Hong Kong Unrest Leaves Millions to Struggle With PTSD, Depression

As mass protests have swept across Hong Kong in recent months, a mounting mental health toll will be tough to tackle, new research suggests.

Surveys conducted over 10 years show there was a sixfold increase in the prevalence of post-traumatic stress disorder (PTSD) symptoms among Hong Kong residents from shortly after Occupy Central in March 2015 (about 5%) to Sept./Nov. 2019 (nearly 32%). Occupy Central is the name given to largely peaceful protests that paralyzed parts of Hong Kong for months in late 2014.

Meanwhile, the prevalence of probable depression was five times higher during the 2019 social unrest in Hong Kong than before the Occupy Central Movement (11% versus 2%).

Taken together, roughly 2 million people have been affected by the latest round of protests, the study found, though the investigators could not prove that the protests caused widespread mental distress.

Last June, demonstrations began over an extradition bill that would have allowed suspects to be sent to mainland China, according to CNN. Though that bill has been scrapped, the demonstrations have broadened into a movement calling for greater civil liberties and police accountability.

The protests have also grown more violent and disruptive, CNN reported. Two protesters have been shot with live rounds, a man was set on fire, and another man died after being hit with a brick during clashes, according to CNN. More than 16,000 rounds of tear gas have been fired by police, with about 7,000 people arrested.

Less than half of the adults affected by mental health issues related to the Hong Kong protests said they would seek professional help. Still, mental health care providers should prepare for as much as a 12% rise in demand for services, the researchers estimated.

The study was published in The Lancet medical journal.

“Hong Kong is under-resourced to deal with this excess mental health burden,” said study co-leader Gabriel Leung, a professor from the University of Hong Kong.

“With only around half the per-capita psychiatry capacity of the U.K., and pre-existing average public sector outpatient waiting times of up to 64 weeks, it is important that we enhance mental health and social care provisions so that all those in need are able to access high-quality services,” Leung added in a journal news release.

Study co-leader Michael Ni added that, “with social unrest rising around the world, including in major cities such as Barcelona, Delhi, Paris and Santiago in 2019, the issue of how social unrest impacts population mental health is of great public health importance.”

Source: HealthDay

Belgian-style Beef Casserole with Beer

Ingredients

4 cups beef stock
5 lb lean stew beef
1/4 cup margarine
1-1/2 cup chopped onions
24 small whole onions or shallots, peeled
salt and freshly ground pepper to taste
4 cups strong beer or ale

Seasoned Flour

1-1/2 cup all purpose flour
1 tbsp salt
1/2 tbsp freshly ground pepper
1/2 tbsp dry English mustard
1/4 tbsp paprika
1/4 tsp basil
1/4 tsp chervil
1/4 tsp thyme
1/4 tsp parsley flakes

Method

  1. Pour the stock into a saucepan and boil until reduced to 3/4 cup of liquid.
  2. Cut the beef into large chunks.
  3. Mix the seasoned flour ingredients in a bowl. Place the seasoned flour in a plastic bag. Add the beef and shake until coated. Remove the beef and reserve the remaining seasoned flour.
  4. Melt the margarine in a heavy skillet. Add the beef and cook until brown, stirring with a wooden spoon. Remove the beef from the skillet and set aside.
  5. Coat the chopped onions with the reserved seasoned flour, then brown in the skillet, adding margarine, if needed.
  6. Arrange half of the chopped onions in a casserole and cover with half of the beef. Cover the beef layer with the remaining chopped onions and top with the remaining beef.
  7. Add the whole onions, then season with salt and pepper. Pour the stock and beer over the beef mixture.
  8. Bake, covered, in a preheated 350ºC oven, 1 rack below center, for 2 hours or until the beef is tender.
  9. Place in a serving dish. Garnish with fresh parsley, if desired.

Makes 10 to 12 servings.

Source: The Creative Cooking Course

Doctors in U.K. Say We should Eat More Offal to Save the Planet

Health experts claim tucking into kidneys, liver and oxtail is healthier than veganism and helps the environment.

And the Public Health Collaboration (PHC) charity has launched a rival campaign to Veganuary called Organuary.

It is promoting organ meat to fight obesity and diabetes with the slogan: “Minimise waste, maximise nutrition.”

PHC trustee Dr Joanne McCormack said: “People these days believe being vegan is best.

“But you have to have a lot of supplements to be healthy on a vegan diet. Organ meat, however, is very cheap and very nutritious. Eating just a little packs a lot of punch nutritionally.”

Top chef Giancarlo Caldesi claims offal helped reverse his type 2 diabetes. He said: “Offal has so much goodness. I’m not anti-vegan, but our bodies intended us to be omnivore.”

Offal used to be popular in the last century, but has almost disappeared from Britain’s dinner table. It is made from any meat that isn’t attached to a carcass and also includes tripe, tongue and brain.

More than 300,000 people have signed up to Veganuary this month.

And Veganuary spokeswoman Toni Vernelli said: “We don’t see Organuary as being in competition to us.

“They will probably have a tough job selling their message as a lot of people are squeamish about offal.”

Source: Daily Star

Study: Eating More Produce will Not Cure, Stop Prostate Cancer

National guidelines recommend that men with prostate cancer eat a vegetable-rich diet, suggesting it might decrease cancer progression and death. But in a Phase III randomized clinical trial, patients with prostate cancer assigned to eat seven or more servings of vegetables and fruits daily saw no extra protection from the increased consumption of micronutrients.

“These data indicate that, despite prevailing scientific and public opinion, eating more vegetables will not alter the course of prostate cancer. It will not, to the best of our knowledge, suppress or cure it,” said J. Kellogg Parsons, MD, University of California San Diego School of Medicine and Moores Cancer Center professor of urology and study lead investigator. “However, while eating a healthy diet rich in fruits and vegetables and getting more exercise may not cure cancer, it may keep the body stronger and healthier, which may help patients tolerate cancer treatments.”

The Men’s Eating and Living (MEAL) study, published in the Journal of the American Medical Association and led by UC San Diego Moores Cancer Center and Roswell Park Comprehensive Cancer Center investigators, enrolled 478 men aged 50 to 80 years at 91 sites in the United States. The patients had been diagnosed with early-stage prostate adenocarcinoma and enrolled in an active surveillance program in which patients defer immediate treatment until the disease advances.

Patients were randomized to a control group that received written information about diet and prostate cancer or to a telephone counseling behavioral intervention program that encouraged participants to eat foods high in carotenoids, such as leafy greens, carrots and tomatoes, and cruciferous vegetables such as broccoli and cabbage. Both groups were monitored for two years.

“Patients assigned to the intervention increased their intake of fruits and vegetables to a statistically significant degree, and significantly more than control patients did. These findings were supported by significant changes in the blood carotenoid levels of patients. Nonetheless, these data fail to support prevailing assertions in clinical guidelines and the popular media that diets high in micronutrient-rich vegetables improve cancer-specific outcomes among prostate cancer survivors,” said James Marshall, PhD, Distinguished Professor with the Department of Cancer Prevention and Population Sciences at Roswell Park, co-senior author on the study with John Pierce, PhD, Professor Emeritus of Cancer Prevention at UC San Diego School of Medicine.

The study is the first randomized clinical trial to test the effect of dietary intervention on prostate cancer. It was conceived based on preliminary scientific data and on inquiries from patients who wondered if a change in diet would influence their diagnosis or treatment, said Parsons, a urologic oncologist at UC San Diego Health, San Diego’s only National Cancer Institute-Designated Comprehensive Cancer Center.

“The most common question I receive from men on active surveillance is, ‘Can I decrease the chances that I will need treatment for prostate cancer by changing my diet?’ We now have good evidence that a diet rich in fruits and vegetables and light on red meat is not likely to impact need for treatment,” said co-author James Mohler, MD, professor of oncology with Roswell Park’s department of urology. “But this study does not provide justification for eating anything you want, either. The overall health benefits of a diet that’s relatively low in fat and rich in fruits, vegetables and healthy grains are well-established.”

The impact of nutrition on diseases is an ongoing conversation among researchers and clinicians. Scientific studies have identified a strong role for changing diet to improve outcomes in diabetes and cardiovascular disease, but not in cancer, said Parsons.

Although the MEAL study revealed no positive impact on prostate cancer, it did demonstrate that behavioral modification can lead patients to make healthier food choices, said Parsons.

“We designed a simple and inexpensive program that proved we could change people’s diets for the better. We hoped that through nutrition we could alter disease outcomes and then use those data to build a network of diet counselors to help men with prostate cancer eat more vegetables,” said Parsons. “It’s still an endeavor worth considering, possibly in patients with advanced prostate cancer.”

Source: EurekAlert!

What Works Best to Help Men with Overactive Bladder?

Steven Reinberg wrote . . . . . . . . .

Learning how to control the urge to urinate may be all the therapy men need to treat an overactive bladder, a new study suggests.

A combination of drugs and behavioral therapy seems to work better than drugs alone, but behavioral therapy alone also worked better than drugs, the researchers found.

The trial of 204 men with overactive bladder suggests behavioral therapy may be a good way to start treatment, the study authors said.

“The study provides good evidence that for the group of men with overactive bladder, symptoms without obstruction from an enlarged prostate can be successfully managed with behavioral therapy alone,” said Dr. Manish Vira, who was not involved with the study, but reviewed the findings. He’s vice chairman of urologic research at Northwell Health’s Arthur Smith Institute for Urology in Lake Success, N.Y.

Many medications typically prescribed for overactive bladder have significant side effects, especially in older men using multiple medications, Vira added.

For the trial, Kathryn Burgio, associate director of research at the Birmingham VA Medical Center in Alabama, and colleagues randomly assigned men to six weeks of behavioral therapy alone, drug therapy alone, or combined drug and behavioral therapy. After the initial six weeks, all of the men received combination therapy for another six weeks.

Behavioral therapy gave men pelvic floor muscle training along with techniques to suppress the urge to urinate and delay urinating.

The drugs prescribed included tolterodine (Detrol) and tamsulosin (Flomax). Like behavioral therapy, the treatment is covered by most insurance.

Symptoms of overactive bladder were reduced in all groups, the study found. Combination therapy reduced symptoms by 31%, behavioral therapy alone by 25%, and drugs alone by 13%.

Further analysis found combination therapy significantly lowered frequency of urination, compared with drug therapy, but not when compared with behavioral therapy alone.

After all the men had been on combination therapy, those who had been on drugs and behavioral therapy from the start had the greatest reduction in the frequency of urination, the findings showed.

“Although some clinicians advocate combined treatment, most do not integrate behavioral components, such as pelvic floor muscle training or delayed voiding, into standard therapy,” the authors concluded in their report. “Behavioral therapy can be implemented by nurses, nurse practitioners, and physical therapists and has the potential for widespread application in a variety of outpatient settings.”

Two Stanford University doctors said the findings confirm what urologists have advocated for more than a decade, and support American Urological Association treatment guidelines on management of overactive bladder.

“While patients may often request medication to address their symptoms, this study supports the recommendation to begin with behavioral therapy, or to combine pelvic floor exercises with medication, as they work better than medication alone,” Dr. Craig Comiter and Dr. Ekene Enemchukwu, assistant professors of urology, obstetrics and gynecology, said in a joint email. They were not involved with the study.

Starting with behavioral therapy can prevent side effects associated with overactive bladder medications, such as dry mouth, dry eyes, constipation, memory changes and drowsiness, they said.

If first-line treatment is not successful, medications may be added, Comiter and Enemchukwu suggested. Alternatively, behavioral therapy may be combined with medications immediately.

“There are very few instances where a patient should be treated with medication alone — even when he asks, ‘Can you just give me a pill to help my symptoms?’ The answer should be a resounding, ‘No,'” Comiter and Enemchukwu advised.

The report was published online in JAMA Internal Medicine.

Source: HealthDay


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