2018 U.S. Open Tennis Championships: Everything You Need to Know

What’s the best way to succinctly describe the U.S. Open Tennis Championships, one of the biggest, most esteemed events in the sport?

It’s a “three-week bonanza of tennis,” David Brewer, U.S. Open tournament director, tells SELF. And that bonanza has already begun.

The qualifying tournaments kicked off today at the USTA Billie Jean King National Tennis Center in NYC, and the main competition, hosted at the same venue, will begin on Monday, August 27 and wrap on Sunday, September 9.

Here, everything you need to know about this big-time series, including its significance, qualifying standards, various events, players to watch this year, and how and when to tune in for it all.

The U.S. Open is one of four Grand Slam Tournaments hosted annually.

The U.S. Open and the three other annual Grand Slam Tournaments (Wimbledon, the French Open, and the Australian Open), are the “tentpoles of the sport,” says Brewer. “They’re the longest running and seen by the players as the most prestigious trophies to win each year.”

They also serve as a gathering ground for essentially every top player in the sport, Brewer adds. Pretty much every big-name tennis player will compete in the Grand Slam events (unless they’re injured or taking time off from the sport) which makes the tournaments extremely high-profile—and extremely exciting.

Though the four Grand Slam tournaments feature the same events and follow the same qualifying procedures, they all carry a unique vibe. “Each Grand Slam event tends to take on the personality of its host city,” says Brewer. As for the U.S. Open: “We are very much reflective of New York—we’re loud, brassy, and gritty.”

Approximately 650 athletes will participate in the U.S. Open in a variety of singles, doubles, mixed doubles, junior, and wheelchair events.

As mentioned, the qualifying tournament began today, with 128 men’s singles players, and 128 women’s singles. “These are the young up-and-comers hoping to earn their way into the U.S. Open main draw,” says Brewer. The top 16 men and 16 women from the qualifying round, which wraps on Friday, will earn spots in the main draw, which is otherwise comprised of the top players based on annual world rankings.

Events in the main draw include men and women’s singles, men and women’s doubles, mixed doubles, junior competitions, and wheelchair competitions. The first two days of the tournament will feature solely singles matches, with additional events beginning on the third day.

Players and teams are eliminated or advance in a bracket-style competition. In total, singles players need to win six matches to make it to the final round; doubles need to win five matches; and mixed doubles need to win four matches. Some players will participate in both singles and doubles, says Brewer, which is a LOT of tennis—or as some might say, a bonanza.

While the championship is anyone’s game, there are several favorites going into the tournament this year—including veterans-slash-legends Serena and Venus Williams.

On the women’s singles side, there’s Romanian Simona Halep, who’s currently ranked number 1 in the world, “but of course Serena [Williams], Venus [Williams] and Maria Sharapova [the defending U.S. Open champ from Russia]” are also top contenders, says Brewer.

As for what’s expected from Serena following her stellar and inspiring performance at Wimbledon in July? “I’m not in the future-predicting business,” says Brewer, “but we’ll just say she always performs well in New York.”

On the men’s singles side, there are the “usual suspects,” says Brewer, including the defending champion Rafael Nadal (currently ranked number 1 the world), plus Serbian Novak Djokovic, who won Wimbledon this year, and Swiss player Roger Federer, currently ranked number 2 in the world.

In honor of the 50th anniversary of the U.S. Open this year, there are several components of the tournament in New York City that are free and open to the public.

For one, the qualifying rounds are entirely free and open to the public now through Friday, August 24, at the USTA Billie Jean King National Tennis Center in Queens, New York. The public is also invited to attend free, open practices at the center now through Friday the 24th. Roger Federer will practice tomorrow from 10 A.M. to 11 A.M. ET, and Novack Djokovic will practice on Thursday, August 23 (time to be announced).

If you can’t make it to Queens, there’s an expo at Brookfield Place in lower Manhattan featuring player
appearances, food, live music, and a full-sized tennis court on Wednesday, August 22, and Thursday, August 23, from 10 A.M. to 8 P.M. each day. Check out USOpen.org for schedules and more details on these free events.

The tournament officially begins on Monday, August 27, and continues with daily games through Sunday, September 9. Here’s how and when you can tune in.

Every single game throughout the tournament (including this week’s qualifying rounds) will be broadcast on ESPN, says Brewer, which you can access via cable, Hulu Live, Sling TV, or DirecTV Now. If you don’t have cable or one of these subscriptions, you can download the ESPN+ app (a seven-day trial is free; you can purchase a monthly subscription for $4.99) to view coverage.

You can also view live scores, live match streaming, and match highlights on USOpen.org and with the US Open app.

Two consumer baby monitors show worrisome results in measuring vital signs

Researchers who tested two commercially available baby monitors are raising serious concerns about the accuracy of these products, which are marketed to parents, but are not regulated by the U.S. Food & Drug Administration (FDA).

“We evaluated how accurate these monitors were in detecting low oxygen levels in infants,” said study leader Chris Bonafide, MD, MSCE, a pediatrician and safety expert at Children’s Hospital of Philadelphia (CHOP). “One monitor detected those levels when they occurred, but was inconsistent; the other never detected those levels when they occurred.” The team also evaluated pulse rate accuracy in the babies, and found that the monitor that never detected low oxygen levels also often falsely displayed low pulse rates.

Bonafide and colleagues, including CHOP neonatologist Elizabeth Foglia, MD, MSCE and co-authors from the ECRI Institute, a nonprofit research organization that evaluates medical devices and practices, published a report today in the Journal of the American Medical Association (JAMA).

Last year, the researchers wrote an opinion piece in JAMA raising concerns about consumer use of physiological baby monitors being broadly marketed to parents. They argued that such products may cause undue anxiety to parents, with no evidence of medical benefits for healthy infants. “We previously discussed the consensus in the pediatric community that there is no medical reason to electronically monitor vital signs in healthy babies at home,” said Foglia. “Our new study adds serious concerns about the accuracy of these consumer monitors, when we compared them to a standardized hospital monitor in a cohort of sick infants.”

In the current study, the team studied 30 infants, six months old and younger, hospitalized in CHOP’s Cardiology and General Pediatrics units between July and December 2017. Each baby wore an FDA-approved reference monitor (the Masimo Radical-7) on one foot and a consumer monitor on the other foot.

The consumer monitors were the Owlet Smart Sock2 and the Baby Vida, the only two currently marketed smartphone-integrated consumer baby monitors that use pulse oximetry — a measure of the blood’s oxygen levels. The scientists analyzed hypoxia (low oxygen levels) and bradycardia (slow pulse rate), comparing results between the reference monitor and each consumer monitor.

While testing the Owlet, the reference monitor reported hypoxia in 12 patients, and the Owlet reported at least one simultaneous hypoxia reading in all 12 patients. However, at least once during hypoxia, the Owlet also erroneously indicated that five of those 12 infants had normal oxygen levels. Across all the data points, the Owlet’s overall sensitivity was 88.8 percent — it detected hypoxia, but not consistently. “If something is going wrong with a sick infant, you would want to know that 100 percent of the time,” said Bonafide.

Testing of the Baby Vida monitor showed that none of the 14 infants who experienced hypoxia according to the reference monitor had simultaneous hypoxia readings on Baby Vida — a sensitivity of 0 percent, a serious flaw. In addition to missing hypoxia, the Baby Vida monitor also falsely displayed bradycardia in 14 patients who had normal pulse rates, a high rate of false positives. “False positives raise the possibility of unintended consequences,” said Foglia. “Parents who see an abnormally low pulse rate reading might call 911, or unnecessarily rush their baby to an emergency department.”

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Materials provided by Children’s Hospital of Philadelphia. Note: Content may be edited for style and length.

Annual pap test a ‘thing of the past?’

The United States Preventive Services Task Force (USPSTF) has released new recommendations on screening for cervical cancer. These latest recommendations continue the trend of decreasing participant burden by lengthening screening intervals, making the “annual Pap” a historical artifact. Since its introduction 75 years ago, exfoliative cytology commonly known as the Pap test has been the “gold-standard” screening test for cervical cancer.

In the current issue of the Journal of the American Medical Association (JAMA), the USPSTF, an independent panel of experts in primary care and prevention, updates its 2012 recommendations for cervical cancer screening with one important addition. This is the first time the USPSTF has recommended a method of cervical cancer screening that does not include the Pap test.

A leading obstetrician/gynecologist Lee A. Learman, M.D., Ph.D., senior associate dean for Graduate Medical Education and Academic Affairs and professor at Florida Atlantic University’s Schmidt College of Medicine, is lead author of an editorial in this JAMA issue. Learman and co-author Francisco A.R. Garcia, M.D., M.P.H., a distinguished professor at the University of Arizona Cancer Center, provide a history of cervical cancer screening and an overview of the new USPSTF recommendations, which open avenues for new tools and opportunities that benefit both clinicians and patients.

The new USPSTF guidelines recommend that women ages 21 to 29 years be screened for cervical cancer every three years with the Pap test alone. This recommendation remains unchanged from 2012. For women ages 30 to 65 years, the USPSTF recommends screening for cervical cancer with primary high-risk human papillomavirus (hrHPV) test alone every five years. As an option, they also recommend the previous guideline of hrHPV test and Pap test together (co-testing) every three years.

What was novel in the 2012 USPSTF recommendations was that women ages 30 to 65 years were given the option for the first time to be screened with hrHPV test and Pap test together every five years to lengthen their screening interval. The 2018 recommendations go one step further by including, for the first time, the option of hrHPV testing alone, without a Pap test, every five years.

The table in the new USPSTF recommendations also acknowledges an important trade-off. Co-testing is slightly better than primary hrHPV testing at detecting precancerous lesions but is associated with increased tests and diagnostic procedures that may not benefit the patient and have real costs to the health care system. Pap tests detect changes in cervical cells that could indicate the presence of pre-cancer or cancer, while HPV tests detect the genetic material or DNA of the high-risk types in cervical samples.

“The current guidelines preserve the greatest range of choices for practitioners and patients; in the sense that both will benefit,” said Learman. “More efficient cervical cancer screening every three to five years will liberate time at the annual visit to discuss prevention of other cancers and chronic diseases that disproportionately burden women.”

Because most high-risk HPV infections among healthy individuals are cleared spontaneously without intervention, over the years, screening and clinical management recommendations have become more conservative in general and for young women in particular.

“Despite many advances such as the HPV prophylactic vaccine, for now, high-quality screening remains an essential tool in the prevention of cervical cancer,” said Learman. “With the new recommendations come new demands on patients, especially those who bear the greatest disease burden from cervical cancer: women from low socioeconomic backgrounds, women from communities of color, and other women with compromised access to timely and effective care.”

Nearly all cases of cervical cancer are caused by infection with oncogenic, or high-risk, types of HPV. Cervical cancer is the fourth most common cancer in women worldwide. In 2012, 10 percent of women in the United States ages 21 to 65 years (an estimated 8 million women) reported not being screened for cervical cancer in the past five years. From 2012 to 2016, there was a continued decline in the number of women receiving cervical cancer screening. In addition, 10 years after approval of the first HPV prophylactic vaccine in the U.S., only 43 percent of adolescents (50 percent of girls and 38 percent of boys) were up to date with the HPV vaccination guidelines, compared with 88 percent for tetanus, diphtheria, and acellular pertussis vaccine.

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Materials provided by Florida Atlantic University. Original written by Gisele Galoustian. Note: Content may be edited for style and length.

Depressed patients see quality of life improve with nerve stimulation

People with depression who are treated with nerve stimulation experience significant improvements in quality of life, even when their depression symptoms don’t completely subside, according to results of a national study led by researchers at Washington University School of Medicine in St. Louis.

The study involved nearly 600 patients with depression that could not be alleviated by four or more antidepressants, taken either separately or in combination. The researchers evaluated vagus nerve stimulators, which send regular, mild pulses of electrical energy to the brain via the vagus nerve. The nerve originates in the brain, passes through the neck and travels down into the chest and abdomen.

The FDA approved vagus nerve stimulation for treatment-resistant depression in 2005, but there has been a recognition more recently that evaluating only a patient’s antidepressant response to stimulation does not adequately assess quality of life, which was the purpose of this study.

The findings are published online Aug. 21 in The Journal of Clinical Psychiatry.

“When evaluating patients with treatment-resistant depression, we need to focus more on their overall well-being,” said principal investigator Charles R. Conway, MD, a Washington University professor of psychiatry. “A lot of patients are on as many as three, four or five antidepressant medications, and they are just barely getting by. But when you add a vagus nerve stimulator, it really can make a big difference in people’s everyday lives.”

As many as two-thirds of the 14 million Americans with clinical depression aren’t helped by the first antidepressant drug they are prescribed, and up to one-third don’t respond to subsequent attempts with other such drugs.

The researchers compared patients who received vagus nerve stimulation with others who received what the study referred to as treatment as usual, which could include antidepressant drugs, psychotherapy, transcranial magnetic stimulation, electroconvulsive therapy or some combination.

The researchers followed 328 patients implanted with vagus nerve stimulators, many of whom also took medication. They were compared with 271 similarly resistant depressed patients receiving only treatment as usual.

In assessing quality of life, the researchers evaluated 14 categories, including physical health, family relationships, ability to work and overall well-being.

“On about 10 of the 14 measures, those with vagus nerve stimulators did better,” Conway said. “For a person to be considered to have responded to a depression therapy, he or she needs to experience a 50 percent decline in his or her standard depression score. But we noticed, anecdotally, that some patients with stimulators reported they were feeling much better even though their scores were only dropping 34 to 40 percent.”

A vagus nerve stimulator is surgically implanted under the skin in the neck or chest. Stimulation of the vagus nerve originally was tested in epilepsy patients who didn’t respond to other treatments. The FDA approved the device for epilepsy in 1997, but while testing the therapy, researchers noticed that some epilepsy patients who also had depression experienced fairly rapid improvements in their depression symptoms.

In the new study, patients with stimulators had significant gains in quality-of-life measures such as mood, ability to work, social relationships, family relationships and leisure activities, compared with those who received only treatment as usual.

Study participant Charles Donovan said he never felt much better when he took antidepressant drugs. He was hospitalized for depression several times before he had a stimulator implanted.

“Slowly but surely, my mood brightened,” he recalled. “I went from being basically catatonic to feeling little or no depression. I’ve had my stimulator for 17 years now, and I still get sad when bad things happen — like deaths, recessions, job loss — so it doesn’t make you bulletproof from life’s normal ups and downs, but for me, vagus nerve stimulation has been a game-changer.

“Before the stimulator, I never wanted to leave my home,” he said. “It was stressful to go to the grocery store. I couldn’t concentrate to sit and watch a movie with friends. But after I got the stimulator, my concentration gradually returned. I could do things like read a book, read the newspaper, watch a show on television. Those things improved my quality of life.”

Conway believes an improved ability to concentrate may be key to the benefits some patients get from stimulation.

“It improves alertness, and that can reduce anxiety,” he said. “And when a person feels more alert and more energetic and has a better capacity to carry out a daily routine, anxiety and depression levels decline.”

Updated: Common Blood Pressure Medications Containing Valsartan Recalled Over ‘Impurity’ Concerns

Update: It’s been over a month since the Food and Drug Administration (FDA) originally announced the recall of several common blood pressure medications containing valsartan over fears that they contain a chemical “impurity” linked to cancer. Now, even more drugs are being recalled.

Torrent Pharmaceuticals Ltd. announced Tuesday that it is voluntarily recalling 14 lots of medications containing valsartan. Earlier this month, the FDA also announced that the recall had expanded to also include products from Camber Pharmaceuticals.

You can see the full list of recalled products at the FDA’s website here and the full list of valsartan products not recalled here. If you do happen to have one of the recalled products, talk to your doctor or pharmacist to figure out a replacement.

Original report (July 17, 2018):

Several valsartan-containing drugs, which are commonly used to treat high blood pressure, have been recalled over contamination fears, the FDA announced late last week. Specifically, the medications were tainted with N-nitrosodimethylamine (NDMA), a compound that’s been linked to cancer, the FDA said in a statement.

As a result, three companies—Major Pharmaceuticals, Solco Healthcare, and Teva Pharmaceuticals Industries Ltd.—have voluntarily recalled their products that contain valsartan. Solco and Teva Pharmaceuticals are also recalling their valsartan/hydrochlorothiazide medication. (Representatives from Major Pharmaceuticals, Solco Healthcare, and Teva Pharmaceuticals did not return SELF’s request for comment.)

“The presence of NDMA was unexpected and is thought to be related to changes in the way the active substance was manufactured,” the FDA said in the statement. Additionally, the FDA noted that all the recalled products containing valsartan were supplied by a third party, which has since stopped supplying the ingredient. “The FDA is working with the affected companies to reduce or eliminate the valsartan [active pharmaceutical ingredient] impurity from future products,” the statement reads.

The problem is that NDMA has been linked to an increased risk for cancer.

NDMA is a semi-volatile compound that forms in both industrial and natural processes, the Environmental Protection Agency (EPA) explains. It’s created from chemical reactions involving nitrates, nitrites, and other proteins, Rowena N. Schwartz, Pharm.D., an oncology pharmacist and associate professor of pharmacy practice at the University of Cincinnati, tells SELF. So, the compound may be an unintentional byproduct of the medications’ chemical manufacturing process, Jamie Alan, Ph.D., an assistant professor of pharmacology and toxicology at Michigan State University, tells SELF.

There’s evidence NDMA can create free radicals in your body that can damage your DNA, which can lead to the formation of cancer in some cases, Alan explains. Although this sort of process could raise the risk for any kind of cancer, Alan says, NDMA is a nitrate; and nitrates have specifically been linked to an increased risk of stomach, colon, and kidney cancers, according to the National Cancer Institute.

Technically, the International Agency for Research on Cancer (IARC) considers NDMA a Group 2A agent, meaning it’s considered a probable human carcinogen. This category sits one step above agents categorized as “possibly” carcinogenic to humans (which is Group 2B) and one step below definite human carcinogens (Group 1). According to the IARC’s definitions, category 2A is usually chosen when there’s sufficient evidence for a compound being carcinogenic in animal studies, but limited evidence in human studies, especially if there’s evidence that the animals studied share a common potential mechanism of action with humans.

But, because there are so many other factors at play, it’s hard to say exactly how much your risk for cancer would increase if you were exposed to NDMA. Those factors include things like your family history, the dose of NDMA you were exposed to and the length of exposure, your other environmental risks, as well as your personal history with cancer. “It really is specific to the individual,” Alan says.

If you’re affected by this recall, there are a few things you should do.

First, check your medication by looking at the drug company and drug name on the bottle and seeing if it’s one that’s included in the recall. If that information isn’t clear on the packaging, contact the pharmacy where you got the medication. If it turns out your medication is affected by the recall, call your doctor or pharmacist and follow the instructions posted on the FDA’s website for that particular medication.

Obviously, if you’re taking a blood pressure medication, there’s probably a good reason for it—and you shouldn’t just stop taking it without having a backup plan in place, Sanjiv Patel, M.D., a cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, tells SELF. Suddenly stopping your medication could cause a rebound effect that makes your blood pressure go up, Dr. Patel says, and that can put you at a higher risk of a stroke or heart attack. So, the FDA currently recommends that you keep taking your medication until you have a good replacement—and that you talk to your doctor or pharmacist about getting that replacement ASAP.

If for some reason you’re having a hard time getting hold of your doctor, call the pharmacy that filled this for you—they may be able to give you a similar product with valsartan that was not affected by the recall, Alan says. Or, your doctor may even recommend that you try a totally different medication. “There are other options beyond valsartan,” Dr. Patel says. “It just one of many medications we can use to treat high blood pressure.”

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Demi Lovato’s Sister Shares an Emotional Message on the Singer’s 26th Birthday

Monday marked Demi Lovato‘s 26th birthday, and in addition to the outpouring of love and support from her fans, the singer also got one special message from her younger sister, Madison De La Garza.

In honor of her big sister’s birthday, De La Garza posted a childhood pic of the two of them smiling at the camera and included a heartfelt message.

“Today could have been one of the worst days of my life, but instead i get to spend it thanking God, the incredible doctors, demi’s team, and everyone across the world who offered their support — without all of these people i wouldn’t have my big sister anymore,” De La Garza wrote in the caption. “I’ve been thinking about how i wish that everyone could see the silly little things that she does, like how her nostrils move when she says certain words and when she brushes my hair behind my ear when i’m trying to sleep, because those are the things i’m thankful for today.

“They seem so small, but those little things make up my sister — not a singer, not a celebrity, and definitely not what she’s been described as in the media,” she continued. “She’s a daughter, a friend, and my big sister… and i am so, so thankful that i can tell her happy birthday. #happybirthdaydemi ❤️”

Earlier this month, Lovato released a statement following a suspected drug overdose and subsequent hospitalization at the end of July.

“I want to thank my family, my team, and the staff at Cedars-Sinai who have been by my side this entire time,” Lovato said in the statement. “Without them I wouldn’t be here writing this letter to all of you. I now need time to heal and focus on my sobriety and road to recovery. The love you all have shown me will never be forgotten and I look forward to the day where I can say I came out on the other side. I will keep fighting.”

Recovery is a long, sometimes challenging road. But, as SELF explained previously, having a solid support system can make a huge difference and give you the foundation you need to move forward.

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I hear what you say! Or do I?

Even with an acute sense of hearing adults don’t always pick up exactly what someone has said. That’s because from childhood to adulthood we rely on vision to understand speech and this can influence our perception of sound.

A study, carried out by Rebecca Hirst, a PhD student in the School of Psychology at the University of Nottingham, in collaboration with Dr Harriet Allen and Dr Lucy Cragg (Univeristy of Nottingham) and Jemaine Stacey and Dr Paula Stacey at (Nottingham Trent University), has shown there is a developmental shift in sensory dominance as children grow older.

The research: ‘The threshold for the McGurk effect in audio-visual noise decreases with development’ has been published in Scientific Reports

In 1976 the McGurk effect demonstrated the interaction of hearing and vision in speech perception. When we hear one syllable, but we see the mouth movement of another syllable, this leads us to perceive a third syllable. And, if a person is getting poor quality auditory information but good quality visual information, they may be more likely to experience the McGurk effect.

It’s down to the way our brain develops

Because the part of the brain responsible for auditory information develops earlier than the part of the brain responsible for processing visual information, and because children gain more visual experience across childhood (i.e. reading), Rebecca and her team predicted that younger children would be less susceptible to McGurk responses, and that adults would continue to be influenced by vision in higher levels of visual noise and with less auditory noise.

This new study showed that susceptibility to the McGurk effect was higher in adults compared with 3-6-year-olds and 7-9-year-olds but not 10-12-year-olds. Adults and older children were more easily influenced by vision. Reduced susceptibility in childhood supports the theory that sensory dominance shifts across development and reaches adult-like levels by 10 years of age.

Rebecca designed a ‘spy’ game called ‘Spot the Sound’ to launch her study during the School of Psychology’s 2017 Summer Scientist event for young children and their parents.

They recruited 96 children at the event and separated them into three age groups 3-6 years; 7-9 years; and 10-12 years. They were joined by 32 adults aged between 20 and 35 years of age.

Rebecca said: “Our findings show that children rely more on auditory information. This means they are less susceptible to illusions in which vision changes sound. Conversely, adults are more likely to be influenced by what they see, and what they see can change what they hear.”

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Materials provided by University of Nottingham. Note: Content may be edited for style and length.

Sharp increase in falls in women during midlife

Falls are not just a problem of advanced age, according to researchers in Trinity College Dublin, who have identified a sharp increase in falls after the age of 40, particularly in women.

The research, which drew on data from TILDA (the Irish Longitudinal Study on Ageing) as well as data from similar studies in Australia, Great Britain and the Netherlands, found that for women the prevalence of falls increases from the age of 40 on — 9% in 40-44 year olds, 19% in 45-49 year olds, 21% in 50-54 year olds, 27% in 55-59 year olds and 30% in 60-64 year olds.

The findings indicate that middle-age may be a critical life stage for interventions designed to prevent falls, according to the authors. The study incorporated the data from 19,207 men and women aged between 40 and 64 years. It has been recently published in the international journal PLOS ONE.

With one in three older adults falling at least once per year, rising to one in two adults over 80 years, falls are a major health challenge. Serious health consequences include fractures, head injuries, reduced social participation, increased risk of nursing home admittance, decline in independence and subsequently increased need for care. Health experts estimate that the costs for falls in Ireland are projected to be over €1 billion by 2020 . Dr Geeske Peeters, Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute at Trinity, lead author on the paper commented: “Researchers and doctors have always assumed that falls are a problem that only affects people above the age of 65. This study shows that the prevalence of falls is already quite high from the age of 50. In fact, our research shows that there is a sharp increase in the prevalence of falls in women during midlife. This occurs at a time that we also see an increase in the prevalence of common risk factors for falls, such as balance problems, diabetes and arthritis.”

Recommended strategies for the prevention of falls in older adults are insufficiently effective, according to the authors. Previous research shows that, in theory, exercise may reduce the rate of falls by up to 32% and assessment and treatment of risk factors may reduce the rate of falls by up to 24%. However, hospital injury records show that the number of injuries from falls which require medical care continue to rise.

Dr Peeters continued: “Current prevention strategies basically wait until people have developed risk factors and then try to make them go away. It may be better and more effective to prevent the risk factors, or to detect them at an early stage to reduce their consequences, particularly falls. We are now working with our research colleagues in the Netherlands, Australia and the UK to investigate whether there is scope to start prevention strategies before the age of 65 years.”

Professor Rose Anne Kenny, senior author on the paper and director of TILDA and of the Falls Unit at St James Hospital, commented: “This work emphasises the importance of early prevention strategies. While falls can cause serious injury and result in disability, they also create fear of further falls. This is a well known phenomenon and from TILDA research we know it is present in one in four people over 50. People who have a fear of falling or have had a fall are most at risk of falls and should be targeted for strength and balance programmes and medication reviews — both strategies significantly reduce falls.”

The timing of the increases in falls coincides with the onset of the menopause, decline in balance performance, and increase in the presence of vertigo and fainting, all of which will benefit from the above falls prevention strategies.

Dr Peeters concluded: “A better understanding of the factors that drive this increase in fall risk in middle age may be the key to effective prevention interventions earlier in life with potential benefits into older age. Further research should help us design the most appropriate strategies to prevent falls at this critical juncture in a person’s life.”

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Materials provided by Trinity College Dublin. Note: Content may be edited for style and length.

Living close to urban green spaces is associated with a decreased risk of breast cancer

An increasing number of studies are reporting health benefits of contact with urban green spaces. A new study from the Barcelona Institute for Global Health (ISGlobal), an institute supported by the “la Caixa” Banking Foundation, has examined, for the first time, the relationship between exposure to green spaces and breast cancer. The study, which analysed data from more than 3,600 women in Spain, concluded that the risk of breast cancer was lower in the women who lived closer to urban green spaces, like parks or gardens.

Previous research has identified an association between contact with green spaces and several health benefits, including better general and mental health and increased life expectancy. In the older population, contact with green spaces has recently been linked with slower cognitive decline. In children, exposure to greenness has been associated with improvements in attention capacity, behaviour, emotional development, and even beneficial structural changes in the brain. To date, few studies have focused on the relationship between exposure to natural green spaces and the risk of cancer, more specifically breast cancer, the most common malignant disease among women and the one that causes the most cancer deaths in the female population. The new study, published in the International Journal of Hygiene and Environmental Health, was carried out in the framework of the Spanish multicase-control study (MCC-Spain), co-financed by the CIBER of Epidemiology and Public Health (CIBERESP). The authors collected and analysed data from 1,738 patients with breast cancer and 1,900 participants with no history of the disease living in ten Spanish provinces (Asturias, Barcelona, Cantabria, Girona, Guipuzcoa, Huelva, Leon, Madrid, Navarre and Valencia).

Data on lifetime residential history, socio-economic level, lifestyle factors and levels of physical activity were obtained during interviews with each one of the participants. Information on proximity to urban green spaces or agricultural areas, air pollution levels, and population density was obtained by geo-codding the residential address of each participants.

The first author of the study, ISGlobal researcher Cristina O’Callaghan-Gordo, explains, “We found a reduced risk of breast cancer among women living in closer to urban green spaces. By contrast, women living closer to agricultural areas, had a risk higher. This findings suggests, that the association between green space and a risk of breast cancer is dependent on the land use.”

Mark Nieuwenhuijsen, the study coordinator and Director of ISGlobal’s Urban Planning, Environment and Health Initiative, goes on to explain that the researchers “found a linear correlation between distance from green spaces and breast cancer risk. In other words, the risk of breast cancer in the population declines, the closer their residence is to an urban green space. These findings highlight the importance of natural spaces for our health and show why green spaces are an essential component of our urban environment, not just in the form of isolated areas but as a connective network linking the whole urban area and benefitting all its inhabitants.”

“We still don’t know which characteristics of natural spaces are the most beneficial and nor do we understand the mechanisms underpinning these beneficial health impacts,” explains ISGlobal researcher Manolis Kogevinas, coordinator of the MCC-Spain project. “Other studies have shown that the mechanisms that might explain the health benefits of green spaces include higher levels of physical activity in the population and a reduction in air pollution, an environmental hazard clearly linked to the onset of cancer. However, we did not observe these associations. We believe that other mechanisms — including lower levels of stress among people living close to green spaces — could play a role, but more research is needed to confirm this hypothesis,” he adds. The results of earlier studies have suggested that the association between a higher risk of breast cancer and residential proximity to agricultural land may be due to the use of pesticides. O’Callaghan-Gordo concludes: “We didn’t analyse levels of exposure to agrochemicals in our study, but they should be taken into account in future research to provide more insight into the mechanism underlying this negative association.”

Simple leg exercises could reduce impact of sedentary lifestyle on heart and blood vessels

A sedentary lifestyle can cause an impairment of the transport of blood around the body, which increases the risk of disease in the heart and blood vessels. New research published in Experimental Physiology suggests that performing simple leg exercises whilst lying down might help to prevent these problems.

Previous work has demonstrated that prolonged sitting for up to 6 hours results in a decline in both blood flow to the limbs and in our larger arteries’ ability to widen to accommodate increased blood flow. This is the first study to demonstrate that sitting for just 10 minutes is sufficient to reduce blood flow to the legs and impairs the function of small blood vessels supplying muscles in the leg.

This paper also demonstrates a reduction in the function of small blood vessels when lying down. However, this study suggests we might be able to somewhat reverse this impairment in function by performing simple leg exercises when lying down in bed or on the sofa. These findings are important in increasing our understanding of the negative impact of sitting and physical inactivity on blood vessel function and the supply of blood to the legs.

The effects of sitting on blood circulation have been attributed to blood passing more sluggishly through arteries whilst sitting. The researchers who performed this study aimed to find out whether these reductions were caused by sustained sitting, or whether 10 minutes would be sufficient to have a negative effect.

The research group used a Doppler ultrasound technique alongside the knee to measure blood flow and examined the extent to which blood vessels widened in 18 healthy, young males. These measurements were made prior to and following a 10-minute period of sitting or during a period of rest whilst lying down, with or without leg exercises, which were performed by extending the foot back and forth every two seconds for a third of the time spent lying down. Results showed that a 10 minute period of sitting reduced participants’ ability to rapidly increase blood flow to the lower legs via small blood vessels, but did not affect the widening of larger arteries in response to increased blood flow. These findings suggest that a brief period of inactivity affects an individual’s ability to rapidly push blood to the lower limbs as efficiently as normal, but doesn’t affect the ability of large blood vessels to widen. The results also suggest leg exercises can help maintain rapid increases in the blood supply to the limbs.

The current study demonstrates changes in blood vessel function measured at the level of the knee. However, the researchers only tested healthy young males, and as such, their findings cannot be extended to females. It remains unknown as to how these responses may vary with age, or with people who have heart problems. Further research may investigate the impact of sitting and inactivity on blood vessels in other places in the body. For example, would sitting impact the function of blood vessels supplying the brain? Finally, studies designed to investigate the impact of repeated bouts of short-term sitting on blood vessel function are needed.

Co-author Dr. Paul Fadel sheds light on his team’s results: “These findings further our understanding of the negative impact of inactivity on blood vessel function and demonstrate the positive effects of simple leg exercises whilst lying down providing further insight into how inactivity affects vascular health of the lower legs.”

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Materials provided by The Physiological Society. Note: Content may be edited for style and length.