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Karen
Shoulder Pain from Using your iPad? Don’t Use It on Your Lap
Recommendations for Tablet Computer Use Published in Work: A Journal of Prevention, Assessment, and Rehabilitation
The sudden popularity of tablet computers such as the Apple iPad® has not allowed for the development of guidelines to optimize users’ comfort and well-being. In a new study published in Work: A Journal of Prevention, Assessment, and Rehabilitation, researchers from Harvard School of Public Health, Microsoft Corporation, and Brigham and Women’s Hospital report that head and neck posture during tablet computer use can be improved by placing the tablet higher to avoid low gaze angles, and through the use of a case that provides optimal viewing angles.
“Compared to typical desktop computing scenarios, the use of media tablet computers is associated with high head and neck flexion postures, and there may be more of a concern for the development of neck and shoulder discomfort,” said lead investigator Jack T. Dennerlein, PhD, of the Department of Environmental Health, Harvard School of Public Health, and Brigham and Women’s Hospital.
Fifteen experienced tablet users completed a set of simulated tasks with two media tablets, an Apple iPad2 and a Motorola Xoom. Each tablet had a proprietary case that could be adjusted to prop up or tilt the tablet computer. The Apple Smart Cover allows for tilt angles of 15° and 73°, and the Motorola Portfolio Case allows for tilt angles of 45° and 63°. Four user configurations were tested: Lap-Hand, where the tablet was placed on the lap; Lap-Case, with the tablet placed on the lap in its case set at the lower angle setting; Table-Case, with the tablet placed on a table with its case at the lower angle; and Table-Movie, with the tablet placed on a table with its case at the higher angle.
During the experiment, users completed simple computer tasks such as Internet browsing and reading, game playing, email reading and responding, and movie watching. Head and neck postures and gaze angle and distance were measured using an infrared three-dimensional motion analysis system.
Head and neck flexion varied significantly across the four configurations and across the two tablets tested. The iPad2 was associated with more flexed postures when it was placed in its case. This appeared to be driven by differences in case design, which drastically altered the tablet tilt angle and the corresponding viewing angle. For both tablets, the gaze angle changed in a similar fashion to the head flexion across all configurations, with non-perpendicular viewing angles causing increased head and neck flexion. Head and neck flexion angles were greater, in general, than reported for desktop or notebook computing.
Only when the tablets were used in the Table-Movie configuration, where the devices were set at their steepest case angle setting and at the greatest horizontal and vertical position, did posture approach neutral. This suggests that tablet users should place the tablet higher, on a table rather than a lap, to avoid low gaze angles, and use a case that provides steeper viewing angles. However, steeper angles may be detrimental for continuous input with the hands. “Further studies examining the effects of tablet and configuration on arm and wrist postures are needed to clarify and complete the postural evaluation,” noted Dr. Dennerlein.
“Our results will be useful for updating ergonomic computing standards and guidelines for tablet computers. These are urgently needed as companies and health care providers weigh options to implement wide-scale adoption of tablet computers for business operations,” Dr. Dennerlein concluded.
The study, “Touch-Screen Tablet User Configurations and Case-Supported Tilt Affect Head and Neck Flexion Angles,” by Justin G. Young, Matthieu Trudeau, Dan Odell, Kim Marinelli, Jack T. Dennerleinhas been made freely available at http://iospress.metapress.com/content/x668002xv6211041/fulltext.pdf.
January 27, 2012
Tags: tablet computer pain Posted in: Other Health Concerns 
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New NIH fact sheet explains test for diabetes, prediabetes
National Institutes of Health News Release
A new fact sheet from the National Institutes of Health explains the A1C test, a widely used and important test to diagnose type 2 diabetes and prediabetes, and to monitor blood glucose levels of people with type 1 and type 2 diabetes.
The A1C blood test provides information about average blood glucose levels, also called blood sugar, over the past three months. The test is sometimes referred to as the hemoglobin A1c, HbA1c, or glycohemoglobin test. The test result is reported as a percentage. The higher the percentage, the higher a person’s average blood glucose levels, which can cause complications in people with diabetes. A normal A1C level is below 5.7 percent.
“The fact sheet, called The A1C Test and Diabetes, offers in-depth information for people being tested,” said Judith Fradkin, M.D., a diabetes specialist at the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Lab tests and results, particularly the A1C, can be confusing. We hope this fact sheet will help people better understand why the test is important, how to interpret results, and why results may differ from expected.”
The A1C Test and Diabetes covers a wide range of information, including
how the test works
other blood tests for type 2 diabetes and prediabetes
accuracy of blood tests
where to learn more about A1C tests in people with hemoglobin variants
A1C targets
Originally, the A1C test had been recommended only for monitoring diabetes. But in 2009, an international committee of experts convened by the American Diabetes Association, International Diabetes Federation and European Association for the Study of Diabetes recommended expanding the use of the test to include diagnosing type 2 diabetes and prediabetes. The test is convenient because it does not require fasting.
Experts hope the ease of A1C testing will encourage more people to be checked for prediabetes and type 2 diabetes. Early identification and prompt treatment can delay or prevent type 2 diabetes and complications of the disease. The A1C test also helps providers adjust medication for people with diabetes to reduce the risk of long-term complications.
About 26 million Americans are living with diabetes, and more than 7 million of them do not know it. Left untreated, diabetes can lead to heart disease, stroke, kidney disease, blindness, amputation, and other serious complications. An estimated 79 million adults have prediabetes, blood glucose levels that are higher than normal but not high enough to be called diabetes, which places people at increased risk for developing type 2 diabetes. Weight loss and increased physical activity or the drug metformin can delay or prevent type 2 diabetes, but fewer than 10 percent of people with prediabetes have been diagnosed.
The standard blood glucose tests for diagnosing type 2 diabetes and prediabetes — the fasting plasma glucose test and the oral glucose tolerance test (OGTT) — measure blood glucose in a person who has not eaten anything for at least eight hours. The OGTT also measures blood glucose two hours after a person drinks a glucose-containing beverage. To confirm positive results, people should return on a different day to repeat the tests. The A1C test should also be repeated to confirm a diagnosis.
“Now people can be tested for diabetes without fasting,” said David Sacks, Ph.D., chair of a group working to standardize lab testing for diabetes and a member of the NIH Clinical Center’s Department of Laboratory Medicine. “We hope the convenience of the A1C test will encourage more people to be tested for prediabetes and diabetes.”
If you are at least 45 years old, or younger than 45 and are overweight, inactive, and have at least one risk factor for type 2 diabetes, consider being tested for the disease. Risk factors include high blood pressure; high cholesterol; a family history of diabetes; a history of gestational diabetes; and African-American, Hispanic-American, Asian-American, Pacific Islander or American Indian heritage.
A1C results can be unreliable in some people. For example, people of African, Mediterranean or Southeast Asian descent, or people who have a family member with sickle cell anemia, may not know that they have a less common type of hemoglobin that can interfere with some A1C tests. If you have a family history of sickle cell or thalassemia, or A1C results seem very different from those of a blood glucose test, talk to your doctor about which A1C tests are appropriate for you.
The fact sheet, The A1C Test and Diabetes, is available from NIDDK’s National Diabetes Information Clearinghouse at www.diabetes.niddk.nih.gov/dm/pubs/A1CTest. For more information about diabetes, visit www.diabetes.niddk.nih.gov.
The NIDDK, part of the NIH, conducts and supports basic and clinical research and research training on some of the most common, severe and disabling conditions affecting Americans. The Institute’s research interests include: diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic and hematologic diseases. For more information, visit www.niddk.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
January 27, 2012
Tags: diabetes prediabetes test Posted in: Other Health Concerns No Comments
Will You Have a Heart Attack or Stroke?
Northwestern University News Center
Will you have a heart attack or a stroke in your lifetime? Your odds may be worse than you think.
Men and women may have a false sense of security about their chances of having a heart attack or stroke based on the current practice of calculating a patient’s risk 10 years into the future. New Northwestern Medicine research shows a young or middle-aged adult who is at low risk in the short term may be at very high risk in the long term — if he or she has just one or two risk factors such as higher than optimal cholesterol or blood pressure levels.
This is the first study to examine the lifetime risk of heart disease in white and black men and women. Previous studies have been in whites and predominantly males. It’s also the first study to look at the entire adult age spectrum. The research also looked at the risk across multiple birth cohorts and found the effect of the risk factors remained consistent regardless of the decade in which a person was born.
The study is published in the New England Journal of Medicine. Part of the Cardiovascular Lifetime Risk Pooling Project, the research tracks more than 250,000 participants from 18 different groups of people living in the community over a period of more than 50 years. The patients’ risk factors for cardiovascular disease — blood pressure, cholesterol levels, smoking status and diabetes status — were measured at ages 45, 55, 65 and 75 years for each participant.
“We are giving incomplete and misleading risk information if we only focus on the next 10 years of someone’s life,” said principal investigator Donald Lloyd-Jones, MD, chair and associate professor of preventive medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital. “With even just one risk factor, the likelihood is very large that someone will develop a major cardiovascular event that will kill them or substantially diminish their quality of life or health.”
The risk-factor profile was considered optimal when a participant had a total cholesterol level of less than 180 milligrams per deciliter and untreated blood pressure of less than 120 over less than 80, was a nonsmoker and did not have diabetes.
The new research on long-term risk may be important in estimating the future burden of cardiovascular disease in the general population, Lloyd-Jones noted.
Some key findings of the study:
Men who are 45 years old and have all risk factors at optimal levels have a 1.4 percent risk of having a heart attack or stroke or other form of death from heart disease while having two or more risk factors hike the risk to 49.5 percent.
For 45-year-old women with all risk factors being optimal, the chance of having a heart attack or stroke in their lifetimes is 4.1 percent while having two or more risk factors boost it to 30.7 percent.
“Just even one small increase in risk, from all optimal risk factors to one that isn’t optimal, like slightly elevated cholesterol or blood pressure, significantly bumps up a person’s lifetime risk,” Lloyd-Jones said. (Non-optimal means a person doesn’t have diabetes and doesn’t smoke but either cholesterol is 180 to 199 or blood pressure is 120 to 130 on top or 80 to 89 on the bottom. These numbers aren’t at levels that need to be treated with medication, but they are still higher than desired.)
Women have a higher risk than men for a stroke over their lifetimes but a lower risk for a heart attack.
African-Americans have higher risk factors such as more hypertension and diabetes than whites, but because they also tend to die at younger ages, their lifetime risk of having a heart attack or stroke ends up being the same as whites.
“This study underscores the importance of lifestyle — particularly diet, exercise and smoking cessation — all the lifestyle patterns that are important in reducing the development of the risk factors in the first place,” said Jarett Berry, MD, who worked on the study when he was at Northwestern’s Feinberg School and is now assistant professor of medicine at University of Texas Southwestern Medical Center.
“We need to do a much better job of making sure these risk factors don’t develop in the first place, getting kids and young adults off to better starts so they don’t gain weight and are following healthier lifestyles throughout their lives,” Lloyd-Jones said.
Lloyd-Jones pointed out that maintaining the full package of optimal risk factors through middle age had a dramatic effect on the remainder of a person’s life. “It appears that the whole is greater than the sum of the parts,” he said.
The research was supported by the National Heart, Lung and Blood Institute.
January 27, 2012
Tags: heart attack risk, stroke risk Posted in: Heart Health Awareness No Comments
Taking Moments to Enjoy Life Helps Patients Make Better Health Decisions
APPROACH SHOWN SUCCESSFUL FOR PATIENTS WITH CORONARY ARTERY DISEASE, HIGH BLOOD PRESSURE AND ASTHMA
RESEARCH BY NEWYORK-PRESBYTERIAN/WEILL CORNELL PUBLISHED IN JAN. 23 ARCHIVES OF INTERNAL MEDICINE
NEW YORK (Jan. 23, 2012) — The experience of daily positive affect — a mild, happy feeling — and self-affirmation helps some patients with chronic diseases, including coronary artery disease, high blood pressure and asthma, make better decisions about their health.
These findings are detailed in three studies of 756 patients published online in the Jan. 23 edition of the Archives of Internal Medicine — the first large, randomized controlled trials to show that people can use positive affect and self-affirmation to help them make and sustain behavior change. The research was funded by a $9.5 million contract from the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health (NIH) and led by Dr. Mary Charlson, executive director of the Center for Integrative Medicine at Weill Cornell Medical College and the William T. Foley Distinguished Professor of Medicine and professor of integrative medicine at Weill Cornell Medical College. She is also chief of the Division of Clinical Epidemiology and Evaluative Sciences Research in the Department of Medicine at Weill Cornell Medical College.
The same intervention was used in all three studies. Patients were encouraged to think of small things in their lives that make them feel good (such as seeing a beautiful sunset) when they get up in the morning and throughout their day. Patients were also asked to use self-affirmation to help them overcome obstacles to their plan by recalling moments in their lives they are proud of, such as a graduation (see script excerpt below). The script, created by Dr. Charlson, is now in the public domain and free to use.
“This simple approach gives patients the tools that help them fulfill their promise to themselves that they will do what’s needed for their health,” says Dr. Charlson. “For example, if it’s raining and they don’t feel like exercising, these strategies can help them get past this mental block and into their sneakers.”
Excerpt from Positive Affect/Self-Affirmation Script:
First, when you get up in the morning, think about the small things that you said make you feel good, like __________________________ (example: babies in hats, the sunrise…). Then as you go through your day, notice those and other small things that make you feel good and take a moment to enjoy them. Second, when you encounter some difficulties or are in a situation that makes it hard for you (e.g. taking your blood pressure medications or exercising), think about things you enjoy or proud moments in your life, like __________________________ (example: a graduation, success of a child…).
The behavior changes employed in the studies are known to be beneficial — whether it is increased physical activity for coronary artery disease or regularly taking medication for high blood pressure or asthma. “In this way, positive affect made a real difference — patients are better able to follow through on behaviors to improve their health,” Dr. Charlson adds.
Patients were randomly assigned either to the experimental “positive affect” group or to a control group. Both groups made personal contracts to adhere to their behavior plans, were given an educational guide on the importance of their intervention, and received phone calls every two months to check in on their progress. Along with daily use of positive affect, patients in the experimental group received surprise gifts like tote bags prior to the phone sessions. The monetary value of the gifts was unimportant, Dr. Charlson explains; rather, they were symbolic and served to reinforce the intervention.
Results were measured at the completion of the yearlong studies. For coronary artery disease, 55 percent of patients practicing the positive affect/self-affirmations increased their physical activity compared with 37 percent in the control group; the positive affect group walked an average of 3.4 miles a week more than the control group. For high blood pressure (the study focused on African-Americans with the disease), 42 percent of the positive affirmation group adhered to their medication plan compared with 36 percent in the control group. For asthma patients, there was no difference in energy expenditure between the two groups; however, there was some benefit for patients requiring medical care during the trial.
The design of the studies, which simultaneously tested the same intervention for different populations, was one of the first for NIH-funded research, and began with contract awarded to Weill Cornell Medical College in 2002. This intervention development approach is now being more broadly used in the obesity-related behavioral intervention trials (ORBIT) sponsored by the NIH. Dr. Charlson is a recipient of an award titled “SCALE: Small Changes and Lasting Effects” under the ORBIT trials. The findings of the three trials are the basis for “SCALE” for overweight or obese patients.
STUDY AUTHORS:
Coronary artery disease study authors include first author Janey C. Peterson, Mary E. Charlson, Shing Chiu Wong and James P. Hollenberg — all from Weill Cornell Medical College; Martin T. Wells from Cornell University; John P. Allegrante from Columbia University; Zachary Hoffman from Weill Cornell and Brown University; Kathryn Boschert from Weill Cornell and the University of Medicine and Dentistry of New Jersey; Alice M. Isen from Cornell University; and Jared B. Jobe from the NHLBI.
High blood pressure study authors include first author Gbenga O. Ogedegbe from NYU School of Medicine; Carla Boutin-Foster and Mary E. Charlson from Weill Cornell Medical College; Martin T. Wells and Alice M. Isen from Cornell University; John P. Allegrante from Columbia University; and Jared B. Jobe from the NHLBI.
Asthma study authors include first author Carol A. Mancuso from Weill Cornell Medical College and the Hospital for Special Surgery; Mary E. Charlson, Tiffany N. Choi, Heidi Westermann, Suzanne Wenderoth and James P. Hollenberg from Weill Cornell Medical College; Martin T. Wells and Alice M. Isen from Cornell University; John P. Allegrante from Columbia University; and Jared B. Jobe from the NHLBI.
NEWYORK-PRESBYTERIAN HOSPITAL/WEILL CORNELL MEDICAL CENTER
NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances — including the development of the Pap test for cervical cancer; the synthesis of penicillin; the first successful embryo-biopsy pregnancy and birth in the U.S.; the first clinical trial for gene therapy for Parkinson’s disease; the first indication of bone marrow’s critical role in tumor growth; and, most recently, the world’s first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. NewYork-Presbyterian Hospital also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children’s Hospital, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian/The Allen Hospital. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. Weill Cornell Medical College is the first U.S. medical college to offer a medical degree overseas and maintains a strong global presence in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar. For more information, visit www.nyp.org and weill.cornell.edu.
January 27, 2012
Tags: enjoying life health benefits Posted in: COPD - Anxiety and Depression No Comments
Choose Your Walking Program - 14 Mood-Boosting Walking Workouts from Prevention.com
Sure, walking does wonders for your heart, health, and waistline, but did you know even a short 10-minute stroll can boost your mood for up to 12 hours? Employing little techniques, like heading outdoors, tuning into your breathing, and changing directions quickly can increase happiness, memory, and your attention span for the rest of the day. The best part: the longer you walk, the more ways your body and mind will benefit. Next time you need a quick pick-me-up, try one of these 14 Mood-Boosting Walking Workouts. Your mind—and body!—will thank you for it.
Reader-tested routines that tone muscle and target stubborn fat
Whether you want to burn fat, boost energy, lift mood, or just be a bit more toned in a few important places, Prevention.com  has the workouts for you. They’ve all been road tested by Prevention readers and are ready to deliver fast results. Pick your goal and discover new, fun ways to achieve it.
They have organized the tips and walking workouts by specific goals–choose the one that’s right for you, and start working towards your fittest body ever!
Download the free printable PDF for a portable guide.
Prevention Fitness Director Michele Stanten, author of Walk Off Weight, designed several of these workouts.
January 25, 2012
Tags: walking programs Posted in: COPD - Exercise No Comments
