More Kids Who are Severely Obese Should Have Weight-loss Surgery, Pediatricians Say

More Kids Who are Severely Obese Should Have Weight-loss Surgery, Pediatricians Say

Even some preteens who are severely obese should be considered candidates for weight-loss surgery, according to new recommendations from the American Academy of Pediatrics.
Recent data show that pediatric obesity surgery rates have tripled in almost 20 years, but they still average fewer than 2,000 operations each year.

The academy’s recommendations say children and teens could be eligible for surgery if their body mass index is 40 or higher, or if they have related major health problems and their BMI is at least 35. (A BMI of 30 or above is considered obese.) These criteria may vary by gender and age, Armstrong said.

The pediatricians’ guidelines are similar to criteria for surgeons from the American Society for Metabolic and Bariatric Surgery.

Faith Newsome was a typical patient. At 5 feet, 8 inches and 273 pounds, her BMI was almost 42 and she had high blood pressure and prediabetes when she had gastric bypass surgery at Duke at age 16.

After about a year, she had shed 100 pounds and those health problems disappeared. She slimmed down enough to become active in sports, shop for prom dresses and gain a better self-image. But to avoid malnutrition she takes vitamins, must eat small meals and gets sick if she eats foods high in fat or sugar. Her BMI, at just under 30, puts her in the overweight range.

Now 21 and a senior at the University of North Carolina in Chapel Hill, Newsome is quick to answer whe ther she has regrets. “Never,” she said. “Teens should be able to discuss every option with their doctors, and surgery should be one of those options.”


Contributor: Associated Press

California Wildfires: Millions Facing Danger

California Wildfires: Millions Facing Danger

“Staying home is a selfish act”: 90,000 ordered to evacuate near Sonoma County

About 90,000 people are under evacuation orders near Sonoma County in Northern California as severe winds are expected to cause the Kincade Fire to spread rapidly Saturday night. “You cannot fight this,” said Sonoma County Sheriff Mark Essick.

It is “truly a selfish act to stay at home and try to fight this,” Essick said.

The Sonoma County sheriff announced earlier Saturday that the towns of Healdsburg, Windsor and their unincorporated areas would be evacuated by 4 p.m. as flames from the expanding Kincade Fire driven by “Diablo winds” continued to advance.
Wind gusts of up to 80 mph — near hurricane-force wings — could be expected in some areas, said CBS News climate and weather contributor Jeff Berardelli said. “That means very rapid, changing conditions,” Berardelli said.

Pacific Gas & Electric, California’s largest utility, began shutting off power at 5 p.m. PT, the third power shutoff in as many weeks. PG&E said the blackouts would affect 940,000 homes and businesses in 36 counties for 48 hours or longer throughout the San Francisco Bay Area, wine country and Sierra foothills. That’s about 90,000 more customers affected than previously predicted.
So far, the Kincade fire has scorched almost 26,000 acres, destroyed 77 structures, including 31 homes, and was only 10% contained as of 7 p.m. on Saturday, CBS San Francisco reported.

“The winds are expected anywhere between 8 p.m. and midnight and from all reports they’re expected to be extremely strong,” said Brian Vitorelo with the California Department of Forestry and Fire Protection.

The Sonoma County Sheriff’s office extended the evacuation zone all the way to the coast Saturday evening. Earlier, the Sheriff’s office added the new warning area to two other potential evacuation zones — the Dry Creek Valley west to Forestville and Larkfield and Mark West Drainage.

Traffic on southbound 101 heading away from the evacuation was slow and bumper-to-bumper as thousands traveled toward a safe haven from the blaze.
A blaze Thursday destroyed at least six homes in the Santa Clarita area near Los Angeles and led to evacuation orders for up to 50,000 residents, although some were allowed back home Friday night after Santa Ana winds began to ease.

To the north, firefighters raced to make progress against a blaze near Geyserville in Sonoma County before ferocious “diablo winds” returned. The fire had burned 49 buildings, including 21 homes, and swept through nearly 40 square miles of the wine-growing region. It was 10% contained by Saturday morning.

One firefighter was injured protecting two trapped residents from the flames, CBS San Francisco reported. All three were taken to a local hospital suffering from non-life threatening injuries and “were expected to survive.”

No cause has been determined for any of the current fires, but PG&E said a 230,000-volt transmission line near Geyserville had malfunctioned minutes before that fire erupted Wednesday night.
The utility acknowledged that the discovery of the tower malfunction had prompted a change in its strategy.

“We have revisited and adjusted some of our standards and protocols in determining when we will de-energize high-voltage transmission lines,” Andrew Vesey, CEO of Pacific Gas & Electric Co., said at a briefing Friday.

The weekend forecasts detail what could be the strongest winds of the year coupled with bone-dry humidity.

“These places we all love have effectively become tinderboxes,” Vesey said. “Any spark, from any source, can lead to catastrophic results. We do not want to become one of those sources.”

The possible link between the wine country fire and a PG&E transmission line contained grim parallels to a catastrophic fire last year that tore through the town of Paradise, killing 85 people and destroying thousands of homes in the deadliest U.S. fire in a century.

State officials concluded that fire was sparked by a PG&E transmission line.

Asherah Davidown, 17, of Magalia and her family lost their house, two dogs and a car in the Paradise fire. She said her family was preparing for another power outage by filling the gas tank of their car and buying non-perishable foods and batteries for their flashlights.

The outages reminded her of her family’s vulnerable position as they struggle to get back on their feet.

“My house doesn’t have a generator so that means another weekend of sitting in the dark with no Wi-Fi, no food in the fridge and shopping in increments since we don’t know how long the power may be out,” Davidown said.

The continuing round of power outages made her feel somewhat vulnerable as her family tries to get back on its feet, she said.

“For the most part a lot of people feel really helpless. Their livelihoods are at the fingertips of a corporation,” she said. “There’s still a lot of hurt and emotional recovery. Having our basic needs repeatedly taken away is really unfortunate.”

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Invitation to Attend the Hay House Summit!

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Louise Lynn Hay (October 8, 1926 – August 30, 2017) was an American motivational author and the founder of Hay House. She authored several New Thought self-help books, including the 1984 book, You Can Heal Your Life.

Why Clowns Like the ‘Joker’ Give us the Creeps

Why Clowns Like the 'Joker' Give us the Creeps

Hollywood has long exploited our deep ambivalence about clowns, and this fall’s film lineup is no different.

Batman’s demented nemesis The Joker, played by Joaquin Phoenix, is the antihero of his origin story, “Joker,” which opened in theaters on Oct. 4. In September, Stephen King’s evil clown, Pennywise, made his second screen appearance in two years in “It Chapter Two.”


How did a mainstay of children’s birthday parties start to become an embodiment of pure evil?


In fact, a 2008 study conducted in England revealed that very few children actually like clowns. It also concluded that the common practice of decorating children’s wards in hospitals with pictures of clowns may create the exact opposite of a nurturing environment. It’s no wonder so many people hate Ronald McDonald.


But as a psychologist, I’m not just interested in pointing out that clowns give us the creeps; I’m also interested in why we find them so disturbing. In 2016, I published a study entitled “On the Nature of Creepiness” with one of my students, Sara Koehnke, in the journal New Ideas in Psychology. While the study was not specifically looking at the creepiness of clowns, much of what we discovered can help explain this intriguing phenomenon.
The march of the clowns


Clown-like characters have been around for thousands of years. Historically, jesters and clowns have been a vehicle for satire and for poking fun at powerful people. They provided a safety valve for letting off steam and they were granted unique freedom of expression — as long as their value as entertainers outweighed the discomfort, they caused the higher-ups.


Jesters and others persons of ridicule go back at least to ancient Egypt, and the English word “clown” first appeared sometime in the 1500s, when Shakespeare used the term to describe foolish characters in several of his plays. The now familiar circus clown — with its painted face, wig and oversized clothing — arose in the 19th century and has changed only slightly over the past 150 years.
Nor is the trope of the evil clown anything new. In 2016, writer Benjamin Radford published “Bad Clowns,” in which he traces the historical evolution of clowns into unpredictable, menacing creatures.


The persona of the creepy clown really came into its own after serial killer John Wayne Gacy was captured. In the 1970s, Gacy appeared at children’s birthday parties as “Pogo the Clown” and also regularly painted pictures of clowns. When the authorities discovered that he had killed at least 33 people, burying most of them in the crawl space of his suburban Chicago home, the connection between clowns and dangerous psychopathic behavior became forever fixed in the collective unconscious of Americans.
Then, for several months in 2016, creepy clowns terrorized America.


Reports emerged from at least 10 different states. In Florida, fiendish clowns were spotted lurking by the side of the road. In South Carolina, clowns were reportedly trying to lure women and children into the woods.
It isn’t clear which of these incidents were tales of clowning around and which were truly menacing abduction attempts. Nonetheless, the perpetrators seem to be tapping into the primal dread that so many children — and more than a few adults — experience in the presence of clowns.


The nature of creepiness


Psychology can help explain why clowns — the supposed purveyors of jokes and pranks — often end up sending chills down our spines.
My research was the first empirical study of creepiness, and I had a hunch that feeling creeped out might have something to do with ambiguity — about not really being sure how to react to a person or situation.
We recruited 1,341 volunteers ranging in age from 18 to 77 to fill out an online survey. In the first section of the survey, our participants rated the likelihood that a hypothetical “creepy person” would exhibit 44 different behaviors, such as unusual patterns of eye contact or physical characteristics like visible tattoos. In the second section of the survey, participants rated the creepiness of 21 different occupations, and in the third section they simply listed two hobbies that they thought were creepy. In the final section, participants noted how much they agreed with 15 statements about the nature of creepy people.
The results indicated that people we perceive as creepy are much more likely to be males than females, that unpredictability is an important component of creepiness and that unusual patterns of eye contact and other nonverbal behaviors set off our creepiness detectors big time.


Unusual or strange physical characteristics such as bulging eyes, a peculiar smile or inordinately long fingers did not, in and of themselves, cause us to perceive someone as creepy. But the presence of weird physical traits can amplify any other creepy tendencies that the person might be exhibiting, such as persistently steering conversations toward peculiar sexual topics or failing to understand the policy about bringing reptiles into the office.
When we asked people to rate the creepiness of different occupations, the one that rose to the top of the creep list was — you guessed it — clowns.


The results were consistent with my theory that getting “creeped out” is a response to the ambiguity of threat and that it is only when we are confronted with uncertainty about threat that we get the chills.
For example, it would be considered rude and strange to run away in the middle of a conversation with someone who is sending out a creepy vibe but is actually harmless; at the same time, it could be perilous to ignore your intuition and engage with that individual if he is, in fact, a threat. The ambivalence leaves you frozen in place, wallowing in discomfort.
This reaction could be adaptive, something humans have evolved to feel, with being “creeped out” a way to maintain vigilance during a situation that could be dangerous.


Why clowns set off our creep alert


In light of our study’s results, it is not at all surprising that we find them to be creepy.
Rami Nader is a Canadian psychologist who studies coulrophobia, the irrational fear of clowns. Nader believes that clown phobias are fueled by the fact that clowns wear makeup and disguises that hide their true identities and feelings.
This is perfectly consistent with my hypothesis that it is the inherent ambiguity surrounding clowns that make them creepy. They seem to be happy, but are they really? And they’re mischievous, which puts people constantly on guard. People interacting with a clown during one of his routines never know if they are about to get a pie in the face or be the victim of some other humiliating prank. The highly unusual physical characteristics of the clown — the wig, the red nose, the makeup, the odd clothing — only magnify the uncertainty of what the clown might do next.


There are certainly other types of people who creep us out; taxidermists and undertakers made a good showing on the creepy occupation spectrum. But they have their work cut out for them if they aspire to the level of creepiness that we automatically attribute to clowns.
In other words, they have big shoes to fill.



Contributor: The Conversation-CNN Health


Here’s Why Zantac Was Pulled From Stores, And What You Should Do Now

Here's Why Zantac Was Pulled From Stores, And What You Should Do Now

By now, you may have seen the headlinesthat major drugstore retailers like CVS and Walgreens have been pulling Zantac off of shelves due to certain versions of the heartburn medication containing potentially cancer-causing ingredients.
The pharmacy chains announced this week that they were no longer selling the product after the Food and Drug Administration issued a statement in mid-September saying that Zantac and its generic form, ranitidine, may contain low levels of N-nitrosodimethylamine (NDMA), a nitrosamine impurity. According to the FDA, NDMA has been classified as a probable human carcinogen based on laboratory test results.
 
 
The FDA had been investigating the occurrence of NDMA and other impurities in some blood pressure and heart failure medicines (mainly angiotensin II receptor blockers, or ARBs). After recognizing nitrosamine impurities in these products, the organization recommended several recalls on specific batches of those drugs. Now, the FDA has discovered that NDMA has been found in certain batches of ranitidine drugs, which are commonly taken to treat ulcers and heartburn.
 
 
So, how does all of this affect you? And should you be concerned if you’ve taken the medication recently? Here’s what you should know, according to experts.
 
 
First, a little primer on the major ways NDMA can be damaging.
 
 
As mentioned above, NDMA is considered to be a carcinogen. James Brian Byrd, an assistant professor of internal medicine at the University of Michigan Medical School, said research has shown that ingesting NDMA could potentially put people at risk for disease.
 
“In animals, it has been found to have the potential to cause cancer,” he said. “NDMA is found in some foods and even in water at times, but it is certainly unfortunate that it has been in a variety of drug products since July 2018, including now some ranitidine products,” he explained.
 
 
So how does the NDMA in food and water compare to drugs like ranitidine in terms of our health? According to Niket Sonpal, a New York-based internist and gastroenterologist and adjunct professor at Touro College, it’s all about the amount in the medicine and what experts know about it (which, right now, isn’t much).
 
 
“NDMA is found in food in small doses. The difference between finding it in foods at low levels and finding it in drugs is that testing needs to be done to make sure that there aren’t bigger amounts of impurities seeping into the formulas for these medications,” Sonpal said. “Whereas, generally speaking, the amount of NDMA in food and drink stays low.”
 
And it’s not just Zantac and other related heartburn medicines that have been affected by NDMA contamination.
 
 
 
Sonpal said that NDMA was one of the chemicals behind the recall of medications like Losartan, which is used to treat high blood pressure, over the past year.
 
 
He added that in addition to being a potential cause of cancer, “overexposure to NDMA can cause yellowing of the skin, nausea, fever, vomiting and dizziness.”
 
 
Here are the details on why the medication was pulled.
 
 
 
The FDA ― which noted that NDMA can be found in “water and foods, including meats, dairy products and vegetables” ― said that “although NDMA may cause harm in large amounts, the levels in ranitidine from preliminary tests barely exceed amounts you might expect to find in common foods.” The organization added that it is currently investigating whether or not these low levels of NDMA in ranitidine are enough to pose a risk to patients and will post the results of its findings when available.
 
 
So why the pull if there were only small traces of NDMA? Simply put, when drug manufacturers issued recalls, drugstore chains made moves out of caution as a result.
 
 
On Sept. 23, Sandoz Inc., a drug manufacturer that makes generic versions of Zantac, announced that it was voluntarily recalling its ranitidine medicines because of “confirmed contamination with N-Nitrosodimethylamine (NDMA) above levels established by the FDA in batches of Sandoz Ranitidine Hydrochloride Capsules.” Apotex Corp., another manufacturer, did the same, issuing a voluntarily and precautionary recall on 75mg and 150mg ranitidine tablets on Sept. 25.
 
Some stores are taking it a step further and taking all Zantac and generic ranitidine formulas off the shelves, regardless of the manufacturer.
 
 
“The fact that it is over-the-counter means more people can potentially ingest dangerous chemicals,” Sonpal said. “If it were a prescription drug, fewer people have access to it and the pharmacy can recall and halt distribution fairly quickly once the alarm is sound … In the case of over-the-counter medication, it is a more difficult task to track down people who have purchased and ingested the infected product.”
 
 
Bobby Price, an Atlanta-based pharmacist and plant-based nutritionist who previously worked with the Center for Drug Evaluation and Research with the FDA, noted that due to the popularity of the product, this decision holds a tremendous amount of weight.
 
 
“Zantac at one point was actually the highest-selling drug ever,” Price said. “And so for a company to [state], ‘I’m pulling this drug off of the shelves,’ that says a lot.”
 
 
While Sonpal wasn’t involved in the decision to pull the medication, he has a few theories as to why stores are exercising an abundance of caution. For starters, “pharmacies don’t want to be responsible for consumers becoming ill over this medication, so they want people to be as safe as possible,” he said.
 
 
Additionally, “when impurities are found, even in small amounts, there is a risk that future products can be contaminated at higher levels if not properly looked into,” he explained. Finally, since the news of the contamination came shortly after the FDA recalled other medications for the same NDMA impurity, pharmacies don’t want consumers to take a chance on this medication when “there are affordable alternatives for heartburn.”
 
 
Not all Zantac and generic products are affected.
 
 
“It is important to know that not all U.S.-marketed ranitidine products have been recalled and FDA has said that they are not recommending that individuals stop taking all ranitidine products at this time,” Byrd said.
 
 
So, if you’ve taken a product with ranitidine recently, don’t be too worried. However, the FDA has advised that patients taking prescription ranitidine who wish to discontinue use talk to their doctor about other treatment options.
 
 
“There are numerous over-the-counter medications currently on the market that treat stomach ulcers and/or acid reflux, including Prevacid (lansoprazole), Nexium (esomeprazole), Pepcid (famotidine), omeprazole, pantoprazole and calcium carbonate,” said Shital Mars, CEO of Progressive Care Inc. and PharmCo RX, a private pharmacy in Florida. It’s a good idea to check with a medical professional first if you are concerned about making a switch from your typical medication.
 
 
If you are curious if medication you use is affected, there are ways to check and get your money back. Sandoz’s affected lot numbers are found here and patients with affected products can call the company at 1-800-525-8747 or visit its website for more information.
 
Apotex provided customers with a chart which helps to see if a specific medication was recalled. Customers can also check on their products and return them to the manufacturer by calling 1-800-706-5575 or emailing UScustomerservice@apotex.com.
 
Contributor: Nicole Pajer-Huffington Post