TIME Infectious Disease

Why Hepatitis C Drugs May Soon Get Far Less Expensive

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Hepatitis C treatment no longer means daily injections and low cure rates that characterized the disease in the past. Now, newer oral drugs on the market require only a 12-week course, but their prices are shocking. Gilead Sciences has two drugs for hepatitis C, both costing astronomical amounts: one drug, Harvoni, costs $95,500 for 12 weeks, and the other, Sovaldi, costs $84,000. That’s $1,000 per pill.

But for the 3.2 million Americans living with chronic hepatitis C, a liver disease primarily spread via the blood of an infected person, a new business deal may mean more affordable care.

Another drug called Viekira Pak, developed by the pharmaceutical company AbbVie, got the green light from the U.S. Food and Drug Administration on Friday, Dec. 19. But many were disappointed upon discovering that the drug would cost $83,319 for a 12-week course, only slightly less than Sovaldi. The medical community had hoped that market competition would drive prices much, much lower.

That hope may soon become a reality, though. A new business deal between AbbVie and pharmacy benefit manager Express Scripts may lower the costs much further. As the New York Times reports, Express Scripts has negotiated a large discount from AbbVie. In return, Express Scripts will make Viekira Pak the exclusive drug option for the 25 million people it serves.

As the Times reports, Express Scripts’ chief medical officer Dr. Steve Miller has been one of the loudest proponents for cheaper prices for hepatitis drugs, given that they’ve become too expensive for some individuals and insurance providers.

The agreed-upon discount has not yet been released, but the hope is that it’s significant enough that the deal could lead other drug makers to lower their costs in response.

TIME Mental Health/Psychology

How to Not Lose it When People Are Driving You Insane

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Is your family already driving you insane? Read on

This holiday, make it a priority to not rip your hair out.

To help you survive the season, we asked psychologist Pauline Wallin, author of Taming Your Inner Brat, for some tips on how to avoid some of the most common pitfalls of the holidays. (But if Aunt Susie drinks too much egg nog, we can’t help you).

If your family is driving you crazy…
One of the best parts of the holidays can also be one of the worst parts of the holidays. Spending quality time with family doesn’t happen often for most of us, but with the expectations of the holidays and the increased amount of face time, it’s easy for someone to lose their lid. Here’s how to cool it.
For parents: You have guests coming, and the bums you call your children are doing a lousy job at cleaning. To avoid this stresser, lay out your expectations early. “When you feel like other people are driving you crazy, it’s often because they don’t have the same sense of urgency that you do,” says Wallin. Instead, tell your kids ahead of time that the house needs to be clean by 10 a.m., or that you are going to be stressed and would appreciate it if they stay out of your way. It’s an easy way to start out on the same page.
For kids and teens: If you really don’t want to go to Aunt Susie’s for dinner, get over it by finding a way to make it count. Think of it as a gift to your family to spend time with them without giving anyone ‘tude. If you’re really feeling irked, ask kindly for a little time alone. Go on a walk, read a book for an hour, or offer to get out of the house and grab groceries.

If someone spills something or you burn the roast…
Take a picture of it. Seriously, pull out that smart phone and snap a photo of the disaster. “If you’re going to laugh about it later, you might as well laugh about it now,” says Wallin. No dinner party is immune to a rip or spill or the tragic loss of the Christmas goose. Laugh it off, post it to Instagram, and move on.

If you’re stressed about the cost of all those presents…
Do you remember what you received for Christmas last year? Probably not. Wallin says one of the most common stressers she sees among patients around the holidays is financial stress. “But never once have I heard someone say, ‘I’ve never forgiven them for not getting me the new iPhone.'” We tend to put a lot of weight on the presents, but guests are more likely to remember the moments shared than what was in the stocking. So try not to stress about finding the perfect gift, and there’s zero shame in bargain hunting.

If your to-do list alone is freaking you out…
This year, instead of making a “To Do” list, make a “To Don’t” list. “Decide what you’re not going to do, and just let it go,” says Wallin. “It’s a tremendous sense of relief.” If you can’t figure out when you’re going to have time for caroling, just skip it. If you don’t have time (or don’t want to make time) for home-baked cookies, don’t both! You don’t have to do everything. If it’s more stress than it’s worth, it won’t be that fun.

If you’re not feeling any warm, fuzzy, holiday feelings…
Instead of scrambling to make everything perfect, carve out time to just sit and talk to friends and family. “We get so busy that we forget the holidays are about people,” says Wallin. Get everyone off the grid and ask for cell phones to be put away while you play a game or watch a movie. Even just taking 20 minutes to sit with a family member you don’t regularly see is a great way to remember to the real meaning of the season.

TIME Veterans

Rising VA Disability Payments Linked to Veteran Unemployment

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A U.S. soldier waves as the final American convoy pulls out of Iraq in 2011 at the end of the second Iraq war. Mario Tama / Getty Images

Stanford study suggests a seesaw relationship between the two

Unemployment persists among military veterans as a sharply growing number of them are receiving disability payments from the Department of Veterans Affairs, according to a new study by a Stanford economist. The steep increase in such payments, Mark Duggan suggests, could be acting as a brake on their employment prospects.

Veterans receiving disability compensation from the VA rose from 8.9% in 2001 to 18% this year, Duggan’s study says. Even as the number of veterans shrank from 26.1 million in 2001 to 22 million this year, those receiving federal money for wounds linked to military service have climbed from 2.3 million to 3.9 million.

 

Stanford Institute for Economic Policy Research

“The substantial rise in Disability Compensation enrollment in recent years suggests that this program may be affecting labor market outcomes for military veterans,” Duggan writes. He cites two possible reasons:

– It can reduce a veteran’s “propensity to work because—with the additional income—he may now prefer additional leisure to work.”

– Additional work may also “prevent a veteran from qualifying for a higher level of Disability Compensation benefits—and thus increase the effective tax rate on work.”

The jobless rate among post-9/11 vets was 7.2% in October, compared to the nation’s 5.8% rate—and a 4.5% rate among all veterans.

The study “is important because it shows how the good intentions of the disability system can sabotage the well-being of veterans,” says Sally Satel, a one-time VA psychiatrist who now works at the conservative American Enterprise Institute think tank. But the report, she adds, could boomerang: “Talking about reforming the veterans’ disability system is a third-rail topic because, on superficial glance, it appears as if reformers want to deny veterans help.”

But Satel, a reform advocate, denies that. “Reformers urge that assistance be given in the most constructive way possible,” she says. “This means that the VA should go all-out in terms of treatment and rehabilitation, to maximize entry into the workforce and minimize exit from it.”

Some vets believe the report misses the point. Repeated deployments and the lack of a formal, uniformed and organized enemy, ground down the Americans who fought the post-9/11 wars, says Alex Lemons, a Marine sergeant who pulled three tours in Iraq, “A number of my friends were blown into many pieces and they never quite reassembled them,” he says. “You might look at this person and think they look fine despite scars, but then you find out they can’t stand for more than an hour a day, they have shrapnel that works its way out of their dermis and have to pry it out, they are near deaf without hearing aids, or they can’t pick up things as a result of nerve damage in a hand. It means they will never be qualified for many jobs.”

Lemons says it’s good that troops are coming forward seeking help for post-traumatic stress disorder, which has gone from the 10th most-common condition among vets on disability in 2000, to third in 2013. “In my infantry battalion the number of Marines who are on PTSD disability is not more than 35%,” he says, “even though I believe everyone who deployed with us has it.”

The average monthly disability payment grew 46%—from $747 to $1,094—between 2001 and 2013, Duggan reports. While that’s not much per veteran, the nation paid out a total of $54 billion in such benefits in 2013.

Congressional Budget Office

Not only are more veterans receiving disability compensation, Duggan’s report says, but they’re receiving more than earlier veterans did. That’s because the VA has ruled that the impact of their military service on their health is greater than for earlier generations of vets. Disability payments are pegged to a VA-determined rating, which is expressed in 10 percentage-point increments. Between 2001 and 2013, the number of vets deemed 10% disabled—generating an average monthly payment of $131 last year—dropped by 1%. Over the same period, the more than 800,000 vets rated 80% or more disabled—receiving an average monthly payment of $2,700—rose by 221%.

Military service also may have “become more demanding over time,” accounting for less veteran participating in the labor force, Duggan’s report says. “Consistent with this explanation,” he adds, “veterans have become more likely than non-veteran males to report that their health is poor or just fair rather than excellent, very good, or good.”

Elspeth Ritchie, a retired colonel who served as the Army’s top psychiatrist before retiring in 2010, believes the report slights what troops experienced in the nation’s post-9/11 wars. “It does not seem to factor in the high rate of physical injuries, traumatic brain injury and PTSD in the veterans from these conflicts,” she says.

Since turning its back on its veterans following the unpopular war in Vietnam, American society has sung the praises of its veterans, and has been footing the bills for those hurt to prove it. “Spending on veterans’ disability benefits has almost tripled since fiscal year 2000, from $20 billion in 2000 to $54 billion in 2013—an average annual increase of nearly 8%, after adjusting for inflation,” the Congressional Budget Office reported in August. “VA projects that such spending will total $60 billion in 2014 and $64 billion in 2015, a 19% increase from two years earlier.”

Duggan reports that a “key driver” in the growth of such benefits has been the VA’s decision to make veterans who served in southeast Asia during the Vietnam war eligible for benefits if they have Type 2 diabetes, ischemic heart disease, Parkinson’s disease, or B-cell leukemia. The agency took the action when it decided to “presume” the ailments were linked to military service in the theater and possible exposure there to the defoliant Agent Orange.

Today’s veterans, the study says, are more likely than their fathers to seek and gain VA disability benefits. Nearly one in four vets since 1990 are being compensated, compared to one in seven veterans prior to 1990. “This higher rate of enrollment may be primarily driven by the VA’s approval of presumptive conditions for Gulf War veterans who served in the Southwest Asia theater from 1990 to the present (including Iraq and Afghanistan),” Duggan found.

 

Congressional Budget Office

He also reports that while veterans between 1980 and 1999 were more like to be employed than non-veterans, that has flipped since 2000. “This significant reduction in labor force participation among veterans,” he adds, “closely coincides with their increase in Disability Compensation enrollment during this same period.”

Duggan notes that a 2010 change in VA regulations no longer required veterans with a diagnosis of PTSD to document their exposure to wartime trauma such as firefights or IED blasts. The number of veterans being compensated for PTSD rose from 133,789 in 2000 to 648,992 last year. “The percentage of all veterans on the Disability Compensation program with a diagnosis of PTSD has increased by a factor of six during this period,” Duggan writes, “from 0.5% in 2000 to 3.0% in 2013.”

The jump doesn’t surprise William Treseder, who deployed to Afghanistan and Iraq as a Marine sergeant. “Many post-9/11 vets can tell you stories about the inflation of VA claims,” he says. “We are often told to file for certain conditions—especially post-traumatic stress—whether or not we think it’s actually an issue. It’s the chicken-soup principle in action: can’t hurt; might help.”

Like Duggan, Treseder believes more study is needed examining the impact of disability payments on veterans. “This is much-needed research,” he says. “I’m glad to see someone out there looking into this.”

TIME Research

11 Remarkable Health Advances From 2014

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And what to look forward to in 2015

From groundbreaking new drugs to doctor-assisted suicide, 2o14 was full of historic moments that are bound to play on in a big way throughout 2015 and beyond.

1. 3D Mammography is proven to be effective
Multiple studies in 2014 showed 3-D mammography to be a highly accurate screening tool for detecting breast cancer with fewer false positive results. It’s not widely available yet, but the growing evidence suggests we’ll see more adoption in 2015. Hologic, one of two U.S. companies selling 3-D mammography machines, told TIME there’s growing interest, with at least one of their machines in all 50 states.

2. The number of uninsured Americans nears record low
Federal data released Dec. 18 revealed that the percentage of uninsured Americans neared historic lows in 2014 at 11.3%. As TIME reported, it appears certain to fall to record lows next year.

3. Brittany Maynard wins support for “death with dignity”
After she discovered she had terminal brain cancer, Maynard, 29, chose to end her own life in the company of her family and friends by taking prescribed barbiturates on Nov. 1. Maynard moved from California to Oregon for the state’s death with dignity law that allows doctors to prescribe lethal medications for the terminally ill. A video of Maynard explaining her choice went viral, and a recent poll showed most U.S. doctors now support death with dignity.

MORE: TIME’s Person of the Year: The Ebola Fighters

4. CVS stops selling cigarettes
In February, CVS announced it would stop sales of cigarettes and tobacco products in its 7,600 U.S. stores by Oct. 1. Tobacco products made up about 3% of the company’s annual revenue. Anti-smoking advocates were pleased by the move.

5. Way more calorie counts are coming
The FDA rolled out new rules in November that require chains—including restaurants, movie theaters, vending machines and amusement parts—with 20 or more locations to list their calories for all their food and drinks. Companies have a year to comply.

6. The FDA unveils new nutrition labels
In a similar move, the FDA revealed in February proposed changes to nutritional labels that will put greater emphasis on calories, added sugars and have more realistic serving sizes. Calories will be listed in bigger and bolder type, and may be listed on the front of food packaging.

MORE: 3D Mammograms Are Better For Dense Breasts

7. The Sunscreen Innovation Act becomes law
In December, President Obama signed into law the much-anticipated Sunscreen Innovation Act, which requires the FDA to quickly respond to pending sunscreen-ingredient applications that have been awaiting a response for over a decade. There’s a good chance that in summer 2015, we could have a batch of new, up-to-date sunscreens to try.

8. New drugs show promise for heart failure
Novartis is anticipating approval for its new heart failure drug, LCZ696, in the second half of 2015. The drug could replace the current treatment of care: ACE inhibitors. The company’s most recent human clinical trial was forced to end when it apparent LCZ696 saved more lives than standard of care.

9. PillPack offers a new kind of pharmacy
For people on multiple medications, remembering what to take and when can be a medical nightmare. That’s why pharmacist T.J. Parker launched PillPack in 2014. Instead of sending customers bottles, every two weeks the company sends a dispenser that has all the customers’ individual pills sorted and organized by day on a ticker tape sheet of tearable pouches. TIME named it one of the best inventions of 2014.

MORE: New Heart Drug Saves More Lives Than Standard of Care

10. A device literally filters Ebola from blood of a sick patient
One of the most novel treatments during the Ebola outbreak is a device that can suck the Ebola virus out of the blood. Developed by Aethlon Medical, the Hemopurifier is a specially developed cartridge that can be attached to a standard dialysis machine and uses proteins that bind to the Ebola viruses and pull them out of patients’ blood. It’s still experimental, but appears to have worked in at least one patient with Ebola in Germany.

11. The Ebola vaccine shows promise
In August, two vaccines to prevent the deadly Ebola virus went onto human clinical trials. The vaccines are being tested with the hope that it could be deemed effective, and safe enough to be distributed widely in West Africa, where the Ebola crisis rages on.

TIME Healthcare

Should You Video Chat With Your Doctor?

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When to embrace the digital doc

In a world where you can manage your money, order a ride to the airport, and shop for pretty much everything via your phone, going to the doctor’s office is probably one of the only things you still do face-to-face. For the most part, that’s for a good reason. Your medical care requires much more specialized expertise than depositing a check, after all.

But if you’ve ever waited more than an hour at an urgent care clinic for a sore throat, you know that the whole business of going to a doctor can seem frustratingly antiquated. How many times have you wanted to see a doctor, but decided to postpone it for as long as possible on account of the hassle? The trek there, the rude receptionist, the waiting room—all for just three minutes of doctor time. Oy.

Well, it looks like change might finally be on the horizon: Thanks to the growing availability of telemedicine or telehealth services, you can now skip all of that noise and video conference with a doctor from home any time–even in your pajamas. Sounds amazing, if also a little too good to be true. We talked to experts to find out whether it’s worth a try.

HEALTH.COM: 7 Women’s Health Problems Doctors Miss

Is it safe?

Telemedicine has actually been around for some time. Right now there are about 200 telemedicine networks and more than half of U.S. hospitals are using it in some way to better connect doctors with patients with chronic illnesses like heart disease, according to the American Telemedicine Association. Certain health insurance companies are also hopping on-board to reimburse for online visits. But because of the wide availability of smartphones it’s only now that we’re starting to see new services for everyday health complaints.

Even the always conservative American Medical Association agrees that it can be helpful, though it’s not a total substitute for in-person care.”We need more research, but there are plenty of circumstances where a video call with a doctor could work,” says Robert M. Wah, MD, president of the American Medical Association and a reproductive endocrinologist in McLean, Va. That said, he adds: “Better information is what leads to better decisions, so on balance, face-to-face is best. Being in the office with your doctor offers a more complete picture of whatever is going on.”

HEALTH.COM: Scary Symptoms You Can Relax About

But according to some of the brains behind the phenomenonexecutives who see a business opportunity in making healthcare more accessible, and yes, the physicians moving their practices onlinewhen used appropriately, telemedicine is not only safe, it’s a much-needed option.

“The fact is my doctors are treating patients every day who have gaps in their care,” says Peter Antall, MD, a pediatrician in Thousand Oaks, Calif. and president and medical director of the Online Care Group, which provides doctors for patients to see online via Amwell. “We don’t aspire to be your primary care physician, but we recognize that many people don’t have a primary care doctor. Even if they do, it’s not convenient or even feasible for that primary care doctor to be available 24-7.”

On top of that, “using a whole afternoon to see a doctor in-person is in many cases, unnecessary,”says Ron Gutman, the CEO of HealthTap, an app and healthcare platform that like Amwell, allows you to log in, choose a doctor, and see him or her via video within minutes. According to Healthtap’s research, “between 35 and 40% of visits are for simple issues that can be solved with a conversation. But doctors ask you to come in because of the way payment works: the only way they will get reimbursed by your insurance is if you make the trip.” (With Healthtap, you pay $44 per visit via their concierge service, or for unlimited access to on-call doctors for $99 per month with Healthtap prime. They don’t take insurance, but some platforms, like Amwell, do.)

HEALTH.COM: Want to Skip The Doctor? Try This

And if you’re worried about who you’ll meet on the other end: “We’re working with real, board-certified doctors that we’ve vetted for you,” Gutman continues. “They are very protective of their medical licenses. If you’re dialing in for a scary situation they will say, get to the ER now. They will tell you when you need in-person care.”

When can I use it?

As Dr. Wah says, online visits aren’t going to replace seeing your doctor in real life. But it may be helpful to have the option in your back pocket when certain situations arise.

Let’s say you wake up one morning and your eye is red, puffy, and oozing. For something like that, Dr. Antall explains, you can be connected within minutes with a doctor who can confirm whether you have pink eye and send a prescription for eyedrops to your local pharmacy, if needed. Same goes for when you have say, a lingering cough or a sinus infection.

If you have a chronic condition like diabetes or asthma, you might want to look into it as an extra resource. “It’s useful when it’s a Friday night. Your sugars are out of whack and you can’t figure out why, and the regular doctor is unreachable until Monday,” Dr. Antall explains. “Or maybe you’re an asthmatic who’s out of your inhaler refills.” It’s also helpful for skin issues: A new study published in JAMA Dermatology found that people with eczema who were treated remotely by sending pictures to dermatologists fared just as well as those treated in-person.

HEALTH.COM: 5 Ways to Tell if You Need Antibiotics

You can also easily get a second opinion. Maybe you have fibroids and your doctor has recommended a certain type of surgery. Signing up for something like Healthtap, which has a database of more than 64,000 doctors in 137 specialties, can be an easy, convenient way to get advice from a handful of experts. You can spend an afternoon asking all the questions you want before making your final decision.

And finally, you know those times when you’re in some pain or have a weird symptom, but you’re not quite sure if you need to see a doctor or not? You can use one of these apps to ask a few questions, explains Buck Parker, MD, a general surgeon who sees patients via HealthTap eight hours a week. “A lot of what I’m doing is simply answering basic questions: ‘I smashed my finger in the door, does it look broken?’ for example. It’s almost like ‘pre-doctor’s visits’ where we can really save people a lot of hassle by counseling them on whether they need to see a doctor in-person or not.”

But how much can you really do over video?

You can’t do blood tests or urinalysis, that’s for sure. “But you can direct the patient to push on lymph nodes or a swollen ankle in the right spot (so the doctor can see how it reacts), and you can ask all the necessary questions,” Dr. Antall says.

To stretch the video capabilities, there are also solutions like HealthSpot, which creates kiosks that are sort of like the medical version of an ATM, says the company’s CEO Steve Cashman. Staffed with doctors from big health systems like the Mayo Clinic, the Cleveland Clinic, and Kaiser Permanente and located in places like community centers and strip malls, all you do is step inside and the doctor appears on screen. The kiosk is equipped with diagnostic devices like a digital stethoscope and thermometer as well as digital scopes for looking in ears, throat and getting close-ups on your skin.

Right now Healthspot only has about 20 stations across the country, but soon you might see them at a Rite-Aid near you.

HEALTH.COM: What to Do When You Disagree With Your Doctor

This article originally appeared on Health.com

TIME Infectious Disease

WHO: Recorded Ebola Deaths Top 7,000

Grave digger walks past fresh graves at a cemetery in Freetown, Sierra Leone
A grave digger walks past fresh graves at a cemetery in Freetown, Sierra Leone, Dec. 20, 2014. Baz Ratner—Reuters

(CONAKRY, Guinea) — The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban Ki-moon continued his tour of Ebola-affected countries in West Africa on Saturday.

The three countries hit hardest by Ebola have now recorded 7,373 deaths, up from 6,900 on Wednesday, according to WHO figures posted online late Friday. A total of 392 of the new deaths were in Sierra Leone, where Ebola is spreading the fastest.

The new totals include confirmed, probable and suspected Ebola deaths. The WHO says there have also been six Ebola deaths in Mali, eight in Nigeria and one in the United States.

The total number of cases in Guinea, Sierra Leone and Liberia now stands at 19,031, up from 18,569.

Ban arrived in Guinea, where the outbreak’s first cases were confirmed back in March, on Saturday after touring Liberia and Sierra Leone on Friday. After meeting with President Alpha Conde, he expressed concern about the situation in the country’s southeast forest region, where he said the number of infected people “seems to continue to grow.” The region borders Liberia, Sierra Leone and Ivory Coast, and Ban called for cross-border collaboration to bring the disease under control.

He urged all Guineans to commit themselves to eradicating Ebola, saying that the U.N. and its partners “are there to help you.”

“It has never been so important to work together,” he said.

Guinea has recorded 2,453 Ebola deaths and 1,550 cases, according to the WHO. This past week, officials in Conakry, the capital, announced a ban on New Year’s Eve celebrations such as fireworks displays and beach gatherings in a bid to curtail transmission.

Ban was expected to travel to Mali Saturday evening.

TIME Diet/Nutrition

5 Tips for Keeping Off the Weekend Weight

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Choosing protein-packed foods can help you stay on track

Around the holidays, weekends are always jam-packed with opportunities to eat, drink, and be merry. Of course, it’s the most wonderful time of year (you should enjoy yourself), but if you’re not careful with your choices, weekend splurges can really add up and wreak havoc on your health and your waistline.

Even though festive holiday get-togethers might be the perfect excuse to let loose, you probably don’t want your healthy habits to fall by the wayside all together. I mean, no one wants to ring in the new year a few pounds heavier, right?

Here are five tips to keep in mind when you’re enjoying yourself during the weekends around the holidays.

Aim to maintain, not lose weight

The holidays are a time to relax and enjoy quality time with family and friends, so putting pressure on yourself to lose weight can potentially stress you out and lead to emotional eating—neither of which will make you feel very festive. Instead of making your goal to lose weight this holiday season, take a more realistic approach and aim to simply maintain your weight. That way, when Friday evening rolls around, you can enjoy yourself, but not overdo it either. You’ll feel much better about yourself when Monday morning arrives.

HEALTH.COM: 11 Ways to Stay Slim Through the Holiday Season

Eat breakfast and lunch (and maybe dinner too)

It might sound a little counterintuitive to eat before a holiday event, but sticking to your normal meal schedule will help you make smarter decisions when it comes to what you eat and drink. During mealtime, be sure to choose foods that are high in protein to keep you satisfied and your blood sugar steady. It’s tough to resist such delicious holiday fare when you’re hungry or experiencing crazy cravings, so be sure to fill up on healthy, high-quality foods before your next holiday soiree.

HEALTH.COM: 20 Filling Foods That Help You Lose Weight

Choose your calories wisely

The food and drinks at your next holiday gathering will likely include many of your favorites, so making a decision about what to enjoy might be difficult. Instead of wasting your calories on the same-old, same-old, like cheese and crackers or chips and salsa, save them for the best of the season. I’m talking bacon-wrapped dates and sugared gingerbread cookies! You want to make sure your splurges are worth it, so choose your calories wisely.

HEALTH.COM: How to Burn Off 24 Holiday Foods

Enjoy a true splurge

Whether it’s a second cocktail or a slice of warm pecan pie with a scoop of vanilla ice cream, allow yourself to enjoy one true splurge each weekend. Having an indulgence like this to look forward to will help you make better choices when it comes to the rest of your eating and drinking decisions. You’re less likely to go overboard if you know you have a splurge coming to you. Plus, if you plan your special indulgence at a time when you’re around loved ones, it will make it that much more enjoyable—and isn’t that what the holiday season is all about?

HEALTH.COM: 20 Habits That Make Holiday Stress Worse

Use Sunday to get back on track

If you lived it up on Friday and Saturday night, use Sunday as the day to get back to your healthy habits. Start your morning with a healthy breakfast and a heart-pumping workout. Then, prepare some nutritious and satisfying foods for the upcoming week, such as overnight oatmeal for breakfast and hard-boiled eggs as a protein-packed snack. And, finally, plan out the rest of your workouts for the week by scheduling them into your calendar like appointments that you can’t miss. Getting yourself organized on Sunday sets you up for a healthy week ahead.

HEALTH.COM: 5 Ways to Prep Healthy Breakfasts Ahead of Time

This article originally appeared on Health.com

TIME medicine

Here’s What Experts Say About the Advice on Dr. Oz and The Doctors

Experts evaluated the advice given on medical talk shows, and the results were surprising

Many Americans get their health advice not from their doctor, but from daytime television. But how good are those recommendations?

Reporting in the BMJ, Canadian researchers analyzed two medical TV talk shows—The Dr. Oz Show and The Doctors—and found that only 46% of the recommendations on The Dr. Oz Show and 63% on The Doctors were supported by evidence. 15% of advice given on Oz and 14% of advice on The Doctors contradicted the available published evidence in journals.

“The bottom line message is for people to be really skeptical about the recommendations made on these medical television shows,” says study co-author Christina Korowynk, associate professor of family medicine at the University of Alberta. “They should look for more balanced information to be presented, and understand that they need all of that information in order to make an informed decision.”

They measured 80 major recommendations made on the two shows from January to May 2013 against evidence gleaned from published studies in medical databases. They looked at both consistency—how much the conclusion was supported by the studies—and believability, which included the quality, number and type of study.

On average, Korownyk’s group found that both shows mentioned how the advice might specifically help a person in only about 40% of the recommendations, and they mentioned the amount of benefit, another aspect of useful health advice, in less than 20% of recommendations. (Harms were mentioned in less than 10% of the recommendations, and costs in less than 15%). She says that without such information on how much benefit and harm a particular recommendation might have, it’s hard for people to make informed choices about whether the advice is right for them.

Korownyk and her colleagues aren’t the first to cast doubt on the quality of advice given on the shows. In June a Senate subcommittee heard testimony from Oz on false advertising of weight loss claims and Sen. Claire McCaskill queried the doctor about the statements he made on the show. “I do personally believe in the items that I talk about on the show,” he said at the hearing. “We have to simplify complicated information. We have to make the material seem interesting and focus on the ‘wow’ factor.”

Representatives for The Doctors said in a written statement to TIME: “The Doctors was never contacted about the study or the article. Our producers and doctors all do their due diligence to make sure information provided on the show is sound, relevant and timely—often debunking the myriad of medical myths that abound in the media and across the internet.”

Members of The Dr. Oz Show wrote: “The Dr. Oz Show has always endeavored to challenge the so-called conventional wisdom, reveal multiple points of view and question the status quo. The observation that some of the topics discussed on the show may differ from popular opinion or various academic analyses affirms that we are furthering a constructive dialogue about health and wellness.”

Korownyk acknowledges that the exact impact of television health advice isn’t clear, since the study didn’t investigate how many of the recommendations people adopted and whether they had an effect on their health. But the advice is clearly reaching people. “What we’d love to see is a process on these shows where the evidence is reviewed in a critical manner, and presented in a balanced, objective way so the audience can understand,” she says. “As physicians, we are moving toward that, and we’d love to see the broader television personalities doing the same sort of thing.”

TIME ebola

Ebola-Stricken Families to Receive Cash Payments

Hawa Musa with her mother and children. Of 25 people living in the house, 17 have died from ebola, including her husband.
Hawa Musa (blue) with her mother and children. Musa used to rent rooms for income, but no one wants to rent her rooms anymore. She previously had 25 people living in her house, but 17 died of Ebola including her husband and a few of her children. She's taken in 10 more kids. Carly Learson—Carly Learson / UNDP

In 2015, the three Ebola-affected countries will start offering cash payments for families hit by Ebola, as well as survivors having trouble re-acclimating to society out of stigma for the disease.

Every aspect of Guinea, Liberia and Sierra Leone’s societies have taken a hit from Ebola, and the disease has shocked what were once fragile but growing economies. Public spaces are now forbidden, so markets are empty, tourists are no longer traveling into the countries and international companies have largely pulled out, including large industries like mining. The World Bank estimates the aftershock of Ebola to already weakened economies will be “devastating.”

“We are seeing a backwards slide of development of about 10 years,” says Boaz Paldi, chief of media and advocacy at the United Nations Development Programme (UNDP). “The outlook is not good. We are fearful for these countries.” That’s why instead of waiting for caseloads to reach manageable numbers, the three countries, with the help of UNDP and other partners, are laying the groundwork now for rebuilding the damaged economies. One of the first major initiatives to be rolled out in the new year are cash transfers and payments to families who no longer have breadwinners and survivors out of work. Many women in the Ebola-affected countries have taken in orphaned children of their family members or neighbors, despite having no steady income.

Dudu Kromah's husband died recently from ebola. She is looking after ten children, many of them orphans including a 3-month-old baby.
Dudu Kromah’s husband died from Ebola. She is looking after ten children, many of them orphans including a 3-month-old baby. She has no income. Carly Learson—Carly Learson / UNDP

According to UNDP leaders, plans for the payment process are still being refined. Lists of names of affected families and survivors are being collected and coordinated for small pilot programs, starting early next year, to test the effectiveness of the payments in preparation for widespread efforts. UNDP has calculated that around $50 will keep a family of five going in the three countries with essential needs for one month, with some variations by country. The group is anticipating making monthly payments to 150-200,000 people in each of the countries.

Ultimately, the payment program may develop into a cash-for-work model, with payments in exchange for work rebuilding communities in an effort to inject cash into the local economy and enable people to earn a living.

Ideas for how to get youth involved are also being considered. In Sierra Leone, Ruby Sandhu-Rojon, the deputy director of the UNDP Regional Bureau for Africa, spoke to young people concerned that since residents can no longer go to their local markets, they are unable to buy the food they need. “So why not start a delivery company to have food delivered to the different communities? How can we provide the start-up capital for young people who want to initiative those types of activities?” says Sandhu-Rojon.

The three countries and the U.N., which launched the U.N. Mission for Ebola Emergency Response (UNMEER) earlier this year, are also looking to the private sector. On Dec. 11 the U.N. held a U.N.-Business Collaboration for Global Ebola Response meeting as a way to get the private sector involved in both the response and recovery. A panel of high-level representatives from U.N. Missions in the affected countries, the U.S., U.K., and France put out a call for help from companies in areas major like logistics. Ultimately, the greatest plea was for companies to return to the countries and invest.

Sadly, all three countries were experiencing high growth rates before the start of Ebola, after coming out of conflicts like civil war. Sierra Leone had only recently launched its “Agenda for Prosperity,” a high-level initiative to become a middle-income country by 2035. High growth rates could largely be attributed to extractive industries like mining, which have now largely decreased their production or shut down, causing a government shortfall in revenue and massive loss of employment. Remaining national resources have been reallocated to the Ebola fight.

“It’s very disheartening, because all three of these countries were on their way up,” says Sandhu-Rojon.

The hope is cash payments will be a boost to help people get by. But increasingly more support and funding will be needed from the international community and private sector to get the countries back on their feet. Whether the countries will make it back to pre-Ebola growth may be a much greater, and longer battle.

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