TIME Drugs

7 Signs You’re Drinking Too Much

Drinking hangover
mattjeacock—Getty Images

Actors Shia LaBeouf and Robin Williams both announced last week that they’re seeking treatment for alcoholism: LaBeouf as an outpatient following an outburst in a New York City theater and Williams in a rehab facility. A representative for Williams, 62, told People that the comedian is still sober—as he has been since a 2006 relapse—but wants to “focus on his continued commitment” to recovery.

Now, not everyone who drinks too much starts hitting strangers at a Broadway play like LaBeouf did. They could be having a more silent struggle like Williams. Regardless, alcohol problems are more common than you think. About 15% of people who drink go on to become alcohol dependent, says Carlton Erickson, PhD, director of the Addiction Science Research and Education Center at the University of Texas at Austin.

“Those who recognize the problem before they develop full-blown addiction have a greater chance they’ll be able to cut down and minimize the role alcohol plays in their life,” says John F. Kelly, PhD, director of the Recovery Research Institute at Massachusetts General Hospital in Boston.

So how can you tell if you’re developing a problem? Not all the clues are the same for all people, but here are common signs you could be headed for trouble—and how to turn it around.

Health.com:27 Mistakes Healthy People Make

You set limits…but can’t stick to them

If you always try to limit yourself to a certain number of drinks and fail every time, you could be struggling with alcohol. “If you find yourself repeatedly going over your self-defined limit, that’s a common early sign you’re losing control over your drinking,” says Kelly, who is also president of the American Psychology Association’s Society of Addiction Psychology.

What to do about it: Figure out what triggers your desire to drink and try to avoid these people, places, and situations. This drinking analyzer card from the National Institutes of Health is a good place to start; the NIH also has a 4-week tracker to see how well you can stick to your limit. If you can’t avoid a trigger, keep a list of reasons not to drink nearby, as well as a list of trusted confidantes you can call.

Your friends comment on your drinking

One of the first signs your drinking is spiraling out of control is when friends or acquaintances express surprise about how much you’re drinking or how “well” you “handle” your alcohol. “People start to get feedback from [other] people long before they realize it themselves,” says Kelly. “That’s a sign.”

What to do about it: Compare how much you drink with the limits for “low-risk” drinking, which, for women, is up to 3 drinks on any single day and no more than 7 drinks per week. The National Institutes of Health says that only about 2 in 100 people who drink within these limits have alcohol problems. But remember that “low risk” still doesn’t mean “no risk.” While alcoholism can derail your entire life, even smaller amounts of alcohol can raise the risk for pancreatic, liver, esophageal, and even breast cancer.

Health.com: How Alcohol Affects Your Body

The majority of your plans involve alcohol

If drinking becomes the center of your social and home life, if you’re the one urging others to order another round, or if you find yourself cutting back on activities that you used to enjoy that don’t involve drinking, you could be in dangerous territory.

What to do about it: Instead of meeting for drinks, ask friends to do things that don’t involve alcohol, like meeting for coffee, taking a yoga class, going to the movies, or lacing up for a run.

You reach for booze whenever you’re stressed

Everyone experiences stress, from a serious break-up to a biting comment from a colleague. Alcohol can give you some short-term relief from the upset but it can also backfire pretty quickly, leaving you with the stress of everyday life AND the stress of a drinking problem.

What to do about it: Find other ways to handle stress such as breathing deeply, taking a walk, or logging a workout (hey, playing basketball helps President Obama unwind).

Health.com:25 Surprising Ways Stress Affects Your Health

You worry about your own drinking

Your alcohol use could be problematic when your first thought in the morning is of how much you drank the night before. “You wake up concerned that you’ve broken your self-defined limit. You wake up thinking, ‘I didn’t stick to it’,” says Kelly. “The worry comes from the innermost part of yourself. That’s a sign of beginning of alcohol dependence.”

What to do about it: Confide in someone you trust. And get a reality check and personalized feedback on your drinking patterns with the Drinker’s Checkup, an online screening tool which also provides strategies on how to moderate your drinking.

Your doctor says you’re drinking too much

Doctors’ visits often involve answering questions about your lifestyle, including how much alcohol you drink. If you’re honest and if your doctor comments that the amount seems excessive, you should pay attention.

What to do about it: A doctor’s remark is not only a sign but also the start of a solution. “It has been shown that when physicians are astute enough to find out more about a person’s drinking behavior, if they make a statement like ‘I think you’re drinking too much,’ patients tend to listen,” says Erickson.

Health.com:15 Signs You Have an Iron Deficiency

You frequently wake up with a hangover

Even a sometimes-drinker gets the occasional hangover but if it starts to happen more and more often, you could be headed for trouble. “If you’re waking up three to four times a week with a hangover, that’s indicative,” says Kelly. And if you can’t remember what happened when you were drinking or you have only a hazy recollection, that’s a not-so-subtle clue that your drinking is out of control.

What to do about it: Monitoring your intake can help you stop before you go too far. Track how much you drink with the note function on your phone or an app—try IntelliDrink ($1.99, itunes.com) or AlcoDroid Alcohol Tracker (free, play.google.com). Just record the drink before you actually imbibe, which can help you slow down if necessary. You should include both the number of drinks and the size of each drink.

This article originally appeared on Health.com.

TIME

These 5 Yoga Moves Will Save You From Back Pain

Yoga forearm plank
Trista Weibell—Getty Images

The key to preventing back pain is to strengthen your core and release tension and tightness in the muscles around your upper and lower back. Plus, back pain can often be the result of stress. Yoga will help you relax and unwind mentally and these poses will continue to keep your core strong, your back supported, and your muscles lengthened and released.

Health.com: 15 Natural Back Pain Remedies

The first three yoga poses below connect us to our deep core muscles, which act as an inner girdle. When we tighten and tone our core, it helps us hold everything in and prevents us from straining our back. The last two are great for releasing tension in the upper and lower body. Tight shoulders can cause an achy upper back and tight hips pull on the lower back.

Try incorporating these poses regularly to keep your spine healthy, back strong, core engaged, and joints flexible.

Bird Dog

Start on hands and knees and imagine you have a glass of water on your lower back and one between your shoulder blades. Without spilling any water, reach your right arm forward and your left leg straight back behind you. Hold here for 30-60 seconds bracing your core. Come back to all fours before switching sides. Repeat 3 to 5 times on each side.

Health.com: 12 Yoga Poses for Non-Flexible People

Boat

Sit tall your knees bent and your feet on flat on the floor. Hinge back without rounding in the lower back as you lift your legs out in front of you at a 45-degree angle. Keep drawing our lower abdominals in and up and lengthen out of your lower back. Hold here for 5 to 8 breaths. Lower down and repeat 2 more times.

If this is too challenging with your legs straight, you can bend your knees so the shins are parallel to the floor.

Forearm Plank

If you only have time for one pose, this is the ultimate core move. It really works the entire midsection, deep core muscles and the back, waist, hips, legs, buttocks, arms, and shoulders.

Lie on your and place your elbows under your shoulders, tuck under your toes and press firmly through the back of your legs and heels. Engage your lower abs and tighten your core as you lift your body up off the floor coming in to one straight line of energy from head to toe. Don’t let your ribs splay open or your butt sag or lift too high. Hold for 45-60 seconds then lower down. Repeat 2 to 3 more times.

Health.com: 25 Exercises You Can Do Anywhere

Cow Face Pose

Start on all fours and slide your right leg over your left leg high at the upper thigh. Sit back between your heels and adjust your hips so they are even distance from each foot. Lift your left arm overhead and bend the elbow so the hand comes down between your shoulder blades. Reach your right arm behind your back and up towards the left hand try and touch the fingers or clasp the hands. If you can’t connect your hands, use a towel or strap. Recline forward over your legs and hold for 5 to 8 breaths. Come up move back on to all fours and repeat on the opposite side.

This pose will stretch out tight external rotators, hips, and buttocks as well as shoulders and upper back.

Camel Pose

Tight hip flexors can pull on the lower back and are often the result of sitting for too long of periods. Camel is an excellent counterpose to the slouched forward position we often assume. Camel opens up the entire front body while stretching the shoulders and front of thighs, hip flexors, quads and psoas muscles.

Health.com: Which Type of Yoga is Best for You?

Come in to a kneeling position with your toes tucked under. Place your hands on your lower back and try and slide your tailbone down towards the floor to lengthen your lower back. Lift your chest up and drop your head back as you reach for your heels (if this places any strain on the back keep your hands on your lower back). Hold and breathe for 5 breaths then lift up. If you want to challenge yourself further repeat the pose with the toes flat on the floor. The goal is to open up the chest and stretch the front of the body while lengthening out of the lower back. Use the strong abdominal muscles you found in the first three postures to support the backbend.

Kristin McGee is a leading yoga and Pilates instructor and healthy lifestyle expert based in New York City. She is an ACE certified personal trainer who regularly trains celebrity clients in New York and Los Angeles. She serves as Health’s contributing fitness editor and is frequently seen on national TV.

This article originally appeared on Health.com.

TIME Diet/Nutrition

5 Tricks to Avoid Being Hungry All the Time

Woman drinking water
Daniel Ingold—Getty Images/Cultura RF

Once, one of my clients half-jokingly requested an exorcism from the demon possessing her body: hunger. Kind of a gruesome analogy but, truth be told, it’s fairly accurate considering how out of control she felt. When my clients struggle like this, I often say I wish I could wave a magic wand to make it all better, which of course I can’t. But what I can do is offer some tried and true advice to effectively rein in appetite and help regain a sense of balance. The five strategies below are tops for doing just that, and each also has the power to enhance your overall health. Win-win!

Make sweating fun

Have you ever found yourself hungrier after working out, and then “ate back” more calories than you burned exercising? It’s a common phenomenon, and the trick to breaking the cycle may just be choosing ways of being active that feel like fun. In a recent Cornell University study, researchers asked two groups of adults to take a two kilometer walk before lunch or a snack. Those who were told they had been on an exercise walk wound up eating 35% more chocolate pudding for dessert at lunch and 124% more M&Ms at snack time than those who were told they had been on a fun, scenic walk.

Health.com:25 Exercises You Can Do Anywhere

Other research shows that intense exercise—sweat sessions that are perceived as work—can lead to eating more overall. In other words, a “no pain, no gain” mentality may wind up wreaking havoc with your appetite. If you’re in a similar boat, try mixing things up. Trade grueling workouts for activities that get your heart rate up but seem like play. Think dancing, hiking, roller skating, and swimming. Many of my clients find that even if they burn fewer calories, engaging in recreational activities often helps them lose more weight, because they don’t experience rebound hunger spikes.

Get enough sleep

Catching too few ZZZs is notorious for not only ramping up hunger, but also increasing cravings for junk food. One study from University of Texas Southwestern Medical Center found that too little sleep triggered excessive eating and weight gain, and getting more sleep slashed the consumption of carbs and fat, leading to weight loss. Another from the University of Chicago found that getting 4.5 hours of sleep (rather than 8.5) ups hunger and appetite, especially in the early afternoon.

In addition to causing appetite craziness, sleep deprivation has been tied to a number of health problems, including weakened immunity, and a greater risk of type 2 diabetes, depression, and heart disease. For these reasons, in my opinion, making sleep a priority may even be more important than exercise for weight loss. If you’re falling short like most people, read up on ways to improve your slumber.

Health.com:14 Reasons You’re Always Tired

Drink more water

Research backs what I find to be true for myself and my clients: drinking plenty of water can help manage appetite. One study found that people who drink about seven cups of water per day eat nearly 200 fewer daily calories compared to those who gulp less than one glass. Another found that when adults drank two cups of water right before meals, they ate 75 to 90 fewer calories. A second study by the same researchers showed that when two groups of people followed the same calorie-limited diet for 12 weeks, those who downed two cups of water before meals lost about 15.5 pounds compared to about 11 pounds for the water-free bunch.

Finally, a German study showed that a 16-ounce dose of water resulted in a 30% increase in metabolic rate within 10 minutes. The effect peaked 30 to 40 minutes after consumption, but was sustained for more than an hour. To take advantage of the benefits, drink about 16 ounces of H2O four times a day. If you dislike the taste of plain water, spruce it up with wedges of lemon or lime, fresh mint leaves, cucumber slices, fresh grated ginger, or a bit of mashed fruit.

Eat on a schedule

Your body loves consistency, which is why in my own personal experience, as well as my clients’, eating at the same times every day can go a long way in regulating appetite. Try eating breakfast within one hour of waking up and spacing your remaining meals about three to five hours apart. In addition to consistent meal times, strive for a steady meal structure in terms of the foods and proportions you include.

Health.com:15 Ways to Lose Weight Without Trying

For example, I recommend always including: produce, lean protein, plant-based fat (like avocado), and a small portion of a healthy starch. I’ve seen that mixing up the foods you choose within these categories, while keeping the types and quantities comparable, can have a huge impact on regulating hunger, supporting sustained energy, and creating a predictable return of hunger, almost like clockwork. In other words, when your meals are all over the place, it’s much easier to feel hungry all the time or confuse true hunger with boredom or other emotions.

Learn how to deal with stress

For most of my clients, stress is the number one eating trigger. And research backs the old adage: “stressed is desserts spelled backwards.” One recent animal study found that female monkeys chronically exposed to stress overate calorie-rich foods, unlike their calm counterparts. They also ate more throughout the day and evening, while the chilled-out chimps naturally restricted their noshing to daytime hours only. This behavior parallels what I see in so many people, and until they find effective ways to reduce stress, emotional eating is a difficult pattern to break.

Health.com:25 Surprising Ways Stress Affects Your Health

The best place to start: stop beating yourself up. Instead of berating yourself for not having enough willpower, acknowledge that when your stress hormones are surging, you’re programmed to reach for chips or chocolate. Speak kindly to yourself, and shift your energy toward testing out positive ways to cope, like listening to guided meditation, venting to a friend, spending time outdoors, reading, stretching, drawing, or whatever gives you a mini-vacation from the intensity of your emotions. That strategy, rather than “dieting,” is a much better way to set yourself up for successful weight control and better overall health.

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.

TIME Aids

This Is What We Lost Aboard Malaysia Airways Flight MH17

UKRAINE-RUSSIA-POLITICS-CRISIS-MALAYSIA-AUSTRALIA-AIDS-FILES
Leading AIDS researcher Joep Lange during a conference on AIDS in Paris on July 14, 2003 . Jean Ayissi—AFP/Getty Images

Late last night, a terrific HIV vaccine researcher, Wayne Koff, sent me a quick note, indicating Joep Lange perished aboard the jet senselessly shot down over Ukraine. I reeled. Joep was one of the group of “Young Turks” from Amsterdam, amazing AIDS researchers that in the 1990s led the way to our modern treatment era.

This morning’s news is still uncertain, but it seems Lange was on board along with some 100 of his Dutch compatriots, and many of the passengers shared an ultimate destination – the twentieth International AIDS Conference in Melbourne, Australia. Some probably highly premature news accounts indicate a third of those shot out of the sky were en route to the conference. One additional has been confirmed – Glenn Thomas, AIDS specialist in the World Health Organization communications office.

There was a time when we convened in these meetings and whispered the names of friends, colleagues, and loved ones that wouldn’t be coming this year because they died of AIDS. In our gatherings in the 1980s, grief hung like a curtain over everything, alongside anger over the way governments were responding, the lack of funding, the stigma, and so many other aspects of what it was like to live in the World of AIDS before there was treatment. We fought through the mourning to get the job done, whatever that job might be: activist protesting, scientific investigation, fundraising, even journalism. The great oratory leader of the early AIDS fight Jonathan Mann would whip us into a fever of determination to stop discrimination against people with AIDS, fight for research funding, and find a cure for the devastating disease. Jonathan, who started the first global AIDS program at WHO, was the early pandemic cheerleader, pushing everybody forward, encouraging teams of scientists to work together in ways biologists and clinicians never previously had, for any disease struggle.

The Young Turks from Amsterdam were a special breed. There were so few of them yet they accomplished a long list of spectacular breakthroughs in understanding how HIV disrupted the human immune system, smart ways to prevent transmission of the virus among drug users, careful but rapid drug discovery and testing. Joep and Jaap – two prominent Dutchmen we foreigners had trouble pronouncing. What is the world is the difference in saying Joep Lange and Jaap Goudsmit? We marveled at the pragmatism of the Dutch. To put it bluntly, they got the job done.

In 1996 the one and only joyous AIDS Conference convened in Vancouver – a meeting marked by announcement of successful combination therapy that knocked the dastardly virus down to levels undetectable in blood. There was hope for a cure, thanks in large part to the Dutch work. Some dared to speak of eradicating HIV all together.

Two years later, as hundreds of thousands of HIV-positive men and women living in wealthy countries were thriving on those treatment combinations, hope dominated the pandemic, until 1998 when Swissair Flight SR11 crashed off Nova Scotia, killing all on board. Among them, Jonathan Mann and his new wife, AIDS vaccine researcher Mary Lou Clements. Their sudden loss felt like a kick in the gut for the world AIDS community.

Here we are, sixteen years later, facing airline tragedy again. As I write this in haste we don’t have more names and the scale of the AIDS community’s loss is unclear. But the loss of one is tragedy.

Like so many of the great AIDS scientists that toiled through the years of extreme loss and urgency before there was effective treatment, Joep Lange absorbed the political dimensions of the pandemic, and gained the skills necessary to translate lab and clinical findings into high-level battles inside the United Nations and across the global stage. He became a leader, in the fullest sense of that word. Like Jonathan Mann, Joep blended science, medicine, and an activist spirit to help bring the life-sparing medicines to people in all of the world – not just rich countries.

The last time Joep and I spent time together we argued, I’m sorry to say. And I may have been completely wrong, he completely right. The saga we argued about hasn’t played out yet. Joep believed without hesitation that effective treatment, “is like a vaccine,” as he put it. The global epidemic could be stopped, he said, simply by getting every HIV+ person on the planet put on an effective regimen of treatment. Once on medicines, he insisted, the load of viruses in their blood, vaginal fluids, and semen would drop so low that they would not be contagious. And that, he said with a grin, will be the end of AIDS. I was skeptical – there were too many cases of drug resistance, non-adherence to treatment, supply chain failures to deliver vital drugs to remote or impoverished areas. I resented use of the word “vaccine” to describe universal treatment – we still desperately need an actual HIV vaccine, I insisted.

I want Joep’s optimism about eliminating AIDS through treatment to win out. I want to be wrong.

I just wish Joep was going to be around to see the great experiment play out.

A Tweeter asked me if the loss of Joep, Glenn, and other AIDS researchers and activists possibly on board MH17 would prove a major set-back in the fight against AIDS. No, I said. One of the glories of the AIDS community is that its bench is deep, its talents enormous, and its sorry history of processing grief and moving on is unparalleled. The dead, as has always been the case since this awful virus emerged in the late 1970s, will be mourned. And then energies will be mustered, to get the job done.

Until there is a cure.

Laurie Garrett is a senior fellow for Global Health at the Council on Foreign Relations. This essay also appeared on http://lauriegarrett.com/blog/.

TIME Drugs

FDA Warns Against Powdered Caffeine

The agency issued a statement Friday recommending that consumers avoid the potent powders

The U.S. Food and Drug Administration issued a warning Friday about the dangers of pure powdered caffeine after the death of a teenager in Ohio in May.

A mere teaspoon of pure powdered caffeine, the FDA said, is equivalent to 25 cups of coffee and can be lethal. “Pure caffeine is a powerful stimulant and very small amounts may cause accidental overdose. Parents should be aware that these products may be attractive to young people,” the agent noted. The substance can be easily purchased online.

Taking too much of the drug can result in heartbeat disruptions, seizures, vomiting, diarrhea and disorientation. “These symptoms are likely to be much more severe than those resulting from drinking too much coffee, tea or other caffeinated beverages,” according to the statement.

The announcement comes almost two months after Logan Steiner, 18, of LeGrange, Ohio, died after overdosing on powdered caffeine on May 27.

TIME plague

3 New Plague Cases Confirmed in Colorado

The state health department has found a total of four people infected with the pneumonic plague

Three new cases of plague have been identified in Colorado for a total so far of four, the state health department announced Friday.

The four people diagnosed all had contact with a dog that died of the plague. The initial patient remains hospitalized but the three infected later “all had minor symptoms, were treated with appropriate antibiotics, recovered and are no longer contagious,” the health department said in a release.

Plague is spread from rodent—in this case prairie dogs—to other animals, including humans, by rogue fleas.

Of the 60 cases of plague in its various forms that Colorado has seen in recent years, nine people have died from the disease, according to a Bloomberg report. Doctors recommend keeping a safe distance from any rodents, alive or dead.

TIME Australia

After MH17 Ukraine Crash, Global AIDS Researchers Mourn Lost Colleagues

The cause of HIV/AIDS research will be set back because of experts lost in the Malaysia Airlines Ukraine disaster

+ READ ARTICLE

[UPDATE: 7/18/14, 11:52 AM EDT]

There was a pall over the 20th annual International AIDS Conference in Melbourne even before the crash of Flight MH17 in eastern Ukraine, which killed an estimated 100 delegates who were en route to the meeting. [Update: Later reports suggest that the number of delegates lost is much lower.]

In the past couple of years the vibrant showcase event—part serious science, part activist networking and carnivalhas been headily optimistic, as HIV treatments improved and the possibility of a cure no longer seemed so far off. “The mood is always an important part,” says Professor Mike Toole, an international communicable diseases veteran with Melbourne’s Burnet Institute who has been at the HIV/AIDS front line since the pandemic began some 30 years ago.

Toole remembers that the landmark Durban International AIDS Conference back in 2000 demonstrated to this eclectic crowd—a disparate crew of laboratory researchers, front-line health workers, activists and people living with the infection—their powerful potential. It was in Durban that the commitment to deliver then-prohibitively expensive antiretroviral drugs to the world’s poorest populations ignited, and was carried through over the next few years by organizations like The Global Fund and the U.S. President’s Emergency Fund for Aids Relief.

The past two International Aids Society (IAS) meetings, in Vienna and Washington DC, have been buoyed by signals that a breakthrough was close, and the expectation was that the momentum would continue into Melbourne. Then, barely a week ago, came a serious blow. For over a year many members of the HIV/AIDS community had been pinning their hopes for a breakthrough on the so-called Mississippi baby, an HIV-positive infant that had apparently been cured through aggressive drug treatment soon after birth. But on July 10, news came, that the child was showing symptoms that the virus had returned.

Although there are other programs that indicate that it might be possible to eliminate HIV infection from a human body, the apparent relapse of the Mississippi baby “depressed people incredibly,” says Toole.

Then came yesterday’s tragedy. For Toole and others HIV/AIDS experts the crash summoned up ghosts. “It reminds me of the Swissair flight, New York to Geneva, when Jonathan Mann died,” he says. Mann then the founding director of the World Health Organization’s global AIDS program was killed with several other researchers, including his wife Mary-Lou Clements-Mann, en route to AIDS meetings when the plane crashed in Canada, September 3, 1998. “I lost five friends on that flight.”

In Sydney, at a pre-conference gathering on July 18, about 200 delegates spent the day closely monitoring Twitter and exchanging snippets of news, desperate for updates on who would and would not be joining them in Melbourne. The word there was that a substantial number of the 100-plus delegates reported to be on the downed aircraft were part of the global network of activists and people living with AIDS.

With only a handful of names of the deceased confirmed by Friday, it’s difficult to measure the overall impact on HIV/AIDS research and advocacy. But the loss of internationally renowned Dutch researcher Joep Lange—a former president of the IAS—would be a massive blow. “It will have a big psychological effect,” says Toole. “He was one of the leaders in the field.”

Another known casualty was Glenn Thomas, a British media officer working for WHO in Geneva. Thomas was to be part of a media launch on July 20 revealing new tools to reduce harm to users of intravenous drugs. He was also recognized as a particularly effective communicator on the links between HIV/AIDS and tuberculosis, says Toole. (The risk of developing TB is up to 20 times greater in people infected with HIV, and in 2012, of the 8.6 million new cases of TB diagnosed internationally, 1.1 million were among people with HIV.)“And the other hundred [on board]—we don’t know who they are, what it means.”

The annual AIS conferences are like no other medical gathering, says Professor Rob Moodie of the University of Melbourne, a former senior WHO official and longtime Australian public health specialist. “You have this incredible mixture of scientists and clinicians, public health people, civilian organizers, human rights activists, people who have the virus … who all have some sort of sense of ownership and collective leadership.”

The energy and collaborations of these gatherings have helped drive the huge advances achieved in understanding and responses to HIV/AIDS in a relatively short time. “We learned more about HIV in the first 10 years than we did in a century with other diseases,” says Moodie. The involvement of grassroots activist groups—as well as lab researchers—has been key to that success. MH17’s toll would not only be measured in the loss of medical expertise, but of advocacy, understanding and hard-won personal experience.

“There is a black cloud on this conference,” says Toole. “I don’t think there is anything that can retrieve that.”

Still, Toole was confident that delegates would be driven to achieve as much as they could in memory of their colleagues. He welcomed the move by the City of Melbourne on July 18 to cancel fireworks that had been scheduled to kick off the conference, but was disappointed that that’s night fixture in the Australian Football League competition—to which AIDS2014 delegates had been given tickets as part of the cultural program—did not pause for a minute of silence.

TIME

Chikungunya in Florida Man Is First Case Acquired in the U.S.

98736416
WS photography—Getty Images/Flickr RF

The Centers for Disease Control and Prevention (CDC) says that the first case of the mosquito-borne virus chikungunya infection picked up in the U.S. occurred in a Florida man who had not recently traveled abroad.

This year, 243 people in the U.S. became infected, but this is the first case of a disease believed to originate from a mosquito in the U.S.

Chikungunya is a disease caused by a virus that leads to fever, joint pain, headaches, swelling and rash. The infection is usually not fatal, but the pain can be debilitating.

“The arrival of chikungunya virus, first in the tropical Americas and now in the United States, underscores the risks posed by this and other exotic pathogens,” Roger Nasci, chief of CDC’s Arboviral Diseases Branch said in a statement.

The CDC is teaming up with the Florida Department of Health to confirm how the Florida man became infected and is monitoring the area for additional cases. The CDC believes that chikungunya in the U.S. will follow a similar pattern to that of the dengue virus, in which imported cases cause some local transmission, but did not cause a widespread outbreak. Public health officials are investigating how the mosquitoes were infected with the virus, including whether the insects acquired the virus by biting infected individuals. Since 2006, there have been an average of 28 cases a year of chikungunya infection; none of those cases have prompted an outbreak, however. Countries in Africa, Asia, Europe, India, the Middle East, and the French side of the Caribbean island of St. Martin have experienced outbreaks in the past and 23 countries have experienced local transmission of the virus in recent years.

The best way to stay protected from the virus is to keep mosquitoes at bay by wearing repellants and creating a physical barrier from being bitten, with long sleeves and pants when possible. Health officials also recommend getting rid of any standing water outside the home, where mosquitoes generally breed.

TIME

Alcohol Plus Energy Drinks Makes You Want to Drink More, Study Says

114330672
New study finds people drinking alcohol with energy drinks have a greater desire to drink Chris Stein—Getty Images

A small study shows people drinking vodka Red Bulls want to drink more

A recent Australian study found that when people drink alcohol with energy drinks they have a stronger desire to keep drinking compared to people who just drank a vodka soda.

The study, published in the journal Alcoholism: Clinical & Experimental Research, assigned 75 participants between the ages 18 and 30 to either just drink alcohol, or drink an alcohol and energy drink combination. The people in the energy drink group received a 60 ml of vodka and a Red Bull energy drink. The other group drank a vodka soda. All the drinks had some fruity beverage added to them so they didn’t taste terrible. The participants then filled out questionnaires about their drinking experience before and after.

The alcohol-energy drink imbibers had a stronger desire to continue drinking compared to the group just drinking alcohol. The researchers note that although the participants in the study drank the same amount, there are some pretty significant implications if there happens to be something about drinking alcohol with energy drinks that makes people want to keep boozing. As people get more tipsy, it can become harder to cut themselves off.

The study is small and preliminary, but there’s a growing interest in how energy drinks and alcohol interact in the body. The energy drink industry is continuing to grow, starting as a $3.8 billion business globally in 1999 to $27.5 billion in 2013, according to market research firm Euromonitor. Knowing the spectrum of their effects is important for safe socializing.

TIME sexual abuse

Childhood Sexual Abuse Raises Heart Disease Risk In Adulthood

Researchers link early sexual abuse to greater risk of developing blocked heart arteries

Sexual and physical abuse during childhood can have long term effects on both mental and physical health, and previous studies have linked childhood sexual abuse to a greater risk of heart attack and other heart events—but it has been unclear exactly why. New research published Thursday in the journal Stroke adds to the case, showing thatwhether or not women had other risk factors for heart problems, a history of childhood sexual abuse remained a strong potential contributor to their atherosclerosis.

“What was a surprise was that when we controlled for [heart disease] risk factors, such as smoking and obesity, the association didn’t go away. We just couldn’t get rid of the association,” says Rebecca Thurston, director of the Womens’ Biobehavioral Health Laboratory at the University of Pittsburgh, who led the research with a team of colleagues.

MORE: Viewpoint: Why a Mandatory Child Abuse Reporting Law Could Backfire

More than 1,000 middle-aged women of various ethnic backgrounds from across the U.S. had yearly clinical exams beginning in 1996 for 12 years. At the end of the study, they also answered questions about sexual and physical abuse and had an ultrasound of their carotid arteries. About a quarter of the women reported being sexually abused as a child, and a similar percentage reported the experience as an adult.

When Thurston compared the women’s answers to their ultrasound, she found that those who reported childhood sexual abuse showed higher rates of plaque buildup in their arteries. They also had hearts and vessels that looked about two to three years older than those of women who hadn’t been abused.

MORE: Psychological Abuse: More Common, as Harmful as Other Child Maltreatment

Thurston’s findings suggest that whether or not the women had other risk factors for heart problems, their history of childhood sexual abuse remained a strong potential contributor to their atherosclerosis.

Thurston plans to continue the work by studying women who have had heart events – in this study, only women without heart disease were included – to see if the correlation still holds. She also wants to better understand how the early abuse affects women in later life. There is some evidence that traumatic experiences may change the stress response system in lasting, and possibly permanent ways.

While none of the women had signs of heart disease at the start of the study, Thurston says the results hint that physicians should be considering childhood experience, particularly traumatic ones, as part of comprehensive heart care for women. If the results are validated, then they might lead to ways of intervening with stress reduction or other psychological techniques to hopefully slow down the hardening of the arteries and lower their risk of heart disease.

Your browser, Internet Explorer 8 or below, is out of date. It has known security flaws and may not display all features of this and other websites.

Learn how to update your browser