Should COVID vaccines be compulsory for care home staff? Experts debate

care home

The UK government has announced that COVID-19 vaccination will become mandatory for staff working in care homes for older people in England. Staff will be given 16 weeks to get the vaccine. If they don’t get the jab, they will be redeployed from frontline care or lose their job.

Mandating vaccination would increase vaccine uptake in care home workers, but it would be a significant intrusion into individual freedom. Is it ethically justifiable?

Yes—Professor Dominic Wilkinson

In the early phase of the pandemic, some of the most medically vulnerable people ended up catching coronavirus from those caring for them; 40,000 patients in England are said to have caught COVID while in hospital. Some patients and care home residents died from infections that they caught from their caregivers. We must do everything possible to avoid repeating this tragic and distressing situation.

First, we should ensure that all those who are at a high risk of dying from COVID have access to the vaccine. About 10% of older adult care home residents have still not had a second dose of the vaccine.

Second, those who work in the frontline with vulnerable high-risk patients have an ethical obligation to take all reasonable measures to prevent the spread of the virus to those they are caring for. They must follow the guidance on things like hand washing and PPE. They should take part in lateral flow testing schemes. And they should be vaccinated.

Mandating vaccination can be ethical if it is both necessary and proportionate. A mandate is not necessary if there are less intrusive means of effectively increasing uptake, such as persuasion and incentives. The problem is that less intrusive means may be much less effective.

Persuasion has so far failed. There is strong evidence to suggest that vaccine mandates are the most effective way to increase uptake.

A mandate could be proportionate if the public health benefit of increasing uptake among staff would outweigh the harms. Given the considerable vulnerability of care home residents, this seems to be the case. Care home residents can’t choose who cares for them. Some remain only partly protected after vaccination. The risks of vaccination for workers are exceptionally low.

However, if vaccines are made mandatory for care home workers (or healthcare workers), they should be able to choose from available vaccines. Every effort possible should be made to address any concerns that they have about the vaccines.A conditional vaccination policy would be ethical.

Care home workers—and NHS staff—who have not had the COVID vaccine should be redeployed to areas other than frontline care. In the absence of a medical exemption, COVID vaccination should be a condition of employment in the same way that hepatitis B vaccination is currently for some health professionals.

No—Professor Julian Savulescu

Mandatory vaccination policies can sometimes be ethical. But the proposal to make vaccination mandatory for care home workers is muddle-headed.

There are rare but serious risks of vaccination: blood clots for AstraZeneca and probable myocarditis in Pfizer. COVID-19 deaths are predominantly in the elderly, while rare side-effects are mostly in the young.

For most, these small risks won’t change the risk-benefit ratio. But for some, the risk-benefit ratio looks very different.

Imagine a 20-year-old care worker on a zero-hours contract, like 24% of her colleagues, who worked through the pandemic and gained natural immunity from becoming infected. She, and those in her care, have little to gain from her undergoing vaccination to gain additional immunity.

A Public Health England study compared vaccine and natural immunity and found “equal or higher protection from natural infection, both for symptomatic and asymptomatic infection.” But under this scheme, our care worker would still be exposed to the additional risks of vaccination. Moreover, if she has to take time off sick with the common side-effects, thanks to her zero-hours contract, she won’t be eligible for sick pay for four days—and perhaps not then.

This won’t be the case for everyone. But it should be up to the individual who will suffer the outcome to make an informed choice. That is perhaps the most basic tenet of medical ethics: respect for autonomy.

It is true that autonomy is not always decisive in public health and that care workers have professional responsibilities to those in their care. But to justifiably override autonomy and remove someone’s livelihood, we need to know that doing so will be an effective measure and that it is necessary.

Increasing vaccine uptake may only have a limited effect in preventing transmission. The very limited data available suggests only a limited effect (as low as 35% and up to 50%). There are also confirmed reports of breakthrough infections, and even outbreaks, among fully vaccinated staff and patients.

Vaccination will confer some protection. But, at best, mandatory vaccination won’t stop family and friends from transmitting the virus while visiting care homes. Singling out one group for the coercive measure will be divisive and may lead many staff to leave the already-understaffed profession.

The policy is also unnecessary. Half of care homes have hit the target level of staff vaccination through voluntary means. Staff could be offered incentives to be vaccinated.

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Should 12-year-olds get the COVID-19 vaccine?

Kids as young as 12 can now receive the Pfizer-BioNTech COVID-19 vaccine, yet some parents are hesitant to get their children vaccinated. Parents might worry about giving a 12-year-old a vaccine that has not yet been approved for even younger kids. So we asked doctors who specialize in infectious diseases in children a question many parents have been wondering about: Should 12-year-olds get the COVID-19 vaccine? 

The answer from experts is a resounding yes. “I absolutely think they should get the vaccine, just like I think anyone who’s vaccine-eligible, which goes down to 12 now, should get vaccinated,” said Dr. Aaron Milstone, a pediatric infectious diseases specialist at Johns Hopkins Children’s Center in Baltimore. “Because it is, one, the best way they can protect themselves against this infection, and, two, it’s the best way to help protect the community from the spread of the virus.” 

The U.S. Centers for Disease Control and Prevention (CDC) recommends that people ages 12 and older get a COVID-19 vaccine, as does the American Academy of Pediatrics (AAP). Indeed, the CDC recently urged parents to encourage their teens to get vaccinated, after an increase in hospitalizations was reported in this age group in March and April.

“At some point, parents will have to decide whether they want to get their kids a vaccine or whether they want them to get COVID,” Milstone said. “I know some people are nervous and they’re anxious. And hopefully, as more and more children are safely vaccinated, it will reassure them that this is a safer approach than risking your child having a complication from the infection itself.” 

On May 10, the U.S. Food and Drug Administration (FDA) extended the emergency use authorization (EUA) for use of the Pfizer-BioNTech COVID-19 vaccine in kids ages 12 to 15, Live Science previously reported. The FDA had already granted an EUA for use of the same vaccine in people ages 16 and older on Dec. 11, 2020. 

The vaccine is 100% effective in preventing COVID-19 in 12- to 15-year-olds, according to a Phase 3 clinical trial with 2,260 participants, the results of which were published May 27 in The New England Journal of Medicine. Approximately half of the participants received the vaccine, and half received a placebo. There were no cases of confirmed COVID-19 in the participants who received the vaccine and 18 cases in those who received the placebo. 

The vaccine also has a “favorable safety and side-effect profile,” the authors wrote in their study. None of the vaccine recipients in the trial had any serious vaccine-related adverse events. Further, in a statement about the EUA, the FDA said it had determined that the benefit of the vaccine to children 12 and older outweighed the “known and potential risks, supporting the vaccine’s use in this population.”

Benefits of vaccination

Severe COVID-19 is uncommon in children, but that’s not to say COVID-19 hasn’t affected kids. By the end of April, there had been more than 3.7 million cases of COVID-19 in children in the United States, 15,456 child hospitalizations due to COVID-19 and 303 child deaths from COVID-19, according to a report by the AAP and the Children’s Hospital Association. Many of those hospitalizations involved intensive care, added Dr. Yvonne Maldonado, chair of the AAP Committee on Infectious Diseases and chief of Stanford University School of Medicine’s division of pediatric infectious diseases.

“We really do think that to protect children themselves, it’s really important to get vaccinated and also to protect people in the community where children live from getting infections transmitted by children. So for both the children’s good and the good of the community, it is important,” said Maldonado, who is also one of the investigators on the trial of the Pfizer-BioNTech COVID-19 vaccine in kids under 12. 

Another reason to get vaccinated is for protection against the long-term consequences of COVID-19, which remain to be determined, Milstone said. An example of a long-term consequence that has already been observed is multisystem inflammatory syndrome in children (MIS-C), which can develop in kids a month or two after infection with SARS-CoV-2, the virus that causes COVID-19, he said. MIS-C is characterized by the inflammation of multiple organs, Live Science previously reported

“We don’t know whether there could be other late effects from this virus that just emerged a year and a half ago,” Milstone said. “So for right now, I think the surest way to protect ourselves is to get vaccinated.”

Furthermore, vaccination offers kids the chance to go about many of their activities without wearing masks. “The social benefits are important,” Maldonado said, adding that the new mask guidelines from the CDC indicate that vaccinated people can go without masks in most situations. “And it really would be helpful for children to have that opportunity,” Maldonado said.

‘Millions of kids’

Within a week following FDA approval of the Pfizer-BioNTech vaccine for kids ages 12 to 15, 600,000 kids within that age group had received their first doses, CDC Director Rochelle Walensky told members of the media May 18, Reuters reported. As of that date, 4 million people 17 and under had been vaccinated, Walensky said. 

“Hopefully, the fact that millions of kids have gotten these vaccines safely in the United States will reassure people that this is a safe thing to do for their child,” Milstone said.

In a survey reported in the Kaiser Family Foundation’s May Vaccine Monitor, 41% of parents of kids ages 12 to 17 said that their children have either gotten at least one dose or that they will get vaccinated right away. 

Yet not all parents are eager for their kids to get vaccinated. In the same survey, 14% of parents said they would get their child vaccinated only if their school required it, and another 20% said they would “definitely not” get their 12- to 17-year-old vaccinated. Many parents said they are worried about vaccine side effects. 

Side effects and risks

The most common side effects of the Pfizer-BioNTech vaccine in kids ages 12 to 15 are “tiredness, headache, chills, muscle pain, fever and joint pain,” according to the FDA statement about the EUA. These side effects are similar to those reported by vaccine recipients ages 16 and up, according to the statement. 

In a May 17 statement, the CDC said it had been investigating a few cases of myocarditis (heart inflammation), primarily in adolescents, within four days of receiving a vaccine, Live Science previously reported. And recently, data from the U.S. Vaccine Adverse Event Reporting System (VAERS) showed a higher than expected number of myocarditis cases in older adolescents and young adults, ages 16 to 24, within a month after receiving their second shot of either the Pfizer or Moderna vaccine, according to the CDC’s Advisory Committee on Immunization Practices (ACIP). Researchers will continue to monitor this link as more young people are vaccinated to determine whether the vaccine is really the cause of these myocarditis cases, the ACIP said. It will be important to determine if there really are more cases among vaccinated people, Milstone said, because only then would it make sense to attribute the heart inflammation to the COVID-19 vaccine.

Given the large number of infections, hospitalizations and deaths from COVID-19 in children, “we do think that the benefits of the vaccine will outweigh the risks, and that if people are concerned about myocarditis, they should know that the CDC and others are still investigating a potential relationship, but if there is a relationship, it will be rare,” Maldonado said. Out of millions of vaccinations given to people under 18, there have been just a few cases of heart inflammation. Those cases have been mild and have resolved quickly, she said. 

—Is the COVID-19 vaccine causing rare myocarditis cases?

—20 of the worst epidemics and pandemics in history

—Could the novel coronavirus one day become a common cold?

Currently, the Pfizer-BioNTech vaccine is the only COVID-19 vaccine approved for use in people under 18. However, Moderna announced in a May 25 statement that its vaccine is safe and effective in kids ages 12 to 17, based on the results of a Phase 2/3 clinical trial, and that it plans to submit its data to the FDA in June.

Originally published on Live Science.

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7 facts women should know to prevent and recognize stroke


It’s telling that although stroke is the third leading cause of death for women in the U.S., and that twice as many women die of stroke than of breast cancer, most women aren’t aware of these facts.

As is the case with heart attacks, stroke is often perceived as occurring mostly in men—even though women account for 51% of all people worldwide who have experienced a stroke.

That’s why neurologist Sarah Song, MD, MPH of the Rush Stroke Program says it’s essential for women to be savvy when it comes to stroke.

Understanding your risks empowers you to take steps to prevent a stroke. And being aware of the symptoms will enable you to get treatment faster if you do have a stroke, when every second counts.

Whether you’re a woman or have loved ones who are women, Song says knowing these facts can help save lives:

1. Don’t dismiss stroke symptoms

These symptoms are commonly identified with stroke in both men and women:

  • Numbness on one side of the body and/or face
  • Weakness on one side of the body and/or face
  • Loss of vision
  • Double vision
  • Vertigo, or room-spinning
  • Slurred speech
  • Difficulty speaking or understanding language

If you notice any of these symptoms in yourself or another person, call 911 immediately, even if the symptoms don’t cause pain or they go away.

Just remember that “time is brain.” If it is a stroke, the sooner you get treatment, the better your chance of surviving. Prompt treatment also improves your chances for successful rehabilitation and recovery.

2. Strokes in young women are on the rise

It’s true that strokes most often strike older women (and men). But the World Stroke Organization reports that 8% of all strokes—and 4% of all stroke-related deaths—occur in people under the age of 44.

One potential reason is thought to be the increase in obesity among younger women. Studies have shown that women who are obese or have gained more than 44 pounds since age 18 are about 2.5 times more likely to have a stroke than women who maintain a healthy weight.

While obesity is a stroke risk factor on its own, it also contributes to other significant risk factors, including high blood pressure, Type 2 diabetes and heart disease—all of which are increasingly common in women today.

Pregnancy and childbirth can also make young women, including transgender women, more vulnerable to stroke.

Most maternal strokes happen within the first few weeks after birth, triggered by blood loss or hormonal changes. Stroke is also associated with certain complications of pregnancy, including infections and preeclampsia. And, generally speaking, clotting activity is heightened during pregnancy; if clots form in the blood vessels of the veins, they can lead to a stroke.

3. Black and Hispanic women have a higher risk of stroke

According to the Office of Minority Health, part of the U.S. Department of Health and Human Services, Black women are twice as likely to have a stroke as white women—and more likely to die from a stroke than either white women or Hispanic women.

One reason? High blood pressure, diabetes and obesity—three of the biggest risk factors for stroke—are all more common in Black women than white women.

A lesser known risk factor: sickle cell disease, a genetic disease common in Black Americans (around 1 in 365 Black Americas is born with it). Twenty-five percent of adults with sickle cell disease will suffer a stroke by the age of 45.

Hispanic women, too, experience high blood pressure, diabetes and obesity at higher rates than non-Hispanic white women, putting them at increased risk of both stroke and stroke-related deaths.

Working to improve your weight, blood pressure and cholesterol with lifestyle changes and medications can help reduce the risk not only of stroke, but of heart disease and cancer.

4. Using birth control pills can potentially raise stroke risk

The American Stroke Association reports that women who take birth control pills may be twice as likely to have a stroke as those who don’t. Birth control pills (often referred to as “the pill”) can cause blood clots to develop. In some cases, blood clots can possibly travel to the brain, causing a stroke or heart attack.

Since the stroke risk for healthy young women is low to begin with, you don’t necessarily have to forgo the pill. Your doctor can help determine whether oral contraceptives or another form of birth control is best for you.

That means identifying your other risk factors. If you take oral contraceptives, any additional risk factors—especially smoking—will increase your potential for stroke even more. The risk of stroke related to oral contraceptives also increases with age.

5. There’s a link between migraines and stroke

These crippling headaches—far more common in women than men—have been associated with an increased risk of stroke when accompanied by a migraine aura.

The reasons for this association are not well understood. But from what we do know, aura (where you experience flashes of light, light or noise sensitivity, tingling in the hands or face, partial loss of vision or other symptoms) must be associated with the headache to increase stroke risk. It may also be associated with hormonal changes.

The American Stroke Association says women who experience migraines with aura are up to 10 times more likely to have a stroke, depending on their other risk factors. Smoking and using oral contraceptives, in particular, can increase your risk significantly.

6. Women should watch their waistlines

Studies have shown that postmenopausal women with a waist measuring more than 35.2 inches and a triglyceride (blood fat) level higher than 128 mg/dL have five times the risk of stroke.

And there are other serious health risks associated with an “apple” body shape in women, including heart disease and diabetes.

There are some stroke risk factors you can’t control, like your family history, ethnicity/race and age. So it is helpful instead to focus on the behaviors you can change.

That includes making time to exercise and eating a diet rich in fruits, vegetables and whole grains. Adopting a healthy lifestyle may help prevent stroke in women, especially if you have other stroke risk factors.

7. A transient ischemic attack, or “mini-stroke,” is a warning sign

A transient ischemic attack, also known as a TIA or “mini-stroke,” causes the same symptoms as a stroke but lasts only minutes to a few hours.

Even though there may not be lasting effects from a TIA, you should still seek immediate medical help. That includes talking to your doctor about how to prevent a full-blown stroke, because having a TIA puts you at greater risk for having a stroke. A TIA is an opportunity to look for stroke risk factors that could be better controlled.

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Here’s What You Should Eat And Drink After Getting Your COVID-19 Vaccine

You’ve probably heard stories about how people feel after getting their COVID-19 vaccine, and some of those stories may be extremely off-putting. But there are ways to help prevent unpleasant after-effects from your shot, and that comes from what you eat and drink right after being vaccinated.

Fever, chills, headaches, nausea, and soreness at the injection site have all been reported as side effects of both the Pfizer-BioNTech and the Moderna vaccines. Smithsonian Magazine reported, however, that the percentages of significant side effects are fairly low. In the two-shot process for the Pfizer-BioNTech vaccine, only 3.7% of those vaccinated experienced a fever after the first short, and only 15.8% reported a fever after the second shot. For those 55 years of age or older, the rates are even lower. 

For the Moderna vaccine, less than 1% of people (no matter the age) experienced a fever after the first dose, while 17.4% of younger people and 10.2% of older people felt feverish after the second dose (via Smithsonian). The same side effects have also been reported for the one dose Johnson & Johnson vaccine, according to Medical News Today. But proper nutrition can help alleviate the after-effects for all three approved vaccines in the United States.

Water, water, and more water is essential for post-vaccination health

Hydration is key when getting any vaccine, and that includes the three vaccines approved to combat COVID-19 — Pfizer-BioNTech, Moderna, and Johnson & Johnson. To avoid dehydration, do not drink alcohol prior to getting jabbed or after, Health noted. Alcohol can interfere with your immune system and you want the best immune response possible for this important vaccine.

Of course, one of the best ways to stay hydrated is to drink water. You don’t have to get excessive about it, but do stick to the recommended 64 ounces of water a day both before and after receiving your shot (via Health). You can break down all this water consumption throughout the day in eight 8-ounce glasses, or you can use a refillable water bottle to keep hydrated. Health also noted that it’s perfectly fine to flavor your water with lemon or lime if you just don’t like the taste of plain water. Proper hydration also helps you sleep, which also boosts your immune system.

Fuel your body with healthy foods after your COVID-19 vaccine

Whole foods, rather than processed foods, can help your immune system work correctly and can also assist in warding off vaccine side effects — especially nausea. Shop before your vaccine appointment and have some bland foods on hand like bananas, apple sauce, broth-based soups, brown rice, and potatoes, as noted by Health. All of these foods can both prevent nausea and treat it.

Health also advised that you can eat takeout if you’re not feeling up to cooking soon after being vaccinated, but stick with healthier options instead of ordering fried or fatty fast food. Choose Indian curry, an Asian stir fry, or even veggie tacos (we’re getting hungry just thinking about it).

It’s also possible to lose your appetite after your shot, but you still need to eat. Try to stick to smaller meals and healthy snacks, because your body still needs nutrition no matter what (via Health). The healthier you eat, the healthier you will be, so finally getting vaccinated against COVID-19 might just be the right time to start your journey towards wellness and nutrition.

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Why You Should Think Twice About Using Headphones At The Gym

There are certain things most women can’t exercise without, from a decent hair-tie, to keep our locks off our faces, to the correct clothing that won’t fall down or cling too tightly during high-intensity moves. Although it’s likely you frequently spot at least a couple people in the gym working out without headphones, or even running outside without them — the horror! — the vast majority of us prefer to train while listening to something, whether it’s music, podcasts, or even audiobooks. 

Wearing headphones in the gym isn’t something most of us think twice about. Doing so is second nature, particularly if you’ve been working out for a while. Headphones make sessions go faster and ensure we focus entirely on what we’re doing rather than worrying about everybody else around us. However, there are several reasons why wearing headphones at the gym isn’t the best idea. Before you grab your favorite pair on your way to your workout, consider the following. 

Blocking everything out has its setbacks

According to News24, pumping loud music into your ears for a prolonged period of time can impact your balance through the vestibular system, making running on the treadmill more dangerous. It can also potentially damage your hearing in the long run. Although headphones may make it easier to concentrate, scrolling endlessly through songs while trying to find the right one for the exercise in question could be robbing you of valuable workout time. Likewise, if your music is too loud it may be distracting fellow gym goers, so try not to block everything out exactly. It’s worth noting, too, if the cord on your earphones isn’t the right length, it might restrict your movement, making it more difficult to strength train properly. You could even hurt your neck while working your core. 

Also, did you know you should be cleaning your headphones regularly after each use? Sweat and bacteria cling to them, which can lead to ear infections, particularly if they’re frequently tossed into your bag with the rest of your gear. However, as with headphones themselves, there’s no one size fits all rule here. As trainer Sue Reynolds Reed advised, try one exercise session without headphones, to ensure your breathing and focus are both on point (via Health E News). Put simply, if headphones assist with your workout, include them. If they’re distracting you, it’s best to go without. Either way, keep them clean and take note of any changes in your hearing, just in case.

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DR MICHAEL MOSLEY: Should doctors prescribe dummy pills to ease pain?

DR MICHAEL MOSLEY: Should doctors now prescribe dummy pills to ease pain? (…and tell you they’re fake)

How would you feel if you went to see your GP with severe pain caused by a bad back or irritable bowel syndrome (IBS), and you were told they had just the thing to help — a placebo; a pill containing nothing but rice flour or sugar.

That possibility has come closer, thanks to a new study showing that giving patients an ‘honest’ placebo, one where they know they are getting a dummy pill, can be extremely effective at reducing pain.

And with a recent report from the Office of National Statistics showing that deaths from taking high-strength painkillers, such as tramadol and codeine, have doubled over the past ten years, there is clearly a need for safe and effective alternatives.

I’ve been involved in studies of the placebo effect, including one where we recruited more than 100 patients with chronic back pain and told them they were either getting a powerful new painkiller or a placebo. In fact, they were all given a placebo

But if the placebo effect is so effective, why don’t doctors make more use of it?

I’m a huge fan of the placebo effect. I think it’s remarkable that you can give someone a bright-coloured pill, which contains no active ingredient, and this will reduce their pain.

But it is also misunderstood. The assumption is that people who respond either weren’t ill in the first place or are credulous. Neither is true.

I’ve been involved in studies of the placebo effect, including one where we recruited more than 100 patients with chronic back pain and told them they were either getting a powerful new painkiller or a placebo. In fact, they were all given a placebo.

In this study, which was published last July in the European Journal for Person Centred Healthcare, nearly half the patients reported significant pain relief, despite swallowing dummy pills.

As I was told by Dr Jeremy Howick, an expert from Oxford University who designed our study, people who respond best to a placebo are not gullible; they are simply more open minded, especially when it comes to new experiences.

So how does it work? Well, a couple of years ago I watched an intriguing experiment carried out by Manchester University’s Human Pain Research Group. They started by attaching electrodes to a volunteer, Jack, so they could measure his brainwave activity. Then he was given two identical-looking creams and told one was a normal moisturiser, and the other may or may not contain an anaesthetic.

In reality, they were both just moisturisers. He was asked to rub cream from one tub into his left arm, the other into his right.

Next, they heated Jack’s arms with a laser, which he had to rate for painfulness on a scale from one to ten. What they didn’t tell him was that while his left arm got a full blast, his right arm had a weaker zap. They did this several times until Jack was convinced the cream he’d rubbed on his right arm contained an anaesthetic.

Finally, they gave his right arm a full blast with the laser. Amazingly, when that happened, part of Jack’s brain, the frontal cortex, began producing large amounts of brainwaves called alpha waves and this immediately moderated the pain signals reaching the brain.

This, and other research they’ve done, suggests the placebo effect works by ‘persuading’ your brain to express more alpha waves, thereby dialling down the pain, although no one knows why the waves work in this way.

But if the placebo effect is so effective, why don’t doctors make more use of it?

My sister, Susie Stead, has just published a book, Stephen From The Inside Out, about a friend who, when young, was labelled ‘schizophrenic’ and spent more than 25 years in psychiatric wards. Stephen wasn’t diagnosed with autism until his late 40s 

Well, there is a belief among doctors that a placebo treatment works only if patients think they are getting a ‘real’ pill. And that would mean lying to patients, which is unethical. A new study, however, involving people with IBS suggests the placebo effect can work even when you know you are taking a placebo. IBS affects around 20 per cent of adults in the UK and can cause crippling stomach cramps, as well as bloating, diarrhoea and constipation.

There is no known cure, though lifestyle changes can help.

To see whether giving patients an ‘honest’ placebo can help, researchers from the Beth Israel Deaconess Medical Centre in the U.S. recruited 262 people with IBS.

The patients were randomly allocated to three different groups. One group was told it would be getting placebo pills, containing no active ingredient, though the patients were also told that taking the pills could improve their symptoms. The second group was told it would get either a placebo or a pill containing peppermint oil (which can help with IBS), but didn’t know which.

A third group acted as a control and received nothing.

Those given a pill were asked to take it three times a day, 30 minutes before meals, for six weeks. At the end of the study, the patients in both of the pill groups reported a much bigger improvement in their symptoms than the control group.

Seventy per cent of those swallowing pills reported at least a 50-point improvement in their symptom score, while 30 per cent reported their score had increased by at least 150 points, which was considered a ‘very strong’ response.

I wasn’t surprised. In our back- pain study, most of the patients who got relief from taking our placebo pills said they wanted to continue taking them, despite knowing that they were swallowing nothing but ground up rice.

It seems you don’t have to deceive people to tap into the power of the placebo, at least for certain conditions. If you trust the doctor prescribing them, then simply taking pills which you have been told might do you good, really can help.

There’s a powerful connection between the microbes living in your gut, known as the microbiome, and your brain. Not only does your microbiome influence your mood, but there is evidence that children with severe autism can be helped by changing their gut bacteria. More on that in a moment.

The popular image of autism is either of a child rocking to and fro, barely able to speak, or someone who is brilliant at science but bad at human relationships. The truth is more complicated. Autistic spectrum disorder (ASD), can range from those who are severely affected to those who simply find it hard to communicate and interact with other people.

A recent study by the University of Cambridge suggests that around 1.76 per cent of children in England are on the autism spectrum, a higher figure than previously thought.

What’s tragic is that so many people with ASD have been misunderstood or misdiagnosed. My sister, Susie Stead, has just published a book, Stephen From The Inside Out, about a friend who, when young, was labelled ‘schizophrenic’ and spent more than 25 years in psychiatric wards. Stephen wasn’t diagnosed with autism until his late 40s, and none of his talents, including his extraordinary memory and aptitude for poetry, was celebrated in his lifetime.

While autism can’t be ‘cured’, speech and social therapy can help. There is also research that suggests changing the gut microbiome with a faecal transplant (using a treated sample from a donor) can improve some of the symptoms and behavioural problems associated with severe autism.

Evidence for this comes from a small study by researchers at Arizona State University in the U.S. At the start of the study, 83 per cent of the children were rated as having ‘severe’ autism, but two years after the transplant, only 17 per cent were rated ‘severe’. The parents also reported significant improvements in their language, interactions and behaviour.

The researchers are now carrying out a bigger, placebo-controlled trial in adults.

Sleeping well? This is not a rhetorical question, I really want to know. So much so that I recently launched, with the help of researchers from Oxford University, what we are hoping will be the UK’s largest ever sleep study.

If you fill in our questionnaire — find it by googling ‘BBC2 Horizon Sleep Census’ — you will get your own personalised sleep score and discover where you are on the owl-lark spectrum, i.e. the extent to which you’re better suited to late nights or early mornings. We’ll be using the anonymous data to build a detailed picture of what we all do to get a good night’s sleep, as well as the impact that sleep has on how we think and feel.

I will report back on our findings later in the year.

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Shocking New Facts Reveal why You Should ALWAYS Sleep at Work

It’s time to put the myth to sleep. The Spanish didn’t really invent siestas as we know them, they just perfected the practice. The word siesta has its origins from the Latin word sexta. In days gone past, the Romans stopped to eat and rest in the sixth hour of the day.

The Spanish have historically had peculiar working hours, with time, they managed to slot in a couple of hours to nap in their daily routines. Their culture supports a practice called presenteeism, which translates to spending more work hours to give the impression of being busy and committed to the workplace. Traditionally, most companies believed that spending more hours at work meant improved productivity. Whilst this is not necessarily always the case, the introduction of afternoon siestas between 2-5pm did allow them to rejuvenate and carry on with their daily activities.

Power Naps

For the siesta to survive in the new age, many things need to be taken into consideration. The sleeping culture of big cities needs to be revised in order to ensure compatibility with the workforce.

There have already been a few initiatives among the Spanish populace to save siesta sessions. Last year sleep pods were tried out in Madrid’s Atocha train station to offer a temporary lunch break relief for tired office work.

An app known as SiestAPP has also been developed to help users refresh and revitalize. The app works by letting users grab some precious 40 winks and then waking them up just in time to get back to work.

In the New Age, people are paid by the Hour, Napping in the Afternoon may thus not make sense for most employers


When we take breaks and/or sleep, the brain engages in mundane but important activities. Scientists have always suspected that when one is not actively engaged in a learning experience, the brain strives to amalgamate new data. It is during this time that memory gets stored up and the brain gets to subconsciously rehearse new skills by etching them into the brain tissue.

Most students can give testimony to the fact that after a late night out studying, they were able to recall most of the things learnt in the morning after a good night of sleep. Musicians practicing instruments also experience this same phenomenon. In essence, a good sleep session is an essential component of memory.


Psychologists have established that taking breaks and vacations can have real advantages for most people. A vacation takes the mind out of focus on particular issues and helps it concentrate on new things.

Taking a quick shower on a hot day can have the same benefits as a good sleep session. By distracting the mind and giving it a new pre-occupation, different parts of the brain responsible for creativity and memory are triggered. This can have a great benefit in how we are able to execute work much more efficiently afterward.

Siestas allow the brain to switch off for a while and take inventory of the day’s happenings whilst preparing us for future functionality with improved effectiveness


In Tolkien’s Middle Earth magnum opus, the Hobbits are known to partake in two breakfasts, the first and the second. The same way pre-industrial Europe was known to have a first and second sleep session typically divided by an hour of crepuscular activity. Numerous studies have shown that taking naps helps the brain sharpen concentration and improve productivity at workplaces.

A good downtime session can significantly help improve the attention span of people

While there are a couple of forward-thinking companies in the US that allow workers to take naps at the office, most still don’t cater for such needs. A good alternative for those unable to take naps at the office space because of their bosses would be to spend some time outdoors exploring. By taking our minds off work and school for short periods, we’re able to prepare the brain for intensive information processing later in the day.

A good downtime session can help improve the attention span of individuals too. Sleep and meditation are considered to be some great ways to help the mind focus on issues we deem important when we’re feeling a bit fatigued. A nap a day, keeps the productivity at an all-time high. It’s the miracle cure that seems too good to be true, yet still, it is.

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How You Should Really Be Cleaning Your Toothbrush

Do you run your toothbrush under hot water every once in a while as a way to sanitize it? If you have, you likely know that it’s important to keep your toothbrush clean, but you might not know the best way to do it. Every time you use your brush, you slough off plaque, bacteria, and other microorganisms — it’s wise to have a hygienic routine for this utensil.

For people who have used the hot water trick, this may be a worthwhile method. Healthline explains that you can sanitize the brush by running it underneath the water both before and after use. Make sure that the water is as hot as possible — the outlet suggests ensuring that the water temperature generates steam to effectively rid your brush of germs. This can help burn off any clung-on bacteria, which is especially important since germs from your toilet can even make their way onto your bristles, Insider notes. Apparently, the moving water sends bacteria into the air which can settle directly on your toothbrush. Make sure to keep your brush far from the toilet and sanitize it often to counteract this effect. 

The way that you store your brush also can make or break its cleanliness. It should always stand in an upright position after use because air kills off most of the bacteria present on the bristles. Rather than tossing your brush in a drawer, find a holder that keeps your brush separated from anyone else’s in your household and allows it to stay vertical.

You can use hydrogen peroxide to clean your toothbrush

If you’re looking for a cleaning agent, you can likely find a viable option in your medicine cabinet. Insider suggests using hydrogen peroxide to do the dirty work by killing off germs and microorganisms — especially if your toothbrush needs a deep clean. You can also use a mouthwash that contains alcohol for a powerful rinse that will sweep any lingering particles out from the bristles.

The outlet even cites a study finding that toothbrushes soaked in 3 percent hydrogen peroxide or an alcohol-based mouthwash came out 100 percent germ-free. Simply pour enough of the liquid into a cup and soak the head of your brush for 15 minutes. Rinse with hot water and enjoy your squeaky clean bristles.

Tools that clean your brush for you are also on the market, and they usually use UV rays to do the work. Healthline explains that this technology is extremely effective in sanitizing your toothbrush — you can find an apparatus online. They do carry a hefty price tag so make sure that you’re ready to use it often to get the most out of it. 

Of course, replacing your toothbrush every three-four months is the best way to keep it free from bacteria. If you notice the bristles fanning out or just a lower quality of clean, it’s best to pick up a new one.

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The Candle Scents You Should Burn If You Need To Relax

Over the past year we’ve spent way more time in our homes than we anticipated, so it’s no surprise that 2020 saw a surge in candle sales. “Home scent has been a strong performer all year,” Larissa Jensen, vice president and beauty industry advisor for market researcher The NPD Group, told CNBC in December. “All of that’s really tied to the fact that we are more homebound than ever.”

Lighting candles before we settle in with a good book or TV show is relaxing in itself. But certain scents are associated with relaxation and even reduced anxiety — so those are the candle scents you’ll want to light when you really need to relax.

Lavender is the perfect example. According to Medical News Today, a recent study found that the scent has calming properties that help ease anxiety. Another scent to light when you’re stressed is rose. A study published in the journal Natural Product Communications found that smelling rose oil decreased the breathing rate and blood pressure of participants.

There are other relaxing candle scents to try

Another scent that promotes relaxation is lemon. In fact, one study found that, in essential oil form, lemon is actually more effective for stress relief than lavender and rose (via Behavioural Brain Research).

Then there’s jasmine. This scent has been touted as the perfect natural remedy for anxiety and depression for years. One study (via Science Daily) even suggested that it could be used as a substitute for prescription valium, which is used to treat anxiety.

A eucalyptus candle also might be just what the doctor ordered after a stressful day. Per Healthline, eucalyptus is known for being a stress and anxiety reducer.

Finally, candles scented with bergamot, a citrus fruit, definitely belong in your relaxing candles collection. According to Medical News Today, studies have found that bergamot aromatherapy reduces anxiety.

It’s also worth noting that all these scents are available as essential oils, which can be used in a variety of ways — in a diffuser, in a steam, simply smelled from the bottle, diluted and applied directly to the skin, and more (Cleveland Clinic).

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Health survey conveys messages on how we should live


Since the 1980s, the physical and mental health of Swedish children and young people has been measured by way of surveys. One of these is the international “Health Behavior in School-aged Children Survey” (HBSC), which is taken by 11-, 13- and 15-year-olds every fourth year during a class in school.

Researchers Anette Wickström and Kristin Zeiler at Linköping University wanted to study the survey to see which norms can be conveyed in health surveys, something that has rarely been studied. The results have been published in the journal Children & Society.

“The study shows that survey questions on parents’ occupation and financial situation create norms about how you should be and what you should own. Our interviews also show that some teenagers ask themselves if they should respond according to reality or in a way that protects themselves and the people they care about,” says Anette Wickström, associate professor at the Department of Thematic Studies at Linköping University, who has previously studied norms and ideals in relation to health.

Survey raised thoughts they had not previously had

These surveys can be seen as a tool for finding out about the wellbeing of young people. But they can also be given a broader significance, as carriers of meaning and norms. This theoretical approach, from science and technology studies, is the one taken by the researchers.

By way of 51 interviews with 15-year-olds in three school classes, an understanding of how the teens view the surveys emerged.

According to the results of the study, some of them feel that the survey conveys a message about how people should live. The very existence of questions about having one’s own room, and about the number of computers and bathrooms in the home, was perceived by some of them as a message that they should have these things. Similarly, they remarked that the survey questions about weight and body can give rise to negative thoughts that they previously had not had.

The survey also made them aware of differences, especially with regard to their families’ financial situation. While some of them said the survey made them realize how fortunate they are, others said they felt afraid of appearing poor.

A growing field of research shows that a person’s subjective idea of their socioeconomic status can affect their health more than their objective status does. In other words, it is more important for your health how you perceive your income and your status in society than how much you are actually paid.

“The young people say that the survey raises issues of status. If we know that the subjective understanding of your social status can mean more for your health than the actual situation, we can ask how this type of question impacts the teenagers,” says Anette Wickström.

Motivating or guilt-inducing questions

The young people’s experience of completing the survey differed. Some felt the survey was fun and informative, a “guide” to how you should live, which motivated them to set new targets.

Others said the survey was difficult to complete because it induced feelings of guilt, responsibility and inferiority. Some of them wondered about who is responsible for them feeling good. They felt the survey assumed that they themselves were ultimately responsible for—and could influence—their health. However their view was that largely, their health was reliant on external factors, things outside their control, such as deaths, abuse and conflict in the family.

Providing sensitive details in a classroom

The interviews also showed that it was difficult for the teenagers to complete the survey in privacy. Some reported that they tried to hide their questionnaire for fear of their classmates seeing it, while others said that questions and answers were discussed openly in the classroom.

Other interviewees spoke of the risk of being reminded of memories they didn’t want to revisit while sitting amongst their classmates. Regarding the question of how old they were when they first had sexual intercourse, one girl commented: “If you’ve been abused and have never had sex voluntarily, how should you respond?”Anette Wickström explains that the results of the study are a reminder that surveys and questionnaires require constant reflection.

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