New documentary from Nova focuses on how opioid addiction affects the brain

A new documentary premiering Wednesday on PBS takes a deep look at how opioid addiction affects the brain.

The film, “Addiction,” created by the team at Boston-based Nova, weaves the stories of impacted families alongside the work being done by scientists to understand and treat the nationwide epidemic, which killed more than 63,600 people in 2016 alone.

Sarah Holt, the film’s writer, director, and producer, told Boston.com she hopes the documentary will help to shed light on the stigma associated with addiction as well as help those seeking ways to assist loved ones struggling with dependance on drugs.

Like nearly half of all Americans, I watched relatives, neighbors, [and] friends struggle with addiction, and it was incredible to me that families were navigating a broken system of care — trying to figure out how to help their loved ones and paying for it out of their own pockets, often times spending tens of thousands of dollars on treatment that wasn’t effective. ” Holt said. “And I was astounded by the stigma surrounding addiction. I thought, well, if I could make a film that kind of explained the science of addition, help people understand how the brain changes when it’s been exposed to drugs, it would really be important and maybe contribute to helping people realize this is not a moral failing. This is not a matter of weak wills. It’s such a baffling force, addiction.”

The most challenging aspect of making the documentary was finding people willing to share their stories on camera, she said. Even those who had years of recovery behind them were unwilling to speak about their struggles, fearful of what would happen once others found out.

“I think the stigma is huge, even in the language we use,” Holt said. “We call people ‘clean’ or ‘dirty.’ You’d never say, if somebody had diabetes and had high blood sugar, that they were dirty.”

In making the film, Holt, whose previous work includes “Can Alzheimer’s be Stopped?”, said she wanted to cover how people fall into addiction, why the disease is considered a brain disorder and chronic condition, and what effective treatment looks like. Helping people who are addicted should be part of the medical system, she said, and what those struggling with dependency on opioids need is support and compassion.

People would say to me, ‘Oh it must be so depressing, working on a film about addiction,’” Holt said. “And I really think the most important point is that it wasn’t depressing because I could see that once people get the right treatment, they get better. I want people to know that addiction is a treatable medical condition — it’s not a hopeless diagnosis. And we really need to be stepping up to the plate and trying to help people get the help they need.”

“Addiction,” which is narrated by Joe Morton, premieres at 9 p.m. on PBS. Watch a clip from the film below:

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Harmful algae bloom: red, blue and you

South Florida is now facing an environmental health challenge more familiar elsewhere in the state: toxic algae. While these microorganisms are always present in our marine and freshwater environments, a combination of temperature, currents, salinity and nutrients can allow them to rapidly reproduce, or “bloom.”

Wendy Stephan.jpg

Wendy Stephan is a health education coordinator for the Florida Poison Information Center at University of Miami/Jackson Memorial Hospital.

Simon Hare umiamihealth.org

During a bloom, these algae cells can number above one million in a single liter of water. In these cases, the water can become brown, green or even red, where Florida’s “red tide” gets its name. When the blooms involve toxic species, the bloom is called a “harmful algal bloom” or HAB. Dr. Richard Weisman, director of South Florida’s poison control center, notes that these blooms can be of particular concern for parents of children with respiratory conditions or serious allergies.

Even without a visible red tide, beachgoers in areas with detectable cell counts may feel the effects of red tide toxins, which rise into the air and are blown onshore. According to Dr. Jeffrey Bernstein, medical director of the poison control center, “Most people will be able to go to the beach and carry on normal activities, much as they do on smoky days from Everglades fires. People may notice irritated eyes, runny nose, sneezing and coughing.”

Children are likely to feel effects at lower concentrations than adults do given their smaller size, as with any poison. Children with asthma, cystic fibrosis, or who have an active or recent respiratory infection are most likely to have more serious symptoms. These might include labored breathing, coughing fits and chest pain. If a child ingests water with high red tide cell counts, they may experience nausea, vomiting and diarrhea.

Families living in Broward and Palm Beach may also have to contend with blue-green algae blooms in local freshwater canals. Kids living near these blooms are less likely to feel respiratory effects than from red tide, but they should not be allowed to swim, boat or water ski through the blooms. Pets should also be kept out of water with a blue-green algae bloom since drinking contaminated water is extremely dangerous, even potentially deadly.

Tips for reducing exposure for the whole family include the following:

  • If anyone is having symptoms of red tide or blue-green algae sensitivity, avoid the beach or the affected canal(s). Toxins from red tide can be felt up to a mile from the beach on a day with an onshore breeze. If you choose to swim, avoid swallowing the water.
  • Use the air conditioning consistently and keep windows closed at home. Change filters more frequently (perhaps weekly instead of monthly) during intense bloom periods.
  • Use the “recirculate” feature on your car’s AC to avoid bringing in outside air.
  • Don’t increase use of inhalers or medication unless your child has noticeably worsened symptoms. Over-the-counter antihistamines may not completely resolve symptoms since the effects are caused by toxins, not histamines.
  • Rinse eyes with “artificial tears” eye drops during the day and right before bed.
  • Kids with high sensitivity should shower and wash their hair before bed to minimize overnight exposure.
  • The poison control center at UM/Jackson is available 24/7 at 1-800-222-1222 to answer any questions related to harmful algae blooms and/or to assess a child’s symptoms. Calls are free.

Climate scientists tell us that the East Coast blooms are unlikely to last long, but in the meantime, you can get updates on the water quality near you by visiting myFWC.com/redtide and floridadep.gov/AlgalBloom. To learn more about these organisms and their health effects, visit the Florida Department of Health, https://hrld.us/2P2Dkkl

Wendy Stephan is a health education coordinator for the Florida Poison Information Center at University of Miami/Jackson Memorial Hospital. For more information, visit UHealthSystem.com/patients/pediatrics.

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Dying woman, 55, granted wish to see lighthouse for first time

Massachusetts paramedics paired with a 55-year-old patient’s hospice care team to make one of her final wishes come true and helped transport the woman over an hour away so she could see a lighthouse for the first time. Laura Mullins, a native of Ohio with no family in the area who could help, took in the sights of the Scituate Lighthouse on Monday and told the Brewster Ambulance Service EMTs that it was her “dream come true.”

The crew brought Mullins via stretcher closer to the lighthouse so she could touch it with her hands and hear the waves.

OBITUARY FOR MOM WHO DIED OF DRUG OVERDOSE GOES VIRAL

“She seemed at such peace,” Johnathon Bobbit-Miller, Brewster Ambulance Service’s paramedic field training officer and public relations contact, told CBS News. “She said, ‘I’m ready to go now.’”

“Today we did not transport a patient to the hospital but to the Scituate Lighthouse,” a post on the Brewster Ambulance Service Facebook page read. “We were honored to work with Kindred Hospice to make a 55-year-old terminally ill hospice patient’s final wishes come true this afternoon.”

GEORGIA WOMAN NEARLY DIED AFTER BOTCHED TUMMY TUCK LEFT HER WITH LIFE-THREATENING INFECTIONS

Mullins, who was accompanied by Bobbit-Miller, her nurse, Beverly Bellegarde, and a chaplain, was also treated to a special stop at McDonald’s on the way back so she could enjoy one of her favorite meals one last time, according to WCVB.com. Neither the news outlet nor the EMTs disclosed Mullins’s diagnosis.

“Thank you to our two talented EMT’s Brian Costa and Era Koriveshi for your compassionate care and making this happen today. We are proud to have you as part of the team,” the Brewster Ambulance Service’s Facebook post said.

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Canada is ready to open the door wide to legal marijuana

TORONTO (AP) – Tom Clarke has been dealing marijuana illegally in Canada for 30 years. He wrote in his high school yearbook that his dream was to open a cafe in Amsterdam, the Dutch city where people have legally smoked weed in coffee shops since the 1970s.

Turns out, Clarke didn’t have to go nearly so far to open his own retail cannabis outlet.

On Wednesday, Canada becomes the second and largest country with a legal national marijuana marketplace. Uruguay was first. Clarke, 43, will be among the first to legally sell recreational marijuana when his shop opens at midnight in Newfoundland, Canada’s easternmost province.

“I am living my dream. Teenage Tom Clarke is loving what I am doing with my life right now,” he said.

At least 111 legal pot shops are planning to open across the nation of 37 million people on the first day, according to an Associated Press survey of the provinces. That is a small slice of what ultimately will be a much larger marketplace.

No stores will open in Ontario. The most populous province is working on its regulations and doesn’t expect stores until next spring.

Canadians everywhere will be able to order marijuana products through websites run by provinces or private retailers and have it delivered to their homes by mail.

Canada has had legal medical marijuana since 2001, and amid excitement over the arrival of legal recreational pot, many in the industry spent the last days of prohibition on tasks familiar to any retail business – completing displays, doing mock openings and training employees to use sales-tracking software.

“It’s been hectic,” said Roseanne Dampier, who joined her husband – both former welders – in opening Alternative Greens, a licensed store in Edmonton, Alberta. “We have been extremely busy just trying to be able to meet that deadline.”

Canada’s federal government, led by Prime Minister Justin Trudeau, spent about two years planning for legalization, fueled by a desire to bring dealers like Clarke out of the black market and into a regulated system.

Canada’s national approach has allowed for unfettered industry banking, inter-province shipments of cannabis and billions of dollars in investment – a sharp contrast with national prohibition in the United States. Nine U.S. states have legalized the recreational use of marijuana, and more than 30 have approved medical marijuana.

A patchwork of regulations has spread in Canada as each province takes its own approach within the framework set out by the federal government. Some are operating government-run stores, some are allowing private retailers, some both.

Alberta and Quebec have set the minimum age for purchase at 18, while others have made it 19.

The provinces also have been able to decide for themselves how much to mark up the marijuana beyond the 10 percent or $1 per gram imposed by the federal government, and whether to allow residents to grow up to four plants at home.

Steve Hawkins, executive director of the Marijuana Policy Project, a Washington-based lobbying organization that has been pressing for legalization since 1995, said it is time for the U.S. to follow Canada’s lead.

“Canada is setting a strong example for how to end marijuana prohibition at the national level and replace it with a system of regulated production and sales that is largely governed at the local level,” he said. “The U.S. and other countries grappling with the complexities of such a significant policy shift will have an excellent opportunity to learn from the Canadian experience.”

As Canada welcomes legalization, supply shortages could develop, as happened in some U.S. states when legalization arrived.

Trevor Fencott, chief executive of Fire and Flower, said his company has 15 Alberta stores staffed and ready to sell marijuana, but the province has supplied only enough product to open three of them Wednesday.

“We’re aware of some of the kinks or growing pains that come with creating an industry out of whole cloth in 24 months,” Fencott said.

Clarke and Brenda Tobin, who is opening a store in Labrador City in Newfoundland and Labrador, expect to sell out quickly after not getting as much from licensed producers as they ordered.

“We expect to run out. I don’t know the first day, but I don’t expect we’ll have it too many days,” Tobin said.

Tobin and her son Trevor plan to open their pot shop at 4:20 p.m., a reference to 420, slang for the consumption of cannabis. Tobin, a longtime convenience store owner, said they will be cutting a ribbon and cake.

“We are just ecstatic,” she said.

She doesn’t expect to make much money off the pot itself, noting Newfoundland’s 8 percent cap on retail pot profits. She hopes to make money from pipes, bongs and marijuana paraphernalia.

“There’s no money in the product itself,” she said. “You got to sell $250,000 worth of product in order to make $20,000. That’s not even paying someone’s salary.”

Ontario won’t have any stores open until April, after the new conservative government scrapped a plan for state-owned stores in favor of privately run shops. British Columbia on the Pacific Coast will have just one store open on Wednesday, but many more are expected to open in coming months.

Brittany Guerra, 30, shut down her illegal dispensary in Hamilton, Ontario, last month so she could open a legal store next year. She has been a pot activist for more than a decade and never thought this day would come.

“Everybody would say, ‘It’s never going to be legal, you are dreaming,’” but obviously it worked,” she said. “We do feel vindicated.”

___

Gene Johnson reported from Seattle. Johnson is a member of AP’s marijuana beat team. Follow him at https://twitter.com/GeneAPseattle. Find complete AP marijuana coverage at http://apnews.com/tag/LegalMarijuana

Copyright © 2018 The Washington Times, LLC.

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J&J beats profit estimates, lifts outlook on pharma unit strength

(Reuters) – Johnson & Johnson reported slightly better-than-expected third quarter profit and raised its full-year forecast on Tuesday as increased demand for cancer drugs and immune disorder treatments powered strong results for its pharmaceutical unit.

The Johnson and Johnson logo is seen at an office building in Singapore January 17, 2018. REUTERS/Thomas White

Shares of the healthcare conglomerate were up 2.3 percent at $137 in morning trading after it raised its adjusted 2018 earnings forecast to a range of $8.13 to $8.18 per share from a prior view of $8.07 to $8.17.

Solid prescription drug sales helped offset continued disappointment in the medical devices segment. Executives on a conference call said that business would start to grow in-line or better than the market by 2020.

“We are not satisfied with the performance in medical devices,” Chief Financial Officer Joseph Wolk said after the unit’s quarterly sales missed Wall Street estimates.

Pricing pressure has impacted all categories in orthopedics, the company said, adding that it will consider both transformative acquisitions and smaller, tuck-in deals to support the business.

The company has been selling off certain businesses, such as diabetes care devices, to focus on better performing units and development of new products.

Overall sales rose 3.6 percent to $20.35 billion in the quarter, exceeding analysts’ average estimate of $20.05 billion, according to Refinitiv data.

Pharmaceuticals sale rose 6.7 percent to $10.35 billion, fueled by double-digit sales growth for prostate cancer drug Zytiga and Stelara for Chrohn’s disease and psoriasis

Zytiga sales surged 43 percent to $958 million, blowing past the consensus estimate of $795 million, according to Barclays. Stelara sales jumped 16.5 percent to $1.31 billion, above expectations of about $1.27 billion.

Sales of rheumatoid arthritis drug Remicade fell 16.3 percent to $1.38 billion due to increasing competition from cheaper biosimilar versions.

Newer blood cancer drug Darzalex brought in sales of $498 million, falling short of lofty Wall Street estimates of about $510 million.

Medical device sales were down 0.2 percent at $6.59 billion, while consumer products sales rose 1.8 percent to $3.42 billion, helped by the U.S. relaunch of the Johnson’s baby brand.

Excluding items, the company earned $2.05 per share, edging past analysts’ average forecasts by 2 cents.

Wolk said on Tuesday that while J&J was supportive of more transparency in drug pricing, the company does not believe a Trump administration proposal for requiring the list price of medicines at the end of television ads would be helpful.

He said including those prices in commercials could be somewhat confusing and “act as a deterrent to good responsible healthcare.”

Reporting by Manas Mishra in Bengaluru; Editing by Shailesh Kuber, Arun Koyyur and Bill Berkrot

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The Best Resistance Bands For Your Home Workouts

Frankly, no home gym is complete without a set of resistance bands. And they should absolutely be the first bit of fitness equipment you pick up when you decide to extend your home workouts beyond bodyweight.

That’s because resistance bands are cheap, effective to use in a variety of ways, and easy to use without putting yourself at any risk of injury. A set of bands won’t cost you more than £20 and you can use them to build strength, do rehab after an injury, increase your mobility, and in many other ways.

Resistance bands usually come in a set of three or five different resistances, with the colour of a band indicating how heavy it is. Generally yellow bands have less resistance, blue and black bands have a high level of resistance, and red and green bands are in the middle. But there is a lot of variation between brands, and special colours are often thrown into the mix – gold bands in particular are usually very strong.

The standard band options are open-ended strap bands, looped bands, or tube bands with detachable handles. Generally strap bands are good for mobility work and stretching, and can be tied off to create a loop, but proper looped bands are usually better for strength sessions, while tube bands with handles are the easiest kind to use for high-resistance strength workouts.

Given the low cost of resistance bands, we reckon it’s worth having a few different types to hand for your workouts. Here are the best available right now.

Theraband Resistance Bands

These straight bands are great for mobility and rehab exercises and come in a wide range of lengths and resistance levels, so you can get exactly what you need, whether that’s a 1m-long light resistance yellow band or a 5m max resistance gold band, which will be handy for flinging rocks at castle during sieges even if you never summon up the strength to use it in your workouts.

Buy from Amazon | £2.49-£40.98

AmazonBasics Resistance and Pull Up Band

A long looped band is useful for hooking around your shoulders and feet for exercises like squats, and can also be used to assist with pull-ups until you progress enough to tackle the exercise unaided. Amazon’s own-brand bands come in three different levels of resistance, with the lightest being purple (Amazon have gone rogue there) and the heaviest being blue, with green in between.

Buy from Amazon | £12.99-£18.99

COREZONE Resistance Loop Bands

There are six bands in this set, which offers a resistance range from 4.5kg to 18kg to cover all the bases that beginners are likely to need covered. The bands also come with a lifetime guarantee, for those who have any concerns about durability, and an online workout guide to show you how to use the bands.

Buy from Amazon | £10.95

Protone Resistance Bands Set

This comprehensive set will fulfil all the resistance band needs of even those used to lifting heavy free weights, because you can double, triple, quadruple or even quintuple up the bands using the detachable handles to increase the resistance if required. The set also comes with a carry case and attachments so you can anchor the bands to a door or post for certain exercises.

Buy from Amazon | £19.99

Bytomic Figure Of 8 Resistance Band

Figure-of-eight resistance bands don’t offer the same range of uses as straight, loop or tube bands, but they are handy for exercise like rows where their short length and large handles are a bonus. The Bytomic bands come in three levels of resistance, ranging from the lightest yellow through red to black.

Buy from Amazon | £7.98-£8.98

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This Parmesan And Broccoli Festoni With Maple-Cured Bacon Recipe Is A Great Mid-Week Dinner

To answer what is probably your first question, it’s a type of pasta, and yes, you can use penne instead. Festoni might be a more exciting ingredient to throw into the mix, but it’s not the easiest type of pasta to find so you can stick with the trusty tube if needs be.

Your second question might well involve some combination of the words “parmesan”, “bacon” and “healthy” in a questioning tone. And sure, this isn’t the healthiest recipe on Coach (there’s white wine in it, too, and let’s face it, you’re not letting the rest of the bottle go to waste are you?), but we’re very much of the view that cooking for yourself with whole foods is an easy route to improving your diet, which is why we thought this recipe from Waitrose was worth sharing. Plus, we’re not saying you should eat bacon and cheese for every breakfast, lunch and dinner. In fact, we’ll actively say not to do that. Don’t do that.

Anyway, this dish also has broccoli in it, so there you go. The recipe below calls for purple-sprouting broccoli spears, but if they’re not available you can use tenderstem instead.

Preparing the ingredients should take around ten minutes and cooking only 15, meaning that this recipe is a great quick meal you can pull together in the evening on work nights when time is tight. That’s as long as you haven’t spent an hour in the local shop trying to find festoni pasta.

Ingredients (serves four)

  • 400g festoni (or penne) pasta, dried
  • 2 x 200g packs purple sprouting broccoli spears
  • 2tsp olive oil
  • 250g maple-cured smoked back bacon, chopped
  • 2 cloves garlic, crushed
  • 150ml dry white wine
  • 50g freshly grated parmesan

Method

  1. Cook the pasta according to pack instructions. Meanwhile, trim the thick ends from the broccoli and cut the stems into 1cm lengths, leaving the florets whole. You should have about 300g, including some of the broccoli leaves. Add to the pasta water for the final two to three minutes then drain, reserving about 4tbsp of the cooking water. Return the pasta and broccoli to the pan, covering to keep warm.
  2. Heat the oil in a large pan and fry the bacon for four to five minutes until crispy. Add the garlic and cook for one minute. Pour in the wine and let it bubble, scraping up any bits from the base of the pan, until the wine is reduced by half.
  3. Add the broccoli, pasta and reserved water to the pan. Mix together, then add most of the parmesan, stirring until all the ingredients are coated.
  4. Serve immediately with freshly ground black pepper and the remaining cheese.

Recipe and image courtesy of waitrose.com

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10 natural ways to boost your fertility

The royal wedding caused a vast global interest with 18 million viewers tuning in. But a royal baby by the Duke and Duchess of Sussex would certainly beat those stats in no time. Well, Prince Harry, 34, and Meghan, now 37, announced just today the best news ever, they are expecting a much anticipated spring 2019 B-A-B-Y.

Meghan got pregnant in virtually no time, but it’s not always that simple for women over 35, the age at which fertility begins to decline, according to experts.

Here, Rick Hay, Healthista’s Nutritional Director, takes us through the maze of vitamins, nutrients, minerals, antioxidants, enzymes and greens that could help boost fertility.

‘After the age of 35, conceiving can become difficult due to declining sperm and egg quality. Good nutrition and supplementing your body for optimum fertility health could be the answer’ explains Rick.

1. Vitamin B6

This vitamin helps to regulate and promote healthy hormonal activity allowing to extend the luteal phase, which is the time between ovulating and your menstrual cycle by producing progesterone and in turn helping with egg development and improving the chances of conception.

Found in: potatoes, fruit, fish and lentils. The Recommended Dietary Intake (RDI) is between 1.1 and 1.7 mg/day.

2. Vitamin B9 Folic acid

Low levels of this vitamin are linked to birth defects, in particular spina bifida, which is a defect in the spine. Folic acid will also provide normal maternal tissue growth and help with cell division processes that will determine foetal development. B9 helps with conception because it improves the overall sperm count and boosts sperm motility. The RDI is between 1.1 and 1.7 mg/day.

Found in: potatoes, fruit, fish and lentils.

3. Vitamin B12

Low levels of B12 may contribute to infertility and also have a role to play in multiple miscarriages. Oxidative stress is one of the main reasons for a decrease in male fertility through DNA damage, B12 provides a healthy production of sperm, motility and vitality. For women it can help prevent irregular ovulation and provide a healthier cycle and balance of hormones. Egg health is also developed and can increase chances of egg implantation.

Found in: red meat, eggs, milk, cheese, fish, yeast extract, fortified soya milks, fortified veggie burgers. The optimal dose is 2.4 µg/day.

4. Selenium

Selenium is an antioxidant that has an important role to help protect our bodies from free radicals and preventing damage to the chromosome which can lead to difficulties in conception, birth defects or miscarriage. Male fertility can also benefit from selenium by aiding the quality of sperm and production.

Found in: Brazil nuts, sardines and tuna as well as green leafy vegetables. The RDI for Selenium is 60 µg/day for women.

5. Vitamin C

Vitamin C is another antioxidant your body needs for fertility. Again this vitamin will help with sperm development, protect against oxidative stress and increase chances of implantation. For women vitamin C looks after ovulation and egg health by producing ascorbic acid, this is needed to help collagen synthesis in the ovaries for follicle growth. The RDI is 45 mg/day.

Found in: citrus fruits, berries, leafy greens and fruit juices.

6. Vitamin E

Here is another important antioxidant to look after the cells from oxidative stress. Similar to vitamin C this can provide a healthier production of sperm with better motility and vitality to give more likelihood of implantation. For women this vitamin can also provide a longer luteal phase and improve chances of conception with better overall egg health. The RDI is 7 mg/day for female adults.

Found in: nuts, seeds, kale and olive oil.

7. Zinc

This mineral can help with normal fertility and reproduction by keeping a healthy balance in the hormones, oestrogen and progesterone to provide good egg cell health. It is important for men to make sure they have good levels of zinc as low levels may lead to poor sperm quality, decreasing the chance of implantation. The RDI is 8 mg/day for female adults.

Found in: seafood, pumpkin seeds and chickpeas.

8. Iron

Women will especially need this mineral due to demand doubling during pregnancy, if iron levels are deficient it can cause miscarriages. Taking iron will help with the formation of healthy red blood cells and provide an improved circulation to the reproductive areas. The RDI intake for female adults aged between 19 and 50 is 18 mg/day.

Found in: pulses, organic eggs, meat, fish, and tofu.

9. Co-Enzyme Q10

This enzyme is used for producing energy in sport, it can also be used to create energy production at a mitochondrial level for egg health. Co-Enyzme Q10 also helps with embryo development and with the health of the mature egg from an older woman which requires a large amount of energy. For men it can help with sperm cell motility and health.

Found in: sardines, broccoli, spinach and sesame seeds.

10. Arginine

Arginine is a key amino acid that helps improve blood flow to the uterus, ovaries and genitals, this will provide more efficient function in the reproductive organs. The increased blood flow also helps to create an healthy environment for the embryo implantation.

Found in: peanuts, turkey, pumpkin seeds and algae such as spirulina.

This article originally appeared on Healthista and is republished here with permission.

For more on this topic, these are the 7 tricks Tiff Hall follows to keep her hormones balanced. And if you’re trying for a baby, scientists have revealed the best time and month to have sex.

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Breast cancer disparities: Black women more likely than white women to die from breast cancer in the US

For Breast Cancer Awareness month this October, tennis star Serena Williams went topless in a music video, singing the song “I Touch Myself” while covering her breasts with her hands. It was all to remind women about the importance of regular self-check breast examinations and being aware of any changes.

“Yes, this put me out of my comfort zone,” Williams, 37, wrote on Instagram. “But I wanted to do it because it’s an issue that affects all women of all colors, all around the world.”

In reality, breast cancer disproportionately affects some groups in the U.S. more than others. Black women are now 42 percent more likely to die from their breast cancer than white women, according to a report from the Breast Cancer Research Foundation.

Despite similar incidences of breast cancer between white and black women in the U.S., black women often suffer from the disease at younger ages and are more likely to die from their disease at all ages. This disparity was first recognized thirty years ago in statistics from the National Cancer Institute, and it’s one that persists today.

In September, the American Association for Cancer Research released their Cancer Progress Report highlighting the ongoing challenge of disparities faced in cancer care. Despite new advancements in earlier detection and therapy, and with an overall decline in cancer deaths by 39 percent in the 26-year lead up to 2015, it’s perplexing that some American women don’t fare as well as others in breast cancer outcomes. What exactly accounts for these differences?

Like many big questions in medicine, the answer is complex. Some of these factors may be genetically driven, and many of them may be related to larger social and structural institutions. Here we break down the major factors.

Possible differences in cancer biology

As Williams points out and as is generally true for all cancers, the earlier breast cancer is caught the better. This is based on the understanding that catching a cancer when it is localized (just in the breast), before it has had the chance to spread, leads to much better outcomes. For example, localized disease treatment boasts a 99 percent survival rate five years after diagnosis, versus only 27 percent in distant, metastatic forms of the disease.

This idea itself may come as no surprise, but what is astounding is that black women have lower incidences of localized disease than white women, even though black women have comparable rates of breast cancer screening via mammography. Although some believe that the data overestimates mammography rates in minorities and especially the elderly, people are looking at other explanations for these differences beyond screening.

One thought on why black women may have worse breast cancer outcomes is rooted in a difference in genes. Although breast cancer is seen as one disease, there are so many subtypes. Scientists are getting better at recognizing through genetic detection, which cancer type a woman has, and each of these subtypes likely has different risks and different outcomes. They also respond differently to therapy.

Scientists are trying to look closely at the different genetic make-up of cancer cells to understand whether biology is at play in determining the different outcomes in American communities. While the genetic evaluation of cancers is only in its infancy, there are some things we already know. It is well-documented that black women are much more likely than white women to have triple negative breast cancer. This is a type of cancer that is not responsive to three of the most common hormones that usually cause breast cells to grow – estrogen, progesterone, and human epidermal growth factor – and is notoriously more aggressive and difficult to treat.

Yet, the link between genes, the environment, and disease is complicated and often a game of chicken or the egg. It’s been shown that a number of risk factors—-such as diet, socioeconomic status, body mass index and pregnancy history–-also affect breast cancer incidences and outcomes, leading some to wonder whether these factors in turn play into genetics.

But the fact that racial disparities can be geographically mapped in communities known to be poorer and more segregated has clued many to the fact that the differences in cancer outcomes can’t be attributed to molecules alone.

Structural systems at play

Understanding breast cancer disparities in America requires an appreciation for the larger structural inequalities that exist and their wide-ranging effects, from varying health care behaviors to health care access to disease burden.

Racial inequalities at a social level have shaped systems in huge ways. Access to safe housing, transportation, quality education and jobs, as well as the availability of fresh fruits and vegetables are all elements of daily life that run along racial and economic lines in the U.S.

Poverty can bring with it a host of bad health outcomes and diseases, including obesity, which can negatively influence a woman’s breast cancer landscape. Studies have shown that economic status explains much of breast cancer outcome disparities. Black women suffering from breast cancer are more likely to have other medical conditions, which can complicate their disease.

Lowered socioeconomic status has also been associated with a lowered rate of receiving recommended chemotherapy and radiation. This may be due to a lack of access to care, for example either because of health insurance or no transportation. States and cities that have made improvements in insurance coverage have seen a narrowing of breast cancer disparities between black and white women.

Over the last several decades, there have been fewer studies in breast cancer research looking at black women. Even now, minority communities are less likely to be involved in cancer trials that will be shaping future approaches to treatment.

Where to go from here

The first step in addressing the problem is recognizing that disparate outcomes between races is an issue in the U.S. Doctors, scientists, and national agencies are now committed to discussing and eliminating disparities in breast cancer outcomes.

The reasons why breast cancer disproportionately affects black women in the U.S. rest in a complicated intersection between genetic and social factors. Further research and attention should bring nuanced interventions from multiple angles, including ongoing investigation into genetic therapies and research into the way that social forces continue to shape health outcomes.

Amisha Ahuja is an internal medicine resident at Thomas Jefferson University Hospital and a contributor to the ABC News Medical Unit.

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Where to get National Pasta Day deals in Denver on Oct. 17

Waiter Noah Warren serves the spicy lobster rigatoni alla vodka table side at Quality Italian Steakhouse in Cherry Creek on Sept. 26. The New York Italian steakhouse offers hearty pasta dishes, creative drinks and delicious desserts. (Helen H. Richardson, The Denver Post)

Dear pasta,

We’re so glad you’re back.

We know things have been rough in recent years, what with that Atkins guy and all the gluten-free stuff, and we’re sure there were days you didn’t even feel like leaving your cardboard box. But we’re so happy you found the strength to jump into that boiling water and onto the center of our plates once again.

We understand why you went into hiding for a bit — the die-hard Keto dieters will do that to anyone — but you’re back, baby, and you’re better than ever.

We hope you realize that the problem was never really you — it was all us. There’s nothing wrong with flour, eggs, salt and water. Nothing at all. On behalf of everyone who ever suffered through a low-carb diet, let me sincerely apologize for our short-sightedness. We were miserable without you.

Now we know that eating you will help us live longer: New research presented at the European Society of Cardiology Congress found that people who consume the least amount of carbs have a higher risk of dying young compared to people who eat the most and, similarly, scientists from Brigham and Women’s Hospital who analyzed nearly half a million people found that low-carbers have a 20 percent higher risk of premature death. But of course you’ve known that all along. Forgive our temporary lapse in judgment; we blame the lack of carbs.

An entree of fresh grouper from the Gulf of Mexico with tagliatelle pasta with pesto and fresh garbanzo beans and ramps on top prepared by Chef Andrea Frizzi at the old location of Il Posto in 2014. (Helen H. Richardson, The Denver Post)

You’re probably familiar with Denver’s thriving pasta scene. Just in the past year or two we’ve gotten Tavernetta, Chow Morso, Quality Italian, Cattivella, Dio Mio, Bettola Bistro, Marcella’s, Mano Pastaria, Coperta, a bigger and better Il Posto and the upcoming Liberati and Jovanina’s Broken Italian. Heck, Boulder’s Emmerson restaurant, which opened last summer, even named itself after the very soul of you. (Emmer is an ancient mother grain.)

And while we’ve mourned the loss of too many old-school pasta joints (RIP Blue Parrot, Patsy’s Inn, Pagliacci’s and Old Spaghetti Factory), there’s reason for noodley optimism. The new cool-kid restaurants are embracing you, too. The Way Back, The Wolf’s Tailor, Concourse and The Bindery all have dedicated pasta sections.

Il Pastaio, Frasca, Gaetano’s, Venice, Barolo Grill, Mama Sanninos, Trattoria Stella, Parisi, Shells & Sauce, Sarto’s and Angelo’s are still packing them in every night. Noodles & Company just had its best quarterly sales performance in six years. It’s really no wonder: There is more protein in two ounces of you than in an egg.

We bet you’re relieved to see that worldwide pasta consumption is on the rise, and you probably blushed when The Telegraph declared “the carb is back.” The crew at pasta-heavy Tavernetta agrees.

“I would say that for 90 percent of the guests at Tavernetta, ‘low carb’ does not exist,” said general manager Justin Williams. “We also have guests who come in and order every pasta on the menu.” Bless them.

Sure, there are gluten-free versions of you as well, and we’re genuinely thrilled that those with serious, life-threatening diseases can also enjoy your splendors. But for the majority of us who can pick and choose what we eat freely, we’re overjoyed to once again pick you.

“People are definitely rediscovering the joy of great pasta, breads and gluten-containing foods,” said Jake Linzinmeir, chef at and co-owner of Jovanina’s Broken Italian, opening this week. “It helps a lot that the base flours and building blocks have gotten so much better.”

In these tumultuous times, we’re so glad we have you to turn to for comfort. Forgive us our lack of commitment; we’ve done the soul-searching and we know that you are our one true starchy love. Today may be National Pasta Day and October National Pasta Month, but you had better believe it’s every day in our hearts.

Yours forever,

Carb-lovers everywhere

Where to celebrate National Pasta Day on Oct. 17:

Orecchiette, Sausage and Broccoli Rabe at Coperta Restaurant on February 13, 2017 in Denver, Colorado. Coperta, which means blanket in Italian and symbolizes comfort and warm hospitality, specializes in wine and food from Southern Italy. (Helen H. Richardson, The Denver Post)

Coperta is hosting a four-course pasta feast all day on the 17th. For $39, you’ll get some seriously good noodles, like squid ink lorighittas (think little braided lassos) and duck confit ravioli. 400 E. 20th Ave., Denver, 720-749-4666; copertadenver.com

Head to any of Mici‘s five locations (including the brand-new Lafayette spot) for buy one, get one pastas all day long. various locations; miciitalian.com; use code PASTA18 if ordering online

While it’s not exactly special for pasta day, it’s never-ending pasta bowl time at Olive Garden. Go big or go home, starting at $10.99. various locations; olivegarden.com

For pasta day, Marcella’s Ristorante, Pizzeria & Wine Bar will sell two pastas, the penne alla arrabbiata and capellini al pomodoro, for $10.17. 1801 Central St., Denver, 720-484-5484; marcellasrestaurant.com

Get a sneak peek (and 25 percent off) Panzano’s new bucatini della casa pasta dish during lunch and dinner on the 17th. 909 17th St., Denver, 303-296-3525; panzano-denver.com

Order Chow Morso Osteria’s carbonara and get 15 percent off all day. (Or make your own with the recipe below.) 1500 Wynkoop St., Denver, 720-639-4089; chowmorso.com

How to celebrate at home:

Chow Morso Osteria carbonara. (Spencer Barnes, provided by Chow Morso Osteria)

Carbonara, from Chow Morso Osteria

Ingredients

  • 5 ounches spaghetti noodles
  • 1 ounce julienne yellow onion
  • 1 ounce julienne pancetta
  • 3 ounce chicken stock
  • 2 ounce parmesan cheese
  • 1 ounce butter
  • 1 egg yolk
  • Chives
  • Extra virgin olive oil

Directions

Sauté yellow onions and pancetta in olive oil until you start to get color on the onions and the pancetta starts to crisp. Add stock, butter and cheese to the pan, stir sauce till it becomes creamy.

Cook pasta in boiling water until half-way cooked, then add to sauté pan and finish noodles in the sauce itself. Plate pasta in a bowl, with a decent amount of sauce to allow you to mix in egg yolk to complete sauce.

Nestle egg yolk on top of pasta. (It’ll cook a bit from the heat of everything else.) Complete dish by garnishing with chives, parmesan, crispy pancetta and extra virgin olive oil.  

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