“Our results dispute the notion that TBI is a one-time event with a stagnant outcome after a short period of recovery,” said study author Benjamin L. Brett, PhD, of the Medical College of Wisconsin in Milwaukee. “Rather, people with TBI continue to show improvement and decline across a range of areas including their ability to function and their thinking skills.”

The study involved people at 18 level 1 trauma center hospitals with an average age of 41. A total of 917 people had mild TBI and 193 people had moderate to severe TBI. They were matched to 154 people with orthopedic injuries but no head injuries. Participants were followed for up to seven years.

The participants took three tests on thinking, memory, mental health and ability to function with daily activities annually from two to seven years post-injury. They also completed an interview on their abilities and symptoms, including headache, fatigue, and sleep disturbances.

When researchers looked at all test scores combined, 21% of people with mild TBI experienced decline, compared to 26% of people with moderate to severe TBI and 15% of people with orthopedic injuries with no head injury, according to Neurology.

Among the three tests, researchers saw the most decline over the years in the ability to function with daily activities. On average, over the course of 2 to 7 years post-injury, a total of 29% of those with mild TBI declined in their abilities and 23% of those with moderate to severe TBI.

Yet some people showed improvement in the same area, with 22% of those with mild TBI improving over time and 36% of those with moderate to severe TBI.

“These findings point out the need to recognize TBI as a chronic condition in order to establish adequate care that supports the evolving needs of people with this condition,” Brett said. “This type of care should place a greater emphasis on helping people who have shown improvement continue to improve and implementing greater levels of support for those who have shown decline.”

A limitation of the study was that all participants were seen at a level 1 trauma center hospital within 24 hours of their injury, so the findings may not apply to other groups of people.

“Fireworks’ high decibel levels pose a significant risk, especially for children, individuals with pre-existing hearing conditions, and those in close proximity to the detonation,” says Sara Lerner, Assistant Director of Clinical Audiology with ENT and Allergy Associates (ENTA), the largest ear, nose, throat, allergy, and audiology practice in the country. “It’s important to recognize that the harm caused by fireworks is not limited to a single instance. Frequent exposure to loud noises, even for short durations, can accumulate over time and result in irreversible hearing damage.”

People who frequently engage in or are regularly exposed to fireworks displays are particularly susceptible to long-term hearing impairments, ENTA says in a news release.. While the 4th of July and the summer season, are times of excitement and festivities, it’s crucial to remember the potential risks fireworks pose to your hearing health. Here are some valuable tips to help you safeguard your hearing during this holiday:

Maintain a Safe Distance: When attending fireworks displays, try to position yourself at a safe distance from the launch site. As a general rule, staying at least 500 feet away can significantly reduce the intensity of the sound waves reaching your ears.

Use Hearing Protection: Invest in high-quality earplugs or earmuffs specifically designed for noise reduction. These protective devices create a barrier against loud noises and help to mitigate the risk of hearing damage. Ensure that they fit snugly and effectively block out excessive sound.

Limit Exposure Time: Prolonged exposure to loud noises increases the likelihood of hearing damage. If you’re planning to enjoy fireworks for an extended period, take regular breaks in quieter areas to give your ears a chance to recover. This break allows your auditory system to rest and reduces the cumulative impact of noise exposure.

Create a Quiet Zone: If you’re hosting a 4th of July gathering, designate a quiet area where individuals can retreat and escape the noise of fireworks. Provide comfortable seating and encourage guests to take breaks in this zone to protect their hearing and overall well-being. Look after pets, who are often upset by loud noises. Keep them inside at a safe distance from hearing the noise.

Be Mindful of Children: Children’s ears are particularly sensitive to loud noises. If you’re celebrating with young ones, closely supervise their exposure to fireworks and ensure they wear appropriate hearing protection. Explain the importance of safeguarding their hearing and lead by example. Remember, protecting your hearing is a lifelong commitment,” says Lerner. “By implementing these tips, you can enjoy your 4th of July and summer celebrations while taking proactive steps to preserve your hearing health for years to come.”

Studies show that parents who faced difficult situations in their childhood may pass on some of those risks to their children.

In a recent study funded by the NIMH, Jessica Uy, Ph.D., of the University of California Los Angeles, and colleagues analyzed the transmission of trauma from one generation to the next. They discovered that when mothers experience adversity in their childhood, it can negatively impact their mental health during and after pregnancy, which in turn, can affect their children’s mental health.

For the study, the researchers followed 541 mother-child pairs who participated in the Growing Up Singapore Toward Health Outcomes (GUSTO) study. Mothers in the study reported their levels of anxiety and depression at 26 weeks of pregnancy and at 3 months, 12 months, 24 months, 36 months, 4.5 years, and 6 years after the birth of their child. When their children were 4.5 years of age, mothers reported their recollections of childhood abuse or neglect.

The researchers asked the mothers and their children to fill out surveys when the children were between 7 and 8 years old to find out if the children were feeling anxious, depressed, or withdrawn. Additionally, the researchers collected functional magnetic resonance imaging (fMRI) data from a subset of 89 children in the study when they were 6 years old.

The study showed that maternal experiences of childhood neglect were associated with worse mental health (reflecting higher levels of anxiety and depression symptoms) both during pregnancy and after birth.

Worse maternal mental health, in turn, was linked to children having more feelings of anxiety and depression and being more socially withdrawn when they were 7.5 years old. Maternal experiences of childhood neglect were also associated with their children reporting more anxiety-related performance fears, physical symptoms, and restlessness.

Maternal experiences of childhood abuse were associated with worse mental health among mothers after birth, which in turn was linked to their children feeling more anxious, depressed, and withdrawn at 7.5 years of age.

The researchers also found a link between maternal mental health and their children’s brain activity. Children of mothers who experienced worse mental health after birth showed weaker connectivity between two parts of the brain (the amygdala and prefrontal cortex)—a connection critical for the regulation and processing of emotion.

The study had several limitations, the researchers said. The mothers who participated were from the general population, which meant most had lower levels of trauma, anxiety, and depression than would be found in a population in treatment. In addition, not all children had fMRI data, and having fMRI data from a larger sample of children would lend greater weight to the findings.

But the study results indicate that when a mother experiences difficult times during her own childhood, it can affect her mental health when she is an adult, during critical life stages such as during pregnancy and after giving birth. This, in turn, can increase the risk of mental health challenges in her children.

The authors suggest one way to break the transmission of risk may be to focus on providing intervention and support to women during these critical time periods.

The randomized clinical trial, which included 3,500 participants aged 60 and over, was the second COSMOS study to show that multivitamins significantly improved brain function—with the “vitamin group” far surpassing the placebo group.

“The benefits of taking a multivitamin were maintained throughout the three years of the study,” says board certified internist Jacob Teitelbaum, MD, who advocates nutritional supplementation as a complement to the standard American diet and standard medical therapies. “This confirms numerous earlier studies showing that folate (simple folic acid) dramatically lowers dementia risk.” In addition to a daily multivitamin, he recommends supplementing with a good B complex, folate, vitamin D, and magnesium—all with proven efficacy.

Teitelbaum is one of the world’s leading researchers on effective treatment for chronic fatigue syndrome (CFS) and fibromyalgia. His landmark double-blind, placebo-controlled study published in the Journal of Chronic Fatigue Syndrome (8:2, 2001) showed profound benefits from nutrition as well as sleep, hormones, treating hidden infections/inflammation, and exercising as able.

“The reason doctors have traditionally been slow to recommend multivitamins is because their training has been pharmaceutical-focused and sorely deficient in nutritional education, he says. “This new COSMOS study is an important step towards setting the record straight—and represents a wakeup call to clinicians, researchers, and media that cover latest medical findings.”

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Hummingbirds consume an average of two to three times their weight in nectar each day. Providing feeders and an abundance of flowers throughout the season will support the hummingbirds and help attract them to your gardens. Keep this in mind as you add plants to your landscape.

Shrubs like azalea, lilac, weigela, buttonbush, and Rose-of-Sharon provide shelter for birds and nectar-filled flowers for hummingbirds and other pollinators to enjoy. The North American native honeysuckle vine adds vertical interest and hummingbird appeal even in small spaces.  Major Wheeler is a variant of the native honeysuckle vine that blooms all summer and is more resistant to powdery mildew.  Watch as the hummingbirds munch on any aphids that attack this plant.  They are great pest managers to have in the garden.

Another native vine, the trumpet vine, is a vigorous grower that can be trained into a small tree or onto a trellis.  This plant will send out suckers requiring some regular maintenance. Be patient as it can take several years for this vine to begin flowering. Avoid overfertilization which results in an even bigger plant and no flowers.

Garden phlox and bee balm are both hummingbird favorites that add color and nectar to the summer garden. Look for powdery mildew-resistant varieties or plant them among other tall plants to hide any discolored foliage that may occur. North American native anise hyssop and liatris are two more favorites you may want to include.

Fill vacant spots in the garden, containers, or hanging baskets with annuals known to attract hummingbirds. Fuchsias, begonias, and impatiens are perfect for shady locations.  Cupheas are often sold under the common names, tiny mice and cigar plant, and prefer a sunnier location. The taller blue horizon ageratum, geranium, bidens, tall verbena, and petunias grow well in gardens and containers.

Both perennial and annual salvias attract hummingbirds.  Place a pot or two of Black and Blue, Black and Bloom, and Wendy’s Wish near your windows, so you can enjoy the frequent visits of your resident hummingbirds.

Add one or more feeders to your landscape. Provide space between the feeders as hummingbirds are territorial. Make sure there is cover within 10 to 15 feet. Fill the container with a 1-part sugar to 4-part water solution. Replace the mixture and clean the feeders every few days. This provides additional food for

It may take a couple of years for the hummingbirds to find your nectar-filled garden. In the meantime, you will enjoy the flowers and other pollinators that stop by to dine.

The study, which looked at the survival of people with ALS over the course of 18 months, was published in the June 21, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Researchers also found an omega-6 fatty acid may be beneficial. The omega-omega-6 fatty acid called linoleic acid that is found in vegetable oils, nuts, meats, seeds and eggs was associated with a lower risk of death during the study. The study does not prove that these omega fatty acids slow decline of ALS or extend survival; it only shows an association.

ALS is a rare, progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. People with ALS lose the ability to initiate and control muscle movement, which often leads to total paralysis and death. The average life span after diagnosis is two to five years.

“The link our study found between diet and ALS is intriguing and suggests, but does not prove, that people with ALS may benefit from incorporating more omega-3 fatty acids into their diet,” said Kjetil Bjornevik, MD, PhD, of Harvard University and member of the American Academy of Neurology. “It will now be important to conduct additional research looking specifically at the plant-based omega-3 fatty acid alpha-linolenic acid in people with ALS to further explore this possibility.”

The study involved 449 people who had ALS with an average age of 58, who were followed over 18 months. Of the total participants, 126 or 28%, died by the end of the study.

Researchers looked at levels of omega-3 fatty acids in participants’ blood. They divided them into four groups based on lowest to highest amounts.

Participants took a test to assess their disease progression and severity of symptoms. The test measured 12 aspects of physical function including swallowing, speaking, chewing, and the ability to use muscles in the hands, arms, legs and torso, as well as respiratory function. Each category was scored from zero, meaning no ability, to four, meaning normal ability. Total scores ranged between zero to 48, with higher scores indicating better function and less severe symptoms.

Researchers found an omega-3 fatty acid called alpha-linolenic acid was the most beneficial. This acid is found in many seeds and oils, including flaxseed, walnuts, chia, hemp, and many common vegetable oils.

The people with the highest amount of alpha-linolenic acid had an average score of 38.3 at the start of the study, while the people with the lowest amount had an average score of 37.6.

A lower number of people from the group with the most alpha-linolenic acid died during the study, with 21 deaths, or 19%, compared to people in the lowest group, with 37 deaths or 33%.

After adjusting for age, sex and ethnicity, people with the highest amounts of alpha-linolenic acid had a 50% lower risk of death during the study compared to people with the lowest amount.

Higher levels of a specific omega-3 fatty acid called eicosapentaenoic acid that is found in fatty fish and fish oil supplements was also associated with a lower risk of death during the study.

A limitation of the study is the lack of access to data on the overall diet of the participants, including other nutrients and supplements as well as total caloric intake, which could all be associated with survival time in ALS.

The study was supported by the ALS Association.

A limitation of the study is the lack of access to data on the overall diet of the participants, including other nutrients and supplements as well as total caloric intake, which could all be associated with survival time in ALS.

Learn more about ALS at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health.

The findings, by a group of British and Canadian researchers, show that the average risk of dying from breast cancer in the five years after a diagnosis has fallen from 14% to 5% since the 1990s. For those diagnosed during 2010-15, more than six in 10 women had a five year risk of 3% or less.

The researchers say their findings can be used to reassure most women treated for early breast cancer that they are likely to become long term cancer survivors. The findings can also help identify those for whom the risk of dying from breast cancer remains substantial.

Worldwide, more than 2 million women receive a diagnosis of early breast cancer each year. While the risk of dying from breast cancer in these women has decreased over the past few decades, the extent of this decrease was previously unknown. Also, it was not known whether this decrease applied to groups of women with certain characteristics or whether it applied to all groups.

To address this uncertainty, researchers used data from the National Cancer Registration and Analysis Service to investigate the long term risks of dying from breast cancer after a diagnosis of early breast cancer.

They included all 512,447 women who were registered in England with early breast cancer (i.e. cancer confined to the breast and possibly the axillary lymph nodes) as their first cancer from January 1993 to December 2015, and who were treated initially with surgery.

Annual breast cancer death rates and cumulative five year risks were estimated, taking account of time since diagnosis, calendar period of diagnosis, and characteristics such as age, whether the cancer was detected by screening, involvement of lymph nodes, and tumor size and grade. All women were followed until December 2020.

The results show that for women with a diagnosis made within each of the calendar periods 1993-99, 2000-04, 2005-09, and 2010-15, the annual breast cancer mortality rate was highest during the five years after diagnosis and then declined.

Cumulative five year breast cancer mortality risk was on average 14.4% for women with a diagnosis made during 1993-99 but only 4.9% for women with a diagnosis made during 2010-15.

Considering just the 156,338 women with a diagnosis during 2010-15, cumulative five year breast cancer mortality risk varied substantially between women with different characteristics. It varied according to patient age, whether the cancer was detected by screening, whether it had certain receptors, and according to cancer size, grade and the number of lymph nodes involved. It was less than 3% for 62.8% of women but more than 20% for 4.6% of women.

The researchers acknowledge that these observational findings can’t determine the specific causes of these reductions in mortality and point to several other limitations. For example, data on cancer recurrence was not available. The study focused on women who were initially treated with surgery. It did not include women who received treatment to reduce the size of their cancer before surgery, women whose cancer had already spread, or women diagnosed with more than one cancer.

However, this study provides a detailed and accurate picture of breast cancer mortality in a complete population of women with early breast cancer for up to 20 years.

As such, they say these analyses “provide patients with early breast cancer, and the clinicians who treat them, with estimates of their likely prognosis based on up-to-date data.”

They add: “Our study is good news for the great majority of women diagnosed with early breast cancer today because their prognosis has improved so much. Most of them can expect to become long-term cancer survivors.”

Given these findings, older adults on low-dose aspirin and their care providers may want to consider periodic monitoring of red blood cells or hemoglobin, the NIH said in a news release. Anemia in older adults is associated with functional decline, increased fatigue, disabilities, depressive symptoms, and cognition problems.

The study was published in the Annals of Internal Medicine.

Scientists from the Aspirin in Reducing Events in the Elderly (ASPREE) study examined the effect of long-term low-dose aspirin use on incident anemia and the effect of aspirin on changes in hemoglobin concentration, as well as ferritin levels, as an indicator of iron deficiency.

The researchers found that low-dose aspirin led to increased incident anemia in otherwise healthy older adults at enrollment, independent of major bleeding.

Previous ASPREE data analyses suggested daily low-dose aspirin does not decrease risk for dementia and cognitive decline; and that daily low-dose aspirin had no effect on healthy lifespan in older people.

ASPREE, a joint U.S. and Australian research project aimed at determining the effect of low-dose aspirin on survival without dementia or disability, began in 2010 and completed recruitment in 2014. It was a randomized, double-blind, placebo-controlled, primary prevention trial of daily 100 mg of aspirin in a population of healthy older people in the U.S. and Australia with a period of treatment averaging 4.5 years. The trial involving 19,114 people age 65 and older was distinctive for its size, methodological rigor, and high participant retention rate in both countries.

“As high blood pressure disproportionately affects Black, Hispanic and Indigenous populations in the U.S., the American Heart Association continues its commitment to improve health equity nationwide, we strive to ensure that everyone has access to resources for a healthier life,” said AHA volunteer president Michelle A. Albert, M.D., M.P.H., FAHA, the Walter A. Haas-Lucie Stern endowed chair in cardiology, professor of medicine and admissions dean at University of California San Francisco School of Medicine. “We appreciate the support from Elevance Health Foundation, which enables us to work in the communities where the need is greatest.”

Acccording to an AHA news release, a recent poll by the Association was designed to evaluate patient perceptions and barriers to blood pressure management in the home setting. The survey participants—patients with high blood pressure at clinics in under-resourced areas throughout the U.S.—were provided with blood pressure kits to monitor their blood pressure at home as part of the Building Healthier, Safer Communities Together initiative supported by Elevance .More than three quarters (88%) of the participants said that they planned to check their blood pressure levels at least once daily, and over half of the respondents (64%) said they believe that monitoring their blood pressure at home will help to improve their overall health.

The program is a community-based initiative focused on blood pressure control in medically under-resourced communities and is one component of a nationwide project with Federally Qualified Health Centers (FQHCs) and other community clinics to facilitate and provide health education, guidance and resources to patients.

“Nearly half of all Americans have high blood pressure, which is why implementing interventions that target health measures – such as increased awareness and management of blood pressure – are crucial to not only improving the health of people living in historically under-resourced communities, but advancing equity for all,” said Shantanu Agrawal, M.D., chief health officer at Elevance Health. “Through this initiative, more than 3,500 patient care kits are in the hands of people at the highest risk, allowing them to monitor their blood pressure at home.”

According to research, community health workers can make a difference in improving patients’ access to care and treatment for health concerns such as high blood pressure. Community health workers can aid their patients and communities in various roles beyond just patient medical care, including providing health education, linking people with social services, and improving overall patient-health professional communication.

Communication is important, according to many of the survey responses. When patients were asked what could help them monitor their blood pressure at home, 38% replied that regular in-person consultations with a doctor or a nurse would be helpful, and 26% responded that more opportunities for education on blood pressure and hypertension would be helpful.

Adult patients from 11 clinics in nine markets throughout the U.S. who were diagnosed with high blood pressure and received a self-monitoring blood pressure kit were invited to participate in the survey. The survey was planned to identify gaps in knowledge of patients encouraged to regularly monitor their blood pressure at home, and is part of the Building Healthier, Safer Communities Together (BHSCT) program. Through the BHSCT initiative, the American Heart Association provided primary healthcare professionals with 350 patient care kits in 16 under-resourced target communities, Baton Rouge, La., New Orleans, La., Houston, Atlanta, Ga., Des Moines, Nashville, Tenn., Newport, Tenn., Los Angeles, Calif., Seattle, Wash., St. Louis, Mo., New York, N.Y., Indianapolis, Ind., Miami, Fla. and Cincinnati, Ohio, to distribute to their high-risk patients in support of remote blood pressure monitoring. The purpose of this evaluation is to use survey-based data collection to assess participant characteristics, perceptions and barriers to blood pressure management. This evaluation will inform the program for the next two years.

The program is a community-based initiative focused on blood pressure control in medically under-resourced communities and is supported by Elevance. Surveys were provided in both English and Spanish, and participants had the option to complete the 18-question survey in electronic form on a tablet during a clinic visit, or in a paper format. Data was collected between August 2021 and June 2022 and analyzed by the Evaluation Team in the Qualtrics system on behalf of the AHA. A total of 317 participants attempted the survey, 80% of whom were age 45 and older. Most of the responses received were from the electronic version of the survey (64%).[7] The majority of respondents identified as female (55%), aged 45-64 (59%), and as being of Hispanic, Latino, or Spanish origin (58%).

It’s a question that’s been asked of consumers for decades. And despite the increasing popularity of digital payment methods, cash and card remain the most popular choices worldwide. In 2021, 65 percent of all point-of-sale transactions globally were made using cash or card, according to Fidelity National Information Services. 

Past research shows that 90 percent of households use multiple payment methods, but new research from the University of Notre Dame takes a first look into how consumers choose between them. The study finds that the justifiability of a purchase affects how consumers choose to pay.

“Purchase Justifiability Drives Payment Choice: Consumers Pay With Card To Remember And Cash To Forget” is forthcoming in the Journal of the Association for Consumer Research from Christopher Bechler, assistant professor of marketing in Notre Dame’s Mendoza College of Business, along with Szu-chi Huang from Stanford University and Joshua Morris, data science manager for Nike.

“When a purchase is difficult to justify — like buying an overpriced bottle of water at the airport, cigarettes or candy — consumers pay with less-trackable methods, like cash, so they can eliminate the paper or electronic trail and ‘forget’ this guilty purchase,” said Bechler, who specializes in consumer behavior and social psychology with an emphasis on attitudes, persuasion and financial decision-making. “When a purchase is easy to justify, consumers have no problem paying with trackable methods like credit cards that create paper or electronic trails.”

Despite the vast amount of research on financial decision-making in behavioral economics, consumer behavior and social psychology, this is the first study to take an in-depth look at how consumers choose to pay.

The team analyzed real transaction data from 118,042 purchases and manipulated the justifiability of purchases consumers imagined making in six experiments on more than 5,000 individuals. They hoped to capture the causal effect of hard-to-justify purchases on consumers’ intentions to use cash vs. a credit or debit card.

“I think a lot of consumers — particularly those who diligently track their card expenses — recognize that they use cash so they don’t have to think about certain purchases again,” Bechler said. “In fact, this strategy of using cash to hide purchases from ourselves if we feel bad about them is something my co-authors and I admitted to doing ourselves.”

The findings show merchants it’s a good idea to be strategic with the types of payment methods they allow.

“A doughnut shop could benefit from letting its customers pay with cash because they may want to forget their unhealthy purchase,” Bechler said. “A salad shop might not see the same benefit.”

And as the world turns to cryptocurrencies and new payment methods, the study underscores implications for both merchants and financial institutions designing payment methods of the future. Bechler said understanding the factors that affect how consumers choose to pay could be important for predicting which new methods will succeed.