Why Leather Football Helmets Could Provide a Better Defense Against Concussion

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If we want to cut down on football concussions, should we bring back the leather helmet? Not quite, says a new study in the Journal of Neurosurgery, though the noggin-protectors of yore do at least as good of a job as modern helmets at staving off concussions.

Modern helmets do a much better job of preventing deadly skull fractures. But on the type of lower-impact hits to the head you typically see in college and high school games — the constant subconcussive blows that can also cause brain damage — leatherheads do a comparable, and sometimes better, job of reducing concussion risks than today's helmets, according to Cleveland Clinic researchers.

“The fact that leather helmets were even in the neighborhood with modern helmets was surprising,” says Adam Bartsch, the study's lead researcher and director of the Spine Research Laboratory at the Cleveland Clinic's Center for Spine Health.

To reach this conclusion, Bartsch says his team basically “smashed some helmets together.” In the experiments, 11 widely-used high school football helmets and two vintage turn-of-the-century models were placed on the heads of crash-test dummies. The researchers simulated head impacts at gravity-force (Gs) levels of 75 Gs or less, which are typically encountered in high school and college games. They simulated impacts at different angles – a head-on collision, a hit to the side of the head, a hit to the back of the head – and measured their effects on skull rotation, neck force, neck torque and other head movements.

MORE: Study Ranks 10 Football Helmets for Concussion Safety

This data was input into a software program that estimates risk of brain contusions, acute subdural hematoma (bleeding on the surface of the brain), and diffuse axonal injury (DAI), which causes the shearing of nerve cells within the brain. “Overall,” the study concludes, leather helmets and modern helmets provide a “similar protectiveness profile” during subconcussive hits. In fact, under one testing scenario, a leather helmet provided a lower level of DAI risk than any of the modern helmets.

How could a leatherhead possibly be more protective? One reason, Bartsch says, probably has to with the stiffness of today's helmets. While these helmets are effective shields against catastrophic skull fractures, they don't do as good a job absorbing energy from a lower impact hit. These hits might not break the skull, but they can cause the brain to shift a little bit within the skull. And such jiggling causes concussions.

Bartsch offers a useful analogy: Think about hitting your thumb with a hammer. If you put, say, a piece of a padded gym mat on your thumb, that padding will absorb the impact from the hammer, and dull the pain. Now, imagine putting a two-by-four on top of your thumb. Whack the hammer against that stiffer surface; your thumb will probably hurt more than the gym mat.  Think of the leatherhead as the gym mat, and a plastic helmet as the two-by-four. The hammer is like a football hit, while the thumb is like your head.

MORE: Study: Boys, Girls Suffer Different Concussion Symptoms

Still, we won't be returning to the leather helmet days; no one wants fatalities on the football field. Yet it's worth considering whether today's football helmets might benefit from a slightly softer outer shell.

For inspiration, Bartsch suggests that the sporting-goods industry look at car companies.  “Unlike cars, in which seat belts, airbags and crumple zones make the choice between a 1920s Model T and the modern mini-van a no-brainer," said Bartsch in a release that accompanied the study, "these results tell us that modern helmets have ample room to improve safety against many typical in-game hits."

Sean Gregory is a staff writer at TIME. Find him on Twitter at @seanmgregory. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

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Alcohol linked to better survival after heart attack

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n">(Reuters) - Women who drank anywhere from a few alcoholic drinks a month to more than three a week in the year leading up to a heart attack ended up living longer than women who never drank alcohol, according to a U.S. study.

The findings, which focused on more than 1,000 women and were published in the American Journal of Cardiology, add to mounting evidence that alcohol, regardless of the type of drink, can be good for the heart.

"One thing that was interesting was that we didn't see differences among different beverage types," said Joshua Rosenbloom, a student at Harvard Medical School who led the study.

"The most recent evidence suggests that it's the alcohol itself that's beneficial."

There was a similarly reduced risk of dying within the follow up period whether the women drank wine, beer or hard liquor, Rosenbloom and his colleagues found.

"One drink a day is a really good target, assuming that a person can be disciplined about that," said James O'Keefe, a cardiologist at St. Luke's Health System in Kansas City, Missouri, who was not involved in the study.

Researchers surveyed more than 1,200 women hospitalized for a heart attack. They asked questions about how many alcoholic drinks the women usually consumed, along with other health and lifestyle questions.

After at least 10 years of follow up, the team found that 44 out of every 100 women who had abstained from alcohol had died, while 25 out of every 100 light drinkers and 18 out of every 100 heavy drinkers had died.

This translated to about a 35 percent lower chance of dying during the follow up period for women who drank, compared to those who didn't.

In an earlier study including men and women, O'Keefe found that people who continued to drink moderately after having a heart attack had better health than those who abstained.

"You don't need to assume that people need to stop drinking once they develop heart disease," he said.

"The problem is that alcohol is a slippery slope, and while we know that a little bit is good for us, a lot of it is really bad." SOURCE: bit.ly/uU3Eor

(Reporting from New York by Kerry Grens at Reuters Health; editing by Elaine Lies)

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Mediterranean diet tied to better fertility

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By Linda Thrasybule

NEW YORK | Tue Oct 25, 2011 4:16pm EDT

NEW YORK (Reuters Health) - Women who eat a Mediterranean-style diet -- high in fruits, vegetables, fish and whole grains -- are less likely to have trouble getting pregnant, hints a new study from Spain.

The findings add to a growing body of evidence linking the Mediterranean diet to all kinds of health effects, including lower risks of obesity, diabetes and heart disease.

But Dr. Jorge Chavarro, who was not part of the study, cautioned that the new results are based on observations, not an experiment.

"There's always the possibility that this association is not causal," said Chavarro, who studies nutrition at the Harvard School of Public Health in Boston.

Researchers looked at nearly 500 women with fertility problems and more than 1,600 women of the same age who had at least one child. Based on questionnaires, they measured how closely women followed either a Western-style or a Mediterranean diet.

The Western diet consisted of red meat, fast food, whole-fat dairy products, potatoes, refined grains and sugar-sweetened soda, and was not linked to fertility.

In other words, there was no difference in fertility problems between women who followed this type of diet religiously and those who followed it less strictly.

But the picture changed for women with a Mediterranean diet. About 17 percent of those who stuck to it meticulously said they'd had trouble getting pregnant, while 26 percent of the women who followed that diet least closely had fertility problems.

"The Mediterranean type diet may have a protective effect on insulin resistance and type 2 diabetes," said study researcher Dr. Estefanía Toledo, who studies nutrition at the University of Navarra in Spain.

Insulin resistance means that the body's cells have a hard time absorbing sugar from the blood stream. But researchers have also found a link between insulin resistance and ovulation -- when the egg is released from the ovary and can be fertilized.

"Insulin has other functions in the body," Chavarro told Reuters Health. "It also regulates a number of hormones, in particular the amount of hormones needed for ovulation which is essential for reproduction."

Chavarro thinks the Mediterranean diet indirectly influences ovulation.

"The Mediterranean diet contains nutrients that help your body clear sugar from the bloodstream while using less insulin to do this job," he said. "This makes it easier for the body to keep the balance of reproductive hormones."

For women who are thinking about getting pregnant, Chavarro sees no harm in adopting the Mediterranean diet.

But for women who are having fertility problems, he said, "we don't have enough data to show that this diet pattern can help you get pregnant as a result of fertility treatment."

More than six million U.S. women of childbearing age have difficulty getting pregnant or staying pregnant, according to the Centers for Disease Control and Prevention.

But men might also want to watch their diet and lifestyle if they are interested in maximizing their chances of becoming fathers. A recent study by Chavarro and colleagues found that overweight men have lower sperm counts than their leaner peers.

"Other than that, there's very little we know about body composition and male fertility," he said. "That's an area that we're working on right now."

SOURCE: bit.ly/puuLP3 Fertility and Sterility, September 22, 2011.

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AUDIO: Autism to be 'better diagnosed'

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28 September 2011 Last updated at 12:11 GMT Help

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Targeted back pain care 'better'

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29 September 2011 Last updated at 00:45 GMT By James Gallagher Health reporter, BBC News Nearly one in 10 UK adults go to their GP with back pain each year More targeted treatment for back pain improves care and "substantially" reduces healthcare costs, say scientists.

Instead of a "one size fits all" approach, different treatments were offered depending on the severity of the condition.

Writing in the Lancet, researchers said the findings would have "important implications" for back pain patients.

Other doctors said the findings were "very promising".

Estimates for the UK suggest back pain is very common with between 6% and 9% of adults visiting their GP with the condition each year. Up to 80% say they still have pain a year later.

The report's authors argued that current care, such as advice, painkillers or referral to a physiotherapist, was based on "intuition" which was "inefficient and inconsistent".

In the study, 283 patients were treated normally and 568 were assessed as having low, medium or high risk of long-term and disabling back pain.

'Very promising' Low-risk patients were given advice by a physiotherapist. Medium-risk patients received intensive physiotherapy. High-risk patients had physiotherapy and help to overcome psychological barriers to recovery, which can occur in chronic conditions.

After 12 months, the targeted groups showed significantly more improvement than the traditional treatment group.

The study said the benefit was achieved at lower cost - saving more than £30 per patient on average.

Lead researcher Prof Elaine Hay, of Keele University, said: "The problem for GPs and other health professionals is spotting who, amongst the patients they see with back pain, is likely to get better with simple advice and reassurance, and who might benefit from further treatment from a physiotherapist."

She said 50 centres in the UK had already adopted the new approach: "The data shows that it is having a substantial beneficial impact where it is being implemented."

The study was funded by Arthritis Research UK. Its medical director Prof Alan Silman said there had been many studies into the effectiveness of exercise and physiological treatments, but: "This research is novel because it shows how to take the best of these two approaches, and make a real difference to large numbers of patients."

Dr Bart Koes, of Erasmus University Medical Centre in The Netherlands, said in an accompanying article that "further improvements are desirable" but "these results are indeed very promising".

He added: "The economic assessment showed that the new approach was cost effective so there is no financial reason not to implement."

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Better heart, better sex

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Nearly 1 in 5 men in the U.S. has difficulty achieving or maintaining an erectionErectile dysfunction is also a known harbinger of heart diseaseDoctors should inform the public of this connection, researchers sayExercise is key for heart health and blood vessel function

(Health.com) -- Middle-aged men who take steps to improve their heart health by eating better, getting more exercise, or taking cholesterol-lowering drugs may end up improving their sex lives as well, according to a new analysis of existing research.

Nearly 1 in 5 men in the U.S. has difficulty achieving or maintaining an erection, a condition known as erectile dysfunction (ED). The new study, which appears this week in the Archives of Internal Medicine, suggests that ED drugs such as Viagra aren't the only solution and aren't always enough to address the problem, says coauthor Dr. Stephen Kopecky, M.D., a cardiologist at the Mayo Clinic in Rochester, Minnesota.

"If you do take care of your lifestyle—eating right, exercising, losing weight—you respond much better to the Viagra, the Levitra, the Cialis," Kopecky says. By the same token, he adds, if these drugs become less effective "that should be a sign that...you need to take care of your lifestyle.'"

Health.com: 7 ways to treat erectile dysfunction

ED is troubling enough by itself, but to make matters worse it's also a known harbinger of heart disease. The arteries in the penis that expand during an erection can become weakened and clogged with cholesterol in the same way as the arteries that surround the heart. This is why ED often shows up three to five years ahead of life-threatening cardiovascular problems such as heart attack or stroke, especially in younger men, Kopecky says.

"The common denominator is blood flow," he explains. "If you look at a guy in his 40s who has erectile dysfunction and then you compare [him] to another guy in his 40s who doesn't have erectile dysfunction, the guy with ED is about 50 times more likely to have heart disease."

Despite this well-established link, there has been little research into whether addressing risk factors for heart disease (such as unhealthy cholesterol numbers) can also reverse ED. The studies that have been conducted have been relatively small and have looked at a single location, which means they may not apply to the population as a whole, Kopecky and his colleagues say.

Health.com: 10 heart-healthy rules to live by

To clarify the effect of heart-healthy lifestyle changes on ED, the researchers combed through the medical literature for placebo-controlled clinical trials in which men with ED modified their lifestyles or began taking cholesterol-lowering statin medications. The analysis was funded entirely by the Mayo Clinic.

In the end they focused on six studies that included a total of 740 men and were conducted in the U.S., Italy, Nigeria, and Iran. In all of the studies, which ranged in length from two months to two years, heart healthy regimens and better cholesterol numbers were associated with modest but measurable improvements on a survey that rates erectile function on a scale from 5 to 25.

The average improvement in sexual function seen in the pooled studies was three points, one point shy of the threshold experts consider "clinically important." For some men, especially those with more persistent cases of ED, a change of that magnitude would be negligible. For those with mild or occasional ED, however, it would translate into noticeable improvements in sexual function, the researchers say.

Health.com: Erectile dysfunction? Try losing weight

Dr. Kevin Billups, M.D., an associate professor of urology at the University of Minnesota, in Minneapolis, says that the close relationship between heart health and sexual function "hasn't become the public health message that it should be."

Doctors and other experts need to do a better of job of informing the public that a healthier heart often means better erections, adds Billups, who studies the link between heart health and erectile function but did not participate in the new research.

"That's the first thing I talk about with all the guys that come in now," he says, referring to the ED patients he sees in his urology practice. "'Are you watching your diet? What kind of exercise program are you on?' Just putting these men on the ED medications...probably isn't enough to get optimal results."

Health.com: The best foods for your heart

Even if they're told that it may improve their ED, getting men to change their lifestyle and lose weight is no easy task, Kopecky says. He stresses, however, that even small and simple lifestyle changes—such as eating at least five servings of fruits and veggies daily—can make a big difference.

But the "real key" is exercise, Kopecky says. Just 10 minutes of vigorous exercise three times a week "does a whole lot to improve your heart function [and] blood vessel function," he says.

Copyright Health Magazine 2010

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A Better Way to Treat Obsessive-Compulsive Kids

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Obsessive compulsive disorder (OCD) can be a nasty enough condition when it strikes an adult. When it hits in childhood it's far crueler. Not only are kids unequipped to understand what's happening to them, they are also being denied what should be the best — or at least most worry-free — years of their lives.

That's one of the reasons that attentive parents  move to treat the condition fast, and that often means drug therapy, which seems like the most direct — and certainly least expensive — way to get the job done. According to a recent study in the Journal of the American Medical Association, however, those parents are leaving a big component of effective treatment on the table — a component that could double the odds of their kids recovering.

OCD is an anxiety disorder — unlike, say, narcissism, which is a personality disorder — and that's a very good thing. Anxiety disorders are extremely amenable to cognitive-behavioral therapy, particularly a kind known as exposure and response prevention (ERP). For OCD sufferers who fear contamination, for example, ERP might involve touching a feared object like a doorknob or a trash can and then resisting the urge to wash their hands for a fixed period of time. Over the course of weeks, that period of abstinence will grow longer and the category of newly touchable objects will grow bigger. In as little as three months, the condition may be in check.

The problem is, behavioral therapy is expensive and insurance companies may cover it only partially or not at all. What's more, it's time-consuming. Better just to pop any one of a number of types of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) — most of which are available in cheap, fully covered generics.

In order to determine how effective that pills-only strategy is, a group of researchers headed by psychologist Martin Franklin of the University of Pennsylvania School of Medicine recruited a sample group of 124 OCD patients aged 7 to 17 years and divided them into three subgroups. A third of them would begin a medication-only protocol; a third would get medication plus instructions in behavioral strategies; and a third would get medication plus in-person therapy sessions to teach and rehearse the behavioral tactics.

At the end of a 12-week period, the kids' OCD symptoms were evaluated using what's known as the Children's Yale-Brown Obsessive Compulsive Scale. The Yale-Brown scale scores kids on a range of OCD metrics, including how much anxiety they're experiencing, the kinds of rituals they're performing and how much time those rituals take. The benchmark Franklin and his colleagues were looking for was a 30% reduction in OCD symptoms — a level of relief that may not be full recovery, but can be a life-altering improvement and make kids receptive to more treatment still.

In the medication-only group, just 30% of the kids exhibited the 30% improvement; for medication plus behavioral instructions it was a tick better — 34%. The kids who received both meds and therapy sessions more than doubled that, with 68.6% getting 30% better.

The good news for children with OCD is not so much that the results are so robust. ERP has long been known to be an extremely powerful tool, and for many therapists, it's the main tool, with drugs used merely as an adjunct and only when needed. The true significance is that Franklin's study is clinical proof of that accepted wisdom — a powerful, peer-reviewed cudgel that will make it harder for insurance companies to deny kids the treatment. The faster that suffering children get the care they need, the more years of genuine childhood they'll have.

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Better heart, better sex

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Nearly 1 in 5 men in the U.S. has difficulty achieving or maintaining an erectionErectile dysfunction is also a known harbinger of heart diseaseDoctors should inform the public of this connection, researchers sayExercise is key for heart health and blood vessel function

(Health.com) -- Middle-aged men who take steps to improve their heart health by eating better, getting more exercise, or taking cholesterol-lowering drugs may end up improving their sex lives as well, according to a new analysis of existing research.

Nearly 1 in 5 men in the U.S. has difficulty achieving or maintaining an erection, a condition known as erectile dysfunction (ED). The new study, which appears this week in the Archives of Internal Medicine, suggests that ED drugs such as Viagra aren't the only solution and aren't always enough to address the problem, says coauthor Dr. Stephen Kopecky, M.D., a cardiologist at the Mayo Clinic in Rochester, Minnesota.

"If you do take care of your lifestyle—eating right, exercising, losing weight—you respond much better to the Viagra, the Levitra, the Cialis," Kopecky says. By the same token, he adds, if these drugs become less effective "that should be a sign that...you need to take care of your lifestyle.'"

Health.com: 7 ways to treat erectile dysfunction

ED is troubling enough by itself, but to make matters worse it's also a known harbinger of heart disease. The arteries in the penis that expand during an erection can become weakened and clogged with cholesterol in the same way as the arteries that surround the heart. This is why ED often shows up three to five years ahead of life-threatening cardiovascular problems such as heart attack or stroke, especially in younger men, Kopecky says.

"The common denominator is blood flow," he explains. "If you look at a guy in his 40s who has erectile dysfunction and then you compare [him] to another guy in his 40s who doesn't have erectile dysfunction, the guy with ED is about 50 times more likely to have heart disease."

Despite this well-established link, there has been little research into whether addressing risk factors for heart disease (such as unhealthy cholesterol numbers) can also reverse ED. The studies that have been conducted have been relatively small and have looked at a single location, which means they may not apply to the population as a whole, Kopecky and his colleagues say.

Health.com: 10 heart-healthy rules to live by

To clarify the effect of heart-healthy lifestyle changes on ED, the researchers combed through the medical literature for placebo-controlled clinical trials in which men with ED modified their lifestyles or began taking cholesterol-lowering statin medications. The analysis was funded entirely by the Mayo Clinic.

In the end they focused on six studies that included a total of 740 men and were conducted in the U.S., Italy, Nigeria, and Iran. In all of the studies, which ranged in length from two months to two years, heart healthy regimens and better cholesterol numbers were associated with modest but measurable improvements on a survey that rates erectile function on a scale from 5 to 25.

The average improvement in sexual function seen in the pooled studies was three points, one point shy of the threshold experts consider "clinically important." For some men, especially those with more persistent cases of ED, a change of that magnitude would be negligible. For those with mild or occasional ED, however, it would translate into noticeable improvements in sexual function, the researchers say.

Health.com: Erectile dysfunction? Try losing weight

Dr. Kevin Billups, M.D., an associate professor of urology at the University of Minnesota, in Minneapolis, says that the close relationship between heart health and sexual function "hasn't become the public health message that it should be."

Doctors and other experts need to do a better of job of informing the public that a healthier heart often means better erections, adds Billups, who studies the link between heart health and erectile function but did not participate in the new research.

"That's the first thing I talk about with all the guys that come in now," he says, referring to the ED patients he sees in his urology practice. "'Are you watching your diet? What kind of exercise program are you on?' Just putting these men on the ED medications...probably isn't enough to get optimal results."

Health.com: The best foods for your heart

Even if they're told that it may improve their ED, getting men to change their lifestyle and lose weight is no easy task, Kopecky says. He stresses, however, that even small and simple lifestyle changes—such as eating at least five servings of fruits and veggies daily—can make a big difference.

But the "real key" is exercise, Kopecky says. Just 10 minutes of vigorous exercise three times a week "does a whole lot to improve your heart function [and] blood vessel function," he says.

Copyright Health Magazine 2010

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Suicide of a Bullied Teenager, Who Promised 'It Gets Better'

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"They'd taunt me in the hallways and I felt like I could never escape it."

—JAMEY RODEMEYER, 14, a Buffalo junior high school student, describing the bullying he endured from peers, in a video for It Gets Better, a project created to give hope to bullied gay teens. "I just want to tell you that it does get better," he said in May, urging other gay teens, "Just love yourself and you're set." Earlier this week, Jamey was found dead outside his home of an apparent suicide. "Sometimes the damage done by hate and by haters is simply too great," wrote Dan Savage, the advice columnist and co-founder of It Gets Better, on his blog Tuesday. [via The New York Times]

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HEALTH MANAGEMENT. American families only $ 95 off better in 10 years because of rising health care costs

A median-income American family is only $95 per month better off today than ten years ago because rising health care costs have eliminated virtually all their income gains, researchers from the RAND Corporation revealed in the journal Health Affairs. Had health care costs risen in line with other goods and services those families would have had an extra $545 disposable income per month in 2009.
Economist David Auerbach, the study's lead author, said:

"Accelerating health care costs are a primary reason that the so many American families feel like they are just treading water financially." "Unless we reverse the trend, Americans increasingly notice that health will costs compromise their other spending options."

Between 1999 and 2009 in the United States: health care spending rose from $1.3 trillion to $2.5 trillionHealth care spending per person rose from $4,600 to just over $8,000.13.8% of country's GNP (gross domestic product) was spent on health care in 1999. It rose to 17.6% in 2009.These numbers may be sobering, but they do not translate to the daily routine of typical American families easily, mainly because health care costs are not all clearly visible, the authors wrote.
To describe the hidden burden that ever increasing health care expenditure placed on a median-income family consisting of two parents with two children, with employer-sponsored insurance from 1999 to 2009, Auerback and Dr. Arthur L. Kellermann gathered various data together from several sources.
American families can see health care costs in two ways: through the amount they have to pay every month on their private health insurance premiumThrough out-of-pocket expenditure for deductibles, drugs, copayments and other itemsHowever, the researchers say there are other less visible costs: for an employer to be able to pay a share of the worker's premium, his/her wages and other compensation are usually reducedA proportion of the family's income goes towards paying for federal and state taxes which are devoted to such health programs as Medicaid, Medicare and the military health had on annual income of $76,000 in 1999, care system the median-income family in the United States this grew to $99,000 in 2009, on increase of 30%. However, health spending increased at a considerably greater rate. Monthly health insurance for families rose from $490 to $1,115 (128%), and out-of-pocket expenses from $135 to $240 (78%).
Public expenditure on health rose by 76% at state level and 140% at federal level.
As federal tax rates dropped during the ten-year period, the portion of family's tax bill that went towards health care costs – from $345 to $440 did not fully reflect this increase.
Therefore, families had much less money to spend because of rapidly rising healthcare costs.
A typical family's income rose by approximately $1,910 during the decade. Over 40% of that went on higher health care costs. Increases in the cost of consumer goods plus non-health care taxes absorbed a further 53%, leaving the average median-income family with a mere $95 extra money in their pockets at the end of each month.
Kellermann said:

"The complex way that the United States pays for health care often obscures the consequences of health care cost growth for most American families." "This makes the challenge of controlling health care costs that much harder."

The researchers worked out that if health care costs had risen by 1% more than the annual GDP rise, the median-income family would have had $335 extra cash at the end of the month at the end of the decade, and $545 if health care costs had risen the same as the overall inflation rate during that period.
The target set by the affordable care Act is a 1% higher increase in health care spending than the increase in GDP.

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