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Gay men often are more sexually active than heterosexual counterparts and have a greater risk of contracting sexually transmitted diseases he said. For these patients doctors are encouraged to focus on discussing safe sex. Gay and bisexual men should be screened regularly for Winn also said physicians should be aware that gay men have higher rates of bulimia and depression than heterosexuals.He recommends that doctors speak with lesbian patients about birth control options because some lesbians have sex with men. He also encourages physicians to be aware of this groups slightly increased risk of breast cancer because many do not get pregnant. The hormonal changes that occur during pregnancy might reduce a womans chances of developing the disease according to the National Cancer Institute.

Transgender people are among the most at risk in the LGBT population and many are victims of violence Houlberg said. For preventive care of this population  Winn recommends that physicians follow screening guidelines for the body parts the patient has. For example if a person who was born a man has breasts due to hormone treatment, doctors should follow mammography guidelines.

Taking steps in the right direction

Until that occurs Dr. Houlberg said LGBT people will remain an invisible population involved in what she calls a silent epidemic Not only can we not address the health disparities we cant prove them either.Some reports have shown that LGBT people are  more likely to smoke cigarettes than heterosexuals They also are more likely to have higher rates of alcohol use and substance abuse said the Dept. of Health and Human Services.Additionally each group within the LGBT population has distinct health risks that primary care physicians should know Winn said.

The consequences of not identifying this population are missed opportunities for preventive care that probably lead to increased rates of morbidity and mortality among LGBT patients said Dr. Houlberg, chief medical officer at Howard Brown Health Center in Chicago. The center specializes in treating LGBT adults and youths.There are limited studies on the health disparities of the LGBT community But that is expected to change after a March Institute of Medicine report urged researchers to engage LGBT people in health studies to identify and better understand health problems that affect them.

NASCAR tries to break up Talladega 2-car tandems

NASCAR tweaked two rules for next month’s race at Talladega Superspeedway, apparently in an effort to limit the two-car tandem racing that has dominated at its two fastest tracks.

The first change ordered Wednesday was an increase in the size of the restrictor plate that will be used in the Oct. 23 race. The larger holes in the carburetor plates should lead to an increase of horsepower that could make the cars 2 to 3 mph faster.

NASCAR also ordered an adjustment on the pop-off valve in the cooling system that should lower the maximum water temperature in engines. A threat of overheating could prevent cars from staying hooked together for too long.

Drivers discovered over the last year that it’s faster to run at Daytona and Talladega in two-car tandems. That style has replaced the popular two- and three-wide packs, and fans have been lukewarm about the tandem racing.

Now, two cars hook up bumper-to-bumper, one clearly pushing the other until the potential for overheating forces them to separate and then swap. It’s made for record lead changes and exciting finishes, but is a totally different style than the white-knuckle pack racing fans loved.

Drivers, meanwhile, said it’s impossible to see anything when they are pushing another car and Dale Earnhardt Jr., NASCAR’s most popular driver, has repeatedly railed against tandem racing.

“What kind of move can you make in racing like this?” he asked in July. “There ain’t no move you can make. You just hold it on the mat and try not to wreck into each other.”

NASCAR vice president of competition Robin Pemberton made no mention of the tandem racing in explaining the rule changes.

“After the last few superspeedway races, we’ve heard many drivers express their desire to open up the size of the restrictor plate some and we thought the time was right to do that,” Pemberton said in a statement. “We anticipate these revisions in the rules package for Talladega will help continue to provide competitive and exciting racing for the fans.”

The larger restrictor plate could push speeds over 200 mph, but the combination of the pop-off valve change likely means the cars won’t be able to stay locked together for as many laps. David Reutimann crew chief Rodney Childers thinks drivers might be limited to a lap of pushing before needing to swap.

“Changing the plates will be better,” Childers said. “It should make it more racy, where you can pull out and pass. If they are wanting to make it where people can’t draft as long, it’s going to do that. Probably only a half of a lap or a lap is all you’re going to get out of it.”

Chad Johnston, crew chief for Martin Truex Jr.,fluorescent bulbs, predicted that drivers will have to swap positions more. That could make it dicey, he said, because drivers will have to swap while also avoiding the two-car packs closing in behind them.

“The chances of something going wrong on a swap are going to go up obviously, but hopefully it will eliminate or lessen the two-by-two racing,” he said.