The American Dental Association suggests how to help prevent periodontal disease:
Give your teeth a thorough brushing at least twice daily.Floss daily. And if your dentist approves, use a mouth rinse containing fluoride.Eat a nutritious, balanced and healthy diet.Have dental checkups and cleanings at least twice annually.The Academy of Nutrition and Dietetics offers this quick course in deciphering a meat label:
Choose meats with the word "round" in the name, such as bottom round or top round.Look for meats with the word "loin" in the name, such as sirloin, top loin and tenderloin.Look for meats labeled "95 percent lean."Trim any visible pieces of fat before cooking.Prepare meat using methods that cut down on fat, such as grilling, stewing, braising, stir-frying or steaming."There has been a phenomenal drop in the last two years," said report lead author Brady Hamilton, a statistician with the U.S. Centers for Disease Control and Prevention's Division of Vital Statistics. "It went down 9 percent between 2009 and 2010 and that's big."
Hamilton said the teen birth trend is a part of a larger trend with the U.S. birth rate. The birth rate for all but older women has been dropping for some time, he said.
The current teen birth rate now stands at about 34 births per 1,000 women ages 15 through 19. That's a 44 percent drop in the rate since 1991, according to the report.
In 2010, teen birth rates by age and race and Hispanic origin were also lower than ever before, the CDC said.
Fewer babies were born to teens in 2010 than in any year since 1946. If the drop in teen births hadn't occurred, there would have been an estimated 3.4 million more births to teens from 1992 to 2010, the report said.
Despite these declines, the U.S. teen birth rate is still among the highest among industrialized countries, according to the report.
In looking to explain the dramatic drop in teen births in the last two decades, Hamilton said there's evidence that messages about sexual practices and the use of contraceptives have been successful.
"This is good news because it allows girls to have the opportunity to devote time toward education and preparing for adulthood," he said.
Teen birth rates fell in all but three states during the three years from 2007 to 2010 -- Montana, North Dakota and West Virginia. The birth rates may vary by state due, in part, to differences in populations by race, the researchers said.
Mississippi had the highest rate of teen births, at 55 per every 1,000 girls aged 15 to 19, followed by New Mexico at about 53 and Arkansas at 52.5. The best-performing states included New Hampshire at just under 16 per 1,000, Massachusetts at about 17, and Vermont at just under 18.
Teen birth rates in 2010 ranged from about 11 per 1,000 Asian and Pacific Island teens, to 23.5 for non-Hispanic white teens, to about 39 for American Indian or Alaska Native teens, to 51.5 for non-Hispanic black teens, and about 56 per 1,000 for Hispanic teens, according to the report.
Dr. Lawrence Friedman, director of adolescent medicine at the University of Miami Miller School of Medicine, called the new report "excellent news" and said it "represents the ongoing positive trend in the reduction of teen births."
According to the CDC, fewer teens are having sexual intercourse, Friedman said.
But Friedman said: "That doesn't mean there is less sexual activity. There's plenty of sexual activity -- oral sex and mutual masturbation and other things that don't produce pregnancies."
There's also increased use of contraception, Friedman said. "In addition, there is more awareness of the negative effects of pregnancy and sexually transmitted diseases," he said.
More information
For more on teen pregnancy, visit the U.S. Centers for Disease Control and Prevention.
Patients are more likely to opt for a simple fecal occult blood test -- a brief part of a medical exam -- that checks for bleeding, which can be a sign of colon cancer, the researchers said.
"The best test is the one that the patient actually performs," said lead researcher Dr. John Inadomi, a distinguished professor and head of the division of gastroenterology at the University of Washington, in Seattle.
"We should not assume that all patients prefer colonoscopy; therefore, patient preferences should be elicited to determine the test to which they are most likely to adhere," he said.
The main difference between the two tests, Inadomi said, is that a fecal occult blood test should be done every year, while for most people a colonoscopy can be done every 10 years starting at age 50.
In addition, any cancerous or precancerous polyps found during a colonoscopy can be removed during the procedure. If a fecal occult blood test proves positive, a colonoscopy is the next step.
The downside of a colonoscopy for many patients is the preparation, which involves fasting and using laxatives the day before the procedure. Many patients also don't like being sedated, and there can be complications, particularly a puncture of the intestine cause by the instrument, Inadomi said.
The report was published in the April 9 issue of the Archives of Internal Medicine.
For the study, 997 men and women were assigned to or given a choice of having a colonoscopy or a fecal occult blood test.
Within a year, 58 percent of the participants had the selected screening test.
Only about 38 percent of those who chose or were assigned to a colonoscopy actually had one, however, compared with more than 67 percent of those who were assigned to or chose a fecal occult blood test, the researchers found.
Significant racial/ethnic differences existed in screening, with whites more likely to have a colonoscopy and nonwhites a fecal occult blood test, the researchers found.
Blacks had the lowest rate of colon cancer screening at 48 percent. Asians and Latinos -- at about 61 percent and 63 percent, respectively -- had the highest rates, the study found.
"We have seen benefit from colon cancer screening with fewer people dying from it," said Dr. Theodore Levin, a gastroenterologist at the Kaiser Permanente Medical Center in Walnut Creek, Calif., and the author of an accompanying journal editorial. "If we want to raise our screening rates then we need to offer people choices other than colonoscopy."
Levin said there are many alternatives to colonoscopy, such as a virtual colonoscopy or sigmoidoscopy, and often when people are given too many choices they end up not doing anything.
"People may become confused and more likely to do nothing, but if you offered them colonoscopy, a test they don't want to do, or another test like a fecal occult blood test, then they are more likely to be screened," he said.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about colonoscopy.
Researchers who evaluated the strategies of more than 1,500 successful obese dieters found that eating less fat, exercising more, taking prescription diet pills and joining a commercial weight-loss program led dieters to lose from 5 percent to 10 percent or more of their body weight.
Just as important as picking a strategy for losing weight is a dieter's commitment to the approach, whatever it is, said lead investigator Dr. Jacinda Nicklas, a clinical research fellow at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston.
"Any of these strategies takes a certain degree of investment -- cutting back on calories, exercising on a regular basis, going to the doctor to get a prescription weight-loss drug, joining a program," she said.
More than a third of Americans are obese. While many obese people may think attempting to lose weight is futile, Nicklas said her study suggests that is not true. And for an obese person, weight loss of 5 to 10 percent can produce health benefits, such as lower blood pressure, she said.
The study, published online April 10 in the American Journal of Preventive Medicine, looked at a nationally representative sample from the 2001 to 2006 U.S. National Health and Nutrition Examination Survey. This ongoing survey collects information about health, health behavior and other data.
The survey takers computed the participants' body mass index (BMI), based on their reported height and weight. BMI is a measurement of size used to calculate weight categories, from underweight to obese. The team focused on the data from those with a BMI of 30 or above, considered obese.
Respondents were asked if they had tried to lose weight and, if so, how they tried to do so.
Of more than 4,000 obese respondents, more than 2,500 said they had tried to lose weight in the last year. Of these, about 1,000 (40 percent) said they had lost 5 percent or more of their body weight. More than 500 (20 percent) said they had lost 10 percent or more.
"For the 5 percent weight loss, people said they used one or more of these strategies -- eating less fat, exercising more and using prescription weight-loss drugs," Nicklas said. "For the 10 percent loss, it was any one or more of those and also joining a commercial weight-loss program."
Other methods, such as liquid diets, nonprescription diet pills or fad diets, were unsuccessful, the researchers said.
"Something advertised over the Internet that seems quick and easy may seem to be an easier way to lose weight but we don't have any evidence that those methods work," Nicklas said.
The study has limitations, however, she said. Height and weight were self-reported, and there is no follow-up data on whether the dieters kept off the pounds.
The results do offer some hope, said Dr. Jennifer Marks, a professor of medicine at the University of Miami Diabetes Research Institute, who is familiar with the study.
The message is, "Weight can come off," she said.
Of those surveyed who were obese and trying to lose weight, about 70 percent were white, so the findings may not apply as much to other ethnicities, she said.
For her patients trying to lose weight, Marks said she advises them to consider the possible strategies and to the one or two that seem "least onerous to you."
With her own patients, Nicklas has noticed yet another strategy used by some successful dieters who want to maintain the loss. They take on a new ''persona." For instance, some become triathletes who are eager to maintain that new image.
These people seem to maintain the loss better, she has observed.
More information
For more about weight control, visit the U.S. National Institutes of Health.
University of British Columbia researchers analyzed data from more than 40,000 American and Canadian male high school students who were surveyed between 1986 and 2011.
Compared to those with no history of sexual abuse, young males who were sexually abused were five times more likely to cause teen pregnancy, three times more likely to have multiple sexual partners and two times more likely to have unprotected sex, according to the study published online and in the June print issue of the Journal of Adolescent Health.
"As far as we know, this is the first study to explore the strength of the effects of sexual abuse on boys' sexual behavior," lead author Yuko Homma, a recent Ph.D. graduate from the University of British Columbia's School of Nursing, said in a university news release. "Our findings show that boys are also vulnerable to the traumatic effects of sexual abuse, which can lead to sexually transmitted infections or teen pregnancy."
About 8 percent of males and 20 percent of females in North America report that they've been sexually abused.
"Boys are far less likely to tell someone when they have been sexually abused," study co-author Elizabeth Saewyc, a UBC professor of nursing and adolescent medicine, said in the news release. "Yet it's clear they too need support and care to cope with the trauma from sexual violence."
Homma agreed. "Parents need to speak to their sons about sexual abuse awareness and prevention, as parents of girls do. Boys may hesitate to tell parents about an incident if parents have misconceptions about sexual abuse -- that it can't happen to males."
The researchers also suggested that schools should include sexual abuse prevention in health education, and health care agencies should screen boys and girls for a history of sexual abuse.
More information
The American Academy of Pediatrics has more about sexual abuse.
The U.S. Department of Health and Human Services has set a goal of reducing the childhood obesity rate to 14.6 percent by 2020, and to do so children aged 2 to 19 would need to eliminate an average of 64 calories a day.
Without this reduction in calorie intake, the average child or teen would be nearly 4 pounds heavier in 2020 than a child of the same age in 2007. In addition, more than 20 percent of youth would be obese, up from 16.9 percent currently.
The last time the childhood obesity rate in the United States was 14.6 percent was in 2002.
"Sixty-four calories may not sound like much individually, but it's quite a consequential number at the population level, and children at greatest risk for obesity face an even larger barrier," study author Dr. Y. Claire Wang, an assistant professor of health policy and management at Columbia University's Mailman School of Public Health in New York City, said in a university news release.
"Closing this gap between how many calories young people are consuming and how many they are expending will take substantial, comprehensive efforts," Wang added.
The new goal could be achieved by reducing calorie intake, increasing physical activity or both. But, although 64 calories is the overall average reduction required to meet the 2020 goal, certain groups of young people may need higher or lower calorie reductions.
White youngsters would need an average reduction of 46 calories, compared with 91 calories for Mexican-Americans and 138 calories for black children, who have higher rates of obesity. Children and teens in low-income communities also have higher rates of obesity and would require greater calorie reductions than those in higher-income areas.
The researchers suggested many policy strategies that could help American youngsters reduce calories:
Replacing all sugar-sweetened beverages in school with water and preventing children from drinking additional sugary beverages outside of school could eliminate an average of 12 calories per day.Having children aged 9 to 11 take part in a comprehensive physical-education program could eliminate an average of 19 calories per day.After-school activity programs for children in kindergarten to fifth grade could eliminate an average of 25 calories per day.The study was published this week in the American Journal of Preventive Medicine.
More information
The U.S. Centers for Disease Control and Prevention outlines how parents can help their children maintain a healthy weight.
The currently used blood test and transvaginal ultrasound may cause more harm than benefit for those patients, according to draft recommendations issued Tuesday by the U.S. Preventive Services Task Force.
"Currently, the task force does not recommend screening for ovarian cancer," said Dr. David Grossman, a member of the task force and senior investigator with Group Health Research Institute in Seattle. "The tests that we have, unfortunately, just aren't very accurate and, with a lot of false positives, a lot of women get harmed with unnecessary biopsies and surgeries."
Women with a family history of ovarian cancer should be referred for genetic testing and counseling, the recommendations also state.
Two methods are currently used to test for ovarian cancer, a blood test which looks for the tumor marker CA-125 and a transvaginal ultrasound, Grossman explained.
However, a large study published last year found no difference in mortality between women who were randomly assigned to receive a blood test plus the ultrasound compared to those who had "usual care."
What's more, some 10 percent of women who underwent screening received a false-positive result and one-third of these had an ovary removed unnecessarily.
Another study estimated that 33 surgeries were needed to diagnose one case of ovarian cancer using the blood test/ultrasound screening.
Preliminary data from yet another trial, ongoing in the United Kingdom, also turned up false-positive results in about 10 percent of women undergoing screening. Half of those women had surgery and about 4 percent of these experienced a major complication from the surgery.
Like many screening tests, the blood test plus ultrasound for ovarian cancer "doesn't work, is potentially dangerous and also costs a lot of money," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La.. "You're giving people a false sense of security, and it creates a lot of false positives which ultimately results in a lot of unnecessary surgeries."
Yet, many doctors still perform the tests because women demand it, Brooks noted.
With no new data affirming the benefit of CA-125 screening plus ultrasound, the new draft recommendations essentially reaffirm 2004 recommendations.
They are also in line with recommendations from the American Cancer Society and the American Congress of Obstetricians and Gynecologists (ACOG), Grossman said.
This leaves women with no good test to screen for ovarian cancer, considered a "silent killer" because symptoms are often noticed too late to be treatable.
"At the present, we do not have a good screening test for ovarian cancer," Brooks said.
And there are no other techniques on the horizon, Grossman added.
The draft recommendations will be posted on the task force website, and physicians and members of the public and of professional societies are invited to comment.
Final recommendations may be out in as soon as two months, Grossman said.
More information
The U.S. National Cancer Institute has more on ovarian cancer.
The study, published online in the Annals of Internal Medicine, reexamined 94 clinical trials testing drugs for women's urge incontinence -- when urine leaks after a sudden, strong urge to urinate.
It's less common than so-called stress incontinence, when urine leaks because of pressure on the bladder from things like exercise, coughing or heavy lifting.
In the U.S., there are several drugs approved to treat urge-type incontinence: fesoterodine (Toviaz), oxybutynin (Ditropan), solifenacin (Vesicare), tolterodine (Detrol) and trospium (Sanctura).
They work by relaxing the bladder and easing the urge to urinate. But that clears up incontinence episodes in only a minority of women, the new review shows.
Researchers found that for every 1,000 women treated with the drugs, anywhere from 85 to 130 saw their incontinence go away.
Fesoterodine was the most effective drug, and tolterodine the least.
But overall, the benefit of medication was modest, since most women in the studies did not become continent, said lead researcher Dr. Tatyana Shamliyan, of the University of Minnesota School of Public Health in Minneapolis.
And that modest effectiveness needs to be balanced against the risk of side effects, Shamliyan said.
She and her colleagues found that for every 1,000 women treated, between 13 and 63 stopped taking their incontinence medication because of side effects. The highest rate was among women on oxybutynin.
Dry mouth and constipation are the most common side effects of incontinence medications. Others include blurred vision and dizziness.
Shamliyan said women should try lifestyle changes and non-drug treatments first. "If you still can't find relief, then talk with your healthcare provider," Shamliyan told Reuters Health.
Medication, she said, "should be seen as a treatment option. But they are not magic pills."
Urinary incontinence is very common among women -- in large part because vaginal childbirth is a major risk factor.
One recent study of U.S. adults found that about 53 percent of women older than 20 said they'd had problems with urine leakage in the past year. That was up from less than half of women surveyed several years earlier. (See Reuters Health story of July 1, 2011.)
Researchers on that study said the increase was partly explained by rising rates of obesity and diabetes; diabetes is thought to contribute for a few reasons -- by causing nerve damage that affects the bladder, and by boosting the body's urine production, for example.
Shamliyan said the relatively small benefits of drug treatment make preventing urinary incontinence even more important.
Women can cut their risk, she said, by eating well and exercising to maintain a healthy weight, and by not smoking -- another risk factor for bladder-control problems.
There are also conservative treatments, Shamliyan pointed out.
One is "bladder training" -- tactics like going to the bathroom at fixed times, even if you don't feel like you need to go. It often includes Kegel exercises to strengthen the pelvic muscles that control urination.
Changing your lifestyle habits can also help. That often means cutting down on caffeine and alcohol, and limiting your beverages at night.
Shamliyan said there are still questions about drugs for incontinence. One is, how do women on the medications fare in the long term? The trials in this review typically lasted two to three months.
Women may also want to consider the drugs' cost, which ranges from around $100 to more than $200 a month. There is, though, a generic version of oxybutynin that is only about $10 a month.
SOURCE: Annals of Internal Medicine, online April 9, 2012.
The report released Tuesday by the W.K. Kellogg Foundation details a review of more than 1,100 documents of care by dental therapists in 54 countries, including the United States.
Beside Alaska, Minnesota is the only U.S. state to allow midlevel providers to perform such work as extracting teeth and filling cavities.
Foundation officials say more than a dozen other states are exploring the idea.
Dental therapists in Alaska and elsewhere have been controversial. Critics, including many dentists, say such complex procedures should be done only by licensed dentists.
The Kellogg Foundation says the study found no evidence suggesting dental therapists weren't fit for the work.
