Can’t Stop Munching But Want To Make The Weight? These Weight Loss Snacks Have Got You Covered

Snacks are becoming an essential aspect of diet, and everyone often has a snack or two daily. Some people use snacks to cover for their lack of time to get a proper breakfast, while others use snacks to keep the mouth busy and the stomach satisfied. When it comes to snacks, getting it wrong could be harmful to your health. The rate at which snacks are consumed daily could impair your health if not eaten properly. Whether you do it while watching a movie or to satisfy your guilty pleasure, the quick snacks you grab from time to time could go a long way in affecting the state of your health.

Eating healthy is essential for a healthy life. Hence, we have come up with a list of healthy snacks that you can enjoy to maintain a healthy lifestyle.

Hard-Boiled Eggs

Eggs are for everyone, and they can be eaten at any time of the day. Eggs possess an abundance of branched-chain amino acids, providing a lot of muscle-building bang for your buck. Boiled eggs can be quick snacks anytime, either at home, school, or work.

Yogurt

The traditional mucky yogurt typically has even more protein than its western counterpart and a creamy texture that makes it feel more like dessert than a healthy snack. Greek yogurt is made by pouring yogurt on a paper cloth to strain away the liquid, so deliciously thick Greek-style yogurts can contain twice as much protein as regular versions, supplying up to 23 grams of protein per cup. It also contains a significant number of gut-friendly bacteria and bone-building calcium.

Chocolate

Chocolate is number one on the all-time guilty pleasure list. Everyone loves chocolate for its melting abilities and delicious taste. Chocolate makes people happy because it contains hormones that brighten mood. Dark chocolate is stuffed with at least 60 percent cocoa and has been linked to a reduced risk of heart disease.

Tomato Juice

Aside from its great taste, tomato juice contains less than half the sugar found in orange juice. Lower-sodium options help reduce the risk of water retention. Tomato juice is very natural and is 100 percent vegetable juice and not a blend made with sugary fruit juices and sweeteners. In a study published in Nutrition Journal, athletes who sipped antioxidant-rich tomato juice had less post-exercise inflammation than those who didn’t, which could speed up recovery.

Baked Chips

Fried potato chips usually contain a high amount of oil, which increases the LDL cholesterol level and is quite harmful to the heart. Fried potato chips can be replaced with baked chips. Baked chips contain much less fat and provide the body with protein, and they are easy to integrate into the daily diet.

Strawberries

Among all types of berries available, strawberries are commonly agreed to be the most delicious and supply the least amount of sugar, making them a great option for satisfying a yearning for a snack. Strawberries are a stellar source of vitamin C, which strengthens the immune system, helps the eyes, and makes the skin glow beautifully.

Milk

Milk remains a basic and primary source of protein for the body. Milk contains minerals that make the bones and teeth stronger and it also provides the body with disease-fighting antibodies. Milk will help you absorb the fat-soluble nutrients like vitamin D present in it.

Protein Bars

If you’ve been searching for a healthy and convenient snack that is both nutritious and delicious, then protein bars is the answer.  Protein bars provide the body with the proper amount of nutrients, and they can conveniently fit into yur daily plans.

Meat

From burgers to ribs to chicken wings, meat is consumed as snacks by lots of people. Meat is very high in protein, and lean meat that contains less fat can be a very healthy snack for your body.

Oatmeal

Grains are not just for breakfast – they can be eaten anytime. Oats are a good source of filling fiber, and adding almond butter offers mono- and poly-unsaturated fats that are satiating and heart-healthy.

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Leisure physical activity is linked with health benefits but work activity is not

work

The first large study showing that leisure time physical activity and occupational physical activity have opposite, and independent, associations with cardiovascular disease risk and longevity is published today in European Heart Journal.

“We adjusted for multiple factors in our analysis, indicating that the relationships were not explained by lifestyle, health conditions or socioeconomic status,” said study author Professor Andreas Holtermann of the National Research Center for the Working Environment, Copenhagen, Denmark.

The World Health Organization (WHO) recommends physical activity during both recreation and work to improve health. Previous studies have suggested that occupational activity is related to an increased risk for heart disease and mortality but have been too small to fully explain whether this was due to the manual work or because employees had unhealthy lifestyles or low socioeconomic status (e.g. low level of education).

This study included 104,046 women and men aged 20-100 years from the Copenhagen General Population Study with baseline measurements in 2003-2014. Participants completed questionnaires about activity during leisure and employment and were categorized as low, moderate, high, or very high activity for each.

During a median follow-up of 10 years, there were 9,846 (9.5%) deaths from all causes and 7,913 (7.6%) major adverse cardiovascular events (MACE, defined as fatal and nonfatal myocardial infarction, fatal and non-fatal stroke, and other coronary death).

Compared to low leisure time physical activity, after adjustment for age, sex, lifestyle, health, and education, moderate, high, and very high activity were associated with 26%, 41%, and 40% reduced risks of death, respectively. In contrast, compared to low work activity, high and very high activity were associated with 13% and 27% increased risks of death, respectively.

Similarly, after adjustments, compared to low leisure activity, moderate, high, and very high levels of leisure activity were associated with 14%, 23%, and 15% reduced risks of MACE, respectively. Compared to low work activity, high and very high levels were associated with 15% and 35% increased risks of MACE, respectively.

Professor Holtermann said: “Many people with manual jobs believe they get fit and healthy by their physical activity at work and therefore can relax when they get home. Unfortunately, our results suggest that this is not the case. And while these workers could benefit from leisure physical activity, after walking 10,000 steps while cleaning or standing seven hours in a production line, people tend to feel tired so that’s a barrier.”

While the study did not investigate the reasons for the opposite associations for occupational and leisure time physical activity, Professor Holtermann said: “A brisk 30-minute walk will benefit your health by raising your heart rate and improving your cardiorespiratory fitness, while work activity often does not sufficiently increase heart rate to improve fitness. In addition, work involving lifting for several hours a day increases blood pressure for many hours, which is linked with heart disease risk, while short bursts of intense physical activity during leisure raises blood pressure only briefly.”

Professor Holtermann’s vision is to reorganize occupational activity so that it mimics the beneficial aspects of leisure exercise. Several approaches are being piloted, such as rotating between workstations on a production line so that employees do a “healthy mixture” of sitting, standing, and lifting during a shift. In another study, childcare workers play games together with children, instead of observing, so that both get their heart rate up and increase fitness. “We are trying to vary the tasks, give recovery time, or raise heart rate so there is a fitness and health benefit,” he said.

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Doctor Survived Cambodia’s Killing Fields, but Not Covid

Linath Lim’s life was shaped by starvation.

She was not yet 13 when the Khmer Rouge seized power in Cambodia and ripped her family apart. The totalitarian regime sent her and four siblings to work camps, where they planted rice and dug irrigation canals from sunrise to sunset — each surviving on two ladles of rice gruel a day. One disappeared, never to be found.

Just a few months before the Khmer Rouge fell in January 1979, Lim’s father starved to death, among the nearly one-quarter of Cambodians who perished from execution, forced labor, starvation or disease in less than four years.

For Lim, the indelible stamp of childhood anguish drove two of her life’s passions: serving people as a physician and cooking lavish feasts for friends and family — both of which she did until she died of covid-19 in January.

Within the week before her death at age 58, she treated dozens of patients who flooded the hospital during the deadly winter covid surge, while bringing home-cooked meals to the hospital for her fellow health care workers to enjoy during breaks.

“These experiences during the war made her humble and empathetic toward the people around her,” said Dr. Vidushi Sharma, who worked with Lim at Community Regional Medical Center in Fresno, California. “She always wanted to help them.”

Lim’s story is one of suffering and triumph.

During the Khmer Rouge’s brutal reign and the Cambodian civil war before it, Lim and her nine siblings attended school sporadically. The ravages of war forced the family first from its small town to the capital, Phnom Penh, and then into the countryside when the Khmer Rouge took power in 1975. As part of its vision to create a classless agrarian society, the communist group split families and relocated residents to rural labor camps.

Lim survived the work camps because she was smart and resourceful, said her youngest brother, Rithy Lim, who also lives in Fresno. She dug ditches, hauled clay-like dirt on her back, built earthen dams in the middle of a river during monsoons — all with little food or rest, he said.

She also became a skillful hunter and fisher, and learned to identify plants that were safe to eat.

“You cannot imagine the horrible conditions,” he said. “Think of it as a place that you live like wild animals, and people tell you to work. There’s no paper, no pens. You sleep on the ground. We witnessed death of all sorts.”

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Vietnamese troops liberated Cambodia from the Khmer Rouge in 1979. Later that year, Lim, her mother and siblings sneaked into Thailand. “The whole family walked through minefields,” Rithy Lim recalled. There, they waited and worked in refugee camps. At one camp, they met a dentist from California’s Central Valley who was on a medical mission.

When Lim and her family arrived in the U.S. in 1982, they landed in Georgia. But she and an older brother soon moved to the small town of Taft, California, about 45 minutes west of Bakersfield, at the invitation of the dentist they’d befriended at the Thai refugee camp.

When she hit the ground, the 4-foot-11 dynamo, then 19, was driven by “pure determination,” Rithy Lim said.

Within two years, Linath Lim learned English, earned her GED and graduated from Taft College — “boom, boom, boom,” her brother recalled. (She learned to make traditional, middle-America Thanksgiving dinners when she worked at the community college’s cafeteria, which she would later cook for scores of friends and family.)

She went on to attend Fresno State and then the Medical College of Pennsylvania, sleeping on friends’ couches, borrowing money from other Cambodian refugees and scraping by.

“Imagine not having any money, studying alone, sleeping in someone else’s living room,” Rithy Lim said.

Lim became an internal medicine doctor “because she always wanted to be really involved with a lot of patients,” Rithy Lim said. After her residency, she returned to the Central Valley to practice in hospitals and clinics in underserved communities, including Porterville and Stockton, where some of her patients were farmworkers and Cambodian refugees.

California has the largest Cambodian population in the country, with roughly 89,000 people of Cambodian descent in 2019, according to a Public Policy Institute of California analysis of American Community Survey data.

Twice, Lim joined the Cambodian Health Professionals Association of America on weeklong volunteer trips to Cambodia, where she and other doctors treated hundreds of patients a day, said Dr. Song Tan, a Long Beach, California, pediatrician and founder of CHPAA.

“She was a kindhearted, very gentle person,” recalled Tan, who said he was the only member of his family to survive the Khmer Rouge. “She went beyond the call of duty to do special things for patients.”

Most recently, Lim worked the swing shift, 1 p.m. to 1 a.m., at Community Regional Medical Center. She admitted patients through the emergency room, where she was exposed to countless people with covid. She worked extra shifts during the pandemic, volunteering when the hospital was short-staffed, said Dr. Nahlla Dolle, an internist who also worked with Lim.

“She told me there were so many patients every day, and that they didn’t have enough beds and the patients had to wait in the hallway,” Tan said.

Colleagues said she was aware of the risks but loved her job. Lim, who was single and didn’t have kids, drew happiness from celebrating others’ joys. After getting home from work in the small hours, she slept for a bit, then got up to cook. Her specialties were Cambodian, Thai, Vietnamese and Italian food. She sometimes ordered a whole roasted pig that she transported to the hospital. Her memorable Thanksgiving dinners served 70 or more people.

“For any occasion that comes up — if it’s a birthday, if it’s a baby shower, if it’s Thanksgiving — she would cook, she would order food and bring everybody together,” Dolle said. “She loved to feed people because she experienced famine and lack of food.”

The week before she died, Lim cooked for her colleagues almost every day, and threw a baby shower for Sharma, complete with chicken calzones and blueberry cake.

“Every day, we were having lunch together,” Sharma said. “She did the shower, and then she’s gone.”

Lim, who had health problems including diabetes, had not been vaccinated.  Family and friends had urged her to take care of herself, and to check her blood sugar and take her medications. “She would care about everyone but herself,” Sharma said.

On Jan. 15, Lim told friends by phone that she was exhausted, achy and having trouble breathing. But she said that she would be fine, that she just needed to rest. Then she stopped responding to calls and texts.

When she didn’t show up for work a few days later, her brother went to check on her at home and found her on the couch, where she had died.

Now her brother and colleagues are haunted by what-ifs over the loss of a remarkable woman and doctor: What if I had checked on her sooner? What if she had been vaccinated? What if she had gotten care when she started feeling ill?

“To have someone who has been through all that in her childhood and then flourish as a physician, a human being, coming to a new country, learning English, going to school and college without having much financial support, it’s phenomenal,” Sharma said. “It’s unbelievable.”

This story is part of “Lost on the Frontline,” a project from The Guardian and Kaiser Health News that aims to document the lives of health care workers in the U.S. who die from COVID-19, and to investigate why so many are victims of the disease.

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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WHO experts say Chinese jabs show ‘safety’, but data lacking

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WHO vaccine experts said Wednesday that an interim analysis of clinical trial data from two Chinese COVID-19 vaccines showed they demonstrated “safety and good efficacy”, but that more data was needed.

The Chinese firms Sinovac and Sinopharm, whose COVID jabs are already being used in several countries, have submitted data in applications for the World Health Organization’s emergency use listing (EUL) green light.

The UN health agency’s Strategic Advisory Group of Experts on Immunization (SAGE) said it had reviewed the data provided so far, and that both vaccines “demonstrated safety and good efficacy against symptomatic COVID-19 disease”.

However, it warned, “both vaccines lacked data in older age groups and in persons with co-morbidities,” meaning other medical conditions.

“Post-introduction vaccine effectiveness and safety studies will be needed to address the impact on those sub-populations,” SAGE said in a list of highlights published after a meeting last week to discuss developments on vaccines against a range of diseases.

The two vaccines are among four homegrown jabs that have been approved by Chinese regulators so far, but SAGE pointed out that neither had yet received authorisation by what the WHO considers “a stringent regulatory authority”.

SAGE, which advises the WHO on immunisation policies, said it would hold off on issuing recommendations for how the two Chinese vaccines should best be used until after another expert panel rules on their EUL applications.

An emergency use listing by the WHO paves the way for countries worldwide to quickly approve and import a vaccine for distribution.

It also opens the door for the jabs to enter the Covax global vaccine-sharing scheme, which aims to provide equitable access to doses around the world and particularly in poorer countries.

“For now, we have information that these vaccines are safe, and that they are in the process of defining their final analysis to show the efficacy that will be used for the emergency use listing approval,” SAGE chair Alejandro Cravioto told reporters.

“Once that is in place we will be able to make the necessary recommendations for its use.”

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AstraZeneca vaccine safe, but rare risk of blood clots not ruled out, EU regulator says

The COVID-19 vaccine made by AstraZeneca and the University of Oxford is safe and not linked to an increased risk of blood clots, according to an investigation by the European Union’s European Medicines Agency (EMA).

“This is a safe and effective vaccine. Its benefits in protecting people from COVID-19 with the associated risks of death and hospitalization outweigh the possible risks,” Emer Cooke, the EMA’s executive director, said at a news conference Thursday (March 18). 

However, the EMA investigation uncovered a few “rare and unusual but very serious clotting disorders” that the committee probed more closely, Cooke said. These included conditions such as disseminated intravascular coagulation (DIC), in which clots form extensively throughout the body, and cerebral venous thrombosis (CVT), a rare form of stroke. 

“As of last night, seven cases of this disseminated intravascular coagulation and 18 cases of cerebral venous sinus thrombosis were reported out of almost 20 million vaccinated people,” Cooke said. “After days of in-depth analysis of lab results, clinical reports, autopsy reports and other information from the clinical trials, we still cannot rule out definitively a link between these cases and the vaccine,” she said. 

Even if there is a link, if every one of these cases was caused by the vaccine, this would translate to a rate of roughly 1.25 per million vaccinated people. 

The committee will launch further investigations of these extremely rare clotting events and will continue to monitor any additional cases that crop up. In the meantime, they concluded that the vaccine is safe and effective enough to warrant its continued use in the general public.

The EMA initially launched its investigation after many European countries — including Germany, France, Italy and Spain — halted their distribution of the AstraZeneca vaccine, citing concerns about blood clots and abnormal bleeding among vaccinated people, CNBC reported. In response to these reports from Europe, Indonesia also decided to delay its rollout of the vaccine, and Thailand briefly suspended use of the shots last weekend, The Associated Press reported

More than 17 million people in the U.K. and EU have already received the AstraZeneca shot, according to a March 14 statement from AstraZeneca. “The number of cases of blood clots reported in this group is lower than the hundreds of cases that would be expected among the general population,” Ann Taylor, AstraZeneca’s chief medical officer, said in the statement. 

Furthermore, the company has not observed any evidence of increased bleeding among the tens of thousands of people in clinical trials for the vaccine, according to the statement. 

As of March 8, the company had received 22 reports of pulmonary embolism (blood clots in the arteries of the lungs), and 15 reports of deep vein thrombosis (blood clots in the deep veins of the body), across the EU and U.K. “This is much lower than would be expected to occur naturally in a general population of this size,” the company stated. 

The company noted that “available evidence does not confirm that the vaccine is the cause” of these clots. However, the nature of the more unusual clotting disorders, like CVT, drew concern from some doctors. 

For instance, numerous patients showed widespread blood clots, internal bleeding and low platelet counts; platelets are small blood cells involved in clotting. And several people in Germany developed CVT, Science Magazine reported. Germany received seven reports of these rare strokes and found that the events occurred four to 16 days after each patient’s vaccination; three of these patients died. This pattern is what prompted Germany to pause use of the shots, Science reported.

In theory, the clotting and bleeding disorders could stem from an overblown immune reaction to the vaccine, Dr. Steinar Madsen, medical director of the Norwegian Medicines Agency, told Science. Future EMA investigations will likely explore this possibility.  

Other scientists have wondered whether the problem may lie with specific batches of the vaccine, which they posit may have become contaminated or contained a higher dose than usual. In general, AstraZeneca supplies European countries with vaccines produced at several different facilities. But the EMA’s safety committee, Pharmacovigilance Risk Assessment Committee (PRAC), has “found no evidence of a quality or a batch issue,” PRAC Chairwoman Sabine Straus said at the news conference.  

Just because the clots and bleeding disorders emerged after vaccination “does not necessarily mean that the events are linked to vaccination itself, but it is good practice to investigate them,” the World Health Organization noted in a statement released March 17. Blood clots are the third-most-common cardiovascular condition globally, and they occur frequently in the general population, according to the statement. 

For instance, an estimated 300,000 to 600,000 U.S. residents develop blood clots in their lungs or deep veins each year, according to the Centers for Disease Control and Prevention (CDC). EU residents develop blood clots at similar annual rates, and in clinical studies of the AstraZeneca vaccine, the rate of clotting episodes did not exceed the expected rate, the EMA reported, according to The Associated Press

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But again, rarer conditions such as DIC and CVT will need to be investigated more closely in vaccinated people.

Echoing the EMA’s conclusions, the U.K. Medicines and Healthcare products Regulatory Agency (MHRA) also found no link between the vaccine and blood clots, according to BBC News

Those who have received the AstraZeneca vaccine can submit reports to the company about any potential side effects or health-related issues they experience. The U.K. publishes summaries of these reports online, and so far, the most commonly reported symptoms include mild to moderate side effects, like headache, fatigue, soreness at the injection site and chills. Scattered reports of thrombosis, or blood clots, can also be seen in these summaries.  

Clearly, not all of these reported conditions could be caused by the vaccine. People have reported post-vaccine conditions such as “sunburn,” “breath odor,” “hiccups,” “arthropod stings” and “genital herpes,” as seen in the summary from early January to late February. One recipient reported getting a face-lift after being vaccinated. In other words, some medical conditions reported post-vaccination may be totally unrelated to the shots. 

Originally published on Live Science. 

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COVID-19 testing in schools complex but doable, worth the effort

school

A RAND Corporation report funded by The Rockefeller Foundation shows that COVID-19 testing can be effectively integrated into K-12 schools’ pandemic response plans, helping families and staff feel more comfortable with in-person instruction.

The report found that even for well-resourced districts and schools, launching a COVID-19 testing program was a major undertaking that required access to rapid-turnaround tests, additional staffing or strong partners for logistical support, technical assistance for the design and execution of testing programs, and a strategy for successfully engaging the school community to participate in testing.

“Our interviews with K-12 schools show that COVID-19 testing is complex, but doable,” said Laura Faherty, lead author and a physician policy researcher at nonprofit, nonpartisan RAND. “Many early adopters found it critical to partner with local public health departments, local health systems, their peers and testing vendors to launch feasible COVID-19 testing programs. But even with strong partnerships in place, school and district leaders described just how much effort it takes to make a testing program run smoothly. They described being ‘hungry’ for guidance and in need of a lot of technical assistance.”

Researchers examined the experiences of schools and districts that were early adopters of COVID-19 testing in Fall 2020, including insights from a national scan of schools as well as more than 80 interviews with K-12 school and district leaders in December 2020.

According to the report, COVID-19 testing programs were more often implemented in public and independent schools with access to resources such as expert advice, sufficient funding and strong local partnerships.

Schools encountered varying degrees of hesitation around testing and used several strategies to encourage participation. Privacy concerns were common: Staff and parents worried their health information could be shared with others. Members of school communities expressed concern about how their test samples would be used. Another barrier to engaging their communities in testing was doubt about the actual risk posed by COVID-19.

“To give their communities peace of mind to return to in-person learning, schools often started small, using a pilot period to work out many of the details before fully launching,” said Benjamin Master, co-leader of the project and a policy researcher at RAND. “The most scalable testing models that we identified involved districts that were able to access expert technical support and partners who could help manage the logistics of testing.”

The report provides recommendations for how schools can develop, and policymakers can support, effective COVID-19 testing programs. Among them:

  • expand funding to ensure schools can access tests, hire additional staff and contract with vendors as needed to implement testing
  • continue to invest in research and development of testing solutions that are convenient for schools to use
  • provide incentives such as paid sick leave for teachers and families to participate in testing and isolate as needed
  • promote the use of standardized metrics and data platforms to support decisionmaking
  • provide resources to strengthen state and local health departments so they’re fully equipped to help schools design testing programs and respond to positive tests.

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Nikki Bella Wants Another Baby But Also a WWE Return: It’s a ‘Battle’

A tough choice ahead. Nikki Bella admitted to struggling with her desire to have a second child with fiancé Artem Chigvintsev — a decision she is contemplating along with her interest in returning to her WWE roots.

Everything We Know Pregnant Nikki Bella Has Said About Starting a Family

“I have such a battle in my head, because I would want to wait and then I’m like, ‘OK, so I’m closer to 40. How’s that going to be?’ And then I’m like, ‘No, no, no. I’m just going to have [my son] Matteo,’” Bella, 37, told Us Weekly exclusively on Thursday, March 4, while promoting her new Tearless haircare line for babies. “But it’s like, now that I have Matteo, I want to give him a sibling because when we see [my sister Brie Bella’s son] Buddy, and Buddy and [his sister] Birdie, I’m like, ‘Oh, no matter what, he’ll always be a sibling.’”

She continued, “It just makes me feel bad that when he goes to bed at night though, he’ll always be by himself. So, Artem — he wants one. If I could have a girl up here … he’d be in heaven.”

Though she is “actually thinking about having another baby,” she is also seriously considering making her way back to WWE.

Working Mom! See Nikki Bella’s Sweetest Pics With Son Matteo

“The thing is, I want to get back in the wrestling ring,” she revealed. “There’s so many things I want to do, and I feel bad. … I just don’t think I have time.”

The Incomparable author welcomed her son, Matteo, with Chigvintsev, 38, in July 2020. The pair’s newborn arrived just one day before Brie, 37, gave birth to her second child, Buddy, with husband Daniel Bryan.

As a silver lining to deciding on baby No. 2, going through pregnancy a second time wouldn’t be a foreign concept to Nikki.

“I feel like I’d be prepped differently and emotionally, I would be different,” she explained. “I think I was so afraid of Mateo or anyone touching him, or this or that. I would be different right from the beginning, for sure.”

See Nikki and Brie Bella’;s Sons Matteo and Buddy’s Sweetest Pics Together

Last year, the former Dancing With the Stars contestant revealed that she and her soon-to-be-husband have disagreed about the possibility of further expanding their brood. “I honestly want to be one and done,” she told Us in November 2020. “Artem really wants a little girl, but I just don’t know if I could do it again.”

Nikki, meanwhile, last mentioned the possibility of her returning to wrestling on The Ellen DeGeneres Show in January. The Total Bellas star noted that she’s “definitely” interested and expressed her excitement over an announcement WWE made about upcoming WrestleMania host cities.

“When I heard about Dallas 2022, Hollywood 2023, I got chills,” she recalled. “And I said, ‘Brie, we have never gone after the tag titles.’ They were made for us. There’s another run in the Bella twins. At some point, we’re coming back.”

In the meantime, Nikki and Brie are focusing on the launch of Tearless — a haircare line that they created just for babies. The new product line will serve as an expansion to the twins’ Nicole + Brizee company.

“Being a mom, every day you’re surrounded by baby products [and] using them. So, you’re constantly thinking about them,” Brie explained to Us. “Nikki and I were like, ‘This is our life now. So, why don’t we come up with our own baby line?’ That’s why we wanted to create Tearless.”

With reporting by Christina Garibaldi

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Evidence for routine brain tumor imaging is murky, but research can shed light

tumor

What is the best way to monitor a brain tumor? This question is at the heart of a new Position Statement published in open-access journal Frontiers in Oncology. The article is the work of a large collaboration of UK experts and stakeholders who met to discuss the value of routinely imaging brain tumor patients to assess their tumor treatment response, which is known as “interval imaging”. Their verdict: there is very limited evidence to support the practice at present. However, the article also discusses how future research could determine and maximize the value of interval imaging by assessing its cost effectiveness and how it affects patient quality of life, treatment and survival.

Medical staff use brain scans at predetermined times to assess if a brain tumor patient is responding to treatment, but scanning frequency can range from every few weeks to every few months. Different countries and hospitals use different approaches, but what is the best approach and is any of this based on science?

Getting things right is important. Not scanning someone enough could mean that doctors miss the signs that a patient requires further treatment. Conversely, scanning someone excessively is inconvenient and impractical for patients and medical staff alike, and can cause patient anxiety, especially if the results of the scan are unclear.

Scanning patients is also expensive, and with limited budgets, healthcare facilities need to use their resources as cost-effectively as possible. Most interval imaging aims to find increases in tumor size, but tumors grow differently in different patients, which sometimes makes it difficult to draw concrete conclusions from interval imaging results. Would patients be better off receiving scans only if they experience new symptoms?

A group of experts and other stakeholders met to discuss these issues in London in 2019. The group was diverse and included numerous people with an interest in these issues. “Charity representatives, neuro-oncologists, neuro-surgeons, neuro-radiologists, neuro-psychologists, trialists, health economists, data scientists, and the imaging industry were all represented,” said Dr. Thomas Booth of King’s College London and the lead author on the article. Their findings are presented in this latest Position Statement.

The group discussed the evidence behind current interval imaging practices in the UK. “We found that there is very little evidence to support the currently used imaging interval schedules and that the status quo is no more than considered opinion,” said Prof. Michael Jenkinson of the University of Liverpool, and senior author on the article.

So, how can we determine if interval imaging is valuable? The meeting participants also discussed a variety of potential research approaches that could cast light on the most important factors—patient quality of life, patient survival, and cost effectiveness. However, this is not without its challenges.

“The treatment complexity and relative rarity of brain tumors mean that solutions beyond traditional ‘randomized controlled trials’ alone are required to obtain the necessary evidence,” said Booth. “We propose a range of incremental research solutions.”

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US vaccinates 10 mln against COVID but remains behind target

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More than 10 million people have received their first dose of a COVID-19 vaccine in the United States, official data showed Wednesday, even as the country remains behind its immunization targets.

Of 29,380,125 doses of the Pfizer and Moderna vaccines sent to states, 10,278,462 have been administered as first doses, according to the CDC’s tracker.

That is around 3.1 percent of the total population of roughly 330 million people—though vaccines are not yet available to children.

The US has vaccinated more people than any other Western country, but rollout has fallen far behind goals set by authorities, who had hoped to reach 20 million people by the end of December.

As a percentage of population vaccinated, Israel is leading the world, followed by the United Arab Emirates, Bahrain and Britain, then the US.

As part of efforts to expand access to COVID vaccines, the federal government said this week it would allow makers to release all their available doses instead of reserving booster shots.

This marks a break from the previous plan in which second doses were held back for those people who had received their first, to ensure that there is no delay.

The Pfizer and Moderna vaccines require boosters after three and four weeks, respectively.

“States have been blamed for being initially overly-prescriptive in how they distributed their supply, which led to doses lying unused in freezers or even being thrown away because they expired,” Andrea Polonijo, a public health expert at the University of California, Riverside told AFP.

“Within states, there is also no standardized means of scheduling vaccination appointments, leaving many members of the public confused about when and where they can get vaccinated.”

The federal government has now also recommended that states start vaccinating everyone over the age of 65, regardless of whether they have health conditions.

Cities are also preparing mass vaccination sites—California, which is facing the worst of the US outbreak, for example has designated Disneyland as such a site.

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People eventually adopt healthy behaviors – but it can take time we don’t have during a pandemic

Why do we do things that are bad for us—or not do things that are good for us—even in light of overwhelming evidence?

As someone with a long career in pharmacy, I have witnessed some pretty dramatic shifts in public health behavior. But I won’t sugarcoat it. It generally takes years—or even decades—of dragging people, kicking and screaming, to finally achieve new and improved societal norms.

This plodding time course seems to be an innate human defect that existed long before the current-day pandemic mask and social distancing conundrums. Historically, people aren’t fond of being told what to do.

Notable victories

Attitudes toward smoking have undergone dramatic changes over the past 50 years. Although there has been a gradual decline in smoking, from 42% of the American population in 1965 to the low teens today, there still are a lot of smokers in the U.S. – and premature deaths due to smoking. Even health care workers fall prey to this unhealthy and highly addictive habit.

There was a strongly held view that smoking was a personal decision that do-gooders and the government should keep their noses out of—until the issue was framed differently by studies showing harm caused by secondhand smoke. You are welcome to do what you want to yourself, but it becomes a horse of a different color when it affects others.

Today, public smoking restrictions have become commonplace. But this change in societal behavior didn’t happen overnight or without painful discourse. The journey from the initial 1964 surgeon general’s report on smoking and health to the 2006 surgeon general’s report on secondhand smoke to today was a fractious one.

Another about-face has been the adoption of seat belts. Seat belts save lives. And most people now use them as a result of the nagging warning alarm, the marketing of automobile safety, the law and the data.

This change in behavior, however, followed a rocky road over many years. In my earlier days, I can remember more than one occasion when I hopped into a friend’s car, put on my seat belt and was then chastised for having so little faith in my friend’s driving ability.

Seat belts were required to be installed in new cars starting in 1964 and New York enacted the first seat belt use law in 1984. In the U.S., seat belt use rose from 14% in 1983 to 90% in 2016.

Continuing challenges

In the medical arena, much effort has been expended in promoting healthy behaviors—diet, exercise, sleep hygiene, adherence to prescribed drugs and immunizations. Frankly, the success has been mixed.

Studies have suggested many possible variables associated with not following accepted medical advice: age, gender, race, education, literacy, income, insurance copays, level of physician and pharmacist care—and plain old stubbornness. But there is no single, easily addressable cause of nonadherence to healthy behaviors.

For example, properly prescribed cholesterol-lowering drugs called statins literally add years to patients’ lives by reducing heart attacks and strokes. Even in people with insurance coverage and minimal side effects, 50% of patients discontinue statin therapy within one year of receiving their first prescription.

Vaccines and immunization offer another window into the puzzle of human behavior. Life expectancy in the U.S. rose from 40 years in 1860 to 70 years in 1960. These gains resulted largely from decreased infant and child mortality due to infectious diseases. A better understanding of infectious diseases along with scientific advances, vaccines and antibacterial drugs were the primary factors for this profound increase in life expectancy.

Common sense alone makes the value of vaccines abundantly clear; how many people do you know who are suffering from polio or smallpox? Yet some intelligent, thoughtful friends, family and neighbors are convinced vaccines are not helpful and are even harmful. Some believe wearing a mask is nothing more than a “feel good” placebo. I believe these contrarian beliefs make better press and are therefore more frequently reported than mainstream ones, but clearly there is reason for concern.

The current crisis

Historically, changes in societal behavior that benefit public health occur in fits and starts—and never fast enough for the individuals who fall victim before society comes around.

The urgency imposed by the coronavirus has actually resulted in comparatively swift behavioral changes (masks, hand-washing, distancing) in the U.S. – as scientists learned how the coronavirus is spread, how dangerous it can be and which groups are more susceptible. But these behavioral changes were not as complete or as fast as they should—or could—have been when judged by far better outcomes in other countries.

I am discouraged by the battle between the scientific method and political ideology when it comes to public health. Ideology never seems to change and is therefore more comforting to some—while science evolves as new findings debunk old ideas or confirm new ones. It is clear to all who want to listen: controlling the virus and maintaining the economy is not an either/or choice—they are interdependent.

At the same time, I am buoyed that the tide seems to be turning. As a better understanding of treating COVID-19 has emerged and with more than one highly effective vaccine on the horizon, the “idiot scientists” are gaining ground, both in the lab and at the bedside. Even the most prominent ideologues run to the hospital to get the best treatments science can offer when the effect of their maskless behavior rears up to bite them.

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