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4 What are biologic medicines? 5 Strength training & women’s health 6 Breathing easier about CPAP treatment 7 Protect eyes from ultraviolet rays 8 Solutions for a better night’s sleep 9 Stategies to keep weight off 10 Arthritis linked to another condition 11 6 things to share with your doctor 12 Minimize dark circles under eyes 13 Personalized medicine 14 Exploring dental crowns 15 How to promote healthy kidneys 16 Benefits to quitting smoking 17 Reduce your risk for colorectal cancer 18 Signs of stress must be addressed 19 New treatments for joint pain 20 Reduce risk of sickness while traveling
The Health & Wellness Guide was created by the staff of The Progress-Index media company. Editorial content and photos provided by Metro Creative Graphics & Jacob Budny, DO and Vic Goradia, MD. This publication may not be reproduced, in full or part, without the express written consent of The Progress-Index. Copyright 2017 The Progress-Index, all rights reserved. www.progress-index.com. Phone (804) 732-3456, Fax (804) 861-9452 Opinions expressed in the publication are those of the authors and do not necessarily represent those of the management of the publication.
22 Safeguard your eyes against CVS 23 Pets & healthier kids www.progress-index.com 2
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What are biologic medicines? A
relatively recent wave of medications has provided significant advances in treating a wide range of illnesses, particularly those that are linked to autoimmune dysfunction or chronic ailments. Many people may be prescribed a biologic response modifier medicine at some point in their lives, and those who understand when and why such medications are prescribed may find such knowledge calms their nerves and reduces any confusion they might have about their conditions.
What are biologic response modifiers?
Biologics are derived from animal products. Firstgeneration biologic products included things like vaccines and blood components. However, a newer wave of biologic medicines has come to market over the last decade or so. These medications are manufactured through biotechnology and are complex proteins, sugars, nucleic acids, or a combination of these substances that are created from living cells. Cells may include yeast, bacteria or a widely used cell called CHO, which originated from hamsters in China. The U.S. Food & Drug Administration 4
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says biologics are often at the forefront of biomedical research and are continually evolving.
Why biologics are different
Unlike traditional medicines, which are largely made from chemical components that follow a strict recipe for manufacture, many biologics are complex mixtures that are not easily replicated. According to the resource Everyday Health, when biologics are made, a specific gene is isolated and inserted into the host cell’s DNA, where it will become permanent. The cell follows the instructions of the gene and how it was programmed and becomes a specifically functioning cell. This one reprogrammed cell is combined with others that have been made the same way. The entire process of biologic manufacturing is complex, requiring state-of-the-art knowledge. It also requires entirely new biotechnology facilities and laboratories that employ top-notch scientists. These factors combine to contribute to the generally high price tag of biologic medications.
How biologics work
According to WebMD, biologics are designed to inhibit specific components of the immune system that may cause a symptom of a disease. For example, in the treatment of rheumatoid arthritis, the medication would suppress inflammation, which is a central feature of the disease. Biologics target specific parts of the immune system rather than broadly treating the body. Diseases that may be treated by biologics include rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis/psoriatic arthritis, multiple sclerosis, and even certain cancers.
Side effects of biologic medicines
Because most biologics are administered intravenously, injection-site irritation can be a common side effect. Biologics also carry a risk of infection. According to the Cochrane Database of Systematic Reviews, because biologics target the immune system, there is a risk for serious infection or disease. Biologic medicines continue to evolve and can be used to treat a variety of medical conditions for which no other treatments are available or effective.
Strength training important to women’s health
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omen’s bodies are built different from men’s to accommodate the changes of pregnancy and childbirth. Although women may store fat differently and have less muscle mass than men, it’s still important that women include weight resistance training in their exercise routines.
Lifting weights is an important part of staying fit. Yet many women do not pick up weights out of fear of bulking up and gaining weight. In a 2011 opinion poll conducted by the U.S. Centers for Disease Control and Prevention, less than 20 percent of women said they accomplished the CDC’s recommended 2.5 hours of aerobic exercise and two periods of strength training each week.
Reduces risk of heart disease by lowering LDL cholesterol and increasing HDL cholesterol. Builds stronger muscles and connective tissues that can increase joint stability.
Improves the way the body processes sugar, which can help reduce the risk of diabetes.
Reduces rates of depression. A Harvard University study found that 10 weeks of strength training reduced clinical depression symptoms more successfully than standard counseling. Women who strength train commonly report feeling more confident and capable. Women with no strength training experience can consult with a personal trainer who can teach them proper strength training form. This ensures that the exercises are being done efficiently while reducing the women’s risk of injury. Qualified trainers also can keep people moving toward fitness goals.
Contrary to popular belief, women who weight train will not turn into the bulking behemoths of competitive weight lifting. The Women’s Heart Foundation says that high levels of estrogen make it quite difficult for women to become overly muscular. When they strength train, rather, women’s muscles will improve in tone, endurance and strength instead of size. Resistance training provides an efficient way to build strength and burn calories. A study from researchers at the University of New Mexico found that the body will take between 15 minutes and 48 hours after exercise to return to a resting state. That means that a person continues to burn calories after exercising, a phenomenon known as “after-burn” or “excess post-exercise oxygen consumption.” The more intense the workout, the longer the after-burn may last.
Studies performed at the Quincy, Mass., South Shore YMCA found that the average woman who strength trains two to three times a week for two months will gain nearly two pounds of muscle, but lose 3.5 pounds of fat. With that lean muscle addition, resting metabolism increases and more calories can be burned each day. The following are some additional benefits of strength training.
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Breathing easier about CPAP treatment Sleep apnea very often is treated successfully with the use of a continuous positive airway pressure machine, often referred to as a CPAP.
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eople who routinely toss, turn, snore, and wake up feeling less than refreshed in the morning may have more to worry about than simply not getting a good’s night sleep. They may be experiencing a relatively common yet largely undiagnosed condition that can contribute to long-term risk for various diseases. Sleep disorders have become a significant health issue. Sleep apnea, which affects an estimated 22 million people in the United States, can contribute to difficulty sleeping. Sleep apnea causes periods defined by an inability to breathe. The American Sleep Apnea Association says sleep apnea comes in three types: obstructive, wherein a blockage of the airway is usually caused by the collapse of the tongue or soft palate; central, when the brain fails to signal muscles to breathe; and complex, which is a combination of the two conditions. Over time, sleep apnea can be a risk factor for heart attack, stroke, diabetes, and other serious conditions, says the Cleveland Clinic. That is why symptoms
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that may begin as mildly agitating snoring sessions should be brought to a doctor’s attention. When sleep apnea is identified, one of the more successful treatments is widely referred to as “CPAP.” According to the National Heart, Lung and Blood Institute, CPAP, or continuous positive airway pressure, is a treatment that uses mild air pressure to keep breathing airways open. A CPAP machine includes a mask or other device that fits over the nose or nose and mouth. The mask is connected to a machine via a tube, through which humidified air is blown. In cases of obstructive sleep apnea, or OSA, CPAP can reverse the complete blockages or narrowing of upper airways. When used correctly, CPAP may be the only treatment necessary to address OSA. Sleep apnea is usually confirmed by an overnight sleep study known as a polysomnogram, or PSG, conducted in a lab or at home. According to the American Sleep Apnea Society, a PSG is often followed by with a CPAP titration study.
Individuals who will require CPAP can choose among masks and equipment that meet the prescription and maximize comfort levels. Many people become accustomed to using CPAP devices right away, while others may need a month or more to transition. Problems like uncomfortable masks or air leakage can be tweaked until users grow comfortable. CPAP needs to be employed under the guidance of a sleep specialist. The mask and tube should be cleaned daily and be replaced when necessary for the treatment to work effectively. More information about sleep apnea and CPAP is available at www.amsleep.org.
Protect eyes from ultraviolet rays the sun is comprised of UVA and UVB rays. UVA rays may hurt central vision by damaging the macula, or a part of the retina at the back of the eye. UVB rays typically affect the front part of the eye or the lens and cornea. The following are some common eye conditions that can be linked to exposure to UV rays.
Photokeratitis
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hanks to increased awareness about the perils of exposure to ultraviolet rays and skin damage, a greater number of people routinely apply sunscreen before spending time outdoors. But while people take steps to prevent sunburns, skin cancer and premature aging, they may fail to consider that UV rays also can damage their eyes. Just as people protect their skin from the sun, so, too, should they safeguard their eyes. Prevent Blindness America warns that
Excessive amounts of UV radiation over a short period of time can cause photokeratitis, which is equivalent to a sunburn of the eye. Photokeratitis may occur after spending long hours at the beach or skiing without proper eye protection. UVB rays cause photokeratitis, and these rays can burn the cornea, potentially causing pain and temporary vision loss.
Macular degeneration
According to the American Optometric Association, macular degeneration is a deterioration of the part of the retina that is responsible for sharp, central
vision. In addition to UV rays, chronic exposure to shorterwavelength visible blue and violet light can be harmful to the retina. The sun and many artificial light sources, such as LEDs and smartphones, emit blue light. Some blue light can be beneficial, but some can be harmful to the eyes. Lenses that absorb harmful blue light or block it can prevent retinal damage.
Pterygium
Pterygium is a growth that forms on the outer portion of the eye, or the cornea and conjunctiva. The World Health Organization says that prolonged UV exposure can contribute to this condition. Pterygium may extend over the cornea and reduce vision, requiring surgical removal.
Cataracts
UV exposure also can contribute to the formation of cataracts. Prevent Blindness America says a cataract is a clouding of the eye’s natural lens, the part of the
eye that focuses the light people see.
Sun protection
Sunglasses should completely cover the eyes, including the skin on the eyelids and under the eye, to provide adequate protection for the eyes. Wraparound frames will offer additional protection to those who spend a lot of time outdoors in bright sunlight. The AOA says sunglasses should also do the following. • Block out 99 to 100 percent of both UVA and UVB radiation.
• Screen out between 75 and 90 percent of visible light. • Have lenses that are perfectly matched in color and free of distortion and imperfection. • Have lenses that are gray for proper color recognition.
Consumers should speak with an eye doctor if they have additional questions about eye protection. Prescription lenses can be tinted and treated to offer UV protection.
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Simple solutions for a better night’s sleep Did you know? According to the National Sleep Foundation, using a computer or electronic device before bed can make it hard to fall asleep. Studies have shown that even small electronic devices like smartphones can emit enough light to confuse the brain. Photoreceptors in the retina sense light and dark, helping to align circadian rhythms to the external day-night cycle. The signals these receptors send to the brain help people be alert in the morning and fall asleep at night. But using devices such as smartphones, tablets or laptop computers before bed can miscue the brain and promote wakefulness at a time when the body should be falling asleep. Men and women who like to read before going to bed can increase their chances of getting a good night’s sleep by reading print books or print editions of magazines or newspapers rather than e-readers or tablets.
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he importance of a good night’s sleep is well-documented. Numerous studies have found that the effects of a good night’s sleep go beyond boosting energy levels and improving alertness. A better sex life, less chronic pain and an improved mood are just a handful of the documented benefits that a good night’s sleep can provide.
As important and beneficial as sleep is, many adults in the United States simply aren’t getting enough rest. A 2016 study from the U.S. Centers for Disease Control and Prevention found that more than onethird of American adults are not getting enough sleep on a regular basis. Those findings are based on guidelines from the American Academy of Sleep Medicine and the Sleep Research Society that recommend adults between the ages of 18 and 60 sleep at least seven hours each night. Getting a more restful night’s sleep requires concerted efforts on the part of adults who are falling short of seven hours each night. But the following are some 8
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simple ways for adults to start getting more rest.
Stick to a routine seven days a week. People tend to alter their sleep routines based on the day of the week, with many going to bed later at night and sleeping in later in the morning on weekends. But the National Sleep Foundation notes that going to bed at the same time each day, including weekends, helps people feel more sleepy at bedtime and fall asleep quickly.
Avoid alcohol in the hours before going to bed. Alcohol can make people feel sleepy, but that effect is short-lived. The sleepiness many people feel after consuming alcohol wears off quickly, and that can lead to interruptions in sleep.
Avoid stimulants in the late afternoon and at night. Alcohol is a depressant that can affect the quality of sleep a person gets. But stimulants can also make it hard to get a good night’s sleep. Nicotine acts as a stimulant in small doses, so smokers should stop smoking that last cigarette before bedtime if they’re not getting decent
or adequate sleep. Caffeinated beverages also should be avoided in the late afternoon and at night because caffeine stimulates the nervous system and can make it difficult to fall asleep, even if it’s been several hours since that last cup of coffee. Take short daytime naps. Some people find that daytime naps improve the quality of their nighttime sleep. That might be due to the link between naps and stress. A 2015 study published in the Journal of Clinical Endocrinology & Metabolism found that short naps can reduce stress. Reduced stress levels can make it easier to fall asleep at night. Limit naps to between 20 and 30 minutes, as naps that stretch on too long may interfere with nighttime sleep. Sufficient sleep can have a dramatic, positive impact on a person’s quality of life. Developing a good sleep routine and employing additional strategies can help sleep-deprived men and women get more restful nights’ sleep.
Strategies to keep weight off once it’s gone
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osing weight requires hard work and determination. Oftentimes, men and women hoping to lose weight must commit to healthier lifestyles than the ones they’ve grown accustomed to. That can be a big adjustment, and it’s important that men and women about to embark on their weight loss journeys recognize that keeping lost weight off can sometimes be as challenging as losing the weight. Some people are inspired to lose weight before their weddings, while others may want to shed some pounds before beach season. While there’s no wrong reason for people who are overweight or obese to lose weight, people who tie their weight loss efforts to something as temporary as beach season may overlook the long-term benefits of maintaining healthy weights, unknowingly increasing their risk of putting weight back on after reaching their short-term goals. According to the Harvard T.H. Chan School of Public Health, maintaining a healthy weight lowers a person’s risk of heart disease, stroke, diabetes, high blood pressure, and various cancers. Maintaining weight loss can be an uphill battle, but men and women can employ various strategies to ensure the weight they lose stays lost for years to come.
Continue your weigh-ins.
Weigh-ins may seem like the enemy as men and women make their initial efforts toward losing weight. However, weigh-ins gradually become something to look forward to as pounds start to drop off. Routinely weigh yourself even after reaching your weight loss goals, as the scale can be
Did you know?
just as motivational for people trying to maintain healthy weights as it is for people trying to lose weight.
Stick to your diet. When trying to lose weight, adults often combine diet and exercise. That’s a great weight loss strategy, and it’s also a great way to maintain a healthy weight. Recognize that weight won’t stay off if you exercise but don’t eat right. Rather, maintaining a healthy weight over the long haul requires both a healthy diet and regular exercise.
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eople who periodically experience difficulty sleeping may benefit from spending more time outdoors. According to researchers at the University of Colorado Boulder, sleeping outside can be beneficial to the sleep-wake cycle. That’s because spending time under the stars increases melatonin levels in the body. Melatonin is a hormone that controls wakefulness. Higher levels help the body relax and induce sleep. The researchers found that individuals who spent a weekend in the woods camping out at night fell asleep earlier and rose an hour and a half earlier in the morning. For those who don’t like to camp, increasing exposure to daylight and then avoiding sources of artificial light (i.e., televisions and cellphones) at night can help create a similar effect.
Eat slowly. While it might not
work for everyone, eating slowly has been linked to lower calorie consumption. A study from researchers at Texas Christian University found that participants who were instructed to take small bites, chew thoroughly and pause and put their spoons down between bites consumed, on average, 88 fewer calories per meal than participants who were told to take large bites, chew quickly and continue eating without putting their spoons down. Study participants who were overweight, however, ate just 58 fewer calories on average.
Document your efforts.
Whether it’s in a journal, on a blog or by emailing a loved one, documenting your efforts to maintain a healthy weight may provide the motivation you need to stay on course. Maintaining a healthy weight after substantial weight loss is a challenge that men and women can overcome by staying as vigilant in their efforts to keep weight off as they were while working to lose weight.
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Arthritis linked to another condition What is psoriatic arthritis?
Psoriasis is an autoimmune condition that affects the rate of skin cell reproduction. People with psoriasis may experience redness, itchiness and raised bumps (plaques) of skin on various areas of their bodies. Psoriatic arthritis is a chronic form of arthritis that typically occurs in people with skin psoriasis, but also can be present in those without the skin condition, but particularly among those who have relatives with psoriasis. The American College of Rheumatology says that psoriatic arthritis typically affects the large joints, especially the lower extremities, distal joints of the fingers and toes and the back and sacroiliac joints of the pelvis. Early recognition, diagnosis and treatment of psoriatic arthritis are crucial to relieving inflammation and preventing permanent joint damage.
Symptoms
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eople who see dermatologists for the skin condition psoriasis should not take the presence of joint aches and pains lightly, as the two things might be connected. The National Psoriasis Foundation notes that psoriasis is a precursor to psoriatic arthritis in 30 percent of patients.
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Symptoms of psoriatic arthritis can develop gradually or quickly, and some symptoms can be severe. NPF indicates that common symptoms of psoriatic arthritis include • morning stiffness and tiredness; • tenderness, pain and swelling over tendons; • swollen fingers and toes; • reduced range of motion;
• nail changes, including pitting, and • redness and pain in the eyes. Symptoms of psoriatic arthritis are similar to rheumatoid arthritis, gout and reactive arthritis. Doctors will rule out other symptoms that may be indicative of those conditions. The American College of Rheumatology also indicates that psoriatic arthritis is typically blood test negative. The diagnosis is typically made by a rheumatologist after reviewing a clinical history and performing a physical exam.
Treatment
Doctors will need to assess symptoms before deciding on a course of treatment. Mild cases may respond to over-the-counter, nonsteroidal anti-inflammatory drugs, such as ibuprofen. However, antirheumatic drugs and newer biologic drugs may be prescribed to treat more aggressive cases of psoriatic arthritis. Corticosteroid injections can be useful for swollen joints, and surgery may be necessary to repair badly damaged joints. Individuals who suspect their arthritis may be linked to psoriasis can first speak with a dermatologist or primary care physician. The NPF also offers a screening tool at www.psoriasis.org/psa-screening.
6 things to share with your doctor
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t is important to be honest with a doctor about certain health habits, but sometimes it isn’t so easy to be forthcoming. Fear of being judged or discussing embarrassing situations may prevent some patients from telling medical professionals the whole story. However, the things people do not share could end up compromising their treatment or prevent doctors from discovering certain ailments.
Rather than omitting information, people need to be frank with their doctors. Honesty is important when speaking with a physician, even when the discussion turns to the following potentially sensitive topics.
1. Smoking
Even if you aren’t a daily smoker, mention if you smoke in social situations or grab a drag once in a while. Smoking increases the risk for many illnesses and can compromise how effective some medications can be.
2. Alcohol consumption
Be honest about how much you drink, as alcohol can interfere with medications.
3. Supplement usage
Over-the-counter medicines, herbs and other supplements can affect overall health. A doctor needs to know the entire picture before prescribing treatment.
4. Exercise habits
Don’t claim to be a gym rat if you’re more of a couch potato. An accurate idea of their patients’ fitness levels and
habits is a key diagnostic tool for physicians.
5. Unusual issues
Be forthright with any issues, even those that occur in embarrassing areas of the body. Remember, if you’re uncomfortable with your doctor, you can always get a referral for a specialist who treats those areas of the body daily.
6. Drug use
Prescriptions are written in dosages for the intended recipient. Taking drugs that are not prescribed to you, whether it’s a loved one’s prescription or an illicit drug, affects your body. If you have a medical issue, consult with your doctor so you can get your own legal prescription or begin working toward addressing your addiction. Health & Wellness 2017
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Minimize dark circles under the eyes
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acoon eyes may be a side effect of forgetting to remove mascara and other eye makeup before retiring for bed. In such instances, dark eye circles are easily remedied with cleaning pads. For those whose dark circles can’t be swept away with soap and water, dark, puffy eyes can be a cause for embarrassment or concern. Dark circles under the eyes may be a byproduct of various circumstances. Getting to the root of the problem can help women (and men) look more awake and fresh.
Accept genetics
swell and inflame. Getting tested for seasonal allergies can help people identify some possible triggers. Alleviating allergy symptoms can reduce the appearance of dark circles in some cases.
Reduce swelling
Undereye bags can cause shadows to form and increase the appearance of dark circles. To remedy this, try to reduce fluid pooling in the face. Sleep elevated on a few pillows so that fluid flows away from the eyes. Reduce consumption of alcohol and salty foods, which can exacerbate fluid retention. Cool compresses can be used to massage fluid gently away from the eyes as well.
Apply sunscreen
Dark circles may result from pigmentation changes that occur after exposure to the sun or some other type of UV light. Individuals who apply sunscreen on their faces, including around their eyes, may be able to reduce or prevent pigment changes.
Genetics may be the biggest culprit in undereye circles. Some people simply inherit fair or thin skin around the eyes. This can make blood that pools in these areas (from stretched or broken capillaries) more visible. While a person cannot change his or her skin tone, gently washing one’s face — paying careful attention to the sensitive eye area — can help reduce damage. Also, getting more sleep can increase circulation to this area and prevent blood pooling.
Rely on concealer
Treat allergies and sinus issues
Undereye circles and swelling can be alleviated when people get to the source of the problem. A combination of treating the sources and masking the issue can help. In severe cases, individuals should visit their dermatologists.
According to Allergy & Asthma Care of New York, allergies and other sinus issues can cause puffiness and dark eye circles. Histamines, which are released when an allergen is present, can cause blood vessels to
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Makeup can help counter the look of dark shadows and pigmentation around the eyes. Use a shade that is opposite the color of the circles to camouflage them. For example, use orange-yellow tones to combat blue-purple shading under the eyes. Makeup artists also advise applying concealer in the shape of a triangle. That way a person is creating a light arrow that draws attention to the bright part of her eyes.
Personalized medicine may be the future of healthcare
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hen a person feels ill, his or her doctor may assess any symptoms and then prescribe a particular medication to treat or alleviate those symptoms. Doctors prescribe medications hoping to treat sickness, but sometimes prescriptions fall short, leaving some to wonder if prescription medications could be customized more for individual needs? The science is already here. Making specialized drugs is not a new concept. Prior to the rise of drug manufacturing companies, early pharmacists routinely customized ingredients. According to Professional Compounding Centers of America, customized medications are created through a process known as pharmacy compounding, which is defined as the art and science of
preparing personalized medications for patients. Specialized pharmacists take a practitioner’s prescription and mix individual ingredients together in the exact dosage and strength required. Compounding may be done to change the form of the medication from a pill to a liquid or to remove a certain additive or ingredient, such as gluten, that might cause an allergic reaction. The American Pharmacists Association says that compounding also can be used to flavor a medication in an effort to make it more palatable. Compounded drugs can be just as safe as mass-produced prescriptions. And thanks to their tailor-made formulas, compounded medications also may help people avoid side effects and other adverse reactions. Compounding gives physicians flexibility in regard to how to best help their patients. Compounding is done in hospital pharmacies and other healthcare facilities. There also are thousands of community-based pharmacies in the United States that specialize in compounding services. Pharmacists in these facilities spend all of their time making special preparations. All pharmacists and pharmacies engaged in compounding are subject to oversight by both federal and state authorities. On November 27, 2013, Congress amended the Federal Food, Drug, and Cosmetic Act by enacting the Drug Quality and Security Act to ensure that compounded drugs are produced in accordance with applicable federal requirements. The National Association of Pharmacy Regulatory Authorities helps to oversee compounding in Canada. Preparations of products are subject to the Food and Drug Act and Regulations, Good Manufacturing Practice guidelines, and inspection by Health Canada. Pharmaceutical compounding may not be new, but it is increasingly relied on to create the best formulations for individual patients.
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Exploring dental crowns
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any people visit their dentists and learn they have a tooth that requires a crown. In many instances, dental crowns are necessary for proper tooth care. Crowns were once widely referred to as “caps.” A crown is a permanent cover for a tooth that would otherwise require a very large filling after dental decay has been removed. Crowns also may be used to repair cracked or broken teeth so that extraction is not necessary. Sometimes crowns are used for cosmetic modifications or to hold a dental bridge in place. The crown itself can be made from different materials, like stainless steel, gold or metallic alloy, porcelain, porcelain fused to metal, and resin. A dentist will determine which material will work best depending on the application and tooth location.
Understanding your appointment(s)
Crowns are typically installed in two appointments. The first appointment requires prep work so the tooth can hold the crown. This is typically a painless procedure, and one in which the dentist will anesthetize the tooth and gum tissue and then file down the tooth along the chewing surface and sides to make room for the crown covering. If the tooth was decayed or insubstantial, the dentist may have to “build up” the tooth instead of filing it down. Again, these determinations are made by the dentist who has the expertise to gauge how much workable tooth is left. Once the tooth has been prepared, an impression will be made of the bite area. That’s because the permanent crown will be fabricated in a laboratory and the fit/color will need to be exact for comfort — and also to ensure that bacteria and food debris do not get caught between the crown and tooth. The final component is a temporary cap that will keep the prepared tooth clean. This is molded in the office and will be worn only until the custom-made crown is ready. When the permanent crown is delivered, the patient will return to the office to have it checked for fit and then cemented into place.
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Full and partial crowns
A partial crown may be used if only a portion of the tooth needs to be covered. Dentists will often rely on full crowns to get maximum coverage and strength.
Cost factor
Crowns can be expensive. According to the resource CostHelper, crowns can range from $500 to $3,000 depending on the material used and the patient’s insurance coverage. Dental insurance may cover a predetermined percentage of the cost when the crown is medically necessary, but insurance may not cover anything if the procedure is only cosmetic. It’s always a good idea for patients to express their concerns and ask questions about crowns prior to starting the procedure. Understanding the potential out-of-pocket costs is essential as well. Dental crowns can last several years and represent the best way to salvage a tooth that is cracked or damaged.
How to promote healthy kidneys
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idney disease is a widespread issue made all the more disconcerting by the fact that many people are unaware they have it. According to the National Kidney Foundation, 26 million American adults have kidney disease, and most don’t know it. And the problem of kidney disease is not exclusive to the United States, as the Canadian Kidney Foundation notes that the number of Canadians being treated for kidney failure has tripled over the last quarter century. Healthy kidneys are something many people take for granted. But those who want to do everything they can to keep their kidneys healthy can consider the following tips, courtesy of the Cleveland Clinic. Stay hydrated, but avoid overhydration. Many people are familiar with the benefits of drinking water each day, and adequate hydration definitely promotes healthy kidneys. But overhydrating has not been proven to enhance kidney function. The Cleveland Clinic recommends adults drink between four and six glasses of water per day. Exercise. Regular exercise benefits various parts of the human body, including the kidneys. High blood pressure and diabetes are two of the biggest risk factors for kidney disease, and regular exercise can reduce a person’s risk of both conditions. However, overexertion can strain the kidneys, so adults who exercise,
Staying hydrated while avoiding overhydration is one way for men and women to protect their kidneys. especially novices who need to improve their conditioning, should avoid going too hard at the gym.
Speak with a physician before taking vitamin supplements or herbal remedies. Vitamin supplements and herbal remedies have become very popular in the 21st century, but excessive supplementation can harm the kidneys. Discuss any supplements or herbals remedies with a physician before taking them.
Quit smoking. Just as exercise benefits the body in myriad
ways, smoking harms the body in myriad ways. Smoking decreases the blood flow in the kidneys, decreasing their ability to function at optimal capacity. Smoking also increases a person’s risk of high blood pressure and cancer of the kidneys. Eat healthy. A healthy diet decreases a person’s risk for high blood pressure and diabetes. Adhering to a healthy diet and controlling portion sizes can help control weight and blood pressure and contribute to healthy kidneys as well.
Get screened. Adults who have been diagnosed with high
blood pressure or diabetes should make sure their physicians screen for kidney dysfunction during routine appointments. Learn more about kidney disease at www.kidney.org.
Did you know? Outdoor exercise can benefit both the planet and the people doing the exercising. By exercising outdoors instead of at home or at indoor fitness centers, men and women can reduce their carbon footprints. Exercising in the great outdoors does not require the use of energy-consuming fitness machines. In addition, when exercising outdoors during daylight hours, nature provides all the light men and women will need for their workouts, further reducing the average person’s energy consumption. And it’s not just adults who can benefit from spending more time outdoors. According to the Harvard Medical School, children are likely to get more exercise if they spend time outdoors than they are if they spend time indoors. A study from researchers in England used GPS devices and accelerometers to track the activity of 1,000 children. The children were more than twice as active when they were outside than they were when they were in inside. When children spend ample time outdoors, that, too, can benefit the environment. According to the National Institutes of Health, the average youngster spends three hours per day watching television and gets as much as seven hours of screen time each day. When kids are outdoors, they are less likely to be staring at energy-consuming screens and devices than they are when they’re indoors. Health & Wellness 2017
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The benefits to quitting smoking According to the American Lung Association, smokers’ heart rates drop to normal levels within 20 minutes of quitting smoking.
Heart Association, after 12 hours of smoke-free living, the carbon monoxide levels in smokers’ blood return to normal.
Smoking has been linked to a number of negative side effects, including raising smokers’ risk of cancer and cardiovascular disease. Quitting smoking can greatly reduce the likelihood of both of those outcomes, but the additional benefits of kicking tobacco to the curb may surprise smokers.
According to the American Lung Association, smokers’ heart rates drop to normal levels within 20 minutes of quitting smoking. While not all side effects of quitting smoking are so immediate, many are just as impactful. The health benefits of quitting smoking are seemingly endless. The Office of the U.S. Surgeon General says quitting smoking is the single most important step smokers can take to improve the length and quality of their lives. The health benefits of quitting smoking are too numerous to list them all, but the following are some of the ways that quitting can improve smokers’ overall health. Quitting benefits blood pressure. Smokers’ blood pressure levels can return to normal levels within two hours of quitting. Smokers may also notice their fingers and toes starting to feel warm shortly after they quit. That sensation occurs because quitting smoking also improves circulation.
Quitting decreases levels of carbon monoxide in the body. When smoked, lit cigarettes release carbon monoxide, which compromises smokers’ ability to absorb oxygen into the bloodstream. That makes it difficult for red blood cells to carry oxygen. Body tissue that does not receive an adequate supply of oxygen can cease to function. But according to the American 16
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Quitting reduces risk of stroke. Stroke is another of the myriad of cardiovascular diseases that has a connection to smoking. According to the U.S. Centers for Disease Control and Prevention, stroke occurs when the blood supply to the brain is blocked or when blood vessels in the brain burst and cause brain tissue to die. Smoking increases the buildup of plaque in blood vessels, which can block blood from getting to the brain. Smoking also causes blood vessels to thicken and narrow, again compromising the body’s ability to get blood to the brain. Within five to 15 years of quitting smoking, smokers’ risk of having a stroke is the same as that of nonsmokers. Quitting can make it easier to exercise. Many smokers experience shortness of breath, which can make it difficult to commit to the kind of exercise that promotes short- and long-term health. Smoking damages the cilia, which are tiny structures that push mucus out of the lungs. Cilia damaged by smoking begin to repair within one month of quitting smoking, resulting in fewer coughing fits and instances of shortness of breath. Smokers interested in quitting can visit www.smokefree.gov for more information and support.
Behaviors that may help you reduce your risk for colorectal cancer
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olorectal cancer is a formidable foe. According to the U.S. Centers for Disease Control and Prevention, colorectal cancer is the second leading cancer killer in the United States. Colorectal cancer is similarly lethal in Canada, where the Canadian Cancer Society reports it is the second leading cause of cancer death in men and the third leading among women. Some risks for colorectal cancer are beyond an individual’s control. For example, the CCS notes that a personal or family history of polyps in the colon, rectum or both significantly increases a person’s
risk of developing colorectal cancer. Lynch syndrome, a condition caused by gene mutations, causes polyps to develop in the lining of the colon, rectum or both. Since Lynch syndrome is inherited, there is nothing men and women can do to reduce their risk of developing it. Research into colorectal cancer is ongoing, making it difficult for doctors to say certain behaviors or approaches are certain to reduce a person’s risk of developing the disease. But there are certain things individuals can do that might help save them from falling victim to colorectal cancer. Get screened. The CDC notes that colorectal cancer usually begins when polyps form in the colon or rectum. If they go undetected, these polyps may turn into cancer. Screening can detect polyps early so they are found before they develop into cancer. The U.S. Preventive Services Task Force recommends colorectal cancer screening using high-sensitivity fecal occult blood testing, or FOBT; sigmoidoscopy; or colonoscopy for men and women between the ages of 50 and 75. Embrace physical activity. While men and women who are physically active can still get colorectal cancer, the CCS notes that people who live sedentary lifestyles are at a higher risk of developing the disease than those who are active. Maintain a healthy weight. According to the CCS, people who are overweight or obese have greater incidence rates of colorectal cancer than those who maintain healthy weights. The CCS also notes that men with a high body mass index, or BMI, seem to be most at risk of developing colorectal cancer. Limit alcohol consumption. The CDC notes that some studies have shown that limiting alcohol consumption may reduce a person’s risk of developing colorectal cancer. Colorectal cancer is a devastating disease, but men and women who embrace healthy behaviors may be able to lower their risks.
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Signs of stress that must be addressed
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he American Institute of Stress notes that various disorders, both emotional and physical, have been linked to stress. Such disorders include depression, stroke, hypertension, and anxiety, among others. In its 2015 Stress in AmericaTM survey, the American Psychological Association found that money, stress and family responsibilities are the three most common stressors. While the symptoms of stress are uncomfortable and potentially very dangerous, the APA notes that such indicators also serve as a warning from the body that it needs maintenance and extra care. The following are some of the ways the body might be telling adults to step back and make an effort to relieve stress.
Headaches, muscle tension, neck or back pain: Some headaches or aches
and pains might be mere nuisances or indicative of issues unrelated to stress. But when such symptoms are accompanied by stress, this could be the body’s way of alerting men and women that the stress is approaching unhealthy levels. The AIS notes that when a person is under 18
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Chest pains and/or rapid heartbeat:
The AIS also notes that a weakened immune system also makes the body more susceptible to additional viral disorders, including herpes, and autoimmune diseases such as rheumatoid arthritis and multiple sclerosis.
Difficulty falling or staying asleep:
Stress can affect the gastrointestinal system in various ways, including influencing appetite. While not all problems with appetite are indicative of a body that is overstressed, stress can prompt some people to eat much more than they normally do, while others may eat considerably less than they normally would.
stress, his or her muscles tense up. The contraction of these muscles for extended periods of time can trigger tension headaches and migraines, among other things. Chest pains and rapid heartbeat may indicate various problems, including stress. This happens when the body is stressed because stress causes the nervous system to signal the adrenal glands to release hormones that make the heart beat faster and increase blood pressure.
Men and women who are feeling stressed out and also experiencing difficulty falling asleep or staying asleep should consult their physicians about ways to alleviate that stress. When strategies to alleviate stress are successful, adults should be able to return to normal, healthy sleeping patterns.
Increased frequency of colds: Stress
can attack the body’s immune system, making it increasingly vulnerable to colds.
Loss of appetite or overeating:
Diarrhea or constipation: Another
indicator that stress is compromising the gastrointestinal system is diarrhea or constipation. Again, while these problems are not exclusive to sufferers of stress, when a person is under stress, this can affect which nutrients the body can successfully absorb and how quickly food is metabolized. This can cause some people to experience diarrhea, while others may be constipated.
New treatments for joint pain Jacob Budny, DO and Vic Goradia, MD Orthopedic Surgeons | G2 Orthopedics and Sports Medicine
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rthopedics, the study and treatment of muscle, bone, ligament and tendon issues, is an exciting and everchanging field. Not all bone and joint problems require surgery and they can often be treated by other means. Whether you have an orthopedic issue that does or does not require surgery, an orthopedic surgeon is whom you should see. It is up to the surgeon to determine if your clinical problem would be better with surgery, physical therapy, or any number of other techniques. Just like your cell phone, the medical field is changing constantly and new techniques are being tried and studied to make your outcomes even better. Here are some of the most recent developments in orthopedic surgery:
Minimally invasive joint replacement surgery
There is a good chance that you or someone you know has undergone a joint replacement surgery, often of the hip, knee, or shoulder. These are some of the most successful surgeries ever performed, yet surgeons continue to strive to make them better. One of the ways to improve joint replacement surgery is to minimize its impact on the body. Therefore, there are now ways to perform the surgeries that protect the surrounding muscles and soft-tissues. One of these minimally invasive surgeries is Direct Anterior total hip replacement. This is a hip replacement through smaller incisions, less muscle damage, and less surgical time. Done properly, this can significantly improve your pain control, maximize your early recovery, and increase your overall satisfaction with your surgery. In many cases this surgery can be performed on an outpatient basis or just one night in the hospital.
New techniques in Sports Medicine
Sports medicine is a specialty of orthopaedics which focuses on athletic type injuries, though you don’t have to have been running a marathon to need a sports medicine specialist. For some, it is going about your normal daily activities that can cause a sportsstyle related injury. If you sustain this type of an injury, there are many techniques to evaluate and treat your condition. Advances in sports medicine surgery include better and more sophisticated techniques to repair ligaments, such as your anterior cruciate ligament (ACL) or the rotator cuff muscles of the shoulder. Over the past 30 years the standard treatment for a torn ACL is to replace or reconstruct the ACL with a tendon that is taken from another part of your knee or from a cadaver. In 2017 some surgeons can repair and preserve your own torn ACL with a procedure known as Bridge Enhanced ACL Repair (B.E.A.R.). About 30% of ACL tears may be repairable using the B.E.A.R. technique.
Currently more than 90% of rotator cuff tears can be repaired with a small camera through very small incisions known as arthroscopic surgery. Even in cases that in the past have been considered irreparable, can now be repaired arthroscopically with a patch. This procedure may be an excellent alternative to a reverse total shoulder replacement.
Multi-disciplinary musculoskeletal care
Surgeons are not the only providers that can help you get back in motion. Essential parts of your recovery are the rehabilitation before and after surgery, usually with physical therapists. There are, however, many other types of medical providers who offer treatments for your injuries. It is common for a surgeon to refer to athletic trainers, chiropractors, acupuncturists, nutritionists and a host of other specialists. The new philosophy of medicine is to treat you better through the knowledge and experience of these highly trained individuals.
Stem cell and other biological treatments
An emerging technology is the use of the body’s natural healing potential. Research has centered on healing factors from platelet rich plasma (PRP), bone marrow stem cells and regenerative cells from fat tissue. PRP is obtained from blood that is drawn from the patient and concentrated into a liquid that is rich in platelets which contains many healing and growth factors. Bone marrow can be obtained from any bone in the body; however, the back of the “hip” (i.e. posterior iliac spine) contains the highest concentration. A short procedure in the office with local anesthetic is performed to obtain the bone marrow. A special device is then used to isolate the stem cells from the marrow. These cells can then be injected into areas of injury, overuse or arthritis. Similarly, fat cells can be obtained with a small procedure similar to liposuction. These cells contain a variety of growth factors and regenerative cells that can be injected into the body. This technology improves every day, as does our knowledge of how these factors work within bones and joints. This is still cutting edge technology and it is a worthwhile discussion to have with your doctor if you are curious about the latest techniques and outcomes.
Robotic and computer-aided surgery
Just as computers are changing many aspects of our daily lives, they are also being used in surgery. Some current orthopedic applications include partial and total knee replacements as well as hip replacements. The KneeAlign system uses a small handheld computer about the size of a smartphone. When patients have knee arthritis the knee can become knock-kneed or bow-legged. The KneeAlign allows the surgeon to prepare the bone so the final result is a straight knee. The MakoRobot is another new technology now available in Richmond for partial and total knee replacement. Data from a CT scan of the knee is entered into the robot so the surgeon can plan the bone preparation prior to surgery. The surgeon programs the robot so it can assist during the operation. By using these technologies, surgeons are able to more consistently and safely perform some surgeries. In the hands of an experienced surgeon, these tools may help patients recover faster and more reliably, and with greater satisfaction. Health & Wellness 2017
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Easy ways to reduce your risk of getting sick while traveling
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ravel and tourism is big business. According to research from the World Travel & Tourism Council in conjunction with Oxford Economics, the travel and tourism industry outpaced the global economy for the sixth consecutive year in 2016. With so many people traveling for business or pleasure, it can be easy for illness to spread. Travelers concerned about their vulnerability to colds or other ailments may be unable to avoid cramped airline cabins or crowded restaurants, but there are ways for both business travelers and vacationers to reduce their risk of getting sick while on the road. Stay hydrated. People may remember to drink water when sitting at their desks in the office or lounging around at home, but travelers who are busy seeing the sights or attending seminars may forget to stay hydrated throughout the day. That can increase one’s susceptibility to illness, as fluids carry nutrients to the cells and flush bacteria from the bladder. Older travelers should be especially vigilant about staying hydrated while traveling, as the Harvard Medical School notes that older men and women do not sense thirst as much as they did when they were younger. Continue exercising. Even vacationers whose primary goal when traveling is to relax and unwind may want to squeeze
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in a little physical activity during their travels. The U.S. National Library of Medicine notes that physical activity can flush bacteria out of the lungs and airways, potentially reducing one’s chances of getting a cold, the flu or another illness. In addition, exercise causes changes in antibodies and white blood cells that could help the immune systems of physically active people detect illnesses earlier than the immune systems of sedentary men and women.
Purchase hand sanitizer. One of the easiest ways to get sick while traveling is to come into contact with germs. Travelers tend to be out and about instead of locked inside hotel rooms, so their exposure to germs is likely greater while traveling than it is at home. Airport security agents may discard hand sanitizer at security checkpoints, so it may be unwise for travelers to bring sanitizer with them on their trips. Instead, travelers can purchase some at their destinations, carrying it with them and routinely applying it to combat germs.
Did you know?
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umerous studies have found that vacationing produces a host of health benefits. The ongoing Framingham Heart Study, which began in 1948 and is currently studying its third generation of participants, found that men who did not take a vacation for several years were 30 percent more likely to have heart attacks than men who took time off. In addition, the FHS found women who take a vacation only once every six years or less were nearly eight times as likely to develop coronary heart disease or have a heart attack as women who vacation at least twice per year. Vacations also have been linked to lower stress levels, as a study from the American Psychological Association concluded that vacations reduce stress by removing people from activities and environments that are the sources of their stress. Vacations can even benefit employers, as an internal study from the professional services firm Ernst & Young found that employees’ year-end performance ratings improved by 8 percent for each additional 10 hours of vacation time they took.
Get sufficient sleep. Traveling alters routines, and some travelers may find themselves getting inadequate sleep on the road. Studies have indicated that sleep helps sustain a fully functioning immune system, and that chronic sleep loss, which may be a greater concern for business travelers than vacationers, can impair the immune system. When traveling, men and women should make a concerted effort to get adequate sleep each night. Traveling can be a jolt to the body and make it more vulnerable to illness. But no matter how often a person travels, he or she can take steps to protect their bodies getting sick while on the road.
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Safeguard your eyes against computer vision syndrome
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echnology has simplified life in a myriad of ways. Thanks to their tablets and smartphones, many people now have a wealth of information at their disposal 24 hours a day, seven days week. Computers, tablets and smartphones can now be seen just about everywhere, so it’s no wonder that studies have shown that as much as 90 percent of computer users have reported symptoms of computer vision syndrome, or CVS. Sometimes referred to as “digital eye strain,” CVS is, according to the American Optometric Association, an umbrella term used to describe a group of eye and vision-related problems that result from prolonged computer use. Manhattan Vision Associates notes that such problems can arise in people who spend two or more hours daily in front of a screen, a qualifier that means just about anyone, from working professionals to children, is susceptible to CVS.
What are the symptoms of CVS?
No two individuals are the same, and some people who spend significant amounts of time may never develop CVS. But those that do may experience the following symptoms. 22
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Eyestrain: When people spend ample time staring at screens, the muscles of their inner eyes can strain and tighten and cause eye irritation. This can result in fatigue and pain. Blurred vision: Blurred vision can compromise a person’s ability to see small details. That loss of sharpness can make it hard to focus on a screen for a significant amount of time. In addition, vision can blur as people go back and forth between their keyboards and screens or multiple screens, as many people do while simultaneously working on a computer and using their smartphones. Headaches: Many people develop headaches after staring at screens for prolonged periods of time. That’s because the brightness and contrast of a screen can produce an indirect glare that’s especially hard on the eyes. Dry eyes: People do not blink as often when staring at screens as they do when they are not looking at screens. As a result, people are vulnerable to dry eyes when staring at screens, as blinking is one of the ways the eyes replenish moisture.
Can CVS be prevented?
While some people may be inclined to
accept CVS as a side effect of living in the 21st century, there are ways to prevent CVS.
Take frequent breaks. The AOA recommend that people alleviate digital eye strain by following the 20-20-20 rule. This rule advises taking 20 second breaks to stare at something 20 feet away every 20 minutes. Reposition your computer screen. The AOA notes that the optimal location for computer screens is between 15 and 20 degrees below eye level, or about four to five inches, as measured from the center of the screen. In addition, position the screen so it is between 20 and 28 inches from your eyes. Avoid glare. Computer screens also should be positioned to avoid glare from lighting and windows. Draw blinds or drapes if sun is shining in on the screen, and opt for low wattage light bulbs in desk lamps.
Blink more. Make a concerted effort to blink more throughout the day so your eyes remain as moist as possible. The average time people spend staring at screens continues to rise, making CVS a legitimate concern for adults and children alike. Learn more about CVS and how to prevent it at www.aoa.org.
Want healthier kids? Get a pet who have early contact with cats and dogs have fewer respiratory infections and ear infections and need shorter courses of antibiotics than children who have not had contact with pets. A study from Dennis Ownby, MD, a pediatrician and head of the allergy and immunology department of the Medical College of Georgia, found that having multiple pets decreases a child’s risk of developing certain allergies. He found that the children who were exposed to two or more dogs or cats as babies were less than half as likely to develop common allergies as kids who had no pets in the home. Pets also may foster social interactions, which can benefit children who are shy. Inviting others over to meet pets can help children make friends and find others with similar interests. Children may also confide in pets and develop their self-esteem.
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f youngsters have been eyeing fuzzy kittens or boisterous puppies at nearby shelters or pet stores, parents may want to give in to those cries for a family pet. Pets are added responsibilities, but the health benefits associated with pet ownership may be well worth the investment of time and effort.
Studies have indicated that the type of pet a family has, whether it’s horses, dogs, snakes, etc., does not matter, as all companion animals have the potential to benefit children.
Caring for a pet is sometimes viewed as a childhood rite of passage, but there’s much more to the experience than just learning responsibility. Experts say a child’s emotional, cognitive, physical, and social development can be enhanced through interaction with a family pet. Studies continue, but the effects of family pets on children was heavily researched by developmental psychologist Gail F. Melson in 2003. Melson looked at literature on child-animal relationships and found that children who had pets were better able to understand biology and children who could turn to pets for unconditional emotional support were less anxious and withdrawn than their peers without family pets to turn to.
Pets can contribute to cognitive, physical and emotional wellness in children.
Data from a small study conducted by researchers at the Cummings School of Veterinary Medicine at Tufts University reported that adolescents who had animal experience were more likely to see themselves as important contributors to communities and more likely to take on leadership roles.
Pets also can help children develop into well-rounded individuals. Playing with a pet requires children to engage in physical activity and can help stimulate motor skills. An English study conducted in 2010 and published in the American Journal of Public Health found that children from dog-owning families spent more time in light or moderate to vigorous physical activity and recorded higher levels of activity counts per minute than kids whose families did not own a dog.
Pets may help with allergies and respiratory ailments as well. A 2012 study by the American Academy of Pediatrics discovered that children
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