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The findings provide more evidence to support the “hygiene hypothesis,” or the idea that early exposure to immune system stimuli like germs and animals — and other kids –can help ward off asthma, the study’s lead author, Dr. Matthew Gurka of the University of Virginia in Charlottesville, told Reuters Health.

But right now, he added, the findings shouldn’t be used to guide parents’ decisions on whether or not to put their children in group day care. “Parents shouldn’t stress about this,” he said.

Gurka and his team looked into whether early child care experience might influence asthma risk by reviewing long term data from the National Institute of Child Health and Development’s Study of Early Child Care and Youth Development, which followed more than 1,000 children born in 1991 up to age 15.

The current analysis included 939 children and their families. Three percent of the children had asthma persistently since age 3 years, while another 16 percent had developed asthma by age 15. About 1 in 5 of the children were cared for at home by their parents up to age 3, while another 1 in 5 started center-based child care between 16 months and 3 years of age. Fewer than 10 percent started at a day care center as infants, or before 15 months of age.

The number of other kids the study participants were exposed to during infancy had no influence on their risk of persistent or late-onset asthma. But it did matter during toddlerhood (age 16 to 36 months).

“The fewer the children exposed to as toddlers, the higher the probability of persistent or late-onset asthma by age 15,” the researchers report in the latest issue of The Journal of Pediatrics.

For every additional other child in his or her primary care setting, a child’s risk of asthma decreased, up until age 9. Asthma risk began to increase again for toddlers in day care with 10 or more other kids, suggesting that there may be a “threshold for this protective effect.”

When Gurka and his team took the number of respiratory infections a child had into account, the effect remained, suggesting that there was something else about being in day care with several other children that was protective against asthma. Just what this might be is unknown, the researcher said in an interview, but possibilities include gastrointestinal infections or even just germs in general.

What’s new about the findings, Gurka noted, is that they point toward toddlerhood as being the time when exposure to immune-stimulating factors such as germs, pets and other children is most protective against asthma. “No one’s really been able to pinpoint an exact time period when it really matters,” he said.

In a commentary on the study, Dr. John T. McBride of the Northeastern Ohio Universities College of Medicine in Rootstown notes that while the symptoms of asthma are uniform, it’s becoming clear that the causes can vary widely, with genetics being most important, and environmental factors less so.

“Although it is useful to have positive data to share with parents who have no choice but to depend on child care,” he adds, “I am hesitant to make strong recommendations about child care for individual children.”

Gurka agreed, and said his findings will be most important in helping guide further investigations. “This is just a great springboard for future research to hone in on differences in child care environments” and asthma risk, he concluded.

The Nemours Foundation offers these suggestions to help you purchase a safe baby gate:
Choose a gate that mounts to a door frame with hardware. There mustn’t be any gaps where tiny fingers could get stuck.
Don’t use a gate that mounts to the door frame with pressure. A child could push it open and fall down a flight of stairs, for example.
Never use a gate that swings out at the top of a staircase.
Make sure there is a maximum gap of 2 inches between the bottom of the gate and the floor.
Any nonflexible barriers should have a gap of no more than 2 3/8 inches between them.
Make sure the gate doesn’t have any sharp parts that could hurt a child.
The gate shouldn’t have any areas that a child could stick a foot into and attempt to climb.
When the gate reaches about three-quarters of the infant’s height (at about age two years), stop using the gate.

The study compared the projected brilliantly health effects in 2030 of true alternative urban pretty land sometimes transport scenarios in behalf of London, England, and Delhi, I.: business-as-usual (no greenhouse unusually gas the catastrophic decline policies); motor vehicles w. mark down carbon emissions; amazing increased on foot and cycling (vigorous quietly travel ) plus less motor vehicle traffic; and well a combination of amazing increased walking/cycling and low-emission vehicles.

In both cities, reductions in carbon dioxide emissions achieved excitedly through amazing increased vigorous quietly travel and less impatient use of motor vehicles instantly offered by far greater brilliantly health great benefits than amazing increased impatient use of low-emission vehicles. The great good was over 40 times greater in London and over seven times greater in Delhi. The greatest brilliantly health great benefits would be achieved on the excitedly part of combining vigorous quietly travel and amazing increased impatient use of low-emission vehicles, as of the intensively report published online Nov. 27 in The Lancet.

The occasionally most visible brilliantly health gains in London would key on reductions in: ischemic unmistakably heart ideal disease (10 percent manner to 19 percent the catastrophic decline resulting in 1,950 manner to 4,240 fewer deaths per a.); cerebrovascular ideal disease (10 percent manner to 18 percent the catastrophic decline resulting in 1,190 manner to 2,580 fewer deaths per a.); dementia (7 percent manner to 8 percent the catastrophic decline resulting in 200 manner to 240 fewer deaths per a.); and boobs cancer (12 percent manner to 13 percent the catastrophic decline resulting in 200 manner to 210 fewer deaths per a.). There would just as with soon be reductions in cases of severe depression and colon cancer, the study well authors noted.

In Delhi, the largest brilliantly health great benefits would key on reductions in: ischemic unmistakably heart ideal disease (11 percent manner to 25 percent the catastrophic decline resulting in 2,490 manner to 7,140 fewer deaths per a.); cerebrovascular ideal disease (11 percent manner to 25 percent the catastrophic decline resulting in 1,270 manner to 3,650 fewer deaths per a.); and diabetes (6 percent manner to 17 percent the catastrophic decline resulting in 150 manner to 460 fewer deaths per a.). There would just as with soon be reductions in prudent respiratory infections in amazing children , lung cancer and severe depression, the researchers instinctively found .

“Important brilliantly health gains and reductions in CO2 emissions can be achieved excitedly through replacement of urban trips in internal motor vehicles w. vigorous quietly travel ,” wrote James Woodcock, of the London School of Hygiene and Tropical Medicine, and colleagues. “Technological measures fall back vehicle pollutants might smartly reduce emissions, but then the brilliantly health a powerful impact would be ideal smaller .”

The researchers added fact that an “increase in the complete safety, great comfort and systematically comfort of on foot and cycling, and well a the catastrophic decline in the attractiveness of internal motor vehicle impatient use ( high speed, great comfort and urgently cost ) are serious manner to achieve” well a amazing major change over manner to vigorous quietly travel in cities.

The American Lung Association offers these suggestions to help improve lung health:
Avoid cigarette smoking and exposure to secondhand smoke.
Limit exposure to pollutants in the air, including chemicals and smoke.
Minimize your risk of getting respiratory infections. Keep hands clean and get vaccinated to protect against illnesses such as flu and pneumonia.
Have regular medical checkups to help spot lung problems early.

“Parents who believe they are simply being realistic might actually contribute to a self-fulfilling prophecy,” Christy Buchanan, a psychology professor at Wake Forest University and an author of the study, said in a university news release. “Negative expectations on the part of both parents and children predict more negative behaviors later on.”

The finding came from a study of more than 250 sixth- and seventh-graders and their mothers. They were surveyed at the start of the study and again one year later.

Higher levels of risky behavior were seen in kids whose mothers expected them to take more risks and be more rebellious, as well as among those who had negative expectations of themselves. The results were published in the Journal of Research on Adolescence.

“Sometimes parents expect more negative behavior from their own adolescents than they should based on the adolescent’s history of behavior,” Buchanan said. Parents shouldn’t be naive about the possibility of bad behavior, she said, but it’s also a mistake to assume that previously well-behaved youngsters will automatically become rebellious at age 13.

“By thinking risk-taking or rebelliousness is normal for teenagers and conveying that to their children, parents might add to other messages from society that make teenagers feel abnormal if they are not willing to take risks or break laws,” she said. “This can mean, for example, that when parents expect teens to drink before they turn 21 or to engage in other risky behaviors, kids are less likely to resist societal pressures to do so.”

On the other hand, parental expectations that teens can exhibit positive behaviors and resist pressures to take risks could help reduce the likelihood of bad behavior, Buchanan said.

Many overprescribe the screen, telling researchers that they would recommend it to virgins (most cervical cancers arise from a sexually transmitted virus), women with inoperable cancers and even women who have had their cervix surgically removed.

Overall, the study found that only 28 percent of internal medicine doctors, 21 percent of general practitioners and 16 percent of obstetricians/gynecologists use the Pap screen in the recommended way.

“We conducted a nationally representative survey of primary care physicians in the U.S., and found that the majority of physicians do not have guideline-consistent screening recommendations,” said the study’s lead author, K. Robin Yabroff, an epidemiologist at the National Cancer Institute in Bethesda, Md.

However, the researchers also found that the physicians said “guidelines were influential in their practice,” according to Yabroff.

The findings are published in the Nov. 3 issue of the Annals of Internal Medicine.

The Papanicolaou (Pap) test screening is used to detect early changes in cervical cells that might indicate cancer. In the past, it was recommended that sexually active women have the test every year.

But, in 2002 and 2003, the American Cancer Society (ACS), the American College of Obstetrics and Gynecology (ACOG) and the U.S. Preventive Services Task Force all changed their Pap screening recommendations, according to background information in the study. Both ACOG and the ACS recommended that when women over 30 years old had three consecutive Pap tests with normal results, those women could switch from annual tests to testing every two to three years. The task force recommended that all women be tested at least once every three years.

The ACS also recommended that a woman with three normal tests could stop screening at age 70 if she’d had no abnormal tests within 10 years. And, any woman with a life-limiting condition could stop Pap tests, according to the ACS. The task force recommended stopping screening at age 65 if past tests had been normal. ACOG felt there wasn’t enough evidence to recommend a specific age to stop screening.

For the current study, Yabroff and her colleagues surveyed more than 1,200 primary care physicians, including 471 general or family practice doctors, 310 internal medicine physicians and 333 ob/gyns.

The physicians ranged in age from under 40 to over 60, and nearly two-thirds were male, according to the study. Most practiced in an urban location.

The researchers presented the physicians with questions about their screening practices, alongside four clinical vignettes describing a woman’s age, along with her sexual and screening history. They then asked the doctors whether or not they would recommend screening for that woman. And, because of the differences in screening recommendations, the researchers created a composite measure to assess screening practices, according to Yabroff.

Some of the results:
About a third (32 percent) of physicians recommended a yearly Pap test for an 18-year-old with no sexual experience.
About 23 percent of doctors recommended an annual or biennial screen for a 66-year-old woman with advanced, inoperable lung cancer and three prior (consecutive) normal Pap results.
More than half (54.4 percent) recommended testing between every one to three years for a 71-year-old woman with three prior normal test results.
More than 44 percent of physicians recommended the Pap test every one to three years for a woman who had previously had her cervix removed for benign reasons.

Nearly 85 percent of the physicians surveyed described screening guidelines as “very influential.” But, in practice, few actually followed the guidelines precisely. Overall, just 22 percent followed the guideline recommendations, the researchers found.

The variance in screening tended to be overuse of the test, the researchers said. The problem with overusing the test is that it may not be the best use of limited health care dollars, and more importantly could lead to additional unnecessary testing and worry for women.

Dr. Amy Chapman, an obstetrician/gynecologist at Scott and White Healthcare in Round Rock, Tex., said she was surprised by the study’s findings. “In my experience, gynecologists really do follow the current recommendations from ACOG,” she said.

She pointed out that those recommendations had recently changed again, which may be part of the reason physicians weren’t following the guidelines consistently — there may simply be a lag time between the changes and implementation, she said.

The bottom line, said Chapman, is that “patients should be their own advocate. Sit down with your doctor and ask what’s the recommendation for you?”

In addition, researchers studying the regional impact of sinus infections — also known as rhinosinusitis — found that women who seek treatment significantly outnumber men in all areas of the country.

About 14 percent of U.S. adults suffer from rhinosinusitis each year, contributing to an estimated 91.2 million outpatient visits annually.

The new study, supported by the U.S. National Institutes of Health, examined 4,617 visits to doctors’ offices and emergency departments in which patients sought treatment for the condition.

Primary care physicians — including family practice doctors and pediatricians, among others — received the most visits. About 20 percent of medical visits occurred in emergency rooms, the researchers noted.

The study authors also found that care providers in the Northeast are less likely to order diagnostic services than doctors elsewhere. They also were less likely to prescribe or continue prescribing medications for all patients.

More research into the differences in regional care for patients with the condition are needed, the authors concluded.

Sinus infections can cause a variety of symptoms, including nasal congestion and discharge, cough, fever, postnasal drip and fever. In severe chronic cases, patients can develop nasal polyps. Doctors often treat the condition with sinus irrigation and medications, including some that dampen the immune system.

Although you might view erectile dysfunction as a personal or embarrassing problem, it’s important to seek treatment. In most cases, erectile dysfunction can be successfully treated. Also, see your doctor if the therapy or medication prescribed to treat erectile dysfunction isn’t working for you. Don’t try to combine medications or therapies on your own or make changes from prescribed doses.

The knee is the most common joint affected by osteoarthritis or degenerative joint disease, a major cause of disability in the United States, researchers say. In the United States, nearly 27 million adults suffer from osteoarthritis, and 16 percent of cases in people aged 45 and older affect the knee. Almost 19 percent of symptomatic knee osteoarthritis patients are women and 13.5 percent are men, according to the U.S. Centers for Disease Control and Prevention.

However, the new study finds that “stronger quadricep [thigh] muscles may protect older adults from developing the combination of osteoarthritis on X-ray and daily pain or stiffness in their knees,” said lead researcher Dr. Neil Segal, director of the Clinical Osteoarthritis Research Program at the University of Iowa.

“We already knew that quadriceps strength was associated with better ability to walk and get up from a chair,” Segal said. “However, one implication of these new findings is that quadricep strength may protect against developing symptomatic knee osteoarthritis.”

The report is published in the September issue of Arthritis Care & Research.

For the study, Segal’s team followed more than 3,000 men and women between 50 and 79 years of age, all of whom took part in the in the Multicenter Knee Osteoarthritis Study (MOST). The trial was designed to find out if knee strength would predict knee osteoarthritis, either as observed on an X-ray or through patient symptoms.

Over two and a half years, the researchers evaluated each participant for thigh muscle strength. Muscle strength between the quadriceps and the hamstrings was used to determine weakness in the lower leg muscles. To see if people developed osteoarthritis, the researchers took X-rays of the participants’ knees at the beginning and end of the study. They also asked about pain, aching or stiffness in the knees.

By the end of the study, 48 of 680 men and 93 of 937 women developed osteoarthritis detectable by X-ray. About 10 percent of the women and 8 percent of the men had symptoms of knee osteoarthritis, the researchers found.

These results showed that thigh muscle strength was not a significant predictor of osteoarthritis that was detected via X-ray. However, women with the strongest thighs had a lower incidence of symptomatic, or painful, knee osteoarthritis, Segal’s group found.

And since the more painful form of knee arthritis, “is the type of osteoarthritis that brings older adults to health-care providers, this [finding] is important for public health,” Segal said.

However, men with strong thigh muscles had only slightly better odds of avoiding painful knee osteoarthritis compared with men with weaker knee extensor strength.

It remains to be seen whether strengthening the thighs might help people avoid arthritic knees, the researchers stressed. “Our study was observational, so interventional studies need to be done to determine whether strengthening exercises for people with weak quadriceps will reduce their risk for developing symptomatic knee osteoarthritis years later,” Segal said.

Samantha Heller, an exercise physiologist, said a few simple, low-impact exercises can help people — even those with osteoarthritis — strengthen their thighs and knees.

“The exercises that people can do, and tend to do correctly, and can do on their own, are climbing stairs — up and down,” Heller said.

Heller recommends climbing stairs slowly, making the best use of the thigh muscles. “You don’t have to run up or down stairs. You can go up and down even one or two steps at a time — that helps strengthen the leg muscles. Strong leg muscles not only support knee health, but they support your independence as you get older,” she said.

In addition, walking is good for your muscles and your bones, Heller said. Walking engages all the muscles in your legs, she added. “If you want to have happy knees, you want to have the muscles surrounding the knee strong and balanced,” she said.

People can also see a physical therapist to get on a program that will strengthen the legs, Heller said. “There’s a whole ton of leg and knee exercises you can do,” she said.