Cholesterol can be confusing. But understanding it could help you live a longer, healthier life.

So in honor of Cholesterol Education Month, we asked a pair of experts to clear up five common questions.

Do my blood cholesterol numbers matter?The answer is yes, said Dr. Neil J. Stone, Bonow Professor in Medicine-Cardiology at Northwestern Universitys Feinberg School of Medicine in Chicago.

Studies show healthy people with LDL levels of 100 mg/dL or below tend to have lower rates of heart disease and stroke, supporting a lower is better philosophy, according to cholesterol guidelines issued by the American College of Cardiology and American Heart Association in 2018.

Older recommendations emphasized targeting specific cholesterol numbers. But today, doctors use cholesterol tests as part of a personalized assessment of overall cardiovascular risk. Those with the highest risk have the most to gain from cholesterol-lowering, said Stone, who was vice chair of the task force for the guidelines.

But cholesterol doesnt exist in isolation, he said. One has to think about diet and lifestyle and medication to treat the whole risk continuum of blood pressure, cholesterol, blood sugar and weight.

The guidelines recommend getting cholesterol and other traditional risk factors checked every four to six years starting at age 20. If the COVID-19 pandemic has complicated those plans, get up to date when you can do so safely, said Kristina Petersen, an assistant professor in the department of nutritional sciences at Texas Tech University in Lubbock.

Im confused about good cholesterol versus bad. What should I focus on?When you get your blood tested, youll probably see numbers for total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.

LDL is the so-called bad cholesterol because it increases the risk of heart disease, stroke and other health problems. HDL is dubbed the good cholesterol because having a higher level is associated with lower risk of heart disease and stroke.

Lowering LDL should be the priority, said Petersen, co-author of an AHA science advisory on dietary cholesterol and heart disease published in December in the journal Circulation.

The most important thing is to lower LDL cholesterol, because that is what ultimately increases your risk of heart disease, she said.

Should I worry about cholesterol in food?Many sources of cholesterol in the diet also are sources of saturated fat, Petersen said. We do want to limit dietary saturated fat intake. And if you do that, your intake of dietary cholesterol will be low. Cutting back on saturated fat can improve your LDL number in four to six weeks, she said.

The advisory on dietary cholesterol emphasizes that a healthy diet is more important than focusing on a specific cholesterol target, and such a diet highlights fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean animal protein or plant protein sources, nuts, seeds and liquid vegetable oils.

Selecting the right food may be particularly important for people who are sensitive to dietary cholesterol, which some studies suggest could be the case for roughly 1 in 4 people. A 2019 review published in JAMA of long-term studies suggested that each additional 300 milligrams of dietary cholesterol consumed per day was significantly associated with higher risk of heart disease.

The patient should talk to the doctor about individualizing limits on dietary cholesterol, Stone said.

Is it OK to eat eggs?Egg yolks are known for their cholesterol, with one large scrambled egg containing 169 milligrams of cholesterol.

You can eat eggs, Petersen said. We suggest eating no more than one full egg per day in order to keep your cholesterol intake low, but you can definitely have eggs as part of a healthy dietary pattern.

The research is inconsistent, she said, because eggs often are consumed with foods high in saturated fat, making it hard to parse out potential harm.

And people vary, Stone said. Some patients have two eggs a day, and their cholesterol doesnt budge. Other patients have two eggs a day and their cholesterol goes up 50 points.

Is possible to inherit high cholesterol?High LDL cholesterol is sometimes caused by a genetic abnormality called familial hypercholesterolemia that affects an estimated 1 in 212 U.S. adults. If its picked up early, medication combined with a healthy diet and exercise can be very effective.

The ACC/AHA guidelines say its reasonable to check cholesterol in children as young as 2 who have a family history of early heart disease or high cholesterol.

Everyone needs to stay aware of their cholesterol levels and be mindful of the connection to overall health, even amid the pandemic, Stone said.

This is exactly not the right time to let diet and regular exercise go to develop habits that are not heart-healthy, he said. This is exactly the right time to learn how to eat less, eat smarter, move more daily, and keep from gaining weight.

See the original post here:
The good, the bad and the dietary: Making sense of cholesterol - The Augusta Chronicle

Matthew F. Watto, MD: Welcome back to The Curbsiders. I'm Matthew Watto, here with my greatest friend, Dr Paul Williams. Paul, tell us what we are going to do on this short video.

Paul N. Williams, MD: We're going to highlight some of our favorite clinical pearls and practice-changing knowledge that we gleaned from a recent interview with the amazing Dr Michelle Kittleson, a renowned cardiologist, heart failure expert, and Twitter phenom. We had a long conversation about the inpatient management of acute decompensated heart failure, and we thought we'd spend a little time in this video talking about the things that we liked best from that discussion.

Watto: Pearl number one. She made it pretty easy on the physical exam. What she cares about is elevated jugular venous pressure or pulsations, and she looks for lower-extremity edema. She gave us permission not to listen to the lungs. She doesn't really care about crackles because they are very nonspecific.

When it comes to the labs, you can check the B-type natriuretic peptide (BNP) once if you are making the diagnosis of heart failure, but it shouldn't be trended. The things you should trend are sodium, potassium, and creatinine levels. Those are the important labs that have some prognostic value. With potassium you just have to make sure it's high enough so that the patient doesn't code on you.

Williams: Tremendous advice. I made a half-hearted defense of the lung examination, but I was scared of her so I didn't really lean too hard into it. Another point that came from a nice conversation the two of you had was about precipitants of heart failure exacerbation and whether we should be blaming the patient for the exacerbation, in terms of things like medication or diet nonadherence. I liked her take on this, which was, you really aren't duty-bound to look for precipitants, whether that's an acute ischemic event or medication nonadherence, either because they couldn't afford the medication or any of the other reasons patients might not have access to them.

You need to look and examine for those problems because they are reversible. But she also made the point that if patients are doing everything right and they still have acute decompensated heart failure, that's a pretty bad prognostic indicator.

Watto: I loved that point. It can't be said enough that when you read notes, people are clearly blaming the patient for their exacerbation. Sometimes the patient might have been able to avoid it, but a lot of times, it's just progression of disease. And I really liked what she said about fluid and salt restriction.

Williams: Her point was that there is no point to mercilessly restricting fluid and salt in the inpatient setting. If you can't control someone's volume status when they are on 2 g of sodium and 2 L of fluid daily, it doesn't matter how much more you restrict them at that point. You need to adjust their diuretic to optimize them. There's no point in relentlessly controlling fluid and sodium intake because you aren't going to significantly impact the volume status that way. It has to be done with medications at that point.

Watto: She even implied that the physician ordering the very restrictive diet should be put on the same diet. I like that point.

Williams: She didn't imply it; she outright said it.

Watto: That's right. She was not mincing words.

Finally, there was one other pearl that I thought was really great and very important, because I see this all the time. When a patient comes into the hospital, we should not just automatically pull off the ACE inhibitor or the beta-blocker. The guideline-directed medical therapy should be continued if you can do it if there's room in the blood pressure.

She talked about spending the blood pressure. In her practice (and we're talking about systolic heart failure here), she prioritizes the ACE inhibitor, the ARB, or these new angiotensin receptorneprilysin inhibitor (ARNi) compounds. Those would be her first agents that she would keep the patient on if she could. The next agent she would try to prioritize is the beta-blocker. You really should have a higher threshold to stop those agents because patients will do better, and we speculate that they might not get restarted when the patient is discharged from the hospital. It's really best to leave them on if you can safely do so.

Williams: That's exactly right. Prioritizing the ARNi over the beta-blocker feels like such a paradigm shift in recent years. It was fascinating to have that discussion.

Those are just a few nuggets of goodness from a wide-ranging conversation. If you want to hear the whole podcast (and you should), just click on the link below. You can also subscribe to our show to get our weekly episodes, and you can get a free PDF copy of our show notes and infographics at thecurbsiders.com.

Click to hear the full episode, Kittleson Rules Acute Heart Failure, or find The Curbsiders podcasts on iTunes.

The Curbsiders is a national network of students, residents, and clinician educators from across the country, representing 15 different institutions. They "curbside" experts to deconstruct various topics in the world of medicine to provide listeners with clinical pearls, practice-changing knowledge, and bad puns. Learn more about their contributors and follow them on Twitter.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

Read more here:
Heart Failure in Primary Care: Do's and Don't's - Medscape

A north-east education boss has thanked parents and carers for their support in recent weeks following the reopening of schools.

Laurence Findlay, Aberdeenshire Councils director of education and childrens services, has issued a letter halfway through the first term of the new school year.

He said the return to school following the Covid-19 peak had generally gone well and they are learning to live alongside the virus.

Mr Findlay said it was important for parents and carers to continue to speak to children about following the safety measures that are in place.

He also urged parents to follow the rules when it comes to drop-off and pick-up arrangements. As is currently stands parents are not allowed inside schools.

Mr Findlay said: The return to school has generally gone well, although the school environment is very different and rightly so given that we are now learning to live alongside Covid-19.

This requires all members of a school community to take responsibility and follow the measures put in place to protect everyone. All Aberdeenshire schools are following the guidance as issued by Scottish Government and all are engaged in an ongoing assessment of risk to keep young people and adults safe.

It is essential that everyone plays their part in this effort. I would encourage you to continue talking to your own child or children about the importance of following the procedures and measures the school has put in place.

Furthermore, I would urge you as parents and carers to follow the instructions the school is giving, particularly with regards to drop-off and pick-up arrangements. This is for everyones safety and wellbeing.

Aberdeenshire Council also issued a frequently asked questions guide which focuses on the Covid-19 restrictions around both primary and secondary schools.

It sets out the guidance schools are following as well as the reasons certain restrictions are in place.

Over the summer months, Scottish Government produced general guidance for local authorities on how to reopen schools safely. The process of publishing more detailed stage and subject-specific guidance is still ongoing, and on receipt of these, schools are required to revisit their working practices and procedures.

Schools undertook extensive risk assessment in the preparation for pupils returning in August. As a result, new rules and routines have had to be and continue to be introduced in all establishments. No two schools are the same, however, so each schools approach must be tailored to fit its own context.

Creating and then implementing all this new guidance has been necessary to ensure the health and safety of young people and school staff. It has been a major challenge and has resulted in a major change to established working patterns.

Significant time is now being spent explaining and reinforcing the guidance and because safety has been prioritised, some of the tasks which were routinely completed by staff before the pandemic are not being done so often or so quickly as before.

From the outside, it may look as if schools are as they always were but they are not. School life has changed significantly. Parents may be aware that queries are not dealt with so promptly, that members of leadership teams are not available to take calls, or that information takes longer to reach home, but we would ask for patience, as delays are often caused by the fact that so much time is now being diverted into supervision and the maintenance of good health and safety, and schools will still get back to parents as soon as they can.

All Aberdeenshire schools are following Scottish Government guidance to ensure the safety of pupils and staff in schools. They are also acutely aware of the need to reduce movement between different groups of people and the need to ensure that every possible measure is in place to try to prevent infection entering schools. Because of this, to protect the safety of pupils and staff, many schools are unable to allow parents to access school buildings.

Where there is need for a parent to engage with the school because, for example, a child has forgotten to take something important into school, or there is some emergency situation at home, the school will do what it can to help. In these cases, parents should telephone the school to explain the problem and the school will then explain how that can be overcome.

The most important thing to remember is that parents should not appear at school unannounced because in such cases, it is likely that they will not be able to access the building.

Although young people are back in school, Covid 19 is still an ever-present threat in our communities, and like everywhere else, schools have had to change and adapt. The certainty which we for so long have taken for granted has now gone and everyone in the country is having to cope with changing rules, and restrictions which differ day to day, week to week.

With this as the backdrop to school life, it is difficult for head teachers to make decisions too far ahead. The focus, for now, will be to try to ensure that young people are supported to learn and achieve in a safe and healthy environment.

At present parents, and other non-essential school personnel, are not allowed to enter school buildings. As a result, therefore, schools are unable to hold parents evenings.

The position as regards parent evenings will be reviewed in November. If the situation around Covid 19 improves significantly, restrictions may be eased and should this happen, individual schools will look at how best they can manage to accommodate parent meetings. These may, however, look different in each school and may differ in Primary and Secondary settings.

Parents should be aware that there may not be a full return to face to face meetings. Schools will, however, be mindful of the need to share information about pupils progress with parents and will look at ways of managing this.

This may mean parents evenings being replaced and we will look at ways of managing this via collegiate dialogue at school level and advise parents accordingly in due course.

We are continuing to cover all aspects of the curriculum in classes as best we can, but there are some activities often practical activities which pose some challenges. Guidance from Scottish Government has suggested that where possible schools should look to use outdoor spaces to deliver some aspects of the curriculum and schools are looking for ways to do this.

Where an activity is heavily dependent on shared specialised equipment, teachers must consider how or if that can be used safely, and risk assess activities accordingly. Everywhere in schools, there is a huge emphasis on cleaning, and regular hand washing or hand sanitising is now part of the routine in all schools.

During normal times at school, homework is an integral part of the school week. Currently, however, homework presents schools with some challenges. Movement of equipment and resources between home and school has to be restricted because of concerns about infection.

Furthermore, when written work is submitted by pupils in jotters, or on paper, the rules say that it must be quarantined for 72 hours before it is marked, a delay which could be counter-productive for many young people. Schools could choose to set homework on-line and ask for work to be submitted in the same way, but this is only feasible where they are certain that all pupils can access such tasks.

We are currently in what the Scottish Government has dubbed the Recovery Phase. In this phase, the focus has been on Health and Wellbeing, Literacy and Numeracy and homework has been less of a priority.

Schools will, however, soon be considering how to resume homework safely and will communicate with parents as necessary to explain how this will be managed.

Many of the subjects pupils study in school involve a significant degree of practical work Art, Music, Drama, Home Economics, PE, Technical subjects, Business subjects and Sciences have very significant practical elements, but there is also practical work built into other courses.

Guidance from Scottish Government, through Education Scotland, and from agencies like Scottish Schools Education Research Centre (SSERC) has been or is being created for schools to use in their planning, but there is no one size fits all approach.

Factors like school rolls, school buildings, staffing levels, timetable design and the availability of resources differ from school to school and all affect what can and cannot be done.

Where a subject is resource and equipment dependent, there are rules about the sharing of equipment and the cleaning protocols that are required to ensure pupil and staff safety.

This may mean that pupils can do less hands-on work and that they must learn from watching demonstrations rather than by doing the activities themselves. Where pupils are getting hands-on experience there are more frequent cleaning protocols to be worked into teaching time and depending on period lengths, this can be prohibitive.

Just as there are restrictions applied to facilities like public gyms and swimming pools, there are restrictions on what can and cannot be done in PE classes. PE classes are mainly, if not wholly, happening out of doors, even in poor weather, and changing facilities are an issue for many schools given that changing rooms are generally quite small and often windowless.

It is because of this that the guidance schools received said that pupils should come to school dressed in PE kit. Some schools have the accommodation to be able to create changing areas which satisfy the safety considerations, but in some schools, pressures on teaching space will not allow this.

Home Economics lessons provide another set of challenges because the design of most school kitchens makes any physical distancing very difficult and some equipment inevitably must be shared.

Pupils are encouraged to observe physical distancing rules, but teaching staff must maintain physical distancing as much as possible. In small kitchens, this is very difficult, and head teachers are mindful that they cannot risk the safety of staff.

There are also additional cleaning routines which add significant time pressures. Solutions to these challenges are being sought but as with everything in our new normal there are no easy answers.

At present, schools are looking for ways to ensure pupils can learn and develop practical skills, but this is not easy. Teachers are working with colleagues within their own school and from other schools locally and nationally to find solutions to these challenges while awaiting the promised national guidance.

Colleges, like schools, had to close their doors to students when lockdown began. Like schools, they have had to do a huge amount of preparation, involving detailed risk assessment, to be able to reopen safely.

The guidance for reopening colleges was only published at the beginning of September and it included the steps that were to be taken to permit school pupils to return to college link courses.

For now, NESCol, SRUC and Dundee and Angus College courses are being delivered to school pupils through on-line platforms and plans are being drawn up to start the process of on-site delivery for some courses. Although the picture varies from college to college, broadly speaking if a course has no significant practical element it may be delivered wholly or mainly on-line this session. For more practical courses, planning is underway to see how pupils might attend college for some lessons. Because of physical distancing rules which have to be imposed in colleges, as they cater largely for adults, pupils are unlikely to be permitted to attend college every week.

This may mean that pupils are unable to complete full courses, but in lieu of the usual qualification, a college certificate could be given.

Schools are doing all they can to ensure appropriate arrangements are in place for pupils with a college course in their timetable, but it may take time for final plans for these courses to be finalised.

Last session, SQA exams did not take place and the submission of coursework was also affected by the closure of schools in late March. This session, Scottish Government and SQA are planning for a full exam diet in 2021.

At the moment, extensive consultation is taking place with local authorities, teaching unions and members of the teaching profession more widely, to try to produce a workable plan for examinations in 2021, with contingencies in place in case there are further spikes in Covid 19 cases.

There are a whole range of factors which will have to be considered:

The uncertainty surrounding SQAs plans is undoubtedly causing anxiety for young people, parents and of course teachers, but we must all wait for final decisions to be made and new guidance on assessment in general, and examinations, in particular, to be produced.

In the meantime, staff in schools are trying to ensure key aspects and skills from each course are covered until revised guidance is made available. Their aim is to try to ensure pupils are encouraged to stay positive and have the best possible chance to achieve.

Which regular school events can I expect to happen during this school year? School life mirrors life in the community and just as many community events have had to be cancelled because of Covid 19, school events are subject to the same rules and regulations.

This means that as things stand, schools cannot plan to hold events like school concerts, fund-raising events and curricular information events. Even occasions like school parties and proms are under threat in their current form.

If restrictions are eased, there may be a possibility of some of the more traditional school calendar events taking place, but as always, schools will keep you fully informed.

This is a time of huge uncertainty for everyone: no one has a guide book to help them chart their way through this pandemic. Our young people will emerge stronger and more resilience from this difficult time if parents and staff work together.

Please continue to support your school in any way you can, within present restrictions, supporting your parent council, or any other parent forums your school has in place, as best you can.

See the article here:
Why can't I go into my child's school, what is happening with SQA Exams? North-east council release FAQ guide to help parents - Aberdeen Evening...

publication date: Sep. 18, 2020

Shelley A. DuBois

Science/health writer,

San Francisco, CA

Raymond N. DuBois, MD, PhD

Dean of Medicine,

Director, Hollings Cancer Center,

Medical University of South Carolina;

Editor in chief, Cancer Prevention Research

This story is part of The Cancer Letters ongoing coverage of COVID-19s impact on oncology. A full list of our coverage is availablehere.

This January, the American Cancer Society reported the sharpest drop in U.S. cancer mortality ever recorded. Between 2016 and 2017, the death rate from cancer fell 2.2%, continuing the trajectory of a 29% decline in cancer mortality since 1991.

Within a month after ACS reported those numbers, the COVID-19 pandemic hit, sending shockwaves through the already fragmented U.S. healthcare system. The pandemic could potentially reverse a decades-long downward trend in cancer mortality. We must not let this happen.

Specifically, we must ensure patients can get indicated screenings they need to detect cancer early, prevent it when possible, and save lives. We must also make sure that cancer patients continue their treatment regimens already underway uninterrupted and initiate new treatment for cancer when needed.

We have our work cut out for uspatients are understandably worried about seeking care during the pandemic, which has caused the death of nearly 200,000 people in the U.S., and continues to claim the lives of around 1,000 people in the country every day. These numbers do not adequately reflect the collective trauma and depth of our loss.

As we continue to mourn the lives lost due to the pandemic and adapt our lives to the measures necessary to keep one another safe, we must recommit to lifesaving preventive measures such as screening for cancer. Every year, cancer kills 600,000 people in the U.S. These lives, too, are invaluable. The risk of a significant reduction in screenings, a proven method to reduce mortality from cancer, is too great to bear.

Any significant drop in screenings could have profound consequences. Routine colonoscopies that led to the removal of noncancerous colorectal polyps reduced mortality from colorectal cancer by 50%, according to a study published in the New England Journal of Medicine.

Screening exams also enable health care providers to detect and treat malignancies early, when they are often more responsive to therapy. A study published in the journal Cancer found that routine mammograms reduced a womans risk of dying from breast cancer within 10 years of her diagnosis by 41%, and also led to a 25% reduction in being diagnosed with advanced breast cancer, which is much more difficult to treat.

According to a 2016 study published in the British Journal of Cancer, screening for cervical cancer has prevented nearly 68% of would-be deaths from the disease.

To gain the lifesaving benefits of routine screening, we must safely resume scheduling patients for these examsor risk a worse outcome in some individuals.

As the pandemic peaked in waves around the country, healthcare organizations and local officials released policies to delay elective procedures. For many, elective procedures included routine screening exams. These measures were necessary for providers to assess the threat of COVID-19, or for hospitals with active COVID-19 wards to redirect staff and resources towards virus-infected patients.

Now, patients continue to delay preventive screenings for many reasons. At first, patients were told to postpone screenings by their healthcare providers, so they did. But even as hospitals have developed protocols to deliver routine care in a much safer environment, screening rates remain too low, and ultimately bad outcomes could result in lives lost.

Again, this is understandable. Even in the best of times, we are not capitalizing on the full potential of prevention measures that we know work. As of 2015, screenings for breast, cervical and colon cancer fell short of targets set by the Office of Disease Prevention and Health Promotion.

These, of course, are not the best of times. The pandemic temporarily brought routine screenings to a halt. That type of inertia is dangerous, especially as the pandemic intensifies factors that make barriers to care worse. Patients tend to seek less care in an economic downturnthey conserve their health care dollars for acute issues and emergencies.

Patients across the world are now suffering from economic hardship. The World Bank predicts the global economy will shrink by 5.2% this year, and that the U.S. economy will contract by 6.1%. Moreover, up to 12 million Americans may have lost their employer-sponsored health insurance during the pandemic, according to the Economic Policy Institute, adding to peoples financial stress.

Besides the economic hardship triggered by the pandemic, patients are sometimes afraid. The background noise of COVID-19 can drown out other health concerns. With a lack of clear direction and/or conflicting messages, some patients have been receiving inconsistent information about how and when to resume health care services.

With state and local healthcare leaders overburdened with the requirements of the pandemic response, it leaves few stakeholders to bang the drum about the importance of screening for cancerand cancer screening is needed to maintain the health and wellbeing of individuals in the U.S., the healthcare system, and the country as a whole.

Already, COVID-19 has halted cancer screenings to a degree that could negatively affect outcomes. Researchers estimate that mammograms, a crucial tool for early detection of breast cancer, have dropped anywhere from 75% to 95% since March 2020. Pandemic-related screening delays could cause an excess of 10,000 deaths over the next 10 years, National Cancer Institute director Ned Sharpless told STAT this past Juneresulting in a 1% increase in expected deaths for the decade.

As of June, cancer screenings had not returned to their pre-COVID-19 levels, according to data from the Epic Health Research Network. Breast, colon and cervical cancer screenings remained 29%, 36%, and 35% lower than expected, respectively.

In short, we risk a significant increase in the number of deaths and poorer outcomes from cancer if we dont successfully address these issues during the pandemic.

Our challenge is to earn patients trust, so that they can safely and cost-effectively resume screening procedures for cancer.

Healthcare leaders need to explain measures they are taking to ensure a low infection risk at clinical facilities that offer screenings.

We must also assure individuals that discovery of a malignancy or a premalignant lesion can be safely treated in the clinic or hospital. Early studies show that cancer patients undergoing chemotherapy or other treatments are not at increased risk of mortality from COVID-19. Although, outcomes data is emerging from large cohort studies that will address this issue much more carefully in the next several months.

We must adhere to social distancing and mask-wearing policies in clinical facilities and communicate those policies clearly to patients and their family members. We must make such small steps as scheduling appointments and negotiating with payers as easy as possible, since every barrier to care takes on added weight during COVID-19.

It can be difficult for people to grasp the harm of not doing a procedure. But forgoing cancer screenings has the potential to derail the countrys decades-long progress in lowering cancer mortality. COVID-19 has been destructive enough. We must not let it stop measures to detect early diseasethe most effective method we have to prevent deaths from cancer.

In order to understand better the impact of COVID-19 on cancer patients, the Hollings Cancer Center here at the Medical University of South Carolina (@muschollings) in Charleston joined the COVID-19 and Cancer consortium (CCC19) and is one of 120 institutions in the country collecting data on adult patients (18 and older) with cancer who have been diagnosed with COVID-19.

This is being done in order to collect and disseminate prospective, granular, uniformly organized information on cancer patients and survivors who are diagnosed with COVID-19at scale and as rapidly as possible to understand, in real time, how this disease is affecting cancer patients.

There are several steps we can all take to reduce our risk of getting cancer:

Dont use tobacco in any form or expose yourself to secondhand smoke. Cancers linked to tobacco use make up to 40% of all cancers, so avoiding this exposure can have a huge benefit.

Eat a healthy diet that includes fruits and vegetables. If you choose to drink alcohol, do so in moderation, and limit intake of processed meats.

Maintain a healthy weight and stay physically active. Any amount of physical activity is helpful, but to maximize benefit, the Mayo Clinic recommends getting at least 150 minutes per week of moderate activity or 75 minutes per week of vigorous aerobic activity.

Protect yourself from exposure to the sun and avoid tanning beds or sun lamps at all costs.

Get vaccinated for hepatitis B and the human papilloma virus (HPV) at the recommended ages. Avoid risky behaviors that can lead to infections known to increase your risk of cancer, like unprotected sex or the sharing of needles used by others.

Seek routine medical care, as noted above, that includes regular self-exams and screenings for various types of cancers, such as cancer of the skin, colon, cervix and breast. These preventive exams increase your chances of discovering cancer early, when treatment is most likely to be successful.

Do not hesitate to ask your doctor about the best cancer screening schedule for you based on your medical and family history.

Remember, if we collectively, as a population, adhere to all of these recommendations, we could reduce cancer globally by as much as 40-50%today, without any further advances in diagnostics or treatment.

Originally posted here:
COVID-19 threatens to increase cancer mortality The Cancer Letter - The Cancer Letter

Lockdown was a time of terror for me. I was a sixty-something granny living alone some 40 miles away from my adult children and my seven-year-old granddaughter, Edie.

I was terrified that actually I might die (something that had not really worried me before) of Covid, or maybe starvation as I struggled to get an elusive supermarket delivery. My home, lovely though it was, had become a kind of prison and I was in solitary confinement. I overdosed on vitamin pills, I talked (a little too much) to the dog and I absolutely lived for my daily face time calls with Edie. In short I discovered what if felt like to be terribly, terribly lonely.

There is, then, just one huge thing I will do the moment that any new lockdown is announced. I will pack the dog, the cat and a suitcase in my car and drive as fast as I can to London.Begging Bryony to please let me into her bubble.

Christine Armstrong, author of The Mother of all Jobs

Given that school has had six months to plan, well be leaving the kids timetabling to them. Which means that instead of wasting time on colour-coded plans of school classes and Joe Wicks that have less basis in reality than the Governments testing plans we can createtimetables for us parents instead. Filled with the things that keep us calm and happy.

Stuff like, times for each of usto exercise every day (hello again Yoga withAdriene). An hour alone to watch rubbish TV, listen to podcasts, call a friend or just hide from the children. And a system to decide whose work video call is more important, which doesnt involve us yelling about it as we dial in.

To help keep the house under control, we will take inspiration from Our Yorkshire Farm, and all jobs will be shared between kids and adults. Cleaning, washing, cooking, food ordering, gardening.

Obviously this will go extremely well and not end up in a squalid shouting match...

Linda Blair, clinical psychologist and author of The Key to Calm

Start by knowing you can face this uncomfortable possibility with confidence. The first time we have to cope with unexpected change is always the most challenging. Youve already done that, which means you can do it again and with the benefit of experience.

Here are three reminders to help you through:

Structure: Nothing is more important to convey a sense of control. Plan each day the night before. Include time to prepare and enjoy wholesome meals at regular intervals. Establish a regular bedtime and rising time, and recreate your favourite bedtime routine. Make sure you take at least 20 minutes of daily aerobic exercise. Set three small goals you know you can achieve each day. Write them down and tick them off at the end of the day.

Micro-breaks: What are your warning signs that stress is building decreased concentration, inability to make decisions, fidgeting, irritability? Whenever you notice them, take a three-minute micro-break. Sit somewhere comfortable, close your eyes, and take 20 slow breaths: in through the nose for four, hold for seven, out through the mouth for eight. For added effect, envelop yourself in your favourite colour or scent at each in-breath.

Compassion: Studies across the US and Europe have repeatedly demonstrated the benefits of kindness, both to yourself and to others better mood, better physical health, increased tolerance of pain and distress, even greater longevity. Contact a friend every day, preferably talking and/or sharing screens rather than by email or text. Ask how theyre coping; listen non-judgmentally and with full attention. If you can, thank or compliment them genuinely. Finally, dont let fear of imposed limitations sabotage your mood. Expect them instead then every day there are none, enjoy the resulting sense of relief.

Read more here:
How to be second wave savvy and what not to repeat from the first lockdown - Telegraph.co.uk