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HPV To vaccinate or not to vaccinate? That is the question. Following a period of much hype and speculation, in June 2006 The Food and Drug Administration approved Merck's human papillomavirus or HPV vaccine, otherwise known as Gardisil for girls and women between the ages of 9 and 26. A myriad of health professional groups including the U.S. Centers for Disease Control and Prevention officially recommended the vaccine which also helps prevent cervical cancer. However, despite all efforts statistics show that only two out of every 10 women in the approved age groups have gotten the vaccine and now a new debate is popping up around the country regarding whether school systems should require girls and young women to get the HPV vaccine.

But let's start at the beginning. HPV or human papillomavirus is one of the most common sexually transmitted infections on the planet- as many as 80 percent of women will be exposed to HPV at some point in time in their lives. According to Newsweek the virus usually causes no symptoms, is harmless and goes away on its own. However, certain varieties of HPV (there are about 100 altogether) are particularly aggressive. Two varieties- HPV 16 and 18- cause 70 percent of all cervical cancers. Caught early, the disease can be treated with surgery and chemotherapy. If untreated, it can be painful and fairly gruesome. Until the Pap smear was introduced in the 1940's, cervical cancer was the No. 1 cancer killer among women. Since then routine screenings have made enormous strides in radically decreasing the number of cases in the United States. But the disease is far from eradicated. It's still the second most common cancer in women and according to the 2003 World Cancer Report every year, half a million women are diagnosed with the cancer and close to 250,000 die from it.

The vaccination referred to as Gardasil, manufactured by Merck, protects against the two aggressive strains of HPV- strains 16 and 18- that lead to cervical cancer. In clinical trials involving about 21,000 women, the vaccine showed notable results- nearly 100 percent protection from HPV 16 and 18, which cause 70 percent of all cervical cancers. Gardisil also protects against 90 percent of genital warts in men and women which are caused by another HPV strain. It also appears to prevent lesions that could lead to vaginal and vulvar cancers.

To be most effective it must be administered to girls before they are sexually active and it's not beneficial for women that already have HPV. It's been approved for those as young as 9 years old. And it is now up to individual states to determine if immunization should be required in school. But many religious and conservative groups that advocate abstinence oppose mandatory HPV vaccinations. Other reasons that may explain the low number of people being immunized also include the high cost and inconvenience- it typically costs $360 for three shots taken over six months, a lack of awareness regarding HPV and cervical cancer, the low number of regular physician visits among the age group (females age 9-26), and parent's unease over immunizing their kids against a disease contracted through sexual activity.

It's essential that vaccinations among tweens increase so that they are immunized before they may be exposed to the virus. Currently, health officials are trying to target tweens with the concept of an "adolescent platform" of vaccinations that includes Gardasil. Preferably, preteens would get immunizations including the meningococcal conjugate vaccine (or MCV4), the tetanus, diphtheria, pertussis vaccine (or Tdap) and the HPV vaccine.

At this juncture it's still too early to tell if or when immunity may wane and whether women will need to get booster shots later in life. But according to Newsweek, levels of the antibody to HPV appear to stay high for at least five years. Even if another dose is needed later in life, health officials are confident that multiple doses of the HPV vaccine are safe. Dr. Amanda Dempsey of the University of Michigan explains, “It's not biologically possible to get HPV from the vaccine, which contains no live or killed virus and no virus like particles.” The most common side effect has been pain at the injection site.

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sleep image 3 Sleep disorder problems haunt a vast number of people nightly. Chronic sleep disorders can be the result of a specific event or health condition, or they can surface for no apparent reason. But we all know that when we're not sleeping well, just a few rough days can trigger a downward spiral.

It's important to look at both the quantity and the quality of sleep to detect a problem. As found on health.com when it comes to sleep quality, problems aren't always obvious to the people who suffer from them. An insomniac who lies awake at night can easily tell that something is wrong, but someone with sleep apnea who repeatedly stops breathing in his sleep might have no idea there's a problem.

The most significant sign of a sleeping disorder is how you feel during the day. If you generally wake up alert and refreshed, you're a healthy sleeper. If you chronically wake up sleepy, irritable, and unfocused and stay that way throughout the day, you may have a sleep disorder.

"No matter what is bothering you, whether its difficulty falling asleep, staying asleep, snoring, restless legs, fatigue and exhaustion during the day these conditions are not normal; they're not just something you should have to live with," says Gary Zammit, PhD, director of the Sleep Disorders Institute in New York City. “You don't have to wait until a sleep disorder destroys your life before you get help.”

Here are a few questions to ask yourself to determine if you may have a sleep disorder problem:

Am I experiencing performance or concentration problems during the day? Have my mood and social capabilities suffered? Do I feel refreshed and rested most mornings, or am I fatigued and not looking forward to starting the day?

Below is a list of some of the more common sleep disorders and symptoms associated with each according to health.com.

Insomnia The medical term for difficulty falling asleep or staying asleep is insomnia. Insomnia can include: Difficulty getting to sleep (taking more than 45 minutes to fall asleep). Frequent awakenings with inability to fall back to sleep. Early morning awakening. Feeling very tired after a night of sleep.

But insomnia usually is not a problem unless it makes you feel tired during the day. If you are less sleepy at night or wake up early but still feel rested and alert, there usually is little need to worry. Fortunately, home treatment measures successfully relieve occasional insomnia.

Occasional insomnia may be caused by noise, extreme temperatures, jet lag, changes in your sleep environment, or a change in your sleep pattern, such as shift work. Insomnia may also be caused by temporary or situational life stresses, such as a traumatic event or an impending deadline. Your insomnia is likely to disappear when the cause of your sleep problem goes away.

Short-term insomnia may last from a few nights to a few weeks and be caused by worry over a stressful situation or by jet lag.

Long-term insomnia, which may last months or even years, may be caused by:

  • Advancing age. Insomnia occurs more frequently in adults older than  age 60.
  • Mental health problems, such as anxiety, depression, or mania.
  • Medicines. Many prescription and nonprescription medicines can cause sleep problems.
  • Chronic pain, which often develops after a major injury or illness, such as shingles or back problems, or after a limb has been amputated (phantom limb pain).
  • Other physical problems, such as asthma, coronary artery disease, or chronic obstructive pulmonary disease (COPD).
  • Alcohol and illegal drug use or withdrawal.
  • Cigarettes and other tobacco use.
  • Drinking or eating foods that contain caffeine, such as coffee, tea, chocolate, or soft drinks (for example, Coke, Pepsi, or Mountain Dew).

Sleep apnea Sleep apnea is one of several sleep disorders. Sleep apnea refers to repeated episodes of not breathing during sleep for at least 10 seconds (apneic episodes). It usually is caused by a blockage in the nose, mouth, or throat (upper airways). When airflow through the nose and mouth is blocked, breathing may stop for 10 seconds or longer. People who have sleep apnea usually snore loudly and are very tired during the day. It can affect children and adults. See pictures of a normal upper airway during sleep and a blocked upper airway.

sleep image 2Narcolepsy Narcolepsy is a sleep disorder that has distinct symptoms, including: Sudden sleep attacks, which may occur during any type of activity at any time of day. You may fall asleep while engaged in an activity such as eating dinner, driving the car, or carrying on a conversation. These sleep attacks can occur several times a day and may last from a few minutes to several hours. Sudden, brief periods of muscle weakness while you are awake (cataplexy). This weakness may affect specific muscle groups or may affect the entire body. Cataplexy is often brought on by strong emotional reactions, such as laughing or crying. Hallucinations just before a sleep attack. Brief loss of the ability to move when you are falling asleep or just waking up (sleep paralysis).

Parasomnias Parasomnias are undesirable physical activities that occur during sleep involving skeletal muscle activity, nervous system changes, or both. Night terrors and sleepwalking are two types of parasomnias. Sleep can be difficult for people who experience parasomnias. While "asleep," a person with parasomnia may walk, scream, rearrange furniture, eat odd foods, or pick up a weapon.

Parasomnia can cause odd, distressing, and sometimes dangerous nighttime activities. These disorders have medically explainable causes and usually are treatable.

Restless legs syndrome Restless legs syndrome (RLS) is a condition that produces an intense feeling of discomfort, aching, or twitching deep inside the legs. Jerking movements may affect the toes, ankles, knees, and hips. Moving the legs or walking around usually relieves the discomfort for a short time.

The exact cause of restless legs syndrome is not known. The symptoms of restless legs syndrome most often occur while a person is asleep or is trying to fall asleep. The twitching or jerking leg movements may wake the person up, causing insomnia, unrestful sleep, and daytime sleepiness.

When a sleep problem or lack of time keeps you from getting a good night's sleep, excessive daytime sleepiness may occur. While almost everyone experiences daytime sleepiness from time to time, it can have serious consequences such as motor vehicle accidents, poor work or school performance, and work-related accidents. Sleep problems can also be a symptom of a medical or mental health problem. It is important to consider whether a medical or mental health problem is causing you to sleep poorly. Treating a long-term sleep problem without looking for the root cause may conceal the real reason for your inadequate sleep.

Visit your doctor if you suspect any type of sleep disorder problem. Besides disrupting your schedule, they may carry serious long-term health risks including depression, substance abuse, high blood pressure, and heart disease. With lifestyle changes, therapy, or medications, sleep disorders are largely manageable. The right treatment can largely enrich your days and your nights.

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sleep image 1 Sleep is one of the richest and most studied topics in science today. The necessity for all living things to submerge into a daily state of subconscious in order to live well and thrive- it's fascinating. Scientists have been examining the guidelines for sleep for decades and unlocking the answers to an array of questions along the way- why we need it, why it can be hard to get, how much we need and how it affects our lives. So how much sleep should I get?

According to health.com there's no normal number of hours that quantifies a good sleep, just like there's no normal shoe size. Most adults require seven to nine hours of sleep a night. Others seem to manage just fine with six hours of sleep a night. A British study conducted in 2007 found that people who slept the same amount of time, seven hours each night lived longer than people who adjusted their schedules to either add or subtract ‘hours from their nightly slumber.

“Finding your own ideal sleep/wake cycle and staying consistent is key to healthy sleep,” explains Dr. Carol Ash, medical director of the Sleep for Life center in Hillsborough, N.J.

Daniel, Kripke, co-director of research at the Scripps Clinic Sleep Center in La Jolla, CA has been studying guidelines for sleep according to the Time Magazine website and is helping to answer the question, ‘how much sleep should I get?' In 2002, he compared death rates among more than 1 million American adults who, as part of a study on cancer prevention, reported their average nightly amount of sleep. His studies show that people, who sleep between 6.5 and 7.5 hours a night, live the longest. And people who sleep 8 hours or more, or less than 6.5 hours a night don't live quite as long. He believes that just as much risk is associated with sleeping too long as with sleeping too short.

It's possible to get too much sleep. Spending an excess amount of time in bed can even be a sign of other health problems such as depression or chronic fatigue syndrome. Morbidity and sickness is “U-shaped” in the sense that consistent very short sleep and consistent overly long sleep are associated with many illnesses including depression, obesity, and heart disease.

“I think we can speculate about why people who sleep from 6.5 to 7.5 hr. live longer, but we have to admit that we don't really understand the reasons. We don't really know yet what is cause and what is effect. So we don't know if a short sleeper can live longer by extending their sleep, and we don't know if a long sleeper can live longer by setting the alarm clock a bit earlier. We're hoping to organize tests of those questions,” Kripke explains.

But don't sell yourself short, that doesn't mean that you can shave off hours of much needed rest without consequence. In the same British study mentioned above, scientists found that people who are consistently sleep deprived (defined as sleeping five hours or less a night) are at greater risk for high blood pressure and cardiovascular problems- especially women.

Insufficient sleep also raises your risk for obesity, diabetes, depression, alcoholism, and automobile accidents. Plus, a 2007 University of California:Berkeley study confirmed the obvious: Sleep deprivation directly affects areas of the brain that deal with mood and concentration, leaving tired people grumpy, overly emotional, and unable to focus.

As with anything in life, moderation is essential. Red wine is good for the heart, but it's important not to overdo it. Exercise if good, but in moderation. Guidelines for sleep are much the same. So how much sleep should I get? Getting either too much or too little sleep can have health complications. Try getting between 6.5 and 8 hours of sleep per night. Try to avoid getting less than 6.5 hours, nor more than 9 hours a night. And try to get the same amount of sleep most nights.

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H1N1 image 1 We've all been following the progression of the H1N1 virus since it first appeared on the world's health scene last spring. With school's re-opening their doors after summer vacation it's important to re-educate ourselves on the H1N1 virus and what it means to you and your family's health.

According to the Centers for Disease Control and Prevention website, H1N1 is a new influenza virus causing illness in people throughout the globe. The new virus was first detected in the United States in April 2009. It spreads from person-to-person in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the World Health Organization signaled that a pandemic of novel H1N1 flu was underway.

Is H1N1 Contagious and How Does it Spread? H1N1 is contagious and spreads from human to human the same way that seasonal flu spreads. Flu is spread through coughing and sneezing. People may also become infected by touching something such as a surface or object that has the flu virus on it and then touching their mouth or nose. People infected with seasonal and novel H1N1 may be able to infect others from 1 day before getting sick to 5 to 7 days after.

It's important to note the signs and symptoms associated with H1N1 virus. Symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some have also reported diarrhea and vomiting. Most people who have become ill with this new virus in the United States have recovered without requiring medical treatment. However, as with any illness effects have ranged from mild to severe.

How Does H1N1 Differ From Seasonal Flu? Seasonal flu most commonly affects people 65 years of age and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions. Seasonal flu can cause mild to severe illness with an average of 36,000 fatalities from flu-related complications in the United States and more the 200,000 hospitalizations from flu-related causes. Of those hospitalized, 20,000 are children younger than 5 years of age. Over 90% of deaths and 60% of hospitalization occur in people older than 65.

On the other hand with H1N1 virus, CDC research shows that H1N1 flu has caused greater disease burden in people younger than 25 years of age than older people. At this time, there are few cases and few deaths reported in people older than 64 years old, which is unusual when compared with seasonal flu. Laboratory studies have shown that children and adults younger than 60 years old do not have existing antibody to the virus and about one third of adults older than 60 have antibodies against the virus.

However, pregnancy and other previously recognized high risk medical conditions from seasonal influenza appear to be associated with increased risk of complications from H1N1. These underlying conditions include asthma, diabetes, suppressed immune systems, heart disease, kidney disease, neurocognitive and neuromuscular disorders and pregnancy.

Prevention and Treatment There is no vaccine available right now to protect against the H1N1 virus, however, there is a vaccine that is currently in production and may be ready for the public sometime in the fall. But there are a few everyday actions that can help to prevent the spread of germs that cause illnesses like influenza. Here's a few actions that the CDC recommends you take to ward H1N1 from you and your family: H1N1 image 2 Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. Wash your hands often with soap and water, especially after you cough or sneeze. CDC recommends that when you wash your hands, wash with soap and warm water for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. Avoid touching your eyes, nose or mouth. Germs spread this way. Try to avoid close contact with sick people. If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone, except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick. Follow public health advice regarding school closures, avoiding crowds and other social distancing measures. Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs, tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious.

What Should I do if I get Sick? If you become ill with flu-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people. CDC recommends that you stay home for at least 24 hours after your fever is gone. Data collected during spring 2009 found that most people with the H1N1 influenza virus who were not hospitalized had a fever that lasted 2 to 4 days; this would require an exclusion period of 3 to 5 days in most cases. Those with more severe illness are likely to have a fever for longer periods of time.

If you acquire the virus, stay away from others as much as possible to keep from making others sick. Keeping people with a fever at home may reduce the number of people who get infected, since elevated temperature is associated with increased contagiousness of influenza virus.

Many people with flu viruses are contagious until 24 hours after their fevers go away, but at lower levels than during their fever. Shedding of influenza virus can be detected for 10 days or more in some cases. Therefore, when people who have had influenza-like illness return to work, school, or other community settings they should continue to practice good respiratory etiquette and hand hygiene and avoid close contact with people they know to be at increased risk of influenza-related complications. Because some people may shed influenza virus before they feel ill, and because some people with influenza will not have a fever, it is important that all people cover their cough and wash hands at all times.

If you feel any of the symptoms described above, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed. If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include: Fast breathing or trouble breathing Bluish or gray skin color Not drinking enough fluids Severe or persistent vomiting Not waking up or not interacting Being so irritable that the child does not want to be held Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include: Difficulty breathing or shortness of breath Pain or pressure in the chest or abdomen Sudden dizziness Confusion Severe or persistent vomiting Flu-like symptoms improve but then return with fever and worse cough

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It seems lately that carbs have been designated the dieters ultimate enemy- they're not to be trusted and avoided at all times. So are carbs really that bad or are they just getting a bad rap? Achieving overall carbohydrate health is essential toward a balanced diet and total wellness. 2 carb image In actuality not all carbs are as terrible as they've been touted. There are good carbohydrates and bad carbohydrates. Fortunately for us, it's easy to achieve carbohydrate health and separate the good from the bad. As consumers we are able to reap health benefits associated with good carbs by choosing high-fiber carbs such as whole grains and vegetables and avoiding refined and processed carbs such as white bread and white rice.

To assume that all carbs are bad is unreasonable. Carbohydrates are needed fuel for our bodies. In a National Academies Institute of Medicine report from 2002, it recommends that in order for adults to meet the body's daily nutritional needs while minimizing risk for chronic disease that they should get 45%-65% of their calories from carbohydrates. The same study also recommends that people focus on getting more good carbs with fiber into their diet.

According to WebMD we can reap health benefits of good carbs by choosing to consume carbohydrates full of fiber. Carbs that are naturally high in fiber slow down the absorption of other nutrients eaten at the same meal, including carbohydrates. This slowing prevents peaks and valleys in blood sugar levels, which reduces the risk for type 2 diabetes. Certain types of fiber found in oats, beans, and some fruits help to lower blood cholesterol and fiber also helps people feel fuller. This in turn, helps moderate the amount of food you eat. There is also evidence to suggest that a high fiber diet may also help to prevent colon cancer and promote weight control. In addition, studies show an increased risk for heart disease with low-fiber diets.

“Another important point about fiber-rich foods is that they tend to be loaded with phytochemicals that appear to have anticancer functions,” says Nagi Kumar, PhD and director of clinical nutrition at the Moffitt Cancer Center at the University of South Florida.

"Pertaining to cancer, we've found 65 or so non-nutrients and nutrients that have action against cancer," she says. "We've seen soy, lycopene, bicarbanol, to name just a few of these, have significant effect against various cancers."

Along with these benefits and its role in weight maintenance, fiber helps prevent constipation, hemorrhoids, appendicitis, and diverticulosis.

The easiest way to include fiber and all of its health benefits in your diet is to eat plant foods. Plants such as fruits and veggies are quality carbohydrates that are loaded with fiber. Besides fiber, plant foods also deliver vitamins, minerals, and phytochemicals along with grams of carbohydrate, such as whole grains, beans, vegetables, and fruits. Overall, a carb can't be considered “good” without considering its fiber content.

Here are a few fiber recommendations from WebMD: Men aged 50 or younger should get 38 grams of fiber a day. Women aged 50 or younger should get 25 grams of fiber a day. Because we need fewer calories and food as we get older, men over aged 50 should get 30 grams of fiber a day. Women over aged 50 should get 21 grams of fiber a day.

Getting some fiber into almost every meal takes a little effort. Here are three tips: Eat plenty of fruits and vegetables. Just eating five servings a day of fruits and vegetables will get you to about 10 or more grams of fiber, depending on your choices. Include some beans and bean products in your diet. A half-cup of cooked beans will add from 4 to 8 grams of fiber to your day. Switch to whole grains every single possible way (buns, rolls, bread, tortillas, pasta, crackers, etc).

In a nutshell, carbohydrate health revolves around consuming plenty of high fiber carbohydrates and steering clear of bad carbs that strip away such beneficial fiber.