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Teens late to puberty may end up with weaker bones, finds new study

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Teens who hit puberty late may end up with weaker bones, a new study finds.


In the study, which included more than 6,000 British children, researchers found that kids who experienced their growth spurts — which occur around the age of puberty — late had lower than average bone density in young adulthood.


“Teens who mature later than their peers tend to have lower bone density on average as they grow and so they are likely to have a risk of breaking a bone,” said the study’s lead author Ahmed Elhakeem, an epidemiologist at the University of Bristol. “These later maturing teens did catch up to some degree with early maturing teens in terms of bone strength, but they continued to have lower bone strength after they finished growing and became adults, so they may also be at increased risk for osteoporosis in later life.”


Finding which teens might be at risk of lower bone density is important because “peak bone mass at the end of growth is thought to be an important determinant of later-life risk of fracture and osteoporosis,” Elhakeem and his colleagues note in JAMA Network Open. “For example, bone remodeling simulations showed that a 10 per cent increase in bone mineral density would delay osteoporosis by 13 years.” To take a closer look at how the timing of kids’ growth spurts might impact their eventual bone density, the researchers turned to the Avon Longitudinal Study of Parents and Children (ALSPAC), a study that recruited all pregnant women who were residing in the area served by three National Service authorities in southwest England who were expected to give birth between April 1991 and December 1992.


The researchers focused on 6,389 of the babies born during that period who had their height measured between the ages of 5 and 20, with at least one measurement made after age 9.


All of the children had been invited to have their bone density measured as part at ages 10, 12, 14, 16 18 and 25.


To determine whether growth spurt age was correlated with bone density, the researchers analysed bone density measurements while accounting for a host of factors, including birthweight, socioeconomic status, body mass index (BMI) and early life diet.


Girls had their growth spurts earlier, at an average age of 11.5, while boys spurted on average at age 13.5. Boys gained bone mineral density at faster rates than girls. The greatest gains in bone density occurred between a year prior to the spurt and two years afterward, the researchers found.


Among both girls and boys, there were faster gains in bone mineral density when the growth spurt came late. But even with speeded up bone density gains, the kids who spurted late never caught up with those who spurted early.


A strength of the new study is that the researchers “had a lot of patients who had (bone density) scans,” said Dr. Robert Rapaport, a professor of pediatrics at the Icahn School of Medicine and chief of pediatric endocrinology and diabetes at the Mount Sinai System.


While the study showed that kids who spurted late may have had less time for bone accumulation, it’s not clear what the value of this finding is, said Rapaport, who was not involved in the research.


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Sick hospital workers often expose patients to contagious illness

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Hospital workers often come to work with contagious respiratory illnesses, against the recommendations of public regulators, a Canadian study suggests.


Nearly all of the 2,093 care workers in the study who had such symptoms came to work at some point while sick.


For the study, published in the Journal of Infection Control & Hospital Epidemiology, nurses, doctors, and support staff at nine across Canada filled in online illness diaries during four flu seasons, recording symptoms such as a runny or stuffy nose, fever, cough or scratchy throat.


Of the 1,036 participants who had contagious respiratory illnesses during the study period, 52% reported working on every scheduled day of work and 94.6% reported working at least one day of their illness.


The most common reason given for working while sick was that the illness seemed mild and manageable. Compared to other care workers, physicians were more likely to work while sick and nurses were less likely.


But nurses who thought their managers expected them to show up unless they were too sick were more likely to feel obligated to work.


For most people, in fact, feeling obligated was a driving factor behind their decision to come to work sick, as was their perceptions of what managers expected from them. Younger workers, and workers without paid sick leave, were more likely to say they could not afford to stay home.


“It is only by knowing these reasons that managers and employers can take steps to mitigate the risk of infection to other people,” said Brenda Coleman, senior study author of the study from the Dalla Lana School of Public Health, University of Toronto, in email to Reuters Health. Eleven percent of the hospital workers said they had come to work even while feeling miserable because they had “things to do.” Physicians were under-represented in the study, and self-reporting of the illnesses may also confound the results, the authors acknowledge in their report.


The US Centers for Disease Control and Prevention advises workers to take seven days off or consider temporary reassignment if they have a fever and respiratory symptoms.


The research team suggests that changing sick leave policies and cultural norms could help reduce the risk of disease transmission from sick health care workers to patients.


Also needed, the researchers say, is an understanding of how to balance the costs and risks of absenteeism by sick workers against the costs and risks of illness transmission associated with working while ill.


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First two cases of Ebola confirmed in Congo’s South Kivu: Officials

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A woman and her child were the first two cases confirmed with in Congo’s South Kivu region this week, opening a new front in the fight against the outbreak.


Health officials said on Friday that the latest cases were more than 700 km (430 miles) south of where the outbreak was first detected.


has killed at least 1,900 people in Democratic Republic of Congo over the past year. This is the second biggest toll ever and militia violence combined with local resistance have made the outbreak harder to contain.


The 24-year-old woman had been identified as a high-risk contact of another case in Beni, more than 700 km north, last month, according to a government statement issued on Friday.


She travelled by bus, boat and road with her two children to Mwenga, in South Kivu, where she died on Tuesday night, according to a slide from a presentation by health officials.


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Research shows how nordic walking may benefit breast cancer patients

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Nordic walking, an aerobic activity performed with walking poles similar to ski poles, may benefit patients with breast cancer, according to a review of existing research.


The low-impact exercise improved swelling, physical fitness, disability and quality of life, the study authors conclude in the European Journal of Cancer Care.


“The main strategy in rehabilitation for women with is a change of habits, where physical exercise is a fundamental tool,” said study co-author Jorge Torres of the Faculty of Educational Sciences and Sports at the University of Vigo in Pontevedra, Spain.


“It’s not easy to turn a sedentary person into an amateur athlete, so sports such as Nordic walking are accepted more easily,” Torres told Reuters Health by email, particularly since the activity doesn’t require expensive equipment, can be done in a group with others, and is easy to learn.


Introduced in the 1980s as a summer training exercise that was similar to cross-country, or Nordic, skiing, Nordic walking became more widespread in the 2000s. It’s now part of some exercise-based rehabilitation programs, especially in Northern Europe where it is more common, Torres noted.


He also owns a personal training company, Vigo Entrena, that creates physical activity programs for people with specific needs, including injuries, obesity, pregnancy, postpartum and women with breast cancer, and he specializes in Nordic walking training.


To see if this form of exercise helps women treated for to reduce side effects like arm swelling, and offers other benefits of exercise, Torres and his colleagues analyzed nine studies. Four studies were randomized controlled trials comparing Nordic walking to other activities; the other studies focused on specific effects of Nordic walking.


Periods of exercise in the studies ranged from 30 to 80 minutes and were performed on one to five days a week for up to 12 weeks.


In eight of the nine studies, Nordic walking had a positive effect on a number of symptoms, including lymphedema, fitness, upper-body strength, disability and perceptions of pain and swelling.


A handful of studies also showed improvements in depression, self-efficacy for managing pain and improvements in physical activity levels. They didn’t find any adverse effects, and the study participants seemed to stick with the programs.


The biomechanical gesture of Nordic walking, compared to just walking, seemed to counteract some of the side effects that can come from cancer treatment, such as shoulder-arm mobility and postural problems, the study team writes.


“(Many) health professionals and therapists do not realize that there are contraindicated exercises during breast cancer rehabilitation and that alternatives such as Nordic walking can be very effective,” Torres said.


“Nordic walking is a structured form of physical activity which nowadays has been shown to be ‘more complete’ than basic walking,” said Marco Bergamin of the University of Padova in Italy, who wasn’t involved in the research review.


“Another important point that is less stressed by these authors: quality of life,” Bergamin said in an email. “Nordic walking gives huge benefits because breast cancer patients are survivors, and from a socio-psychological point of view, that really impacts their life.”


Future studies should also investigate the intensity, frequency, duration, and length of exercise needed to help breast cancer patients, said Lucia Cugusi of the University of Cagliari in Italy, who also wasn’t involved in the review.


“What is most evident is the growing interest of the scientific community in tracking the needs, interests and preferences of patients,” Cugusi said by email.


“Offering them novel forms of physical activity that are both effective and engaging has become one of the new and stimulating research fields in cancer therapy and management.”


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