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Even if you're not yet an older adult, MS might make you more inclined to fall, and you want to cut down on that risk. Tai chi exercising is apparently having impressive results when it comes to reducing the risk of falling, according to this brief article in NEJM Journal Watch, July 24:

Meta-Analysis: Tai Chi May Reduce Fall Risk in Older Adults

By Amy Orciari Herman

Edited by Susan Sadoughi, MD

Tai chi may help prevent falls in older adults, according to a meta-analysis in the Journal of the American Geriatrics Society.

The analysis included 10 randomized trials comparing tai chi with other interventions or usual care in adults aged 56 to 98. Tai chi sessions were generally an hour long, one to three times per week, for 12 to 26 weeks.

High-quality evidence suggested that tai chi lowered the risk for falls by 43% over short-term follow-up (<1 year), and by 13% over longer-term follow-up. For injurious falls in particular, the data were limited. Evidence showed no effect on time to first fall.

The authors conclude, "Tai chi practice may be recommended to prevent falls in at-risk adults and older adults, especially over the short term."
« Last post by agate on July 26, 2017, 04:53:16 pm »

It is 2004, and in Tennessee, Hank (Tommy Lee Jones), who was once an MP in the military, is notified that his son Mike is AWOL though his unit arrived in the US only 4 days before, from the Iraq war.

The rest of the movie is devoted to Hank’s quest to learn what has happened. He finds out, and it is horrible, especially since Hank and his wife Joan (Susan Sarandon) have already lost their older son to the military.

The movie closes with a dedication: “For the children.” The viewer will probably have no doubt about the meaning of the dedication, and it doesn’t just pertain to this particular sadly bereft couple.

Hank reveals himself to be very much a military man, down to the way he treats his shoes and the way he makes his bed. This man has been formed by the military and has the deepest respect for it. Hank loves the Bible and the flag and has tried hard to be a good father. That he is bigoted in his views comes out in one stressful scene but we suspect that ordinarily he makes an attempt at being more fair-minded than the grief-crazed Hank who calls his son’s Army buddy a wetback.

He hasn’t got very far in his investigation before he encounters Emily, whose work as part of the city detective unit is made more tense on account of the jeering she is routinely  subjected to from some of her fellow cops in the office. She appears to be the only woman there, and the others insist on treating her as if she is soft–too kind to animals, a mere joke as a cop.

We see her trying to meet their expectations of toughness as she deals with a young woman who keeps trying to tell her that her husband’s drowning of a dog in the bathtub, while their child is looking on, indicates that the man has an abusive, dangerous streak. The woman is sent away, after being told that after all her husband hasn’t actually harmed her or the child, but much later Emily witnesses the scene after the same man has drowned that woman in the bathtub–whereupon Emily, who by now has established herself as very much in control of her emotions, starts to cry.

This story-within-a-story has little connection to the main plot–Hank’s search for the truth about his son, but it is very directly related to a more general point that the movie is making, in its quiet but definite way: A country that teaches its young people to admire thugs and violence is in big trouble, and the wars it sends them to fight will have a way of turning them into calloused shadows of their former selves.

–As we find out only slowly, as Hank visits sleazy places to question people who might remember his son. He has traveled to Arizona, where his son’s base is, and what we see are bleak little diners, chicken shacks, strip clubs, the kinds of places found near a military base, hangouts for the soldiers during their time off.

Hank’s encounters with the **** women are a study in a guy who has been trained to be “decent.” He keeps his eyes away from their inflated bosoms though the young men who constitute the rest of the customers stare appreciatively. Hank might have been like them when younger. Now he’s older–and looking for a son who’s disappeared.

The bleak scene is at its bleakest when we see the crime scene.  A couple of times we see a bunch of tumbleweed pulled away from a hole where it has been concealing some of the horror. The tumbleweed is one of the few bits of nature visible. Some of us might be reminded of one of the famous cowboy Roy Rogers’s signature songs, “Tumbling Tumbleweed,” and recall that the tumbleweed is one of the symbols in the Western movies, also known as shoot-em-ups, that were the steady diet of our US childhood.

Off in one corner of that desert landscape is a neon sign:  GUNS.

Midway through the movie we are prepared to accept that Mike has met his death in a horrible way, probably at the hands of some of his buddies. But the movie doesn’t let us off so easily. There is more horror yet to come.

As if it isn’t bad enough for Hank and Joan Deerfield to have lost both sons to the military, they (or at least Hank–we’re not sure he will tell his wife all of the details he eventually learns) are going to have to realize that Mike himself was as brutalized by the military system and its rules as the others.

Whether or not the scene where Mike calls Hank just after having run over a child with his military vehicle actually happened or is Hank’s idea of something that could have happened doesn’t much matter. What matters is that in that scene, Hank probably let his son down badly. The son who was appealing to him for help didn’t really get it.

The movie opens with Hank, the proud veteran, showing a man, who happens to be from El Salvador, how to do his job of hoisting the US flag, which was hanging upside down. He lectures the man, much as he himself was probably lectured in military training, on the meaning of a flag flown upside down: “It means we’re in a whole lot of trouble, so come save our ass because we don’t have  a prayer in hell of saving ourselves.”

The movie’s eye is on the upcoming generation, but in an understated way. There is Emily’s son David, who hears a bedtime story from Hank–the story of David and Goliath, in which Hank emphasizes David’s courage in being willing to tackle the giant with just five stones and a slingshot.

Later we see Emily retelling the story to David, who asks, “But why would he let him fight a giant? I mean, when he was just a boy?”–to which she replies that she doesn’t know. David persists: “Wouldn’t he have been scared?” Her answer–while the scene shifts to Hank looking somberly at Mike’s Army photo):  “Yeah, I think he would’ve been really scared.”

When Hank makes his last trip to his son’s barracks to pick up his duffel bag, he stops to stare at the young man who is just coming in to take the empty cot and locker. We get only a glimpse of him but he is clearly very young, with his freshly cropped Army haircut. Earlier in the story, during Hank’s first visit to the barracks, he notes an empty cot–and is casually told, “We lost a man.”

The extent to which the war has dehumanized Mike and his buddies is clear enough when one of them blithely tells how hungry they all were right after murdering their buddy–and how they all went to the chicken place to eat. The pale stricken faces of Emily and Hank upon hearing this brief account speak volumes: Now they know just how grim things have become.

The acting is superb throughout this movie–particularly Charlize Theron as Emily and Tommy Lee Jones as Hank.  It is one of the best movies I’ve seen in a long time.
From Science Daily, May 15, 2017:

Potential risks of common MS treatment

In one of the most comprehensive studies to date, UBC researchers have identified potential adverse reactions of a commonly used multiple sclerosis drug.

The study aimed to identify potential adverse events related to beta-interferon treatment for relapsing-remitting multiple sclerosis by analyzing health records of over 2,000 British Columbians with multiple sclerosis between 1995 and 2008.

"Once a drug is released on the market, there are very few ways to systematically monitor adverse events," said Helen Tremlett, senior author of the study and a professor in the department of medicine at the Djavad Mowafaghian Centre for Brain Health. "Clinical trials cannot identify all adverse effects of a drug treatment partly due to small sample sizes and relatively short follow-up periods."

The study found an increased risk of events such as stroke, migraine and depression, as well as abnormalities in the blood with taking beta interferon for multiple sclerosis.

"Beta interferons are generally thought of as having a favourable safety profile, especially compared to the newer therapies for multiple sclerosis. And that is still the case; our study does not change that," said Tremlett, Canada Research Chair in Neuroepidemiology. "However, very few studies had comprehensively and quantitatively assessed their safety in real world clinical practice. Our findings complement and extend on previous observations."

The researchers found that there was a 1.8-fold increased risk of stroke, a 1.6-fold increased risk of migraine and a 1.3-fold increased risk of both depression and abnormalities in the blood. The researchers stress that patients and physicians should not change their treatment plans. The study is based on population-level data and the risk to individual patients will vary greatly depending on individual factors.

Tremlett hopes that their study will lead to further research to develop biomarkers to help identify patients who are at the greatest risk of having an adverse event.

"Further advances could enable personalized or precision medicine where patients who are at increased risk of having an adverse reaction can be identified. This could help guide discussions about individual treatment options and considerations," she said.

"It is important for patients with multiple sclerosis to have ongoing review of the benefits and risks of therapy, and to identify supportive strategies, such as diet and exercise, that could optimize their brain health" said Dr. Anthony Traboulsee, co-author of the study, associate professor of neurology and director of the MS Clinic at UBC.

In addition to the negative effects, Tremlett and her colleagues identified a positive relationship. They found a reduced risk of bronchitis and upper respiratory infections with taking beta interferon for more than two years. These infections can be common and problematic in people with multiple sclerosis.

Story Source:

Materials provided by University of British Columbia. Note: Content may be edited for style and length.
MISCELLANEOUS / Wondering why you're confused?
« Last post by agate on July 24, 2017, 07:33:46 pm »
A friend sent me this in an e-mail.

Wondering why you're confused?




MISCELLANEOUS / Safety while swimming
« Last post by agate on July 23, 2017, 04:32:48 pm »
In my childhood if you had any sense you avoided public swimming pools. You swam in lakes and rivers instead. There was too great a danger of polio, often linked to public pools. Now that there is no more polio scare, public pools still have their problems, as discussed in this article from Berkeley Wellness (June 23):

"Stay safe, avoid illness at public swimming pools"
OCREVUS (ocrelizumab) / One person's experience with Ocrevus
« Last post by agate on July 22, 2017, 04:28:55 pm »
Parts I and II of an account by Laura Kolaczkowski in Medical News Today, about her experience with Ocrevus so far:

Part I, July 6, 2017

Part II, July 13, 2017

It sounds as if the only side effect of the infusion might be itching.
TREATMENTS / New MS drugs threaten Biogen-Novartis dominance
« Last post by agate on July 21, 2017, 03:21:38 pm »
Some information on what might be coming next on the MS drug scene--from Investor's Business Daily, July 21, 2017:

"New MS drugs threaten Biogen-Novartis dominance"
NEWS / Game may be over for Senate health care bill
« Last post by agate on July 20, 2017, 08:30:56 pm »
From MedPage Today, July 17, 2017:

"Game over for Senate health care bill?"
From NEJM Journal Watch, July 18, 2017:

Healthy, Plant-Based Diet Linked to Lower Risk for Coronary Heart Disease

By Kelly Young

Edited by David G. Fairchild, MD, MPH

Eating a diet heavy in plants is associated with reduced coronary heart disease risk, provided they're the right plants, suggests a study in the Journal of the American College of Cardiology.

Researchers scored over 200,000 participants' diets on three indices based on food frequency questionnaires:

Plant-based diet index (PDI): points awarded for plant intake and taken away for animal foods

Healthful PDI: points for whole grains, vegetables, nuts, etc.

Unhealthful PDI: points for refined grains, sweets, potatoes, etc.

During roughly 25 years' follow-up, 4% developed coronary heart disease. The highest decile of the PDI was associated with a 7% reduced CHD risk, compared with the lowest decile after adjusting for confounders. A healthful PDI was associated with a 12% reduced risk, while an unhealthful PDI carried a 10% increased risk.

Editorialists recommend: "Just as physical activity is a continuum, perhaps an emphasis on starting with smaller dietary tweaks rather than major changes would be more encouraging and sustainable for those finding it difficult to make a complete and precipitous change in dietary habits."
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