TIME Infectious Disease

Ebola Lockdown in Sierra Leone Finds 150 New Cases

Ebola Sierra Leone Lock Down
A volunteer health worker talks with a resident on how to prevent and identify the Ebola virus in others, and distributes bars of soap in Freetown, Sierra Leone, Sept. 20, 2014. Michael Duff—AP

The lockdown was one of the most aggressive containment strategies employed so far in the outbreak

A three-day lockdown meant to contain the Ebola virus in Sierra Leone ended late Sunday night with officials hailing it as a “huge success” after health workers found almost 100 victims who perished from the disease and another 56 who have been infected.

The head of the Emergency Operations Center leading Sierra Leone’s Ebola response, Stephen Gaojia, called the lockdown “a huge success,” Reuters reports. About 123 people had contacted authorities by Sunday morning thinking they might be infected; 56 tested positive for the virus, 31 negative and 36 were still awaiting results.Final numbers will only be released once information is compiled from around the country.

The lockdown was one of the most aggressive containment strategies to be employed so far in the growing effort to contain the worst Ebola outbreak in history, which has killed more than 2,600 people across West Africa. Sierra Leone ordered its six million residents to stay indoors for three days, while 30,000 health workers, volunteers and teachers circulated, educating households on how to prevent the spread of the disease.

Health Minister Abubakkarr Fofanah told AFP that volunteers had managed to reach about 80% of homes and said: “Although this campaign has ended, there is a possibility we would have a similar one some other time.”

[Reuters]

TIME Sex/Relationships

10 Ways to Improve Your Relationship Instantly

Couple running
Getty Images

With everything going on in the lives of the average couple, it’s easy to forget the small gestures that keep a relationship ticking. What most couples don’t realize, though, is that it doesn’t take much to help your partner feel more valued every day. “Stringing together these little things is an ongoing way to make a change in your relationship,” says Dr. Gail Saltz, Health’s contributing psychology editor. The expert tricks here can fit easily into any routine — in minutes you’ll be on your way to building a stronger connection and lasting bond over time.

Turn off your smartphone

If you’re glued to Facebook during dinner, then it’s time to unplug. A study published in Computers in Human Behavior looked at data from 1,160 married people and found a negative correlation between heavy social-media use and relationship happiness. “When angry, some people may turn to texting to avoid saying something,” Saltz says. “It’s a way of creating distance.” While it doesn’t hurt to send a flirty or loving message, it does pay off to be more direct with your partner when something is really eating at you.

Go to bed at the same time

Feel like you never have a free moment together? Hitting the sack at the same time will help. “Bedtime might be the only opportunity you’re alone together all day,” says Barton Goldsmith, Ph.D., author of The Happy Couple: How to Make Happiness a Habit One Little Loving Thing at a Time. Even if you’re a night owl, you can always stay in bed until your partner drifts off. You should also make sure you’re both getting a healthy amount of shut-eye. A study from the University of California, Berkeley, looked at the sleep habits of more than 100 couples. Those who reported poor sleep were much more likely to argue with their significant other the next day.

Brew a cup of coffee for your partner

Grand gestures aren’t the only way to express your love. Something as simple as brewing your partner a cup of coffee in the morning helps improve your relationship, says Terri Orbuch, Ph.D., a marriage researcher and author of 5 Simple Steps to Take Your Marriage From Good to Great. Orbuch has studied 373 couples for more than 28 years through the University of Michigan’s Survey Research Center, and her research shows that frequent small acts of kindness are a predictor of happiness in a relationship. “People may feel taken for granted,” Orbuch says. By doing these small tasks on a regular basis, you’ll help your partner feel noticed.

Bring up a funny moment from your past

Sometimes the best memories are the funny ones. In a Motivation and Emotion study, couples that remembered laughing together — like the time a grocery-store clerk did something funny in the checkout line — reported greater relationship satisfaction than those who remembered experiences that were positive but not necessarily when they’d laughed. “Laughter reminiscence packs an additional punch because people relive the moment by laughing again,” says study author Doris Bazzini, Ph.D., a psychologist at Appalachian State University in Boone, N.C.

Work up a sweat

It’s no secret that getting buff helps you out in the bedroom by boosting your endurance, strength and flexibility — but a sweat session also has more immediate effects. “Endorphins from exercise give you an adrenaline rush that boosts arousal,” Orbuch says. Activities that get your heart rate up, like hiking, running or biking, are guaranteed to have a positive effect on desire. “Any kind of arousal rush can be transferred to your partner and add passion to your relationship,” Orbuch says.

Health.com: 10 Best Workouts for Your Sex Life

Dance before dinnertime

Couples who frequently try new things together have higher-quality relationships, according to research published in the Journal of Personality and Social Psychology. And we’re not necessarily talking extreme activities like skydiving or traveling to an exotic corner of the world (though those work too) — the activities simply should be new to the two of you, and can last for as little as seven minutes, researchers say. Dinnertime is one moment it’s easy to try something new. Turn on some catchy music while you’re cooking and start dancing together, Orbuch suggests. Or you could try a new a cooking technique — homemade sushi, anyone?

Have sex in a different place

Getting busy often enough to satisfy you both is key. If you’re feeling so-so about your bedroom romps, it might be time for a change. One idea: try having sex in a room or area you’ve never done it in. “New elements of play stimulate the dopamine system,” Saltz says. “When you do something that causes you to release more dopamine, it’s a positive reinforcer.” Want to suggest a tryst in the kitchen? Don’t worry about making it a drawn-out conversation, she says. It can be as simple as a one-liner that hints at your intention like, “The kids are gone. How about the kitchen table?” As long as your partner is game for the idea too, nothing’s stopping you.

Give your partner a hug

Nonsexual touching like hugging or handholding is just as important as sex itself in keeping your relationship healthy. “Touching is probably the most definitive way to let other people know you’re in a relationship,'” Goldsmith says. In the long run, the more you touch your mate, the more you’ll feel comfortable with each other. “Touching is a way we calm ourselves down,” Goldsmith says. “Every time you do it, you’re sending a positive message to your significant other.”

Ask a new question

As a couple, you probably spend most of your time chatting about work, your kids or your friends. When’s the last time you stopped to ask something new about each other? Everyone changes as relationships progress, Orbuch says, so it’s likely your partner has different interests and passions from the early years of your relationship. So ask your partner about anything you wouldn’t normally — movies, music, even what you’d do with lottery winnings.

Say thank you

Think about the last time your partner did something to help you out or made you feel special, and then say “thank you” for it. “You get so comfortable with your partner, it’s easy to expect them to meet your needs,” Saltz says. Too often couples forget to express a simple thanks, whether one of you helps out with the chores or surprises the other with a gift. And have you ever said thank you to your partner for simply being in your life? It’s important to express gratitude for this — not just for what they’re doing for you, Goldsmith says.

This article originally appeared on Health.com.

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TIME Diet/Nutrition

5 Reasons to Eat Healthier That Have Nothing to Do With Your Weight

Golden Acre Farm,  a small organic veggie farm next to North Table Mountain in Golden
Cyrus McCrimmon—Denver Post/Getty Images

While many clients come to me to slim down, in the long run, nearly all find themselves feeling far more motivated by the numerous benefits of healthy eating outside of shedding pounds and inches.

For example, a new study published in the British Journal of Health Psychology found that young adults who eat more fruits and veggies experience greater “flourishing,” meaning they’re happier, more positive, creative, and curious. I absolutely see these effects among the people I counsel, regardless of age, and it’s this overall enhanced sense of well being that keeps most of them going strong.

Here are five more meaningful benefits of eating well that have absolutely nothing to do with your size or shape.

Better mood

Like the study I referenced above, another from New Zealand has tied a higher produce intake to mood. In the study, nearly 300 young adults completed daily food diaries for three consecutive weeks, along with psychological and mood-related ratings. Scientists found that a higher intake of fruits and veggies resulted in more energy, calm, and greater feelings of overall happiness. They also noted that the effects were seen not only on the days more produce was consumed, but also throughout the following day.

Another study, published in the journal Social Indicators Research, which tracked the eating habits of 80,000 adults, found that downing more servings of fruits and veggies boosted mental well being, with the magic number for happiness being seven daily servings (think half of each meal).

Sounder sleep

Numerous studies have tied better sleep to improvements in overall wellness, and more and more research indicates that eating the right foods can help. Scientists from Taiwan found that when men and women who struggled with sleep disturbances ate two kiwis one hour before bed over a four-week period they fell asleep 35% faster, slept more soundly, and snoozed 13% longer.

Researchers from the University of Pennsylvania and University of Rochester have also found tart cherry juice to be an effective elixir for sleep. In their study, volunteers sipped either one ounce of tart cherry juice or a placebo daily for a week. The cherry drinkers experienced a 25-minute increase in sleep quantity, and a 5-6% boost in sleep efficiency, a measure of overall sleep quality. Not surprisingly, other foods that have been tied to better sleep are all of the good-for-you variety, including fish, whole grains, nuts, and dark leafy greens. In other words, better diet, better slumber.

Better workouts

As a sports nutritionist, I’m always on the lookout for research about foods that enhance athletic performance, and in recent years several healthy foods have been shown to either build muscle, boost recovery, or improve endurance. For example, a study published in the Journal of Applied Physiology found that gulping 16 ounces of organic beetroot juice daily for six days helped male athletes cycle for up to 16% longer compared to a placebo, an effect the researchers say isn’t achievable through training.

Glowing skin

Healthy eating really does give you a natural glow. At least that’s what University of Nottingham scientists found when their study concluded that photographs of people who ate more produce were rated as more attractive than those with suntans. Another from the University of St. Andrews found that people who upped their intake of fruits and veggies by roughly three more daily portions for six weeks were rated as more attractive than those with lower produce intakes. The lesson: you really are what you eat—both inside and out!

Improved brain function

For some time the Mediterranean diet has been considered the gold standard for optimal health. Cornerstones of this eating plan include a eating lots of veggies and fruits, along with fish, beans, whole grains, extra virgin olive oil, avocado, nuts and seeds, a moderate amount of wine—and a low intake of fatty meats, dairy products, refined grains, and sugar. A recent study from the National Institutes found that people who consistently adhere to a Mediterranean-like diet were less likely to have brain infarcts, small areas of dead tissue in the brain linked to cognitive problems.

Researchers also found that over 6 years, Mediterranean diet eaters were 36% less likely to have brain damage than those who least closely followed this eating pattern. This backs other research supported by the National Institute on Aging, which found that close adherence to a Mediterranean diet resulted in a 28% lower risk of developing mild cognitive impairment with aging, and a 48% lower risk of progressing from cognitive impairment to Alzheimer’s disease.

Cynthia Sass, MPH, RD, is Health’s contributing nutrition editor, and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Rangers NHL team and the Tampa Bay Rays MLB team, and is board certified as a specialist in sports dietetics.

This article originally appeared on Health.com.

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TIME Infectious Disease

Sierra Leone Staggers in Ebola Isolation Effort

Sierra Leone Ebola
A health worker volunteer talks with a resident on how to prevent and identify the Ebola virus in others, and distributes bars of soap in Freetown, Sierra Leone, Saturday, Sept. 20, 2014. Michael Duff—AP

FREETOWN, Sierra Leone (AP) — Some in Sierra Leone ran away from their homes Saturday and others clashed with health workers trying to bury dead Ebola victims as the country struggled through the second day of an unprecedented lockdown to combat the deadly disease.

Despite these setbacks, officials said most of Sierra Leone’s 6 million people were complying with orders to stay at home as nearly 30,000 volunteers and health care workers fanned out across the country to distribute soap and information on how to prevent Ebola.

The virus, spread by contact with bodily fluids, has killed than 560 people in Sierra Leone and more than 2,600 in West Africa since the outbreak began last December, according to the World Health Organization. It is killing about half of the people it infects.

The streets of the capital, Freetown, were empty Saturday except for the four-person teams going door to door with kits bearing soap, cards listing Ebola symptoms, stickers to mark houses visited and a tally to record suspected cases.

Among the volunteers was Idrissa Kargbo, a well-known marathoner who has qualified for races on three continents but whose training and career have been stymied by the outbreak.

Although early responses to the disease have been marred by suspicion of health workers, Freetown residents on Saturday seemed grateful for any information they could get, Kargbo told The Associated Press.

“Some people are still denying, but now when you go to almost any house they say, ‘Come inside, come and teach us what we need to do to prevent,'” Kargbo said. “Nobody is annoyed by us.”

Sierra Leone’s government is clearly hoping the lockdown will help turn the tide against the disease which the U.N. health agency estimates will take many months to eradicate in the country. In a speech before the lockdown, President Ernest Bai Koroma said “the survival and dignity of each and every Sierra Leonean” was at stake.

The strategy has drawn criticism, however. The charity group Doctors Without Borders warned it would be “extremely difficult for health workers to accurately identify cases through door-to-door screening.”

Even if suspected cases are identified during the lockdown, the group said Sierra Leone doesn’t have enough beds to treat them.

In a district 20 kilometers (12 miles) east of Freetown, police were called in Saturday to help a burial team that came under attack by residents as they were trying to bury the bodies of five Ebola victims, Sgt. Edward Momoh Brima Lahai said.

A witness told state television the burial team initially had to abandon the five bodies in the street and flee. Lahai said later the burials were successfully completed after police reinforcements arrived. The bodies of Ebola victims are very contagious and must be buried by special teams.

In northern Sierra Leone, health worker Lamin Unisa Camara said Saturday he had received reports that some residents had run away from their homes to avoid being trapped inside during the lockdown.

“People were running from their houses to the bush. Without wasting time, I informed the chief in charge of the area,” said Camara, who was working in the town of Kambia.

Several health care workers and volunteers complained that supply kits were delivered late, preventing their teams from starting on time.

But Kargbo, the marathoner, said his team was on track to meet its goal of visiting 60 households by the end of the lockdown Sunday. He said the effort would be worth it if the outbreak is shortened even a little.

Other Freetown residents, however, were having trouble making it through the three days.

“The fact is that we were not happy with the three days, but the president declared that we must sit home,” said Abdul Koroma, the father of nine children in Freetown.

“I want to go and find (something) for my children eat, but I do not have the chance,” he said.

TIME Diet/Nutrition

10 Mistakes That Make Cravings Worse

Cupcake choices, Crushcakes Cupcakery and Cafe, Santa Barbara, California
UIG/Getty Images

Cravings—such a dirty word when you’re trying to lose weight or keep it off. No matter what your “I-want-it-now” food is—pizza, burgers, ice cream, cupcakes—you probably wrestle with what you want to do (eat it now!) with what you “should” do (go eat veggies). Unfortunately, it’s true that many of our daily habits actually make cravings more intense and frequent, making healthy decisions harder. That doesn’t mean you can’t do something about it. Learn the 10 biggest mistakes that make cravings even worse to get yours under control.

You skimp on breakfast

Maybe you’re not hungry in the a.m., but eating some calories now can keep cravings at bay later. In one study in the Nutrition Journal, overweight girls who ate a 350-calorie breakfast with at least 13 grams of protein had reduced cravings for sweet and savory foods compared to breakfast skippers. Researchers aren’t exactly sure why, but protein may help stimulate the release of dopamine, a neurochemical involved in the brain’s reward centers that can help manage cravings. A half-cup of cottage cheese, 2 hard-boiled eggs, or a cup of cooked oatmeal with two tablespoons of peanut butter will do the trick.

Your serving is too big

You’ve got a craving for brownies, you’re going to have some, and you’re okay with that. So you take three. Thing is, you probably only needed half, suggests a 2013 study from Cornell University. Research on 104 students found that people who were given small snack-sized portions of chocolate, apple pie, or potato chips reported feeling as satisfied as those presented with larger servings—and they ate 76.8% fewer calories. So take a small serving, eat it and enjoy, and then wait 15 minutes until the yearning for more subsides.

You don’t eat anything

Craving candy? Try eating a bowl of super-sweet sliced strawberries. What about chips? Crunch on salted, in-shell pistachios. Substituting what you’re jonesing for with a similar-tasting healthy equivalent should be enough to satisfy you, says Marisa Moore, RD, a spokesperson for the Academy of Nutrition and Dietetics. “Cravings are short-lived and soon you’ll forget about it but will have helped your health with a good snack. It’s a win-win,” she says. However, if chips—and only chips—will do, count out one serving, eat them slowly, and be done.

You don’t know why you’re craving something

You can’t get your hand out of the bag of cheesy crackers. If you don’t understand why, you can’t do anything about it, says Christine Palumbo, RD, a faculty member of Benedictine University in Lisle, IL. She recommends keeping a cravings journal. It doesn’t have to be anything fancy—just jot down a few notes on your phone. When a craving hits, log your emotions: you’re tired, anxious, stressed, bored. Eventually, you’ll pick out common patterns, and you can deal with the causes head on, rather than trying to eat as a solution.

You don’t pair the food you crave with something healthy

Cravings aren’t all or nothing. You can satisfy your yearning while still eating healthy by pairing a larger portion of healthy foods with a small amount of what you think you want. It works because it makes meals more fun and tasty, but still gives your body the nutrition it needs to function at its best, suggests a Vanderbilt University study. The researchers call it a “vice-virtue bundle.” So here’s how to do it: order the salad with grilled salmon with a side of fries or get a piece of grilled chicken and veggies with a small bowl of mac and cheese. Fill up on the good stuff, and eat a quarter to half a portion of the splurge.

You pile on the guilt

It’s your friend’s birthday and there is cake. If you eat a slice, will you feel joyous or wracked with guilt? Delighting in delicious food rather than feeling shame about eating it may be key. People who said they associated chocolate cake with celebration had more control over their eating habits and had less trouble maintaining and losing weight, reported a 2014 study in the journal Appetite. One reason? Feeling guilty may make you try to ignore your thoughts, a strategy that actually backfires, causing you to obsess over the cake even more.

You try willpower

Straight-up willpower doesn’t always work. “It leads people to feeling like failures when they give in,” says Moore. A winning strategy: distraction. One study found that three minutes spent playing the game Tetris reduced the strength of food cravings better than a control condition where people spent the same amount of time waiting around. A 15-minute walk can also help reduce chocolate cravings, reports a 2013 UK study. Since cravings usually don’t stick around long, you just need to stick it out momentarily.

You keep temptation around

The mental battle between you and the box of cookies in the pantry does not have to be fought every day. “Out of sight, out of mind,” says Moore. “If it’s 10 p.m. and you want a cookie, you’re probably not going to go out and get some,” she says. On the other hand, if they’re staring you in the face every time you open the pantry, it’s all too easy to grab one. If your family insists you keep foods like cookies in the house, at least move them to the back of the pantry. Hide them behind the box of fruit-and-nut bars, so you see those first. And avoid buying crave-worthy snack foods in bulk from warehouse stores, adds Palumbo, since the more you have around, the more you’ll eat.

You’re dieting

You’ve got good intentions: in an effort to eat well, you tell yourself that the doughnut is off limits or the burger is sinful or a “bad” food. But your perception matters. Dieters have more intense and harder-to-resist cravings than non-dieters or people who are just trying to maintain their weight, particularly for their off-limits foods, according to a study published in Appetite. “When you deny yourself foods you love all the time, it will build up and explode, making you more likely to binge,” says Palumbo. Allowing yourself a little something every day, whether you’re looking to lose weight or not, can help take the power away from your cravings

You use Instagram or Pinterest

Gooey grilled cheese. A fudge-topped sundae. Pizza. Food porn is fun to look at, but don’t be shocked when suddenly you’re struck with a desire to run to the nearest Mexican restaurant or gelato store. In a small preliminary study from the University of Southern California, researchers found that images of high-calorie foods spark more activity in the reward areas of the brain than photos of low-cal fare.

There are plenty of health bloggers out there who create delicious-looking-but-nutritious food, so if you can’t resist food porn, at least follow people who post pics of healthy eats. Maybe you’ll be inspired to cook something new tonight.

This article originally appeared on Health.com.

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TIME Infectious Disease

Early Deaths Could Fall By 40% in the Next 20 Years

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According to researchers writing in The Lancet, we’re doing a good job of reducing the number of premature deaths—those occurring in people under 70. And if current trends continue with some improvements, such early deaths should drop by 40% over the next two decades.

When a group of 16 researchers from across the world looked at mortality trends from 2000 to 2010, they were encouraged by the results. “We actually found that mortality is falling very rapidly,” says lead author Ole Norheim, professor of global public health at the University of Bergen, Norway–by one-third for children and one-sixth for everyone below age 70. In low-income countries, where avoiding premature death is often more challenging due to weaker health systems and infectious diseases, the news was even better — deaths fell by an even larger percentage: 24% over the last ten years.

A number of factors are responsible, Norheim says, including improvements in child and maternal health, more effective ways to combat infectious diseases, economic factors, and cleaner water. “I don’t think people realize how positive these trends are and how important this would be for health worldwide,” he says. “People’s probability of surviving up to the age of 70 is actually much, much better now, compared to 1970.”

If those trends continue, and get even better, the 40% reduction over the next 20 years is both realistic and possible, Norheim says. One thing that would accelerate the process — helping more people to quit smoking. While preventive services, access to vaccines, treatments, and better nutrition are critical for hitting the goal, “If prices [of cigarettes] were doubled, that would reduce smoking by 1/3. That would mean millions of lives saved,” he says.

TIME Mental Health/Psychology

4 Things People Don’t Tell You About Major Weight Loss

Clothes on hangers
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Losing weight and getting healthier should be a good thing…right? Well, as Rosie O’Donnell told ABC News, shedding a lot of pounds may not instantly change your life for the better.

O’Donnell recently returned to hosting The View after leaving the talk show in 2007. She suffered a heart attack in 2012 and since then, she had a procedure known as a vertical gastric sleeve and dropped 50 pounds. Unlike a gastric bypass, which re-routes how your stomach processes food, a vertical sleeve gastrectomy removes a large portion of the stomach, leaving it about the size of a banana, according to the National Institutes of Health.

It’s hard to imagine seeing any downsides to slimming down, especially since people who are overweight are more prone to serious health conditions like heart disease and diabetes. Still, O’Donnell says it took some adjusting to get used to her new body.

“Everyone assumes that obese people would just be jumping for joy that they were healthier and thinner,” O’Donnell told ABC News. “But it’s also filled with a lot of emotional turbulence you wouldn’t expect.”

In fact, a UK study published in the journal PLOS One found that losing weight may not alter your mood the way you might expect. Of the 1,979 overweight and obese participants, 14% lost at least 5% of their initial body weight. After controlling for factors like serious health issues and major life events, researchers found more than half of the people who lost weight were more likely to report being depressed.

That may be because weight loss doesn’t address any underlying problems you may have. “Sometimes other things are making you unhappy, and the expectation that weight loss will fix it doesn’t pan out, which makes you even more unhappy,” says Gail Saltz, MD, Health‘s contributing psychology editor.

Here are some surprising things people might not think about when it comes to losing weight:

You may not be prepared for increased attention

Not many people may have gone out of their way to talk to you when you were overweight, and the attention that may come with your new look could be shocking at first. “Some people keep weight on unconsciously to protect themselves from intimacy with others,” Dr. Saltz says. This is especially true in settings of sexual intimacy. The fear of being hit on or being sexual with others may terrify some so much it causes them to regain the weight, Dr. Saltz says.

Your partner may not be supportive

O’Donnell says her partner encouraged her to be healthy, but that may not be the case for everyone. “A lot of marriages break up once one person gets healthy,” she told ABC News. Your partner might feel threatened by your weight loss for a number of reasons. A big one is they’ll fear others will want you or you’ll look better than them, Dr. Saltz says. Your shaping up forces your significant other to think about their own health choices, which they may not be prepared to handle. Another problem: Your partner may worry about how your personality might change. “You feeling great, sexy, or confident could shift the balance of the relationship,” Dr. Saltz says. “They fear losing the identity of the more confident one or losing the upper hand.” Many of these challenges could apply to friendships, too.

Your clothing options may feel scary

It’s not uncommon to feel unsure about shopping outside of plus size stores or sections. “It may be unexpected to feel nervous and conflicted about styles you might not have worn before because they are body revealing,” Dr. Saltz says. After losing weight, you may not know how to react to clothes that fit your body in new ways—not to mention the hefty price tag that comes along with buying a new wardrobe.

Your body might not match your expectations

Being thinner doesn’t mean your body will look “perfect” to you now. Loose skin, a flat behind, and sagging breasts are all changes that might accompany weight-loss procedures or lifestyle changes that help you shed a lot of pounds. Those changes won’t go away overnight either. And when your reflection doesn’t match what you imagined, you may feel more disappointed that there’s no healthy lifestyle change to fix the problem right away, Dr. Saltz says.

This article originally appeared on Health.com.

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TIME medicine

China Fines GlaxoSmithKline $485 Million for Bribery

The pharma company admits it's at fault and will not appeal

After a one-day secret trial, a Chinese court has fined pharmaceutical company GlaxoSmithKline (GSK) $489 million for bribing hospitals and doctors to use their products.

According to the New York Times, the court also sentenced GSK’s former country manager Mark Reilly as well as four additional managers to prison time of up to four years. However, the sentences were suspended, and the managers will avoid prison with good behavior–though Reilly must leave the country. The is the largest ever corporate fine in China, reports the Wall Street Journal, though some analysts had expected the fine to be even higher.

GSK issued a statement of apology, writing:

GSK fully accepts the facts and evidence of the investigation, and the verdict of the Chinese judicial authorities. Furthermore, GSK sincerely apologizes to the Chinese patients, doctors and hospitals, and to the Chinese Government and the Chinese people. GSK deeply regrets the damage caused. GSK plc also apologizes for the harm caused to individuals who were illegally investigated by GSKCI [GSK China Investment Co. Ltd].

You can read GSK’s full apology here.

GSK says they fully cooperated with the authorities and are reducing and changing the nature of their activities with health professionals, as well as growing the process the company uses to monitor payments and invoices. “We will also continue to invest directly in the country to support the government’s health care reform agenda and long-term plans for economic growth,” said GSK CEO, Sir Andrew Witty in a statement. The fine will come from existing cash resources, the company says.

According to IBISWorld Global Pharmaceuticals analyst Sarah Turk, GSK’s 3% market share in the global pharmaceuticals and medicine manufacturing industry will likely drop over the next five years, and the fine will significantly hinder the company’s research and development funding, thus increasing its competition with global companies like Pfizer and Novartis.

“As [GSK] seeks new investment opportunities in the coming years, the $489 million fine will limit the company’s leverage to acquire other companies and remain competitive in an industry that is increasingly looking for methods to harness new drug development pipelines,” writes Turk in an emailed statement. “Additionally, other pharmaceutical companies will likely tread carefully in the Chinese market, due to GSK’s fine possibly indicating that Chinese regulators are increasingly cracking down on corporate malpractice.”

This is not the first time GSK has been fined significantly for wrongdoing. In July 2012, the U.S. State Department fined the company $3 billion for marketing drugs for unapproved uses.

TIME Mental Health/Psychology

3 Surprising Reasons You’re Burned Out at Work

Woman head on desk
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You’re so over your job: the endless stream of emails, catty coworkers, unpaid overtime—the reasons go on and on. But a new study published in the journal Social Psychiatry and Psychiatric Epidemiology found it’s not only office problems that wear you down (though on-the-job factors can definitely affect you, too). Here, three other things that may be causing your work burnout:

You’re not getting enough support at home

Feel like you can’t vent to your partner about your day? Turns out having an understanding significant other is just as important as having a supportive boss in preventing work burnout, the Canadian researchers found. If you feel like your partner doesn’t get where you’re coming from, be it at work or at home, have a sit-down with them and talk about how a little listening can go a long way.

You’re not social enough

And we’re not talking about Facebook. People who had the support of a social network outside the office hadfewer mental health issues associated with job burnout, the study also found. So take the time to meet with your friends for coffee or a drink after work, even if you’re not in the mood after long day. And if most of your friends are your officemates, consider joining a social group that syncs with a hobby or pastime (think hiking or reading) that’s well-removed from your work social circle.

You’re not taking a lunch break

Well, at least not away from your desk. A separate study from the University of Toronto found that skipping your lunch break can make you less motivated and less productive. Researchers say this habit can drain your psychological energy by lunchtime and doesn’t give you time to recharge. So while you may think you’re being an office star by eating your salad at your desk, you may actually feel more sluggish and get less done (potentially leading to later nights on the job). A survey by tech company the Draugiem Group takes it one step further: They found the most productive people got up once every 52 minutes (for 17-minute breaks, but that seems like a bit much). Try starting with an actual lunch break, and go from there.

This article originally appeared on Health.com.

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TIME Infectious Disease

Why Reducing Antibiotic Resistance Is Harder Than It Seems

Changing business models and upping innovation may be part of the answer

Just a day after President Obama announced an executive order to create a task force and action plan for confronting antibiotic resistance, the House Energy & Commerce Committee held a hearing on antibiotic resistance and how to foster new drug development.

“Make no mistake: we are losing effective antibiotic treatments because the pace of new and novel drug development has not kept up with these organisms’ ability to build resistance to the treatments available today,” said committee chair and congressman Fred Upton in an opening statement.

Antibiotic resistance is the result of antibiotic overuse, which allows bacteria to mutate and become resistant to the very drug intended to treat it. Estimates show that 2 million infections and 23,000 deaths every year result from antibiotic resistant bacteria.

Business woes

One of the problems addressed in the meeting by Dr. Janet Woodcock, director of the Center for Drug Evaluation and Research at the FDA, is that developing new antibacterial drugs (to replace ineffective ones and fight bugs) is extremely challenging. “From a scientific standpoint, many patients with bacterial infections are often very sick and need to begin antibiotic therapy immediately. But enrolling a very sick patient in a clinical trial at the same time can be very difficult,” she said, adding that antibiotics are also generally viewed as less profitable due to their low prices and the fact they are taken for short periods of time.

“The judicious use of antibacterial drugs is at odds with the traditional business models and marketing practices used by the pharmaceutical industry for other drug categories, and serves as just one more disincentive to investment in antibiotics,” said Woodcock. She also argued the need for new business models for antibiotic development that disassociate antibiotic drug sales with companies’ returns on investments.

Kenneth Hillan, CEO at biopharma company Achaogen, Inc agreed, and urged support for the DISARM Act (Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms), which would reform reimbursement of antimicrobial products in hospitals by providing value-based pricing instead. Currently, hospitals get paid the same amount regardless of the antibiotic and whether it’s the most effective, so they usually choose the cheapest one.

“This would provide a powerful incentive,” said Hillan. “By providing separate reimbursement for qualifying antibiotics, the DISARM Act would…provide manufacturers with the opportunity to price new antibiotics in a way that is commensurate with the value provided.”

Moving faster than the bugs

As part of the FDA’s Generating Antibiotics Incentives Now Act (GAIN Act), the agency says they are streamlining antibiotic research and have developed a task force to focus on antibiotic drug development. But the FDA also acknowledged that it needs to expedite the process of updating antibiotic “breakpoints.” Breakpoints are found on antibiotic drug labels and show the concentrations at which bacteria are susceptible to successful treatment with antibiotics. Not having the right numbers can lead to over- or under-treatment.

While the committee hearing focused on drug innovation, one speaker, Kevin Outterson, a law professor at Boston University, brought up antibiotic resistance in regards to agriculture, which many argue is a greater problem. Agriculture accounts for more than 80% of antibiotic use in the U.S. and as TIME reported on Thursday, tackling how animals pass resistant strains on to humans is a greater challenge. “Resistance genes have been found throughout the agricultural sector, including dairy cows that did not receive antibiotics,” said Outterson. “We should launch serious research efforts to find and deploy techniques to reduce the need for antibiotics in agriculture and to reduce health risks to humans, including animal husbandry, vaccines, alternative forms of growth promotion, and other innovations.”

Whether these efforts will effect real change is yet to be determined, especially given some of the criticisms of Obama’s new plan. You can read the hearing statements here.

 

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