The Total-Body Medicine Ball Workout You Need in Your Life

Most people walk right past the medicine balls and head straight for the dumbbells at the gym. Why? Often it’s simply because they’re just not sure what to do with one.

But a medicine ball is one of the most versatile pieces of equipment you’ll find in a gym. It’s a great tool for a total-body strength workout, and incorporating one into your routine also helps improve your core stability, coordination, and speed.

Ready to learn? Next time you’re at the gym, grab a medicine ball that weighs between 5 and 10 pounds and move through these exercises circuit-style. Rest as needed and repeat the circuit 2 to 4 times.

RELATED: The 6-Minute Ab Workout

Squat thrusts

Stand tall with your chest out, shoulders back, and feet shoulder width apart. Hold the medicine ball in front of your chest. Squat down as low as you can, keeping the weight in your heels, and then stand up and press the medicine ball high above your head. Repeat for 12-15 reps.

Photo: Jennifer Cohen

Sit-ups

Begin lying on your back with your feet flat on the floor and while holding the medicine ball with two hands. Reach the ball above your head and tap it on the ground. From here, use your abs to sit up, while keeping the medicine ball over your head. Repeat for 10-12 reps.

Photo: Jennifer Cohen

RELATED: 15-Minute Workout: Get Total-Body Toned

Medicine ball slams

Stand tall with your chest out, shoulders back, and feet shoulder width apart. Hold the medicine ball high over your head. In one swift motion, slam the ball down into the ground, using both your legs and your arms. Catch the ball as it bounces back up and repeat for a total of 12-15 reps.  

Photo: Jennifer Cohen

Russian Twists

Sit with your feet flat on the floor, holding the medicine ball in front of your chest, and leaning back slightly. You should feel your core engage the further you lean back. From here, twist your torso from left to right, tapping the medicine ball on each side of you as you move back and forth. Repeat for 12-15 reps per side.

Photo: Jennifer Cohen

Push-Ups

Get into a push-up position, keeping your core tight, with your right hand on the floor and your left hand on the medicine ball. Perform a push up and then roll the ball from your left hand to your right hand, placing your left hand on the floor and repeat. Perform 4-5 reps per side. You can also do this from your knees, but make sure that your hips are in alignment with your back.

Photo: Jennifer Cohen

RELATED: 5 Upgrades to Your Favorite Body Weight Moves

Walking lunges with a twist

Start with your feet shoulder width apart, holding the medicine ball in front of your chest. Step out with your right foot and lunge down until your left knee is about an inch from the ground. While you’re in this position, rotate your torso to the right before stepping your left foot forward. Repeat with the left leg until you have completed 10-12 reps per leg.

Photo: Jen Cohen

Overhead extensions

Stand with your feet shoulder width apart, chest out, core engaged, and shoulders back. Hold the medicine ball high over your head. Keep your elbows tucked next to your ears and slowly allow your arms to bend, lowering the medicine ball down to your upper back, behind your neck. Press through your triceps to push the medicine ball back above your head. Repeat for 15 reps.

Photo: Jennifer Cohen

RELATED: 6 Ways to Get MORE Out of a Push-Up

Looking for new-to-you ways to stay fit? Check out How to Master the Kettlebell: 3 Moves for Beginners

Jennifer Cohen is a leading fitness authority, TV personality, entrepreneur and best-selling author of the new book, Strong is the New Skinny. With her signature, straight-talking approach to wellness, Jennifer was the featured trainer on The CW’s Shedding for the Wedding, mentoring the contestants’ to lose hundreds of pounds before their big day. She appears regularly on NBC’s Today Show, Extra, The Doctors and Good Morning America. Connect with Jennifer on Facebook, Twitter, G+ and on Pinterest.

RELATED: More Medicine Ball Workouts

 

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Drug Avastin Not Linked to Higher Risk of Blindness: Study

THURSDAY, Aug. 13, 2015 (HealthDay News) — Concerns that eye injections of the drug Avastin increase the risk of a potentially blinding eye infection may be unfounded, a new study finds.

Researchers analyzed insurance claims data from across the United States to compare the use of Avastin (bevacizumab) to treat retinal diseases with a much more expensive drug called Lucentis (ranibizumab).

The study was conducted in response to reports of Avastin-related eye infections that led the U.S. Food and Drug Administration to propose tight restrictions on the use of the drug for eye conditions.

But the findings showed that patients treated with Avastin do not have a higher risk of an eye infection called endophthalmitis than those treated with Lucentis, the study authors said.

The researchers looked at more than 296,000 injections of Avastin and more than 87,000 injections of Lucentis. They found the rates of the serious eye infection were 0.017 percent for Avastin and 0.025 percent for Lucentis.

The U.S. National Institutes of Health funded the study, which was published Aug. 13 in the journal JAMA Ophthalmology.

“Our analysis of a national data set shows that the risk for endophthalmitis is no higher with Avastin and hints that there may actually be a lower endophthalmitis risk compared to Lucentis, so the proposed FDA restrictions for Avastin might have the unintended consequence of increasing the infection risk for patients,” study senior author Dr. Brian VanderBeek, an assistant professor of ophthalmology at the University of Pennsylvania, said in a university news release.

The American Academy of Ophthalmology opposes the proposed new FDA rules.

“The findings from our study support their stance,” VanderBeek said.

Avastin costs approximately $50 per injection, while Lucentis can cost as much as $2,000 per treatment, the researchers noted.

Avastin is used to treat a variety of cancers. It’s also used to treat wet age-related macular degeneration, a progressive disease of the eye that causes loss of the ability to see straight ahead.

More information

The U.S. National Library of Medicine has more about endophthalmitis.

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Broader Gene Tests for Breast, Ovarian Cancer Might Benefit Some: Study

By Dennis Thompson
HealthDay Reporter

THURSDAY, Aug. 13, 2015 (HealthDay News) — Some women with a family history of breast or ovarian cancer might benefit from a broader genetic test that includes more than 20 genes that have been found to increase cancer risk, a new study suggests.

Genetic tests have tended to focus solely on BRCA1 and BRCA2, the two genetic mutations that have been proven to dramatically increase a woman’s risk for breast or ovarian cancer, the researchers said.

But women who don’t carry BRCA1 or BRCA2 could still have another genetic mutation that is the source of a history of cancer in their families, explained study senior author Dr. Leif Ellisen, program director of the Center for Breast Cancer at Massachusetts General Hospital and a professor at Harvard Medical School, both in Boston.

Ellisen’s research concluded that a broad genetic test could help doctors better advise and treat about half of the women who have a genetic predisposition to cancer that’s not due to either BRCA1 or BRCA2.

“In the majority of women in which these other mutations were found — 52 percent of the group — you would actually make a different recommendation than you would based on personal and family history alone,” Ellisen said.

The study was published online Aug. 13 in the journal JAMA Oncology.

A recent and dramatic drop in the cost of genetic testing has sparked an ongoing debate about the positives and negatives of such testing, said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.

For example, a company called Color Genomics now offers a 19-gene test to help women gauge their risk of breast and ovarian cancer for only $249, he said. The company will even help women find a doctor who will order the test on their behalf.

But Ellisen said that such testing, done indiscriminately and without proper counseling, could promote a lot of fear and even prompt some women to undergo unneeded mastectomies or ovary removals.

“It has to be communicated in an accurate way,” he said. “If a woman comes in and she’s had a cancer scare, and you tell her she has this significant cancer risk gene, she might be tempted to go out and have one of these surgeries when the risk isn’t that high and it really isn’t warranted.”

To see whether a broad-panel genetic test would be helpful in some situations, Ellisen and his colleagues recruited 1,046 women who had a family history of breast or ovarian cancer but did not have BRCA1 or BRCA2 mutations.

These women underwent genetic testing using either a 25-gene panel or a 29-gene panel, both of which are commercially available.

The researchers found that 3.8 percent of the women — 63 total — carried another type of genetic mutation that would increase their cancer risk, Ellisen said.

In half those cases, the mutation likely would alter the outcome of a cancer risk assessment on the women, researchers concluded. Doctors might recommend additional cancer screening, or even removal of the breasts or ovaries, based on the new genetic info.

“The question was, these people who have a family history, is their risk already high enough that you would have been watching them very closely anyway, and finding this new gene wouldn’t have made any difference?” Ellisen said.

“We found that if you do a risk calculation that doesn’t include the information about the gene and you make a recommendation, but then you find the gene and you redo the risk calculation, the risk is much different and you would make a much different recommendation,” he said.

The researchers also concluded that close female relatives of 72 percent of patients with a cancer-causing mutation would be urged to undergo genetic testing, to see if they carry the same mutation.

But this new data could lead to more confusion than clarity, as the ability to test a person’s genetics outpaces the knowledge of how specific genes contribute to cancer, according to Lichtenfeld and Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.

A ton of research has been conducted on BRCA1 and BRCA2, and the way they affect cancer risk is well documented. They account for about 20 percent to 25 percent of hereditary breast cancers, and about 5 percent to 10 percent of all breast cancers, according to the U.S. National Cancer Institute. They also account for about 15 percent of ovarian cancers.

But not much is known about the cancer risk posed by all these other genes, the cancer experts said. And doctors without proper training in genetics might find it hard to provide quality information for patients.

“We say information is power, and I think it is for many patients, but we don’t always know what to do with the information,” Bernik said. “With these other genes, the risk is often low to intermediate. If the risk is lower, at what point does the risk become enough to tell a woman that prophylactic surgery is the best route?”

Lichtenfeld agreed, adding that, “in practical terms, the question is, are we ready for this in the everyday practice of medicine?”

Ellisen believes that only women with a family history of breast or ovarian cancer should undergo genetic testing at this time. He added that the genetic testing must be combined with the woman’s personal and family history to produce a nuanced assessment of her cancer risk.

“If that information is conveyed inappropriately to patients, they may think they have something bad when really they don’t have anything bad at all,” he said.

Once more is known about all of these genes, there may come a day when genetic testing becomes a broad standard of care for all people, starting with a test conducted on newborns, Lichtenfeld said.

“We’re certainly not there yet,” he said. “All of this is a learning process, and we’re still very much in that mode of finding out what all of this really means.”

More information

Visit the U.S. National Cancer Institute for more on genetic tests for cancer risk.

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Vaccine Sharply Curbs Chickenpox Cases in U.S.

THURSDAY, Aug. 13, 2015 (HealthDay News) — Chickenpox cases in the United States have dropped sharply since a vaccine against the disease became available in 1995, a new study shows.

Also, hospitalizations and outpatient visits for chickenpox have continued to fall since 2006, when a second dose of the vaccine was recommended to boost protection against the disease, the researchers found.

Before 1995, about 4 million people in the United States got chickenpox each year, nearly 11,000 were hospitalized, and up to 150 died of the disease, according to the U.S. Centers for Disease Control and Prevention.

For this study, CDC researchers analyzed national health insurance claims data. They found there were 93 percent fewer hospitalizations for chickenpox in 2012, and 84 percent fewer outpatient visits for the disease than in the period before the vaccine was introduced.

After the second dose recommendation took effect, hospitalizations dropped 38 percent and outpatient visits declined 60 percent, according to the study published Aug. 13 in the Journal of the Pediatric Infectious Diseases Society.

“We found that, in our study, rates for varicella [chickenpox] in the U.S. continued to decline as the varicella vaccine program has become fully implemented,” study co-author Jessica Leung said in a journal news release.

“We saw significant declines in rates of varicella after the one-dose vaccine was recommended in 1995 in the U.S., and we’re continuing to see additional declines in varicella after two doses were recommended in 2006,” she added.

The largest decrease in chickenpox occurred among children and teens aged 1 to 19, a group targeted for vaccination against the disease. But there were also significant drops in outpatient visits and hospitalizations among children younger than 12 months — for whom the vaccine is not recommended — and among adults, who tend not to get vaccinated.

These findings suggest the possibility of something called herd immunity.

“The surrounding population that can be vaccinated are not getting sick, and therefore the data suggest that these infants are also being protected,” Leung said. “We’re seeing that for adults as well.”

Chickenpox typically causes a blister-like rash, itching, fever and fatigue.

More information

The American Academy of Family Physicians has more about chickenpox vaccination.

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1 in 4 Senior Women in U.S. Has Osteoporosis: CDC

THURSDAY, Aug. 13, 2015 (HealthDay News) — The weakening bones of osteoporosis greatly raise a person’s odds for dangerous fractures, and a new report finds that one-quarter of all American women aged 65 or older suffer from the condition.

Close to 6 percent of men in this age group also have osteoporosis, according to the report from the U.S. Centers for Disease Control and Prevention.

Experts weren’t surprised, and said more must be done to test for and treat the loss of bone density that often comes with age.

Osteoporosis and its precursor condition — osteopenia (low bone mass) — “is not just a problem for the 80-year-old individual, but starts to become an issue for many adults in their 50s and 60s,” said Dr. Saad Chaudhary, a spine surgeon at Mount Sinai Beth Israel Hospital in New York City.

In the study, Anne Looker and Steven Frenk, of the CDC’s Division of Health and Nutrition Examination Statistics, examined 2005-2010 data from a major federal government health survey.

The investigators reported that more than 16 percent of all American seniors — about 25 percent of women and nearly 6 percent of men — have full-blown osteoporosis as evidenced on bone density tests of the spine and hip.

The numbers rise even higher when the data involves osteopenia, where bone loss is already apparent but hasn’t reached the stage of osteoporosis. In that case, almost half (48 percent) of seniors — more than 52 percent of women and 44 percent of men — had osteopenia, the data showed.

Of course, rates of osteoporosis rose with age — about 26 percent of adults aged 80 or older had the condition. But the CDC team also noted that almost 13 percent of all adults between 65 and 79 years of age had osteoporotic bones.

In terms of demographics, Mexican-American seniors had the highest rate of osteoporosis (almost 25 percent), while blacks had the lowest rate (a little more than 10 percent), the report found.

Chaudhary stressed that much of this bone loss could be prevented.

“We reach our peak bone mineral density in adolescence and then must work conscientiously to maintain that through activity, a balanced diet, and consultation with health care providers,” he said.

Neglect your bone health in youth, and the consequences to quality of life could be significant, Chaudhary added. “Osteoporosis is the more severe stage and can often result in one or more fractures of the spine and cause pain and disability,” he said.

“Bone mineral density screening is recommended for postmenopausal women, and men aged 50 and above based on their risk factor profiles, or for all women age 70 and above and men aged 80 and above,” Chaudhary said. He believes that diet is also important — especially intake of calcium and vitamin D, which work together to help strengthen bones.

Dr. Caroline Messer directs the Center for Pituitary and Neuro-Endocrine Disorders at Lenox Hill Hospital in New York City. She noted the “unexpectedly high percentage of men over 65 with osteopenia.”

While current guidelines don’t recommend routine bone density testing for men younger than 80, “based on this new data, perhaps males aged 65 or over should also be considered for routine testing,” Messer said.

The report was released Aug. 13 by the CDC’s National Center for Health Statistics.

More information

Find out more about bone loss at the National Osteoporosis Foundation.

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Former President Jimmy Carter Has Cancer

By E.J. Mundell
HealthDay Reporter

WEDNESDAY, Aug. 12, HealthDay News — Former President Jimmy Carter has announced that he has cancer.

Carter, 90, said he learned only recently of his condition. In a statement released late Wednesday by The Carter Center, he said that, “Recent liver surgery revealed that I have cancer that now is in other parts of my body. I will be rearranging my schedule as necessary so I can undergo treatment by physicians at Emory Healthcare [in Atlanta]. A more complete public statement will be made when facts are known, possibly next week.”

The Carter Center had previously sent out a statement on Aug.3 noting that Carter, who was president from 1977-1981, “underwent an elective procedure at Emory University Hospital today to remove a small mass in his liver.”

At the time, the statement said that Carter’s “operation proceeded without issues, and the prognosis is excellent for a full recovery.”

According to the New York Times, there have been questions surrounding Carter’s health for a few months now. On May 10, he left early from a trip to Guyana because he felt unwell, the Times reported.

In a statement, President Barack Obama said that, “Our thoughts and prayers are with Rosalynn and the entire Carter family as they face this challenge with the same grace and determination that they have shown so many times before. Jimmy, you’re as resilient as they come, and along with the rest of America, we are rooting for you.”

More information

There’s more on cancer at the American Cancer Society.

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Tuning Into Your Favorite Music May Boost Post-Op Recovery

WEDNESDAY, Aug. 12, 2015 (HealthDay News) — Mozart, Madonna or Eminem: Whatever your taste, music may help you recover from a surgery, according to a new review of data on the subject.

“More than 51 million operations are performed every year in the U.S.,” lead author Dr. Catherine Meads, of Brunel University in the United Kingdom, said in a news release from The Lancet, which published the findings Aug. 12.

“Music is a non-invasive, safe, cheap intervention that should be available to everyone undergoing surgery,” she said. “Patients should be allowed to choose the type of music they would like to hear to maximize the benefit to their well-being.”

The only caveat: “Care needs to be taken that music does not interfere with the medical team’s communication,” Meads said.

In their research, her team reviewed data from 72 studies that included nearly 7,000 patients.

The investigators found that listening to music before, during or after surgery significantly lowered patients’ anxiety and pain, decreased their need for pain medicines, and increased their satisfaction with their care.

Listening to music at any time was beneficial, but patients who did so before their surgery tended to have better outcomes than those who did so during or after surgery, the researchers found. They also said that patients who selected their own music had slightly larger reductions in pain and the use of painkillers.

Even listening to music while under general anesthesia reduced patients’ levels of pain after surgery, but not as much as when patients were conscious during surgery, the findings showed.

Listening to music did not reduce the length of time patients spent in the hospital, the study found.

Two experts in the United States agreed with the findings.

“Music is a powerful tool with roots deep in every culture and civilization — it is wired deeply into the human brain and soul,” said Dr. Ron Marino, associate chair of pediatrics at Winthrop-University Hospital in Mineola, N.Y.

“This is another demonstration of nontraditional, non-pharmacologic methods of helping patients deal with pain anxiety and the general medical experience,” he said.

Curtis Reisinger is a clinical psychologist at Zucker Hillside Hospital in Glen Oaks, N.Y. He agreed that “music can have a significant positive impact on a patient’s experience while in a medical setting.”

Listening to music in the time around a stressful event, such as a surgery, “allows the patient to move their focus from their personal physical pain or psychological distress to that of the audio experience,” Reisinger said.

Still, “we must never assume that music will work for everyone,” he said. “Some patients may want quiet, or other types of distractions such as TV shows or just listening to the sounds of their surroundings.”

More information

The American Association of Clinical Endocrinologists has more about music and health.

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3 Steps to Beat Every Junk Food Craving

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Highly processed fare like pizza and ice cream are the most addictive eats, according to University of Michigan researchers. “These foods have tons of sugar, fat and refined grains, all of which influence blood sugar levels and the release of serotonin, which is quickly converted to sleep-inducing melatonin,” says Libby Mills, RDN (who was not involved in the study). “So we feel good one moment and deflated and tired the next. Then we crave a quick fix—more sugar, fat and refined carbs.” Break the cycle with these techniques.

Pause

Before you dig in to your chocolate stash, evaluate your hunger. “Ask yourself, ‘Am I just eating because it’s there?’” Mills says. If you’re truly starving, eat a healthy lunch or a snack. Tell yourself you can have a small bite of chocolate later if you still want it.

Plan

“If you try to ignore your cravings, you’ll end up bingeing,” Mills explains. “Decide on a small serving and a time to enjoy it. Also, have healthier choices like hummus and veggies alongside it to fill you up—and blunt the roller-coaster effects.”

Savor

When you do have a slice of pizza or some ice cream, “focus on the aroma and the visual appeal of the food,” Mills advises. “Allow yourself to take in the nuances of texture and taste rather than just scarfing it down.” This can help you feel satisfied— and in control.

RELATED:

12 Mental Tricks to Beat Cravings and Lose Weight

9 Ways to Quit Sugar for Good

10 Types of Hunger and How to Control Them

 

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Blood Chemical Test May Predict Risk of Heart Disease Death

By Maureen Salamon
HealthDay Reporter

WEDNESDAY, Aug. 12, 2015 (HealthDay News) — Higher-than-normal levels of a certain blood chemical may place some patients at significantly greater risk of dying from heart disease, new research indicates.

Scientists found that nearly one out of three people with diabetes and stable angina — a condition causing chest pain — who also had elevated levels of troponin in their blood died of a heart-related problem within five years.

Troponin, a protein found in heart muscle, is released into the bloodstream when heart damage occurs. Normally detected in patients suspected of having a heart attack, troponin at much lower levels is also identifiable in a high-sensitivity version of a test commonly used in Europe but not yet approved by the U.S. Food and Drug Administration.

“I think we anticipated that there would be a strong relationship between the troponin test and future death from heart attack, heart failure and stroke,” said study author Dr. Brendan Everett, director of the general cardiology inpatient service at Brigham and Women’s Hospital in Boston.

“But we’re surprised by the strength of the relationship,” added Everett. “The most compelling thing is that we have a marker that’s a really strong predictor of outcome and . . . gives us the opportunity to develop new therapies for these patients.”

The study is published Aug. 13 in the New England Journal of Medicine.

Heart disease is the top killer of Americans, causing about 735,000 heart attacks and 610,000 deaths each year, according to the U.S. Centers for Disease Control and Prevention.

Using the high-sensitivity troponin test, Everett and his team measured troponin levels in nearly 2,300 patients with both type 2 diabetes and so-called stable heart disease, or angina, which includes narrowed cardiac arteries but no acute heart injury. Type 2 diabetes is also a major risk factor for heart disease.

About 40 percent of participants had abnormal troponin levels, the study found. After five years, 27 percent of participants with elevated troponin had died of a heart attack, stroke or other cardiovascular causes, compared to 13 percent of those with normal troponin levels.

The researchers also found that the five-year death risk of patients with high troponin levels did not significantly decrease when these patients underwent treatments designed to open up narrowed heart arteries, such as coronary bypass surgery or stent placement.

“I was hopeful that the therapy tested . . . would offer an improvement in those outcomes,” Everett said, “but unfortunately that’s not what we saw.”

Dr. Matthew Roe, an associate professor of medicine at Duke University Medical Center in Durham, N.C., praised the study, saying it focused on “an important topic and the findings are highly relevant.”

Roe, author of an editorial accompanying the study, said the results confirm prior findings.

“It’s highly likely this test is a unique test discriminating patients who have a high risk of adverse cardiovascular outcomes,” said Roe, who wasn’t involved in the research.

But despite the test’s demonstrated usefulness in predicting higher risk of early death among those with angina and type 2 diabetes, Everett said he doesn’t think it should be routinely administered to these patients.

“I think it would be premature [to do that] because we don’t have a specific therapy to deal with an abnormal troponin level,” he said. “If we get the test back and can’t do anything about [high levels], it’s tough to recommend.”

Roe said more research should be done in short order, both to understand how to further utilize the high-sensitivity troponin test and determine effective treatments for patients with elevated troponin levels.

“There are many patients with cardiovascular disease in the U.S., and we’re always trying to refine how we can better evaluate and treat these patients,” he said. “I think this is a good step forward. This study was well-conducted and it’s time to start having these discussions.”

More information

The U.S. Centers for Disease Control and Prevention offers heart disease prevention tips.

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Nearly Two-Thirds of Americans Live in Poverty at Some Point: Study

WEDNESDAY, Aug. 12, 2015 (HealthDay News) — Many Americans will live in poverty at some point in their lives, a new study shows.

Researchers looked at national data collected since 1968 and concluded that between the ages of 25 and 60, almost two-thirds of Americans will live in poverty for a year. Poverty was defined as living under the 20th percentile of income distribution, the study noted. About 42 percent of Americans will have a year of extreme poverty — that’s below the 10th percentile of income distribution, the researchers said.

What’s more, nearly 25 percent will live through five or more years of poverty, and more than 11 percent will live in five or more years of extreme poverty, the study found.

“The numbers we found are higher than those we originally expected to find,” study author Mark Rank, a professor of social welfare at Washington University in St. Louis, said in a university news release. Rank conducted the study with Thomas Hirschl, a professor of development sociology at Cornell University, in Ithaca, N.Y.

A number of factors were linked to living in poverty or extreme poverty for a year. People who were younger, female, nonwhite, or single were more likely to have a year of poverty or extreme poverty. People with 12 years or less of education, and those who had a work disability were also more likely to have a year of poverty or extreme poverty, the study revealed.

The study was published recently in the journal PLoS ONE.

“Our previous work has shown that the typical American has a one in nine chance of joining the wealthiest 1 percent of the income distribution for at least one year in her or his working life,” Rank said.

“We knew that there would be a large number of Americans on the other end of the spectrum, but this research shows specifically how wide that income gap really is,” he added.

More information

The Institute for Research on Poverty, University of Wisconsin-Madison has more about poverty.

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