Painkillers for Teen Athletes Won’t Spur Addiction: Study

By James Bernstein
HealthDay Reporter

MONDAY, July 25, 2016 (HealthDay News) — Teenage athletes are less likely to abuse prescription painkillers than kids who don’t play sports or exercise, a new study finds.

The study results run counter to some research in recent years detailing concerns about injured teen athletes abusing opioid painkillers prescribed by doctors and then moving on to use heroin.

Dr. Wilson Compton, deputy director of the U.S. National Institute on Drug Abuse, said he was “surprised” by the findings. He said, “A key risk (for teenage athletes) is a desire to please and for acceptance. But this study shows overall rates (of use) are declining.”

For the study, University of Michigan researchers examined data from nearly 192,000 students in 8th and 10th grade who participated in a federally funded study between 1997 and 2014. Over these years, doctors wrote many more opioid painkiller prescriptions for children and teens, and nonmedical use of opioids increased sharply as well.

At roughly the same time, overdose deaths involving opioids such as Vicodin, OxyContin, Percocet and heroin nearly quadrupled in the United States, according to the U.S. Centers for Disease Control and Prevention.

However, the study results suggest that daily participation in sports and exercise may actually serve as a protective factor with respect to painkiller and heroin abuse, said report co-author Philip Veliz. He is with the university’s Institute for Social Research.

Even kids who participated in sports just once a week had lower odds of reporting any painkiller or heroin abuse, the study found.

Anecdotal evidence suggests that prescribing opioids to teens after a sports injury may lead some of them to become heroin addicts, Veliz explained. It’s said these kids become addicted to their painkillers and eventually resort to heroin, which is also an opioid, because it’s cheaper and easier to obtain.

While the narratives are compelling, Veliz said, no large-scale studies have assessed whether abuse of recommended painkillers is actually leading to an “epidemic” of heroin use among teens who frequently engage in sports and exercise.

On the contrary, this new study suggests there may be “positive social connections embedded in sports that can deter youth from serious types of illicit substance use,” such as heroin or cocaine, he said.

But some types of intense contact sports place teens “at greater risk” for painkiller abuse, Veliz noted. More research is needed into why this may be the case, he said.

For instance, other research has suggested that participation in wrestling or football may result in higher degrees of painkiller abuse. Veliz acknowledged that the chance of severe injury is greater in those sports than in other sports, such as baseball. He said he hopes to search for more definitive answers.

Overall, the new study found a decline in painkiller abuse by young athletes as well as non-athletes. Veliz and Compton agreed that greater awareness by parents and youngsters has helped lead to this decline.

“Maybe this is a sign that people are being more vigilant” about their children’s use of painkillers, Veliz said.

The study found that more than half of the students reported involvement in sports and exercise almost daily the previous year. Almost two out of five participated weekly at most, while about 8 percent reported no athletics or exercise.

Among the daily participants, nonmedical use of opioids declined from about 9 percent in 1997 to less than 5 percent in 2014. Heroin use fell from about 2 percent to less than 1 percent in that period, the study revealed.

The media’s focus on a rise of painkiller abuse by college students and young adults has also hammered at the dangers of opioid use by teens, Veliz said. Public messages on television, the internet and at schools have played a role as well, he said.

However, Compton said, painkiller abuse remains a rising problem among college students and young adults. Primarily, this is the result of less supervision by adults, the pressure to succeed at college and in the workplace, and the easy availability of such drugs on the streets, he noted.

“The young people are going in different directions” on this issue, Compton said.

While the new report assures that sports and regular exercise don’t lead to painkiller abuse, Veliz recommended more study on sports injury and pain management. Such studies help expand knowledge of the risks and benefits of teenage sports participation, he said.

The study findings were published online July 25 in the journal Pediatrics.

More information

The U.S. National Institute on Drug Abuse outlines signs of drug abuse and addiction.

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Strawberry chip protein scone recipe

 

Do you have a soft spot for scones? Try these wheat and sugar free, high-protein scones for your next high tea.

What you'll need

The scones

• 1 cup oat flour (ground quick oats)
• ½ cup vanilla protein powder 
• ¼ cup rolled oats
• ½ tsp baking soda
• ¼ tsp sea salt
• 3 tbsp coconut oil
• 1 egg white
• ¼ cup strawberry Greek yogurt
• 2 tbsp almond milk
• 3 sachets Stevia
• 3 tbsp dark chocolate chips

Mixed berry jam

• 1 cup frozen mixed berries (thawed)
• 2 sachets of Stevia
• 2 tsp chia seeds

Natural fat-free whipped 'cream'

• ½ cup non-fat dry milk 
• ½ cup ice water 
• 1 egg white  
• 1 tsp lemon juice 
• ¼ cup powdered sugar, sifted (you can use Stevia, quarter teaspoon or to taste)
• ½ tsp vanilla extract

What you'll do

The scones

Preheat the oven to 220ºC.

Mix all the dry ingredients together and all the wet ingredients together.

Add the wet to the dry and fold together.

Stir in chocolate chips.

Add heaped tablespoon amounts to a parchment-lined cookie sheet and bake for 12 to 15 minutes. Be careful that the tops reach golden, not brown. Enjoy with tea or cold almond milk.

The jam

Thaw frozen berries and, when thawed, puree. Add the berry puree to a small saucepan and add the Stevia and chia seeds.

Keep stirring the jam over low heat for 5 to 6 minutes – never leaving it unattended or to stick to the saucepan.

Let cool and serve with protein scones or your favourite toast or muffin. 

The cream

Put the ice water, egg white, and non-fat dry milk in the bowl of a stand mixer fitted with the whip attachment. Beat on high for 4  to 5 minutes until it starts to thicken. Stop the machine to scrape down the sides of the bowl to get the milk powder incorporated.

Add the lemon juice and continue whipping on the highest speed for another minute or two until thick.

Lower the speed and slowly add sugar or Stevia, then vanilla. Beat until well mixed. 

Serve immediately with scones and jam.

Cream recipe adapted from Betty Crocker’s Pie and Pastry Cookbook.

Recipe by lifestyle blogger Kris Bitton of I Heart Wellness.

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Behavior Changes May Be First Signs of Alzheimer’s

By Amy Norton
HealthDay Reporter

MONDAY, July 25, 2016 (HealthDay News) — Certain behavior changes may be a harbinger of Alzheimer’s disease, and researchers say they’ve developed a symptom “checklist” that might aid earlier diagnosis.

Experts have long focused on so-called mild cognitive impairment as an early warning sign of Alzheimer’s disease. That refers to problems with memory and thinking that may or may not progress to full-blown dementia.

But now some researchers are zeroing in on a new concept they call “mild behavioral impairment.”

The term is meant to describe persistent changes in an older person’s normal behavior. The changes include problems like social withdrawal, angry outbursts, anxiety and obsessiveness.

“We’re not talking about a blip in someone’s behavior,” said Dr. Zahinoor Ismail, of the University of Calgary’s Hotchkiss Brain Institute, in Canada. “It’s a sustained change from their former ways of functioning.”

And, he said, “that out-of-character behavior can be the first sign of something going wrong in the brain.”

So Ismail and his colleagues have developed a symptom checklist that doctors could potentially use to assess older patients for mild behavioral problems. The tool still needs to be studied further, but the hope is that it will help spot people in the early stages of Alzheimer’s.

Ismail was to present the work Sunday at the Alzheimer’s Association International Conference, in Toronto. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

“People often think [Alzheimer’s] is all about memory loss,” Ismail said. “But it’s not.”

Many patients with dementia, he explained, also have neuropsychiatric symptoms — an umbrella term for problems with behavior, mood and perception.

But the concept of “mild behavioral impairment” as a precursor to dementia is new, according to Ismail.

“Until now, there hasn’t been a good way to measure it,” said Keith Fargo, director of scientific programs and outreach for the Alzheimer’s Association.

Fargo, who was not involved in the developing the new checklist, said it still has to be tested in studies. Researchers will need to see whether patients’ results really predict how they will ultimately fare.

For now, Fargo said, it’s important for doctors and families to be aware that sustained behavior changes can be a red flag.

The checklist breaks symptoms of mild behavioral impairment into five groups.

One is “decreased motivation.” It refers to apathy, or lack of interest, in the things a person once enjoyed. An example would be when a grandparent seems to lose interest in her grandchildren’s lives, Ismail said.

Another describes emotional symptoms, like depression, anxiety and irritability.

A third focuses on social issues. “Have they lost their social graces, for example?” Ismail said. “Or is there a lack of empathy for others?”

Problems with impulse control is yet another warning sign, according to the checklist. That could manifest as agitation, obsessiveness or even habits like gambling.

Finally, there are issues with perception or thought “content” — where a person might suffer from delusions or even hallucinations.

According to Ismail, older adults may have mild behavioral impairment if they have any of those symptoms, at least periodically, for six months or more.

How common is mild behavioral impairment? That’s not completely clear, Ismail said.

But some findings he presented at the meeting offer a clue: Among 282 patients at one memory clinic, 82 percent had at least one sign of behavioral impairment.

Emotional symptoms and problems with impulse control were most common, but over half of the patients were showing apathy and more than one-quarter had problems socializing, he said.

According to Ismail, early issues with behavior may foretell a faster decline toward dementia.

It’s estimated, Ismail said, that of older adults with mild cognitive impairment, about 13 percent progress to dementia per year. But if they also have mild behavioral impairment, that rate goes up to 25 percent per year, he said.

Right now, there are no treatments that can prevent or change the underlying course of Alzheimer’s disease. But early detection is still key, according to Fargo, so that patients can get the available treatments and support services as early as possible.

When it comes to behavioral problems, he said, there are ways to manage them.

In some cases, a minor change in a person’s surroundings can help. “There may be something in their environment that’s agitating them, like too much sunlight,” Fargo said. “Sometimes it’s as simple as removing a trigger.”

Some people, he added, might benefit from medications, like antidepressants or anti-anxiety drugs. But that has to be decided on a case-by-case basis, under a doctor’s supervision, Fargo stressed.

He also encouraged families to contact the Alzheimer’s Association Helpline (1-800-272-3900) if they are looking for resources on dealing with behavioral issues.

More information

The Alzheimer’s Association has more on warning signs of dementia.

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People-Oriented Jobs May Help Lower Alzheimer’s Risk

By Dennis Thompson
HealthDay Reporter

SUNDAY, July 24, 2016 (HealthDay News) — Brain-challenging jobs — especially ones focused on people — may help shield a person’s mind against the ravages of age-related dementia, a new study finds.

People who work in jobs that task the intellect are better able to withstand the effects of brain lesions commonly associated with Alzheimer’s disease, report researchers from the University of Wisconsin’s Alzheimer’s Disease Research Center.

That’s particularly true if you have a job requiring complex social interactions, as opposed to working on your own analyzing data or working complicated apparatus, said lead researcher Elizabeth Boots. She’s a research specialist and Ph.D. candidate at the center.

“People are just more complex than data or things,” Boots explained. So, she reasoned, “human interactions require much more brain power than working with data on a computer or working with machinery.”

The study, as well as two others focused on similar themes, were to be presented Sunday at the Alzheimer’s Association International Conference, in Toronto.

The other two studies also suggest that working your brain, on the job or at play, can somehow “toughen it” against dementia:

• Toronto researchers found that socially active people with higher education, plus mentally stimulating work, were protected from age-related brain decline, even if they ate a bad diet that increased their risk for dementia.
• A decade-long “brain exercise” study showed some success in lowering dementia risk, too, but only for brain-training that emphasized quick thinking under pressure.

All of these findings relate to a concept called “cognitive reserve,” Boots said.

“It’s this idea that enriched life experiences, like higher education or occupational complexity, can provide protection against Alzheimer’s disease pathology in the brain,” she said.

These studies are helping to narrow down the particular types of brain activity that can help protect the brain as it ages, added Dean Hartley, director of science initiatives for the Alzheimer’s Association.

“We don’t quite know what that means in your daily life,” Hartley said. “Learning doesn’t always have to be in a formal situation. You can be learning on your job. You can be learning at home by reading. You could be learning in many ways, which to me is critical for building that resilience in the brain.”

In their study, Boots and her colleagues performed MRI brain scans of 284 healthy people, average age 60. The researchers were looking for “bright spots” in the brain that indicate tiny lesions caused by micro-strokes.

These lesions are the third-most common physical symptom associated with Alzheimer’s, after plaques and protein tangles, Boots explained.

The researchers also tested participants’ ability to remember and problem-solve, and they also took a work history from each.

The researchers found that people who had many of these brain lesions were better able to maintain their ability to think and reason if they worked in jobs that also required a lot of interaction with people.

“Interactions with people and working with people is something that happens in real time and requires a lot of brain power,” said study senior author Ozioma Okonkwo, an assistant professor and principal investigator at UW’s Alzheimer’s Disease Research Center.

“With the brain, you use it or you lose it,” Okonkwo continued. “The brain is like a muscle. The more you use it, the more it develops, and the more it develops the more it is able to withstand insults and injuries.”

None of this means that people with jobs that aren’t mentally stimulating are somehow doomed to dementia, he stressed.

Volunteering in the community can have the same effect, he added, particularly if one serves as a mentor with a group like the Boy Scouts or Little League.

“What is important here is not the exact job you have, but the skills you implement in this job,” Okonkwo said. “Clearly, there are many avenues for someone to provide mentoring outside of the work environment.”

He noted that the study could not show a direct cause-and-effect relationship between a person’s job and their ability to withstand dementia. For example, it could be that people who are less likely to experience age-related brain decline simply tend to drift into intellectually rigorous jobs, Okonkwo said.

In another study, researchers investigated the interplay between diet, intellectual stimulation and brain health.

They found that a “Western” diet — red and processed meats, white bread, potatoes, prepackaged foods and sweets — is associated with steeper brain decline in older adults.

However, people who had a mentally stimulating lifestyle were protected from this decline, even if they ate an unhealthy diet.

Again, the study couldn’t prove cause and effect. However, “our results show the role higher educational attainment, mentally stimulating work and social engagement can play in protecting your brain from cognitive decline, counteracting some negative effects of an unhealthy diet,” said lead researcher Matthew Parrott in a meeting news release. He is from Baycrest Health Sciences in Toronto.

The third study provided results from a 10-year clinical trial involving almost 2,800 people sorted into one of three different brain training groups. One group received memory training, another received reasoning skills training, and the third took training that emphasized speed of brain processing.

A decade later, researchers found that the speed-processing group had a 33 percent reduction in new cases of brain decline or dementia. People who participated in follow-up “booster” sessions did even better, with a 48 percent reduction.

However, people who took either the memory or reasoning training did not show any significant difference after 10 years.

“We believe this is the first time a cognitive training intervention has been shown to protect against cognitive impairment or dementia in a large, randomized, controlled trial,” lead author Jerri Edwards, an associate professor at the University of South Florida, said in the news release. “Next, we’d like to get a better grasp on what exactly is the right amount of cognitive training to get the optimal benefits.”

Experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

More information

For more on brain health, visit the Alzheimer’s Association.

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Women May Be More Resilient to Effects of Alzheimer’s Genes

SUNDAY, July 24, 2016 (HealthDay News) — Certain gene variants are known to raise a person’s risk of Alzheimer’s disease. But a new study finds that even in people carrying this DNA, factors such as gender and physical or mental activity can affect that risk.

The study tracked dementia rates for 642 people aged 53 to 95 at the start of the study. All carried at least one of two types of DNA linked to higher Alzheimer’s disease risk: the APOEe4 or CLU CC gene variants.

Carrying the APOEe4 variant “confers a risk of developing Alzheimer’s disease of up to 10 to 14 times compared to that of non-carriers,” explained Dr. Luca Giliberto, who reviewed the new findings.

He’s an investigator in Alzheimer’s disease at the Feinstein Institute for Medical Research in Manhasset, N.Y.

But Giliberto stressed that “having a [genetic] risk factor does not mean you will get the disease.” And that’s what the new study found — especially for people with certain characteristics.

Led by Kirstie McDermott, of the University of Alberta in Edmonton, Canada, the researchers tracked the Alzheimer’s gene carriers for nine years.

The study found that gender appeared to matter. While about 47 percent of men showed signs of decline in their memory level and stability over the study period, that number was approximately 32 percent for women.

This “memory resilience” over time was also found to be improved for both sexes in people who had higher education, better muscle tone, or who engaged in “challenging, everyday” intellectual activities, such as playing bridge, for example.

For women, specifically, having healthy lungs, a good walking speed and an active social life — things such as volunteering and visiting family and friends — were also linked to maintaining a healthy memory, the study found.

One factor seemed specific to men in keeping dementia at bay: Avoiding depression.

Giliberto wasn’t surprised by the findings.

“Conducting an active lifestyle, higher education and physical activity are all reasonable predictors of better aging,” he said. “Thus, it is not surprising that their effect would also be evident in carriers of genetic risk for Alzheimer’s disease.”

Dr. Ezriel Kornel directs the Neurosciences, Orthopedic and Spine Institute at Northern Westchester Hospital in Mount Kisco, N.Y.

“What all of this means, in a nutshell, is that if you take care of yourself physically, mentally and participate in your community, you are more likely to maintain a well-functioning memory,” even if you carry Alzheimer’s-linked DNA, Kornel said.

The findings were to be presented Sunday at the Alzheimer’s Association’s International Conference in Toronto. Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

More information

Find out more about genes linked to Alzheimer’s disease at the U.S. National Institute on Aging.

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How to Keep Bug Bites at Bay

SATURDAY, July 23, 2016 (HealthDay News) — Bug bites can make you more than itchy. Ticks, mosquitoes and certain flies are known to spread some nasty diseases. But U.S. health experts say there are ways to keep pesky insects in their place.

One of the best ways to prevent bug bites is to use an insect repellent, according to the U.S. Centers for Disease Control and Prevention.

The agency recommends insect repellents that contain at least 20 percent DEET. These products (which include Cutter Backwoods and Off! Deep Woods) offer protection against mosquitoes, ticks and other bugs.

It’s unclear how effective natural insect repellents are in preventing bug bites, the CDC said.

The agency says other repellents that may only protect against mosquitoes include:

• Picaridin, which is also known as KBR 3023, Bayrepel, and icaridin (products include Cutter Advanced, Skin So Soft Bug Guard Plus).
• Oil of lemon eucalyptus or para-menthane-diol (products include Repel Lemon Eucalyptus).
• IR3535 (products include Skin So Soft Bug Guard Plus Expedition and SkinSmart).

The CDC noted in a news release that these “insect repellent brand names are provided for your information only. The Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services cannot recommend or endorse any name-brand products.”

It’s important to use insect repellents properly. Be sure to read all the directions on the product’s packaging and use it as directed, the CDC advises.

Typically, repellents with greater concentrations of the active ingredient provide longer-lasting protection. But DEET concentrations above about 50 percent offer no additional protection, the agency explains.

The CDC offers additional tips to help prevent bug bites:

• If you want both sun and bug protection, apply the sunscreen first and allow it to dry before applying insect repellent.
• Do not apply insect repellent on the skin under clothing.
• Consider using clothing, boots, tents and other gear that are treated with the insecticide permethrin. Pre-treated clothes are available for purchase. Anyone treating clothes at home should follow instructions carefully. Permethrin should not be applied directly to the skin.
• It’s also a good idea to cover up as much as possible. Wearing long-sleeved shirts, long pants, socks and a hat can help prevent bug bites. Shirts should be tucked in. Pants can also be tucked into socks for additional protection. Keep in mind, however, that some bugs can bite through thin fabrics.
• When traveling, stay in hotels or other places with air conditioning or good window and door screens.
• If bugs can’t be kept out of sleeping areas, sleep under a permethrin-treated bed net that can be tucked under the mattress.
• When sleeping outside, use mosquito coils or other area repellents that contain metofluthrin or allethrin.

More information

The U.S. National Library of Medicine has more about insect bites and stings.

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Could New ‘Talk Therapy’ Cut Cost of Treating Depression?

FRIDAY, July 22, 2016 (HealthDay News) — A simpler and less expensive form of talk therapy is as effective as the gold-standard treatment — cognitive behavioral therapy — for treating depression in adults, a new study suggests.

The researchers found that so-called behavioral activation therapy treats depression just as well as cognitive behavioral therapy (CBT). But behavioral activation can be provided by mental health workers with minimal training and is significantly cheaper, the study authors contended.

Cognitive behavioral therapy is provided by highly trained and highly paid specialists. In many countries, CBT is available only to patients who can afford it or who have health insurance, and waiting lists can be long. For example, in the United States, only about one-fourth of people with depression have received any form of psychological therapy in the last 12 months, the researchers said.

The use of behavioral activation treatment could improve depression patients’ access to talk therapy treatment and reduce long waiting lists, the study authors suggested.

The research results were published July 22 in The Lancet.

“Our findings challenge the dominance of CBT as the leading evidence-based psychological therapy for depression,” lead author David Richards said in a journal news release. He is professor of mental health services research at the University of Exeter in England.

The study recruited 440 adults with depression who were assigned to receive either behavioral activation therapy or cognitive behavioral therapy. One year after the start of therapy, about two-thirds of patients remaining in both groups had at least 50 percent fewer depression symptoms.

Both groups also had similar numbers of depression-free days and anxiety diagnoses, and were equally likely to achieve remission, the study authors said.

Treatment costs for patients in the behavioral activation group were 20 percent lower than for those in the cognitive behavioral therapy group, the researchers said.

“Behavioral activation is an ‘outside in’ treatment that focuses on helping people with depression to change the way they act. The treatment helps people make the link between their behavior and their mood. Therapists help people to seek out and experience more positive situations in their lives. The treatment also helps people deal with difficult situations and helps them find alternatives to unhelpful habitual behaviors,” Richards said.

“In contrast, CBT is an ‘inside out’ treatment where therapists focus on the way a person thinks. Therapists help people to identify and challenge their thoughts and beliefs about themselves, the world, and their future. CBT helps people to identify and modify negative thoughts and the beliefs that give rise to them,” he explained.

Richards said the study findings suggest that behavioral activation could increase the availability of psychological therapies to both the rich and the poor. In addition, the newer therapy could also reduce the need for costly professional training, he said.

“However, more work still needs to be done to find ways to effectively treat up to a third of people with depression who do not respond to CBT or behavioral activation,” Richards added.

A commentary by Jonathan Kanter, of the University of Washington, and Ajeng Puspitasari, of Indiana University, accompanied the study. They wrote: “Now that we have support for behavioral activation as a treatment that is clinically effective and cost-effective, we can shift our efforts to focus on what is necessary to produce sustainable large-scale behavioral activation implementation across diverse geographical and cultural settings.”

More information

The U.S. Centers for Disease Control and Prevention has more about depression treatment.

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Don’t Let Your Campfire Become a Wildfire

FRIDAY, July 22, 2016 (HealthDay News) — Campfires can provide the backdrop for lots of outdoor fun. But, if people are careless, those campfires can spark a damaging wildfire, the New York Department of Environmental Conservation says.

So, how can you safely have a campfire?

First, use existing campfire rings whenever you can. Or, if you’re in a remote area, consider using a small portable stove instead of a campfire.

If you can’t find an existing campfire ring, take care to situate your campfire away from tree branches, steep slopes, rotten tree stumps, logs, dry grass, leaves and other vegetation that could catch fire. Extra wood should also be stored at a safe distance from a campfire site, the New York state conservation experts cautioned.

The agency also provided the following safety tips for campfires:

• Campfires must be less than 3 feet high and 4 feet in diameter.
• Only charcoal or untreated wood should be used as fuel. A bed of coals or a small fire surrounded by rocks provides significant heat.
• Sweep away litter and any flammable material within a 10-foot diameter circle to prevent a campfire from spreading.
• Hold a match until it is cold to be sure the flame is out.
• Never leave a campfire unattended. A campfire can spread with just a small breeze.
• Douse a campfire with water to be sure all embers, coals, and sticks are wet. If water is unavailable, use dirt. Never bury coals, because they can smolder and spark a fire.
• Move rocks to make sure there are no burning embers beneath them. Stir the remains, add more water, and stir them again.

More information

The U.S. Department of Agriculture Forest Service has more about campfire safety.

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Watermelon Cakes: The Best Healthy Dessert for Your Summer BBQ

There’s no denying that watermelon is the quintessential summer fruit. This low-calorie, thirst-quenching backyard BBQ favorite is a staple in the sticky summer months. When you need to cool down, stat, a juicy slice of watermelon does the trick. But lately on our social media feeds, the fruit has been swapping its signature green rind for something a little different: a light coating of frosting. Watermelon cakes, as they’re called, are an Instagram-worthy dessert that taste indulgent but still manage to be healthy-ish. Count us in.

Even better news: Creating your own watermelon cake at home is easier than you’d think. After slicing off the top and bottom (you’ll want both ends to be flat), carve away the rind to create a cake-like shape. Another option is to cut the watermelon into rounds and stack them on top of each other in layers.

Once you achieve your desired shape, you have a blank canvas to decorate. For frosting, you could go the traditional route and use whipped cream, or make it vegan by using coconut cream. How you choose to embellish your watermelon cake is up to you. Here, a few of the most creative ideas we’ve seen on Instagram.

RELATED: Watermelon Facts You Probably Don’t Know

Add fresh sliced fruit on top and toasted almonds on the side:

Top with fresh fruit, candy, and candles for a birthday-worthy treat:

You could up your game and create fancy fruit patterns:

Give it a floral flair with edible flowers:

Make it layered to serve a larger crowd:

Or simply leave it “naked” on the sides to show off the beautiful red hues in all their glory:

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Antibiotic-Resistant Bacteria Detected in Sewage Spill

FRIDAY, July 22, 2016 (HealthDay News) — Sewer line breaks can release antibiotic-resistant bacteria that pose a public health threat, a new study says.

Consider the 2014 sewer line break in St. Petersburg, Fla., that released 500,000 gallons of untreated wastewater into neighborhoods and Boca Ciega Bay.

University of South Florida researchers who did follow-up testing of soil and water said they detected genes from vancomycin-resistant bacteria for nearly two weeks after the sewer line break. One of those genes is capable of transferring vancomycin resistance to other strains of bacteria.

Vancomycin, considered an antibiotic of last resort, is used to treat serious infections that don’t respond to other antibiotics, the researchers noted.

“While we have known that raw sewage contains many disease-causing bacteria, this experience tells us that sewage and fecal pollution also carry vancomycin-resistant bacteria,” said study co-author Valerie Harwood, a professor in the department of integrative biology.

“Most [vancomycin-resistant bacteria] are confined to hospitals, but detecting them in waters of the Tampa Bay community is quite concerning. People need to be aware of what may be entering the water after heavy rains, accidental spills, or after intentional sewage releases,” she added in a university news release.

The study highlights the need to reduce antibiotic use, said study lead author Suzanne Young, a Ph.D. student.

“The more antibiotics we use — in both humans and animals — the more the antibiotic resistant organisms and antibiotic resistance genes can enter the environment and contribute to the spread of antibiotic resistance, especially for those drugs considered the ‘last resort’ for many infections,” Young explained.

“Also, we need to invest in more sustainable infrastructure for managing storm water and wastewater to decrease the frequency of sewage spills,” she added.

The study findings were published recently in the journal Applied and Environmental Microbiology.

More information

The U.S. Centers for Disease Control and Prevention has more on antibiotic resistance.

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