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In updated guidance issued by the CDC on Monday, it recommended that all cruise ship and river boat travel be avoided anywhere in the world during the spread of the coronavirus. The announcement comes as nearly 150 countires worldwide have reported a confirm case. The recommendation is especially important for older individuals, and those with a serious chronic medical condition. The CDC noted several recent examples of where the the coronavirus spread among passengers on board cruise ships. Recent examples include 696 cases and 8 deaths on the Diamond Princess cruise ship in Japan and 28 cases on the Grand Princess cruise ship in the United States, the CDC said. The CDC issued the following recommendations to tell patients who plan on going on cruise ships and river boats:Advise patients to defer all cruise ship travel, including river cruises, worldwide.Explain that their return travel to the United States may be impacted, and formal quarantine procedures may be implemented if confirmed cases are identified on board.Explain that appropriate medical care or medical evacuation may not be available internationally.Explain that some countries may refuse docking or disembarkation if there are known or suspected cases on board.For patients who still intend to cruise, advise them to practice social distancing and monitor their health both during travel and for 14 days from the time they disembark. Social distancing means staying out of crowded places, avoiding group gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others, when possible.The guidance came on the same day that President Donald Trump and leading health officials suggested that gatherings of 10 or more people pose a risk to older and disabled people. The CDC also said all gatherings of 50 or more people should be outright postponed amid the spread of the coronavirus. 1895

KANSAS CITY — Maureen Boesen has always known cancer risk was high in her family."We're able to really track our history of breast cancer back to the late 1800s and early 1900s," Boesen said. "My grandmother actually passed away from ovarian cancer when she was 44. She had five sisters and none of them lived to the age of 50. Then, my mother was diagnosed with breast cancer when she was 32. We knew there was something going on and that it was a very young age."When Boesen and her two sisters were ages 3, 5 and 7, their mom was already receiving chemotherapy for stage 2 breast cancer. Because of the extensive family history, the girls were part of a study at a university in another part of the Midwest. Their mom was hoping to help the world better understand what was killing so many women. She was hoping to better her daughters' chances for survival."We were all tested in the same exact room," said Boesen's sister, Bridget Stillwell. "I can even remember what the room looked like." Because the girls were so young, and the health threat still likely years away, they wouldn't receive their DNA test results until they turned 18."We knew we were part of a study," Boesen said. "We knew our results were waiting for us, but we didn't know what they were."When asked if she found that wait frustrating, she said emphatically it was not."Quite the opposite. We felt empowered," she said.She didn't get the results right away. The sisters knew there was nothing they could likely do at age 18 even if their test results showed they'd inherited the BRCA gene mutation. The sisters all waited until they were around age 21. One sister was positive. One sister was negative. Boesen remembers meeting with the researcher to learn her results."We sat down and we had a conversation about what BRCA was and what it meant for my family," Boesen said. "It was a lengthy conversation, which made me very uncomfortable because why would a conversation that wasn't going to change my life last that long?"Eventually, the researcher told her she had inherited the gene mutation."It was just devastating because I knew what breast cancer and ovarian cancer can do to a family. You know, my first question out of my mouth was, 'Is there any chance this could be wrong?' The researcher said 'No.' "Boesen walked out of that meeting determined. She was going to make decisions to save her own life. She was going to have a bilateral prophylactic mastectomy. She would schedule a surgery to remove both breasts to prevent breast cancer."This was me doing what I was supposed to do and this was me being empowered and me being proactive and not waiting until I have a cancer diagnosis," Boesen said.She didn't want to feel like a ticking time bomb. She wanted to live.Boesen had the surgery to remove both breasts when she was just 23 years old. She went on to get married and have three children."I didn't get to breastfeed them. It was sad. I'm not brokenhearted or devastated about it, but it is sad to think I couldn't provide for my children like that," she said.At the time, she still believed she'd made the right decision because she was healthy.Once done having children, she knew there was another step that most people with the dangerous BRCA gene mutation have to consider."I knew that when I was done having children, I needed to have a complete hysterectomy," Boesen said.The BRCA gene mutation not only dramatically increases a woman's chance of developing breast cancer at a young age, it also significantly increases a woman's chance of ovarian cancer."The right thing to do and what the doctors say to do is have a complete hysterectomy by the age of 35 and I was in my early 30s," Boesen said.In 2018, she went to a hospital in Kansas City, Missouri, to start the process of preparing for her hysterectomy. Both her health care provider and her insurance company wanted a new DNA test. Everyone knew what the results would be, but they went through the motions to get the required confirmation she was positive for the deadly gene mutation which was so rampant in her family.The test results were supposed to be back in a few weeks, but it had been four and Boesen was starting to worry. Then, she got the call from the doctor."I was at work. And the first thing she said was, 'We need to talk', and my heart just sank," Boesen said. "She said, 'You're negative,' and I just started bawling."She was overwhelmed, confused and full of emotions."I was angry. I was regretful. I was happy. I was sad. I so desperately wanted to feel relief, 'Oh, thank God, this is the best day of my life,' but it wasn't," Boesen said. "It was just devastating."Boesen got another test to confirm the second test results. It also came back negative.She did not get the hysterectomy. There was no need now. There was no longer a threat that cancer was waiting to explode in her body. She now knew she had not inherited the BRCA gene mutation that had killed so many of her relatives.Dr. Jennifer Klemp of the University of Kansas Cancer Center has worked in the field of cancer genetics, specifically breast and female cancers, since 1997. She is the director of Cancer Survivorship and a cancer risk counselor. While she was not involved in Boesen's original research, she says she's not surprised."Twenty years ago, when we sent our first tests and BRCA 1 and 2 were the two genes we tested for, about 30-40 percent of the time we would get something called a 'variant of uncertain significance,' " Klemp said. "Basically, that meant we found a mutation or an error in the DNA, but we didn't know if that was associated with an increased risk of cancer. Today, using a reputable lab, that should be less than 1-2 percent."Klemp says things are changing rapidly in the field of genetic testing. If someone had a DNA test more than five years ago, they should consider having an updated test. She also says the at-home tests are good for finding out details about your ancestry, but they shouldn't be used to make major decisions about your health. For that, you'd want a health professional to order a commercial test through a certified, reputable lab. With more and more companies offering testing, and more medical professionals and patients interested in genetic testing for so many reasons, she says demand right now is outpacing supply."If you have 10 different labs doing testing, and you have every primary care, OB-GYN, oncology clinic, surgical clinic and any number of patients eligible for testing, it's a little bit of the wild west," Klemp said, adding there's no central repository for this patient and test information.As for Boesen, the university where the original research was done and the false positive originated offered to re-test her DNA. She is currently waiting on the results from what is now her fourth genetic test. She hopes it comes back negative, too, which is what the experts all expect. She believes, then, finally, she'll be able to move forward with her life. Boesen and her two sisters are writing a book about their experiences. Each of her sisters has a story to tell, too. Their book will be titled, " 7146

JUST IN: Zenaida Colin says she was temporarily denied custody of her grandson, 3 y/o Noelvin. He is the little boy found on a strangers porch Monday morning. @WKBW pic.twitter.com/LRHxx2ljwe— Ali Touhey (@Ali2e) September 17, 2019 243

Jon Stewart: "Why this bill isn't unanimous consent and a stand-alone issue, is beyond my comprehension. And I've yet to hear a reasonable explanation as to why." https://t.co/XxGykfEvZv pic.twitter.com/PVmLT7Jvvj— The Hill (@thehill) June 11, 2019 260

In the battle between the adolescent penchant for hitting the snooze button and parental desire to rush them onto an early morning school bus, experts say science is increasingly siding with the snooze.The biological clock of teens is shifted, Dr. Mary Carskadon, director of the Sleep and Chronobiology Research Lab at EP Bradley Hospital, told CNN. That means everything influenced by the circadian timing process, including sleeping, waking and eating patterns are set later.And if teens have trouble naturally falling asleep at an early hour and don't get the recommended eight and a half to nine hours of sleep, asking them to be awake, ready and in a classroom by 7:30 a.m. can wreak havoc on their systems, Carskadon said.Students in one state have gotten a reprieve from the early morning blues. California Gov. Gavin Newsom signed legislation Sunday that pushes back start times for middle and high schools to align with teens' circadian rhythms. It's a move sleep experts hope more school districts will follow.That's especially because research suggests that when teens get a later start in the morning, they can do a better job of checking off the things on many parents' priority lists like:Paying attention and getting their homework doneFour out of five public middle and high schools in the US start before 8:30 a.m., the earliest time recommended for teens, according to the US Centers for Disease Control.Carskadon says the negative consequences of early waking on academic performance are obvious: Students have more trouble concentrating in class and retaining information, feel tired during the day, have more absences and tardiness and have a hard time doing their homework and class reading well.There isn't enough time between when their clocks tell them to go to sleep and when they need to be in class to get the sleep they need, she says. And to make matters worse, for many teens, their bodies are telling them it's still time to be in bed when they are trying to listen in class."A lot of kids will just be asleep in first period because their brains are -- almost literally -- on the pillow and not yet in the classroom," she said.Avoiding the junk foodWhen students are off of their regular sleep cycle, they often also fall off of their ideal eating cycle too, Carskadon said. Since the biological clock influences humans' eating, straying from the circadian rhythm could mean eating too much or eating the wrong food at the wrong times, she said.Who among us reaches for a healthy snack when we are tired and awake when we aren't supposed to be, asked Stacy Simera, a licensed social worker who is chair of the sleep committee for the Ohio Adolescent Health Partnership.That disruption not only means worse nutrition, but it can lead to an increased risk for Type 2 diabetes, Carskadon said.Staying out of troubleWhen it comes to impulse control, Carskadon and her colleagues say teenagers already have the accelerator pushed down without any breaks. That's because the emotional side of the brain is well developed in those years, but doesn't have a very strong link to the executive decision-making side.And neuroimaging studies showed that link is even weaker in teens without enough sleep. The result can be trouble controlling their impulses and increasingly engaging in risky behaviors like foregoing helmets, driving under the influence and abusing substances, Carskadon said.Keeping happy and safeFrom a physical health perspective, teens who get adequate sleep also are shown to suffer fewer car accidents and sports injuries, said Simera.She says teens fall asleep easiest and get the best quality sleep from 11 p.m. to 8 a.m. -- the sweet spot. And research shows that straying from that sweet spot and sleeping less is correlated to depression, anxiety and suicide, she said.One study found that for each extra hour of sleep adolescents get, 3899