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Am Fam Physician. 1999;59(9):2407-2408

The government may help physicians join unions. According to The Kiplinger Washington Letter, only about 35,000 physicians out of a total of 680,000 now belong to unions. The government is likely to remove barriers to the unionization of physicians who are tired of managed-care groups that have been holding down salaries and setting the rules.

While hereditary and psychologic factors have important roles in obesity, calories still count. A U.S.D.A. survey has identified the top 10 sources of calories in American diets. The highest source of calories is bread, followed by beef; milk; cakes, cookies and doughnuts; soft drinks and soda; poultry; cheese; salad dressing and mayonnaise; margarine; and sugars, syrups and jams, according to Consumer Reports on Health.

Having breakfast each day helps keep depression away, according to the International Journal of Food Sciences and Nutrition. Researchers found that adults 20 to 79 years of age who eat breakfast daily tend to feel less depressed, less stressed and have lower levels of emotional distress than people who don't eat breakfast every day. The research also showed that persons who eat breakfast tend not to smoke, drink less alcohol and follow a healthier diet.

Formal education in the adult years may help delay the onset of Alzheimer's disease and dementia. Although researchers from St. Louis University School of Medicine aren't sure how education protects the brain, they theorize that education creates both a “neurologic reserve” and a “cognitive reserve” in the brain. Education may physically bulk up the brain so the neurologic reserve can kick in and take over for the areas of the brain damaged by dementia. Also, education may create a cognitive reserve that gives people better coping strategies for dealing with the processing problems caused by dementia.

Need a lift? Try a little ice water in the right ear. According to The Brain in the News, an Australian researcher believes that people with manic depression have a “sticky switch” in their brain, which keeps the left and right hemispheres from switching into the dominant position during various mental tasks. Normally, the left and right sides of the brain take turns throughout the day, each performing separate tasks. A sticky “switch” may cause one hemisphere be locked in position during periods of depression and the other hemisphere to be locked in position during periods of mania. Ice water in the ear is a traditional neurologic test, which activates orientation pathways connected to regions on the opposite side of the brain. Researchers found that cold water in the right ear can temporarily alleviate depression and cold water in the left ear can ease the symptoms of mania.

Age-related decline in memory isn't always associated with Alzheimer's disease or stroke—it occurs even without the presence of such brain-altering conditions. To determine what is “normal” in the aging brain, a series of imaging studies using positron emission topography were conducted by researchers from Duke University. The results showed that older adults store and retrieve information at a slower rate than younger adults, and that older adults use more brain power (more regions of the brain) to reach the same level of memory and recall as a younger person.

Eggshells: a valuable commodity? About 120,000 tons of eggshells are disposed of each year by egg-processing companies. Scientists at Penn State University have devised a method of scraping off the thin membrane that lines the insides of the eggshells. A machine scrapes the membranes from the shells with razor-sharp blades. The shells with the membranes are worth only $20 a ton, but without the membranes they are worth 10 times as much because they can be used as a pulp substitute for making paper. The membranes alone can be worth even more, possibly hundreds of dollars per gram, since they contain collagen that can be used for medical purposes, reports Business Week.

On any given day, family physicians may encounter a significant number of patients who are experiencing mild to severe depression, according to data collected by PacifiCare Behavioral Health on National Depression Screening Day. Patients who were waiting to see their physician were asked to complete a five-minute screening form. The forms were analyzed by staff and then used by the physician during the office visit. Physicians reported that the screening was useful because they were not always previously aware of the patients' depression, and after seeing the results, they were able to take action to treat the problem.

Nearly half of persons with moderate to severe chronic pain haven't found relief for their pain. A national survey of 805 persons with chronic pain, conducted by the American Pain Society, the American Academy of Pain Medicine, and Janssen Pharmaceutica, showed that moderate to severe pain significantly impairs the following aspects of living: exercise (81 percent of participants); getting a good night's sleep (79 percent); enjoying leisure activities (67 percent); doing housework (65 percent); socializing (65 percent); walking (59 percent); having sex (54 percent); concentrating (49 percent); working (41 percent); and maintaining relationships with family and friends (31 percent).

Where are U.S. residents 15 years of age or older most likely to die? According to a poll by the National Center for Health Statistics, 56 percent of U.S. residents die in a hospital, clinic or medical center; 21 percent die at home; 19 percent die in a nursing home and 4 percent die in some other place, reports USA Today.

Osteoporosis may strike silently, according to the Third National Health and Nutrition Examination Survey, published in Morbidity and Mortality Weekly Report. Ninety-three percent of estrogen-deficient women with osteoporosis don't realize that they have the disease. After surveying 2,314 women, researchers found that osteoporosis affects 18.7 percent of non-Hispanic white women and 11.6 percent of women of other racial/ethnic groups. Women whose body mass index was below 25, those without a high school education and those at or below the poverty level are also more likely to have the disease.

A few years after conceiving by in vitro fertilization, some women are able to conceive naturally. Researchers studied 142 women ranging in age from 24 to 40 years and found that, within five years of giving birth after in vitro fertilization, 18 percent were able to conceive spontaneously. The women had an average of 2.2 in vitro fertilization treatments after an average of 5.2 years of infertility. According to the report in Fertility and Sterility, the spontaneous conception rate was 20 percent in couples with previously diagnosed mild malefactor infertility, 19 percent in couples with previously unexplained infertility and 12 percent in couples with previous infertility caused by endometriosis.

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Copyright © 1999 by the American Academy of Family Physicians.

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