Decemberrowan2015

Celebrating 16 Years

Keeping the holidays from weighing you down Unwrapping stress for the holidays Holidays can be slippery and dangerous

December 2015

New Year, new resolution, new you Each January, roughly one in three Americans resolve to better themselves in some way. A much smaller percentage of people actually make good on those resolutions. While about 75 percent of people stick to their goals for at least a week, less than half (46 percent) are still on target six months later, a 2002 study found.

It's hard to keep up the enthusiasm months after you've swept up the confetti, but it's not impossible. This year, pick one of the following worthy resolutions, and stick with it. Here’s to your health!

GO BACK TO SCHOOL No matter how old you are, heading back to the classroom can help revamp your career, introduce you to new friends, and even boost your brainpower.

A 2007 study found that middle-age adults who had gone back to school (including night school) sometime in the previous quarter century had stronger memories and verbal skills than those who did not. What’s more, several studies have linked higher educational attainment to a decreased risk of Alzheimer’s disease.

"You are gaining a sense of accomplishment by gaining new knowledge, and you are out there meeting people and creating possibilities that were never there before," Kanaris says

LOSE WEIGHT The fact that this is perennially among the most popular resolutions suggests just how difficult it is to commit to. But you can succeed if you don’t expect overnight success. "You want results yesterday, and desperation mode kicks in," says Pam Peeke, MD, author of Body for Life for Women. "Beware of the valley of quickie cures."

Also, plan for bumps in the road. Use a food journal to keep track of what you eat and have a support system in place. "Around week four to six...people become excuse mills," Dr. Peeke says. "That’s why it’s important to have someone there on a regular basis to get you through those rough times."

STAY IN TOUCH Feel like old friends (or family) have fallen by the wayside? It’s good for your health to reconnect with them. Research suggests people with strong social ties live longer than those who don’t.

In fact, a lack of social bonds can damage your health as much as alcohol abuse and smoking, and even more than obesity and lack of exercise, a 2010 study in the journal PLoS Medicine suggests.

In a technology-fixated era, it’s never been easier to stay in touch—or rejuvenate your relationship—with friends and family, so fire up Facebook and follow up with in-person visits.

QUIT SMOKING Fear that you’ve failed too many times to try again? Talk to any ex-smoker, and you’ll see that multiple attempts are often the path to success.

Try different methods to find out what works.

And think of the cash you’ll save! (We know you know the ginormous health benefit.)

"It’s one of the harder habits to quit," says Merle Myerson, MD, director of the Cardiovascular Disease Prevention Program at St. Luke’s and Roosevelt Hospitals, in New York City. "But I always tell people to think of how much money they will save."

CUT BACK ON ALCOHOL

SAVE MONEY Save money by making healthy lifestyle changes. Walk or ride your bike to work, or explore carpooling. (That means more money in your pocket and less air pollution.)

Cut back on gym membership costs by exercising at home. Many fitness programs on videogame systems like Nintendo’s Wii Fit Plus and Microsoft’s Xbox Kinect Your Shape Fitness Evolved can get you sweating.

Take stock of what you have in the fridge and make a grocery list. Aimless supermarket shopping can lead to poor choices for your diet and wallet.

"Someone who makes this sort of resolution is likely to obtain a tremendous personal benefit in the happiness department."

Peter Kanaris, PhD, New York State Psychological Association on volunteering

CUT YOUR STRESS

VOLUNTEER

A little pressure now and again won’t kill us; in fact, short bouts of stress give us an energy boost. But if stress is chronic, it can increase your risk of—or worsen—insomnia, depression, obesity, heart disease, and more.

Long work hours, little sleep, no exercise, poor diet, and not spending time with family and friends can contribute to stress, says Roberta Lee, MD, an integrative medicine specialist at Beth Israel Medical Center, in New York City, and the author of The Super Stress Solution.

"Stress is an inevitable part of life," she says.

"Relaxation, sleep, socializing, and taking vacations are all things we tell ourselves we deserve but don’t allow ourselves to have."

We tend to think our own bliss relies on bettering ourselves, but our happiness also increases when we help others, says Peter Kanaris, PhD, coordinator for the New York State Psychological Association.

And guess what? Happiness is good for your health. A 2010 study found that people with positive emotions were about 20 percent less likely than their gloomier peers to have a heart attack or develop heart disease. Other research suggests that positive emotions can make people more resilient and resourceful.

"Someone who makes this sort of resolution is likely to obtain a tremendous personal benefit in the happiness department," Kanaris says.

While much has been written about the health benefits of a small amount of alcohol, too much tippling is still the bigger problem.

(In fact, binge drinking seems to be on the rise.)

Drinking alcohol in excess affects the brain’s neurotransmitters and can increase the risk of depression, memory loss, or even seizures.

Chronic heavy drinking boosts your risk of liver and heart disease, hypertension, stroke, and mental deterioration, and even cancers of the mouth, throat, liver, and breast.

GET MORE SLEEP You probably already know that a good night’s rest can do wonders for your mood—and appearance. But sleep is more beneficial to your health than you might realize.

A lack of sleep has been linked to a greater risk of obesity and type 2 diabetes. And sleep is crucial for strengthening memories (a process called consolidation).

So take a nap—and don’t feel guilty about it.

TRAVEL The joys and rewards of vacations can last long after the suitcase is put away. "We can often get stuck in a rut, and we can’t get out of our own way," Kanaris says. "Everything becomes familiar and too routine."

But traveling allows us to tap into life as an adventure, and we can make changes in our lives without having to do anything too bold or dramatic.

"It makes you feel rejuvenated and replenished," he adds. "It gets you out of your typical scenery, and the effects are revitalizing.

It’s another form of new discovery and learning, and great for the body and the soul."

Source: Alyssa Sparacino, Health.com

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Keeping the holidays from weighing you down

By January, you might be congratulating yourself on surviving more than a month of Thanksgiving feasts, Christmas soirées and New Year’s bashes. What may not be so thrilling is what those festive celebrations leave behind. Evidence of too many servings of stuffing sits around your midsection and regret over the number of martinis you consumed weighs on your mind.

Studies suggest the average American believes they gain between five and 10 pounds during the holiday season.

“It is very easy to gain weight during this festive time.

One bite here, one bite there and slowly you start seeing it in your clothes. You’ve gained weight!” said Dr. Adarsh Gupta. A Rowan Family Medicine physician, Dr. Gupta is also the director of the Center for Medical Weight Loss and Metabolic Control at the Rowan University School of Osteopathic Medicine.

“It is very easy to gain weight during this festive time. One bite here, one bite there and slowly you start seeing it in your clothes. You’ve gained weight!” said Dr. Adarsh Gupta.”

In reality, the actual amount of weight typical people gain is between only one and two pounds, according to Gupta.

“Holiday weight gain is fat gain [from] indulging in desserts, calorie rich drinks and fat-rich foods,” Rowan University Nutrition Program Coordinator Qian Jia said.

“Meanwhile, most people decrease their physical activities and enjoy leisure time.”

The problem is that most people don’t usually lose those one or two pounds gained. Over time, small increments of weight gain from the holidays can accumulate, leading to dangerous health complications, including obesity, diabetes and stroke.

To survive the holiday season without experiencing weight gain and the potential side effects that accompany it, there are several simple measures to take.

Portion Control One of the simplest ways to avoid gaining weight during any time of the year is to monitor portions, according to Gupta. “You can still eat the foods you

enjoy, but in moderation. If your favorite food on the holiday table is the cheese-smothered potato and greenbean casserole, a small serving is appropriate.”

Keep snacking at a minimum until you are actually sitting down to a meal, where you can properly account for the portions you are eating. Additionally, the feeling of dehydration can be confused with hunger. As a rule of thumb, if feeling hungry, have a glass of water first.

Be aware of ingredients Gupta advises avoiding foods that are fried, heavily buttered, or drenched in sauce, as the amount of fat in those dishes “packs on the pounds faster.” Instead, fill up on low-calorie foods, like raw vegetables and fruits.

Keep an eye out for healthier alternatives to holiday classics; rather than eating traditional mashed potatoes that are laden with salt, butter and gravy, opt for a baked potato.

Pay attention to liquid calories Mixed drinks, sugary eggnog and hot chocolate are often the highlight of the party, but they are also one of the easiest ways to mindlessly consume calories.

Alcoholic or not, a single cup of eggnog contains 223 calories, 20 grams of carbohydrates and 20 grams of sugar.

Carrying a glass of water in your hands as you mingle at a party makes you less likely to pick up another drink. As far as quantity, one or two drinks fall into the category of enjoyment without over-indulging.

Dr. Adarsh Gupta is a family physician and the director of the Center for Medical Weight Loss and Metabolic Control at the Rowan University School of Osteopathic Medicine with offices in Mount Laurel, Sewell and Stratford. To schedule an appointment with him, please call 856-566-7020.

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Unwrapping stress for the holidays The holiday season is often thought of as a time to be with loved ones, give to others and celebrate tradition. Yet today’s amount of shopping, decorating, cooking and party planning can create enough stress to affect your winter health. Dr. Meagan Vermeulen, a Rowan Family Medicine physician and an assistant professor at the Rowan University School of Osteopathic Medicine, offered ways to curb the pressure of the holiday season.

There’s no such thing as perfect One contributor to holiday stress is the ever-demanding standards encouraged by the media. Advertising during the season often displays picturesque, yet unrealistic depictions of the holidays.

The need to keep up is reinforced by the imageconscious nature of social media, according to Vermeulen. “It’s the idea of the virtual picture we present of ourselves, our family and our home to those we are friends with online.”

Those celebrating the holidays should keep in mind that everyone is flawed, and there is no social police judging every detail of your seasonal routine, Vermeulen said.

“One contributor to holiday stress is the ever-demanding standards encouraged by the media. Advertising during the season often displays picturesque, yet unrealistic depictions of the holidays.”

Presents, Decorations, Self Care?

Before tackling the huge list of holiday tasks, take care of everyday needs first. An appropriate amount of rest is an important factor in keeping up that festive energy. Everyone should strive for a seven- to eighthour stretch of sleep, and when you can’t, be mindful of extra pick-me-ups.

“Remember, that extra caffeine you’re consuming to ‘keep you going’ may wind up leaving you staring at the ceiling at midnight when you’re now overtired,” Vermeulen said.

Time management also plays a crucial role for the anxious holiday partaker. When there is a long

to-do list lingering ahead, be sure to plan accordingly. That way time is made for holiday tasks and personal needs.

“People can do this by setting realistic goals for themselves, whether it be with their health, personal habits, or at-home (or even work) projects,” Vermeulen said.

Be mindful, be active Holiday weight is often another source of stress during the long winter months. If you regularly exercise, it’s important to keep on the same schedule and not let the holidays draw you into complacency. Exercise makes your body release endorphins as well, which are known mood boosters.

There are a number of ways to avoid weight-related stress even if you’re not one to hit the gym every morning. Simple actions such as mindfully parking farther from the mall to increase walking distance, or taking stairs as opposed to escalators can have a big impact, Vermeulen said. But, managing how you eat is one of the most important things you can do.

“Be mindful of your food choices; holiday parties are like mine fields of culinary ‘delights,’” Vermeulen said. “Fill up a little on water, healthy snacks (like veggies and fruit) before you hit a party, then stick to snacking on a smaller plate to help keep your portions under control.”

Ultimately, Vermeulen said that the number one rule is simply to remember that you’re human.

“My first rule is to allow yourself to be human,” Vermeulen said. “Accept that there are going to be some days, including holidays, when you are going to do a fabulous job at work, [be] an OK spouse/child/partner, and [not be] parent of the year. It’s all right.”

Dr. Meagan Vermeulen is a Rowan Medicine family physician and a member of the faculty at the Rowan University School of Osteopathic Medicine. To schedule an appointment in her Washington Township office, please call 856-218-0300.

Rowan Medicine MedicaLink is an Advertorial Supplement published by Rowan University School of Osteopathic Medicine (RowanSOM). RowanSOM staff: Mary Louise Bianco-Smith (editor), Julia Swope, Gerald Carey, Lynne Yarnell, Lucy McGorry, Bernardine Jones. Please send inquiries via email to: sominfo@rowan.edu or RowanSOM Marketing Department, Suite 1600, 42 East Laurel Road, Stratford, NJ 08084, 856-566-6191.

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Wa lk i n g p rob l e m s followi n g a st roke?

The MILESTONESM Study is looking at the safety and effectiveness of a potential new medication for the treatment of walking problems in people who have had a stroke.

You may be able to take part if you: • are 18 years of age or older • have had an ischemic stroke • have walking problems as a result of the ischemic stroke The study will last about 5 months and will involve approximately 10 visits to a study center.

All study-related visits, assessments, and study medication will be provided at no cost to you. In addition, compensation for time and travel may be provided.

To learn more about the MILESTONESM Study, please contact the Office of Clinical Trials Management

Care for the entire family As your primary care office, we will manage and coordinate all of your medical care, including: • • • • • • • • •

Adult and Pediatric Medicine Medical Weight Management Osteopathic Manipulative Medicine (OMM) Routine preventive care Acute care Annual wellness physicals Chronic disease management Specialist referrals Onsite LabCorp

Most insurances accepted

Stratford 856-566-7020

Mount Laurel 856-566-7020

Hammonton 609-704-0185

Sewell 856-218-0300

856-566-2305

Minimizing your fall risk Falls are a leading cause of accidental injury and death for all persons over the age of 65.

Our Falls Assessment and Prevention Program looks at your individual case to develop strategies to prevent future occurrences.

By focusing on the cause and reducing risk factors, many falls can be prevented.

New Jersey Institute for Successful Aging (NJISA) 42 East Laurel Road, Suite 1800 Stratford, NJ 08084 • 856-566-6843

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Holidays can be slippery and dangerous The holiday season is here and that means it’s time activities, such as skiing, snowboarding and ice to prepare for those sneaky patches of snow, black skating all contribute to these injuries. ice, reckless drivers and other seasonal hazards.

Not all of the injuries related to falls are caused by From Thanksgiving through New Year’s Day, slippery surfaces. Government statistics indicate that people face an increased risk for roughly 5,800 holiday-related injuries. In fact, “According to a study published people end up according to a study published by in emergency

by Forbes magazine, of the top six rooms each Forbes magazine, of the top six most dangerous holidays, half – Thanksgiving most dangerous holidays, half – year because Day, Christmas and New Year’s Day – of injuries Thanksgiving Day, Christmas and suffered occur during the holiday season.

Dr. James Bailey, a specialist New Year’s Day – occur during the through falls in physical medicine and associated holiday season.” rehabilitation at Rowan Medicine’s with holiday NeuroMusculoskeletal Institute in decorations.

Stratford, explained there are many common types of More than half of these are falls from ladders or injury that occur during the winter. roofs. In addition, the U.S. Consumer Product Safety “A lot of times it’s snow shoveling, which results in Commission estimates that roughly half of the 4,000 acute back pain,” Bailey said. “People also slip and fall trips to the emergency room related to electrical on the ice, resulting in back injuries. When people extension cords are the result of individuals tripping fall, they sometimes hit their head on the pavement, over the cords. causing a concussion.”

National fire protection associations also warn of In 2012, the U.S. Centers for Disease Control the heightened risk of fire during the winter season. and Prevention reported that more than 13 million By far, cooking and heating equipment are the two Americans sought treatment for fall-related injuries. leading sources of home fires throughout the year, Along with icy sidewalks, wintertime recreational with about one-third of all home fires occurring

during the three-month period of December through February.

The holiday season contributes to that spike in home fires. Between 2004 and 2008, nearly 1,200 home fires began from holiday decorations other than Christmas trees. Candles accounted for 45 percent of those fires, with Christmas Eve, Christmas and New Year’s Day being the top three days of the year for candle fires.

During the holiday season, Dr. Bailey advises following these tips to keep your family safe and injury-free: • Never leave lit stoves, fireplaces or candles unattended • Keep candles away from furniture and curtains and out of the reach of children and pets • Use step stools and ladders when hanging holiday decorations • Always lift with your legs and not your back • When shoveling snow, avoid twisting or throwing motions. Instead, turn, carry and drop the snow

The Rowan Medicine articles in this edition of MedicaLink were conceived and written by the following students from Rowan University’s Health Reporting class: Christopher Adams, Samantha Berenberg, Ulysses Escobar-Alvarez, Chelsey Fairfield, Geneva Gerwitz, David Green, Kevin Howard, Alexandra Jordan, Steven Polis, Stephen Smyrl, Kyle Sullender, Caitlin Ware and Donald Wittkowski

Rowan Medicine MedicaLink According to Dr. Bailey, an acute onset of low-back pain should begin to feel better within a few days. A short course of rest, along with over-the-counter medication such as acetaminophen or ibuprofen with food, will help you manage any pain. You may also get relief by sitting upright with a small pillow or rolled up towel supporting your lower back and by applying ice for 10 to 20 minutes at a time over the first couple of days to reduce any swelling or inflammation.

Consult with your physician if back pain continues beyond two days, if pain or numbness radiates from the lower back into the legs or if pain worsens when standing or walking.

Dr. James Bailey specializes in Physical Medicine and Rehabilitation at Rowan Medicine’s NeuroMusculoskeletal Institute and is an assistant professor at the Rowan University School of Osteopathic Medicine in Stratford. To schedule an appointment, please call 856-566-7010.

COMMUNITY OMM CLINIC Come for a FREE Osteopathic Manipulative Medicine Treatment provided by supervised medical students.

NeuroMusculoskeletal Institute (NMI) 42 East Laurel Road Suite 1700 Stratford, NJ 08084 Contact us to schedule an appointment: OMMclinic@rowan.edu 856-258-0905 Powered by: DISCLAIMER: There is no obligation to use any doctor affiliated with Rowan University School of Osteopathic Medicine or any other OMM doctor after being treated at the OMM Clinic. The OMM clinic is not an alternative to long-term management of an issue. The Clinic can deny treatment to any patient for any reason.

NeuroMusculoskeletal Institute Call for an appointment 856-566-7010

Our specialists not only treat your pain, but work to optimize your quality of life. Our services target diseases of the neuromuscular system, including acute or chronic pain, multiple sclerosis, muscular dystrophy, traumatic brain injury, gait dysfunction, headaches/migraines, balance disorders, post-stroke syndrome, spinal cord injury, neck and back pain and nerve injuries.

42 East Laurel Road Suite 1700 Stratford, NJ 08084 rowanmedicine.com

Careful out there!

Snow shoveling can be a pain Regarded by many as one of the least popular wintertime activities, shoveling snow can also be hazardous and is associated with many serious and even fatal events among both adults and children. Each year, snow shoveling leads to approximately 100 deaths and 11,500 injuries and medical emergencies that require treatment in an emergency department, according to Nationwide Children's Hospital's most recent study.

Most injuries occur from either overexertion while shoveling or slipping and falling on ice.

The most common injuries are bumps, bruises, cuts and broken bones. The lower back, head, arms and hands are injured most often.

People 55 years of age and older are more likely to be hurt due to a fall or to have heart-related symptoms, including chest pain and cardiac arrest.

Among patients who receive emergency treatment for a snow shoveling-related

problem, men 55 years of age and older are twice as likely as women of the same age to get snow shoveling-related heart symptoms.

Injuries occur when children use a shovel the wrong way or use them during play instead of for shoveling snow.

Among patients who receive emergency treatment for a snow shoveling-related problem, children under 18 years of age are 15 times more likely than adults to be hurt from being hit with a snow shovel.

PREVENTING INJURIES • Talk to your doctor before shoveling snow.

Not everyone is physically fit enough to shovel • If you have a pre-existing medical condition, or if you do not exercise regularly, ask someone to shovel for you • Consider using salts, deicing sprays, heated sidewalk mats, and snow blowers instead of shoveling • If shoveling is the only option, then use an ergonomically-designed snow shovel • Make sure to do warm-up exercises before you start • Take plenty of rest breaks • If you experience chest pain or shortness of breath, get help immediately • Driveways and sidewalks may be icy and slippery, so wear slip-resistant footwear • Push the snow instead of lifting it up • Avoid large shoveling jobs by shoveling smaller amounts several times throughout the day • Wear warm clothing, including a hat and gloves • Teach children the correct way to shovel and provide appropriate supervision • Remind children that snow shovels are not toys Source: Nationwide Children’s.org

Risk Factors for Back Pain

• Growing older; Back pain often starts when a person is in their 30s or 40s • Getting infrequent physical activity • Being overweight or obese • Having a family history of back pain • Having a chronic illness, such as arthritis or cancer • Having a job that involves a lot of lifting or twisting of the spine • Having poor posture • Being a smoker Source: The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases

Fun winter activities

with the grandchildren

Outdoor fun needn’t fade when the temperatures dip below freezing. Staying active is something you can do with your grandchildren all year round. While snow-related activities, such as alpine skiing, can get pricey, there are plenty of options on your home turf that won’t break the bank. The key is to think outside the sandbox, and transfer the fun and games to frosty terrain.

Dress the Part

Playing outside isn’t fun if noses and

fingers are numb and frozen. The first rule is to dress for the weather. “There’s no such thing as bad weather, only inappropriate clothing,” said Mike Logsdon, executive director of the Adventuresports Institute of

Garrett College in McHenry, Md. “Our goal is to keep children engaged, which won’t happen if they’re cold.”

For suiting up, David Gallahue, former dean of Indiana University’s School of Health, Physical Education and Recreation, recommends a first and second layer of moisture-wicking polypropylene, followed by a third layer of fleece and a waterproof outer layer. And be sure everybody stays hydrated, preferably with warm fluids, all the better for maintaining body heat.

Give It a Name — Make It a Game Sports aside, there are plenty of

activities that can transform a winter wonderland into an outdoor playground.

Gallahue’s approach to capturing a child’s imagination is simple: give it a name — make it a game.

“A stroll through a winter landscape becomes an adventure when you're hunting for animal tracks or identifying winter birds,” he said. "Give your activity a name and a purpose to make it exciting.” If you have a stream on your property, go on a “creek hike” to find fossils or geodes. Look for the biggest trees, compare bark and measure how many arms it takes to wrap around the trunks. Older children can use a map, compass or GPS to find

landmarks along the way. One New York City grandma who lacks nature’s gifts in her urban neighborhood takes a walk with her granddaughter and does what she calls “snow writing.” She and her granddaughter use their gloved fingers to write happy winter greetings in the snow accumulated on parked cars.

It’s important to keep moving in the cold, which means that team games, like kickball, might need adapting to prevent kids from standing around. “Change up the rules to engage all the players,” said Gallahue.

Hot Winter Sports

Once snow is in the picture, the playing

field gets even more exciting. Building snowmen, having snowball fights, making angels, building snow sculptures, seeing who can build and climb up the biggest snow pile becomes a good-natured competition.

But even when sleds and equipment are involved, a child as young as three or four can get moving. Snowshoeing in a snow-blanketed backyard is a great activity for all skill levels, because if you can walk, you can snowshoe. Cross-country takes a little more practice, but both offer a terrific aerobic workout. Frequent breaks, including a stop for hot chocolate, add to the fun.

When a grandchild is learning a new activity, it’s important to offer both guidance and supervision. “I’ve found that muscles learn fast but decision-making

develops,” said Logsdon. “I wouldn’t just assume that a young person has the mental capability to weigh all factors. They may be extremely equipment-savvy, but it takes experience to build judgment.”

Not all kids are at the same fitness level, so make it a practice to encourage every step of the way. “Encouragement isn’t just praise. Say something positive, incorporating an instructional comment, and end on another positive note,” said Gallahue.

Spending time outdoors has a positive affect on a child’s physical well-being, and adds to his emotional growth and development. “We find that young people become better environmental stewards when they’re outdoors a lot,” said Logsdon.

“They see for themselves that resources are limited, and they learn to respect the environment on a more meaningful level.”

Start Young

Starting young is the best way to get

children used to outdoor activities. Just remember to consider your grandchild’s physical abilities before embarking.

Ages 4 and older • Outdoor exploring and hiking • Snowshoeing • Ice skating • Downhill skiing (the bunny slopes) • Cross-country skiing

Ages 5 and older • Ice hockey • Snowboarding

Ages 8 and older • Ice climbing (kids have to be experienced in rock climbing before they try ice climbing) Source: American Grandparents Association

Planned cesareans tied to slight increase in asthma risk for kids

By STEVEN REINBERG HealthDay

Children born by planned cesarean delivery appear to have a slightly higher chance of developing asthma than those born through vaginal delivery, researchers report.

The difference in risk was small, with 3.73 percent of those born through planned C-section hospitalized by age five for asthma, compared to 3.41 percent of kids who were born through vaginal delivery.

And those who had a cesarean delivery had a 10.3 percent risk of needing an asthma inhaler at age five, compared to 9.6 percent for those born vaginally, the researchers found.

"C-section may play a part in explaining global increases in asthma, but overall this study provides some reassurance that

children delivered by planned C-section are not at substantially higher risk of childhood illness," said lead researcher Dr. Mairead Black. Black is a clinical lecturer and research fellow in obstetrics at the University of Aberdeen, in Scotland.

"This is an observational study, so we cannot definitively say that the planned C-section is the cause of the small increase in risk of asthma," she said.

"The absolute difference in risk to children delivered by planned C-section was very low. So, while C-section may play a part in explaining global increases in asthma, it is unlikely to be important enough to influence individual delivery decisions," Black said.

The report was published Dec. 1 in the Journal of the American Medical Association.

For the study, Black and her colleagues collected data on more than 321,000 firstborns in Scotland between 1993 and 2007, and followed them until February 2015.

The investigators found that, compared with children born by emergency cesarean delivery, those born by planned cesarean delivery were not at a significantly increased risk for asthma requiring hospitalization, asthma inhaler prescription at age five, obesity at age five, inflammatory bowel disease, cancer or death. But they were at increased risk of type 1 diabetes, the findings showed.

Dr. Mitchell Maiman, chairman of the department of obstetrics and gynecology at Staten Island University Hospital in New York City, said, "C-section can be a disadvantage for babies."

The process of going through the birth canal may be a benefit to the infant's immune system, he suggested. "There's something about going through the birth canal — the most difficult trip the child will have in its entire life — that has a competitive advantage," Maiman said.

Maiman said having a C-section, unless it is medically necessary, is not recommended.

For mothers, a C-section can increase the risks of bleeding, dying and having problems delivering the placenta. "A C-section is much less safe than a vaginal delivery," he added.

Another study in the same journal looked at C-section rates around the world, and found higher cesarean rates correlated with lower death rates among infants and new mothers. The rates of cesarean delivery vary widely from country to country, from as low as two percent to more than 50 percent, the researchers found.

"There's something about going through the birth canal — the most difficult trip the child will have in its entire life — that has a competitive advantage."

Dr. Mitchell Maiman, Staten Island University Hospital

"In countries that provide very low rates of C-sections, there are very high rates of maternal and neonatal deaths," said lead researcher Dr. Thomas Weiser, an assistant professor of surgery at Stanford University School of Medicine, in Stanford, Calif.

As the number of C-sections increases, the rates of maternal and neonatal deaths decrease, he said. But when the rate of C-sections reaches about 19 per 100 births, there are no further reductions in deaths, Weiser stated.

"Countries that are trying to improve outcomes are going to have to consider C-section as part of comprehensive maternal care," he said. "Countries that have very low rates of C-sections are going to have to improve that in the context of overall health care."

But, "on that flip side, countries that have high rates of C-sections may have rates that are excessive," Weiser said.

MORE INFORMATION Visit the U.S. Office on Women's Health for more about C-sections and labor and delivery at www.womenshealth.gov

Sneeze 'cloud'

quickly covers a room

J

ust in time for cold and flu season, a new study finds the average human sneeze expels a high-velocity cloud that can contaminate a room in minutes.

Researchers at the Massachusetts Institute of Technology (MIT) came to that conclusion by analyzing videos of two healthy people sneezing about 50 times over several days.

It’s well known that sneezes can spread infectious diseases such as measles or the flu, because viruses suspended in sneeze droplets can be inhaled by others or deposited on surfaces and later picked up as people touch them.

But it wasn’t clear how far sneeze droplets can spread, or why some people are more likely to spread illness through sneezes than others.

In a prior study, the team led by MIT’s Lydia Bourouiba found that within a few minutes sneeze droplets can cover an area the size of a room and reach ventilation ducts at ceiling height.

In their latest new study, they discovered how sneeze droplets are formed within what they called a “high-propulsion sneeze cloud.” The findings are slated for presentation this month at the annual meeting of the American Physical Society in Mobile, Ala. “Droplets are not all already formed and neatly distributed in size at the exit of the mouth, as previously assumed in the literature,” Bourouiba said in a society news release.

Rather, sneeze droplets “undergo a complex cascading breakup that continues after they leave the lungs, pass over the lips

A STUDY SAYS, SNEEZE DROPLETS CAN COVER AN AREA THE SIZE OF A ROOM AND REACH VENTILATION DUCTS AT CEILING HEIGHT.

and churn through the air,” said Bourouiba, who is head of MIT’s Fluid Dynamics of Disease Transmission Laboratory.

Learning more about the dynamics of sneezing could lead to new ways to prevent the spread of diseases, especially during epidemics or pandemics, she said.

Source: HealthDay

Mind your manners when coughing and sneezing The following measures to contain respiratory secretions are recommended for all individuals with signs and symptoms of a respiratory infection.

• Cover your mouth and nose with a tissue when coughing or sneezing • Use in the nearest waste receptacle to dispose of the tissue after use • Perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) after having contact with respiratory secretions and other contaminated objects/materials Source: Centers for Disease Control and Prevention

MORE INFORMATION The U.S. Centers for Disease Control and Prevention has more about sneezing and coughing at www.cdc.gov.

Rowan Medicine MedicaLink

The best choice for your maternity and gynecological care Ob/Gyn and Midwifery Clinical Services • • • • •

• PMS care Annual preventive examinations • Diagnosis and treatment of STDs Pap smears • Colposcopy Breast exams • Consultations for gynecologic surgeries Personalized health and wellness education such as hysterectomy, sterilization, Contraceptive education and management hysteroscopy, laparoscopy and more

Most insurances accepted

Mullica Hill 856-256-5800

Sewell 856-589-1414

Stratford 856-566-7090

Kennedy Health is the principal hospital of the Rowan University School of Osteopathic Medicine. Other affiliated hospitals and health systems include Lourdes Health System, Inspira Health Network, Cooper University Hospital, Meridian Health System, Christ Hospital and Atlantic Health System.