Bøger af National Institutes of Health

The recent increase in cigar consumption began in 1993 and was dismissed by many in public health as a passing fad that would quickly dissipate. Recently released data from the U.S. Department of Agriculture (USDA) suggests that the upward trend in cigar use might not be as temporary as some had predicted. The USDA now projects a total of slightly more than 5 billion cigars were consumed last year (1997) in the United States. Sales of large cigars, which comprise about two-thirds of the total U.S. cigar market, increased 18 percent between 1996 and 1997. Consumption of premium cigars (mostly imported and hand-made) increased even more, an astounding 90 percent last year and an estimated 250 percent since 1993. In contrast, during this same time period, cigarette consumption declined 2 percent. This dramatic change in tobacco use raises a number of public health questions: Who is using cigars? What are the health risks? Are premium cigars less hazardous than regular cigars? What are the risks if you don't inhale the smoke? What are the health implications of being around a cigar smoker? In order to address these questions, the National Cancer Institute (NCI) undertook a complete review of what is known about cigar smoking and is making this information available to the American public. This monograph, number 9 in a series initiated by NCI in 1991, is the work of over 50 scientists both within and outside the Federal Government. Thirty experts participated in the multi-stage peer review process. The conclusions presented in the monograph represent the best scientific judgment, not only of the NCI, but also of the larger scientific community.

A UTI is an infection in the urinary tract. Infections are caused by microbes-organisms too small to be seen without a microscope. Bacteria are the most common cause of UTIs. Normally, bacteria that enter the urinary tract are quickly removed by the body before they cause symptoms. But sometimes bacteria overcome the body's natural defenses and cause infection. The urinary tract is the body's drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are a pair of bean-shaped organs, each about the size of a fist. They are located below the ribs, one on each side of the spine, toward the middle of the back. Every minute, your kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine you produce each day. The urine travels from the kidneys down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder and emptied through the urethra, a tube at the bottom of the bladder. This publication by the National Institutes of Health (Publication No. 12-4807) provides information on the causes, signs and symptoms, diagnosis, and treatment of Urinary Tract Infections.

Violence or natural disasters can cause trauma in young people. Trauma is hurt or harm. It can be hurt to a person's body. It can be harm to a person's mind. Parents and family members play important roles. They help children who experience violence or disaster. They help children cope with trauma. They help protect children from further trauma. They help children get medical care and counseling. They also help young people avoid or overcome emotional problems. These problems can result from trauma. There are two types of trauma - physical and mental. Physical trauma includes the body's response to serious injury and threat. Mental trauma includes frightening thoughts and painful feelings. They are the mind's response to serious injury. Mental trauma can produce strong feelings. It can also produce extreme behavior; such as intense fear or helplessness, withdrawal or detachment, lack of concentration, irritability, sleep disturbance, aggression, hyper vigilance (intensely watching for more distressing events), or flashbacks (sense that event is reoccurring).

When Your Parent Has Cancer: A Guide for Teens, National Institutes of Health Publication 12-5724: If your mom, dad, or an adult close to you has cancer, this book is for you. Here you can read about what has helped other teens get through this tough time. Doctors, nurses, social workers, friends, and family are working hard to help your mom or dad get better. You are a very important part of that team, too. In the weeks and months ahead, you may feel a whole range of emotions. Some days will be good, and things might seem like they used to. Other days may be harder. This book can help prepare you for some of the things you might face. It can also help you learn to handle living with a parent or relative who has cancer. This book includes information about cancer treatments, ways teens can talk to family and friends, how to connect with other teens, and where to find other resources for information and support. It includes a glossary of cancer terms and appendices explaining monitoring tests and member of the cancer team.

On September 7, 2006, Acting Surgeon General Kenneth Moritsugu held a Surgeon present the state of the science in the field of health literacy from a variety of perspectives, including those of health care organizations and providers, the research community, and educators. During the course of the one-day workshop, participants identified the public health consequences of limited health literacy and established an evidence base for taking action. People make choices about their health everyday, such as what they eat or how they exercise. In order to stay healthy, Americans must know how to read the labels on food and medicine, describe symptoms, or use a map to locate the closest health center. The ability to read, understand, and act on health information is called health literacy. Health literacy impacts Americans of all ages, races, incomes, and education levels. It affects our ability to search for and use health information, adopt healthy behaviors, and act on important public health alerts. The Surgeon General's Workshop on Improving Health Literacy was divided into three expert panels. Panel 1: Health Literacy, Literacy, and Health Outcomes, Panel 2: Meeting the Health Literacy Needs of Special Populations, Panel 3: Toward an Informed and Engaged Public Based on the evidence presented at the workshop, Acting Surgeon General Moritsugu made the following conclusions: First, public health professionals must provide clear, understandable, science-based health information to the American people. In the absence of clear communication and access to services, we cannot expect people to adopt the health behaviors we champion. Second, the promises of medical research, health information technology, and advances in health care delivery cannot be realized without also addressing health literacy. Third, we need to look at health literacy in the context of large systems-social systems, cultural systems, education systems, and the public health system. Limited health literacy is not an individual deficit but a systematic problem that should be addressed by ensuring that health care and health information systems are aligned with the needs of the public. Lastly, more research is needed, but there is already enough good information that we can use to make practical improvements in health literacy.

In most cases, the exact cause of bedwetting is not known. But many possible causes exist. Your child's bladder might be too small. Or the amount of urine produced overnight is too much for your child's bladder to hold. As a result, your child's bladder fills up before the night is over. Some children sleep so deeply that they don't wake up when they need to urinate. Others simply take longer to learn bladder control. Many children wet the bed until they are 5 years old or even older. Bedwetting often runs in families. If both parents wet the bed as children, their child is likely to have the same problem. If only one parent has a history of bedwetting, the child has about a 30 percent chance of having the problem. Some children wet the bed even if neither parent ever did. A child who has been dry for several months or even years may start wetting the bed. The cause might be emotional stress, such as the loss of a loved one, problems at school, a new sibling, or even toilet training too early. Bedwetting is not your child's fault. Children rarely wet the bed on purpose. You can help your child by learning about the different causes and treatments for bedwetting. This publication by the National Institutes of Health (Publication No. 12-5631) provides information on bedwetting, helping your child stay dry, when to see a doctor, and treatments for bedwetting.

The world of tobacco control has become increasingly complex over the past several decades. It involves more extensive collaborations; new structures and configurations for coordinating efforts; and multilevel social, professional, and knowledge networks to improve information sharing for public health. Given such complexity, there has been a corresponding increased need to address tobacco control issues using a systems perspective that enables one to better understand and navigate the dynamic and evolving nature of the terrain to achieve the next generation of improved health outcomes. This monograph describes the results of the initial two years of the Initiative on the Study and Implementation of Systems (ISIS), a four-year project. This initiative is one of the first major coordinated efforts to study and implement a systems thinking perspective using several systems approaches and methodologies that appeared to be promising for tobacco control in itself and as an exemplar for other complex issues in today's public health environment. In the ancient, revered Egyptian myth, the goddess Isis breathed clean air into her late husband Osiris to restore him to life. In analogous fashion, the ISIS project hopes to contemporize the myth in a tobacco control context and encourage systems perspectives that have the potential to help people breathe cleaner air and be restored to a smoke-free life. Although this work is aimed at the efforts of the tobacco control community, the word "tobacco" intentionally appears only in the subtitle of this monograph. That is because ISIS was a research effort that focused on the tobacco control environment to examine how to apply systems approaches to issues that have become endemic throughout public health, including the need for: Better understanding of outcomes, including the unintended consequences of complex interventions and events; Effective capture, dissemination, and management of knowledge throughout the multilayered public health system; More efficient organization and linkage of the efforts of multiple, diverse stakeholders; Adoption of evidence-based practices that inform practice and improve outcomes; Strengthening of collaborative networks of scientists, policy makers, government and foundation managers, practitioners, and the public. This work was undertaken to help address some of the fundamental organizational issues in tobacco control and, by corollary, much of public health. The goal was to investigate the potential of integrated, systems-based approaches to facilitate the efforts of all stakeholders to make substantive changes in public health outcomes.

Do you need to lower your Cholesterol? This book by the National Institutes of Health (Publication 06-5235) and the National Heart, Lung, and Blood Institute is designed to help you make the lifestyle changes that will help you to lower your blood cholesterol and reduce your risk for heart disease. High blood cholesterol can affect anyone. It's a serious condition that increases the risk for heart disease, the number one killer of Americans-women and men. The higher your blood cholesterol level, the greater your risk. Fortunately, if you have high blood cholesterol, there are steps you can take to lower it and protect your health. This book will show you how to take action by following the "TLC Program" for reducing high blood cholesterol. TLC stands for Therapeutic Lifestyle Changes, a three-part program that uses diet, physical activity, and weight management. Sometimes, drug treatment also is needed to lower blood cholesterol enough. But even then, the TLC Program should be followed. The book has four main sections: It explains why cholesterol matters and helps you find your heart disease risk; describes the TLC Program; talks about a condition called the metabolic syndrome that can also be treated with TLC; and offers advice on how to make heart healthy lifestyle changes. Within the sections you'll find tips on such topics as how to: communicate better with your doctor and other health care professionals, read food labels, make and stick with lifestyle changes, plan heart healthy menus for the whole family, and make heart healthy choices when you eat out. Anyone can develop high blood cholesterol-everyone can take steps to lower it.

Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, meaning that the symptoms are caused by changes in how the GI tract works. Food is digested, or broken down, in the GI tract. IBS is not a disease. Symptoms can come and go repeatedly without signs of damage to the GI tract. The most common symptoms of IBS are abdominal pain or discomfort, often reported as cramping, along with diarrhea, constipation, or both. This publication by the National Institutes of Health (Publication No. 12-4686) discusses IBS, symptoms, causes, diagnosis, and treatments.

National Institutes for Health Publication 10-3408 Down Home Healthy Cooking: Recipes and Tips for Healthy Cooking address the concerns that African Americans suffer from higher rates of serious diseases like high blood pressure, Type 2 diabetes, heart disease and some types of cancer. African Americans suffer more serious health problems and die at an earlier age from these diseases. The good news is that eating a healthy diet and leading an active lifestyle promote good health and lowers the chances for getting these illnesses. A healthy diet includes fruits and vegetables, whole grains, fat-free or low-fat milk products, lean meats, fish, beans, eggs, and nuts. A healthy diet is also low in saturated fat, trans fat, cholesterol, salt and added sugars. Everyone has the power to make choices to improve his/her health. And eating right doesn't mean giving up our wonderful soul food. In fact, the basic staples of traditional soul food include lots of healthy vegetables: dark leafy greens, sweet potatoes, and high-fiber black eyed peas just to name a few. But they are often cooked with ingredients that add too much saturated fat, calories and salt to our diet. By making a few simple changes, you and your loved ones can enjoy the flavors of healthy down home cooking. The recipes and hints in this cookbook will help you get started.

Clinical research refers to studies in which people participate as patients or volunteers. Different terms are used to describe clinical research, including clinical studies, clinical trials, studies, research, trials, and protocols. Clinical research may have a number of goals, such as developing new treatments or medications, identifying causes of illness, studying trends, or evaluating ways in which genetics may be related to an illness. Choosing to take part in clinical research is an important personal decision. Your decision to participate will depend on your interests, needs, and expectations about research. This publication, prepared by the National Institute of Mental Health (NIMH), provides answers to common questions about volunteering for mental health clinical research NIMH is part of the National Institutes of Health (NIH), the primary Federal agency for conducting and supporting medical research. Our goal is to give you basic information about clinical research and help you make a decision about whether to participate. Please review this information and discuss it with those close to you. As you read, write down questions you may want to ask. This document provides an overview about participating in clinical research. To get details on a study, it is important to bring any questions and concerns to the researchers who are doing the study. For example, only the researchers can answer questions about whether a participant will be able to stay on medications or will be compensated for taking part in the study. You may wish to review the glossary first to become familiar with some of the terms used in clinical research studies.

This, the eighth monograph in the Smoking and Tobacco Control series published by the National Cancer Institute (NCI), is in many respects also the most significant. Contained in this volume are new results from five of the world's largest prospective epidemiological studies defining the magnitude of disease risks caused by cigarette smoking. Thirty years ago, in January 1966, NCI published a similar monograph titled Epidemiological Approaches to the Study of Cancer and Other Chronic Diseases. The report of the Surgeon General's Advisory Committee on Smoking and Health had been released in 1964 and had relied extensively on data from prospective mortality studies to delineate the relationship between cigarette smoking and various chronic diseases. The 1966 NCI monograph provided a detailed examination of the outcomes of several of the large prospective mortality studies presented in the 1964 advisory committee report. At that time, the outcomes available from these studies were based on 3 to 6 years of follow up; with the exception of the American Cancer Society's (ACS) Cancer Prevention Study I (CPS-I), studies in the 1966 NCI monograph did not include substantial numbers of females. This monograph includes three new prospective mortality studies (CPS-II, the Nurses' Health Study, and the Kaiser Permanente Prospective Mortality study, provides the outcomes of the CPS-I study after 12 years of follow up, and provides 26 years of follow up of the study of U.S. veterans. Data from these studies provide the most comprehensive description of the disease consequences produced by smoking available to date and are accompanied by a detailed description of the changes in smoking behaviors of the U.S. population over the past century. Prospective mortality studies continue to play a critical role in quantifying the relative mortality risks of smoking for the individual as well as in estimating the overall disease burden caused by cigarette smoking in our society. The goal of this monograph is to facilitate both these tasks by providing, in one volume, comprehensive descriptions of smoking behaviors and the disease risks that result from those behaviors.

The National Institutes of Health Publication 08-5491, "For Women With Diabetes: Your Guide to Pregnancy," provides information for women who have type 1 or type 2 diabetes and are pregnant or hoping to get pregnant. You can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy. Pregnancy and new motherhood are times of great excitement, worry, and change for any woman. If you have diabetes and are pregnant, your pregnancy is automatically considered a high-risk pregnancy. Women carrying twins-or more-or who are beyond a certain age are also considered to have high-risk pregnancies. High risk doesn't mean you'll have problems. Instead, high risk means you need to pay special attention to your health and you may need to see specialized doctors. Millions of high-risk pregnancies produce perfectly healthy babies without the mom's health being affected. Special care and attention are the keys. Keeping your blood glucose as close to normal as possible before you get pregnant and during your pregnancy is the most important thing you can do to stay healthy and have a healthy baby. Your health care team can help you learn how to use meal planning, physical activity, and medications to reach your blood glucose goals. Together, you'll create a plan for taking care of yourself and your diabetes. Pregnancy causes a number of changes in your body, so you might need to make changes in the ways you manage your diabetes.

National Hospital Discharge Survey Data indicate that 86,000 people with diabetes in the United States underwent one or more lower-extremity amputations in 1996. Diabetes is the leading cause of amputation of the lower limbs. Yet it is clear that as many as half of these amputations might be prevented through simple but effective foot care practices. The 1993 landmark study, the Diabetes Control and Complications Trial funded by the National Institute of Diabetes and Digestive and Kidney Diseases, conclusively showed that keeping blood glucose, as measured by hemoglobin A1c, as close to normal as possible significantly slows the onset and progression of diabetic nerve and vascular complications, which can lead to lower extremity amputations. People who have diabetes are vulnerable to nerve and vascular damage that can result in loss of protective sensation in the feet, poor circulation, and poor healing of foot ulcers. All of these conditions contribute to the high amputation rate in people with diabetes. The absence of nerve and vascular symptoms, however, does not mean that a patient's feet are not at risk. Risk of ulceration cannot be assessed without careful examination of the patient's bare feet. Early identification of foot problems and early intervention to prevent problems from worsening can avert many amputations. Good foot care, therefore, is an essential part of diabetes management - for patients as well as for health care providers. This kit is designed for primary care and other health care providers who counsel people with diabetes about preventive health care practices, particularly foot care. "Feet Can Last a Lifetime" is designed to help you implement four basic steps for preventive foot care in your practice: Early identification of the high risk diabetic foot, Early diagnosis of foot problems, Early intervention to prevent further deterioration that may lead to amputation, and Patient education for proper care of the feet and footwear.

Chances are, you already know that physical activity is good for you. "Sure," you may say. "When I get out and move around, I know it helps me to feel and look better." But you may not realize just how important regular physical activity is to your health. According to the U.S. Surgeon General's Report on Physical Activity and Health, inactive people are nearly twice as likely to develop heart disease as those who are more active. This is true even if you have no other conditions or habits that increase your risk for heart disease. Lack of physical activity also leads to more visits to the doctor, more hospitalizations, and more use of medicines for a variety of illnesses. The good news is that physical activity can protect your heart in a number of important ways. Moreover, to get benefits, you don't have to run a marathon. Regular activity-something as simple as a brisk, 30-minute walk each day-can help you to reduce your risk of heart disease. This publication (the National Institutes of Health Publication No. 06-5714) will help you to understand the impact of physical activity on your heart, as well as the power of regular activity to help keep you healthy overall. It will also offer plenty of ideas on starting a physical activity program that will be both healthful and enjoyable. Just as important, you'll get tips for keeping up with the activity or activities you choose, since staying active over time is important to long-term health. So use this booklet often for information, ideas, and to keep you motivated.

This monograph is the eleventh volume in the Smoking and Tobacco Control series released by the National Cancer Institute (NCI). The National Association of County and City Health Officials (NACCHO) and the National Association of Local Boards of Health (NALBOH) are working with NCI in disseminating findings from this important publication. NACCHO is a nonprofit membership organization that serves all of the nearly 3,000 local public health agencies (LPHAs) in the nation's cities, counties, townships, and districts. The organization provides local health departments with education, information, research, and technical assistance on a variety of topics. It also facilitates partnerships among local, state, and federal agencies in order to promote and strengthen public health. NALBOH is an organization that represents the interests of local boards of health and assists those boards in assuring the health of the community. NALBOH enhances and supports all 3,200 local health boards across the country by providing linkages, networks, education, and training. It is also committed to promoting health and effective public health policy at all levels of government and also to strengthening the ability of health boards to develop tobacco control policy efforts. NACCHO and NALBOH constituents have unique roles in tobacco prevention and control. They often represent the local government infrastructure, and as such, they can play leadership roles in local policy development, implementation, and enforcement. For years, tobacco control legislation enacted at the city and county levels were much more stringent than those enacted at the federal or state level. However, few local communities were involved in implementing and managing actual public health programs to reduce tobacco use. This was seen primarily as a national or state responsibility. Fortunately, local communities have become more involved in recent years. This trend has been supported mainly by LPHAs, and both NACCHO and NALBOH have helped local communities become more involved in the development of public health policy.

All parents can relate to the many changes their kids go through as they grow up. But sometimes it's hard to tell if a child is just going through a "phase," or showing signs of something more serious. In the last decade, the number of children receiving the diagnosis of bipolar disorder, sometimes, called manic-depressive illness, has grown substantially. But what does the diagnosis really mean for a child? This booklet discusses bipolar disorder in children and teens. Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, and activity levels. It can also make it hard to carry out day-to-day tasks, such as going to school or hanging out with friends. Symptoms of bipolar disorder can be severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor school perfor¬mance, and even suicide. But bipolar disorder can be treated, and many people with this illness can lead full and productive lives. Symptoms of bipolar disorder often develop in the late teens or early adult years, but some people have their first symptoms during childhood. At least half of all cases start before age 25. Bipolar disorder tends to run in families. Children with a parent or sibling who has bipolar disorder are up to six times more likely to develop the illness, compared with children who do not have a family history of bipolar disorder. However, most children with a family history of bipolar disorder will not develop the illness. Currently, there is no cure for bipolar disorder. However, treatment with medications, psychotherapy, or both may help people recover from their episodes, and may help to prevent future episodes.

A UTI is an infection in the urinary tract. Infections are caused by microbes-organisms too small to be seen without a microscope. Bacteria are the most common cause of UTIs. Normally, bacteria that enter the urinary tract are quickly removed by the body before they cause symptoms. But sometimes bacteria overcome the body's natural defenses and cause infection. The urinary tract is the body's drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are a pair of bean-shaped organs, each about the size of a fist. They are located below the ribs, one on each side of the spine, toward the middle of the back. Every minute, the two kidneys process about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine produced each day. Children produce less urine each day; the amount produced depends on their age. The urine travels from the kidneys down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder and emptied through the urethra, a tube at the bottom of the bladder. This publication by the National Institutes of Health (Publication No. 12-6075) provides information on the causes, prevention of, symptoms, diagnosis, and treatment of your child's Urinary Tract Infections.

Lactose intolerance means you have trouble digesting lactose. Lactose is the sugar found in milk and foods made with milk. The small intestine needs lactase enzyme to break down lactose. With lactose intolerance, you may not feel well when you eat or drink something with lactose because you don't have enough lactase enzyme. Many people have problems digesting lactose. Some people become lactose intolerant as children. In others, the problem starts when they are teenagers or adults. Lactose intolerance is rare in babies. Premature babies may be lactose intolerant for a short time after they are born. This publication by the National Institutes of Health (Publication No. 10-2751) provides information about the symptoms, diagnosis and treatment and management of lactose intolerance.

This monograph, Risks Associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine, is the 13th report published in the National Cancer Institute's (NCI) Smoking and Tobacco Control Program Monograph Series. One feature of this monograph is that it blends the old with the new. Monograph 7, The FTC Cigarette Test Method for Determining Tar, Nicotine, and Carbon Monoxide Yields of U.S. Cigarettes, covered the history of that protocol and recommended changes in its procedures. Chapter 2 of this publication cites this earlier monograph, brings us up to date on the FTC method, and provides additional suggestions as to what can be done to help alert the public to the dangers of smoking. The examination of the scientific literature on low-tar and low-nicotine cigarettes is not unique to this monograph. Several of the earlier volumes devoted one or more chapters to discussions of the various health aspects of tar and nicotine levels. However, this monograph includes more than just the study of amounts of tar and nicotine. Chapter 5 includes a discussion on the continued health risks to smokers, even those who smoke a low-tar/low-nicotine cigarette, while Chapter 2 describes how changes in the cigarette design affect an individual's smoking habit. Chapter 7 points out how the tobacco companies' advertisements have changed to match the emerging public preference for low-tar/low-nicotine cigarettes. This monograph is unique in another important aspect. For the first time, the authors who prepared the various chapters have had extensive access to the information gleaned from the internal documents of the tobacco companies. The tobacco industry files now open to the public and available on the Internet constitute some 33 million pages of formal and informal memos, meeting notes, research papers, and similar corporate documents. Included are marketing strategies that express the growing concern among the various tobacco companies of the potential loss of new recruits. This concern over the potential loss of market was due to the evolving public opinion that smoking is harmful to health and that it is related to many of the illnesses that smokers experience over the course of their lives. The singular message that has been delivered to the public-smoking causes cancer-is gradually being accepted by more and more people of all ages.

Constipation means different things to different people. You may have constipation if you have three or fewer bowel movements in a week or if stool is hard, dry, painful, or difficult to pass. Some people with constipation lack energy and feel full or bloated. Some people think they have constipation if they don't have a bowel movement every day. However, bowel habits are different for everyone. The foods you eat, how much you exercise, and other factors can affect your bowel habits. At one time or another, almost everyone gets constipated. In most cases, it lasts for only a short time and is not serious. When you understand what causes constipation, you can take steps to prevent it. This publication by the National Institutes of Health (Publication No. 09-4157) provides information on the causes and treatments for constipation.

This guide is for people who care for family members or other with Alzheimer's Disease at home. AD is an illness that changes the brain. It causes people to lose the ability to remember, think and use good judgment, and to have trouble taking care of themselves. Over time, as the disease gets worse, they will need more help. NIH Publication #12-6173.

Interstitial cystitis/painful bladder syndrome (IC/PBS) is one of several conditions that causes bladder pain and a need to urinate frequently and urgently. Some doctors have started using the term bladder pain syndrome (BPS) to describe this condition. Your bladder is a balloon-shaped organ where your body holds urine. When you have a bladder problem, you may notice certain signs or symptoms. This publication by the National Institutes of Health (Publication No. 11-5750) provides information about the symptoms and signs of bladder problems, the causes, diagnosis and treatment of interstitial cystitis or painful bladder syndrome.

This book (NIH Publication 05-5213) by the National Institutes of Health and the National Heart, Lung, and Blood Institute provides practical, easy-to-use information for losing and maintaining weight. Reaching and maintaining a healthy weight is good for your overall health and will help you prevent and control many diseases and conditions. We know that an increase in weight also increases a person's risk for heart disease, high blood cholesterol, high blood pressure, diabetes, gallbladder disease, gynecologic disorders, arthritis, some types of cancer, and even some lung problems. Maintaining a healthy weight has many benefits, including feeling good about yourself and having more energy to enjoy life. A person's weight is the result of many things-height, genes, metabolism, behavior, and environment. Maintaining a healthy weight requires keeping a balance - a balance of energy. You must balance the calories you get from food and beverages with the calories you use to keep your body going and being physically active. The same amount of energy IN and energy OUT over time = weight stays the same More IN than OUT over time = weight gain; More OUT than IN over time = weight loss. Your energy IN and OUT don't have to balance exactly every day. It's the balance over time that will help you to maintain a healthy weight in the long run. For many people, this balance means eating fewer calories and increasing their physical activity. Cutting back on calories is a matter of choice. Making healthy food choices that are lower in fats, especially saturated and trans fat, cholesterol, added sugars, and salt can help you cut back on calories, as can paying attention to portion sizes. This booklet will provide you with information to figure out your body mass index and weight related risk for disease. It will also give you information on when and how to lose weight, including tips on healthy eating and physical activity, setting weight loss goals, and rewarding your success.

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out daily tasks. Symptoms of bipolar disorder can be severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives. Bipolar disorder often appears in the late teens or early adult years. At least half of all cases start before age 25. Some people have their first symptoms during childhood, while others may develop symptoms late in life. Bipolar disorder is not easy to spot when it starts. Some people suffer for years before they are properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout your life. Bipolar disorder cannot be cured, but it can be treated effectively over the long-term. Proper treatment helps many people with bipolar disorder-even those with the most severe forms of the illness-gain better control of their mood swings and related symptoms. But because it is a lifelong illness, long-term, continuous treatment is needed to control symptoms. However, even with proper treatment, mood changes can occur. Treatment is more effective if you work closely with a doctor and talk openly about your concerns and choices. An effective maintenance treatment plan usually includes a combination of medication and psychotherapy.

With this volume, the National Cancer Institute (NCI) presents the 17th monograph of the Tobacco Control Monograph series. This monograph documents the evaluation of a groundbreaking NCI program. The American Stop Smoking Intervention Study for Cancer Prevention, known as ASSIST, put into practice NCI's commitment to prevent and reduce tobacco use across all populations and age groups. ASSIST took evidenced-based interventions from controlled studies and implemented them in the larger community of 17 states. Its underlying rationale-that significant decreases in tobacco use could be realized only with interventions that changed the social environment such that smoking was non-normative-was a significant departure from previous tobacco control programs and in the vanguard of the "new" public health. Prior to ASSIST, few states addressed tobacco use at the population level. The ASSIST legacy remains today in the tobacco control professionals whose work continues to reduce the burden of disability and death caused by tobacco. ASSIST raised significant conceptual and practical challenges for its evaluation team. These challenges included context-dependent implementation and the diffusion of ASSIST and ASSIST-like interventions into non-ASSIST states. In addition, the evaluation did not begin until several years after ASSIST was implemented, and its budget was limited. What had been envisioned as a simple evaluation of a demonstration project became a complex evaluation effort that engaged a diverse group of scientists and practitioners and required numerous sources of data. The resulting evaluation successfully documented the effectiveness of ASSIST. It also validated the causal pathway described in NCI's 1991 Smoking and Tobacco Control Monograph 1: Strategies to Control Tobacco Use in the United States: A Blueprint for Public Health Action in the 1990's-that comprehensive interventions can change the social environment of tobacco use and subsequently result in decreased tobacco use. This monograph stands alone as a documentation of the ASSIST evaluation and describes the challenges met in evaluating a program that was influenced by numerous forces outside the program's control. However, this monograph may also be viewed as a companion to NCI Tobacco Control Monograph 16, which reviews the ASSIST program in detail. Together these two monographs provide a detailed history and evidence base that document the success of an NCI initiative that began with a series of research hypotheses, tested those hypotheses with community-based interventions, and ultimately fielded a demonstration program that fundamentally changed tobacco use prevention and control in the United States. This volume and several future volumes in the Tobacco Control Monograph Series have important implications for research, practice, and policy in tobacco control as well as in other areas of public health. Lessons learned from tobacco prevention and control can be applied to a variety of public health issues, including physical activity, diet and nutrition, overweight and obesity, and substance abuse. NCI is committed to disseminating this cross-cutting knowledge to the widest possible audience so that others can benefit from the experience of the tobacco prevention and control community. By so doing, NCI is increasing the evidence base for effective public health interventions and improving the translation of research to practice and policy.

The National Institutes of Health Publication 10-5088 Facing Forward: Making a Difference in Cancer review the potential benefits of becoming involved in cancer-related activities, such as helping with outreach and education, fundraising, or raising awareness about research or public health issues. It is designed for anyone who has been diagnosed with cancer or affected by it in some way. While some people prefer to put their experiences with cancer behind them, many choose to draw on them to get involved with cancer-related activities. They may feel that there are certain areas or issues where there's more work to be done. Or perhaps someone helped and inspired them during treatment, and they feel it's their turn to give to others. People often feel that they can make a difference in cancer by taking part. They may want to learn how to help their neighbors, join an educational group, run in a race, or be a part of a group that makes decisions about cancer research or programs. Whether you have cancer or know someone who does, this book has many ideas about ways you can give to others.

In response to the emerging scientific evidence that cigarette smoking posed a significant health risk to the user, in the early 1950's the major cigarette manufacturers began widespread promotion of filtered cigarettes to reassure smokers that, regardless of whatever unhealthy constituents were in cigarette smoke, filters were a "scientific" breakthrough. Advertisements for Viceroy's "health guard filter" stated, "DENTISTS ADVISE-Smoke VICEROYS-The Nicotine and Tars Trapped by The Viceroy Filter CAN NEVER STAIN YOUR TEETH!" and "Leading N.Y. Doctor Tells His Patients What to Smoke-Filtered Cigarette Smoke Is Better For Health. The Nicotine and Tars Trapped ... Cannot Reach Mouth, Throat Or Lungs." Chesterfield was "Best for you-low in nicotine, highest in quality," while L&M's were "Just What the Doctor Ordered." Lorillard Tobacco Company stressed its science-based Kent micronite filter (the original micronite filter was made of asbestos) and claimed it removed seven times more tar and nicotine than any other cigarette, which "put Kent in a class all by itself where health protection is concerned." Of course, we know today that not only were these claims patently false, but the cigarette companies knew, it. In the early 1950's the Federal Trade Commission (FTC) challenged a variety of health claims made for cigarettes in their advertising, including claims about tar and nicotine. In 1955 FTC published advertising guidelines that, among other things, prohibited claims by cigarette manufacturers that a particular brand of cigarettes was low in tar and nicotine or lower than other brands, when it had not been established by competent scientific proof that the claim was true and the difference was significant. Cigarette manufactures, however, continued to advertise tar numbers. In the absence of a standardized test methodology, this resulted in what is referred to as a "tar derby"-a multitude of inconsistent, noncomparable claims that did not give consumers a meaningful opportunity to assess the relative tar delivery of competing brands. The tar derby ended in 1960 when discussions with FTC culminated in an industry agreement to refrain from tar and nicotine advertising. In 1966, however, the U.S. Public Health Service (PHS) prepared a technical report on "tar" and nicotine that concluded, "The preponderance of scientific evidence strongly suggests that the lower the 'tar' and nicotine content of cigarette smoke, the less harmful would be the effect." In reaching this conclusion, the report noted the clear relationship between dose of cigarette smoke received by the smoker and disease risk. Regardless of how dose was calculated-by number of cigarettes smoked per day, age of initiation, total number of years one smoked, or depth of inhalation, mortality rates among smokers increased. When smokers quit smoking, their risk was reduced in proportion to the length of time off cigarettes.

You may think bladder control problems are something that happen when you get older. The truth is that women of all ages have urine leakage. The problem is also called incontinence. Men leak urine too, but the problem is more common in women. Many women leak urine when they exercise, laugh hard, cough, or sneeze. Often women leak urine when they are pregnant or after they have given birth. Women who have stopped having their periods-menopause-often report bladder control problems. Female athletes of all ages sometimes have urine leakage during strenuous sports activities. Urine leakage may be a small bother or a large problem. About half of adult women say they have had urine leakage at one time or another. Many women say it's a daily problem. Urine leakage is more common in older women, but that doesn't mean it's a natural part of aging. You don't have to "just live with it." You can do something about it and regain your bladder control. Incontinence is not a disease. But it may be a sign that something is wrong. It's a medical problem, and a doctor or nurse can help. This publication by the National Institutes of Health (Publication No. 07-4195) provides information in bladder control problems, causes, diagnosis, and treatment.

Borderline personality disorder is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed borderline personality disorder as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses. Because some people with severe borderline personality disorder have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders. While mental health experts now generally agree that the name "borderline personality disorder" is misleading, a more accurate term does not exist yet. Most people who have borderline personality disorder suffer from: Problems with regulating emotions and thoughts; Impulsive and reckless behavior; Unstable relationships with other people. People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides. According to data from a subsample of participants in a national survey on mental disorders, about 1.6 percent of adults in the United States have borderline personality disorder in a given year. Borderline personality disorder is often viewed as difficult to treat. However, recent research shows that borderline personality disorder can be treated effectively, and that many people with this illness improve over time.