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Health & Fitness (233)
The FDA has regulated tanning beds and sun lamps for over 30 years, but for the first time ever the agency says those devices should not be used by people under age 18. The agency wants that warning on pamphlets, catalogues and websites that promote indoor tanning. And regulators are also proposing that manufacturers meet certain safety and design requirements, including timers and limits on radiation emitted.
The government action is aimed at curbing cases of melanoma, the deadliest form of skin cancer, which have been on the rise for about 30 years. An estimated 2.3 million U.S. teenagers tan indoors each year, and melanoma is the second most common form of cancer among young adults, according to the American Academy of Dermatology.
Recent studies have shown that the risk of melanoma is 75 percent higher in people who have been exposed to ultraviolet radiation from indoor tanning. While most cases are diagnosed in people in their 40s and 50s, the disease is linked to sun exposure at a young age.
Physician groups have been urging the U.S. government to take action on tanning beds for years, citing increases in the number of cases of skin cancer among people in their teens and 20s.
"As a dermatologist I see the consequences of indoor tanning. I have to diagnose too many young people with melanoma and see the grief that it causes to these families," said Dr. Mary Maloney of the American Academy of Dermatology, on a call with FDA officials. Maloney said the FDA action is an important first step, but that her group would continue to push for a ban on the sale and use of tanning beds for people under age 18.
Earlier this year, a study of Missouri tanning salons found that 65 percent of 250 businesses surveyed would accept children ages 10 to 12, often without parental permission. The study was conducted by dermatologists at the Washington University School of Medicine in St. Louis.
Currently the machines are classified as low-risk devices, in the same group as bandages and tongue depressors. The proposal would increase their classification to moderate-risk, or class II, devices. That would allow the FDA to review their safety and design before manufacturers begin selling them.
"They don't have to provide any data in advance before they go on the market, so we have no way of providing assurance that the tanning beds are performing up to specifications," said Dr. Jeffrey Shuren, FDA's director for medical devices.
Safety standards are important because recent studies show that many devices can cause sunburn even when used as directed. A 2009 study found that 58 percent of adolescents who tan indoors had sunburn exposure.
"If you get an indoor tan you shouldn't be burning," Shuren said.
The Indoor Tanning Association said it supported any changes that improve its customers' safety. But, in a statement, the group added that "we are concerned that these changes will burden our members with addition unnecessary governmental costs in an already difficult economic climate."
The FDA proposal would not place warnings on the devices themselves, but on related promotional material and websites. Some consumer advocates said those warnings might never actually reach users.
"The FDA is requiring that the labels and pamphlets include risk information about skin cancer, but consumers would not be required to see those labels or pamphlets - they are apparently only for the company buying the tanning bed," said Diana Zuckerman, of the National Research Center for Women and Families.
The agency said it will take comments on its proposal for 90 days before formulating a final regulation. Agency officials didn't give a timeframe for completion, but said it would be a priority.
TRENTON, N.J. (AP) - Men who are bashful about needing help in the bedroom no longer have to visit a drugstore to buy that little blue pill.
In a first for the drug industry, Pfizer Inc. says starting today it will sell begin selling erectile dysfunction pill Viagra directly to patients on its website.
Men still will need a prescription to buy the blue pill on viagra.com, but they won't have to face a pharmacist to get it filled.
Other drugmakers likely will watch closely, and could begin selling other medicines online.'
The trend was most pronounced among white men and women in that age group. Their suicide rate jumped 40 percent between 1999 and 2010.
But the rates in younger and older people held steady. And there was little change among middle-aged blacks, Hispanics and most other racial and ethnic groups, the report from the Centers for Disease Control and Prevention found.
Why did so many middle-aged whites - that is, those who are 35 to 64 years old - take their own lives?
One theory suggests the recession caused more emotional trauma in whites, who tend not to have the same kind of church support and extended families that blacks and Hispanics do.
The economy was in recession from the end of 2007 until mid-2009. Even well afterward, polls showed most Americans remained worried about weak hiring, a depressed housing market and other problems.
Pat Smith, violence-prevention program coordinator for the Michigan Department of Community Health, said the recession - which hit manufacturing-heavy states particularly hard - may have pushed already-troubled people over the brink. Being unable to find a job or settling for one with lower pay or prestige could add "that final weight to a whole chain of events," she said.
Another theory notes that white baby boomers have always had higher rates of depression and suicide, and that has held true as they've hit middle age. During the 11-year period studied, suicide went from the eighth leading cause of death among middle-aged Americans to the fourth, behind cancer, heart disease and accidents.
"Some of us think we're facing an upsurge as this generation moves into later life," said Dr. Eric Caine, a suicide researcher at the University of Rochester.
One more possible contributor is the growing sale and abuse of prescription painkillers over the past decade. Some people commit suicide by overdose. In other cases, abuse of the drugs helps put people in a frame of mind to attempt suicide by other means, said Thomas Simon, one of the authors of the CDC report, which was based on death certificates.
People ages 35 to 64 account for about 57 percent of suicides in the U.S.
The report contained surprising information about how middle-aged people kill themselves: During the period studied, hangings overtook drug overdoses in that age group, becoming the No. 2 manner of suicide. But guns remained far in the lead and were the instrument of death in nearly half of all suicides among the middle-aged in 2010.
The CDC does not collect gun ownership statistics and did not look at the relationship between suicide rates and the prevalence of firearms.
For the entire U.S. population, there were 38,350 suicides in 2010, making it the nation's 10th leading cause of death, the CDC said. The overall national suicide rate climbed from 12 suicides per 100,000 people in 1999 to 14 per 100,000 in 2010. That was a 15 percent increase.
For the middle-aged, the rate jumped from about 14 per 100,000 to nearly 18 - a 28 percent increase. Among whites in that age group, it spiked from about 16 to 22.
Suicide prevention efforts have tended to concentrate on teenagers and the elderly, but research over the past several years has begun to focus on the middle-aged. The new CDC report is being called the first to show how the trend is playing out nationally and to look in depth at the racial and geographic breakdown.
Thirty-nine out of 50 states registered a statistically significant increase in suicide rates among the middle-aged. The West and the South had the highest rates. It's not clear why, but one factor may be cultural differences in willingness to seek help during tough times, Simon said.
Also, it may be more difficult to find counseling and mental health services in certain places, he added.
Suicides among middle-aged Native Americans and Alaska Natives climbed 65 percent, to 18.5 per 100,000. However, the overall numbers remain very small - 171 such deaths in 2010. And changes in small numbers can look unusually dramatic.
The CDC did not break out suicides of current and former military service members, a tragedy that has been getting increased attention. But a recent Department of Veterans Affairs report concluded that suicides among veterans have been relatively stable in the past decade and that veterans have been a shrinking percentage of suicides nationally.
--- Associated Press writer Jeff Karoub in Detroit contributed to this report.
Air quality forecasting officially begins Wednesday for the 2013 summer season, and St. Louis residents will want to pay attention in order to protect their health.
Officials with the American Lung Association say that's because the air in St. Louis is getting worse. Their latest State of the Air report shows the Gateway City is now ranked 25th worst in the nation for ozone pollution. We were 34th last year.
And St. Louis is 12th when it comes to year round particulate pollution. That's a slight improvement over our 10th place finish last year. But officials say it still means St. Louis is among the most polluted metropolitan areas in the nation.
Residents who want to receive air quality updates by email, can sign up at the Clean Air St. Louis website.
WASHINGTON (AP) - Looking for a new way to get that jolt of caffeine energy? Food companies are betting snacks like potato chips, jelly beans and gum with a caffeinated kick could be just the answer.
The Food and Drug Administration is closely watching the marketing of these foods and wants to know more about their safety.
The FDA said Monday it will look at the foods' effects on children in response to a caffeinated gum introduced this week by Wrigley. Alert Energy Gum promises "the right energy, right now."
The agency is already investigating the safety of energy drinks and energy shots, prompted by consumer reports of illness and death.
A few products that have added caffeine:
— Wrigley Alert Energy Gum contains about 40 milligrams a piece, or the equivalent amount found in half a cup of coffee.
— Jelly Belly Extreme Sport Beans have 50 mg of caffeine in a 100-calorie pack.
— Arma Energy Snx markets chips, trail mix and other products that contain caffeine, including "chocolate caramel cookie caffeine mix."
— Wired Waffles sells caffeinated maple syrup and "energy waffles."
— Some varieties of Frito-Lay's Cracker Jack'd Power Bites are coated wafers that include two tablespoons of ground coffee.
— Kraft's Mio Energy "water enhancer" squirts caffeine and flavoring into water.
In U.S. hospitals, an estimated 1 in 20 patients pick up infections they didn't have when they arrived, some caused by dangerous `superbugs' that are hard to treat.
The rise of these superbugs, along with increased pressure from the government and insurers, is driving hospitals to try all sorts of new approaches to stop their spread:
Machines that resemble "Star Wars" robots and emit ultraviolet light or hydrogen peroxide vapors. Germ-resistant copper bed rails, call buttons and IV poles. Antimicrobial linens, curtains and wall paint.
While these products can help get a room clean, their true impact is still debatable. There is no widely-accepted evidence that these inventions have prevented infections or deaths.
Meanwhile, insurers are pushing hospitals to do a better job and the government's Medicare program has moved to stop paying bills for certain infections caught in the hospital.
"We're seeing a culture change" in hospitals, said Jennie Mayfield, who tracks infections at Barnes-Jewish Hospital in St. Louis.
Those hospital infections are tied to an estimated 100,000 deaths each year and add as much as $30 billion a year in medical costs, according to the Centers for Disease Control and Prevention. The agency last month sounded an alarm about a "nightmare bacteria" resistant to one class of antibiotics. That kind is still rare but it showed up last year in at least 200 hospitals.
Hospitals started paying attention to infection control in the late 1880s, when mounting evidence showed unsanitary conditions were hurting patients. Hospital hygiene has been a concern in cycles ever since, with the latest spike triggered by the emergence a decade ago of a nasty strain of intestinal bug called Clostridium difficile, or C-diff.
The diarrhea-causing C-diff is now linked to 14,000 U.S. deaths annually. That's been the catalyst for the growing focus on infection control, said Mayfield, who is also president-elect of the Association for Professionals in Infection Control and Epidemiology.
C-diff is easier to treat than some other hospital superbugs, like methicillin-resistant staph, or MRSA, but it's particularly difficult to clean away. Alcohol-based hand sanitizers don't work and C-diff can persist on hospital room surfaces for days. The CDC recommends hospital staff clean their hands rigorously with soap and water - or better yet, wear gloves. And rooms should be cleaned intensively with bleach, the CDC says.
Michael Claes developed a bad case of C-diff while he was a kidney patient last fall at New York City's Lenox Hill Hospital. He and his doctor believe he caught it at the hospital. Claes praised his overall care, but felt the hospital's room cleaning and infection control was less than perfect.
"I would use the word `perfunctory,'" he said.
Lenox Hill spokeswoman Ann Silverman disputed that characterization, noting hospital workers are making efforts that patients often can't see, like using hand cleansers dispensers in hallways. She ticked off a list of measure used to prevent the spread of germs, ranging from educating patients' family members to isolation and other protective steps with each C-diff patient.
The hospital's C-diff infection rate is lower than the state average, she said.
Westchester Medical Center, a 643-bed hospital in the suburbs of New York City has also been hit by cases of C-diff and the other superbugs.
Complicating matters is the fact that larger proportions of hospital patients today are sicker and more susceptible to the ravages of infections, said Dr. Marisa Montecalvo, a contagious diseases specialist at Westchester.
There's a growing recognition that it's not only surgical knives and operating rooms that need a thorough cleaning but also spots like bed rails and even television remote controls, she said. Now there's more attention to making sure "that all the nooks and crannies are clean, and that it's done in perfect a manner as can be done," Montecalvo said.
Enter companies like Xenex Healthcare Services, a Texas company that makes a portable, $125,000 machine that's rolled into rooms to zap C-diff and other bacteria and viruses dead with ultraviolet light. Xenex has sold or leased devices to more than 100 U.S. hospitals, including Westchester Medical Center.
The market niche is expected to grow from $30 million to $80 million in the next three years, according to Frost & Sullivan, a market research firm.
Mark Stibich, Xenex's chief scientific officer, said client hospitals sometimes call them robots and report improved satisfaction scores from patients who seem impressed that the medical center is trotting out that kind of technology.
At Westchester, they still clean rooms, but the staff appreciates the high-tech backup, said housekeeping manager Carolyn Bevans.
"We all like it," she said of the Xenex.
At Cooley Dickinson Hospital, a 140-bed facility in Northampton, Mass., the staff calls their machines Thing One, Thing Two, Thing Three and Thing Four, borrowing from the children's book "The Cat in the Hat."
But while the things in the Dr. Seuss tale were house-wrecking imps, Cooley Dickinson officials said the ultraviolet has done a terrific job at cleaning their hospital of the difficult C-diff.
"We did all the recommended things. We used bleach. We monitored the quality of cleaning," but C-diff rates wouldn't budge, said nurse Linda Riley, who's in charge of infection prevention at Cooley Dickinson.
A small observational study at the hospital showed C-diff infection rates fell by half and C-diff deaths fell from 14 to 2 during the last two years, compared to the two years before the machines.
Some experts say there's not enough evidence to show the machines are worth it. No national study has shown that these products have led to reduced deaths or infection rates, noted Dr. L. Clifford McDonald of the Centers for Disease Control and Prevention.
His point: It only takes a minute for a nurse or visitor with dirty hands to walk into a room, touch a vulnerable patient with germy hands, and undo the benefits of a recent space-age cleaning.
"Environments get dirty again," McDonald said, and thorough cleaning with conventional disinfectants ought to do the job.
Beyond products to disinfect a room, there are tools to make sure doctors, nurses and other hospital staff are properly cleaning their hands when they come into a patient's room. Among them are scanners that monitor how many times a health care worker uses a sink or hand sanitizer dispenser.
Still, "technology only takes us so far," said Christian Lillis, who runs a small foundation named after his mother who died from a C-diff infection.
Lillis said the hospitals he is most impressed with include Swedish Covenant Hospital in Chicago, where thorough cleanings are confirmed with spot checks. Fluorescent powder is dabbed around a room before it's cleaned and a special light shows if the powder was removed. That strategy was followed by a 28 percent decline in C-diff, he said.
He also cites Advocate Christ Medical Center in Oak Lawn, Ill., where the focus is on elbow grease and bleach wipes. What's different, he said, is the merger of the housekeeping and infection prevention staff. That emphasizes that cleaning is less about being a maid's service than about saving patients from superbugs.
"If your hospital's not clean, you're creating more problems than you're solving," Lillis said.
--- Online: CDC: HTTP://WWW.CDC.GOV/HAI/
A new poll examined how people 40 and over are preparing for this difficult and often pricey reality of aging, and found two-thirds say they've done little to no planning.
In fact, 3 in 10 would rather not think about getting older at all. Only a quarter predict it's very likely that they'll need help getting around or caring for themselves during their senior years, according to the poll by the AP-NORC Center for Public Affairs Research.
That's a surprise considering the poll found more than half of the 40-plus crowd already have been caregivers for an impaired relative or friend - seeing from the other side the kind of assistance they, too, may need later on.
"I didn't think I was old. I still don't think I'm old," explained retired schoolteacher Malinda Bowman, 60, of Laura, Ohio.
Bowman has been a caregiver twice, first for her grandmother. Then after her father died in 2006, Bowman moved in with her mother, caring for her until her death in January. Yet Bowman has made few plans for herself.
"I guess I was focused on caring for my grandmother and mom and dad, so I didn't really think about myself," she said. "Everything we had was devoted to taking care of them."
The poll found most people expect family to step up if they need long-term care - even though 6 in 10 haven't talked with loved ones about the possibility and how they'd like it to work.
Bowman said she's healthy now but expects to need help someday from her two grown sons. Last month, prompted by a brother's fall and blood clot, she began the conversation by telling her youngest son about her living will and life insurance policy.
"I need to plan eventually," she acknowledged.
Those family conversations are crucial: Even if they want to help, do your relatives have the time, money and knowhow? What starts as driving Dad to the doctor or picking up his groceries gradually can turn into feeding and bathing him, maybe even doing tasks once left to nurses such as giving injections or cleaning open wounds. If loved ones can't do all that, can they afford to hire help? What if you no longer can live alone?
"The expectation that your family is going to be there when you need them often doesn't mean they understand the full extent of what the job of caregiving will be," Susan Reinhard, a nurse who directs AARP's Public Policy Institute, said. "Your survey is pointing out a problem for not just people approaching the need for long-term care, but for family members who will be expected to take on the huge responsibility of providing care."
Those who have been through the experience of receiving care are less apt to say they can rely on their families in times of need, the poll found.
With a rapidly aging population, more families will be facing those responsibilities. Government figures show nearly 7 in 10 Americans will need long-term care at some point after they reach age 65, whether it's from a relative, a home health aide, assisted living or a nursing home. On average, they'll need that care for three years.
Despite the "it won't happen to me" reaction, the AP-NORC Center poll found half of those surveyed think just about everyone will need some assistance at some point. There are widespread misperceptions about how much care costs and who will pay for it. Nearly 60 percent of those surveyed underestimated the cost of a nursing home, which averages more than $6,700 a month.
Medicare doesn't pay for the most common types of long-term care. Yet 37 percent of those surveyed mistakenly think it will pay for a nursing home and even more expect it to cover a home health aide when that's only approved under certain conditions.
The harsh reality: Medicaid, the federal-state program for the poor, is the main payer of long-term care in the U.S., and to qualify seniors must have spent most of their savings and assets. But fewer than half of those polled think they'll ever need Medicaid - even though only a third are setting aside money for later care, and just 27 percent are confident they'll have the financial resources they'll need.
In Cottage Grove, Ore., Police Chief Mike Grover, 64, says his retirement plan means he could afford a nursing home. And like 47 percent of those polled, he's created an advance directive, a legal document outlining what medical care he'd want if he couldn't communicate.
Otherwise, Grover said he hasn't thought much about his future care needs. He knows caregiving is difficult, as he and his brother are caring for their 85-year-old mother.
Still, "until I cross that bridge, I don't know what I would do. I hope that my kids and wife will pick the right thing," he said. "It depends on my physical condition, because I do not want to be a burden to my children."
The AP-NORC Center poll found widespread support for tax breaks to encourage saving for long-term care, and about half favor the government establishing a voluntary long-term care insurance program. An Obama administration attempt to create such a program ended in 2011 because it was too costly.
The older they get, the more preparations people take. Just 8 percent of 40- to 54-year-olds have done much planning for long-term care, compared with 30 percent of those 65 or older, the poll found.
Mary Pastrano, 74, of Port Orchard, Wash., has planned extensively for her future health care. She has lupus, heart problems and other conditions, and now uses a wheelchair. She also remembers her family's financial struggles after her own father died when she was a child.
"I don't want people to stand around and wring their hands and wonder, `What would Mom think was the best?'" said Pastrano, who has discussed her insurance policies, living will and care preferences with her husband and children.
Still, Pastrano wishes she and her husband had started saving earlier, during their working years.
"You never know how soon you're going to be down," she said. "That's what older people have a problem understanding: You can be in your 60s and then next flat on your back. You think you're invincible, until you can't walk."
The AP-NORC Center for Public Affairs Research survey was conducted Feb. 21 through March 27, with funding from the SCAN Foundation. The SCAN Foundation is an independent, nonprofit organization that supports research and other initiatives on aging and health care. The nationally representative poll involved landline and cellphone interviews with 1,019 Americans age 40 or older. It has a margin of sampling error of plus or minus 4.1 percentage points.
Associated Press writer Stacy A. Anderson and News Survey Specialist Dennis Junius contributed to this report.
Government long-term care primer: HTTP://LONGTERMCARE.GOV
AP-NORC Center for Public Affairs Research: HTTP://WWW.APNORC.ORG