TIME ebola

How Effective Is Screening for Ebola at Airports?

New York's JFK Airport Begins Screening Passengers For Ebola Virus
A plane arrives at New York's John F. Kennedy Airport (JFK) airport on October 11, 2014 in New York City. Spencer Platt—Getty Images

Since August, 80,000 passengers have been screened for Ebola at various airports around the world. Here’s what health officials found

As the Ebola outbreak in West Africa escalated over the summer, the World Health Organization recommended airport screening as a way to contain spread of the disease. WHO advised that all people leaving the most severely affected countries—Guinea, Liberia and Sierra Leone—should have their temperatures taken and be asked about any Ebola-related symptoms they might have, including fever, headaches, vomiting and diarrhea.

Since the program began in August, more than 80,000 passengers have been screened as they left these countries, 12,000 of them headed for the U.S. Do the screenings work? In a report published in the MMWR, officials at the U.S. Centers for Disease Control reveal the latest information from the program.

Anyone with a fever or other symptoms—or who reported having a high risk of being exposed to Ebola, such as having contact with Ebola patients—was not allowed to fly. According to the CDC report, none of those who were denied boarding were diagnosed with Ebola. But two patients without symptoms when they left West Africa, Thomas Eric Duncan and Dr. Craig Spencer, eventually developed Ebola after arriving in the U.S.

The MMWR report also details the U.S.’s more stringent airport entry screening for all passengers arriving from the three affected countries. Beginning Oct. 11, all passengers coming to the U.S. from these countries were required to fly into one of five airports: John F. Kennedy International Airport in New York, Newark Liberty International Airport in New Jersey, Washington-Dulles International Airport, Chicago O’Hare International Airport or Hartsfield-Jackson Atlanta International Airport. They are also required to take their temperatures for 21 days, the incubation period for the Ebola virus, and report them to local health officials. The designated airports are equipped with trained public health personnel who meet passengers and provide them with a kit to help them record their temperatures, as well as educate them about who to call if they develop symptoms.

From Oct. 11 to Nov. 10, 1, 993 passengers were screened this way, and 4.3% were referred to the CDC for additional evaluation. Seven people had symptoms and were referred to proper medical personnel, but none developed Ebola. “Using these processes to educate each traveler and then link the traveler to public health authorities for the duration of the incubation period is of critical importance to facilitate rapid detection of illness and implementation of appropriate public health control measures,” the authors write.

But the most effective way to prevent the epidemic from spreading is to control it at its source. In a separate MMWR report, researchers at the CDC say that their first assessment of Ebola infection and control in Sierra Leone reveals many gaps. In a review of six of the 14 districts in Sierra Leone that are affected by Ebola, the CDC Ebola Response Team found that none had a dedicated infection control supervisor to oversee training and implementation of infection control procedures, such as wearing protective equipment and isolating patients. There were also no national, district or facility standards for infection control, and screening of patients for Ebola was inadequate. All districts also lacked sufficient personal protective equipment, the gear that is critical for protecting health care workers treating Ebola patients, and many did not have running water, enough chlorine bleach to sanitize contaminated objects, or incinerators for burning disposable medical waste.

“An increasingly coordinated and comprehensive [infection and prevention control] program with district and health facility level support is urgently needed to prevent Ebola in districts where the prevalence is low and to strengthen the existing…response in areas with high prevalence of Ebola,” the CDC officials write.

TIME Behind the Photos

How John Moore Covered the Ebola Outbreak

Getty Images photographer John Moore was covering the Ebola outbreak in Liberia from the onset

In the early months of an Ebola epidemic that has claimed more than 6,000 lives in West Africa, Getty Images photographer John Moore was on the frontline in Liberia.

At that time, untrained medical workers fell victim to the virus, with hospitals and clinics unable to handle the rising number of cases. Moore’s harrowing images, published on TIME LightBox in August, crystallized these challenges. “I went relatively early on to cover the Liberia outbreak,” he says. “And I hope that my work had at least some small influence on mobilizing aid, [helping to] instill a sense of urgency into the international community.”

Moore spent a total of four weeks on the story, and he advised several other photographers on the crucial and life-saving procedures one has to carefully follow to prevent infection. “I was very happy to see other news organizations go to West Africa afterwards and expand the coverage,” says Moore. “I believe that with a humanitarian crisis like this, more media is better. In the case of Liberia, there were actually fewer media there than there would normally be on such a large story. Perhaps fear had something to do with that.”

With the virus posing an invisible risk, many news organizations have been reticent to send journalists and photographers to cover the outbreak. But, says Moore, while the epidemic has “the appearance of being too dangerous, in reality, I believe it was less dangerous than some of the other places I’ve been and worked consistently over the years like Afghanistan and Iraq.”

Today, the situation has improved, with scientists and healthcare workers fighting back—and the Ebola Fighters were selected as TIME’s Person of the Year. But the fight is far from over, as recent work from photographers Daniel Berehulak, Samuel Aranda and Pete Muller, among many others, can attest.

Moore plans on returning, as he tells TIME in an exclusive video interview: “I don’t know yet the timing of my return, but I’ll go back to West Africa.”

Olivier Laurent is the editor of TIME LightBox. Follow him on Twitter and Instagram @olivierclaurent. Paul Moakley, TIME’s Deputy Director of Photography, produced this video essay.

TIME Research

You Asked: What Is My Poo Telling Me?

you-asked-poop
Illustration by Peter Oumanski for TIME

Your excrement is illuminating

Some say you are what you eat. But really, you are what you poop. “Not only does stool tell you about the health of your diet, but it shows you how your body’s digestive system is handling the foods you eat,” says Dr. Anish Sheth, a Princeton-based gastroenterologist and author of What’s Your Poo Telling You?

From hemorrhoids to cancer, diseases grave and small often show up first in your feces, Sheth says. And in recent years, health experts have learned your excrement also contains a wealth of information about your microbiome, the world of microscopic organisms that live and support your body’s many internal systems.

Put simply, your poop is a window to your health—even if you don’t consider the view all that appealing.

The first thing to consider when assessing your stool (a practice Dr. Sheth heartily advocates) is consistency, both in terms of physical attributes and regularity. “The ideal stool,” Dr. Sheth says, “has been described as a single soft piece.” You’re looking for something log-ish but not too firm, he continues. Imagine dispensing soft serve ice cream into your toilet, and you’ll have the general, somewhat less delicious idea.

This type of stool indicates you’re getting plenty of water and fiber in your diet. An absence of either can produce firmer, broken-up, difficult-to-expel feces or constipation, Sheth says. How hard you have to push is also important, he adds. Ideally, you should “evacuate” your waste with almost zero effort and feel as though you’ve fully emptied yourself.

Of course, everyone has the occasional bout of diarrhea or too-firm poo. But Sheth says neither should worry you much if it happens just once or twice before you’re back to normal. If a week passes without you passing healthy-looking stool, you should speak with a doctor. Even if you’re taking a number-two every day, hard or broken-apart poop is a sign that your diet is probably too low in fiber or water, which can lead to all sorts of gastrointestinal (GI) tract issues, Sheth says.

The color of your feces is also important. If it appears black or tarry, that may be evidence of blood. “The darker the stool, the higher up in your GI tract the blood is likely coming from,” Sheth says. He explains that blood emanating from ulcers or stomach problems will darken as it passes through your digestive system.

If you see maroon or dark red hues or streaks in your poop, that could mean inflammation, colitis, or certain intestinal cancers, Sheth explains. Bright red blood often indicates hemorrhoids or problems localized very near your anus.

Even the buoyancy of your bowel movements can reveal concerns. If your poop usually floats, that may signal an issue with your body’s ability to absorb fat, which in turn might mean your pancreas is having problems, Sheth says. Some particularly bad odors could also be red flags for health issues, although you probably wouldn’t know them if you smelled them. “Some doctors can identify certain GI diseases just by the distinct smell, although people who don’t diagnose them all the time wouldn’t be able to,” Sheth explains.

To keep your poop and your health in top form, Sheth recommends a diet than includes, again, plenty of fiber. “The average American gets about nine grams of fiber a day, when you need 25,” he says. He recommends lots of whole grains, fruits, vegetables, legumes and seeds like flax or chia. “Throw those in a daily smoothie,” he suggests. “And look before you flush!”

TIME ebola

Scenes From Monrovia, Liberia

A look inside Eternal Love Winning Africa (ELWA), the nondenominational Christian mission which opened the first Ebola treatment unit in Monrovia, Liberia at the onset of the Ebola outbreak.

TIME Research

Can You Really Trust the Health News You Read Online?

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Getty Images

Sometimes you should take reports with a grain of salt, research found

Are science-backed headlines bad for your health? A new study published in The BMJ shows that you can’t always trust what conclusions news stories draw about the latest research.

Researchers wanted to look at how often press coverage misrepresents scientific studies. So they analyzed 462 press releases from 20 leading research universities in the UK, comparing their claims to those found in the peer-reviewed paper on which they were based. After analyzing the news stories those press releases generated, the researchers traced whether the papers’ claims got inflated in translation to mainstream media. They focused on three main types of exaggeration: flawed health recommendations to change their behavior based on the “findings”; a causal association when a merely correlational one existed; and the application of animal data to the health of humans.

A full 40% of press releases contained exaggerated advice, 33% drew causative conclusions from mere correlation, and 36% drew human conclusions from animal data.

Press coverage largely followed suit, based on those flawed releases. While “there actually wasn’t that much exaggeration being invented fresh in the news,” the rates of exaggeration were much lower when press releases stayed true to the research, said the study’s co-author Petroc Sumner, PhD, a professor of neuroscience at Cardiff University in the UK.

“If you ask the scientists who’s to blame when things go wrong, 100% of them say journalists,” says Sumner. “But at least 30% of them admitted that their own press releases had exaggeration, even when they’d been heavily involved in writing them themselves.”

Why would an institution issue an inflated press release? “Universities are now all in competition with each other,” Sumner explains. “Academics have now felt this pressure, and we’re all being encouraged to come out of our ivory towers and make what we do known in the real world.”

Time-crunched journalists also feel pressure to publish, and often do so without fully investigating a university’s claims, he says. Overreaching press releases breed over-promising headlines—bad news for the majority of the population that still get most of their health and science information from media sources, Sumner says.

“That’s an awful lot of people, many, many millions of people, making lifestyle decisions based on information about health or health-related science that they’ve read in papers or heard on the news…much more so than based on actual government-driven or medically-driven public health campaigns,” he says, adding that it’s common for people to ask for certain drugs or stop taking medication based on headlines they’ve heard or read. “The cumulative effect of so much potential exaggeration and misinformation could be very large.”

News outlets didn’t differ much from one another in terms of which ones exaggerated more. Instead, press releases seemed to be the most significant factor. “In a sense, that’s actually good news,” Sumner says. “As academics, we have the power to change universities. We don’t have the power to change the pressures in newsrooms.”

TIME Healthcare

Abortion Complication Rates Are ‘Lower Than That For Wisdom Tooth Extraction’, Study Says

People who get abortions are less likely to have complications than people who have their wisdom teeth removed, finds a new study published in the journal Obstetrics & Gynecology.

Researchers at University of California San Francisco wanted to understand, from a medical standpoint, the safety of abortions, so they analyzed 54,911 of them performed from 2009-2010 on women, as well as the health care services the women received in the six weeks following the abortion.

Of those abortions, only 2.1% resulted in a complication—considerably lower than the 7% complication rate for wisdom tooth removal and 9% rate for tonsillectomy, the authors point out. Major complications that required hospitalization, surgery or a blood transfusion occurred in only 0.23% of the women in the study—126 cases. That’s lower than the rate of major complications for colonoscopy, says study author Ushma Upadhyay, PhD, an assistant professor in the department of obstetrics, gynecology and reproductive sciences at UCSF.

Fewer than 2% of abortions resulted in a minor complication. Medication abortions—a sequence often called the “abortion pill“—had the highest rate of complications at 5.2%, “the vast majority of which were minor and expected,” the study authors write. Those minor complications often mean they come back for another dose to complete the abortion.

According to the study, 23 states now have regulations that an abortion clinic must meet standards for ambulatory surgical centers. 8 states have hospital transfer agreement requirements, and 13 require hospital admitting privileges. The typical explanation for these regulations has been that safety is a factor, but the researchers hope to remove that as an issue. “Across the country, there are a record number of restrictions against abortions,” Upadhyay says. “I think basically that they’re supported by the public because they seem like they are needed”—but abortion providers sometimes can’t get admitting privileges, so abortion clinics often end up being shuttered, she says. “I hope [the data] clarifies that abortion is a safe procedure, and that it’s not this scary procedure it can be made out to be in the media or public policy,”

TIME global health

The 20 Best and Worst Health News Stories of 2014

Stethoscope
Getty Images

Wins, fails, and sensational headlines in medicine and public health

As far as sensational headlines go, the past 12 months provided no shortage of health-related material. Of course, 2014 had its share of doom-and-gloom stories about depression, domestic violence, untimely deaths, and disease outbreaks (at home and abroad), to name a few. But it also gave us reasons to celebrate: Promising new discoveries and legislation, inspiring role models and worthy causes, and healthy trends that are improving lives and changing the future. Here, in a nutshell, are the best and worst health stories of the year.

Best: Obamacare hits one-year milestone

Despite its rocky beginnings in 2013 (and the fact that many Americans still don’t understand it), the Affordable Care Act achieved several of its major goals in its first year, according to a study published in July by the Commonwealth Fund. The report found that the number of uninsured Americans dropped by 25% and that most people like their new plans and find it easier to find a doctor.

Separate studies this year also found that the ACA, also known as Obamacare, has helped young adults receive mental health treatment and could potentially lead to a decline in deaths.

Worst: Ebola outbreak in Africa (and freakout in America)

By far the biggest and most devastating health story this year has been the thousands of West Africans sickened and killed by the Ebola virus, which hit the areas of Liberia, Guinea, and Sierra Leone particularly hard.

And although the virus can only be spread through contact with bodily fluids—and despite the fact that no American has yet contracted Ebola who has not spent time treating patients with the disease—that didn’t stop hysteria in the United States. Amid calls for a travel ban and anger directed toward doctors and nurses returning home from Africa, mental health experts stated in October that anxiety about Ebola was now a bigger threat than the virus itself.

Best: Medical devices lose some of their stigma

Women who enter beauty pageants and pose for Internet selfies are often seen as vain and materialistic, but in 2014 two women fought to dispel those notions, while at the same time showcased health conditions that aren’t often seen as beautiful.

In July, Miss Idaho contestant (and eventual winner) Sierra Sandison wore an insulin pump she uses to treat her Type 1 diabetes clipped to her swimsuit during a competition. One month earlier, UK resident and Crohn’s disease sufferer Brittany Townsend had shared her own bikini photo on Facebook, complete with the colostomy bags she needs to remove waste from her body. Both photos went viral, sending messages that women like Sandison and Townsend don’t have to be ashamed.

Worst: Measles outbreak fueled by anti-vaccinators

The CDC reported in May that measles cases in the United States were at a 20-year high so far this year, largely due to unvaccinated people who contracted disease while traveling abroad and then returned home and spread it among unvaccinated members of their communities.

The number of parents who choose not to vaccinate their children in the United States is growing, despite a scientific consensus that childhood vaccines are safe and don’t cause serious health problems like autism or leukemia. Unvaccinated children have also contributed to recent outbreaks of whooping cough and mumps.

HEALTH.COM: 12 Strange-But-True Health Tips

Best: CVS stops selling cigarettes; FDA limits e-cigs

Customers can no longer pick up cigarettes along with their prescriptions at CVS pharmacies, thanks to a ban in all stores implemented in September—four weeks earlier than the date the chain had originally announced. Carnival Cruise lines also jumped on the bandwagon this year, banning smoking on its stateroom balconies in October.

E-cigarettes have seen plenty of regulations this year as well. In April, the FDA proposed regulations to ban the sale of electronic cigarettes to minors and to include health warnings on their packages, and in August, the World Health Organization recommended that countries regulate electronic cigarettes and ban their indoor use.

Worst: Enterovirus outbreak hits children nationwide

At last count, a severe respiratory illness called Enterovirus D68 has been reported in 43 states and the District of Columbia. More than 500 cases have been confirmed across the United States, mostly children, with four suspected deaths (and one confirmed).

ED68 has been described as a polio-like illness that can cause paralysis. Most infected children recover without serious illness, but those with lung conditions like asthma are at increased risk for severe symptoms.

Best: Orthorexia gets mainstream coverage

Being a diligently healthy eater may seem like a good problem to have, but a prominent blogger showed fans this year what can happen when it’s taken to an unhealthy extreme. Jordan Younger, also known as The Blonde Vegan, announced to her readers in June that she was moving away from her strict vegan lifestyle because she’d developed an eating disorder called orthorexia—an obsession with healthy foods that leads to more and more restrictions and, potentially, malnourishment.

Worst: Domestic violence rears its ugly head

The topic of domestic violence made national headlines this year when then-NFL player Ray Rice punched his then-fiancee (now wife) in an elevator; investigations since then have uncovered many more instances of spousal or partner abuse among professional football players, and cover-ups among their teams.

But a survey released in September revealed that one in five American men admits to using violence against his spouse or partner, and that domestic abuse affects people of all professions, races, and classes. A study in April also found that domestic violence can cause fear and anxiety for children who witness it, hear it, or see the resulting injuries.

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Best: Science gets wise to the dangers of sugar, white bread

Doctors and nutritionists have known for decades that added sugar is linked to diabetes and heart disease, but a study published in February really hammered home just how dangerous it can be: The average American diet contains enough added sugar to increase the risk of heart-related death by nearly 20%, reported researchers from the Centers for Disease Control and Prevention.

The health risks of white bread were exposed this year, as well: People who eat two or more servings of the refined stuff a day are more likely to become overweight or obese than those who eat less or who favor whole-grain bread, according to a Spanish study presented in May.

Worst: ‘Biggest Loser’ winner reveals shocking weight loss

When The Biggest Loser contestant Rachel Frederickson surprised viewers with her 155-pound weight loss during the show’s Season 15 finale, not everyone was pleased. Viewers expressed alarm on social media about Frederickson being too skinny, and even the show’s trainers Bob Harper and Jillian Michaels were visibly shocked at her transformation.

Frederickson has since gained back 20 pounds and found her ’perfect weight,’ but the incident seems to have had at least one permanent impact: In April, People reported that Michaels wanted to distance herself from the show because of concern for the participants’ health and wellbeing, and in June, NBC announced that Michaels would not be returning. The celebrity trainer later revealed that the show’s producers weren’t willing to make certain changes she’d requested to the show’s format.

Best: Food labels are changing for the better

The “nutrition facts” box on food packages should soon become easier to understand, thanks to a makeover first proposed by the Food and Drug Administration in February. Under the new guidelines, serving sizes will be more straightforward, calorie counts highlighted more prominently, and “daily values” for nutrients will be revised.

Some food companies have spoken out against part of the proposal that would require “added sugars” to be included on nutrition labels, but a Change.org petition submitted by the American Heart Association in November showed that public support for the measure is still strong.

It’s not yet clear if or when these measures will be put into place, but one major food-label change did happen in 2014: Beginning in August, foods can only be labeled gluten-free if they truly are free of gluten—a major win for anyone with celiac disease or gluten intolerance.

Worst: Smartphones and social media are making us sick

We can’t live without it—but more and more research is suggesting that if we’re not careful, personal technology can really mess with our health. Facebook makes us jealous of our friends and self-conscious of our bodies, texting gives us bad posture, and just having a smartphone in the same room can affect our parenting skills.

No one’s quite figured out the solution to these problems yet, but people are certainly trying; there’s no shortage of writers going on ‘digital detoxes’ and reporting back what they’ve learned. Meanwhile, a new technology-related health risk surfaced this year, as well: A paper published in October describes a man who became addicted to Google Glass.

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Best: Ice Bucket Challenge raises millions for ALS

You probably got tired of seeing the videos in your Facebook feed, but the truth is they worked: Since the Ice Bucket Challenge exploded onto the social-media scene in July, ALS nonprofits and research organizations have received more than $100 million in donations.

Amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, is a fatal neurodegenerative disease with no cure, but ALS researchers are hoping to change that. Nancy Frates, whose son Pete dreamed up the Ice Bucket Challenge after his own ALS diagnosis in 2012, recently shared in a TED Talk how clinical trials have been fast-tracked thanks to funding from the Challenge.

Worst: Robin Williams commits suicide after Parkinson’s diagnosis

America lost one of its most beloved actors in August when Robin Williams took his own life after years of struggling with depression. After his death, Williams’ wife revealed he had also recently been diagnosed with Parkinson’s disease, and an autopsy revealed his brain showed signs of Lewy Body Disease, a form of dementia that can cause hallucinations and concentration problems.

Although it’s not confirmed that these conditions played a role in Williams’ suicide, his death has shed light on several disorders that are often linked and frequently misdiagnosed or understood.

Best: Ninja warrior, curvy ballerina become unlikely fitness stars

When it comes to athlete role models, girls now have more than just soccer players and ice skaters to look up to. In July, Kacy Catanzaro became the first female contestant to reach the finals of NBC’s fitness competition American Ninja Warrior. Catanzaro made the challenging course look easy, and her victory sparked a #MightyKacy Twitter hashtag that trended worldwide.

Then in August, UnderArmour introduced us to its newest spokesperson, American Ballet Theater soloist Misty Copeland. The brand’s first commercial starring the dancer—about how she triumphed over negativity after being told she lacked the right body and was too old to become a ballerina—has more than 6 million views on YouTube, and has been called stunning, mesmerizing, and jaw-dropping.

Worst: Joan Rivers’ death raises questions about surgery safety

Comedian Joan Rivers was known for her irreverent humor, her biting fashion critiques, and perhaps most famously, her self-proclaimed obsession with plastic surgery. She went under the knife frequently, always pushing the boundaries of what it meant to age healthfully and happily.

But when the 81-year-old stopped breathing during what should have been a routine throat procedure in September (her family eventually took her off life support), her death sparked a new controversy: whether her doctors were to blame—especially after it was suggested that her surgeon took a selfie with an unconscious Rivers before the operation. In November, TMZ reported that staff members did not weigh Rivers before sedating her, potentially giving her too much medication.

HEALTH.COM: 14 Foods that Make You Look Older

Best: ‘Angelina effect’ increases rates of genetic testing

Actress Angelina Jolie made headlines in 2013 when she had a preventative double mastectomy after testing positive for the BRCA1 gene. But the effects of her decision had wide implications in the months that followed. In September, Canadian cancer researchers revealed that the number of women seeking genetic counseling and testing at their center rose dramatically after Jolie’s announcement.

Although cancer doctors caution that not every woman should be tested, most agree that extra education and awareness is certainly a good thing. Luckily, the increase in genetic testing is coming from women who actually do have a higher risk for breast cancer, and who will get the most benefit from what they might learn.

Worst: Antibiotics still being overprescribed

Despite warnings to physicians about the overuse of antibiotics, the drugs are still being prescribed when they’re not needed. Pediatricians, for example, dole out antibiotics twice as often as needed for throat and ear infections, found a study published in September. Researchers also discovered this year that doctors are more likely to prescribe unnecessary antibiotics later in the afternoon, as their decision-making skills wear down throughout the day.

Regardless of when it’s happening, the consequences could be deadly: Misuse of antibiotics fuels the growth of drug-resistant bacteria, reported the Centers for Disease Control and Prevention in March, as it outlined new recommendations to keep the drugs from being overused in hospitals.

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Best: Air quality is improving in U.S. cities

The Environmental Protection Agency shared some good news in August: The air in American cities has become significantly cleaner since 1990, with major reductions in levels of mercury, benzene, and lead. About 3 million tons per year of pollutants have also been reduced from cars and trucks, as well.

More good news for your lungs: in November, the United States announced a climate change agreement with China that aims to cut both countries’ greenhouse gas emissions by nearly a third over the next 20 years. In announcing the deal, President Obama said he hopes other nations will be inspired to make positive environmental changes, as well.

Worst: Internet flips out over Renee Zellweger’s face

As far as celebrity scandals go, Renee Zellweger’s appearance on the red carpet in October shouldn’t be anywhere near the top of this year’s list, but you’d never know it judging by the reactions she received on Twitter and in the media.

The 45-year-old actress attended an awards ceremony meant to honor the work of talented women in Hollywood, but all anyone could talk about was how different her face looked and whether she’d had plastic surgery or just, well, gotten old. Zellweger spoke out the following week, telling People that she’s glad people noticed her new look, adding, “I am healthy. For a long time I wasn’t doing such a good job with that.”

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This article originally appeared on Health.com.

TIME Addiction

Here’s How Big America’s Painkiller Problem Is

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Getty Images

More Americans are taking potentially deadly doses

The rate of Americans using pain medications like codeine, morphine, oxycodone and hydrocodone long term has remained stable in the last five years, but the amount of medication they take has increased, according to a new report.

The report, called A Nation in Pain, comes from pharmacy benefit manager Express Scripts and shows that almost half of chronic painkiller users are taking short-acting combinations that increase the risk for addiction, and often these cocktails are very dangerous.

Sixty percent of Americans on pain treatments for longterm conditions were prescribed potentially dangerous mixtures. One in three patients were taking a combination of an opiate and an anti-anxiety benzodiazepine, which is the most common combo in multiple drug overdose deaths. Eight percent were taking what’s called a “Houston Cocktail”: an opioid, muscle relaxant and a benzodiazepine. And nearly 30% were taking multiple painkillers together.

Use was most rampant in small Southeastern cities, and two-thirds of patients were prescribed the drugs by two or more physicians. About 40% filled their prescriptions at multiple pharmacies.

“There could be instances when prescribing these combinations of drugs is appropriate, but not at this scale,” said Jo-Ellen Abou Nader, the senior director of Fraud, Waste and Abuse at Express Scripts in a statement.

You can read the full report here.

TIME infectious diseases

Malaria Deaths Have Almost Halved Since 2000 Says WHO Report

But eliminating the disease altogether remains an uphill task

Global deaths from malaria, as well as the number of overall malaria cases, have reduced dramatically in the last thirteen years, the World Health Organization said in a statement on Tuesday.

According to the World Malaria Report 2014, the mortality rate for the disease decreased by 47% worldwide since 2000, and the number of people infected by it went from 173 million the same year to 128 million in 2013.

“We have the right tools and our defenses are working,” said WHO Director-General Dr. Margaret Chan. “But we still need to get those tools to a lot more people if we are to make these gains sustainable.”

The report attributed the progress combating malaria to increased access to insecticide-treated mosquito nets and enhanced diagnostics and treatment, but admitted that there is still a lot of work to be done.

The increased susceptibility to the disease in Ebola-affected countries like Guinea, Liberia and Sierra Leone is an added cause for concern.

TIME Heart Disease

The Other Reason Canned Food Is Raising Your Blood Pressure

Tinned sardines
Brad Wenner—Getty Images

Forget sodium—BPA might be the real canned food villain

If your food or drink comes out of a can, chances are it’s not the healthiest choice for your blood pressure (thanks to all that salt preserving your beans, for example.) But the latest research suggests there may be another reason to avoid canned goods. In a study published in Hypertension, researchers from South Korea found that drinking from cans, many of which have linings that contain the chemical bisphenol A (BPA), can raise blood pressure by 16 times compared to drinking from glass bottles.

The data isn’t the first to implicate BPA as a potential health hazard. Previous studies have connected the chemical, which can be found in plastics, the linings of cans and coating some cash register receipts, to disruptions in reproductive hormones such as estrogen, as well as a higher risk of asthma, obesity and disruptions in brain development in children. Exposure is almost unavoidable. Most studies show that people living in the U.S. have high exposures to BPA, and the chemical has been found in the urine of more than 95% of adults. One study found that eating canned soup for five days in a row can boost BPA levels in the urine by more than 1,000% compared to those eating soup prepared with fresh ingredients.

MORE: Why Receipts and Greasy Fingers Shouldn’t Mix

But those studies have compared different populations of people at different times. The Korean scientists decided to study the same group of 60 older people who drank the same beverages from both cans and glass bottles. Because the same people were being studied, it was unlikely that other factors that can affect BPA concentrations were influencing the results.

Senior author Yun-Chul Hong from the department of preventive medicine and the environmental health center at Seoul National University and his colleague found that the containers the drinkers used made a big difference in their BPA levels. Each was given two servings of soy milk during each of three visits. The milk was served in either two cans, two glass bottles, or one can and one glass bottle. The volunteers’ urine BPA levels were lowest after drinking from the two glass bottles, and highest after consuming milk from the two cans.

This difference translated to a change in 5 mmHg in blood pressure. Hong notes that an increase of 20 mmHg doubles the risk of heart disease, so the rise from BPA exposure is concerning.

MORE: BPA Linked with Obesity in Kids and Teens

“Because hypertension is a well-known risk factor for heart disease, our study showing the link of BPA exposure to elevation in blood pressure strongly suggests that BPA exposure may increase the risk of heart disease,” Hong writes in an email discussing the results.

When doctors evaluate patients for high blood pressure, asking them how many canned products they consume may be worthwhile, since the exposure to BPA from those containers could be pushing their blood pressure higher. “Clinicians and patients, particularly hypertension or heart disease patients, should be aware of the potential clinical problems for blood pressure elevation when consuming canned foods or using plastics containing BPA,” Hong says. And if you have a choice of getting your vegetables from the preserved aisle or the produce aisle, it might be better for your heart to kick the can.

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