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Ask the expert: Vision health as you age

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Many people expect their eyesight to decline with age — perhaps requiring a stronger eyeglass prescription or “readers.” Some vision changes are linked to age, but there are steps to consider to help our eyes stay as healthy as possible.

Dr. Linda Chous, OD, chief eye care officer, UnitedHealthcare, answered the following questions:

1. Are my eyes going to keep getting worse as I age?

While your eyesight is not guaranteed to deteriorate with age, it is normal to notice changes to your vision as the years pass, including:

  • Minor adjustments to your eyeglasses prescription or needing to use “readers” for the first time;
  • Trouble distinguishing colors, such as blue from black; and
  • The need for more light to see well.

Although these changes are often normal, they can also be signs of conditions like cataracts or even diabetes. It is important to maintain regular appointments with your eye doctor to help identify pressing concerns. If you experience sudden vision loss or any rapid change to your eyesight, contact your eye care provider immediately.

2. What are the tiny spots or specks that float across my vision?

These tiny threads of protein float across the gel-like substance between your eye’s lens and retina.

Usually there is no need to worry if you notice these spots occasionally and they disappear after a few minutes, but only a dilated eye examination can determine the cause of the “floaters.”

If your vision is overcome by these specks or you notice vision loss, contact your eye doctor, as it could be a symptom of a sight-threatening condition.

3. What are some common vision-related diseases that come with age?

Age-related macular degeneration (AMD)

AMD is the leading cause of vision loss in people over 65. AMD causes damage to the macula, the small spot on the retina that enables people to see clearly and view things straight ahead of them.

Common symptoms are distortion and blurring of the center of your field of vision. If caught early, there are potential benefits from certain prescription medications and nutritional supplements. Late-stage AMD is much more difficult to treat.

Certain factors like heredity, ultraviolet light exposure and smoking may increase the risk of AMD. Consult with your eye doctor to determine if a preventive treatment plan is right for you.

Cataracts

A cataract is the clouding of the lens in your eye, blocking the flow of light to the back of your eye (retina), which ultimately causes loss of sight. Most form slowly and do not cause pain. Significant clouding can form in some people and, ultimately, negatively impact vision.

Cataracts are treatable via surgery that replaces the clouded lens with a clear plastic lens. Cataract surgery is generally safe and one of the most common surgeries in the U.S. Once a cataract is removed, it cannot grow back.

Glaucoma

Glaucoma is caused by increased pressure inside the eye, which can cause permanent vision loss and blindness if untreated. The most common form usually has no noticeable symptoms in the early stages — the only way to detect it is routine testing.

Treatment may include prescription eye drops, oral medications, laser treatment surgery or a combination of any of these. It is important to find glaucoma early because once vision is lost, it cannot be regained.

4. What are the best ways to keep my eyes healthy as I age?

Some of the best ways to protect your eyes include:

  • Stop smoking. Smokers are up to four times more likely to develop AMD and may contribute to development of cataracts.
  • Maintain a healthy weight. Conditions associated with being overweight, like diabetes and heart disease, increase your risk of vision loss from cataracts, glaucoma and retinopathy.
  • Wear sunglasses. Help protect your eyes from harmful ultraviolet rays.
  • Be physically active. People who are physically active experienced less vision loss over 20 years compared to those who are less active.
  • Eat a healthy diet. Colorful fruits and vegetables contain nutrients that can keep your eyes healthy and reduce AMD risk.

5. Do sunglasses really protect my eyes?

Sunglasses act as a buffer between your eyes and the sun’s ultraviolet (UV) rays. Exposure to these rays can put you at greater risk of cataracts and AMD. Look for a pair that blocks 99% to 100% of UV rays.

Note that polarization is different from UV protection; however, most polarized sunglasses also provide UV protection. Check the product tag or ask for assistance in choosing the right pair.

6. How often should I see my eye care doctor?

Eye exams are crucial to maintaining eye health as you age. Many eye diseases, like glaucoma, have no symptoms in early stages. And many systemic conditions, such as diabetes and high blood pressure, can be first found during a routine eye exam. Aim to see your eye doctor annually even if your vision hasn’t changed, so your doctor has a record of your eye health. See your doctor immediately for sudden changes.

For UnitedHealthcare Medicare Advantage members, many plans include routine vision services as well as additional services not covered under Original Medicare. It’s helpful to learn how to take advantage of these and other benefits.

Plans insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

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Health & Wellness

WHO approves Chinese COVID-19 vaccine for emergency use

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A COVID-19 vaccine produced in China has been given the green light for global rollout, potentially paving the way for its use in underserved countries, the World Health Organization (WHO) announced on Friday. 

The UN agency has approved the Sinopharm vaccine for emergency use, which is a prerequisite for inclusion in the global vaccine solidarity initiative, COVAX.  

The vaccine is easy to store, making it suitable for locations with limited resources, and proved 79 per cent effective in clinical trials. 

“The addition of this vaccine has the potential to rapidly accelerate COVID-19 vaccine access for countries seeking to protect health workers and populations at risk”, said Dr Mariângela Simão, WHO Assistant-Director General for Access to Health Products.  

“We urge the manufacturer to participate in the COVAX Facility and contribute to the goal of more equitable vaccine distribution.” 

A vaccine first 

The Sinopharm vaccine is produced by Beijing Bio-Institute of Biological Products Co Ltd, a subsidiary of China National Biotec Group (CNBG).   

It is the first vaccine to carry a vaccine vial monitor. The vials have a small sticker that changes colour as the vaccine is exposed to heat, so health workers know whether it can be safely used. 

The vaccine is recommended for adults 18 and older, with a two-dose schedule spaced over a period of three to four weeks. 

Although few people over 60 participated in the clinical trials, WHO did not recommend an upper age limit for use as data suggests the vaccine is likely to have a protective effect in older persons.   

Safely expediting vaccines 

WHO emergency use listing (EUL) allows countries to expedite their own regulatory approval to import and administer COVID-19 vaccines. 

The EUL process assesses the suitability of new medicines, vaccines and diagnostics during public health emergencies.  

The goal is to make them available as rapidly as possible, while maintaining strict criteria of safety, efficacy and quality. 

The Sinopharm vaccine is the sixth to receive the EUL approval.  The others are by Pfizer/BioNTech, Astrazeneca-SK Bio, Serum Institute of India, Janssen (Johnson & Johnson) and Moderna.

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Risky business: COVID-19 and safety at work

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Photo: UN Women Asia-Pacific

The numbers of home workers around the world  have been swelled by the COVID-19 pandemic, putting a fresh focus on the need for employers to ensure that their employees are working in a safe environment. On the World Day for Safety and Health at Work, we look at some of the ways the UN is helping employers and governments to keep people safe, wherever they work.

The world of work has been upended by COVID-19, and the effects are likely to be long-lasting. Before the pandemic, there were some 260 million home-based workers (not including domestic or care workers). The International Labour Organisation (ILO) estimates that figure could have doubled, with as many as one in three workers remote working in North America and Europe, and one in six in sub-Saharan Africa.

The rollout of vaccines, mainly in the developed world,  has increased the possibilities of a return to the workplace, but many companies and workers have signalled a wish to retain a degree of home working, after seeing some of the benefits. For employers, these include minimising the risk of contagion and  potentially spending less on expensive office space whilst staff no longer have to spend commuting to and from the workplace.

‘If you’re losing your mind, I’m right there with you’

However, whilst some are enjoying baking bread or taking a stroll during a conference call, and using the commuting time to indulge in new pursuits, others have been craving a return to a more structured work-life routine.

“I tell myself daily that I am grateful to have a job with understanding supervisors and colleagues. But all of it is hard. If you’re also a working mum losing her mind daily, know that I’m right there with you,” says Paulina, a New York-based teleworker.

“I have chaired meetings with a laptop and headphones on one side of a tiny, New York City kitchen while cooking lunch and having a screaming toddler wrapped around my ankles. While all of this is cute once or maybe twice, regular screams of children in the background can only be tolerated for so long. I should know, because I passed that line sometime in July.”

Stories such as this explain why a recent study by the International Labour Organisation (ILO) found that 41 per cent of people who worked from home considered themselves highly stressed, compared to 25 per cent of those who worked on-site.

“The most effective way to eliminate the risk of contagion in a work context is, for those who can do it, teleworking, says Joaquim Nunes, head of occupational health and safety at the ILO, “But we still need to pay attention to the physical and mental well-being of workers”.

As teleworking is likely to remain an important factor in many people’s jobs, Mr. Nunes says that work-related policies will have to be updated to reflect the new reality.

“There’s a good chance that the rise of teleworking during the COVID-19 pandemic will permanently change how we live and work. Many governments have realised this, and are taking a fresh look at the rights of employees working from home. For example, companies should ensure that workers do not feel isolated, whilst giving them the right to disconnect, rather than being online 24 hours a day”.

In Chile, a law adopted early in March 2020 goes some way to addressing some of these concerns. The legislation recognizes the right of remote workers to disconnect for at least 12 continuous hours in a 24-hour period. In addition, employers cannot require workers to respond to communications on rest days or holidays.

A healthy home?

Beyond the question of comfort and mental health, is one of physical safety. It is often said that most accidents happen at home, so, if this is where much of the working week is spent, should employers be responsible for making sure apartments aren’t death traps?

“For now, there are no easy answers when it comes to ensuring a suitable home office environment”, says Mr. Nunes. “However, we can say that the same principles that apply to other workplaces apply to teleworkers, in that employers have a general duty of care, as reasonably practicable. Employers can’t control the workplace when staff are working from home, but they can provide ergonomic equipment to workers, such as suitable chairs, and help them to assess their own risks and to learn about how to maintain healthy lifestyles.”

Teleworking is also challenging for enforcement agencies, as usually inspectors do not have free access to the private spaces. One solution to ensure compliance with legislation could be virtual inspections, which are already taking place in Nordic countries on a voluntary basis. “These involve labour inspectors video calling a worker at home, and being shown their work chair, desk, and lighting setup”, explains Mr. Nunes. “These inspections can serve as a way to monitor the home workplace and provide advice, but also raise understandable privacy concerns”.

Frontline fears

Whilst the new teleworkers and their employers grappled with their new reality, a large part of the global workforce had no choice but to go to a physical place of work. The difficulties faced by health care workers were widely reported, but employees in several other industries had to brave the trip to the workplace – sometimes on crowded trains and buses – and, often, interact with other people, at considerable risk to their health.

In the US, these fears led to collective action by workers at Whole Foods, a grocery subsidiary of Amazon. On March 31, 2020, in response to seeing their colleagues testing positive with COVID-19, workers decided to call in sick, and demand sick leave, free coronavirus testing and hazard pay. This was followed in April by work stoppages at some of America’s biggest companies, including Walmart, Target and FedEx.

Whilst early advice on protection and prevention focused on measures such as hand washing, the wearing of masks and gloves, and physical distancing, the ILO quickly realised that more needed to be done to address work-related issues.

“In the workplace, you have to think about more than just the individual worker: the whole environment needs to be protected’, explains Mr. Nunes. “One example that many of us will have come across is in shops and supermarkets, where it is now common to see PVC separators between cashiers and customers. Work surfaces are also being cleaned much more frequently, but this raises other concerns that need to be addressed, such as the potential for skin complaints or respiratory problems caused by the chemicals in cleaning products.”

Whilst areas such as healthcare and retail have been grappling with these issues for several months, other parts of the economy could soon be opening up. In several countries, plans are being made to allow gatherings of large numbers of people to take place, in venues such as concert halls and cinemas, and, heading into summer in the northern hemisphere, the range of permitted tourist activities looks set to expand.

However, for this to take place, and for economies to safely open, governments and employers, in collaboration with workers, will need to make sure that workers in these, and all other industries, are safe at their workplaces, and confident they will not be exposed to unnecessary risks, particularly those related to COVID-19.

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Biotechnologies: Commission seeks open debate on New Genomic Techniques

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research coronavirus

European Commission published, at the request of the Council, a study on New Genomic Techniques (NGTs). The study shows that NGTs, which are techniques to alter the genome of an organism, have the potential to contribute to a more sustainable food system as part of the objectives of the European Green Deal and the Farm to Fork Strategy.

At the same time, the study finds that the current GMO legislation, adopted in 2001, is not fit for purpose for these innovative technologies. The Commission will now start a wide and open consultation process to discuss the design of a new legal framework for these biotechnologies.

Commissioner for Health and Food Safety, Stella Kyriakides, said: “The study we publish today concludes that New Genomic Techniques can promote the sustainability of agricultural production, in line with the objectives of our Farm to Fork Strategy. With the safety of consumers and the environment as the guiding principle, now is the moment to have an open dialogue with citizens, Member States and the European Parliament to jointly decide the way forward for the use of these biotechnologies in the EU.”

NGTs developing rapidly in many parts of the world

NGTs, which can be defined as all techniques to alter the genome of an organism developed after 2001 (when the EU’s legislation on GMOs was adopted), have rapidly developed over the last two decades in many parts of the world, with some applications already on the market of some EU trade partners.

The main findings of the study are:

  • NGT products have the potential to contribute to sustainable food systems with plants more resistant to diseases, environmental conditions and climate change effects. Moreover, the products can benefit from higher nutritional qualities such as healthier fatty acid content, and reduced need of agricultural inputs such as pesticides;
  • By contributing to the EU’s objectives of innovation and sustainability of food systems, as well as a more competitive economy, NGTs can have benefits for many sectors of our societies;
  • At the same time, the study also analysed concerns associated with NGT products and their current and future applications. Concerns included the possible safety and environmental impact, for example, on biodiversity, the coexistence with organic and GM-free agriculture, as well as labelling;
  • NGTs are a very diverse set of techniques and can achieve different results, with some plant products produced by NGTs being as safe as conventionally bred plants for human and animal health and for the environment;
  • The study finds that there are strong indications that the current 2001 GMO legislation is not fit for purpose for some NGTs and their products, and that it needs adaptation to scientific and technological progress.

Next Steps

The study will be discussed with EU ministers at the Agriculture and Fisheries Council in May. The Commission will also discuss its findings with the European Parliament and all interested stakeholders.

In the coming months, an impact assessment, including a public consultation, will be carried out to explore policy options concerning the regulation of plants derived from certain NGTs.

Background

The study was prepared following a request from the Council of the European Union which, on 8 November 2019, asked the Commission to carry out “a study in light of the Court of Justice’s judgment in Case C-528/16 regarding the status of novel genomic techniques under Union law.”

The study was conducted by the Commission and informed by expert opinions and contributions from Member States’ competent authorities and EU-level stakeholders via targeted consultations.

A wide range of participants was involved in the consultation, which preceded the preparation of the report. All contributions are published.

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