Health Headlines

Pornpak Khunatorn/iStock(NEW YORK) -- This year's flu shot isn't an exact match for the flu strain that's been circulating most widely, but that doesn't mean you shouldn't get it, health experts say.

"The influenza vaccine protects against various strains, three or four, depending on which vaccine you receive," said Dr. William Schaffner, medical director for the National Foundation for Infectious Diseases.

Early 2019-2020 flu activity was primarily driven by influenza B/Victoria viruses, which the vaccine is not a great match for. Now that flu activity is changing, "We’re now experiencing an increase in A/H1N1," Schaffner said.

"It looks like we’re having a second wave. The vaccine is exactly on target against this strain," he added.

In general, influenza B is more common in children, while influenza A, also known as H1N1, is more commonly seen in older adults, according to Dr. Jessica Grayson, an assistant professor at the University of Alabama at Birmingham.

So far, 6,600 people have died and 120,000 people have been hospitalized during the 2019-2020 flu season, according to preliminary estimates the Centers for Disease Control and Prevention released Friday.

Of those deaths, 39 were children, a group that's particularly vulnerable to the flu and its complications.

During recent past flu seasons, deaths among children have ranged from 37 to 187 fatalities.

"The flu season began early this year and took off aggressively," said Schaffner.

"It began prominently in the southeastern states but quickly spread," he said. "So far, there is no sign that the momentum of the annual epidemic is slowing."

The highest flu activity is decreasing and is now clustered in 34 states, including much of the southern and western parts of the country as well as New York City and Puerto Rico.

In total, the CDC estimates that 13 million people have gotten the flu so far this season.

It remains too early to say how severe this flu season will be or how long it will last.

Typical symptoms of the flu include fever, sore throat, aches, chills and sweats, and fatigue, according to the Mayo Clinic.

While the flu might seem like a relatively minor disease because it's so common, complications from the flu, which can include pneumonia, bronchitis, asthma flare-ups and heart problems, can be deadly.

People with weakened immune systems, adults older than age 65 and babies are all at a higher risk of contracting the flu.

If you experience flu symptoms, Grayson recommends staying home from work and other public places to avoid transmitting the disease to others. Wash your hands often and avoid others who are ill.

"Before going to your doctor's office, call," Grayson said. "They may have a different waiting room for those who are sick."

Getting vaccinated against the flu is the best way to protect against the disease, experts say.

Receiving the vaccine earlier in the season is preferable, because the vaccine takes about two weeks to kick in, but even partial protection against the flu can ward off the worst symptoms and make the duration of the disease less severe.
 
"It's not too late to get vaccinated," Grayson stressed. "We still have a lot of flu season left."

Guidelines for children are slightly different than they are for adults, according to the CDC. The agency is now recommending that some children between the ages of 6 months and 8 years old get two doses of the vaccine, spaced at least four weeks apart. The child's doctor or health care provider should determine whether he or she needs a second dose for the best possible protection against the flu.

Despite those recommendations, however, many Americans mistakenly believe that the flu vaccine doesn't work or has side effects. (Apart from soreness at the needle's injection site, there are no notable side effects linked to the flu vaccine.)

Partly because of these misconceptions, only half of Americans reported that they planned to get the flu vaccine this year, according to a survey conducted by the National Foundation for Infectious Diseases this summer.

In addition to the flu vaccine, there are four Food and Drug Administration-approved antiviral drugs that the CDC recommends for treating the flu.

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CatLane/iStock(SALT LAKE CITY) -- An HIV campaign in Utah was suspended over raunchy condom packaging it featured, according to the state's health department.

Condom wrappers had taglines that Gov. Gary Herbert deemed inappropriate, prompting him to urge the Department of Health to stop distributing them, spokeswoman Jenny Johnson, of the health department, told ABC News on Friday.

The taglines included quips such as "Explore Utah's caves," "This is the place" and "Enjoy your mountin.'"

Herbert's office said in a statement to ABC News the Republican governor understands the importance of a campaign aimed at educating the public on HIV awareness.

"He does not, however, approve the use of sexual innuendo as part of a taxpayer-funded campaign, and our office has asked the department to rework the campaign’s branding," the statement read.

Johnson told ABC News that the campaign is currently on hold while organizers examine all of the featured branding.

The condoms were sent out to local partners, who would then give them out to individuals at a high-risk for HIV, according to Johnson.

She and her team are now scrambling to get some 42,000 condoms back. They will not take the condoms from individuals who were already given them, but are taking them back from the local partners.

She said the HIV campaign itself is much bigger than just the condoms and was an effort to help high-risk individuals and better educate the public.

Johnson said she hopes by next week all of the campaign assets will have been reviewed and the campaign can proceed shortly after that.

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Peopleimages/iStock(ATLANTA) -- The number of drinks Americans are consuming per bingeing episode has increased dramatically, according to a new study.

The annual number of binge drinks among adults who reported binge drinking jumped on average from 472 in 2011 to 529 in 2017, a 12% increase, according to the study published Thursday by the U.S. Centers for Disease Control and Prevention (CDC).

Binge drinking is defined by the CDC as a "pattern of drinking that brings a person’s blood alcohol concentration to 0.08 grams percent or above."

That typically means consuming five or more drinks in a two-hour period for men and four or more drinks in a two-hour period for women, according to the CDC.

One in six adults in the U.S. binge drinks about four times a month, consuming about seven drinks per binge, and binge drinking is twice as common among men than among women, according to the CDC.

In the latest study, the CDC found that increases in binge drinking were most prominent in people over the age of 35 and those with lower educational levels and household incomes.

Drinking a steady amount of alcohol in a short amount of time has a different impact on your body than drinking, for example, one glass of wine each night over the course of one week, according to Dr. Jennifer Ashton, ABC News chief medical correspondent and a board-certified OBGYN.

"If you look at the effects of alcohol in a short-term, acute period, there can be memory blackouts, there can be accidents -- we’re talking about things from falls, burns, motor vehicle accidents, even homicides -- increase in risky behavior, like sexual behavior and acute tissue damage, mostly to the liver," she said Friday on "Good Morning America." "This is a significant issue and so our radar is up to take a look at it."

Ashton stressed the importance of "self-awareness" for people who consume alcohol.

For women, a moderate alcohol intake per week is defined as seven servings of alcohol or less. For men, it is 14 servings of alcohol or less per week, according to Ashton.

One serving of alcohol is defined as five ounces for wine and just one-and-a-half ounces for hard alcohol, far less than what is typically served in bars, restaurants and people's homes.

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HAKINMHAN/iStock(NEW YORK) -- A few weeks into January can be a time New Year's resolutions starts to die.

Jan. 17 has even become known as "Ditch New Year's Resolutions Day" because it's such a common time for resolutions to slowly fade away.

If you find yourself in that grind, it's not too late to reset, according to Dana Cavalea, author of Habits of a Champion.

Cavalea trained some of the world's top athletes, including Derek Jeter, Alex Rodriguez and Mariano Rivera, in the 12 years he spent as the New York Yankees' performance coach.

Here, in his own words, are Cavalea's four tips to keep your resolutions going and make this your best year yet.

Tip #1: Connect your goal to something bigger


Resolutions almost never work without a true commitment to something greater than vanity goals like making X more money or losing that 10 to 20 pounds you most desire.

You must create links and associations to those goals you desire.

Meaning: I am sluggish and tired most days. I am tired of being sluggish and tired since I know it is costing me my raise at work, the desire to exercise and get fit and the energy to play with my children.

So, if I start eating well, exercising even 20 minutes each day and drinking more water, I will then not be sluggish and tired most days.

This translates consciously and subconsciously, too: By taking care of myself each day, I will have more energy, and as a result, I will work harder, be more productive, feel healthier, get that raise and lose that stubborn 20 pounds.

Just saying you want to lose weight or make more money and not connecting it to anything bigger never works. You must always link your goal to something bigger than just you.

Tip #2: Focus on one goal


We can only focus on one goal and one to two actions at a time max.

For example, say your singular health goal is, "I want to lose 10 pounds over the next 90 days."

Action one is, "I am going to do cardiovascular exercise Monday through Friday for 20 to 30 minutes before work."

Action two is, "Monday through Friday, I will not eat starch and sugar-based carbohydrates like bread, muffins and baked treats."

After 90 days, you will continue doing what you have been doing for your physical health goal, and use the same process again to work on your next set of goals (possibly career, business, family, relationships or faith).

Tip #3: Start with a health goal


I always believe in starting with health goals because if you feel better and look better, you will have the energy and excitement to do more. You will feel so energized and proud of yourself that you will be ready to take on the next set of goals.

Remember, nothing happens over night. Stay patient. The results will showcase themselves with consistent behaviors.

Tip #4: Remember these four steps


These are the steps that will take you places you have been dreaming of:

1. Plan for success by determining what it is you most desire and creating clear associations and action steps.

2. Schedule your daily actions (similar to the above example where Monday to Friday you will do your morning cardio and stay starch and sugar free).

3. Do it. Take action on those action steps daily. Do not miss your scheduled action. If something comes up and you have to miss it, make up for it on the weekend. Without consistent action, you will never form the habits you need to become a true goal-setting, resolution achieving champion.

4. Celebrate it. Not just the big victory, but each day that you take action. We love rewards. For many of use, just telling ourselves we did a great job and stuck with the plan is enough. We have to be our biggest fan. Celebrate the process, since the process gets us closer each day to our desired outcomes.

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smolaw11/iStock(TOKYO) -- Japan on Thursday reported its first case of a new coronavirus, which has infected 41 people in China, sparking concern about the virus's potential to spread during Chinese New Year next week, when millions are expected to be traveling.

"Considering global travel patterns, additional cases in other countries are likely," the World Health Organization said.

The patient in Japan, a man in his 30s, had traveled to Wuhan, China, but had not visited the city's large seafood market that's been linked to many coronavirus cases.

The patient was treated and discharged from the hospital, Yoshihide Suga, Japan's chief cabinet secretary, said at a news conference Thursday.

It's the second case of the new virus that's been reported outside of China this week. The virus, which has not previously been identified in humans, is part of the same family of viruses as SARS, MERS and the common cold. On Monday, Thailand reported a case of the new coronavirus in a Chinese tourist from Wuhan in her 60s who was hospitalized Jan. 8.

The market in Wuhan was shut down and disinfected Jan. 1, but new cases of the virus have appeared since then suggest that the risk of disease transmission is not over.

The cases outside of China make it even more important to identify the source of the virus and how widespread it might be, explained Anthony Fehr, an assistant professor of molecular biosciences at the University of Kansas, where he researches coronaviruses.

SARS, a severe type of coronavirus, "mutated while spreading through the wet animal markets, which allowed it to better transmit between people," Fehr said.

A six-month long SARS outbreak in southern China in 2003 sickened more than 8,000 people and killed 774, according to the Centers for Disease Control and Prevention.

"While a mutation event like this would be rare, it is important to stop the spread before that could happen," Fehr warned.

While WHO maintains that there's no "clear evidence of sustained human-to-human transmission" of the new virus, the organization also struck a cautious note, based on the news that neither the patient in Japan, nor Thailand, had visited the seafood market associated with the outbreak.

"The fact that some cases do not seem to be linked with the Huanan seafood market means we cannot exclude the possibility of limited human-to-human transmission," WHO said.

Another concern is that the new virus might not be isolated to one market in Wuhan, explained Dr. Stanley Perlman, a professor of microbiology and immunology at the University of Iowa, who has done research on both SARS and MERS.

"The concern is as much about the outbreak in Wuhan as is is about the virus being in bats in other wet markets in China," Perlman said, noting that there are lots of different coronaviruses circulating among bats in south and east China.

"If it's like SARS and has the capability to change, you could imagine there being a greater outbreak," he added. "So far, there's no evidence of that."

For now, Perlman said, we should keep an eye on health care workers, a population that was at high risk for contracting SARS and MERS during those respective outbreaks. So far, there have been no reports of health care workers in Wuhan contracting the new virus.

Perlman's perspective on concerns about Chinese New Year travel was measured. Outside of advising tourists to the region to avoid wet markets, Perlman said he didn't think travel over the holiday would have much effect on the disease spreading.

"People get very worried about these things," he said. "But I probably wouldn't be worried at this point, especially with no evidence of human-to-human transmission."

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FatCamera/iStock(NEW YORK) -- New research shows for the first time that women's blood vessels, both large and small arteries, age at a faster rate than men's.

The findings, published Wednesday in JAMA Cardiology, challenge the long-held belief that vascular disease and cardiovascular risk in women lags behind men by up to 20 years, concluding that certain vascular changes in women actually develop earlier and progress faster in women compared to men.

"We were inspired to take a much closer look at blood pressure trajectories over the life course in women compared to men because, at the end of the day, the vast majority of cardiovascular disease processes tend to start with blood pressure elevation as a major driving risk factor," said Dr. Susan Cheng, director of public health research at the Smidt Heart Institute at the Cedars-Sinai Medical Center in Los Angeles, and senior author on the study.

The study looked at nearly 145,000 blood pressure measurements from more than 32,000 people, ranging in age from 5 to 98, over the course of four decades.

Researchers found that blood pressure started increasing in women as early as 30, and continued to rise higher than blood pressure in men throughout the women's life span.

"Our findings suggest that all the ways by which we think about and aim to prevent or treat high blood pressure likely needs to be more tailored, for women," Cheng said.

Krakoff, a cardiologist at The Mount Sinai Hospital, said the study highlights the importance of noting trends in your own blood pressure and monitoring it for a rise earlier in life.

"Lifestyle modifications such as regular exercise, eating a heart healthy diet, and avoiding smoking as well as excessive alcohol use are the first things women can do if a rise in blood pressure is seen," said Krakoff, who was not involved in the study.

Dr. Nieca Goldberg, a cardiologist and the medical director for the NYU Women's Heart Program and the senior adviser for women's health strategy at NYU Langone Health, said in an interview with ABC News, "In this country, only 20% of the women that have high blood pressure are controlled, which is sad since we have medications that are proven effective in controlling blood pressure."

One of the reasons Goldberg, who was not involved in the study, cited for patients not taking their blood pressure medications is that people stop taking them if their blood pressure improves. Treating blood pressure is not like treating a pneumonia or cough, patients must continue to take blood pressure medication for them to be effective.

"We need to be more vigilant, because when high blood pressure is treated it is a way of preventing other diseases, like stroke, heart attacks and heart failure," Goldberg said.

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Motortion/iStock(NEW YORK) -- We're taught the basics about the female body in sex ed. But after milestones for women like getting your period and giving birth, many women feel uninformed about the basics of their reproductive system -- especially as they age.

Just like aging is visible outside of your body, many don’t realize their internal organs are also going through a transition.

Dr. Jennifer Ashton, ABC News' chief medical correspondent, breaks down four things all women should know about their reproductive system.

"When we look down the road, it should be with optimism and understand that everyone will get through it," Ashton said. "Just like we all got through puberty."

Beyond the basics of the female reproductive system


First, it’s important to understand that the full female reproductive system is more than just the vagina and ovaries.

"We’re talking about the whole external and internal urogenital system," Ashton explained, which also includes the bladder, urethra and vulva.

Hormones cause the changes


The ovaries are responsible for the production of the hormones estrogen, progesterone and a portion of the body’s testosterone, all of which decrease as a woman approaches menopause.

Estrogen is a major hormone responsible for affecting change in a woman’s body.

"Everything in the pelvic, genital area is affected by a decrease in estrogen levels," Ashton said. "Dropping estrogen levels are responsible for hot flashes, vaginal dryness, weakening of bones -- you name it and estrogen is likely involved."

A decrease in estrogen levels in the pelvic and genital areas causes the tissues to become weaker and more fragile. This can make this region of the body more susceptible to injury and infection.

Meanwhile, a decrease in progesterone levels can affect mood and also lead to memory loss, while a decrease in testosterone can be related to a decrease in a woman’s libido.

"A lot of people don’t realize that women have testosterone as well," Ashton said. "That drop in testosterone level in a woman is responsible for the dreaded, 'I don’t understand why I am gaining weight while I’m still exercising and eating well.'"

Pelvic organs can prolapse


As the strength and elasticity of muscles in the pelvic region decrease, problems such as incontinence and prolapse of pelvic organs, such as the bladder, uterus and rectum, may occur. A prolapse is when organs fall down or slip out of place.

"Any of those organs can prolapse or protrude through the vagina, in most severe cases, outside of a woman’s body, but most of the time just into the vagina," Ashton said.

Women who have had many vaginal deliveries can be at higher risk of pelvic organ prolapse, but chronic coughing and obesity are also associated causes. Though women of any age can experience issues related to a weak pelvic floor, it is more common in older women.

"The most common symptom is the sensation of pressure," Ashton explained. "Some women will feel a lot of pelvic pressure and some women might have to urinate more frequently."

She notes that medical devices, such as the Yarlap, can strengthen and tone pelvic floor muscles, helping women regain control over their bladder and work to prevent pelvic organ prolapse.

"One thing women should focus on is the importance of the pelvic floor when it comes to the reproductive system," MaryEllen Reider, co-founder of Yarlap, said. "It’s a muscle that hasn’t gotten a lot of recognition and women shouldn’t be ashamed to talk about any issues."

Embracing menopause


Menopause is defined as one year without a menstrual period.

According to the Mayo Clinic, menopause can happen in women in their 40s or 50s, but the average age is 51 in the U.S. Ashton explained that factors such as family history, smoking and medical conditions can affect the age when a woman begins through menopause.

Common symptoms leading up to menopause include mood swings, memory loss, hot flashes, an increase in body fat, a decrease in bone density and irregular vaginal bleeding, but not all women will experience all of the symptoms.

"In some women, as they approach menopause, their period will just fade off into the sunset and bleeding will completely stop," Reider said. "In other women, bleeding can become more irregular. In some cases, heavier and closer together. There is really no way to predict, it's very individual."

Although menopause is something many women dread, Ashton said women have something to look forward to.

"For many women it might feel like the worst thing ever, but there are treatments and ways to manage it," she said. "Women are now living a third of their life after menopause and those can be really vital and vibrant years."

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Jacob Wackerhausen/iStock(NEW YORK) -- Women with more active sex lives may experience menopause later in life, according to the results of a 10-year study.

Published by the Royal Society Open Science, the study showed that women who reported weekly physical intimacy over a decade were about 28% less likely to experience menopause than women who reported less-than-monthly sexual activity.

The reason may be because "ovulation requires a lot of energy, and it has also been shown to impair your immune function. From an evolutionary standpoint, if a person is not sexually active it would not be beneficial to allocate energy to such a costly process," said Megan Arnot of the University College of London, the study's lead author.

"Doctors have long known that there were many benefits from continued sexual activity," said Dr. Jennifer Wu, a New York-based OBGYN who didn't participate in the project. "This study highlights a new finding: Women who do not engage in regular sexual activity go through menopause at an earlier age. With the earlier onset of menopause, patients experience more loss of bone and adverse cholesterol profiles."

The study doesn't explain the exact connection between sex and menopause, but it illustrates a possible association. Further studies would be required to establish stronger links.

The study began with a look at approximately 3,000 women -- 46% were peri-menopausal, meaning they had some symptoms, and 54% were pre-menopausal, meaning they had no symptoms. Over the 10-year study, 45% of the women began menopause, at an average age of 52.

The women studied were described as having sex weekly, monthly or less than month. Sex was defined as intercourse, oral sex, touching or caressing, or self-stimulation.

"It's the first time a study has shown a link between frequency of sex and onset of menopause," Arnot added. "We don't want to offer behavioral advice at this point at all. These results are an initial indication that menopause timing may be adaptive in response to the likelihood of becoming pregnant. More research will need to be done in the future."

Menopause often happens when women are in their mid-to-late 40s or early 50s. It occurs when the ovaries stop producing estrogen and progesterone, and menstrual cycles stop for 12 months. Many women experience hot flashes, fatigue, headaches or abdominal cramps. Some experience emotional difficulties as well.

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Valeriya/iStock(NEW YORK) -- While the Affordable Care Act ushered in huge improvements in access to health care for black and Hispanic adults in the United States, that progress appears to have stalled, according to new research.

Between 2013 and 2016, the uninsured rate dropped from 24.4% to 13.7% among black adults, and from 40.2% to 25.5% among Hispanic adults, according to a report published Thursday by the Commonwealth Fund, a nonprofit research foundation. Uninsured white Americans dropped from 14.5% to 8.2% during the same period.

Those gains narrowed the gap in insurance coverage between Americans of color and white Americans until 2016. Beginning that year, that progress came to a halt, with the gap increasing slightly for blacks and only decreasing slightly for Hispanics by 2018.

The study examined federal survey data between 2013 and 2018 from adults ages 18 to 64, to determine how the ACA affected racial and ethnic disparities in health care.

"Historically, black and Hispanics in the U.S. have been far less likely to have health insurance," said Sara Collins, vice president of health care coverage and access at the Commonwealth Fund. She pointed to the changes in insurance rates since the ACA went into effect, which made it easier for people, especially low-income Americans, to get health care.

While disparities between black and white adults decreased, there's been "no improvement in this gap since 2016," she stressed.

That turning point can be linked to in part to congressional inaction, according to the researchers. Since 2010, there's been no federal legislation to enhance the health care law and myriad efforts to dismantle it. Weakening efforts include repealing the individual mandate penalty for having health care coverage and loosening restrictions on plans that don't comply with ACA guidelines.

In addition to examining the rate of uninsured adults, a key measure of health care access, the researchers also looked at Americans who went without health care because of cost during the previous year, as well as whether or not survey respondents said they had a regular health care provider.

In both cases, the researchers found improvements in the years after the ACA was implemented. Fewer adults in every racial group reported avoiding health care because of high costs between 2013 and 2018, and more adults reported having a regular health care provider during the same time frame. Similar to insurance rates, however, adults reporting consistent provider care tapered off after 2016, and by 2018 had decreased slightly.

One key driver of what Collins called "historic improvements" in health care access was Medicaid expansion under the Affordable Care Act. But while all states had the option to expand the program, many have chosen not to do so.

In states that did expand, black and Hispanic Americans benefited the most of any racial group, the report found. In turn, in states that did not expand their Medicaid programs, those groups suffered more from the decision. Expanded Medicaid isn't available to "nearly half of black adults and more than a third of Hispanics," who disproportionately live in non-expansion states, according to the report.

"This means that the failure to expand Medicaid in the remaining 15 states has a larger impact on black and Hispanic populations," said Jesse Baumgartner, a research associate at the Commonwealth Fund.

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(IDAHO FALLS, Idaho) -- Two Idaho teachers have come up with an eye-opening way to remind students to wash hands during flu season.

Last month, Jaralee Metcalf, a behavior specialist at Discovery Elementary School in Idaho Falls, posted the aftermath of a science project which taught kindergarten through sixth graders the importance of cleanliness.

Metcalf, special education teacher Dayna Robertson and the kids put single slices of bread into bags. The slices were either touched by students with dirty hands, touched with hands washed with soap and water or doused with hand sanitizer.

One slice was wiped on classroom laptops. In a matter of days, mold began forming on some of the bread.

Metcalf posted the results of the experiment onto Facebook, where it was shared 69,000 times. The CDC has estimated at least 9.7 million flu-related illnesses this season.

Metcalf said she got the idea from a similar experiment on Mystery Science, an education website.

"It's important because of all the illnesses that are so easily transmitted," Metcalf said of the learning experience. "It's gross and handwashing can help prevent."

And she's not the only educator to try it out. An elementary school teacher shared the results of her class' bread experiment, which went viral five years ago.

"It is so cool and a great way to teach the importance of hand washing," the teacher wrote in a Facebook post.

According to the CDC's handwashing campaign, there are five steps to washing your hands the right way to prevent the spread of germs.

1. Wet your hands with clean running water, turn off the tap and apply soap.
2. Rub your hands together with the soap. Lather the backs of your hands, between your fingers and under your nails.
3. Scrub your hands for at least 20 seconds. For a timer, the CDC suggests humming the "Happy Birthday" song from beginning to end twice.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel or air dry.

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jittawit.21/iStock(NEW YORK) -- It's been a persistent question on the campaign trail and during debates, whenever presidential hopefuls Sen. Elizabeth Warren, D-Mass., and Sen. Bernie Sanders, I-Vt., tout their respective Medicare for all plans: How much is this going to cost?

The Warren campaign priced her plan at an eye-popping $52 trillion over the next decade. Sanders' approach would cost $34 trillion over the same period, according to the Urban Institute, a public policy think tank.

While those steep price tags may spook some voters, new research, which analyzed nearly two dozen national and state-level single-payer health care proposals made over the last 30 years, suggests that single-payer plans are projected to save the country money over time, many in their first year after being implemented.

"If we're spending less as a country and covering more people, more people are going to benefit," said Christopher Cai, lead author of the study and third-year medical student at the University of California, San Francisco.

While his study didn't examine Warren or Sanders' plans, or speak to specifics of how their respective financing and taxes would be calculated, "you can imagine that if we're paying less as a country, on average, people would be paying less," Cai said.

To come to this conclusion, Cai and his coauthors reviewed 22 single-payer proposals from 18 studies, published between 1991 and 2018, including eight national plans and 14 plans from states like Massachusetts, California, Maryland, Vermont, Minnesota, Pennsylvania, New York and Oregon. Of those 22 plans, 19 predicted health care cost savings in the first year of program operation.

"I think that's a testament to the waste currently in our health care system," Cai said of the potential savings after one year of single-payer implementation.

Twenty plans -- more than 90% of those evaluated -- predicted savings over several years -- with savings accumulating over time.

The bulk of those savings would come from streamlining health care administration costs, according to the study, with additional savings coming from lowering drug prices and reducing provider reimbursements.

According to a study published last week in the Annals of Internal Medicine, administration costs now make up 34% of U.S. health care expenditures, with the country spending roughly $2,500 per person. In comparison, Canada, which has a single-payer health care system, spends roughly $550 per person on health care administration, the study found.

One limitation of Cai's research, published in the journal Plos Medicine Wednesday, was that there was so much variation in funding sources, political motivations and methodological rigor among the different studies it analyzed, which made comparing them more difficult.

Other analyses of single-payer plans in recent months have come to different conclusions about health care spending.

An October analysis by the Commonwealth Fund found that a single-payer health care system, which included all Americans, including undocumented ones, would grow health care spending by about $720 billion in 2020. A less generous, single-payer "lite" option, which included cost-sharing for out-of-pocket expenses based on income level, and which did not include coverage for undocumented people, would lower health care costs by $210 billion in 2020.

John Holahan, a fellow in the health policy center at the Urban Institute, who coauthored the Commonwealth Fund report, was skeptical that such savings could be easily achieved, especially over a short period of time.

"This would be fought tooth and nail by drug manufacturers," he said, noting that many countries with single-payer health care, like Canada, started their programs 50 or 60 years ago. "They're not used to getting the money our providers get," he said.

"Our view is that it just wouldn't be feasible," he added.

Then there's the problem of people who currently work in health care administration jobs, such as health care billing, losing their jobs under a single-payer system.

"We build in to our Medicare for All program a transition fund of many, many billions of dollars that will provide for up to five years income and health care and job training for those people," Sanders said during the Jan. 14 Democratic debate, when asked how his single-payer plan would affect the health insurance industry.

In Cai's opinion, it's important to keep those lost jobs and high overall price tags in perspective. "There's pretty strong evidence that moving to a Medicare for all, single-payer system would save money," he said.

"But a lot of the information out there would make you think the opposite. With any kind of reform, we should have an honest debate. We shouldn't be saying this is going to cost more when that's not what the evidence says."

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P_Wei/iStock(NEW YORK) -- Roderick Sewell had almost reached mile 26 of the grueling Ironman triathlon in Kona, Hawaii, when he felt himself starting to slow down.

That was until he heard the cheering from the crowd growing -- and when he realized that this moment was bigger than him.

It was the first time a bilateral above-knee amputee would complete the Ironman World Championship on prosthetic legs.

“I feel like the pressure of what this meant was enough to make me keep going,” Sewell told ABC News' Good Morning America.

His stomach was in knots as he raced through the last leg of the triathlon.

“If this was just about me, I know I might not have finished, but I know there’s kids out there that are watching, and their parents are wondering if their kid is going to be OK,” he said.

The 27-year-old completed a 2.4-mile open-water swim, a 112-mile bicycle ride and a marathon 26.2-mile run.

It was the first time the San Diego native ever competed in an Ironman.

As he crossed the finish line, his smile spread from ear to ear. Tears filled his eyes as he embraced his mother, Marian Jackson.

They had both come such a long way.

Growing up as an amputee

Sewell was born missing tibias in both of his legs, which prevented him from walking.

“It was either amputation or live life in a wheelchair. There was no stability,” Sewell shared.

“My mother, a single mother, decided to have my legs amputated, and she was terrified because she had never seen an amputee living a normal life,” he said. “She didn’t really see amputees, period.”

Jackson, like any other mother, fed her son and changed his diapers, but she couldn’t understand why her son cried. As he grew older, he experienced "phantom pain" where his legs had once been.

His mother decided that he needed prosthetic legs to help him live a better life.

A mother’s sacrifice to help her son

In order for her to afford the proper equipment for her son, she filed for unemployment after working for the Navy. She believed that the only way for her son to get full coverage for his legs was if she did not have an income.

His mother’s sacrifice helped him get his legs, but at 8 years old, the pair was homeless and had to move from shelter to shelter.

“I can only imagine what it was like for a parent to go through that with their child, who already has a situation that needs to be in a secure home,” Sewell said.

Despite criticism from family members about how she made "the wrong choice," Sewell said “it was the sacrifice she made and it worked.”

He said he and his mom were like "Bonnie and Clyde" and she constantly encouraged him to focus on going to school and staying active in sports.

“She says I was the best thing that happened to her, because in that time, when we were going through [homelessness], we met Challenged Athletes Foundation (CAF),” Sewell said.

CAF is an organization that raises funds for individuals around the world who have disabilities to compete in sports and live a healthy lifestyle.

The organization has raised money to get their athletes wheelchairs, adaptive bikes, prosthetic legs, blades and more.

CAF was able to help Sewell when he was 8 so he could participate in sports with others just like him.

“For [my mom] to be exposed to that world, and have something to give her hope and make her happy, and then see her son being active, smiling, she was good,” he said.

A love for sports

Sewell became hooked on everything CAF had to offer -- he did everything from handcycling to wheelchair basketball.

He even found a love for swimming, all thanks to Rudy Garcia-Tolson, the now Paralympic swimmer, who became Sewell's life-long friend and mentor.

“[Seeing him swim] and him being a double above-the-knee amputee, I knew there was no reason why I can’t do it,” Sewell, who has now been swimming for 12 years, said.

"Right away we had an instant connection," Garcia-Tolson told GMA. "Like we both knew you know the daily struggles that we that we have."

The pair has always held each other accountable.

"We never let our 'disability' become who we are," Garcia-Tolson said.

Every day, Sewell would go from the shelter to school and then practice.

Being involved in sports changed his life because he learned how he could “push past his limits.”

The journey towards Ironman

The Ironman World Championship is a high-endurance triathlon that has been held in Kona since 1978.

The mission of all those involved in Ironman is to give back on both a local and global scale.

Sewell heard about the triathlon through his fellow athletes involved in CAF, but he never considered doing it until Ironman asked him to participate in the Ironman World Championship in October 2019.

“I didn’t want to say no because I knew what it meant to CAF and our community. This is a big deal,” he said.

He knew the obstacles that he would face, including the heat and the wind, but he devoted himself to months of practice in the pool and on the bike.

The big day took place on Oct. 12.

“I couldn’t eat my food, my stomach was completely torn up,” Sewell said. “I’m kind of feeling the ground up to me, but I know I just gotta keep going forward.”

He finished at 16 hours, 26 minutes and 59 seconds, and was greeted by applause and joyful tears as he collapsed into his mother’s arms.

“This was a dream, for sure,” he said. “I've had people come up to me with legs, and they're like, 'You did a marathon? I don't even run a marathon!'”

His victory meant so much more than just winning a medal -- it meant showing others what is possible.

Now, his sights are set on preparing for the trials for the Paralympics in Tokyo later this year.

“Just because you have a disability, you don’t have to live your life disabled,” he said. “If [Ironman] didn’t teach me anything else, it’s that I literally can do anything I want.”

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vadimguzhva/iStock(NEW YORK) -- Suzanne Ryan weighed nearly 300 pounds when she decided to make a change.

Ryan, a mom from the San Francisco area, started following the ketogenic diet, a diet focused on foods high in fat and low in carbohydrates.

Five years later, Ryan, who documents her weight loss journey online, has lost 120 pounds and transformed not just her body but her life.

Ryan is the author of a new book Beyond Simply Keto. In it, she shares not only keto-friendly recipes but also how she was able mentally to achieve such a major weight-loss goal.

Read below for Ryan's three tips for keto followers:

1. Focus on your mindset and mental health.

"Even the most perfect plan will fall short if you don’t believe in your ability to succeed. The bottom line here is that getting healthier is an inside job. As someone who has struggled with low self-esteem and depression, working on my inner voice and mindset through reading and counseling was by far one of the most important steps in my journey of losing 120 pounds. Also, it’s really beneficial to have a support system that keeps you uplifted and accountable."

2. Progress not perfection. Ditch the all or nothing approach.

"It’s important to know that forming healthy eating habits will always be a work in progress. Therefore, try to stay away from the mindset of all of nothing. Even if you eat something that is "off plan," don't allow that one choice to landslide the rest of your choices for the day. Get back on track with your next meal, and leave the guilt trip at the door. Progress, not perfection is the goal here."

3. Keep it simple. Don’t overthink it.

"When you’re starting a new way of eating, it’s easy to go down a rabbit hole of learning all the things. While it’s good to be educated, sometimes this can feel overwhelming and prevent you from starting. Often, it’s better to keep things simple and just jump in. Don’t be afraid to make mistakes and learn along the way. You will continue to make adjustments as you go. For example, when I first started keto, I didn’t check my blood ketones or worry extensively about macros. I simply ate keto-friendly foods and tracked carbs."

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Kuzma/iStock(BOSTON) -- A former executive of Insys Therapeutics was sentenced Monday to nearly three years in prison as part of the first federal case meant to hold an opioids manufacturer criminally accountable for the ongoing epidemic in the country.

Former Insys Vice President of Managed Markets Michael Gurry, whose sentence was handed down by a federal judge in Boston, received less than the 11 years prosecutors sought for someone they said instructed underlings to lie to insurance companies about patient diagnoses so the insurers would cover the company’s highly addictive under-the-tongue fentanyl spray, Subsys.

Gurry, 56, will serve 33 months in prison, three years of supervised release and forfeit $3.6 million. He was convicted of racketeering conspiracy in May 2019.

Six other former Insys executives, including founder John Kapoor, face sentencing in the coming days.

"From May 2012 to December 2015, Gurry and his co-defendants conspired to bribe practitioners, many of whom operated pain clinics, in order to induce them to prescribe Insys’ fentanyl-based pain medication, Subsys, to patients, often when medically unnecessary," the government said in a press release announcing Gurry's sentencing.

Kapoor, Gurry and the others were charged with paying millions of dollars in bribes to doctors nationwide so they would over-prescribe Subsys.

Prosecutors have asked that Kapoor be put away for 15 years. The defense said he deserved no more than one year since he developed Subsys after watching his wife suffer and die from breast cancer.

At least two other drug distribution companies face criminal charges related to the opioids crisis but Insys is the first, and so far only, manufacturer.

The company filed for Chapter 11 bankruptcy in June 2019, one week after it agreed to pay $225 million to settle the federal government's criminal and civil investigations into the company's illegal marketing scheme of Subsys.

Insys was de-listed from the Nasdaq following the bankruptcy filing.

About 130 Americans die every day on average from an opioid overdose, according to the Centers for Disease Control and Prevention.

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nopparit/iStock(NEW YORK) -- A case of the mysterious new coronavirus strain was identified in Thailand, health officials said Monday, marking the first such known infection outside of China.

The patient, a tourist from Wuhan, China, was hospitalized in Thailand on Jan. 8, according to the World Health Organization, and is recovering there.

"The possibility of cases being identified in other countries was not unexpected, and reinforces why WHO calls for ongoing active monitoring and preparedness in other countries," WHO said in a statement.

While Chinese authorities initially reported 59 cases of the new virus, they've since adjusted that number to 41 confirmed cases. Of those cases, six are considered to be severe, and one patient, who had serious underlying medical conditions, according to WHO, died.

More than 700 close contacts are being monitored for signs of the disease.

Many of those affected worked in a large seafood market in Wuhan, where live animals were sold. The market has since been closed to investigate and sanitize the facility.

Last week, China released a genetic sequence of the new coronavirus, which is in the same family as SARS, MERS and the common cold.

Symptoms of the disease include difficulty breathing, fever and lesions on the lungs, which were revealed through chest X-rays.

"The genetic sequencing shared by China enables more countries to rapidly diagnose patients," WHO said.

For now, WHO is not issuing any travel guidance for Wuhan, a major transportation hub with a population of 11 million, that's 700 miles south of Beijing.

The organization noted that heavy travel is expected during Chinese New Year, beginning Jan. 25, which raises the risk of cases being reported outside of China.

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