Experiences at first sexual encounter impact risk of HIV and violence for women in Kenya

Adolescent girls and young women in Mombasa, Kenya are more likely to experience higher risks of HIV and gender-based violence when they are involved with sex work venues or have sexual experiences at a young age, suggests a study co-led by St. Michael’s Hospital and the University of Manitoba in Canada.

Published in the Journal of Acquired Immune Deficiency Syndromes (JAIDS), the research suggests that the conditions of a first sexual encounter, such as a woman’s age, the man’s age, use of condoms, and whether or not the encounter is consensual can be indicators of future risk of HIV infection and gender-based violence.

The research team found that adolescent girls and young women in Mombasa, Kenya, who are forced or coerced in their first sexual experience, are four to five times more likely to face ongoing gender-based violence throughout their lifetime. This research also showed that one in four participants experience gender-based violence after their first sexual experience, with 37.5 per cent prevalence amongst those involved in sex work.

Dr. Sharmistha Mishra, a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and one of the study’s lead authors, and her team found that women who experienced their first sexual encounter before the age of 15 were two times more likely to be at risk of HIV acquisition. This was especially prevalent for those in the sex work industry and those who frequented sex work venues.

“We wanted to understand early risk and vulnerabilities for HIV because many prevention programs for key populations reach young sex workers several years after they have already experienced high-risk encounters,” Dr. Mishra said. “There are vulnerabilities that appear in the first few years of becoming sexually active and entering sex work more formally.”

The study’s results were drawn from a cross-sectional biological and behavioural survey conducted among sexually active adolescent girls and young women in Mombasa, Kenya. Community organizations, including past and current female sex workers working with the International Centre for Reproductive Health Kenya, identified participants at local sex work hotspots who then participated in interviews and HIV testing. Participants were referred to HIV prevention and care programs in Mombasa.

“Global health partnerships are strongest when there is a generation of new knowledge that informs programs led on the ground,” said Dr. Mishra, speaking of this work’s partnership between St. Michael’s Hospital, the University of Toronto, the University of Manitoba, and the National AIDS and STI Control Programme in Kenya.

This research is part of a multi-component study designed to count how many young women are involved in sex work in Mombasa, Kenya; measure early HIV risks through a representative survey; and conduct mathematical modelling to understand the impact of not accounting for the early risk many young women face.

“We’ve identified a need to provide HIV prevention and treatment plans for adolescent girls and young women at an earlier age,” Dr. Marissa Becker, associate professor at the University of Manitoba and co-lead of the study. “We hope the findings of this research can assist HIV prevention programs to adapt their strategies to reach vulnerable young women and teenaged girls at a younger age and intervene on risks early on.”

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Coffee while breastfeeding: Safety and risks

A morning cup of coffee might help a person manage sleep deprivation, but many people worry about the effects of caffeine on their babies. However, caffeine is safe in moderation for people who are breastfeeding.

In this article, learn about drinking coffee while breastfeeding, including the risks, benefits, and other sources of caffeine.

Coffee and breastfeeding

Many people are told to limit or even eliminate caffeine during pregnancy due to the risk of caffeine crossing the placenta and affecting the developing fetus. However, caffeine is much less likely to affect a breastfeeding infant.

The body metabolizes most of the caffeine in coffee is before it reaches breast milk or has a chance to affect the baby.

According to Dr. Thomas Hale in Medications and Mothers Milk, caffeine is a low-risk drug in moderation. Only about 1 percent of the caffeine a woman consumes gets into her breast milk, and this minuscule amount is not enough to harm most babies.

Breastfeeding parents who want to take the safest approach should consider limiting caffeine intake to about 300 milligrams (mg) a day, according to the Centers for Disease Control and Prevention (CDC). This amount of caffeine is equivalent to 2–3 cups of coffee.

Even caffeine consumption of more than 300 mg is unlikely to harm a baby. However, the CDC note that extreme caffeine consumption of more than 10 cups a day may cause symptoms in the baby, such as fussiness and jitteriness.

Caffeine levels in breast milk peak 1–2 hours after drinking coffee. A person who has recently breastfed may choose to watch their baby during this time to see whether they experience any effects from the caffeine.

Coffee is not the only source of caffeine. People concerned about their caffeine consumption or those who notice that caffeine seems to adversely affect the baby should be mindful of other caffeine-rich foods.

Some common sources of caffeine include:

  • energy drinks
  • black, green, and white tea
  • cola drinks
  • chocolate and cocoa products

Takeaway

No scientific evidence says that someone should give up caffeine while breastfeeding, though it is wise to enjoy it in moderation.

Some ways to manage caffeine intake include:

  • Monitoring the baby. Some babies are sensitive to caffeine and may become fussy or restless when the breast milk contains too much caffeine.
  • Considering how other dietary choices, not just caffeine, affect the baby. For instance, a high-sugar drink might affect the baby just as much as caffeine.
  • Knowing that the adult’s well-being matters, too. People who need caffeine to help them maintain energy and deal with frequent nighttime wake-ups and early mornings should not feel guilty about moderate consumption.
  • Drinking caffeine right after a nursing or pumping session. Depending on how frequently a baby nurses, this may allow enough time for the caffeine content in milk to drop before the next nursing session.
  • Making exceptions for a premature baby. If the baby was premature or has a particular medical condition, such as a history of food intolerances, it is best to talk to a doctor or lactation consultant about caffeine.
  • Cutting back. People who consume more than 2–3 cups of coffee a day, could try reducing the amount of caffeine slowly by making “half-caf” cups, which are a mix of regular and decaf coffee.

For more advice about balancing the risks and benefits of caffeine, people who are breastfeeding can talk to a doctor or lactation consultant.

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Better access to quality cancer care may reduce rural and urban disparities

When enrolled in a cancer clinical trial, the differences in survival rates between rural and urban patients are significantly reduced, SWOG study results show.

The study results are published in JAMA Network Open by a team led by Joseph Unger, Ph.D., a SWOG biostatistician and health services researcher at Fred Hutchinson Cancer Research Center. It’s the first study to comprehensively compare survival outcomes in rural and urban cancer patients enrolled in clinical trials.

The results cast new light on decades of research, which paints a stark picture of cancer disparities. About 19 percent of Americans live in rural areas, and studies have shown that, when faced with cancer, rural patients don’t live as long as urban cancer patients. For example, statistics published by the federal Centers for Disease Control and Prevention in 2017 show a significant difference in the rate of cancer deaths, with 180 people out of 100,000 dying of cancer in rural areas compared with 158 people out of 100,000 dying of cancer in urban areas between 2011 and 2015.

But the new analysis by SWOG, the international cancer clinical trials network funded by the National Cancer Institute (NCI), indicates that this difference in survival is not due to patients—but to the care they receive.

“These findings were a surprise, since we thought we might find the same disparities others had found,” Unger said. “But clinical trials are a key difference here. In trials, patients are uniformly assessed, treated, and followed under a strict, guideline-driven protocol. This suggests that giving people with cancer access to uniform treatment strategies could help resolve the disparities in outcomes that we see between rural and urban patients.”

Unger and SWOG member Dr. Banu Symington, an oncologist who practices at the Sweetwater Regional Cancer Center in rural Idaho, received a grant from SWOG’s public charity, The Hope Foundation, to study cancer disparities by analyzing existing data from the group’s trials. The team had a big trove of data to mine. Founded in 1956, SWOG has run more than 1,400 cancer clinical trials enrolling nearly 215,000 patients.

Unger and his team identified 36,995 patients who enrolled in 44 SWOG phase II or III treatment trials between 1986 and 2012. Patients hailed from all 50 states, and had 17 different cancer types, including acute myeloid leukemia, sarcoma, lymphoma, myeloma, and brain, breast, colorectal, lung, ovarian, and prostate cancers. The team limited their analysis of survival to the first five years after trial enrollment to emphasize outcomes related to cancer and its treatment.

Using U.S. Department of Agriculture population classifications known as Rural-Urban Continuum Codes, the team categorized the patients as either rural or urban and analyzed their outcomes. Patient outcomes included overall survival, or how long patients lived; progression-free survival, or how long patients lived before their cancer returned; and cancer-specific survival, or how long the patients lived without dying of cancer. The team used a statistical model known as a multivariate Cox regression to analyze their data.

This method allows investigators to examine the relationship between survival and one or more predictor values, such as the age of the patient or the stage of their cancer.

No matter the variable, or the cancer type, results were clear. There was no meaningful difference in survival patterns between rural and urban patients for almost all of the 17 different cancer types. The only exception was patients with estrogen receptor-negative, progesterone receptor-negative breast cancer. Rural patients with this cancer didn’t live as long as their urban counterparts, a finding the team says could be attributed to a few factors, including timely access to follow-up chemotherapy after their first round of cancer treatment.

“If people diagnosed with cancer, regardless of where they live, receive similar care and have similar outcomes, then a reasonable inference is that the best way to improve outcomes for rural patients is to improve their access to quality care,” Unger said.

Unger noted that the NCI CommunityOncology Research Program (NCORP) – which funded his study—brings clinical trials into community hospitals and clinics, including in rural areas, and represents the community-level outreach that can provide the quality cancer care that may be needed. In 2014, NCI officials broadened NCORP eligibility to include oncology practices that serve large rural populations. Currently, there are NCORP sites in 13 states in which the rural population exceeds 30 percent—Alaska, Ark., Iowa, Ky., Miss., Mont., N.C., N.D., S.C., S.D., Tenn., Wis., and Wyo. The result is that tens of thousands of rural cancer patients can enroll in NCI clinical trials and be cared for right at their local hospital and clinic.

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Watermelon allergy: Symptoms, diagnosis, and what to avoid

If a person with an allergy does not eat watermelon often, they may not know what has caused their symptoms. It could be an allergy to a different food, or an unrelated illness.

The symptoms of a watermelon allergy are similar to those of other food allergies. A doctor can perform tests to identify the problematic food.

A watermelon allergy usually develops during childhood, but some people develop it as adults.

What are the symptoms?

Watermelon allergies share symptoms with other food allergies. Symptoms usually occur within a few minutes of contact with the melon.

Some of the most common watermelon allergy symptoms include:

  • persistent coughing
  • hives
  • an itchy tongue or throat
  • stomach cramps
  • stomach pain
  • nausea or vomiting

A severe allergic reaction can trigger anaphylaxis, which can be life-threatening.

Anyone experiencing a severe reaction to watermelon should receive immediate medical attention. They may require an injection from an epinephrine auto-injector, such as an EpiPen, before help arrives.

Symptoms of anaphylaxis include:

  • trouble breathing
  • trouble swallowing
  • shortness of breath
  • swelling of the throat, face, or tongue
  • nausea
  • abdominal pain
  • vomiting
  • wheezing
  • shock (from low blood pressure)
  • vertigo (a feeling of dizziness)

Anyone experiencing a watermelon allergy for the first time should talk to a doctor. The doctor can confirm the diagnosis and provide suggestions about treating and preventing future reactions.

An individual can usually treat a mild allergic reaction with over-the-counter medication.

If a person knows that they have a severe allergy to watermelon, they should carry an epinephrine auto-injector, in case of accidental exposure.

Anyone who witnesses someone experiencing anaphylaxis should:

  • call emergency medical services
  • assist in using an epinephrine auto-injector
  • help the person remain calm
  • remove restricting clothes, particularly those around the throat
  • lay the person flat with their feet elevated
  • if the person starts to vomit, turn their head without raising it
  • if needed, administer CPR

Do not offer food or drink to a person experiencing anaphylaxis.

If a person has a severe allergic reaction, they should talk to a doctor right away about prescribing an epinephrine auto-injector.

When to see a doctor

A person should see a doctor after their first allergic reaction, particularly if the reaction was severe.

The doctor will take a medical history and discuss symptoms. They may be able to diagnose an allergy, which will be especially helpful for people who are unsure of the cause of their symptoms.

If necessary, the doctor may refer a person to an allergist. They can test for various triggers, prescribe an epinephrine auto-injector, and offer advice.

Watermelon allergies in children and babies

Young children are more likely to develop watermelon allergies than adults.

A doctor will need to diagnose the allergy in a child, and the treatments are similar for children and adults.

Though uncommon, it is possible for babies to be allergic to watermelon. Follow a pediatrician’s advice, and introduce new foods gradually. This can make identifying allergies easier.

Anyone allergic to watermelon should avoid similar foods and vegetables, such as:

  • honeydew melons
  • cucumbers
  • cantaloupes

A person may also want to avoid foods that cause similar reactions in the body, including:

  • kiwis
  • celery
  • peaches
  • bananas
  • oranges
  • avocados
  • zucchini
  • tomatoes
  • papayas

Ragweed pollen can also trigger reactions during the summer months.

Before ordering a restaurant in a meal, inform the server about any food allergies.

Takeaway

Watermelon allergies are uncommon, but they can trigger reactions ranging from mild to severe. The allergy is most common in children.

Most people can control or prevent allergic reactions by taking over-the-counter medications and avoiding triggers.

A doctor can help a person with a severe allergy to prepare for accidental exposure.

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Clinical trial suggests new direction for heavy-smoking head and neck cancer patients

Patients with a greater than 10 pack/year history of smoking tend to develop an especially dangerous form of head and neck squamous cell cancer (HNSCC) for which prognosis remains poor and treatments have changed little during the past two decades. However, recent phase 1 clinical trial results by the Head and Neck Cancer Group at University of Colorado Cancer Center suggest a possible new direction for these patients. The first-in-human trial of the oral PARP inhibitor olaparib, with the anti-EGFR drug cetuximab and radiation, led to 72 percent 2-year survival in 16 patients on trial, compared with an expected 2-year survival rate of about 55 percent for standard-of-care treatment.

“Colorado promotes innovation, and this trial was certainly innovative when it was designed by our group,” says David Raben, MD, CU Cancer Center investigator and professor in the CU School of Medicine Department of Radiation Oncology. “Much credit goes to Antonio Jimeno, MD, Ph.D. who was very supportive of this idea and helped move this forward along with Dr. Sana Karam and Dr. Daniel Bowles.”

The drug cetuximab targets EGF receptor signaling (EGFR) and while it earned FDA approval in 2006 for use against head and neck cancers over-expressing EGFR, Raben stated there is significant room for improvement.

“That’s where olaparib and radiation come in,” he says. “Ten years ago, I was on a sabbatical from CU, working for AstraZeneca in England. And I remember taking the train from Manchester to Cambridge to learn about this new drug from a small biotech company called Kudos Pharmaceuticals. It was a PARP-inhibitor, meant to keep cells from repairing damaged DNA. That’s the drug we now call olaparib.”

Early in development, the drug had shown remarkable activity in woman with BRCA mutations, “but we wanted to know if it worked in other diseases where BRCA wasn’t the story,” Raben says.

Olaparib inhibits the action of an enzyme known as PARP, which is important for DNA repair. HNSCC in heavy smokers already tends to carry a heavy load of DNA damage. And radiation creates additional DNA damage. When olaparib nixes the ability of these cancers’ to repair DNA, it can push cancer cells past the tipping point of damage and into cell death. In this way, PARP inhibition and radiation may be synthetically lethal, meaning that together they exploit deficiencies in gene defects that leads to enhanced cell death.

In fact, lab work by Raben and CU Cancer Center colleagues including Xiao-Jing Wang MD, Ph.D., Barb Frederick, Ph.D., and Ariel Hernandez, among others, shows that PARP inhibitors like olaparib may also amplify the effects of anti-EGFR drugs like cetuximab.

“The traditional approach against this kind of cancer uses cisplatin chemotherapy along with radiation. I had seen data suggesting that the combination of cisplatin and olaparib might be too toxic on patients’ blood counts. So our team explored this alternative approach that we hoped would offer a more targeted treatment in this poor prognosis group,” Raben says.

In addition to promising survival results, the trial reinforces earlier work showing that cancer patients who continue to smoke while receiving treatment tend to fare worse than those who quit.

“We didn’t cherry pick our patients for this trial. All were heavy smokers, many were heavy drinkers, advanced T-stages, and some continued to smoke during the treatment. People who continued smoking were the ones who did the worst,” Raben says.

However, the trial’s survival benefit came with additional side effects, some of which appeared relatively late in the course of the trial (demonstrating the importance of long-term follow-up for patients in radiation Phase I studies).

“We did see an increase in skin toxicity, which wasn’t unexpected, and we learned that when you combine olaparib with radiation, you need perhaps one tenth the dose that you would when using olaparib alone,” Raben says. Most common side effects included dermatitis (39 percent) and mucositis (69 percent). Several patients experienced increased long-term fibrosis and one showed carotid stenosis, though Raben points out that some side effects could be due to the continued influence of smoking, as well.

“The question now is whether we should move this combination into a randomized phase II trial or use what we’ve learned to design new combinations,” Raben says. For example, “There is tremendous enthusiasm in the oncology community to combine DNA damage repair inhibitors like olaparib with immune enabling drugs, and this may reduce overall toxicity further when combined with or used after radiation,” he says.

Or, Raben suggests that targeted therapies and immunotherapies could be used earlier in the course of treatment, pointing to a forthcoming clinical trial by collaborator Sana Karam, MD, Ph.D., that will test the ability of radiation and immunotherapy to shrink head and neck cancer tumors before surgery.

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Best fruits to eat during pregnancy and what to avoid

A nutritious diet plays an essential role in a person’s overall health, helping the body to function effectively and reducing the risk of some diseases.

Most people are aware that a healthful diet should include plenty of fruits, vegetables, whole grains, lean protein, and healthful fats. However, they may not realize that specific fruits are particularly beneficial during pregnancy.

In this article, we explain why it is important to eat fruit during pregnancy. We also cover which fruits are best to eat during this time, and which types of fruit pregnant women may wish to avoid.

What are the benefits of eating fruit during pregnancy?

Eating a healthful, varied diet is particularly important during pregnancy as the right nutrients can help the fetus to develop and grow as it should.

In addition to supporting the growing baby, an increased intake of vitamins and minerals can help a pregnant woman keep her own body in the best condition possible.

Eating plenty of fresh fruit during pregnancy can help to ensure that both the woman and baby remain healthy. Fresh fruit contains lots of essential vitamins and nutrients and is a good source of fiber too.

Guava is an excellent choice of fruit for people wanting more of the following nutrients:

  • vitamins C and E
  • polyphenols
  • carotenoids
  • isoflavonoids
  • folate

Guava contains a varied combination of nutrients, making it ideal for pregnant women. Eating guava during pregnancy can help to relax muscles, aid digestion, and reduce constipation.

8. Bananas

Bananas contain high levels of:

  • vitamin C
  • potassium
  • vitamin B-6
  • fiber

The high fiber content of bananas can help with pregnancy-related constipation, and there is some evidence to suggest that vitamin B-6 can help relieve nausea and vomiting in early pregnancy.

9. Grapes

Eating plenty of grapes can boost people’s intake of:

  • vitamins C and K
  • folate
  • antioxidants
  • fiber
  • organic acids
  • pectin

The nutrients in grapes can help to aid the biological changes that occur during pregnancy.

They contain immune-boosting antioxidants, such as flavonol, tannin, linalool, anthocyanins, and geraniol, which also help prevent infections.

10. Berries

Berries are a good source of:

  • vitamin C
  • healthy carbohydrates
  • antioxidants
  • fiber

Berries also contain lots of water, so they are an excellent source of hydration. Vitamin C helps with iron absorption and boosts the body’s immune system.

11. Apples

Apples are packed with nutrients to help a growing fetus, including:

  • vitamins A and C
  • fiber
  • potassium

One study found that eating apples while pregnant may reduce the likelihood of the baby developing asthma and allergies over time.

12. Dried Fruit

The following nutrients occur in dried fruit:

  • fiber
  • vitamins and minerals
  • energy

Dried fruit contains all the same nutrients as fresh fruit. Therefore, pregnant women can get their RDA of vitamins and minerals by eating portions of dried fruits that are smaller than the equivalent amount of fresh fruits.

However, it is important to remember that dried fruit can be high in sugar and does not contain the water content that fresh fruit does. This means that it does not aid digestion. Pregnant women should only eat dried fruits in moderation and should avoid candied fruits altogether.

It is best to eat dried fruits in addition to fresh fruits, rather than instead of them.

There is no particular fruit that pregnant women should avoid. However, it is essential for women to be aware of portion size. Some fruits have a high sugar content, and certain forms of fruit, such as juices and dried fruits, are often significantly higher in sugar and calories than their fresh counterparts.

Buying organic fruit will ensure that it has not come into contact with fertilizers and pesticides that could damage its quality. However, if organic fruit is not an option, non-organic fruit is still better than eliminating fruit from the diet altogether.

It is important to remove any pesticides and bacteria that might be present on fruit by washing it thoroughly before eating it. People should take other safety precautions by:

  • removing areas of bruised fruit, which are more likely to contain bacteria
  • storing fruit in a separate area of the fridge to any raw meat products
  • avoiding precut melons
  • only drinking pasteurized or boiled fruit juice

Takeaway

Fruit is an excellent source of nutrients that are essential during pregnancy. Fruits can provide vitamins, folate, fiber, and more, which all help to keep the woman and baby healthy. These nutrients can also help to relieve some of the common symptoms of pregnancy.

Pregnant women should aim to consume at least five different portions of fruit and vegetables each day. The 12 fruits listed in this article are particularly good choices during pregnancy. Pregnant women should also limit their intake of dried fruits and fruit juices as these can be high in sugar and calories than fresh types.

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ASPCA Helps People and Pets at National Night Out


Left to Right: The ASPCA’s Susana Villa and Miguel Torres with Cindy Birchall and her dog, Blanche, at the East L.A. National Night Out event.

For the third straight year, ASPCA representatives joined police officers to celebrate National Night Out on Tuesday, August 7. ASPCA staff and volunteers participated in a total of 16 events in New York City’s five boroughs, as well as in Los Angeles, California, and Miami, Florida.

Established in 1984, National Night Out is an event observed annually around the country to promote positive police-community relationships in order to reduce crime and make neighborhoods safer.

In New York, L.A. and Miami, the ASPCA’s Community Engagement (CE) teams work every day in neighborhoods with limited resources for pets to ensure that residents have access to supplies and services for their furry friends. Their work is often referred to them by local police officers.

In New York City, the ASPCA’s official partnership with the NYPD dates back to 2014, with the NYPD taking the lead role in responding to all animal cruelty complaints in NYC, while the ASPCA provides direct care for animal cruelty victims. 

Despite hot temperatures in all three cities, residents lined up for pet care information and free supplies at local parks and police precincts across the country. Police and elected officials were also present to show support.


Police Officer Sanjay Gidarisingh, Neighborhood Coordination Officer, with The ASPCA’s Paul Mayr, Erin Satterthwaite and Mo Khaled at National Night Out in the South Bronx’s 40th Precinct.

“This precinct always does a great job,” said Mohamed (Mo) Khaled, an ASPCA Community Engagement Caseworker in the Bronx, where streets in the 40th Precinct were transformed into a summer block party, teeming with bounce houses, musical performances, food vendors and non-profits distributing information services for children, families, seniors, and thanks to the ASPCA—pets.  

“Everyone knows about the ASPCA, but at this event people can find out where to get the services they need for their pets,” added Mo.


Left: The ASPCA’s Amie Saladis with Officer Timothy Hepworth of the 120 Precinct in Staten Island during National Night Out; Right: Marisol Andino and her dog, Dexter, visit the ASPCA in the South Bronx.

After just two hours, Mo, along with the ASPCA’s Erin Satterthwaite, Legal Advocacy Counsel; Brian Fitzpatrick, IT Project Manager; and Destiny Rivera, Benefits Coordinator, had signed up nearly 60 pets for veterinary services and two dozen for spay/neuter surgeries.


Police Officers in the Bronx’s 40th Precinct with (L to R) the ASPCA’s Brian Fitzpatrick, Mo Khaled, Destiny Rivera and Paul Mayr.

Kemani and Quinyjah Rivers, sisters who live in East Harlem with their Yorkshire Terrier, Jamie, and cat, Mickey, visit their National Night Out event in the 25th Precinct every year.

“It’s educational and offers a lot of opportunities to get involved in our community,” explained Kemani.

At Miami’s Liberty City event, Community Engagement Manager Marlan Roberts reported that residents were very receptive to the ASPCA. Jose Rivera, a resident who attended National Night Out with his family, took home free pet supplies. “Our dog loves toys, so these will be put to good use,” said Jose.

In East L.A.’s Salazar Park, Cindy Birchall visited the ASPCA with her three-year-old Chihuahua, Blanche, whom she recently acquired from a relative who is terminally ill and could no longer care for Blanche.


The ASPCA participated in two National Night Out Events in L.A., including this one in Baldwin Park.

Community Engagement Manager Miguel Torres offered Cindy assistance with basic veterinary care as well as pet supplies, making it possible for Cindy to keep Blanche as she transitions to becoming a new pet owner. 

More than 500 adults and children attended the L.A. County event at a Target store in Baldwin Park, where ASPCA staff and volunteers interacted with nearly 100 residents and provided food for just as many pets. 

“We spoke to people about the importance of spaying and neutering and handed out flyers to our free spay/neuter clinic,” said Community Engagement Senior Manager Erica Macias. 


At the 115th Precinct in Jackson Heights, Queens, Lilliana Ortiz with her mom Carolina Valdez stop by the ASPCA table for pet supplies.

The success of the ASPCA’s Community Engagement program enabled the organization to participate in 16 events nationwide this year—an increase from 12 in 2017. 

At the 42nd precinct in New York, where the ASPCA was present for the first time, residents signed up their pets for wellness visits and spay/neuter appointments, and the ASPCA’s Mobile Adoptions team found homes for five cats.

In Miami, the City of Miami Police Department upped its events to three from just one last year, and the ASPCA attended all three in Shenandoah Park, Liberty Square and the Northside District.


Left to Right: ASPCA Corporate Counsel Lauren Brunswick, City of Miami Chief of Police Jorge Colina and Community Engagement Director Susan Cardoso at the City of Miami PD’s National Night Out event in Shenandoah Park.

“Our team has done an incredible job building relationships with police departments in these cities,” said Colleen Doherty, Senior Director of ASPCA Community Engagement. “The stronger our relationships, the more doors that open for opportunities to help people and pets in communities where we work.” 

“We could not have this level of participation without the support of our volunteers as well as staff,” emphasized Colleen.

“This is what creating safe, healthy and happy communities is all about,” added Marlan Roberts, Community Engagement Manager in Miami. “To see the community come together with law enforcement and other key stakeholders for a good cause couldn’t lead to a better outcome.”

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Hypoglycemia without diabetes: Causes, treatment, and diet

In this article, we explore the health conditions beyond diabetes that can cause hypoglycemia. We also look at treatment options and the dietary changes that can help prevent low blood sugar.

What is hypoglycemia?

Hypoglycemia occurs when blood sugar levels drop below 70 milligrams per deciliter (mg/dl). Severe hypoglycemia can be life-threatening if a person does not receive treatment. Treatments focus on returning blood sugar to safe levels.

Blood sugar, or glucose, is the body’s primary source of energy. When levels fall too low, the body does not have enough energy to function fully. This is called hypoglycemia.

Insulin helps the body’s cells to absorb sugar from the bloodstream. A person with diabetes may take insulin shots because their body is resistant to insulin or because it does not produce enough.

In people with diabetes, taking too much insulin can cause blood sugar levels to drop too low. Not eating enough or exercising too much after taking insulin can have the same effect.

However, people who do not have diabetes can also experience hypoglycemia.

When a person has hypoglycemia, they may feel:

  • shaky
  • dizzy
  • unable to concentrate
  • unable to focus their eyes
  • confused
  • moody
  • hungry

A person with hypoglycemia may develop a headache or pass out (lose consciousness).

If a person has hypoglycemia often, they may stop experiencing symptoms. This is called hypoglycemia unawareness.

Treating the underlying cause is the best way to prevent hypoglycemia in the long term.

In the short term, receiving glucose helps blood sugar levels return to normal.

According to research from 2014, the best way to treat mild hypoglycemia is to:

  • take 15 grams of glucose
  • wait for 15 minutes
  • measure blood glucose levels again
  • repeat this treatment if hypoglycemia persists

There are many ways to receive glucose, including:

  • taking a glucose tablet
  • injecting glucose
  • drinking fruit juice
  • eating carbohydrates

Eating slow-release carbohydrates may help sustain blood sugar levels.

Non-diabetic hypoglycemia diet

A non-diabetic hypoglycemia diet can help keep blood sugar levels balanced. The following tips can help to prevent hypoglycemia:

  • eating small meals regularly, rather than three large meals
  • eating every 3 hours
  • eating a variety of foods, including protein, healthful fats, and fiber
  • avoiding sugary foods

Carrying a snack to eat at the first sign of hypoglycemia can prevent blood sugar levels from dipping too low.

Ultimately, the best way to prevent hypoglycemia is to identify and treat the underlying cause.

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Adolescent health undervalued and under-invested across the globe

Melbourne’s Murdoch Children’s Research Institute, in partnership with Harvard Medical School, has discovered that adolescent health programs across the developing world receive only a tiny share of international aid, even though young people make up 30 per cent of the population of low-income countries.

Published in JAMA Network Open, researchers from the US and Australia examined how much international donors spent on youth health projects in 132 low-income countries over the 14 years from 2003 to 2015. (89 per cent of the world’s adolescents live in low and middle income countries.)Co-author University of Melbourne Prof George Patton, from MCRI’s Centre for Adolescent Health, said the research found that only 1.6 per cent of global investments in health over those 13 years were spent on projects for adolescents even though adolescents account for 12 to 13 per cent of disease burden in the developing world. “Of the little invested, most funds go to adolescents indirectly through programs for HIV particularly in sub-Saharan Africa. However a large number of young people in low-income countries are being disabled as a result of depressive disorders, self-harm and car accidents,” he said.

Prof Patton said these youth challenges received almost no investment, yet expenditure in neglected areas such as mental health and car accidents would bring huge benefits for adolescents—for their future health, their productivity and the healthy growth of their children.”The international donor community has been ‘asleep at the wheel’ in failing to keep pace with changing demography and health needs,” Prof Patton said. “Despite supporting the UN’s ‘Global Strategy for Women’s, Children’s and Adolescents Health’, international investment from agencies have so far failed to make serious investments in the world’s young people.”Adolescence lays a foundation for future health, quality-of-life and economic productivity. And it is therefore remarkable that this group has been so undervalued in international development.”

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10 natural and home remedies for ulcers

Stomach ulcers are sores that develop in the lining of the stomach or duodenum, which is the first part of the small intestine. Stomach ulcers are also known as peptic ulcers, gastric ulcers, or duodenal ulcers.

Stomach ulcers develop when stomach acid irritates the lining of the stomach.

Causes of ulcers include:

  • an infection with Helicobacter pylori (H. pylori) bacteria
  • long-term use of nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen or aspirin

Some people believe stress or spicy food can cause an ulcer. These do not cause ulcers, but they can make them worse by increasing stomach acid production.

Read about ten evidence-based methods to help relieve the pain from stomach ulcers.

Ten evidence-based remedies for stomach ulcers

If a person has an ulcer, they may feel a burning sensation in their stomach. This burning sensation often:

  • lasts a few minutes or several hours
  • eases after taking antacids or stopping food intake
  • starts in the middle of the night or during meals
  • occurs off and on for several weeks

People can relieve these symptoms using the following home remedies:

1. Probiotics

Probiotics are living organisms that help restore balance to the bacteria in the digestive tract. As well as helping achieve optimal gut health, they can help with treating ulcers.

According to a review from 2014, probiotics cannot kill H. pylori bacteria. However, they may reduce the amount of bacteria present, speed up the healing process, and improve some symptoms.

When taken alongside other treatments, probiotics may help eradicate harmful bacteria.

People can find probiotics in the following sources:

  • yogurts
  • fermented foods
  • probiotic supplements

Some foods have probiotics in them. But, consider taking supplements as they have higher concentrations of probiotics per serving.

2. Ginger

Many people think that ginger has gastroprotective effects. Some people use it to treat stomach and digestive conditions, such as constipation, bloating, and gastritis.

A review from 2013 suggests that ginger can help with gastric ulcers caused by H. pylori bacteria. Eating ginger may also prevent ulcers caused by NSAIDs.

However, many of these results come from animal studies, so it is not clear whether the effects would be similar in humans.

Honey is a popular, natural sweetener used across the United States. People who consume honey regularly can enjoy a range of health benefits.

A review from 2016 states that Manuka honey has antimicrobial effects against H. pylori. It suggests that honey could be useful for treating stomach ulcers.

People also use honey to speed up wound healing, including skin ulcers, burns, and wounds.

6. Turmeric

Turmeric is a popular yellow spice frequently used in India and other parts of southern Asia. Like chili peppers, turmeric contains a compound called curcumin. Researchers are beginning to study curcumin in regards to its health benefits.

A 2013 review concluded that curcumin has anti-inflammatory and antioxidant activities that may help prevent stomach ulcers. However, there are a limited number of studies on humans.

There needs to be more research to examine how effective turmeric is in treating ulcers. Still, initial results appear to be positive. Scientists hope that turmeric can help relieve ulcer symptoms and treat the sores.

Medical treatments for stomach ulcers will vary based on what is causing the ulcer.

If taking NSAIDs caused the ulcer, a doctor will likely advise the person to stop or reduce their use of those drugs. People can switch to another medication for pain.

A doctor may prescribe proton-pump inhibitors (PPIs) to reduce stomach acid and protect the lining of the stomach. They cannot kill bacteria, but they can help fight an H. pylori infection. Some examples include Nexium, Prilosec, and Prevacid.

A doctor may also prescribe histamine receptor blockers. These prevent the stomach from producing too much acid. Some examples include Zantac and Pepcid.

Also, a doctor may prescribe a protectant called sucralfate (Carafate). This helps prevent further damage to the area around the ulcer.

When an H. pylori infection caused the ulcer, a doctor may also prescribe antibiotics. Since H. pylori can be hard to kill, a person must take all doses exactly as prescribed even after symptoms go away.

Often, a doctor will combine several medications and therapies when treating an ulcer. Combination therapies help address pain, prevent further damage, and cure any infection.

Outlook

A person may be able to find relief with some home remedies. But, people should see their doctor to find out the cause and receive medical treatment.

A doctor can create a treatment plan to help treat the ulcer. At-home remedies may help prevent ulcers developing in the future and naturally help ease symptoms.

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