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Scott Pruitt's first weeks leading the Environmental Protection Agency have been marked by infighting among competing factions, three sources tell CNN, including a group that believes Pruitt may not go far enough to reshape the agency and pare back regulations.

Some conservatives both inside and outside the agency are concerned their dream of reigning in Obama-era EPA regulations and gutting the agency in a more wholesale fashion will not come to fruition.

Several sources outlined three feuding factions within EPA: firm conservatives who want to see a more aggressive pullback of the agency's regulatory footprint; career employees, many of whom are concerned the new administration is hostile to environmental and climate concerns; and Pruitt's inner circle, who are reluctant to go along with some of the most unpopular rollbacks that are controversial even among moderate Republicans.

A source from the more conservative faction described Pruitt as an administrator focused more on optics than reform, causing the source to believe Pruitt is more interested in his post-EPA political career than bringing to fruition the wishes of the most ardent EPA critics.

For example, the source said Pruitt has missed a handful of policy briefings, and in some cases decisions have been made by his chief of staff.

Policy briefings are normal for an incoming administrator, said a fourth source who is a former career employee and in touch with current EPA employees. Pruitt has not requested further briefings, according to the former employee.

The more conservative sources lament Pruitt's current course.

Tracking Trump's promises

\"Pruitt shares the ideology that excessive EPA overreach and over regulation does need to be rolled back, but he's resistant to some regulatory action for fear some of the more unpopular actions could harm his future political career,\" said another source close to the administration who is concerned about Pruitt's first month on the job.

Asked about the infighting and whether it has had an effect on policy, EPA special adviser to the administrator John Konkus told CNN: \"It's just rumor and speculation, and we are not going to comment on that.\"

Cuts not deep enough for some

During discussions about the administration's proposed budget, one source with knowledge of internal EPA activities tells CNN Pruitt pushed back on some of the cuts and expressed concern over some other cuts, upsetting his most conservative critics.

Still, the Trump administration has proposed steep cuts to the agency's funding. CNN reported the first draft of the President's proposed EPA budget called for a 24% cut. The final budget proposal released March 16 had deeper cuts, slashing EPA's budget by 31%.

While Pruitt and his camp have had a contentious relationship with firm conservatives who don't believe Pruitt is going far enough to support a more drastic rollback of the agency's regulations, career employees have virtually no relationship with the new administrator, according to multiple sources.

Rift with career employees

\"The relationship between Pruitt and career employees is defunct,\" said a conservative source familiar with EPA activities. \"He doesn't work with them, and he needs to understand he can't do it alone.\"

That sentiment was echoed by the former career employee who is in touch with current career employees as well as a liberal source with knowledge of the inner workings of the agency.

\"It's, 'This is what's going to happen and that's it,'\" the liberal source said. \"Normally, there's a lot more engagement. New leadership usually states their overall goals and then try to figure out how to make it happen.\"

\"He's not showing he knows how to engage with folks, find common ground, and tap into their expertise like I've seen other administrators do,\" the liberal source continued, adding career staffers have a perception that Pruitt is \"disconnected.\"

One of the conservative sources said this dynamic would likely hurt Pruitt's ability to have an impact at the agency.

\"Nothing will get done beyond the President's executive orders,\" the source said, predicting a small regulatory agenda for Pruitt. \"This is complex stuff. You have to know it and understand it in order to identify which regulations needs to be killed. Career folks can help with that, if you work with them. But he's not doing that.\"

Cause for delay

The infighting over environmental regulation is spilling out beyond the agency as well.

Internal fighting was to blame for a weeks-long delay in an executive order that the president is now poised to sign this week, the sources said.

The order, a step towards dismantling President Barack Obama's environmental and climate change legacy, will roll back the Clean Power Plan. Trump will sign the order on Tuesday, Pruitt said in an interview on ABC News this weekend. The Obama administration saw the measure way to slow greenhouse gas emissions from power plants, while Pruitt and conservatives see it as part Obama's job killing \"anti-fossil fuel strategy.\"

One of the sources told CNN internal fighting -- a \"huge\" debate over what would be included in the order -- is the reason the order was not released earlier.

\"There are two to three hour discussions on this,\" this source, who is familiar with the discussions, said.

The White House last week disputed there was a delay, saying nothing had been announced and therefore couldn't be delayed.

One of the largest points of contention was whether to include the Paris agreement on climate change as part of the executive order.

There is also debate on whether to include instructions to revise the EPA's endangerment finding, a cornerstone decision allowing the agency to regulate greenhouse gas emissions from coal power plants. In 2009, the EPA ruled that based on scientific and technical data, greenhouse gases \"in the atmosphere threaten the public health and welfare of current and future generations.\"

Some of the President's team wants a revision of the finding, meaning a re-examination of the science used to determine that greenhouse gases are harmful to human health. That could have a sweeping effect since the endangerment findings are the underpinnings of many regulations.

Pruitt pushed back against including it in the executive order, a source familiar with the discussions said.

It's a surprising stance for Pruitt who as Oklahoma's Attorney General in 2012 unsuccessfully worked with 14 states to unravel EPA's endangerment finding.

Pruitt's position thus far has dismayed the more conservative faction.

\"It isn't that he now likes the finding. It is that he has been advised that it is a third rail, and should leave it alone and let the next guy clean up the mess he left behind,\" a conservative source said.

Gregory Wallace contributed to this report.

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Art has always been a means of expression, dialog and dissent.

But perhaps more than ever these days, it\u2019s important to keep in mind art\u2019s capacity to heal \u2014 and a new exhibition at the Pelican Bomb Gallery X space on Oretha Castle Haley Boulevard in Central City seeks to provide an opportunity for just that.

\u201cMutual Support\u201d includes the work of several artists whose work engages various issues of individual and community wellness, healing and care and \u201caddress(es) the connection between physical, social, and spiritual well-being,\u201d according to a news release.

\u201cGiven the importance and timeliness of discussions around mental health, wellness and collectivity in our country, we wanted to invite artists with different approaches and perspectives to explore how to create healthier and more caring communities\u201d said Cameron Shaw, Pelican Bomb executive director.

As such, while small in scale and relatively focused in scope, the show encompasses a surprisingly broad range of media.

One highlight is a film piece and installation built around an eight-month-long project in which Chicago-based artist Nick Cave collaborated with community groups in Shreveport to produce a multimedia performance event, which also included the participation of bounce icon Big Freedia and more than 75 artists from northwest Louisiana.

\u201cNick is one of the most renowned living artists in the world and he was working closely with residents and social service agencies serving youth, homeless people, people living with HIV and AIDS and people with mental disabilities in Shreveport,\u201d Shaw Said. \u201cI had the privilege of traveling several times to be a part of the project and it was abundantly clear how it transformed and touched lives.\u201d

Filmmaker Evan Falbaum produced the hour-long documentary about the performance on view in the exhibition, and it\u2019s worth making some time to watch as Cave\u2019s astounding Soundsuits (which have been shown in New Orleans at shows at the Newcomb Art Museum and Contemporary Arts Center in recent years) share space with a series of elaborately beaded blankets created by Shreveport residents to symbolize their life experiences and burdens.

The blankets were draped over Cave\u2019s recumbent body in the performance and came to life as Cave arose and dragged the pieces offstage. A mannequin serves as proxy for the artist in the Pelican Bomb show, but the blankets retain their literal and figuratively weighty presence.

In the back of the gallery, Saul Robbins\u2019s photographs depict spaces in and around New Orleans \u2014 like community centers and therapist\u2019s offices \u2014 in which healing encounters take place. Often visually mundane on the surface, they are conceptually transformed by the potentially transformative experiences that take place within them.

The photographs surround a seating area (courtesy of West Elm) that will provide a setting for an interactive component of the show that will take place over its duration.

\u201cAs part of Saul\u2019s project, Pelican Bomb is hosting a pop-up wellness center in the gallery on Saturdays to offer a space for conversation as a form of healing,\u201d said Charlie Tatum, Pelican Bomb editorial and communications manager. \u201cPractitioners from different backgrounds, including artists, counselors and even massage and movement therapists are leading one-on-one appointments to discuss any topic of your choice and to share techniques for self-care.\u201d

Elsewhere in the show, a panel from Rachel Wallis\u2019s community quilt project incorporating the names and ages of individuals killed by Chicago police or while in police custody simultaneously comforts and unsettles.

And Tatyana Fazlalizadeh\u2019s series of sensitively rendered but penetrating drawings depicting her mother\u2019s struggle with bipolar disorder, accompanied by an audio recording of a conversation between them, aims to destigmatize mental illness and brings the concept of self-care to a personal and relatable level.

Fazlalizadeh also will participate in a talk during the final weekend of the exhibition addressing the particular issues faced by women of color.

But anyone who visits \u201cMutual Support\u201d will also find reminders that art can be a source of strength when the going gets tough \u2014 or at least help point you in the right direction to find some.

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The adult body has 206 of them, but unless something goes wrong, bones are often ignored.

\u201cBones are an integral part of our structure of our body,\u201d says Pete Dawson, physician with Mosaic Life Care who specializes in sports medicine. \u201cThey keep us upright and they move our joints. They serve as attachment points for various organs. Without strong bones, we would not be able to really be mobile or function in any way.\u201d

A majority of women\u2019s bone growth is developed by age 20, with some continued growth through age 30. Men typically develop most bone density by ages 17 or 18 years old.

\u201cEighty percent or so of your skeleton is completed, or your bone density is nearly complete, by the time you are 18 or 20 years old,\u201d Dawson says. \u201cAfter that, you are just trying to maintain the bone density that you\u2019ve got.\u201d

How much bone mass has been accumulated and how rapidly it is lost after age 30 effects how likely a person is to develop osteoporosis, which causes bones to become weak and brittle, usually after age 65. An estimated 44 million people age 50 and older have osteoporosis or low bone mass.

\u201cThere are some genetic factors. There are some medications and drugs like alcohol or tobacco that can thin the bones,\u201d Dawson says. \u201cReally, osteoporosis is the main issue when you think about bone health.\u201d

A diet low in calcium, physical inactivity, and tobacco and alcohol use all attribute to lower bone density. The risk generally increases with age. Almost 70 percent of people with osteoporosis or low bone density are women. There typically aren\u2019t signs of low bone density until a fracture occurs.

\u201cThe main things you can do in terms of keeping up bone density are physical activity and a healthy diet,\u201d Dawson says. \u201cCalcium and vitamin D are two of the main components of bone. It\u2019s important to get those, supplementing calcium and vitamin D if you need to.\u201d

Adults ages 19 to 50 should consume 1,000 milligrams of calcium a day. That number increases to 1,200 mg per day for women after age 50 and for men after age 70. Vitamin D aids in the absorption of calcium and is found in oily fish, egg yolks and fortified milk. Sunlight also promotes the body\u2019s production of vitamin D. Dawson recommends getting 15 minutes of sunlight exposure to the face and hands to increase vitamin D intake.

\u201cIt\u2019s important (during bone development), but it\u2019s also super important afterward when you are trying to maintain bone density,\u201d he says. \u201cIf you don\u2019t get those things, your bones will gradually get weaker and weaker over time and it\u2019s harder to get that density back afterward.\u201d

Regular weight bearing and muscle strengthening exercises can help build and maintain bone density. Once it is lost, bone density is harder to replace and requires medication.

\u201cAs people get older, they are less mobile. Mobility is important for strengthening bones,\u201d Dawson says. \u201cAny kind of bed rest is going to weaken your bones dramatically over short periods of time.\u201d

Weak bones can lead to fractures, including serious fractures of the spine or hip. According to the Centers for Disease Control and Prevention, more than 300,000 people over the age of 65 are hospitalized for hip fractures each year, a majority of who are women.

\u201cSpine fractures cause a lot of back pain. They are difficult to treat,\u201d Dawson says. \u201cThe worst of the two is a hip fracture. Hip fractures have a very high mortality rate. Somewhere around 20 percent of people with hip fractures don\u2019t survive a year. It\u2019s pretty serious.\u201d

Patients with an average risk for osteoporosis should consider having bone density scans beginning at age 65, Dawson says. Those with an elevated risk, including people taking certain medications, heavy drinkers, and people with low body weight and rheumatoid arthritis, should consider earlier testing.

\u201cTrying to catch these things before they become a problem is very important,\u201d Dawson says. \u201cTalk to your primary-care doctor first and foremost, especially if you are one of the people that are in the high risk group.\u201d

"}, {"id":"fecc3892-3b79-5e42-bbb5-b9e1fecd2c0d","type":"article","starttime":"1490654640","starttime_iso8601":"2017-03-27T17:44:00-05:00","sections":[{"iowa":"news/state-and-regional/iowa"},{"health-med-fit":"lifestyles/health-med-fit"}],"application":"editorial","title":"Iowa mental health advocate dies at 49","url":"http://qctimes.com/news/state-and-regional/iowa/article_fecc3892-3b79-5e42-bbb5-b9e1fecd2c0d.html","permalink":"http://qctimes.com/news/state-and-regional/iowa/iowa-mental-health-advocate-dies-at/article_fecc3892-3b79-5e42-bbb5-b9e1fecd2c0d.html","canonical":"http://qctimes.com/news/state-and-regional/iowa/iowa-mental-health-advocate-dies-at/article_fecc3892-3b79-5e42-bbb5-b9e1fecd2c0d.html","relatedAssetCounts":{"article":0,"audio":0,"image":1,"link":0,"vmix":0,"youtube":0,"gallery":0},"byline":"Chelsea Keenan\nThe Gazette","prologue":"CEDAR RAPIDS \u2014 One of the state\u2019s strongest voices for Iowa\u2019s most vulnerable population has been silenced. Rhonda Shouse, who died Saturday because of health complications, was a staunch advocate for mental health issues in Iowa and a sharp voice on the state\u2019s transition of its Medicaid program to three private insurers. She was 49.","supportsComments":false,"commentCount":0,"keywords":["iowa","rhonda shouse","teresa bomhoff","cedar rapids","alexandra moeller","iowa\u2019s mental health planning council","the gazette","cynthia shouse","hiawatha community center","mental health planning council","mental health","medicaid","politics","law","institutes","genealogy"],"internalKeywords":[],"customProperties":{},"presentation":"","images":[{"id":"04fce68b-8ab1-5d21-9bd9-1c0cfb9b80b8","description":"Rhonda Shouse, a Medicaid recipient from Marion, speaks during a Medicaid oversight hearing in August 2016 at the State Capitol in Des Moines.","byline":"Rebecca F. Miller, THE GAZETTE","hireswidth":1763,"hiresheight":1175,"hiresurl":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/4f/04fce68b-8ab1-5d21-9bd9-1c0cfb9b80b8/58d99a2b0052b.hires.jpg","presentation":"","versions":{"full":{"type":"image/jpeg","width":"1763","height":"1175","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/4f/04fce68b-8ab1-5d21-9bd9-1c0cfb9b80b8/58d99a2af38eb.image.jpg?resize=1763%2C1175"},"100": {"type":"image/jpeg","width":"100","height":"67","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/4f/04fce68b-8ab1-5d21-9bd9-1c0cfb9b80b8/58d99a2af38eb.image.jpg?resize=100%2C67"},"300": {"type":"image/jpeg","width":"300","height":"200","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/4f/04fce68b-8ab1-5d21-9bd9-1c0cfb9b80b8/58d99a2af38eb.image.jpg?resize=300%2C200"},"1024":{"type":"image/jpeg","width":"1024","height":"682","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/4f/04fce68b-8ab1-5d21-9bd9-1c0cfb9b80b8/58d99a2af38eb.image.jpg?resize=1024%2C682"}}}],"revision":1,"commentID":"fecc3892-3b79-5e42-bbb5-b9e1fecd2c0d","body":"

CEDAR RAPIDS \u2014 One of the state\u2019s strongest voices for Iowa\u2019s most vulnerable population has been silenced.

Rhonda Shouse, who died Saturday because of health complications, was a staunch advocate for mental health issues in Iowa and a sharp voice on the state\u2019s transition of its Medicaid program to three private insurers. She was 49.

Those who knew her described her as a fearless individual who was willing to talk about her struggles with mental illness, testify before the state Legislature on behalf of Medicaid beneficiaries and work to make sure the viewpoints of Iowa\u2019s most vulnerable were heard.

\u201cWe\u2019ll miss her voice,\u201d said Teresa Bomhoff, chairwoman of Iowa\u2019s Mental Health Planning Council.

Bomhoff worked with Shouse on the council \u2014 comprised of 33 people who assess the adequacy of the mental health system as well as advocate for those with mental illness and their families \u2014 for nearly a decade.

\u201cShe was always a very rational, practical voice,\u201d she said. \u201cAnd someone who was always there that you could depend upon.\u201d

Shouse was from a family with a long history of mental health problems, said her daughter Alexandra Moeller. Growing up, her family didn\u2019t discuss their issues.

\u201cShe fought hard to break down the walls of that stigma,\u201d she said. \u201cWhen it came to her own mental health, she wanted to use herself as an example \u2014 \u2018This is how my life is, and if I can help someone see it\u2019s OK or draw inspiration, then I will.\u2019\u201d

Shouse was stubborn and independent, Moeller said. A single mother, she raised Moeller and her younger sister, Cynthia Shouse, teaching them to ask questions and play devil\u2019s advocate.

\u201cShe always did everything she could do to make things great for us,\u201d Moeller said. \u201cBut she didn\u2019t sugarcoat things, we knew what was going on. She protected us like a mom should and sheltered us when we needed to be sheltered.\u201d

Because Shouse was so willing to speak publicly and openly about her mental health struggles, Moeller said she worries people will assume that was what led to her death.

\u201cShe had her ups and downs, but this was definitely an up moment in her life,\u201d she said. \u201cShe had two grandkids, and we all loved her so much.\u201d

Shouse, a former reporter at The Gazette, was the driving force behind a Facebook group for the state\u2019s Medicaid beneficiaries and providers, and she herself was a Medicaid beneficiary. She did not create the group, but under her leadership, she was able to turn the group \u2014 with nearly 2,500 members \u2014 into an easily accessible resource with the latest news and updates.

She also helped organize multiple trips to the Statehouse from eastern Iowa, finding donors to fund transportation and meals for Medicaid enrollees so they had the opportunity to speak with legislators.

\u201cI think her legacy for sure is her leadership on the Medicaid issue,\u201d Bomhoff said. \u201cShe is who you would want as an advocate \u2014 she always persevered and she didn\u2019t give up.\u201d

A memorial service is set for 4 p.m. Friday, March 31, at the Hiawatha Community Center. 101 Emmons St., Hiawatha.

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There are weight loss programs that work, but there are many more \u201cfads\u201d out there that will temporarily drop your weight (or perhaps make you sick), only to have the pounds return in a few short weeks. Fad diets are tempting, but like eating a rich dessert when you already have a full stomach: resist, resist, resist. In the long run, you will be healthier and less frustrated.","supportsComments":false,"commentCount":0,"keywords":["advertising","diet","medicine","dietetics","weight loss","commerce","compound","food","fad diet","group","miracle"],"internalKeywords":[],"customProperties":{},"presentation":"","images":[{"id":"7803f902-d637-5549-bd54-17aa526aa684","description":"Kristin Bogdonas","byline":"","hireswidth":1113,"hiresheight":1861,"hiresurl":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/7/80/7803f902-d637-5549-bd54-17aa526aa684/5878fc1beba4a.hires.jpg","presentation":"mugshot","versions":{"full":{"type":"image/jpeg","width":"1113","height":"1861","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/7/80/7803f902-d637-5549-bd54-17aa526aa684/5878fc1beae86.image.jpg?resize=1113%2C1861"},"100": {"type":"image/jpeg","width":"100","height":"167","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/7/80/7803f902-d637-5549-bd54-17aa526aa684/5878fc1beae86.image.jpg?resize=100%2C167"},"300": {"type":"image/jpeg","width":"300","height":"502","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/7/80/7803f902-d637-5549-bd54-17aa526aa684/5878fc1beae86.image.jpg?resize=300%2C502"},"1024":{"type":"image/jpeg","width":"1024","height":"1712","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/7/80/7803f902-d637-5549-bd54-17aa526aa684/5878fc1beae86.image.jpg?resize=1024%2C1712"}}},{"id":"a4485f59-1ccf-5be9-b5de-3a6227d60986","description":"One tip to spotting a fad diet is any diet that allows only certain foods.","byline":"FILE PHOTO","hireswidth":1000,"hiresheight":667,"hiresurl":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/a/44/a4485f59-1ccf-5be9-b5de-3a6227d60986/58d70f86b7ee3.hires.jpg","presentation":"","versions":{"full":{"type":"image/jpeg","width":"1000","height":"667","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/a/44/a4485f59-1ccf-5be9-b5de-3a6227d60986/58d70f86bb5d6.image.jpg?resize=1000%2C667"},"100": {"type":"image/jpeg","width":"100","height":"67","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/a/44/a4485f59-1ccf-5be9-b5de-3a6227d60986/58d70f86bb5d6.image.jpg?resize=100%2C67"},"300": {"type":"image/jpeg","width":"300","height":"200","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/a/44/a4485f59-1ccf-5be9-b5de-3a6227d60986/58d70f86bb5d6.image.jpg?resize=300%2C200"},"1024":{"type":"image/jpeg","width":"1024","height":"683","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/a/44/a4485f59-1ccf-5be9-b5de-3a6227d60986/58d70f86bb5d6.image.jpg"}}},{"id":"e1bd3961-c842-5b82-a2e2-2d183f7b4987","description":"","byline":"","hireswidth":564,"hiresheight":1800,"hiresurl":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/e/1b/e1bd3961-c842-5b82-a2e2-2d183f7b4987/58d435aedf5ee.hires.jpg","presentation":"","versions":{"full":{"type":"image/jpeg","width":"564","height":"1800","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/e/1b/e1bd3961-c842-5b82-a2e2-2d183f7b4987/58d435aebedcd.image.jpg?resize=564%2C1800"},"100": {"type":"image/jpeg","width":"100","height":"319","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/e/1b/e1bd3961-c842-5b82-a2e2-2d183f7b4987/58d435aebedcd.image.jpg?resize=100%2C319"},"300": {"type":"image/jpeg","width":"300","height":"957","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/e/1b/e1bd3961-c842-5b82-a2e2-2d183f7b4987/58d435aebedcd.image.jpg?resize=300%2C957"},"1024":{"type":"image/jpeg","width":"1024","height":"3268","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/e/1b/e1bd3961-c842-5b82-a2e2-2d183f7b4987/58d435aebedcd.image.jpg"}}}],"revision":9,"commentID":"5e8b8a1c-d7b4-51ed-8efa-e074d1897d97","body":"

Every week, there\u2019s a new \u201cmiracle\u201d diet and every year you can\u2019t help but wonder: Is this the weight loss diet that will finally work, once and for all? There are weight loss programs that work, but there are many more \u201cfads\u201d out there that will temporarily drop your weight (or perhaps make you sick), only to have the pounds return in a few short weeks. Fad diets are tempting, but like eating a rich dessert when you already have a full stomach: resist, resist, resist. In the long run, you will be healthier and less frustrated.

Fad diets can be deceiving. They are usually described in detail by a book that has been written by an expert with a Ph.D., or a doctor who is an MD. There may be a list of scientific references that seem to back up the claims (that no one ever checks carefully to make sure they are true). And, tons of people (including all of your friends and family) seem to be following the diet and having great results.

Does this sound familiar? Here are some obvious clues that a diet is a \u201cfad\u201d rather than a recommended approach for permanent weight loss:

1. It sounds too good or easy to be true.

2. Promises rapid weight loss (5-10 pounds in a week) or \u201cmiracle cures.\u201d

3. Allows only certain foods or food groups (cutting out others).

4. Promotes a product, special herb, vitamin or other compound.

5. Can only be \u201cfollowed\u201d temporarily, but it\u2019s not supervised by a doctor.

6. It\u2019s hard to imagine or difficult to follow the diet forever.

7. It doesn\u2019t recommend a form of exercise or says that it\u2019s unnecessary.

8. Warns that one food or food group will make you seriously ill or worse.

9. Makes recommendations based on published science that are not endorsed by credible organizations or peer reviewed by other scientists.

10. Cites research that is preliminary, based on animals or has very few subjects.

"}, {"id":"39523f03-4560-5b31-ab75-4debdfa85d6a","type":"article","starttime":"1490533200","starttime_iso8601":"2017-03-26T08:00:00-05:00","lastupdated":"1490591746","priority":0,"sections":[{"health-med-fit":"lifestyles/health-med-fit"}],"flags":{"ap":"true"},"application":"editorial","title":"Less Salt, Fewer Nighttime Bathroom Trips?","url":"http://qctimes.com/lifestyles/health-med-fit/article_39523f03-4560-5b31-ab75-4debdfa85d6a.html","permalink":"http://qctimes.com/lifestyles/health-med-fit/less-salt-fewer-nighttime-bathroom-trips/article_39523f03-4560-5b31-ab75-4debdfa85d6a.html","canonical":"http://news.lee.net/lifestyles/health-med-fit/less-salt-fewer-nighttime-bathroom-trips/article_ac5bb02a-0a8f-5674-b352-4587ca9f9b39.html","relatedAssetCounts":{"article":0,"audio":0,"image":1,"link":0,"vmix":0,"youtube":0,"gallery":0},"prologue":"SUNDAY, March 26, 2017 (HealthDay News) -- Lowering your salt intake could mean fewer trips to the bathroom in the middle of the night, a new study suggests.","supportsComments":false,"commentCount":0,"keywords":["wire","food & nutrition: misc.","salt / sodium","urine problems"],"internalKeywords":["#lee"],"customProperties":{},"presentation":null,"images":[{"id":"08303fac-6699-51eb-9708-2e03a1d34690","description":"","byline":"","hireswidth":null,"hiresheight":null,"hiresurl":null,"presentation":null,"versions":{"full":{"type":"image/jpeg","width":"800","height":"600","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/83/08303fac-6699-51eb-9708-2e03a1d34690/58d89fef07fd5.image.jpg?resize=800%2C600"},"100": {"type":"image/jpeg","width":"100","height":"75","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/83/08303fac-6699-51eb-9708-2e03a1d34690/58d89fef07fd5.image.jpg?resize=100%2C75"},"300": {"type":"image/jpeg","width":"300","height":"225","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/83/08303fac-6699-51eb-9708-2e03a1d34690/58d89fef07fd5.image.jpg?resize=300%2C225"},"1024":{"type":"image/jpeg","width":"1024","height":"768","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/83/08303fac-6699-51eb-9708-2e03a1d34690/58d89fef07fd5.image.jpg"}}}],"revision":2,"commentID":"39523f03-4560-5b31-ab75-4debdfa85d6a","body":"

SUNDAY, March 26, 2017 (HealthDay News) -- Lowering your salt intake could mean fewer trips to the bathroom in the middle of the night, a new study suggests.

Most people over age 60, and many even younger, wake up to pee one or more times a night. This is called nocturia. This interruption of sleep can lead to problems such as stress, irritability or tiredness, which can affect quality of life.

There are several possible causes of nocturia, including -- as this study found -- the amount of salt in your diet.

\"This is the first study to measure how salt intake affects the frequency of going to the bathroom, so we need to confirm the work with larger studies,\" said study leader Tomohiro Matsuo, from Nagasaki University in Japan.

\"Nighttime urination is a real problem for many people, especially as they get older. This work holds out the possibility that a simply dietary modification might significantly improve the quality of life for many people,\" he said in an ESU news release.\"

The study included more than 300 Japanese adults. They all had high salt intake and sleeping problems. They were given instructions and help to reduce their salt intake and followed for 12 weeks.

The American Heart Association recommends that people consume no more than 2,300 milligrams (2.3 grams) of sodium daily. That's about a teaspoon of salt.

Ideally, the AHA says, people shouldn't have more than 1,500 milligrams (1.5 grams) of sodium per day. Table salt is made up of about 40 percent sodium, according to the AHA.

More than 200 people in the study reduced their salt intake. They went from an average of 11 grams per day to 8 grams a day.

With that reduction in salt, the average number of nighttime trips to the bathroom to urinate fell from 2.3 to 1.4 times per night. The number of times people needed to urinate during the day also decreased.

The drop in nighttime bathroom visits also led to an improvement in quality of life, researchers said.

In comparison, the nearly 100 participants whose average salt intake rose -- from 9.6 grams per night to 11 grams nightly -- had an increase in nighttime trips to the bathroom, from 2.3 to 2.7 times a night, the study revealed.

Dr. Marcus Drake is a professor at the University of Bristol in England and leader of the working group for the ESU Guidelines Office Initiative on Nocturia. \"This is an important aspect of how patients potentially can help themselves to reduce the impact of frequent urination. Research generally focuses on reducing the amount of water a patient drinks, and the salt intake is generally not considered,\" he said.

\"Here we have a useful study showing how we need to consider all influences to get the best chance of improving the symptom,\" Drake added.

The study was to be presented Sunday at the European Society of Urology annual meeting, in London. Findings presented at meetings are typically viewed as preliminary until they've been published in a peer-reviewed journal.

More information

The National Sleep Foundation has more on nocturia.

"}, {"id":"26a6a3fb-305d-5af8-aed6-bca29bfe64c8","type":"article","starttime":"1490446800","starttime_iso8601":"2017-03-25T08:00:00-05:00","lastupdated":"1490505376","priority":0,"sections":[{"health-med-fit":"lifestyles/health-med-fit"}],"flags":{"ap":"true"},"application":"editorial","title":"Is MRI the 'Mammography' of Prostate Cancer Screening?","url":"http://qctimes.com/lifestyles/health-med-fit/article_26a6a3fb-305d-5af8-aed6-bca29bfe64c8.html","permalink":"http://qctimes.com/lifestyles/health-med-fit/is-mri-the-mammography-of-prostate-cancer-screening/article_26a6a3fb-305d-5af8-aed6-bca29bfe64c8.html","canonical":"http://news.lee.net/lifestyles/health-med-fit/is-mri-the-mammography-of-prostate-cancer-screening/article_11ba0d02-34ce-5aef-b504-a08af7ad577f.html","relatedAssetCounts":{"article":0,"audio":0,"image":1,"link":0,"vmix":0,"youtube":0,"gallery":0},"byline":"By Steven ReinbergHealthDay Reporter","prologue":"SATURDAY, March 25, 2017 (HealthDay News) -- MRI screening might greatly reduce overdiagnosis and overtreatment of prostate cancer in older men, a preliminary study suggests.","supportsComments":false,"commentCount":0,"keywords":["cancer: prostate","health costs","imaging devices","mri scans","prostate problems","screening","mri","medicine","radiology","oncology","biopsy","prostate cancer","anatomy","arnout alberts","wire"],"internalKeywords":["#lee"],"customProperties":{},"presentation":null,"images":[{"id":"b7e69283-a421-5108-9e0f-c6d07e177d73","description":"","byline":"","hireswidth":null,"hiresheight":null,"hiresurl":null,"presentation":null,"versions":{"full":{"type":"image/jpeg","width":"800","height":"600","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/b/7e/b7e69283-a421-5108-9e0f-c6d07e177d73/58d74e5e2e2a5.image.jpg?resize=800%2C600"},"100": {"type":"image/jpeg","width":"100","height":"75","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/b/7e/b7e69283-a421-5108-9e0f-c6d07e177d73/58d74e5e2e2a5.image.jpg?resize=100%2C75"},"300": {"type":"image/jpeg","width":"300","height":"225","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/b/7e/b7e69283-a421-5108-9e0f-c6d07e177d73/58d74e5e2e2a5.image.jpg?resize=300%2C225"},"1024":{"type":"image/jpeg","width":"1024","height":"768","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/b/7e/b7e69283-a421-5108-9e0f-c6d07e177d73/58d74e5e2e2a5.image.jpg"}}}],"revision":2,"commentID":"26a6a3fb-305d-5af8-aed6-bca29bfe64c8","body":"

SATURDAY, March 25, 2017 (HealthDay News) -- MRI screening might greatly reduce overdiagnosis and overtreatment of prostate cancer in older men, a preliminary study suggests.

Compared to the current screening method, MRI can reduce overdiagnosis of prostate cancer by 50 percent, and unnecessary biopsies by 70 percent in men over 70, Dutch researchers reported Saturday at a conference in England.

Prostate cancer is common in aging men, but it's often slow-growing and non-threatening.

Screening sometimes begins with a blood test to measure the level of PSA (prostate specific antigen). If elevated, it might indicate cancer. So, the next step is a needle biopsy, where a doctor takes multiple samples from the prostate and has them tested for cancer.

Because PSA testing is an inexact science, \"the benefit of early prostate cancer detection with random biopsy generally does not outweigh the harm induced by screening,\" particularly in men 70 and older, said lead researcher Dr. Arnout Alberts.

These harms can include unnecessary radiation and surgery, explained Alberts, who is in the urology department at Erasmus University Medical Center in Rotterdam, the Netherlands.

However, some elderly men may benefit from early detection, \"and the use of MRI scans significantly reduces the harms and drawbacks of screening,\" he said.

For the study, Alberts and colleagues focused on 335 men, aged 71 and older, who had elevated blood PSA levels.

To determine who did and did not have prostate cancer, the investigators took six biopsy samples from the prostates of 177 men. Another 158 men had 12 samples taken, plus an MRI scan of their prostate before the biopsy.

If the MRI revealed a potentially cancerous area, then further MRI-targeted biopsy samples were taken, Alberts explained.

The research team found that biopsies using either six or 12 samples were, in most cases, able to detect serious cancers.

However, Alberts' team found that 70 percent of the men in the study would not have needed biopsies at all if MRI had been used beforehand, because no suspicious areas showed up on their scans.

Although MRI is more expensive than PSA testing, it could save money in the long run, in much the same way that mammography breast cancer screening has paid off for women, the researchers suggested.

One specialist, however, doesn't think MRI is the answer to the prostate cancer screening controversy.

\"There is not enough data to say MRI is a home run, and there is not enough data to say it is cost-effective,\" said Dr. Anthony D'Amico, a professor of radiation oncology at Harvard Medical School in Boston.

Data from other institutions shows that MRI finds only 80 percent of severe cancers and misses 50 percent of the other high-grade cancers, D'Amico said.

\"So having a negative MRI doesn't mean that you don't have aggressive prostate cancer,\" he added.

Alberts countered that a larger trial has started, with 40,000 men randomly selected for MRI screening at various PSA levels or for no screening.

\"This trial will hopefully further elucidate the role of MRI in prostate cancer screening,\" he said.

D'Amico believes the only way to know for sure if MRI effectively screens for prostate cancer is to scan thousands of patients and remove their prostate to analyze the type of cancer.

\"This would need to be done before we could justify the cost of MRI, which could be several thousand dollars, as opposed to a PSA, which is in the $50 to $70 range,\" D'Amico said.

D'Amico said MRI might be of value in certain cases, however.

\"If you have a high PSA and you have biopsies and they are all negative, consider MRI, not for screening, but because you probably have a cancer that has gone undetected,\" he said. \"But if you don't have a high PSA, we shouldn't be using MRI as a substitute for PSA.\"

The study results were scheduled for presentation Saturday at a European Association of Urology conference in London. Findings presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

More information

For more about prostate cancer, visit the American Cancer Society.

"}, {"id":"cbc5c1fc-97ab-55c9-9e69-56e297ec9d81","type":"article","starttime":"1490446800","starttime_iso8601":"2017-03-25T08:00:00-05:00","lastupdated":"1490505376","priority":0,"sections":[{"health-med-fit":"lifestyles/health-med-fit"}],"flags":{"ap":"true"},"application":"editorial","title":"How Doctors Decide to Treat a Ruptured Achilles","url":"http://qctimes.com/lifestyles/health-med-fit/article_cbc5c1fc-97ab-55c9-9e69-56e297ec9d81.html","permalink":"http://qctimes.com/lifestyles/health-med-fit/how-doctors-decide-to-treat-a-ruptured-achilles/article_cbc5c1fc-97ab-55c9-9e69-56e297ec9d81.html","canonical":"http://news.lee.net/lifestyles/health-med-fit/how-doctors-decide-to-treat-a-ruptured-achilles/article_53b127a3-9540-5b3c-84ab-4ffa35bfc4fc.html","relatedAssetCounts":{"article":0,"audio":0,"image":1,"link":0,"vmix":0,"youtube":0,"gallery":0},"prologue":"SATURDAY, March 25, 2017 (HealthDay News) -- Whether your doctor recommends surgery for a ruptured Achilles tendon may depend partly on your age and activity level, foot experts say.","supportsComments":false,"commentCount":0,"keywords":["bone / joint / tendon problems","sports medicine","surgery: misc.","achilles tendon","anatomy","medicine","patient","treatment","rupture","jeffrey mcalister","surgeon","michael vanpelt","wire"],"internalKeywords":["#lee"],"customProperties":{},"presentation":null,"images":[{"id":"080a72dd-bcc7-5c21-bbb1-a9855b23e4da","description":"","byline":"","hireswidth":null,"hiresheight":null,"hiresurl":null,"presentation":null,"versions":{"full":{"type":"image/jpeg","width":"800","height":"600","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/80/080a72dd-bcc7-5c21-bbb1-a9855b23e4da/58d74e5edcd2b.image.jpg?resize=800%2C600"},"100": {"type":"image/jpeg","width":"100","height":"75","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/80/080a72dd-bcc7-5c21-bbb1-a9855b23e4da/58d74e5edcd2b.image.jpg?resize=100%2C75"},"300": {"type":"image/jpeg","width":"300","height":"225","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/80/080a72dd-bcc7-5c21-bbb1-a9855b23e4da/58d74e5edcd2b.image.jpg?resize=300%2C225"},"1024":{"type":"image/jpeg","width":"1024","height":"768","url":"http://bloximages.chicago2.vip.townnews.com/qctimes.com/content/tncms/assets/v3/editorial/0/80/080a72dd-bcc7-5c21-bbb1-a9855b23e4da/58d74e5edcd2b.image.jpg"}}}],"revision":2,"commentID":"cbc5c1fc-97ab-55c9-9e69-56e297ec9d81","body":"

SATURDAY, March 25, 2017 (HealthDay News) -- Whether your doctor recommends surgery for a ruptured Achilles tendon may depend partly on your age and activity level, foot experts say.

The Achilles tendon is a band of tissue that runs down the back of the lower leg and connects the calf muscle to the heel bone. A rupture is a complete or partial tear of the tendon that leaves the heel bone separated or partially separated from the knee.

Length of recovery from this type of injury varies depending on whether a patient undergoes surgical or nonsurgical treatment.

\"Treatment processes are dependent upon a patient's overall health, activity level and ability to follow a functional rehabilitation protocol,\" said Dr. Jeffrey McAlister, a foot and ankle surgeon in Sun City West, Ariz.

Advances in treating Achilles tendon rupture were discussed by McAlister and other specialists at a recent meeting of the American College of Foot and Ankle Surgeons, in Las Vegas.

Typically, less active and unhealthy patients receive nonsurgical treatment, since they are not trying to return to active sports, McAlister said in a college news release. But this approach usually involves a long rehabilitation/recovery period (9-12 months). Also, these patients may be at increased risk of potentially dangerous blood clots due to inactivity during this period.

\"For more athletic and younger patients, the surgical option may be best,\" said Dr. Michael VanPelt, a Dallas foot and ankle surgeon. \"We anticipate these patients have shorter healing times.\"

But because there is low blood flow to the Achilles tendon, healing after surgery can be tricky.

\"Advances in surgical techniques to repair Achilles tendon ruptures include limited incision, or smaller incision, surgical approaches to help patients have smaller scars, and less of a chance of wound complications,\" said Dr. Jason Kayce, a Phoenix foot and ankle surgeon.

More information

The American Orthopaedic Foot and Ankle Society has more on Achilles tendon rupture.

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