Experts Are Seriously Worried About Trump's Science Information Blackout. Here's Why

Early last week, news broke that the Trump administration had issued an information blackout for the Environmental Protection Agency (EPA). The agency was directed to stop issuing press releases, posting to their social media pages, and speaking to members of the press or directly to the public.

The Boston Globe reported on Tuesday that EPA transition-team member Doug Ericksen expected the communications ban to be lifted by the end of last week. “We’re just trying to get a handle on everything and make sure what goes out reflects the priorities of the new administration,” he said.   

On Thursday, however, USA Today reported that—although a temporary freeze on EPA research grants had been lifted—the “tight control on how the agency communicates with the public through social media and news outlets will remain in place for now.” The EPA has not published any press releases, or updated its Facebook or Twitter pages, since January 20. Calls and emails from Health to the agency’s press office were not immediately returned.

The EPA’s not the only science agency that’s been in the news, either: The Department of the Interior and the Department of Agriculture were both given temporary gag orders last week, which have since been lifted. It also came to light last week that the Centers for Disease Control and Prevention (CDC) had canceled or postponed two conferences planned around the topics of climate change and LGBT youth. (These decisions were made before President Trump took office, the agency says.) 

So what does this mean for our day-to-day health and safety?

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The answer isn’t entirely clear, but public health experts are concerned about the messages being sent to the scientific community—and to American citizens—so far.

“The worry is generated by the administration’s willingness to censor information for what appears to be political purposes,” says Arthur Caplan, PhD, professor of bioethics at NYU Langone Medical Center. “There’s hinting that there could be requirements to clear things through political operatives before they get released to the public, and this type of thing hasn’t really been done before.” 

Experts have serious concerns about the EPA’s uncertain future, and its policies regarding clean air, clean water, and climate change—all things that inevitably affect human health. But in addition to its research and environmental clean-up efforts, the EPA also communicates with the public about issues directly related to health and safety. For example, its Facebook page includes posts (pre-January 20) about the dangers of wood-smoke inhalation, carbon monoxide poisoning, and radon—a gas that’s present in many homes and causes lung cancer.

If these types of media bans were to extend to other science agencies, the impacts on our health would likely be even greater. The CDC, for example, monitors the spread of illness and disease all over the world. “But this information really only matters to the extent that they are able to communicate it,” says Tara McKay, PhD, assistant professor of medicine, health, and society at Vanderbilt University.

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“If the CDC notices a big spike in flu hospitalizations, but isn’t able to provide any public messaging or prevention around this because of a gag order, then some people will die from infections that might have been avoided,” she says. “Resources will not be directed to the appropriate prevention, identification, and treatment activities.”

The CDC also plays an important role in decreasing panic around issues that really aren’t as scary as they seem. When Ebola virus was diagnosed in the United States in 2014, for example, the agency provided reassurance that treatment and prevention of transmission were top priorities.

At that time, Donald Trump criticized the government’s approach to the Ebola scare, advocating on Twitter for quarantines and travel bans not supported by scientific research. It's not outlandish to think that, as President, he might similarly go against—or try to change—the CDC’s recommendations in the event of another major health scare, says Caplan.

“If these agencies are seen as untrustworthy or censored, or they can’t get in a fast enough response, it can lead to widespread panic,” he says. That could mean unfair treatment of  people seen as disease risks, he adds, or to a misallocation of resources that would make the situation worse.

“Nobody ever called up Steve Bannon or Sean Spicer or Kellyanne Conway to find out what to do about Zika; they want to know what the CDC says and they want to know fast,” Caplan continues. “These agencies shouldn’t have to wait to find out what the administration thinks in order to answer factual questions.”

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Similar concerns would apply to the Food and Drug Administration (FDA), which is tasked with warning the public about dangers posed by foods and medicines currently on store shelves. “We don’t want to worry about whether an E. coli outbreak is being covered up because you don’t want to see certain businesses being damaged, or exaggerated because it comes from a country you don’t like, like Mexico,” says Caplan. 

The good news is, the CDC and FDA still appear to be functioning normally; both organizations are updating their social media sites, and the FDA put out a press release just Friday. And not everyone thinks the existing blackouts are cause for alarm: Last week the New York Times quoted several agency staff members who viewed the Trump directives as a normal part of a presidential transition.

Vox.com also points out that these agencies are protected by scientific integrity policies put in place by the Obama administration. The FDA’s policy, for example, states that staff is allowed to “communicate their personal scientific or policy views to the public, even when those views differ from official Agency opinions.” (As FiveThirtyEight reports, however, there’s also no legal consequence for violating these protections.) 

With the exception of the EPA, there’s been no indication that government agencies won’t be able to continue studying and monitoring imminent health threats, including disease outbreaks and foodborne illnesses. (The EPA’s research projects will reportedly be approved by the administration on a case-by-case basis.)

McKay is more concerned about the second part of both the FDA’s and CDC’s mission: to inform decision-makers about how to address these health concerns, and provide people with information so they can take responsibility for their own health.

“That second part is just as important, if not more so, than the first,” she says. “It does the agency little to know these things are happening and not be able to do or say anything about them.” 

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What You Should Know About Meningitis, the Deadly Infection That Killed a Man in California

Imagine getting an alert from your gym that a member has died of meningitis, an infection that can be passed via close contact. You’d probably be worried, to say the least.

This is what happened after 48-year-old Sevin Philips, a frequent visitor to a SoulCycle studio in Larkspur, California, died of bacterial meningitis on January 7. Out of an abundance of caution, health officials have since contacted more than 200 of his fellow riders who may have been exposed; but they are being told not to panic, according to NBC Bay Area news.

So what is meningitis, exactly—and how contagious is it really?

Meningitis is an inflammation of the membranes covering the spinal cord and brain. There are many possible causes, including viruses, fungi, parasites, drugs, and cancer. But the type that frequently appears in the news is a bacterial form called meningococcal meningitis, caused by the bacterium Neisseria meningitidis.

“This can be horrifically serious,” says Aileen Marty, MD, professor of infectious diseases at the Florida International University Herbert Wertheim College of Medicine. It can cause brain damage and hearing loss. In the worst cases, it can lead to death in just a few hours.

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“Meningitis is not uncommon,” says Dr. Marty. “But it’s especially common in populations that are living in tight quarters, like the military or college students.“ (Many universities recommend the meningococcal vaccine if you live in student housing.)

That’s because bacterial meningitis is transmitted via close interaction. But it’s unlikely that working out next to someone who’s infected would put you at risk, as health officials told SoulCycle regulars in Larkspur.

You need to be in contact with an infected person’s saliva, which can happen when you live together, for example, or kiss, says Jessica MacNeil, an epidemiologist in the Division of Bacterial Diseases at the U.S. Centers for Disease Control and Prevention. “The bacteria that cause meningococcal disease require prolonged (lengthy) or very close, person-to-person contact in order to spread,” she explained in an email to Health.

It’s not like catching a cold or the flu, she added: “The bacteria are not spread by casual contact, being in the same room as someone who is sick, or breathing the air where a person with meningococcal disease has been." 

And the bacteria can’t live outside the body for long. So you can’t catch the disease by touching surfaces like a spin bike, a keyboard, or a doorknob that someone who is sick has also touched, MacNeil said.

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The classic symptoms are sudden fever, headache, and a stiff neck. "When we say headache, we mean it’s among the worst headaches that somebody’s had in their life. And with the stiff neck, they really can’t move their neck, or they can’t, for example, touch their chin to their chest,” MacNeil said. Other symptoms include nausea and vomiting, confusion, exhaustion, and sensitivity to light. It can be mistaken for a bad flu, says Dr. Marty. But because meningococcal meningitis is so serious, you should seek treatment immediately.

As for protecting yourself, the best defense is washing your hands, says Dr. Marty. “Hand washing is unbelievably underrated and so important. But people don’t know how to do it,” she says.

Here’s a quick refresher: Under running water, scrub your hands (get in all the crevices!) for at least 20 seconds. Rinse, and then dry with a clean towel. Wash after you go to the bathroom, before you eat, and whenever you’re around someone who’s sick.

 

 

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Repealing Obamacare Would Take Insurance Away From 32 Million Americans and Double Premiums

How to Make Your Resolutions Last All Year

Did you resolve to make a change this year? Whether your goal was to eat healthier, run a marathon, or finally start meditating, keep those shiny new resolutions and avoid backsliding with these proven strategies from Gretchen Rubin, author of Better Than Before: What I Learned About Making and Breaking Habits—to Sleep More, Quit Sugar, Procrastinate Less, and Generally Build a Happier Life ($16; amazon.com).

1. Name it

Aiming to be fitter or healthier is a laudable goal, but what does that mean? “Choose a goal that is concrete and measurable and tied to an actual behavior,” says Rubin. Examples: You want to be more active, so you’ll walk your dog every morning in the park. You want to eat better, so you’ll snack on fruit instead of chips.

2. Know yourself

Ask, “What kind of person am I, really?” If you’re not a morning person, don’t resolve to wake up at 5 a.m. to go to the gym before work—that approach is not only unrealistic, it’s going to fail fast. Rubin suggests recalling past successes to clue you in to what will work for you.

RELATED: How to Make Over Your Worst Health Habits

3. Plan for failure

Things are bound to go wrong along the way (you’ll attend a party and be surrounded by to-die-for cupcakes, say). The key is to anticipate those challenges and make an if-then plan, notes Rubin. For instance, tell yourself: “If there are cupcakes at this party, then I’ll take one, relish every bite and walk away.”

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4. Show yourself some love

“When you feel energized and cared for, it’s easier to resist temptation,” says Rubin. So beyond basic self-care, make sure you’re regularly treating yourself in healthy (i.e., not food- or shopping related) ways: Do a crossword puzzle when you drink your coffee, or burn a scented candle.

5. Reframe it

People sometimes feel “done” when they achieve their goal, says Rubin. “Don’t think of it as a finish line. Consider it just one milestone out of many,” she says. Think about how you can build on your original goal so you have a new target to shoot for—even before you reach the first one. That way, the good-for-you momentum will carry on

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What Your Doctor Isn’t Telling You on Twitter

This article originally appeared on Time.com.

Cancer doctors with Twitter accounts have something else in common: more than 70% of them receive funding from drug companies, according to a new research letter published in JAMA Internal Medicine.

In the study, researchers identified 634 hematologist-oncologists who were active on Twitter and looked up whether they received personal payments from drug companies, unrelated to research or grants, in 2014. Most of them did: 72% received payments from drug companies and 44% were paid more than a thousand dollars. Payments received by the doctors in the study ranged from $100 to more than $50,000 in a single year.

The topic has fascinated study author Dr. Vinay Prasad, an assistant professor of medicine at the Oregon Health and Science University, ever since he noticed that cancer doctors were tweeting about drugs and clinical trials. He and his team didn’t analyze the content of the tweets in this study, so they can’t show whether the doctors were tweeting about drugs from those companies—and whether the doctors’ conflicts of interest influence what they share on social media.

However, Prasad says his team is currently answering that question in a second study, and while the research is still ongoing, Prasad says the practice is prevalent. “It is 100% happening that doctors who have conflicts of interest are tweeting about those specific drugs,” he says.

Regulatory agencies have struggled to come up with rules on promoting prescription drugs through social media. In 2014, the U.S. Food and Drug Administration (FDA) introduced voluntary guidelines for companies on how to present the risks and benefits of a given product online, even with character restrictions. Among them are suggestions to post messages about risks with a hyperlink that can direct people to a more detailed listing of side effects. Currently there is no official guidance for doctors on social media.

The study authors say that their findings raise the important issue of whether, and how, a doctor’s conflict of interest should be disclosed on social media like Twitter. Prasad says he thinks doctors should disclose their conflicts in their social media bios and consider flagging them when tweeting about drugs or clinical trials by companies they are paid by.

“Although there are cancer drugs with tremendous benefits, most cancer drugs have marginal benefits and real risk and harms,” says Prasad. “People deciding what treatment is right for them are in a tough situation. If part of what’s shaping your view of these drugs is the opinion of thought leaders on Twitter, then I think you have the right to know if they are paid by drug companies.”

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6 Surprising Things That May Disappear With an Obamacare Repeal

This article originally appeared on KHN.org.

The Affordable Care Act of course affected premiums and insurance purchasing. It guaranteed people with pre-existing conditions could buy health coverage and allowed children to stay on parents’ plans until age 26. But the roughly 2,000-page bill also included a host of other provisions that affect the health-related choices of nearly every American.

Some of these measures are evident every day. Some enjoy broad support, even though people often don’t always realize they spring from the statute.

In other words, the outcome of the repeal-and-replace debate could affect more than you might think, depending on exactly how the GOP congressional majority pursues its goal to do away with Obamacare.

No one knows how far the effort will reach, but here’s a sampling of sleeper provisions that could land on the cutting-room floor:

Calorie counts at restaurants and fast food chains

Feeling hungry? The law tries to give you more information about what that burger or muffin will cost you in terms of calories, part of an effort to combat the ongoing obesity epidemic. Under the ACA, most restaurants and fast food chains with at least 20 stores must post calorie counts of their menu items. Several states, including New York, already had similar rules before the law. Although there was some pushback, the rule had industry support, possibly because posting calories was seen as less onerous than such things as taxes on sugary foods or beverages. The final rule went into effect in December after a one-year delay. One thing that is still unclear: Does simply seeing that a particular muffin has more than 400 calories cause consumers to choose carrot sticks instead?  Results are mixed. One large meta-analysis done before the law went into effect didn’t show a significant reduction in calorie consumption, although the authors concluded that menu labeling is “a relatively low-cost education strategy that may lead consumers to purchase slightly fewer calories.”

Privacy please: Workplace requirements for breastfeeding rooms

Breastfeeding, but going back to work? The law requires employers to provide women break time to express milk for up to a year after giving birth and provide someplace—other than a bathroom—to do so in private. In addition, most health plans must offer breastfeeding support and equipment, such as pumps, without a patient co-payment.

Limits on surprise medical costs from hospital emergency room visits

If you find yourself in an emergency room, short on cash, uninsured or not sure if your insurance covers costs at that hospital, the law provides some limited assistance. If you are in a hospital that is not part of your insurer’s network, the Affordable Care Act requires all health plans to charge consumers the same co-payments or co-insurance for out-of-network emergency care as they do for hospitals within their networks. Still, the hospital could “balance bill” you for its costs—including ER care—that exceed what your insurer reimburses it.

If it’s a non-profit hospital—and about 78 percent of all hospitals are—the law requires it to post online a written financial assistance policy, spelling out whether it offers free or discounted care and the eligibility requirements for such programs. While not prescribing any particular set of eligibility requirements, the law requires hospitals to charge lower rates to patients who are eligible for their financial assistance programs. That’s compared with their gross charges, also known as chargemaster rates.

Nonprofit hospitals’ community health assessments

The health law also requires non-profit hospitals to justify the billions of dollars in tax exemptions they receive by demonstrating how they go about trying to improve the health of the community around them.

Every three years, these hospitals have to perform a community needs assessment for the area the hospital serves. They also have to develop—and update annually—strategies to meet these needs. The hospitals then must provide documentation as part of their annual reporting to the Internal Revenue Service. Failure to comply could leave them liable for a $50,000 penalty.

A woman’s right to choose… her OB/GYN

Most insurance plans must allow women to seek care from an obstetrician/gynecologist without having to get a referral from a primary care physician. While the majority of states already had such protections in place, those laws did not apply to self-insured plans, which are often offered by large employers. The health law extended the rules to all new plans. Proponents say direct access makes it easier for women to seek not only reproductive health care, but also related screenings for such things as high blood pressure or cholesterol.

And what about those therapy coverage assurances for families who have kids with autism?

Advocates for children with autism and people with degenerative diseases argued that many insurance plans did not provide care their families needed. That’s because insurers would cover rehabilitation to help people regain functions they had lost, such as walking again after a stroke, but not care needed to either gain functions patients never had, such speech therapy for a child who never learned how to talk, or to maintain a patient’s current level of function. The law requires plans to offer coverage for such treatments, dubbed habilitative care, as part of the essential health benefits in plans sold to individuals and small groups.

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Here's Why Email Makes You So Stressed Out

This article originally appeared on RealSimple.com.

Email is often cited as one of the most stressful things about the modern workplace, especially for people who feel pressure to stay logged on 24/7. Now, researchers say that different personality types respond in different ways to certain email habits and behaviors—and that knowing your “type” may help you reduce email-related dread or anxiety.

The new research, which was presented today at the British Psychological Society’s annual conference for occupational psychology in Liverpool, is based on an online survey of 368 people who had also completed Myers-Briggs questionnaires to determine their personality type.

This simple test prompts users to select traits for themselves in four categories: Introverted or Extroverted; Sensing or Intuitive; Thinking or Feeling; and Judging or Perceiving. The result is a four-letter combination of these traits: ISFJ or ENTP, for example.

When psychologists from OPP—a research branch of the Myers-Briggs company—compared survey data with respondents’ personality types, they found some interesting differences in how people used email, and in what they considered the most stressful aspects.

“Our research shows that while there are some general guidelines for using email, everyone is different,” said study author and OPP researcher John Hackston, in a press release. “Knowing your personality type can help you to avoid stress and communicate better with others.”

For example, those whose types included an “N” for intuitive—whom the researchers described as having a “big-picture focus”—were more likely to check their emails on vacation, over the weekends, and before and after work than their more “matter-of-fact” (or “S” for sensing) peers.

That’s unfortunate for them, says Hackston, since emailing outside of work hours has been associated with emotional exhaustion and work-life imbalance. (This issue has become so pervasive around the world that France recently instituted a “Right to Disconnect” law, requiring companies to negotiate off-hours communication boundaries.)

That’s not all the survey found. Based on the full results, OPP developed personalized email management tips for eight unique personality types.

For example, “activists” (people who are extroverted and sensing) should remember to make sure they send all of the emails they start in a day. “Conservers” (introverted and sensing) should turn off email notifications when they need to focus and concentrate, and are encouraged to follow up with people when they don’t respond to initial emails.

“Explorers” (extroverted and intuitive) should not worry about creating subfolders if they never use them, while “Visionaries” (introverted and intuitive) should consider sending a short “holding” email if they aren’t able respond right away.

“Directors” (extroverted and sensing) should avoid being too direct when stressed, and “Nurturers” (extroverted and feeling) shouldn’t be offended if people omit pleasantries in their emails.

Some advice was more broad: Extroverts are reminded that not everyone wants to meet face-to-face all the time, while introverts are reminded the opposite—that some things really are best hashed out in person, rather than online. The entire collection of email tips, as well as tips for sending emails to different personality types, is available on the OPP website.

The researchers also provide suggestions that all personality types can use to improve their relationship with work email. These include responding more quickly; taking care with chain emails and when cc'ing large groups; being clear, concise, and polite; and thinking about your audience.

They also recommend sending fewer emails overall, and sticking to the workday whenever possible. “This may be difficult, but try and have at least some time email free to reduce your stress levels,” they write.

Psychologist Ben Dattner, PhD, a New York City-based executive coach who was not involved in the new research, agrees that there are very few set-in-stone rules when it comes to managing emails.

“Some people might find it more relaxing to totally unplug on vacation, while other people might find that stressful because they don’t have their finger on the pulse of what’s going on,” Dattner told RealSimple.com. “You might have to experiment a little, and be strategic about what you put in your out-of-office reply, to see what works best for you.”

He does think, however, that everyone can benefit from setting some time-and-place limits on email. He even cites an amusing 2005 study that revealed how email and phone distractions could affect workers’ IQ scores even more than smoking marijuana could.

“You need some sort of delineation between when you’re trying to be productive, like reading or writing, and when you’re doing email,” he says. “Close your browser or put your smartphone on mute, and tell yourself you’re only going to check once an hour or once every half hour. You may not be responding to as much all at once, but you’ll be responding better and more efficiently, and that’s what’s important.”

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I Started My Morning Meditating In a Pod And It Was Awesome

By now, we’ve all learned about the health benefits of meditation: the practice boosts serotonin levels (yay, happiness!), lowers blood pressure, and can even alleviate chronic pain. But for many of us, taking the time to totally disconnect and do literally nothing for any period of time may seem like an impossible feat. Trust me, I understand the struggle: whenever I have a few spare minutes, I’m tethered to my phone watching YouTube videos or scrolling through my Instagram feed.

I never thought I’d ever be able to convince myself to meditate—but then I heard about Somadome, a pod equipped with soft, colorful lights and soothing music designed to help users fully immerse themselves in a meditative experience.

I decided it was worth a try. After all, my favorite part of yoga is the 10 minutes of savasana at the end of class, since it leaves me feeling calm and refreshed. I was hoping Somadome would provide the same results.

On a Thursday morning before work, I headed to Pure Yoga, a New York City yoga studio that has a Somadome. When I arrived, I was surprised to see the pod set up in a corner of the studio’s lobby, out for the world to see. Would I really be able to focus on achieving a peaceful state in such busy space?

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A receptionist lifted the pod’s domed roof and had me sit in the padded, lounge-style chair underneath. She covered me in a blanket, handed over a pair of headphones, and told me to pick one of six audio tracks (three were guided meditations, and three were soundtracks for more seasoned meditators). I chose “Love.” Then, the receptionist closed the pod, took my bag (and phone), and I was by myself, ready to get my zen on.

At first, I had trouble relaxing, since meditating inside a fluorescent pod is a little, well, new to me. But after a few minutes of fidgeting around in the chair, I found a comfortable position, closed my eyes, and forgot about the world outside of the pod. Being enclosed in the pod blocked out any potential distractions, making this the easiest meditation experience I’ve ever had. With no coughing or sniffling sounds from fellow yogis, or the temptation of my phone, I drifted off in about five minutes.

After 20 minutes of calm, a soothing recorded voice told me my session was over. I opened the pod, climbed out, and immediately noticed how serene I felt. For me, mornings are somewhat chaotic, as I rush to get ready and get to work on time. But now, that sense of urgency was replaced with a sense of Relax, everything will get done. And that sense was right: I felt less stressed as I went about my day, and was still able to check everything off of my daily to do list.

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While Somadome is a somewhat involved form of meditation, I definitely recommend it for beginners who have trouble relaxing on their own. The guided audio tracks walk you through relaxing your entire body and mind, while the personal pod keeps you from thinking about the outside environment. Once you get the hang of the guided meditation, you can probably stick to at-home sessions, though. Since my successful morning in the Somadome, I’ve decided to make time for a few minutes of mindfulness throughout the week.

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11 Surprising Uses For Botox

This article originally appeared on Time.com.

Though it’s best known for smoothing wrinkles, Botox, which is derived from one of the most deadly toxins known to man, has repeatedly stunned the medical community for its seemingly endless applications. Though the drug is approved for nine medical conditions and several cosmetic ones, Allergan, the company that owns Botox, holds close to 800 more patents for potential uses of the drug. Since it was approved nearly 30 years ago, Botox has indeed become a staple of cosmetic enhancement, but today, more than half of its revenue comes from its therapeutic uses for conditions as varied as chronic migraines and back pain to excessive sweating and twitching eyelids.

Botox is generally considered safe if used in tiny amounts and administered by a licensed professional, but the drug is not without risks. In 2009, the U.S. Food and Drug Administration (FDA) required Botox carry a black box warning—the strongest type of warning label on any drug—cautioning the drug had been linked to serious side effects. For Botox, those can include the effects of the drug spreading from the injection site, which can cause muscle weakness, vision problems, trouble breathing and difficulty swallowing. There have also been a number of high-profile lawsuits brought against Allergan in which plaintiffs claimed that off-label uses of Botox for ailments like a child’s cerebral-palsy symptoms or an adult’s hand tremors caused lasting side effects.

Once a drug is approved in the U.S. for one medical condition, doctors are legally allowed to prescribe it for any medical issue they think it could benefit, regardless of whether it’s been proven to work for that condition. The practice is common in medicine, but some experts caution that more research is needed to understand how Botox works and whether it’s safe for all health problems before off-label use balloons.

The off-label use of this particular toxin has helped turn Botox into a blockbuster, as TIME reports in an in-depth cover story. Here are some of the most intriguing uses for Botox:

Chronic migraines (FDA approved)
In 1992, a Beverly Hills plastic surgeon named Dr. William Binder observed that when he gave people Botox for wrinkles, they reported fewer headaches. Allergan later tested the drug on people with chronic migraines, and Botox was approved for the disorder in 2010. Some doctors question whether the drug is truly effective for migraines, or whether placebo effect deserves the credit. “Even if it’s placebo, the patients have fewer migraines,” says Dr. Denise Chou, an assistant professor of neurology at Columbia University Medical Center (who has no financial ties to Allergan). “Right now the other medications we have are antidepressants, anti-seizure, or anti-blood pressure drugs—other medications that have also accidentally been found to help migraines.” Today people who receive Botox for migraine prevention get 31 injections in different spots on their head and neck, and the effects can last around three months.

Excessive underarm sweating (FDA approved)
When doctors noticed that their patients being treated for facial spasms were sweating less, scientists at Allergan and outside of the company began studying whether Botox could be a successful therapy for people with a condition called severe primary axillary hyperhidrosis. Botox was approved for the treatment in 2004. Some people also use Botox to treat overly sweaty hands and feet.

Overactive bladder (FDA approved)
“In my 30 years of medical practice, Botox was one of the most impactful treatments I had never seen” for overactive bladder, says Dr. Linda Brubaker, dean and chief diversity officer of the Loyola University Chicago Stritch School of Medicine. In one study, Brubaker found that about 70% of women she treated with Botox reported about three leaks a day, compared with the average of five leaks a day at the start of the study. But there’s a catch. Sometimes, Botox can shut down the bladder too much, and people may need to use a catheter, she says.

Crossed-eyes (FDA approved)
One of the first Botox approvals was for a disorder that affects about 4% of Americans: strabismus, where the eyes do not line up in the same direction.

Depression (not FDA approved)
Though many experts are still skeptical, early trials suggest Botox may alleviate symptoms in people with depression. The proposed mechanism is based on what’s called the facial feedback hypothesis, which holds that a person’s facial expressions can influence their mood. One small 2014 study of 74 people with major depressive disorder found that 52% of people who received Botox reported a drop in symptoms six weeks later, compared with 15% of the people given a placebo. Allergan is currently conducting clinical trials to see if Botox can treat depression.

Premature ejaculation (not FDA approved)
Injecting Botox into the penis might relax the muscle and delay ejaculation; Allergan is currently testing Botox for this issue. The company also holds a patent for the treatment of erectile dysfunction, which is currently being tested in a third-party clinical trial.

Abnormal heartbeat (not FDA approved)
Allergan is exploring Botox as a therapy to prevent abnormal heartbeat patterns after open-heart surgery (called postoperative atrial fibrillation). “After having a drug on the market for 27 years, and having a good understanding of the safety profile, we’ve made the decision to take it to an area of significant unmet need,” says Dr. Mitchell Brin, senior vice president of Drug Development at Allergan and Chief Scientific Officer for Botox about the potential use.

Severely cold hands (not FDA approved)
At the Cold Hand Clinic at the University of Chicago, doctors use Botox off-label to treat people with very cold hands. Botox is injected into a person’s hand in order to relax muscles that surround constricted blood vessels, the course of poor circulation. When the vessels relax and enlarge, blood flows through the hand and into the fingertips, providing symptom relief. Doctors say the treatment can last up to three months.

Cleft lip scars in babies (not FDA approved)
Every year, about 2,650 babies are born with a cleft palate and 4,440 are born with a cleft lip. Many undergo surgery. Some doctors—like Dr. Roberto Flores, director of the Cleft Lip and Palate Program at NYU—will inject the infants’ scars with Botox in order to hold the muscles still and allow it to heal. This can greatly improve the appearance of the scars. “[We are] giving Botox to infants, but there is science behind it,” says Flores. “It’s a relatively new and innovative offering.”

Painful sex (not FDA approved)
Some women experience muscle spasms on their pelvic floor or contractions of the vagina that can make sex painful. Botox injections can ease pain by making the muscles stop contracting. Doctors at the Cleveland Clinic who offer Botox injections for painful sex say some women may need injections every six months, while others may only need them every couple years.

Severe neck spasms (FDA approved)
Even before Botox was approved for frown lines between the eyebrows in 2002, Allergan got approval for the drug in 2000 for its use in treating a disorder called cervical dystonia, which is characterized by abnormal head position and severe neck pain.

Read more about the weird and wild science behind Botox, here.

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What You Should Do Today If You Have Obamacare

This article originally appeared on Money.com.

As Republicans move to eliminate Obamacare, you might be worried about the future of your health insurance plan—and rightfully so.

Here’s what’s happening: Republicans are meeting to try to figure out how to speedily repeal major parts of Obamacare through an obscure process called budget reconciliation. The reality is that it’s very likely that major portions of Obamacare—like premium tax credits and the individual and employer mandate—could be axed in the near future.

What’s more, getting rid of the health care law in its entirety might not be all that difficult. As MONEY’s Alicia Adamczyk noted in the aftermath of the presidential election, a clause in the contract between insurers and the government would allow insurers to discontinue their policies if subsidies were to end.

In order to keep insurers on board with a government-run health care plan, “it’s going to take more than ‘stay tuned’ if they repeal without a replacement plan,” said Tim Jost, a health care law expert at Washington and Lee University.

Unfortunately, if you depend on Obamacare for health insurance, there’s not much you can do except sit tight and keep your current plan as long as you can. If you haven’t signed up for Obamacare via open enrollment and would like to, the deadline for 2017 coverage is Jan. 31 and you can sign up at Healthcare.gov.

“People should sign up and continue to be covered as long as the Republicans let them,” Jost said. “People should think about if there’s anything I can get now, that might not last past repeal.”

One such policy that has people worried is birth control. Under Obamacare, it falls under preventative care, which must be provided to you for free. MONEY has previously reported that it’s not likely that this policy could be axed through budget reconciliation.

However, a full repeal could leave women without coverage for gender-specific services like birth control and breast pumps. Even worse, insurers could charge women more than men for insurance, as was the practice before the ACA was passed.

The bright side for worried Obamacare subscribers is that repealing Obamacare would be disastrous for Republicans if they aren’t able to present an alternative plan. Without a replacement plan, more than 20 million people with diseases like cancer or diabetes would be left without health insurance—a political catastrophe for the GOP.

“Responsible Republicans will do everything they can to make sure people are covered,” Jost said. “There will be a high political price to pay if people aren’t covered through 2018.”

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Here’s Why the Cancer Death Rate Has Plummeted

This article originally appeared on Time.com.

Death rates from cancer, the second-biggest killer in the United States, have dropped 25% since 1991, according to a new report from the American Cancer Society. That statistic translates into a lot of lives saved; had the cancer death rate remained steady from its peak in 1991, about two million more people would have died from cancer in the years until 2014, the report finds.

The drop is fueled by decreasing death rates from the four largest types of cancer: lung, breast, prostate and colorectal. “It’s pretty exciting for us that the cancer death rate continues to decline,” says Rebecca Siegel, strategic director of surveillance information services at the American Cancer Society and lead author of the annual report, which was published in CA: A Cancer Journal for Clinicians. “We’re making a lot of progress.”

The authors credit the drop to reductions in smoking—shown last year to be responsible for about 30% of all cancer deaths—as well as advances in treatment and earlier detection.

The report also finds that cancer incidence is 20% higher in men than in women, and the cancer death rate is 40% higher in men. “There’s a different mix of cancers in men and women, and a lot of it has to do with differences in exposure to cancer risk factors,” Siegel says. Though the gender difference isn’t fully understood, men are more likely than women to smoke and drink excessively, both risk factors for several kinds of cancers. Hormone and even height differences may also make men more susceptible, though it’s not yet clear how.

Racial disparities also affect who dies from cancer, but those differences are shrinking, the report shows. In 1990, black men were almost 50% more likely to die from cancer than white men, but in 2014, that difference dropped to 21%. The gap is also narrowing in women. These drops are largely due to declines in smoking by black youth in the 1970s and early 1980s, Siegel says.

Minorities also have better access to healthcare and insurance, and the proportion of uninsured Blacks and Hispanics halved from 2010 to 2015. Those changes are too recent to make much of a dent in the present data, Siegel says, but they do suggest a way to drive cancer death disparities down even more. “The potential for an acceleration in closing that gap is there with this increased access to healthcare,” Siegel says. “Hopefully it will be sustained.”

While good news overall, the report doesn’t guarantee a continuous downward trend of death rates from cancer. Recent evidence shows that death rates from other leading causes of death—like heart disease, closely related to obesity—are on the rise. Obesity, a risk factor for cancer, probably has yet to show its full effect on the death rates of cancer, Siegel says. “We don’t know when we’re going to see the effects of the tripling of the obesity rate in the past several decades,” she says, adding that excess body weight, unhealthy diet and a lack of physical activity account for about 20% of cancer diagnoses in the U.S. Some statistics hint that obesity may already be taking a toll. Rates of colorectal cancer, which is linked to obesity, are declining overall, Siegel says, but they’re rising in people younger than 50.

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A Month-by-Month Guide to the Best Places to Travel in 2017

How to Get Rid of Earwax

This article originally appeared on RealSimple.com.

Mom always told you not to put anything in your ear that's smaller than your elbow. Well, she was right. Not only is that good advice; it’s now an official guideline for the diagnosis and treatment of earwax, published Tuesday by the American Academy of Otolaryngology—Head and Neck Surgery Foundation.

This update to the Foundation’s existing earwax guidelines, originally published in 2008, takes a new, consumer-focused approach, says Seth R. Schwartz, M.D., chair of the guideline update group and medical director at The Listen for Life Center at Virginia Mason Hospital in Seattle. That includes a list of do’s and don’ts for doctors to pass on to their patients.

“We tried to include information that was directly applicable to what people are experiencing at home,” Dr. Schwartz told RealSimple.com. “And the most important thing we want to get across to patients is that earwax is not unhealthy.”

In fact, earwax is normally quite good for our ears: Dirt and dust particles stick to the gunky deposits, which keep them from traveling farther down into the ear canal. And when our bodies work the way they should, old earwax moves outward naturally over time, and flakes off—or is washed off during bathing—as new earwax is formed.

But there are times this self-cleaning mechanism gets stuck, and earwax can build up and block the ear canal—a condition called cerumen impaction. It’s estimated that about 1 in 10 children and 1 in 20 adults has impacted or excessive cerumen (a.k.a. earwax), which can cause symptoms like hearing loss, ringing in the ears, a foul odor, or ears that feel clogged, painful, or itchy. In geriatric and developmentally delayed groups, the percentage may be as high as one third.

And that’s where the guidelines come in. In addition to the commonly cited elbow advice, the new list of “don’ts” warns against over-cleaning the ears (which may irritate the ear canal, cause infection, or even increase earwax levels) and using ear candles (which have no established benefit, but can cause serious and permanent damage).

What they do recommend, on the other hand, is seeking medical attention if you have symptoms of hearing loss, ear pain, or ear fullness. You should also see a doctor if you experience drainage or bleeding from your ears, they add, which are likely not caused by earwax and need further evaluation.

Patients should also ask their doctors about ways they can treat their earwax at home, the guidelines state. That may include using wax-softening eardrops or even rinsing your ears with water, says Dr. Schwartz. Your doctor might also recommend a home irrigator designed for ear cleaning, or may refer you to a specialist (like an otolaryngologist or an audiologist) for in-office cleanings or wax removal.

What you shouldn’t do is use a Q-tip—or any other tiny tool—to try to clean out your ear canal. “Even something as soft as a cotton swab can traumatize that delicate skin, which can cause pain and infection,” says Dr. Schwartz. “And a lot of people end up pushing the wax deeper into the eardrum. That makes it harder for it to make its way out naturally, and can cause even more symptoms.”

And finally, if you’re not experiencing any earwax-related symptoms, simply leave your ears alone. “For most people, wiping the outer edges of your ears with a washcloth or a tissue is all you need to do,” says Dr. Schwartz. “Don’t go any deeper than that.”

The updated guidelines were published in the journal Otolaryngology-Head and Neck Surgery, and are endorsed by several large medical groups, including the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Geriatric Society.

The guidelines should serve as a “strong reminder to patients that ear health starts with them,” says Dr. Schwartz, and should help doctors better communicate the importance of healthy habits—and, in this case, a healthy respect for earwax.

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The Case for Taking a 7-Day Facebook Detox

This article originally appeared on RealSimple.com.

It’s no secret that sometimes, spending time on Facebook can be a real downer. Maybe you’ve considered deleting your account for the sake of your sanity. But you don’t have to quit the social network altogether to feel better, suggests a new study. Researchers say that simply changing your behavior on the site—or taking an occasional break—may be just the mood-booster you need.

To be fair, the research on Facebook, and on social media in general, has been all over the map when it comes to mental health. Several studies have linked heavy use of these sites to loneliness and depression, while others have found that social networking can actually improve mood and satisfaction with life.

One problem, says Morten Tromholt, a sociology researcher at the University of Copenhagen, is that most of these studies have been observational; they’re only able to track people over time and find associations, not cause-and-effect relationships. So Tromhold wanted to conduct a true experiment that could suggest whether Facebook use actually leads to negative emotions (and not the other way around)—and whether changing one’s behavior could help.

To do that, he recruited more than 1,000 Danish Facebook users in late 2015, and tested them on several measures of social-media use, well-being, and life satisfaction. Then he asked half of them to continue Facebook use as normal, and half to take a one-week break.

Those on a break were encouraged to delete the Facebook app from their mobile devices. Most users complied with the digital detox rules, although—as a testament to the site’s pervasiveness (and addictiveness!)—some admitted to briefly checking in once or twice, either as a habit or because they needed information about an event.

After that week, Tromhold again assessed the mental health of all participants. He found that those in the no-Facebook group showed significant improvement in well-being, while those in the normal-use group showed no change.

Those gains varied depending on how, and how much, people normally used Facebook. People who were heavy users (as measured by the Facebook Intensity Scale), those who reported having a lot of envy while on Facebook, and those who tended to use Facebook passively rather than actively (reading and viewing, rather than posting and commenting) saw the most mental-health benefits from taking time off.

Tromhold’s final results were published in the journal Cyberpsychology, Behavior, and Social Networking. (His preliminary findings were published in 2015.) The experiment “provides causal evidence that Facebook use affects our well-being negatively,” he wrote, and also that “taking a break from Facebook has positive effects on the two dimensions of well-being: our life satisfaction increases and our emotions become more positive.”

Brenda K. Wiederhold, Ph.D., editor-in-chief of the journal and executive director of Virtual Reality Medical Institute in Brussels, Belgium, said in a press release that this study supports previous research that has found that “lurking” on Facebook may cause negative emotions.

“However, on the bright side, as previous studies have shown, actively connecting with close friends, whether in real life or on Facebook, may actually increase one’s sense of well-being,” she added.

Tromhold notes that his findings are only averages, and that studies are almost never able to determine whether one variable truly causes another. And more research is needed to see if quitting Facebook (or other social networks) for longer periods of time have the same impact—or perhaps even better impacts—on mental health, he says.

But he believes the study does provide some real lessons for Facebook users. “These findings indicate that it might not be necessary to quit Facebook for good to increase one’s well-being,” Tromhold wrote. He suggests that if you’re a heavy user, try scaling back. If you tend to feel envy when on Facebook, avoid browsing the sections (or the specific friends) that cause this feeling. And if you often use it passively, try participating a little bit more.

Of course, Tromhold added, old habits die hard, and these things may be too difficult to change. “If this is the case,” he wrote, “one should consider quitting Facebook for good.”

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