PrEP stands for pre-exposure prophylaxis.It is a medicine people at risk of getting HIV take to prevent HIV infection.

Who should consider taking PrEP?

individuals at high risk of HIV acquisition, such as those with HIV-positive partners or engaging in unprotected sex, should consider PrEP.

How effective is PrEP?

PrEP is highly effective when taken as prescribed, reducing the risk of HIV infection by up to 99%.

Are there any side effects of PrEP?

Most people who take PrEP do not experiance serious side effects. Mild side effects, such as nausea or headache, may occur initially.

How often do I need to be tested while on prep?

Regular HIV and STI testing is essential while on PrEP to ensure continued effectiveness and detect any potential infections.

What are ultra-processed foods?

Ultra-processed foods are industrial formulations made mostly from substances derived from foods and additives. They often lack whole food ingredients.

How does protein help with fullness?

protein slows digestion and influences hormones related to hunger and satiety.

Is it possible to eat processed foods in moderation?

While minimizing processed food intake is ideal, incorporating them sparingly within a balanced diet may be possible for some individuals.

What are some other ways to increase satiety?

Fiber-rich foods and mindful eating practices can also promote fullness.

Can increasing protein intake help with weight loss?

By promoting fullness and reducing calorie intake, increased protein can support weight loss efforts.

What is the ideal amount of sleep for heart health?

Most adults should aim for 7-8 hours of quality sleep each night to optimize cardiovascular function.

Can improving my sleep actually lower my blood pressure?

Yes, consistent adequate sleep can help regulate blood pressure and reduce the risk of hypertension.

Is a short nap during the day beneficial for heart health?

Short power naps (20-30 minutes) can be refreshing, but long or frequent naps may indicate underlying sleep issues.

What are signs that I might have a sleep disorder?

Signs include excessive daytime sleepiness, loud snoring, pauses in breathing during sleep, and difficulty falling or staying asleep.

Does the quality of sleep matter as much as the quantity?

Absolutely. Deep, restorative sleep is more important than simply spending a certain number of hours in bed.

European Clinics show Progress in HIV Prevention, But Gaps Remain

Table of Contents

1. European Clinics show Progress in HIV Prevention, But Gaps Remain
2. Key Findings of the PrEP Audit
3. Areas for Improvement Identified
4. Future Directions and Audit Refinements
5. The Growing Importance of PrEP
6. Frequently Asked Questions About PrEP
7. What specific metrics are used to evaluate adherence to CDC guidelines regarding STI screening frequency for PrEP users?
8. Extensive Review of HIV Pre-exposure Prophylaxis (prep) Standards of Care Audit Report
9. Understanding the PrEP Standards of Care Audit
10. Core Components of the PrEP Standards
11. Key Audit findings & Common Deficiencies
12. Impact of the Audit on prep Implementation
13. benefits of Adhering to PrEP Standards of Care
14. Practical Tips for Healthcare Providers

Brussels – A recent thorough audit of HIV prevention programs across Europe indicates significant strides in providing PrEP (pre-exposure prophylaxis) services, but also highlights areas needing focused improvement. The audit, conducted in December 2023, assessed ten clinics in eight European countries regarding adherence to established standards of care for PrEP.

The evaluation, a joint effort between the European Center for Disease Prevention and Control (ECDC) and the European AIDS Clinical Society (EACS), examined clinic policies and actual implementation of PrEP care. This is a crucial step towards optimizing HIV prevention strategies continent-wide.

Key Findings of the PrEP Audit

The audit revealed that the majority of clinics are successfully meeting established process indicators related to PrEP safety, continuity of care, and integrated service delivery. Specifically,most facilities adhere to national or EACS guidelines,targeting PrEP eligibility to individuals at heightened risk,including gay men and transgender individuals.

Funding for PrEP was fully available in seven of the ten clinics surveyed, a positive sign for accessibility. Crucially, all participating clinics provided HIV and STI testing, with eight offering STI testing.

here’s a snapshot of the audit results:

Area of Assessment	Target	Clinics Meeting Target
HIV Exclusion Before Initiation	≥ 80%	6 out of 10
Annual Glomerular Filtration rate (GFR) for Users > 50	≥ 80%	Most clinics
HBV Status Determination	≥ 80%	9 out of 10
Annual Adherence Assessments	≥ 80%	8 out of 10
HIV Testing Rate	≥ 80%	All clinics
Syphilis Testing Rate	≥ 80%	Most clinics
Gonorrhea/Chlamydia Testing Rate	≥ 80%	5 out of 10

Did You Know? PrEP is highly effective in preventing HIV when taken as prescribed, reducing the risk of infection by up to 99%.

Areas for Improvement Identified

While the audit paints a largely positive picture, certain areas require attention. Testing rates for gonorrhea and chlamydia were notably lower than targets, with only half the clinics achieving the desired 80% testing rate. This may stem from variations in testing practices or reliance on symptomatic testing.

Optimizing the timing of HIV testing and addressing the lower rates of gonorrhea and chlamydia screening are critical steps toward enhancing the overall effectiveness of PrEP programs.

Pro Tip: Regular STI screening is crucial for individuals engaging in sexual activity, even when using PrEP.

Future Directions and Audit Refinements

The ECDC and EACS are already planning improvements to the audit process itself. These include incorporating questions about PrEP interruptions,clarifying the types of HBV testing conducted,and refining timeframes for assessments. Automation of the audit process is also under consideration to streamline data collection and ongoing monitoring.

Participating clinics have expressed the value of the audit in pinpointing areas for service enhancement. By leveraging these findings, healthcare providers can strengthen PrEP programs and better serve individuals at risk of HIV infection.

The Growing Importance of PrEP

PrEP has become a cornerstone of modern HIV prevention strategies. Globally, the number of people using PrEP has increased considerably in recent years. According to UNAIDS,approximately 1.6 million people accessed PrEP in 2022, a ample rise from previous years. However, access remains uneven, particularly in low- and middle-income countries.

Ongoing research continues to explore new PrEP formulations and delivery methods, including long-acting injectable PrEP, which promises to improve adherence and convenience.

Frequently Asked Questions About PrEP

What are your thoughts on the findings of this audit? Do you believe increased investment in STI testing within PrEP programs is necessary? Share your opinions in the comments below.

What specific metrics are used to evaluate adherence to CDC guidelines regarding STI screening frequency for PrEP users?

Extensive Review of HIV Pre-exposure Prophylaxis (prep) Standards of Care Audit Report

Understanding the PrEP Standards of Care Audit

The HIV Pre-exposure Prophylaxis (PrEP) Standards of Care Audit report is a critical assessment of healthcare providers’ adherence to established guidelines for delivering effective PrEP services. This review focuses on ensuring quality, equity, and optimal outcomes for individuals seeking HIV prevention through PrEP. Regular audits are essential for identifying gaps in service delivery and implementing improvements to maximize PrEP uptake and adherence. Key areas assessed include patient screening,risk assessment,prescribing practices,follow-up care,and linkage to comprehensive HIV prevention services.

Core Components of the PrEP Standards

Several organizations contribute to defining PrEP standards of care. Thes include:

* CDC (Centers for Disease Control and Prevention): Provides comprehensive clinical practise guidelines for PrEP,updated regularly based on emerging research. These guidelines cover indications for PrEP, prescribing details, monitoring requirements, and management of potential side effects.

* WHO (World Health Association): Offers global recommendations on PrEP implementation, especially relevant for resource-limited settings.

* National HIV/AIDS Strategy: Sets national goals for HIV prevention, including increasing PrEP access and utilization.

* Professional Societies (e.g., IDSA, AAFP): Develop specific recommendations for PrEP management within their respective specialties.

Key Audit findings & Common Deficiencies

Recent PrEP Standards of Care audit Reports consistently highlight several areas needing betterment:

* Insufficient Risk assessment: Many providers lack standardized protocols for comprehensive risk assessment, leading to under-identification of individuals who could benefit from PrEP. This includes failing to adequately assess sexual behaviors,substance use,and co-occurring STIs.

* Suboptimal STI Screening: Guidelines recommend routine STI screening at baseline, every 3-6 months during PrEP use, and when symptoms arise. Audits reveal frequent gaps in STI screening practices, potentially leading to undiagnosed and untreated infections.

* Inadequate Kidney Function Monitoring: PrEP medications (tenofovir disoproxil fumarate – TDF) can impact kidney function. Regular monitoring (baseline, 1 month, 3 months, 6 months, and annually) is crucial. Audit reports show inconsistent adherence to these monitoring schedules. Newer formulations (tenofovir alafenamide – TAF) have a more favorable renal profile, but monitoring remains crucial.

* limited Linkage to Comprehensive Care: PrEP is most effective when integrated with broader sexual health services, including STI treatment, contraception, and mental health support.Audits demonstrate a need for stronger linkages between PrEP providers and these essential services.

* Disparities in Access & Adherence: Important disparities exist in PrEP access and adherence based on race, ethnicity, gender identity, and socioeconomic status. Audit data frequently enough reveals lower PrEP uptake and retention rates among marginalized populations.

* Lack of Provider Education: Ongoing education for healthcare providers is vital to ensure they remain up-to-date on the latest PrEP guidelines and best practices. Audit findings frequently point to a need for enhanced provider training.

Impact of the Audit on prep Implementation

The PrEP Standards of Care Audit Report serves as a catalyst for quality improvement initiatives. Following audit results, healthcare organizations typically implement:

Policy & Protocol Development: Creating standardized protocols for risk assessment, STI screening, kidney function monitoring, and follow-up care.
Provider Training: Offering continuing medical education (CME) courses and workshops on PrEP best practices.
Workflow Optimization: Streamlining PrEP prescribing and monitoring processes to improve efficiency and patient convenience.
Quality Assurance Programs: Implementing ongoing monitoring systems to track PrEP adherence and identify areas for further improvement.
Community Engagement: Collaborating with community-based organizations to address barriers to PrEP access and promote culturally competent care.

benefits of Adhering to PrEP Standards of Care

Strict adherence to PrEP standards yields significant benefits:

* Reduced HIV Incidence: Effective PrEP implementation demonstrably reduces the risk of HIV acquisition.

* Improved Patient Outcomes: Comprehensive PrEP care enhances overall sexual health and well-being.

* Enhanced Healthcare Quality: Adherence to standards promotes best practices and reduces medical errors.

* Increased Patient Trust: Demonstrating a commitment to quality care builds trust and encourages patient engagement.

* Reduced Healthcare Costs: Preventing HIV infection through PrEP is more cost-effective than treating HIV disease.

Practical Tips for Healthcare Providers

* Utilize the CDC’s PrEP Decision-making Tool: This interactive tool assists providers in determining PrEP candidacy.

* Implement a Standardized Risk Assessment Form: Ensure all patients are assessed consistently for HIV risk factors.

* Offer Same-Day PrEP Initiation: Reducing barriers to access by offering immediate PrEP prescribing when appropriate.

* Provide patient Education Materials: Offer clear

October 26, 2024

Why You Can’t Stop Eating Processed Foods – And How Protein Can Help

A recent exploration into dietary habits reveals a concerning trend: Highly processed foods are engineered to override the body’s natural signals of fullness, leading to overconsumption. These foods, ofen high in calories, intensely palatable, and rapidly consumed, present a meaningful challenge to mindful eating.

The Science of Satiety and Processed Foods

The modern food landscape is dominated by products designed for immediate gratification. Researchers suggest that these ultra-processed items possess inherent characteristics that circumvent the body’s innate ability to recognize satiety. Their speedy consumption and high caloric density contribute to a vicious cycle of eating, leaving individuals feeling unsatisfied despite consuming a ample number of calories.

These foods frequently enough lack the necessary texture to properly signal fullness. Unlike natural foods that require thorough chewing,processed options are frequently enough soft and easy to swallow,reducing the activation of satiety signals.

Protein’s Role in Regaining Control

Fortunately, dietary adjustments can help counteract the effects of these engineered foods. increasing protein intake demonstrates a promising strategy for managing overeating. The human body requires more energy to digest proteins compared to carbohydrates or fats, effectively slowing down the eating process and promoting a greater sense of fullness.

Furthermore, protein actively influences hormonal regulation. It demonstrably lowers levels of ghrelin, commonly known as the “hunger hormone,” while simultaneously boosting the production of satiety hormones such as peptide YY. This hormonal shift contributes to a more sustained feeling of satisfaction after meals, reducing the likelihood of impulsive snacking.

Nutrient	Effect on Satiety
Highly Processed Foods	Suppresses satiety signals, encourages overeating
Protein	Slows digestion, reduces ghrelin, increases satiety hormones

Did You Know? Studies show that increasing protein intake by as little as 15-20 grams per meal can significantly reduce hunger and calorie intake throughout the day.

The texture of protein-rich foods frequently enough necessitates more purposeful chewing, further reinforcing satiety signals. This physical act of chewing provides the brain with additional time to register fullness, promoting a more conscious and controlled eating experience.

Pro tip: Incorporate lean protein sources-like fish, poultry, beans, and lentils-into every meal to maximize satiety and improve overall dietary quality.

As obesity rates continue to rise globally, according to the World Health Association, understanding these physiological mechanisms becomes increasingly crucial for public health initiatives. WHO data shows a dramatic increase in obesity since 1975.

Do you find yourself struggling to resist highly processed foods? what strategies have you found most effective in managing your appetite?

Beyond Protein: Building a Sustainable Eating Pattern

While increasing protein intake is a valuable step, a holistic approach to nutrition is essential for long-term success. Prioritizing whole, unprocessed foods, such as fruits, vegetables, and whole grains, provides the body with essential nutrients and fiber, further promoting fullness and overall health.

Mindful eating practices – paying attention to hunger and fullness cues, eating slowly, and savoring each bite – can also help regain control over eating habits. These techniques encourage a more conscious and intentional relationship with food, reducing the likelihood of emotional or mindless eating.

Frequently Asked Questions about Satiety and Processed Foods

What are ultra-processed foods? Ultra-processed foods are industrial formulations made mostly from substances derived from foods and additives.They often lack whole food ingredients.
How does protein help with fullness? Protein slows digestion and influences hormones related to hunger and satiety.
Is it possible to eat processed foods in moderation? While minimizing processed food intake is ideal, incorporating them sparingly within a balanced diet may be possible for some individuals.
what are some other ways to increase satiety? Fiber-rich foods and mindful eating practices can also promote fullness.
Can increasing protein intake help with weight loss? By promoting fullness and reducing calorie intake, increased protein can support weight loss efforts.

Share this article with others and let us know your thoughts in the comments below!

<a href="https://www.archyde.com/summary-in-advance-of-the-week-of-january-3-2022/" title="summary in advance of the week of January 3, 2022">Sleep</a>: The Overlooked Key to a Healthy heart

Person Sleeping — Prioritizing sleep is essential for cardiovascular wellbeing.

Sleep Deprivation: A Silent Threat to Your Heart

Table of Contents

1. Sleep Deprivation: A Silent Threat to Your Heart
2. How Sleep Safeguards Your Cardiovascular System
3. Simple Lifestyle Changes for a Stronger Heart
4. Sleep: Self-Care, Not Self-Indulgence
5. Understanding the Long-Term Impact of Sleep
6. Frequently Asked Questions About sleep and Heart Health
7. What are the key inflammatory processes triggered by sleep deprivation that contribute to coronary artery disease?
8. The Heart Risks of Insufficient Sleep: Expert Advice from a Cardiologist
9. understanding the Sleep-Heart Connection
10. How Sleep Deprivation Impacts Your Cardiovascular System
11. Specific Heart Conditions Linked to Sleep Loss
12. Sleep Apnea: A Major Cardiovascular Threat
13. Recognizing the Signs: when to Seek Help
14. Benefits of Prioritizing Sleep for Heart Health
15. practical Tips for Better Sleep – A Cardiologist’s Recommendations

For years, public health campaigns have emphasized the importance of healthy eating, regular exercise, and avoiding smoking for a strong heart.However, a crucial element is often overlooked: adequate sleep. Leading Cardiologists are now sounding the alarm; insufficient or poor-quality sleep poses a important threat to cardiovascular health, comparable to the risks associated with high cholesterol or chronic stress.

Recent studies show a direct correlation between sleep patterns and heart disease incidence. “Heart health is intrinsically linked to our daily routines,” explains a prominent cardiologist. “And those routines extend far beyond diet and physical activity; consistently inadequate sleep can be profoundly damaging to the heart and blood vessels.”

How Sleep Safeguards Your Cardiovascular System

Getting 7 to 8 hours of quality sleep each night isn’t simply about feeling rested; it’s a vital restorative process for the heart.During sleep, heart rate and blood pressure naturally decrease, allowing the cardiovascular system to recover from the day’s stresses. This period of reduced activity enables the body to repair cellular damage and regulate essential functions.

Chronic sleep deprivation disrupts these restorative processes and can lead to a cascade of negative health consequences. Individuals who consistently get too little sleep are at an increased risk of developing hypertension, irregular heartbeats, diabetes, and chronic inflammation-all major contributors to heart disease. These effects often develop gradually,initially without noticeable symptoms,silently compromising the health of blood vessels and the heart itself.

Simple Lifestyle Changes for a Stronger Heart

Protecting your heart doesn’t require drastic changes; small, consistent habits can make a significant difference.Experts recommend at least 30 minutes of moderate-intensity exercise daily, a diet rich in fruits, vegetables, and whole grains, and effective stress management techniques.

The Mediterranean diet, characterized by its emphasis on plant-based foods, healthy fats like olive oil, and limited red meat consumption, has been repeatedly linked to improved cardiovascular health. However, one long-held belief has been debunked: current research indicates that even moderate alcohol consumption offers no cardiovascular benefits and may, in fact, increase the risk of heart rhythm problems and disease.

Habit	Impact on Heart Health
Regular Exercise (30+ minutes daily)	Strengthens the heart muscle, lowers blood pressure, and improves circulation.
Healthy Diet (Mediterranean Style)	reduces inflammation, lowers cholesterol, and provides essential nutrients.
Adequate Sleep (7-8 hours)	Allows for heart recovery, regulates blood pressure, and reduces stress.
Stress Management	Lowers cortisol levels, reducing strain on the cardiovascular system.

Sleep: Self-Care, Not Self-Indulgence

In today’s fast-paced world, prioritizing sleep often feels like a luxury. However, medical professionals emphasize that sleep is a essential aspect of self-care, as crucial as nutrition and exercise. Regularly achieving a consistent sleep schedule not only benefits the heart but also enhances brain function, strengthens the immune system, and reduces overall inflammation.

Prioritizing sleep is an investment in your long-term health. It’s a simple, achievable habit that can yield ample benefits. As one cardiologist emphasized, “Caring for your heart doesn’t necessitate extreme sacrifices; it’s about consistency and dedication to straightforward habits.”

Understanding the Long-Term Impact of Sleep

The link between sleep and heart health extends beyond immediate physiological effects. Chronic sleep deprivation can disrupt the body’s hormonal balance, impacting appetite regulation and increasing the risk of obesity-another significant risk factor for heart disease.Moreover, poor sleep quality has been linked to increased arterial stiffness, a precursor to atherosclerosis (hardening of the arteries).

Frequently Asked Questions About sleep and Heart Health

What is the ideal amount of sleep for heart health?: Most adults should aim for 7-8 hours of quality sleep each night to optimize cardiovascular function.
Can improving my sleep actually lower my blood pressure?: Yes, consistent adequate sleep can definitely help regulate blood pressure and reduce the risk of hypertension.
Is a short nap during the day beneficial for heart health?: Short power naps (20-30 minutes) can be refreshing, but long or frequent naps may indicate underlying sleep issues.
What are signs that I might have a sleep disorder?: Signs include excessive daytime sleepiness, loud snoring, pauses in breathing during sleep, and difficulty falling or staying asleep.
Does the quality of sleep matter as much as the quantity?: Absolutely. Deep, restorative sleep is more crucial than simply spending a certain number of hours in bed.

Are you making sleep a priority in your life? What small changes can you implement today to improve your sleep habits and safeguard your heart health?

The Emerging Dementia Defense: How AI & Brain Training Are Rewriting the Future of Cognitive Health

Imagine a future where Alzheimer’s isn’t a looming inevitability, but a risk identified and mitigated years before symptoms emerge. This isn’t science fiction; it’s the rapidly approaching reality fueled by breakthroughs in artificial intelligence and a surprising resurgence in the power of targeted brain training. For decades, we’ve reacted to dementia; now, we’re poised to prevent it.

AI: The New Frontier in Early Detection

The FDA’s recent approval of BrainSee, developed by Darmiyan, marks a pivotal moment. For the first time, a scientifically validated AI solution can predict the likelihood of developing Alzheimer’s disease within a five-year window, analyzing standard MRI images and cognitive tests with remarkable accuracy. This isn’t about replacing doctors, but empowering them with a powerful new tool. As Dr. Michael Walker, a leading neurologist at Massachusetts General Hospital, explains, “Early detection isn’t just about knowing if someone will develop Alzheimer’s, it’s about understanding when, allowing for proactive intervention.”

But BrainSee isn’t alone. The Mayo Clinic’s StateViewer AI boasts an even more granular approach, differentiating between nine distinct types of dementia with an 88% success rate. This level of precision is transforming diagnostics, allowing for faster, more accurate assessments – doctors can now analyze scans twice as quickly and with three times the accuracy. The impact is already being felt in primary care, with Swedish researchers developing BioCog, a tablet-based test that reliably flags cognitive issues, triggering targeted blood tests for further investigation.

Beyond Detection: Rejuvenating the Brain with Digital Training

Early detection is crucial, but it’s only half the battle. What can be done once a risk is identified? The answer, surprisingly, may lie in digital brain training. Groundbreaking research from the Montreal Neurological Institute demonstrates that targeted exercises can actually rejuvenate brain chemistry. Participants using the BrainHQ app showed restoration of their acetylcholine system – a key messenger for memory and attention – effectively reversing brain aging by a decade.

This isn’t simply about “using it or losing it.” The biochemical effects observed are comparable to, and in some cases surpass, those of pharmaceutical interventions. Apps like Lumosity, MindMate, and NeuroTracker are gaining scientific credibility, moving beyond wellness tools to potential therapeutic interventions.

“We’re seeing a paradigm shift in how we approach cognitive decline. It’s no longer just about managing symptoms; it’s about actively building brain resilience and potentially reversing age-related changes.” – Dr. Anya Sharma, Cognitive Neuroscientist, University of California, San Francisco.

The Emerging Brain Health Ecosystem

These advancements aren’t happening in isolation. They’re converging to create a comprehensive brain health ecosystem. Telemedicine, accelerated by the pandemic, is expanding access to neurological assessments, particularly in rural areas. AI-powered prediction, accessible digital screening, and validated training programs are forming a preventative, rather than reactive, approach to dementia care.

The Role of Wearable Technology & Continuous Monitoring

Looking ahead, the integration of wearable technology promises continuous, passive monitoring of cognitive health. Smartphones and smartwatches can track subtle changes in gait, speech patterns, and even typing speed – digital biomarkers that could signal early cognitive decline. This data, combined with regular tablet-based screenings at the family doctor, could create a personalized risk profile and trigger targeted interventions.

The future may see brain training apps transitioning from wellness products to prescription therapies, with health insurance companies covering the costs based on demonstrated medical benefits. Imagine a scenario where your smartphone alerts you to potential cognitive changes, your doctor confirms with a quick tablet test, and a personalized training app begins a tailored resistance program.

Addressing the Data Gap: Ensuring Equitable AI

However, this progress isn’t without its challenges. A critical concern is the lack of demographic transparency in the training data used for many AI tools. Researchers are rightly questioning whether these algorithms perform equally well across all population groups. Ensuring equitable access and accurate assessments for diverse communities is paramount.

Frequently Asked Questions

Q: How accurate are these AI-powered diagnostic tools?
A: While accuracy varies, tools like StateViewer boast an 88% success rate in differentiating between dementia types. BrainSee provides a risk score, indicating the probability of developing Alzheimer’s within five years. It’s important to remember these are tools to aid diagnosis, not definitive pronouncements.

Q: Is brain training a guaranteed way to prevent dementia?
A: No, but research suggests it can significantly improve cognitive function and potentially delay the onset of symptoms. It’s a proactive step you can take to build brain resilience.

Q: Will my health insurance cover brain training apps?
A: Currently, coverage is limited, but as more research demonstrates the medical benefits, it’s likely that insurance companies will begin to cover these programs in the future.

Q: What can I do *today* to protect my brain health?
A: Prioritize a healthy lifestyle – regular exercise, a balanced diet, sufficient sleep, and social engagement. Incorporate brain training exercises into your routine, and talk to your doctor about cognitive screening.

The convergence of AI-powered diagnostics and scientifically validated brain training represents a monumental shift in our approach to dementia. We are moving from a reactive model of disease management to a proactive era of prevention and cognitive enhancement. The future of brain health isn’t just about living longer; it’s about living better, with sharper minds and fuller lives. What steps will you take to safeguard your cognitive future?

Explore more about preventative healthcare in our guide to optimizing longevity.