ATP-binding-cassette (ABC)-transporter expression in human liver. Hepatology. 2006 Jul;44(1):62-74. (http://www.ncbi.nlm.nih.gov/pubmed/16799996?dopt=Abstract)
- Meier Y, Zodan T, Lang C, Zimmermann R, Kullak-Ublick GA, Meier PJ, Stieger B, Pauli-Magnus C. Increased susceptibility for intrahepatic cholestasis of pregnancy and contraceptive-induced cholestasis in carriers of the 1331T>C polymorphism in the bile salt export pump. World J Gastroenterol. 2008 Jan 7;14(1):38-45. (http://www.ncbi.nlm.nih.gov/pubmed/18176959?dopt=Abstract)
- NCBI Gene (http://www.ncbi.nlm.nih.gov/gene/8647)
- Pauli-Magnus C, Stieger B, Meier Y, Kullak-Ublick GA, Meier PJ. Enterohepatic transport of bile salts and genetics of cholestasis. J Hepatol. 2005 Aug;43(2):342-57. Review. (http://www.ncbi.nlm.nih.gov/pubmed/15975683?dopt=Abstract)
- Strautnieks SS, Bull LN, Knisely AS, Kocoshis SA, Dahl N, Arnell H, Sokal E, Dahan K, Childs S, Ling V, Tanner MS, Kagalwalla AF, Németh A, Pawlowska J, Baker A, Mieli-Vergani G, Freimer NB, Gardiner RM, Thompson RJ. A gene encoding a liver-specific ABC transporter is mutated in progressive familial intrahepatic cholestasis. Nat Genet. 1998 Nov;20(3):233-8. (http://www.ncbi.nlm.nih.gov/pubmed/9806540?dopt=Abstract)
- Strautnieks SS, Byrne JA, Pawlikowska L, Cebecauerová D, Rayner A, Dutton L, Meier Y, Antoniou A, Stieger B, Arnell H, Ozçay F, Al-Hussaini HF, Bassas AF, Verkade HJ, Fischler B, Németh A, Kotalová R, Shneider BL, Cielecka-Kuszyk J, McClean P, Whitington PF, Sokal E, Jirsa M, Wali SH, Jankowska I, Pawłowska J, Mieli-Vergani G, Knisely AS, Bull LN, Thompson RJ. Severe bile salt export pump deficiency: 82 different ABCB11 mutations in 109 families. Gastroenterology. 2008 Apr;134(4):1203-14. doi: 10.1053/j.gastro.2008.01.038. Epub 2008 Jan 18. (http://www.ncbi.nlm.nih.gov/pubmed/18395098?dopt=Abstract)
- Thompson R, Strautnieks S. BSEP: function and role in progressive familial intrahepatic cholestasis. Semin Liver Dis. 2001 Nov;21(4):545-50. Review. (http://www.ncbi.nlm.nih.gov/pubmed/11745042?dopt=Abstract)
- Vallejo M, Briz O, Serrano MA, Monte MJ, Marin JJ. Potential role of trans-inhibition of the bile salt export pump by progesterone metabolites in the etiopathogenesis of intrahepatic cholestasis of pregnancy. J Hepatol. 2006 Jun;44(6):1150-7. Epub 2005 Nov 7. (http://www.ncbi.nlm.nih.gov/pubmed/16458994?dopt=Abstract)
The resources on this site should not be used as a substitute for
professional medical care or advice. Users seeking information about
a personal genetic disease, syndrome, or condition should consult with a qualified
See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.
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New technology is making detecting cancer in women with dense breast tissue easier.
Women with dense breast tissue now have additional screening alternatives available to them in Northern Nevada that can enable their doctors to better identify cancerous growths.
Finding breast cancer in women with dense breast tissue can be difficult through just a mammogram, which is an X-ray picture of the breast, because dense breast tissue and cancer both show up as white. In fact, the process is often described as looking for a snowball in a snowstorm .
To provide improved detection, Saint Mary's Regional Medical Center began offering its FDA-approved Automated Breast Ultrasound System, or ABUS, in March.
"[The ABUS] is a new screening test for breast cancer in women with dense breast tissue," said Dr. Shin Kim, medical director of imaging at Saint Mary's. "It is quick, comfortable and does not use radiation. When used in addition to mammography, it can improve breast cancer detection by 36 percent over mammography alone."
At Renown Regional Medical Center, the SonoCine has been available for several years, and the machine provides a supplemental way to detect small cancers that may be missed through mammography. Adding SonoCine to a annual mammogram can double the detection of small cancers in women with dense breasts, a ccording to Dr. Susan Ward, radiologist with Reno Radiological Associates at Renown Breast Health Center.
Neither the ABUS nor SonoCine uses radiation, and both processes are described as painless. Dense breast tissue can be found in women of any age, but is more commonly found in young women. That's because the tissue that is milk producing is thick and dense. Nearly 75 percent of all women in their 30s have dense breasts compared to 25 percent of women in their 70s. The Susan G. Komen Foundation also reports women with dense breasts have an increased cancer risk that is four to five times greater than women with low breast density. The cause for this increased risk are unknown, according to Kim.
The American College of Radiology's Breast Imaging Reporting and Data System (BI-RADS) uses a rating system of one through four to categorize breast tissue density. Density levels of three to four are categorized as dense, with a three indicating 51 percent to 75 percent of a woman's breast tissue is dense and a four indicating more than 75 percent of the breast tissue is dense. In some states, radiologists are now required to inform women that they have dense breast tissue on their mammogram results.
Women notified they have dense tissue may want to speak with their doctor to see what additional screening options exist, such as ultrasound.
"Women with dense breast tissues have a higher risk of breast cancer and mammograms are less sensitive for detecting breast cancer in these women," Kim said. "Therefore, they should talk to their doctor about getting a screening breast ultrasound."
However, it also may be important to note some health insurances may not cover the costs of additional screening, according to the American Cancer Society, but Saint Mary's does report its ABUS is covered by most health insurances. Some states, like Connecticut, have now required health insurance providers to cover the additional costs of screening for women who are identified as having dense breasts, according to Renown. A doctor can help in making decisions about additional screening.
"Screening breast MRI scans are only recommended for patients with high risk of breast cancer such as patients with BRCA [BReast CAncer] mutation, chest radiation between age 10 and 30 years, and mother or sister with breast cancer before age 40," Kim said. "Even in these, patients, still have to get annual mammograms because mammograms can detect cancers not seen on MRI scans."
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Sickle cell trait occurs when a person inherits a sickle cell gene from just one parent. It's not the same as sickle cell disease, in which a person inherits two sickle cell genes, one from each parent.
People with sickle cell disease have just one kind of hemoglobin (hemoglobin S), which turns their normal, round red blood cells into abnormally curved (sickle) shapes. But people with sickle cell trait have both normal hemoglobin (hemoglobin A) and hemoglobin S, so they rarely have symptoms of sickle cell disease. But they are carriers and can pass the sickle cell gene to their children.
Cervical disc disease may be the most common cause of neck pain. It's caused by an abnormality in one or more discs, the cushions that lie between the neck bones (vertebrae). When a disc is damaged, due to arthritis or an unknown cause, it can lead to neck pain from inflammation or muscle spasms. In severe cases, pain and numbness can occur in the arms from nerve irritation or damage.
While pain relievers, physical therapy, neck traction, and as a last resort, surgery, can help ease neck pain from...
A simple blood test can show whether you have sickle cell trait. During pregnancy, a woman can have a test to find out if the baby will have either sickle cell disease or sickle cell trait. In the United States, most states test for sickle cell status at birth. Some college athletic programs screen student athletes to find out if they have sickle cell trait.
What does it mean to test positive for sickle cell trait?
People with sickle cell trait rarely have symptoms. Testing positive for sickle cell trait doesn't mean that you need to have treatment or make changes in your activities.
But in rare cases, a person with sickle cell trait may have muscle pain or other serious health problems. These problems can happen under certain extreme conditions, such as intense exercise, overheating, or being at a high altitude.
If you exercise intensely or are a competitive athlete, you can take precautions to help prevent complications:1
Drink plenty of fluids, especially during intense activities.
Increase your level of performance gradually.
Stop right away if you feel muscle pain, weakness, fatigue, or breathlessness.
Work with your doctor and coaches to create a plan to prevent complications. Know what to do if you have problems.
Does sickle cell trait affect pregnancy?
Women who have sickle cell trait can have a healthy pregnancy.
If you or your partner has sickle cell trait, you may want to talk with a genetic counselor before getting pregnant. A genetic counselor can help you learn more about your chances of having a child with sickle cell disease.
A person with sickle cell trait has a 1-in-2 (50%) chance of passing the sickle cell trait gene to each of his or her children. If both parents have sickle cell trait, each of their children will have a 1-in-4 (25%) chance of having sickle cell disease.
In this article
This information is produced and provided by the National
Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National
Institute via the Internet web site at http://
.gov or call 1-800-4-CANCER.
WebMD Medical Reference from Healthwise
March 12, 2014
This information is not intended to replace the advice of a doctor.
Healthwise disclaims any liability for the decisions you make based on this
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|A service of the U.S. National Library of Medicine®|
On this page:
Reviewed August 2014
What is the official name of the FOXN1 gene?
The official name of this gene is “forkhead box N1.”
FOXN1 is the gene's official symbol. The FOXN1 gene is also known by other names, listed below.
Read more about gene names and symbols on the About page.
What is the normal function of the FOXN1 gene?
The FOXN1 gene provides instructions for making a protein that attaches (binds) to specific regions of DNA and regulates the activity of other genes. On the basis of this action, the FOXN1 protein is called a transcription factor.
The FOXN1 protein is important for development of the skin, hair, nails, and immune system. Studies suggest that this protein helps guide the formation of hair follicles and the growth of fingernails and toenails. The FOXN1 protein also plays a critical role in the formation of the thymus, which is a gland located behind the breastbone where immune system cells called T cells mature and become functional. T cells recognize and attack foreign invaders, such as viruses and bacteria, to help prevent infection.
Researchers suspect that the FOXN1 protein is also involved in the development of the brain and spinal cord (central nervous system), although its role is unclear.
Does the FOXN1 gene share characteristics with other genes?
The FOXN1 gene belongs to a family of genes called FOX (forkhead box genes).
A gene family is a group of genes that share important characteristics. Classifying individual genes into families helps researchers describe how genes are related to each other. For more information, see What are gene families? in the Handbook.
How are changes in the FOXN1 gene related to health conditions?
Where is the FOXN1 gene located?
Cytogenetic Location: 17q11.2
Molecular Location on chromosome 17: base pairs 28,506,228 to 28,538,899
The FOXN1 gene is located on the long (q) arm of chromosome 17 at position 11.2.
More precisely, the FOXN1 gene is located from base pair 28,506,228 to base pair 28,538,899 on chromosome 17.
See How do geneticists indicate the location of a gene? in the Handbook.
Where can I find additional information about FOXN1?
You and your healthcare professional may find the following resources about FOXN1 helpful.
You may also be interested in these resources, which are designed for genetics professionals and researchers.
What other names do people use for the FOXN1 gene or gene products?
See How are genetic conditions and genes named? in the Handbook.
Where can I find general information about genes?
The Handbook provides basic information about genetics in clear language.
These links provide additional genetics resources that may be useful.
What glossary definitions help with understanding FOXN1?
alopecia ; amino acid ; arginine ; bacteria ; cell ; central nervous system ; congenital ; DNA ; gene ; immune system ; immunodeficiency ; infection ; mutation ; nervous system ; protein ; thymus ; transcription ; transcription factor
You may find definitions for these and many other terms in the Genetics Home Reference Glossary.
See also Understanding Medical Terminology.
References (8 links)
The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? in the Handbook.
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What It Is
Reticulocytes are immature red blood cells (RBCs). They're made in the bone marrow (the spongy material inside bone) and are released into the bloodstream, where they circulate for about 1-2 days before developing into mature red blood cells. Normally, only about 1% of all RBCs in the bloodstream are reticulocytes.
A reticulocyte count measures the rate at which these cells are made in the bone marrow and enter the bloodstream.
Why It's Done
A reticulocyte count is helpful when a doctor needs more information about someone's anemia (a low number of RBCs). For example, the number of reticulocytes in the blood can be low if anemia is occurring because fewer reticulocytes are being produced by the bone marrow.
The count can be high because more reticulocytes are being produced to replace mature RBCs being destroyed by disease. The test also can be used to monitor whether treatment for anemia is working.
No special preparations are needed. Having your child wear a short-sleeve shirt on the day of the test can make things easier for the technician who will be drawing blood.
Let the doctor know if your child has had a blood transfusion in the past 3 months because this can affect the reticulocyte count.
A health professional will usually draw the blood from a vein, after cleaning the skin surface with antiseptic and placing an elastic band (tourniquet) around the upper arm to apply pressure and cause veins to swell with blood. A needle is inserted into a vein (usually in the arm inside of the elbow or on the back of the hand) and blood is withdrawn and collected in a vial or syringe.
After the procedure, the elastic band is removed. Once the blood has been collected, the needle is removed and the area is covered with cotton or a bandage to stop the bleeding. Collecting blood for this test will only take a few minutes.
What to Expect
Collecting a sample of blood is only temporarily uncomfortable and can feel like a quick pinprick. Afterward, there may be some mild bruising, which should go away in a few days.
Getting the Results
The blood sample will be processed by a machine and the results are usually available after a few hours or the next day.
If the reticulocyte count is abnormal, further testing may be necessary to determine what's causing the problem and how to treat it.
The reticulocyte count is considered a safe procedure. However, as with many medical tests, some problems can occur with having blood drawn:
- fainting or feeling lightheaded
- hematoma (blood accumulating under the skin causing a lump or bruise)
- pain associated with multiple punctures to locate a vein
Helping Your Child
Having a blood test is relatively painless. Still, many children are afraid of needles. Explaining the test in terms your child can understand might help ease some of the fear.
Allow your child to ask the technician any questions he or she might have. Tell your child to try to relax and stay still during the procedure, as tensing muscles and moving can make it harder and more painful to draw blood. It also may help if your child looks away when the needle is being inserted into the skin.
If You Have Questions
If you have questions about the reticulocyte count, speak with your doctor.
Reviewed by: Steven Dowshen, MD
Date reviewed: March 2011
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2015 The Nemours Foundation/KidsHealth. All rights reserved.
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EMBO reports, a life sciences journal published by the European Molecular Biology Organization, has just published online the scientists’ findings about small non-coding RNAs.
While RNA is known to be key to our cells’ successful creation of proteins, the role of small non-coding RNAs, a newly discovered cousin of the former, has eluded scientific understanding for the most part. Until now, it was only surmised that most of these molecules had nothing to do with protein production.
However, scientists at SFU, the University of British Columbia and the B.C. Cancer Agency have discovered that many non-coding RNAs are perturbed in cancerous human cells, including breast and lung, in a specific way. The disturbance, which manifests itself as shorter than normal molecular messaging, also occurs at a specific spot on genes.
“These two identifiable characteristics give cancer-causing non-coding RNAs a chemical signature that makes it easy for scientists to identify them in the early stages of many different types of cancer,” says Steven Jones.
The SFU molecular biology and biochemistry professor is this study’s senior author, and the associate director and head of bioinformatics at the B.C. Cancer Agency’s Genome Sciences Centre.
“These molecules’ existence can also be used to classify cancer patients into subgroups of individuals with different survival outcomes,” adds Jones. “While the precise reason why a tumour would change the behaviour of genes in this way is not known, it is likely that it represents a mechanism by which the cancer can subvert and takeover the normally well controlled activity of our genes.”
This study uncovered non-coding RNAs’ cancerous role by using high-throughput sequencing techniques to analyse reams of genetic information on normal and diseased tissue as part of the Cancer Genome Atlas project.
The Cancer Genome Atlas is an ambitious project to characterize the genetic material of more than 500 tumours from more than 20 different cancers. The project provides a goldmine of data for bioinformaticians such as Jones.
Simon Fraser University is consistently ranked among Canada's top comprehensive universities and is one of the top 50 universities in the world under 50 years old. With campuses in Vancouver, Burnaby and Surrey, B.C., SFU engages actively with the community in its research and teaching, delivers almost 150 programs to more than 30,000 students, and has more than 125,000 alumni in 130 countries.
Simon Fraser University: Engaging Students. Engaging Research. Engaging Communities.Contact:
Carol Thorbes | EurekAlert!
27.03.2015 | Oak Ridge National Laboratory
How did the chicken cross the sea?
27.03.2015 | Michigan State University
In an experiment at the Department of Energy's SLAC National Accelerator Laboratory, scientists precisely measured the temperature and structure of aluminum as...
The IPH presents a solution at HANNOVER MESSE 2015 to make ship traffic more reliable while decreasing the maintenance costs at the same time. In cooperation with project partners, the research institute from Hannover, Germany, has developed a sensor system which continuously monitors the condition of the marine gearbox, thus preventing breakdowns. Special feature: the monitoring system works wirelessly and energy-autonomously. The required electrical power is generated where it is needed – directly at the sensor.
As well as cars need to be certified regularly (in Germany by the TÜV – Technical Inspection Association), ships need to be inspected – if the powertrain stops...
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The Atlantic overturning is one of Earth’s most important heat transport systems, pumping warm water northwards and cold water southwards. Also known as the Gulf Stream system, it is responsible for the mild climate in northwestern Europe.
Scientists now found evidence for a slowdown of the overturning – multiple lines of observation suggest that in recent decades, the current system has been...
Because they are regularly subjected to heavy vehicle traffic, emissions, moisture and salt, above- and underground parking garages, as well as bridges, frequently experience large areas of corrosion. Most inspection systems to date have only been capable of inspecting smaller surface areas.
From April 13 to April 17 at the Hannover Messe (hall 2, exhibit booth C16), engineers from the Fraunhofer Institute for Nondestructive Testing IZFP will be...
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| 13 |
London, United Kingdom
Photograph - Photograph
Antibody, computer artwork. An antibody, also known as an immunoglobulin, is an assembly of proteins that allows the immune system to identify and neutralise foreign objects in the body. Two 'heavy' protein chains form a Y shape, with two shorter, 'light' chains bonded to the short arms of the Y. At the top of each arm is an antigen binding fragment (red), which is specific to a single antigen. Antibodies bind to foreign substances to neutralise them directly (by blocking an active region), or to tag them for neutralisation by another part of the immune system.
May 14th, 2013
Viewed 9 Times - Last Visitor from Izmit, 41 - Turkey on 12/31/2014 at 6:40 AM
| 13 |
Technique developed at Eindhoven University of Technology shows tumors with much greater precision
Each year prostate tissue samples are taken from over a million men around the world – in most cases using 12 large biopsy needles – to check whether they have prostate cancer. This medical procedure, which was recently described by an American urology professor as 'barbaric'**, shows that 70% of the subjects do not have cancer.
This is a prostate image made with Contrast Ultrasound Dispersion Imaging and a photo of same prostate (after surgical removal) with cancerous area colored red.
Credit: Eindhoven University of Technology
The examination is unnecessarily painful and involves risk for these patients, and it is also costly to carry out. A patient-friendly examination, which drastically reduces the need for biopsies, and may even eliminate them altogether, has been developed at Eindhoven University of Technology (TU/e), together with AMC Amsterdam. The results will be presented at the European Association of Urology Congress in Stockholm, on 14 April.
Hundreds of thousands of men die each year from prostate cancer. The standard procedure used worldwide for prostate cancer examinations starts with measurement of the PSA (prostate specific antigen) value in the blood.
If this is high, physicians will usually remove samples of prostate tissue through the anus at six to sixteen points for pathological examination. However, 70% of the subjects show no signs of cancer. So does this mean the high PSA level is a false alarm? Not always: the biopsies may have been taken at just the wrong places. Cancer is later found in 30% of the patients with negative results (no cancer).
Among the positive results (patients with signs of cancer), doctors do not know the exact sizes of the tumor. In many cases, operations show that the tumors are so small that surgery was unnecessary. As well as that, the examination leads to inflammations in up to 5% of patients. Plus the fact that each examination costs around USD 2500 to carry out.
Recognizable blood vessel pattern in cancer
Research team leader Massimo Mischi at TU/e has developed a method to investigate whether and where men have prostate cancer using existing ultrasound scanners, together with the Academic Medical Center Amsterdam. These devices create images of organs in the body using sound waves, in the same way as prenatal ultrasound scans. But these systems are usually unable to show the difference between healthy and tumor tissue. To make this visible, Mischi used the fact that tumor tissue produces large numbers of small blood vessels to allow it to grow, with a characteristic pattern. Patients are given a single injection of a contrast medium containing tiny bubbles, which are shown by the ultrasound scanner right down to the smallest blood vessels. Using advanced image-analysis techniques that can recognize the characteristic blood vessel pattern in tumors, the computer then generates an image showing where the tumor is. The examination only takes one minute, and the results are available no more than a few minutes later. These examinations also save money, because costly biopsy analysis is no longer necessary.
The researchers were able to compare the 'tumor images' from 24 patients at three hospitals in the Netherlands with the actual prostates after removal by operation. The images were found to give a good indication of the locations and sizes of the tumors. Massimo Mischi will present the results at the European Association of Urologists Congress in Stockholm on 14 April. It is exceptional for a scientist from a university of technology to be given the opportunity to speak at this congress of medical specialists.
Far fewer biopsies
The use of the new method, which has been patented by TU/e, can avoid the need for biopsies to be taken from millions of men around the world. The procedure will no longer be necessary for a large part of the 70% of men from whom biopsies are currently taken unnecessarily. And far fewer biopsies will need to be taken from the remaining 30% because the location of the tumor is already clear. Once the new method has been sufficiently proven in clinical practice, the need to do biopsies may even be eliminated almost entirely.
Quick and simple introduction
The research is being carried out together with the Academic Medical Center Amsterdam and two other Dutch hospitals. A major comparative study will be held in these hospitals next year between the old and new methods, to proof that the new method is better. This will involve the use of both methods on at least 250 men. If all goes well the method will also be made available from 2016 for other patients, a large part of which will then no longer have to undergo the old and painful form of examination. The new method can be introduced quite simply because no new equipment is required; the existing ultrasound scanners which the hospitals already have can continue to be used.
Massimo Mischi received a Vidi grant from the NWO (Netherlands Organisation for Scientific Research) in 2009 for his research, and in 2011 he received a Starting Grant from the European Research Council. A 4-year grant for further research was provided by the Dutch Cancer Foundation (KWF Kankerbestrijding) in 2013 to the AMC and TU/e.
** Matthew Gettman, professor of urology at the Mayo Graduate School of Medicine in Rochester, MN, USA, wrote in 2012 in the journal European Urology that the method is "barbaric", despite the use of local anesthetic.
Note for editors (not for publication)
For more information please contact Massimo Mischi ([email protected], +31 6 1326 9039).
In this video Mischi explains the project: http://vimeo.com/31837362
VIDEO: For video or tv-productions high quality footage of the current procedure (taking biopsies) and the new procedure is available. Please contact us if you want to use this footage.
Attached there is a picture of Massimo Mischi giving a lecture. You can use this picture if you mention the source: Bart van Overbeeke/Eindhoven University of Technology.
Also attached is a powerpoint document containing prostate images that were made with the new technology. The orange/red areas show where the tumor area is. Alongside there are pictures of the actual prostates in which the cancerous tissue is colored red.
Massimo Mischi | EurekAlert!
Vanderbilt Team First to Blend High-End Imaging Techniques
17.03.2015 | Vanderbilt University Medical Center
Developing radically new technologies for X-ray systems
04.02.2015 | Siemens AG
In an experiment at the Department of Energy's SLAC National Accelerator Laboratory, scientists precisely measured the temperature and structure of aluminum as...
The IPH presents a solution at HANNOVER MESSE 2015 to make ship traffic more reliable while decreasing the maintenance costs at the same time. In cooperation with project partners, the research institute from Hannover, Germany, has developed a sensor system which continuously monitors the condition of the marine gearbox, thus preventing breakdowns. Special feature: the monitoring system works wirelessly and energy-autonomously. The required electrical power is generated where it is needed – directly at the sensor.
As well as cars need to be certified regularly (in Germany by the TÜV – Technical Inspection Association), ships need to be inspected – if the powertrain stops...
When an earthquake hits, the faster first responders can get to an impacted area, the more likely infrastructure--and lives--can be saved.
The Atlantic overturning is one of Earth’s most important heat transport systems, pumping warm water northwards and cold water southwards. Also known as the Gulf Stream system, it is responsible for the mild climate in northwestern Europe.
Scientists now found evidence for a slowdown of the overturning – multiple lines of observation suggest that in recent decades, the current system has been...
Because they are regularly subjected to heavy vehicle traffic, emissions, moisture and salt, above- and underground parking garages, as well as bridges, frequently experience large areas of corrosion. Most inspection systems to date have only been capable of inspecting smaller surface areas.
From April 13 to April 17 at the Hannover Messe (hall 2, exhibit booth C16), engineers from the Fraunhofer Institute for Nondestructive Testing IZFP will be...
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| 13 |
Brain cancer is an overgrowth of cells in the brain that form masses called tumors. Cancerous (malignant) brain tumors tend to grow very quickly. They disrupt the way your body works, and this can be life threatening. However, brain cancer is rare. Each year, only about seven in 100,000 people in the United States are diagnosed with malignant brain tumors.
What Causes Brain Cancer?
The exact cause of brain cancer is unknown.
Types of Brain Cancer
Cancer is named based on where in your body it begins. So brain cancer begins in your brain. This is sometimes referred to as primary brain cancer. You can also have cancer in your brain that spread to it after starting somewhere else in your body. This is called metastatic brain cancer. Cancerous tumors in the brain are more often metastatic than primary.
There are also types and grades of brain tumors. The tumor type is based on where it is in your brain, and the grade (I to IV) indicates how quickly a tumor grows, with grade IV being the fastest. There are more than 120 types of brain tumors. However, there is no standard for naming according to type, and there are many subtypes. Different doctors might use different names for the same tumor.
Who Is at Risk for Brain Cancer?
Factors that can increase your risk of brain cancer include:
- exposure to high doses of ionizing radiation
- family history (According to the New York Department of Health, only about five percent of people who get brain cancer have a history of the disease in their family. [NYDH])
- cancer in another part of your body. Cancers that commonly spread, or metastasize, to the brain include lung, breast, kidney, and bladders cancers and melanoma (a type of skin cancer).
Other factors that might be related to developing brain cancer include:
- increased age
- exposure to pesticides, herbicides, and fertilizer
- working with carcinogenic (known to cause cancer) elements, such as lead, plastic, rubber, petroleum, and some textiles
- having an Epstein-Barr virus infection (mononucleosis)
What are the Symptoms of Brain Cancer?
The symptoms of brain cancer depend on the size and location of the tumor. Common brain cancer symptoms include:
- headaches (usually worse in the morning)
- lack of coordination
- lack of balance
- difficulty walking
- memory problems
- difficulty thinking
- speech problems
- vision problems
- personality changes
- abnormal eye movements
- muscle jerking
- muscle twitching
- numbness or tingling in the arms and/or legs
Many of the symptoms of brain cancer are also caused by other, less serious conditions. There is no need to panic if you are experiencing these symptoms, but it is a good idea to visit your doctor to have them investigated, just in case.
How Is Brain Cancer Diagnosed?
If you have symptoms of a brain tumor, your doctor may perform one of the following tests to make a diagnosis:
- neurological examination to determine if a tumor is affecting your brain
- imaging tests, such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans, to locate the tumor
- lumbar puncture (a procedure that collects a small sample of the fluid that surrounds the brain and spinal cord) to check for cancer cells
- biopsy (a surgical procedure where a small amount of the tumor is removed) for diagnostic testing to determine if the tumor is malignant (cancerous)
How Is Brain Cancer Treated?
There are several treatments for brain cancer. Treatment for primary brain cancer will be different than treatment for metastatic brain tumors. This is because treatment for metastatic cancer will be more focused on the original cancer site.
You may receive one or more treatments depending on the type, size, and location of your brain tumor. Your age and general health are also factors. Treatments include:
Surgery is the most common treatment for brain cancer. Sometimes only part of the tumor can be removed due to its location. In some instances, a tumor is located in a sensitive or inaccessible area of the brain, and surgery to remove it cannot be performed. These kinds of tumors are referred to as inoperable.
Medication and Other Therapies
Chemotherapy and Radiation Therapy
You may be given chemotherapy drugs to destroy cancer cells in your brain and to shrink the tumor. Chemotherapy drugs may be given orally or intravenously. Radiation therapy may be recommended to destroy tumor tissue or cancer cells that cannot be surgically removed. This is done with high-energy waves such as X-rays. Sometimes you undergo chemotherapy and radiation therapy at the same time. Chemotherapy is also done after radiation treatment.
Your doctor may prescribe biologic drugs to boost, direct, or restore the body’s natural defenses against the tumor. For example, the drug bevacizumab works to stop the growth of blood vessels that supply tumors.
In advanced cases of brain cancer that do not respond to treatment, clinical trial therapies and medications may be used. These are treatments that are still in the testing phase.
You may need to go through rehabilitation if the cancer has caused damage in your brain that affects your ability to talk, walk, or perform other normal functions. Rehabilitation includes physical therapy, occupational therapy, and other therapies that can help you relearn activities.
Your doctor may prescribe medications to treat symptoms and side effects caused by the brain tumor and brain cancer treatments.
There is not a lot of scientific research that supports the use of alternative therapies to treat brain cancer; however, they may be a supportive in conjunction with conventional treatments.
- healthy diet and vitamin and mineral supplementation to replace nutrients lost from cancer treatment
- herbs (Talk to your doctor before taking herbs because some herbs can interfere with medications you are taking.)
Your prognosis is dependent on the type, size, and location of your brain tumor. Brain cancer generally has a low survival rate; however, for some types of brain cancer, 80 percent of patients survive for 5 years UMMC, 2011). Some brain cancer treatments can increase your risk of getting other cancerous tumors and may cause cataracts (clouding of the eyes).
Reducing Your Risk of Brain Cancer
There is no way to prevent brain cancer, but you can reduce your risk of getting it if you:
- avoid exposure to pesticides and insecticides
- avoid exposure to carcinogenic chemicals
- do not smoke
- avoid unnecessary exposure to radiation
| 13 |
Fortunately, cancer in children and adolescents is rare, although the overall incidence of childhood cancer has been slowly increasing since 1975. Children and adolescents with cancer should be referred to medical centers that have a multidisciplinary team of cancer specialists with experience treating the cancers that occur during childhood and adolescence. This multidisciplinary team approach incorporates the skills of the primary care physician, pediatric surgical subspecialists, radiation oncologist, pediatric oncologist/hematologist, rehabilitation specialists, pediatric nurse specialists, social workers, and others to ensure that children receive treatment, supportive care, and rehabilitation that will achieve optimal survival and quality of life. (Refer to the PDQ summary on Pediatric Supportive Care for specific information about supportive care for children and adolescents with cancer.)
Guidelines for pediatric cancer centers and their role in the treatment of pediatric patients with cancer have been outlined by the American Academy of Pediatrics. At these pediatric cancer centers, clinical trials are available for most types of cancer that occur in children and adolescents, and the opportunity to participate in these trials is offered to most patients/families. Clinical trials for children and adolescents with cancer are generally designed to compare potentially better therapy with therapy that is currently accepted as standard. Most of the progress made in identifying curative therapies for childhood cancers has been achieved through clinical trials. Information about ongoing clinical trials is available from the NCI Web site.
Dramatic improvements in survival have been achieved for children and adolescents with cancer. Between 1975 and 2010, childhood cancer mortality decreased by more than 50%. For rhabdomyosarcoma, the 5-year survival rate increased over the same time, from 53% to 67% for children younger than 15 years and from 30% to 51% for adolescents aged 15 to 19 years. Childhood and adolescent cancer survivors require close follow-up because cancer therapy side effects may persist or develop months or years after treatment. (Refer to the PDQ summary on Late Effects of Treatment for Childhood Cancer for specific information about the incidence, type, and monitoring of late effects in childhood and adolescent cancer survivors.)
Incidence and Epidemiology
Childhood rhabdomyosarcoma, a soft tissue malignant tumor of mesenchymal origin, accounts for approximately 3.5% of the cases of cancer among children aged 0 to 14 years and 2% of the cases among adolescents and young adults aged 15 to 19 years.[3,4] The incidence is 4.5 per 1 million children and 50% of cases are seen in the first decade of life.
Incidence may depend on the histologic subtype of rhabdomyosarcoma:
- Embryonal: Patients with embryonal rhabdomyosarcoma are predominantly male (M:F = 1.5) and peaks in the 0 to 4 year age group at approximately 4 cases per 1 million children, with a lower rate in adolescents, approximately 1.5 cases per 1 million adolescents.
- Alveolar: The incidence of alveolar rhabdomyosarcoma does not vary by gender and is constant from ages 0 to 19 years at approximately 1 case per 1 million children and adolescents.
- Undifferentiated sarcoma: Infants younger than 1 year have a higher incidence of undifferentiated sarcoma and tumors of the trunk and abdomen and a lower incidence of parameningeal tumors than do older patients.
The most common primary sites for rhabdomyosarcoma are the head, the genitourinary tract, and the extremities.[7,8] Within extremity tumors, tumors of the hand and foot occur more often in older patients and have an alveolar histology; these tumors also have a higher rate of metastatic spread. Other less common primary sites include the trunk, chest wall, perineal/anal region, and abdomen including the retroperitoneum and biliary tract.
Most cases of rhabdomyosarcoma occur sporadically, with no recognized predisposing factor or risk factor. For patients with embryonal tumors, high birth weight and large size for gestational age are associated with an increased incidence of rhabdomyosarcoma. Genetic conditions associated with rhabdomyosarcoma include Li-Fraumeni cancer susceptibility syndrome (with germline p53 mutations),[12-14] pleuropulmonary blastoma (with DICER1 mutations),[15,16] neurofibromatosis type I, Costello syndrome (with germline HRAS mutations),[18-21] Beckwith-Wiedemann syndrome (with which Wilms tumor and hepatoblastoma are more commonly associated),[22,23] and Noonan syndrome.[21,24,25]
The prognosis for a child or adolescent with rhabdomyosarcoma is related to the age of the patient, site of origin, tumor size (widest diameter), resectability, presence of metastases, number of metastatic sites or tissues involved, presence or absence of regional lymph node involvement, histopathologic subtype (alveolar vs. embryonal), and delivery of radiation therapy in selected cases,[7,8,26-32]; [Level of evidence: 3iiiA] as well as unique biological characteristics of rhabdomyosarcoma tumor cells. It is unclear whether response to induction chemotherapy, as judged by anatomic imaging, correlates with the likelihood of survival in patients with rhabdomyosarcoma, because the Intergroup Rhabdomyosarcoma Study Group (IRSG) and Children's Oncology Group studies found no association.; [Level of evidence: 3iiDi] However, an Italian study found that patient response did correlate with likelihood of survival.[Level of evidence: 3iiA]
Rhabdomyosarcoma is usually curable in most children with localized disease who receive combined-modality therapy, with more than 70% surviving 5 years after diagnosis.[7,8,38] Relapses are uncommon after 5 years of disease-free survival, with a 9% late-event rate at 10 years. Relapses, however, are more common in patients who have gross residual disease in unfavorable sites after initial surgery and in those who have metastatic disease at diagnosis.
Examples of both clinical and biological factors with proven or possible prognostic significance include the following:
Age: Children aged 1 to 9 years have the best prognosis, while those younger and older fare less well. In recent IRSG trials, 5-year failure-free survival (FFS) was 57% for patients younger than 1 year, 81% for patients aged 1 to 9 years, and 68% for patients older than 10 years. Five-year survival for these groups was 76%, 87%, and 76%, respectively. Historical data show that adults fare worse than children (5-year overall survival (OS) rates, 27% ± 1.4% and 61% ± 1.4%, respectively; P < .0001).[40-43]
- Infants may do poorly because their bone marrow is less tolerant of chemotherapy doses that older children can receive; thus, infants are relatively underdosed compared with older patients. In addition, infants younger than 1 year may be less likely to receive radiation therapy for local control, because of concern about the high incidence of complications in this age group. [27,38,44] Thus, they have a relatively high rate of local failure.
- In older children, vincristine and dactinomycin have upper dosage limits based on body surface area, and these patients may also require reduced vincristine doses because of neurotoxicity.[27,45]
- Adolescents: A report from the AIEOP (Italian) Soft Tissue Sarcoma Committee suggests that adolescents may have more frequent unfavorable tumor characteristics, including alveolar histology, regional lymph node involvement, and metastatic disease involvement, accounting for their poor prognosis. This study also found that 5-year OS and progression-free survival rates were somewhat lower in adolescents than in children, but the differences among age groups younger than 1 year and aged 10 to 19 years at diagnosis were significantly worse than those in the group aged 1 to 9 years.
Site of origin: Primary sites with more favorable prognoses include the following:[7,8,47,48]
- Orbit and nonparameningeal head and neck.
- Paratestis, vulva, vagina, uterus (nonbladder, nonprostate genitourinary tract).
- Biliary tract.
Diameter of the tumor: Patients with
smaller tumors (≤5 cm) have improved survival compared with children with
larger tumors. Both tumor volume and maximum tumor diameter are associated with outcome.[Level of evidence: 3iiA]
A retrospective review of soft tissue sarcomas in children and adolescents suggests that the 5 cm cutoff used for adults with soft tissue sarcoma may not be ideal for smaller children, especially infants. The review identified an interaction between tumor diameter and body surface area (BSA). This was not confirmed by a Children's Oncology Group study of patients with intermediate-risk rhabdomyosarcoma. This relationship requires prospective study to determine the therapeutic implications of the observation.
- Metastases and regional lymph node involvement: Children with metastatic disease at diagnosis have the worst prognosis. The prognostic significance of metastatic disease is modified by tumor histology (embryonal is more favorable than alveolar), the site of metastatic disease, and the number of metastatic sites.[28,51,52] Patients with metastatic genitourinary (nonbladder, nonprostate) primary tumors have a more favorable outcome than do patients with metastatic disease from primary tumors at other sites.
- Resectability: The extent of disease after the primary surgical procedure (i.e., the Surgical-pathologic Group, formerly called the Clinical Group) is also correlated with outcome. In the IRS-III study, patients with localized, gross residual disease after initial surgery (Surgical-pathologic Group III) had a 5-year survival rate of approximately 70%, compared with a more than 90% 5-year survival rate for patients without residual tumor after surgery (Group I) and an approximately 80% 5-year survival rate for patients with microscopic residual tumor after surgery (Group II).[7,26] Regardless, outcome is primarily related to the use of multimodality therapy; all patients require chemotherapy and at least 85% also benefit from radiation therapy, with favorable outcome even for those patients with nonresectable disease. In IRS-IV, the Group III patients with unresectable disease who were treated with chemotherapy and radiation therapy had a 5-year FFS of about 75%.
Histopathologic subtype: The alveolar subtype is more prevalent among patients with less favorable
clinical features (e.g., younger than 1 year or older than 10 years,
extremity primary tumors, and metastatic disease at diagnosis), and is generally associated with
a worse outcome than in similar patients with embryonal rhabdomyosarcoma. In the IRS-I and IRS-II studies, the alveolar subtype was
associated with a less favorable outcome even in patients whose primary
tumor was completely resected (Group I). A statistically significant
difference in 5-year survival by histopathologic subtype (82% for embryonal rhabdomyosarcoma vs. 65% for alveolar rhabdomyosarcoma), was not noted
when 1,258 IRS-III and IRS-IV patients with rhabdomyosarcoma were analyzed. In the IRS-III study, outcome for patients with Group I alveolar subtype tumors was similar to that for other patients with
Group I tumors, but the alveolar patients received more
Patients with alveolar rhabdomyosarcoma who have regional lymph node involvement have significantly worse outcomes (5-year FFS, 43%) than patients who do not have regional lymph node involvement (5-year FFS, 73%).
Anaplasia has been observed in 13% of cases of rhabdomyosarcoma and its presence may adversely influence clinical outcome in patients with intermediate-risk embryonal rhabdomyosarcoma. However, anaplasia was not shown to be an independent prognostic variable in a multivariate analysis (P = .081).
- Biological characteristics: Refer to the Molecular Classification section of this summary for more information.
- Response to therapy: In a study of 94 patients with rhabdomyosarcoma who underwent preirradiation and postirradiation positron emission tomography (PET) imaging at a median of 55 days after the completion of radiation therapy, a negative postirradiation PET predicted improved local failure-free survival. This difference was most pronounced for patients who had a negative postirradiation PET and no evidence of residual disease on coregistered computed tomography.
Adult patients with rhabdomyosarcoma have a high incidence of pleomorphic histology (19%). Pleomorphic histology is extremely rare in children and young adults with rhabdomyosarcoma. Adults also have a higher incidence of tumors in unfavorable sites than do children.
Because treatment and prognosis depend, in part, on the histology and molecular genetics of the tumor, it is necessary that the tumor tissue be reviewed by pathologists and cytogeneticists/molecular geneticists with experience in the evaluation and diagnosis of tumors in children. Additionally, the diversity of primary sites, the distinctive surgical and radiation therapy treatments for each primary site, and the subsequent site-specific rehabilitation underscore the importance of treating children with rhabdomyosarcoma in medical centers with appropriate experience in all therapeutic modalities.
- Smith MA, Altekruse SF, Adamson PC, et al.: Declining childhood and adolescent cancer mortality. Cancer 120 (16): 2497-506, 2014. [PUBMED Abstract]
- Guidelines for the pediatric cancer center and role of such centers in diagnosis and treatment. American Academy of Pediatrics Section Statement Section on Hematology/Oncology. Pediatrics 99 (1): 139-41, 1997. [PUBMED Abstract]
- Gurney JG, Severson RK, Davis S, et al.: Incidence of cancer in children in the United States. Sex-, race-, and 1-year age-specific rates by histologic type. Cancer 75 (8): 2186-95, 1995. [PUBMED Abstract]
- Ries LA, Kosary CL, Hankey BF, et al., eds.: SEER Cancer Statistics Review, 1973-1996. Bethesda, Md: National Cancer Institute, 1999. Also available online. Last accessed October 29, 2014.
- Ognjanovic S, Linabery AM, Charbonneau B, et al.: Trends in childhood rhabdomyosarcoma incidence and survival in the United States, 1975-2005. Cancer 115 (18): 4218-26, 2009. [PUBMED Abstract]
- Malempati S, Rodeberg DA, Donaldson SS, et al.: Rhabdomyosarcoma in infants younger than 1 year: a report from the Children's Oncology Group. Cancer 117 (15): 3493-501, 2011. [PUBMED Abstract]
- Crist W, Gehan EA, Ragab AH, et al.: The Third Intergroup Rhabdomyosarcoma Study. J Clin Oncol 13 (3): 610-30, 1995. [PUBMED Abstract]
- Maurer HM, Gehan EA, Beltangady M, et al.: The Intergroup Rhabdomyosarcoma Study-II. Cancer 71 (5): 1904-22, 1993. [PUBMED Abstract]
- Casanova M, Meazza C, Favini F, et al.: Rhabdomyosarcoma of the extremities: a focus on tumors arising in the hand and foot. Pediatr Hematol Oncol 26 (5): 321-31, 2009 Jul-Aug. [PUBMED Abstract]
- Gurney JG, Young JL Jr, Roffers SD, et al.: Soft tissue sarcomas. In: Ries LA, Smith MA, Gurney JG, et al., eds.: Cancer incidence and survival among children and adolescents: United States SEER Program 1975-1995. Bethesda, Md: National Cancer Institute, SEER Program, 1999. NIH Pub.No. 99-4649., pp 111-123. Also available online. Last accessed October 29, 2014.
- Ognjanovic S, Carozza SE, Chow EJ, et al.: Birth characteristics and the risk of childhood rhabdomyosarcoma based on histological subtype. Br J Cancer 102 (1): 227-31, 2010. [PUBMED Abstract]
- Li FP, Fraumeni JF Jr: Rhabdomyosarcoma in children: epidemiologic study and identification of a familial cancer syndrome. J Natl Cancer Inst 43 (6): 1365-73, 1969. [PUBMED Abstract]
- Diller L, Sexsmith E, Gottlieb A, et al.: Germline p53 mutations are frequently detected in young children with rhabdomyosarcoma. J Clin Invest 95 (4): 1606-11, 1995. [PUBMED Abstract]
- Trahair T, Andrews L, Cohn RJ: Recognition of Li Fraumeni syndrome at diagnosis of a locally advanced extremity rhabdomyosarcoma. Pediatr Blood Cancer 48 (3): 345-8, 2007. [PUBMED Abstract]
- Dehner LP, Jarzembowski JA, Hill DA: Embryonal rhabdomyosarcoma of the uterine cervix: a report of 14 cases and a discussion of its unusual clinicopathological associations. Mod Pathol 25 (4): 602-14, 2012. [PUBMED Abstract]
- Doros L, Yang J, Dehner L, et al.: DICER1 mutations in embryonal rhabdomyosarcomas from children with and without familial PPB-tumor predisposition syndrome. Pediatr Blood Cancer 59 (3): 558-60, 2012. [PUBMED Abstract]
- Ferrari A, Bisogno G, Macaluso A, et al.: Soft-tissue sarcomas in children and adolescents with neurofibromatosis type 1. Cancer 109 (7): 1406-12, 2007. [PUBMED Abstract]
- Gripp KW, Lin AE, Stabley DL, et al.: HRAS mutation analysis in Costello syndrome: genotype and phenotype correlation. Am J Med Genet A 140 (1): 1-7, 2006. [PUBMED Abstract]
- Aoki Y, Niihori T, Kawame H, et al.: Germline mutations in HRAS proto-oncogene cause Costello syndrome. Nat Genet 37 (10): 1038-40, 2005. [PUBMED Abstract]
- Gripp KW: Tumor predisposition in Costello syndrome. Am J Med Genet C Semin Med Genet 137 (1): 72-7, 2005. [PUBMED Abstract]
- Kratz CP, Rapisuwon S, Reed H, et al.: Cancer in Noonan, Costello, cardiofaciocutaneous and LEOPARD syndromes. Am J Med Genet C Semin Med Genet 157 (2): 83-9, 2011. [PUBMED Abstract]
- Samuel DP, Tsokos M, DeBaun MR: Hemihypertrophy and a poorly differentiated embryonal rhabdomyosarcoma of the pelvis. Med Pediatr Oncol 32 (1): 38-43, 1999. [PUBMED Abstract]
- DeBaun MR, Tucker MA: Risk of cancer during the first four years of life in children from The Beckwith-Wiedemann Syndrome Registry. J Pediatr 132 (3 Pt 1): 398-400, 1998. [PUBMED Abstract]
- Moschovi M, Touliatou V, Vassiliki T, et al.: Rhabdomyosarcoma in a patient with Noonan syndrome phenotype and review of the literature. J Pediatr Hematol Oncol 29 (5): 341-4, 2007. [PUBMED Abstract]
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