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The health secretary is backing the introduction of "Martha's Rule", to ensure hospital patients know they have the right to a second opinion, and NHS England will begin work to action it.
On Wednesday, Steve Barclay met Merope Mills, who had raised concerns with doctors about her daughter's treatment.
Martha, 13, had been admitted to hospital after falling off her bike.
An injury to her pancreas was serious but survivable. Within days, however, she had died of sepsis.
Mrs Mills told BBC Radio 4's Today programme doctors had told her the extensive bleeding was "a normal side effect of the infection, that her clotting abilities were slightly off".
The King's College Hospital trust said it remained "deeply sorry that we failed Martha when she needed us most" and her parents should have been listened to.
An inquest said she could have survived had her care been better.
Mr Barclay told Today he was committed to bringing in Martha's rule as quickly as possible.
"The case that Merope has set out is compelling," he told the programme.
"It is, I think, for everyone that's heard it an absolutely heartbreaking case and I am determined that we ensure we learn the lessons from it.
"I particularly want to give much more credence to the voice of patients.
"And I think a key part of this measure is ensuring that patients feel heard and can get a second opinion."
'Adopt quickly'
Mr Barclay has asked the patient-safety commissioner to meet NHS leaders and learn from similar schemes abroad.
Ryan's rule was introduced in hospitals, in Queensland, Australia, after the death of a boy who also had a poorly managed serious infection.
"There's scope for us to move much more quickly in terms of paediatrics and ensuring, particularly in that area, we adopt quickly... but to do so in a way that's easy to communicate to patients rather than having lots of different schemes across the country," Mr Barclay told Today.
On Monday, NHS England medical director Prof Sir Stephen Powis said change was needed but different hospitals might need different approaches.
"Patient and relative voice is paramount," he said.
"Over the last six months or so, we at NHS England have been working with a number of hospital across England to work out what sort of methodologies, what sort of processes, will ensure that that voice is heard when it needs to be heard."
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One of the biggest trends in tech right now is material innovation, with the development of organic materials to replace their synthetic counterparts in everything from cosmetics to food to healthcare.
I recently met PrintyMed, a Latvian company developing biocompatible artificial spider silk for different medical applications.
PrintyMed is using spider silk produced by bacteria to create scaffolds for tissue engineering. These scaffolds can be used for various applications like building heart fibres, artificial nerves, synthetic meniscus, and artificial bones. The technology has potential uses in medical procedures such as skin reconstruction and bladder repair.
I spoke to Jekaterina Romanova last week to learn more.
Why spider silk?
Well, spider silk is biocompatible, strong (most often compared to steel), and elastic.
Around the world, researchers are developing use cases in industries like textiles, cosmetics, and wound dressing. Earlier this year we profiled German company AMSilk, developing synthetic spider silk for use in clothing, aviation, footwear, and automotive industries, as well as surgical biotech materials.
Printymed was spun out of the Latvian Institute of Organic Synthesis.
Its developed spider silk that is strong, biocompatible, safe for humans, has much surface area compared to its size, and doesn't cause a strong immune response.
In our bodies, cells live in a solid matrix called the extracellular matrix (ECM), which gives cells a structure to hold onto and lets them grow in 3D.
It also gives tissues certain qualities, like strength and stretchiness, that make them do their jobs (such as letting muscles stretch or keeping skin bouncy). Plus, it breaks down when needed (like during wound healing).
In tissue engineering, the ECM is replaced with different scaffolds made of biomaterials that act like the ECM in biology and mechanics.
While spider silk has a legacy of research, its commercial spin-out (excuse the pun) has struggled.
According to Romanova:
"Most companies are only producing spider silk for textiles, which is expensive at scale. Further, their material is not biocompatible, it cannot be used in the human body. We have developed a different production method."
The importance of biocompatibility
This biocompatibility is vital use cases such as organ creation. Currently, over 100.000 people are waiting for an organ transplant, and every 10 minutes, someone is added to the organ transplant waiting list, and 22 people die every day waiting. Worse, even if you get an organ, there is still a possibility that the organism will reject the transplanted organ.
Romanova explained that PrintyMed's scientists have developed a unique bioconjugation method for producing chemically modified artificial spider silk. The technique mimics the native process of spider silk formation and yields synthetic fibres that reproduce the properties of natural spider silk.
As a result, new functionalities are enabled by the chemical modification of designed spider silk proteins, with further research working to adapt the method to 3D printing technology.
The company has multiple LOIs with potential clients across various industries. This includes organ-on-a-chip solutions — I recently visited Cellbox Labs on a trip to Latvia, which is developing organs on a chip that are miniature organ replicas outside the human body.
Their focus is microbiome and gut on a chip that makes it easier to study the biological processes of drug development — shaping up for a future without animal testing.
The company is also testing the silk with rat blood and recently unveiled the third prototype of a 3D spider silk heart value.
Romanova believes that artificial silk will be available as a raw material in cosmetics and organ-on-a-chip solutions within a year, with other solutions coming in the future after completing the necessary clinical studies — although the company has done a fair amount of the leg work in academia.
Currently, the company is seeking fundraising to extend and expand its R&D and further proof of concept. This is a company to watch.
Lead image: PrintyMed. Photo: Uncredited. | Medical Innovations |
A pop star looked worlds away from her band heyday as she headed out for a dog walk on Tuesday. Having had a string of successful hits, the songstress is set to be joining her other bandmates for a reunion tour, filled with nostalgia from the nineties and early noughties. The singer was pictured for the first time since swirling rumours emerged the group are reforming 25 years after they first found fame - but can you guess who it is? A pop star looked worlds away from her band heyday as she headed out for a dog walk on TuesdayThat's right. It's Jo O'Meara. The Reach hitmaker, 43, who often sported brightly coloured crop tops and low-slung jeans in the band, wrapped up warm as she headed out for a stroll with a pal. Sporting a cream padded coat and a cheetah print floral tracksuit, Jo's signature barbed wire inking on her bicep was covered.Jo teamed the look with black Nike trainers, huge glasses and wore her blonde locks back in a bun - a noticeably different style from her poker straight peroxide blonde hairdo in S Club. Exciting: The singer was pictured for the first time since swirling rumours emerged that the group are reforming 25 years after the first found fame - but can you guess who it is? That's right! It's Jo O'Meara. The Reach hitmaker, 43, who often sported brightly coloured crop tops and low-slung jeans in the band, wrapped up warm Casually-clad: Sporting a cream padded coat and a cheetah print floral tracksuit, Jo's signature barbed wire inking on her bicep was coveredThe songstress kept a low-key profile on her outing - which comes just days after the Mail On Sunday revealed S Club 7 are reforming. All seven of the group have agreed to the comeback, which has been masterminded by music mogul Simon Fuller – the man who put them together in 1998 after the Spice Girls, his previous band, sacked him as their manager. He called each of the seven stars – Rachel Stevens, 44, Tina Barrett, 46, Jon Lee, 40, Paul Cattermole, 45, Bradley McIntosh, 41, Jo and Hannah Spearritt, 40 – in person to suggest the project and made it clear it would only work if all of them were to agree. Bring it all back: Having had a string of successful hits, the songstress is set to be joining her other bandmates for a reunion tourLow key: Jo teamed the look with huge glasses and wore her blonde locks back in a bun - a noticeably different style from her poker straight peroxide blonde hairdo Don't stop moving! Jo's little Pomeranian happily trotted alongside her Natural: Jo showed off her clear complexion as she went make-up free on the dog walk Their comeback is expected to be announced to huge fanfare in the coming weeks where they will reveal the details of the reunion.One source close to the project said: 'Simon Fuller saw the value in this, S Club 7 had a huge following of all ages who he thinks will want to go and see them for nostalgia reasons.'Their songs were so upbeat and fun, it is a massive commercial opportunity for them all, particularly Simon.' Never had a dream come true: Their comeback is expected to be announced to huge fanfare in the coming weeks where they will reveal the details of the reunionThey are planning a huge tour for the summer, though they are discussing whether this will have to be put back to Christmas due to Jo's back injury which has seen her undergo four operations to remove part of a slipped disc.The singer hurt her back during the band's heyday in 2002 with surgeons wanting to operate at the time - but Jo turned it down as she was touring.Last year, however, the excruciating injury flared up, forcing Jo to undergo four surgeries to remove part of a slipped disc in her back. Setback: They are planning a huge tour for the summer, though they are discussing whether this will have to be put back to Christmas due to Jo's back injuryJo was trampolining during a health kick back in September and thinks the jolty movement sparked her back to go into spasm with four bulged discs rubbing on her sciatic nerve.Doctors operated at the time but had to do multiple surgeries, her last being in November after Jo woke up in the middle of the night screaming and shaking in agony. Now two months on, Jo has given a health update revealing she now needs regular physiotherapy and has permanent damage to her right leg. Painful: Jo now needs regular physiotherapy and has permanent damage to her right leg'It was like someone had shot me in the bum, my whole body went into shock. I thought I was having a convulsion. The very first thing I did was call an ambulance', she told The Sun. 'Back surgery is so complex and every time they go in, they’re just weakening my back. I was absolutely petrified.'The surgeons said there was a very good chance of permanent damage to the legs and that I might never dance again. I was thinking, 'Well that’s me done then,' because standing up on stage and singing Reach is kind of impossible if you can’t move.'Jo said she found it heartbreaking to be told by doctors there was a risk of permanent damage to her mobility, but had to go through the operation as 'the alternative was even worse'. S Club: The lead singer said the injury occurred more than 20 years ago (L-R Paul Cattermole, Tina Barrett, Bradley McIntosh, Jo, Rachel Stevens, Hannah Spearritt and Jon Lee)The lead singer said the injury occurred more than 20 years ago, with doctors finding at the time she had two bulged discs. While medics were keen to operate, Jo felt she couldn't take the time out to have the surgery and so was given steroids to help her through the fast paced routines. Injured: The singer is taking things day by day and appreciating the little things in life like now being able to take her dogs out for a walkAfter the band split up, the songstress said her back was fine but now believes it was a 'ticking time bomb', with a surgeon who originally saw her saying he knew he would see her again when she walked into hospital 20 years later.Jo is terrified one wrong cough or sneeze could send her back into hospital. The singer is taking things day by day and appreciating the little things in life like now being able to take her dogs out for a walk. Scary: Jo is terrified that one wrong cough or sneeze could send her back into hospital. The singer is taking things day by day and appreciating the little things in life | Medical Innovations |
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Though tobacco use is declining among adults in the U.S., cannabis use is increasing. Laws and policies regulating the use of tobacco and cannabis are also moving in different directions.
Tobacco policies are becoming more restrictive, with bans on smoking in public places and limits on sales, such as statewide bans on flavored products. In contrast, more states are legalizing cannabis for medical or recreational use, and there are efforts to allow exceptions for cannabis in smoke-free laws.
These changes mean an increasing number of people are likely to get exposed to cannabis smoke. But how safe is direct and secondhand cannabis smoke?
EXPLAINER: U.S. regulators might loosen restrictions on marijuana. Here’s what that would mean
I am a primary care doctor and researcher in a state where cannabis is now legal for medical and recreational use. My colleagues and I were interested in how opinions about tobacco and cannabis smoke safety have been changing during this time of growing cannabis use and marketing.
In our survey of over 5,000 U.S. adults in 2017, 2020 and 2021, we found that people increasingly felt that exposure to cannabis smoke was safer than tobacco smoke. In 2017, 26 percent of people thought that it was safer to smoke a cannabis joint than a cigarette daily. In 2021, over 44 percent chose cannabis as the safer option. People were similarly more likely to rate secondhand cannabis smoke as being “completely safe” compared with tobacco smoke, even for vulnerable groups such as children and pregnant women.
Despite these views, emerging research raises concerns about the health effects of cannabis smoke exposure.
Decades of research and hundreds of studies have linked tobacco smoke to multiple types of cancer and to cardiovascular disease. However, far fewer studies have been done on the long-term effects of cannabis smoke. Since cannabis remains illegal at the federal level, it is more challenging for scientists to study.
It has been particularly hard to study health outcomes that may take a long time and heavier exposure to develop. Recent reviews of research on cannabis and cancer or cardiovascular disease found those studies inadequate because they contained relatively few people with heavy exposure, didn’t follow people for a long enough time or didn’t properly account for cigarette smoking.
Many advocates point to the lack of clear findings on negative health effects of cannabis smoke exposure as proof of its harmlessness. However, my colleagues and I feel that this is an example of the famous scientific quote that “absence of evidence is not evidence of absence.”
READ MORE: As legal marijuana use increases, discarded joints pose hazards for dogs
Scientists have identified hundreds of chemicals in both cannabis and tobacco smoke, and they share many of the same carcinogens and toxins. Combustion of tobacco and cannabis, whether by smoking or vaping, also releases particles that can be inhaled deep into the lungs and cause tissue damage.
Animal studies on the effects of secondhand tobacco and cannabis smoke show similar concerning effects on the cardiovascular system. These include impairments in blood vessel dilation, increased blood pressure and reduced heart function.
Though more research is needed to determine the risk of lung cancer, heart attacks and strokes posed by cannabis smoke, what is already known has raised concerns among public health agencies.
How people perceive the safety of cannabis has important implications for its use and public policy. Researchers know from studying cannabis and other substances that if people think something is less risky, they are more likely to use it. Opinions on cannabis safety will also shape medical and recreational cannabis use laws and other policies, such as whether cannabis smoke will be treated like tobacco smoke or whether exceptions will be made in smoke-free air laws.
Part of the complexity in decisions about cannabis use is that, unlike tobacco, clinical trials have demonstrated that cannabis can have benefits in certain settings. These include managing specific types of chronic pain, reducing nausea and vomiting associated with chemotherapy and increasing appetite and weight gain in those with HIV/AIDS. Notably, many of these studies were not based on smoked or vaped cannabis.
WATCH: How states have reshaped marijuana laws and what’s next
Unfortunately, though Googling cannabis will return thousands of hits about the health benefits of cannabis, many of these claims aren’t supported by scientific research.
I encourage people who want to learn more about the potential benefits and risks of cannabis to talk to health care providers or seek sources that present an unbiased view of the scientific evidence. The National Center for Complementary and Integrative Health has a good overview of studies on cannabis for treatment of a variety of medical conditions, as well as information about potential risks.
This article is republished from The Conversation. Read the original article.
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Aug 31 | Disease Research |
No more needles? A daily pill may work as well as Wegovy shots to treat obesity
What if treating obesity could be as easy as popping an effective pill?
That’s a notion that has long fueled hope for many of the more than 40% of Americans who are considered obese — and fueled criticism by those who advocate for wider weight acceptance. Soon, it may be a reality.
High-dose oral versions of the medication in the weight-loss drug Wegovy may work as well as the popular injections when it comes to paring pounds and improving health, according to final results of two studies released Sunday night. The potent tablets also appear to work for people with diabetes, who notoriously struggle to lose weight.
Drugmaker Novo Nordisk plans to ask the U.S. Food and Drug Administration to approve the pills later this year.
“If you ask people a random question, ‘Would you rather take a pill or an injection?’ People overwhelmingly prefer a pill,” said Dr. Daniel Bessesen, chief of endocrinology at Denver Health, who treats patients with obesity but was not involved in the new research.
That’s assuming, Bessesen said, that both ways to take the medications are equally effective, available and affordable. “Those are the most important factors for people,” he said.
There have been other weight-loss pills on the market, but none that achieve the substantial reductions seen with injected drugs like Wegovy. People with obesity will be “thrilled” to have an oral option that’s as effective, said Dr. Katherine Saunders, clinical professor of medicine at Weill Cornell Health and co-founder of Intellihealth, a company that focuses on obesity treatment.
Novo Nordisk already sells Rybelsus, which is approved to treat diabetes and is an oral version of semaglutide, the same medication used in the diabetes drug Ozempic and Wegovy. It comes in doses up to 14 milligrams.
But results of two gold-standard trials released at the American Diabetes Association’s annual meeting looked at how doses of oral semaglutide as high as 25 milligrams and 50 milligrams worked to reduce weight and improve blood sugar and other health markers.
A 16-month study of about 1,600 people who were overweight or had obesity and were already being treated for Type 2 diabetes found the high-dose daily pills lowered blood sugar significantly better than the standard dose of Rybelsus. From a baseline weight of 212 pounds (96.16 kilograms), the higher doses also resulted in weight loss of between 15 pounds (6.80 kilograms) to 20 pounds (9.07 kilograms), compared to about 10 pounds (4.54 kilograms) on the lower dose.
Another 16-month study of more than 660 adults who had obesity or were overweight with at least one related disease — but not diabetes — found the 50-milligram daily pill helped people lose an average of about 15% of their body weight, or about 35 pounds (15.88 kilograms), versus about 6 pounds (2.72 kilograms) with a dummy pill, or placebo.
That’s “notably consistent” with the weight loss spurred by weekly shots of the highest dose of Wegovy, the study authors said.
But there were side effects. About 80% of participants receiving any size dose of oral semaglutide experienced things like mild to moderate intestinal problems, such as nausea, constipation and diarrhea.
In the 50-milligram obesity trial, there was evidence of higher rates of benign tumors in people who took the drug versus a placebo. In addition, about 13% of those who took the drug had “altered skin sensation” such as tingling or extra sensitivity.
Medical experts predict the pills will be popular, especially among people who want to lose weight but are fearful of needles. Plus, tablets would be more portable than injection pens and they don’t have to be stored in the refrigerator.
But the pills aren’t necessarily a better option for the hundreds of thousands of people already taking injectable versions such as Ozempic or Wegovy, said Dr. Fatima Cody Stanford, an obesity medicine expert at Massachusetts General Hospital.
“I don’t find significant hesitancy surrounding receiving an injection,” she said. “A lot of people like the ease of taking a medication once a week.”
In addition, she said, some patients may actually prefer shots to the new pills, which have to be taken 30 minutes before eating or drinking in the morning.
Paul Morer, 56, who works for a New Jersey hospital system, lost 85 pounds using Wegovy and hopes to lose 30 more. He said he would probably stick with the weekly injections, even if pills were available.
“I do it on Saturday morning. It’s part of my routine,” he said. “I don’t even feel the needle. It’s a non-issue.”
Some critics also worry that a pill will also put pressure on people who are obese to use it, fueling social stigma against people who can’t — or don’t want to — lose weight, said Tigress Osborn, chair of the National Association to Advance Fat Acceptance.
“There is no escape from the narrative that your body is wrong and it should change,” Osborn said.
Still, Novo Nordisk is banking on the popularity of a higher-dose pill to treat both diabetes and obesity. Sales of Rybelsus reached about $1.63 billion last year, more than double the 2021 figure.
Other companies are working on oral versions of drugs that work as well as Eli Lilly and Co.’s Mounjaro — an injectable diabetes drug expected to be approved for weight-loss soon. Lilly researchers reported promising mid-stage trial results for an oral pill called orforglipron to treat patients who are obese or overweight with and without diabetes.
Pfizer, too, has released mid-stage results for dangulgipron, an oral drug for diabetes taken twice daily with food.
Novo Nordisk officials said it’s too early to say what the cost of the firm’s high-dose oral pills would be or how the company plans to guarantee adequate manufacturing capacity to meet demand. Despite surging popularity, injectable doses of Wegovy will be in short supply until at least September, company officials said.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Copyright 2023 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. | Drug Discoveries |
Repeated cases of bullying and a toxic environment at one of England's largest NHS trusts have been found in a review.
The Bewick report was ordered after a BBC Newsnight investigation heard from staff at University Hospitals Birmingham (UHB) saying a climate of fear had put patients at risk.
It cites anger senior staff did not attend the funeral of Vaish Kumar, a junior doctor who killed herself.
The West Midlands trust said it fully accepted the report's recommendations.
The trust is responsible for Queen Elizabeth (QE), Heartlands, Good Hope and Solihull hospitals.
A first phase of the rapid review, headed by independent consultants IQ4U and led by Prof Mike Bewick, was published at 11:30 BST.
It is one of three major reviews into the trust, commissioned following a series of reports by Newsnight and BBC West Midlands in which current and former staff raised concerns.
Summarising the findings, Prof Bewick, a former NHS England deputy medical director, said: "Our overall view is that the trust is a safe place to receive care.
"But any continuance of a culture that is corrosively affecting morale and in particular threatens long-term staff recruitment and retention will put at risk the care of patients across the organisation - particularly in the current nationwide NHS staffing crisis.
"Because these concerns cover such a wide range of issues, from management organisation through to leadership and confidence, we believe there is much more work to be done in the next phases of review to assist the trust on its journey to recovery."
Prof Bewick's report examines how leadership reacted to the death of Dr Kumar, 35, a junior doctor at the QE Hospital who left a suicide note blaming her death entirely on the place where she worked.
Dr Ravi Kumar, her father, said he strongly believed the QE had "destroyed" his daughter.
The report says while the funeral service was live-streamed for staff, there was "disappointment and anger" it was not attended by senior colleagues.
It said "many felt that the trust had kept itself at arm's length from the Kumar family".
The report also says a senior member of staff was not aware of Dr Kumar's death and emailed her personally 26 days later to ask why she was removed from her post and if she was still being paid.
While steps have been taken to reach out to her family and "develop learning going forward", the report adds: "The response to an event like this can only partly be met by updated guidelines and policies... but more significantly [the trust] needs a fundamental shift in the way an organisation demonstrably cares about its staff as people."
The junior doctor's father said: "[The trust] should come out openly and accept this has happened, they should find out who the people are who are responsible for this and take appropriate action.
"Otherwise people will not have confidence in any of these inquiry panels and committees if there is no visible action."
Prof Bewick's report highlights three main concerns:
- Several areas where clinical safety concerns exist and levels of staffing, particularly in nursing at Good Hope Hospital
- Clear evidence cultural problems at the trust persist and require serious attention. Concerns cover management organisation, leadership and confidence
- An organisation that is culturally very reluctant to accept criticism
It makes four overall recommendations to improve clinical safety, governance and leadership, staff welfare and culture.
Jonathan Brotherton, the trust's current chief executive, said he was pleased Prof Bewick's overall view was "that the trust is a safe place to receive care".
"We fully accept his recommendations and welcome the additional assurance that has been asked for through further independent oversight," he said.
"There are a number of significant concerns that we need to, and have started to, address; we will continue to learn from the past, as we move forward.
"We want to develop a positive, inclusive work environment where people want to come to work, in a place that they are proud to work in, to do their very best for our patients.
"While we will not be able to fix things as quickly as I would like, we do need to do it as quickly as possible, for the benefit of patients and staff. I am committed to ensuring this happens."
David Melbourne, chief executive at NHS Birmingham and Solihull ICB, said the review made for "difficult reading" and confirmed a cross-party reference group which supported the review, led by Edgbaston Labour MP Preet Gill, would be involved in the second and third reports.
Richard Burden, who chairs Healthwatch Birmingham and Solihull, said the report "paints a disturbing picture of serious failings" adding patients needed greater reassurance UHB was safe.
"This interim report and the upcoming reviews into culture and governance must not be the end but the beginning of an urgent process of learning and transformative change at UHB," he said.
"Everyone with a degree of influence in the local health sector owes it to patients, the dedicated staff who care for them and the memory of Dr Kumar to work together to ensure the deep-seated problems at UHB are tackled quickly and effectively."
Dr Tristan Reuser, an eye specialist who won an employment tribunal for wrongful dismissal after whistleblowing at the trust, added: "All the people who have been participating in this culture of fear... they need to go because these people have been a part of this and the perception of how this trust is governed will not change unless these people go, in my view."
The second and third reviews, covering governance and culture at the trust, are expected to be published by June. | Health Policy |
- Nike CEO John Donahoe can't get seven hours of sleep every night, but says he has developed an alternate sleep hours cycle that works for him.
- Sleep science experts say a key for every individual is to sleep according to your unique circadian patterns, which smartwatches from the Apple Watch to Fitbit and apps such as “Circadian” can help accurately track.
- Lack of sleep can cause health problems such as diabetes, obesity, stroke, and depression.
For leaders in corporate America, sleep is often the rare luxury they don't have and can't buy.
Success, especially early success, rarely comes without pulling some all-nighters, but among the market's most well-known leaders, there is recognition that burning the midnight oil is not a smart long-term strategy for productivity.
"I've tried to sleep less, but even though I'm awake more hours, I get less done. And the brain pain level is bad if I get less than six hours of sleep per night," Elon Musk said in a recent interview with CNBC's David Faber.
"I knew I wasn't as sharp when I was operating mostly on caffeine and adrenaline, but I was obsessed with work," Bill Gates said in a blog post back in 2019.
Nike CEO John Donahoe leads a hectic life, and deals with a wide range of issues, those both predictable, such as managing margins for a Wall Street quick to sour on any signs of financial challenges, to the geopolitics of being a massive U.S. business presence in China, and the social, culture and political issues that have made corporations a target of factions on both the right and the left.
That's a list of issues that could lead one to lose sleep.
Donahoe, well aware of this health risk, told attendees at the recent CNBC CEO Council Summit in Santa Barbara, California, that he has been running an experiment on himself to manage his sleep in a way that works with his life and work demands. Donahoe can't get seven hours of sleep every night, but he said that he tries to hit 70 hours of sleep every 10 days. Hitting this target, rather than exactly how much sleep he gets per night, is a sleep science workaround that the Nike CEO says has been working for him.
That won't necessarily work for you, though. Several sleep experts consulted by CNBC say Donahoe's approach is insufficient. Sleep science research has consistently shown that the average adult should aim for seven hours of a sleep each night. However, scientists stress that the ideal amount of sleep varies from person to person. Some people need more, some need less. And with the demand of some occupations, seven hours may not be feasible.
The key, sleep scientists say, is giving your body time to rest, which is crucial to increase attention span and improve overall health.
Don't rely on anyone else's sleep tricks. Study yourself.
It's not necessarily always going to be the recommended seven hours of sleep that will ensure a good night's rest, according to sleep experts. The most important starting point, they say, is to sleep according to your circadian patterns, have a consistent bedtime, and avoid stimulants like caffeine after lunchtime.
Everyone has a circadian rhythm, which is defined as "an internal clock that synchronizes all of the physiological functions in the body."
These rhythms affect how we sleep, and it's important to keep these clocks on track.
In order to accurately detect these patterns for ourselves, there are apps, such as "Circadian," which presents your day-to-day activities in an easy-to-understand diagram, in order to keep you in line with your circadian rhythms. Smartwatches have also been proven to study one's circadian rhythms based on experiences and provide information on how to adjust as needed. Most daily consumer tech we carry or wear now offers some form of sleep tracking, whether from a third-party app or the device maker. The Apple Watch has a Sleep app, as does Samsung's Galaxy phone, the Google Fitbit, and the Oura ring.
Sleep is a key pillar to health
Dr. Mark Wu, professor of neurology and sleep medicine at Johns Hopkins University, says not getting enough sleep at night is a big issue in contemporary society.
"We think about sleep as one of the key pillars to health," Wu said. "There's many things that can go wrong if you don't get enough sleep. There's acute and there's chronic issues. In the acute phase, you are basically sleepy the next day. Then, your attention is reduced, and attention is the foundation of all your mental processes. In the long term, if you don't get enough sleep, there's health outcomes that can occur."
Science suggests that being up for prolongated amounts of time, like Musk and Gates once did, is equivalent to alcohol intoxication. According to the National Institute for Occupational Safety and Health (NIOSH), being awake for 24 hours is like having a blood alcohol content of 0.10%. The United States legal limit for driving is 0.08%.
Sleep, the heart, and the circulatory system
The National Heart, Lung, and Blood Institute says not hitting a healthy amount of sleep each night not only affects how we think, it can also affect our heart and circulatory system, metabolism, respiratory system, and immune system.
When our circadian patterns are out of sync, the chances of disease increase.
Not sleeping well has been proven to promote glucose intolerance, which can lead to diabetes, even in individuals who appear to be completely healthy. Obesity is another risk, because not getting enough sleep may affect the part of the brain that controls our hunger. Blood pressure is a concern as well. The less sleep we get, the higher our blood pressure becomes, leading to risks for heart disease and stroke. The worst forms of sleep deprivation have severe health repercussions. Insomnia, for example, is linked to a higher chance of developing depression.
One nine-year study conducted at Ball State University found that sleep deprivation has been increasing across all American working demographics in recent years, though the risks are higher in some professions. Short sleep duration rates were found to be especially high for those working in protective services and the military, health care, production jobs, and transportation.
Dr. Jagdish Khubchandani, professor of public health at New Mexico State University and a contributor to the Ball State study, says managing sleep is part of the work-life balance that we must be the leader in maintaining. In that sense, Nike's CEO is taking the right approach.
"You are the No. 1 player," Khubchandani said. "In the American workforce, that's where we have to start the thinking. There's no one here to monitor my sleep, and I have to take care of myself."
—By Emily Grill, CNBC Strategic Content Intern | Stress and Wellness |
A key committee in the New York Senate has given approval to legislation that would legalize safe drug consumption sites, sometimes referred to as overdose prevention centers and safe injection sites.
The Senate Health Committee passed Senate Bill S399A this week in a voice vote, exactly four months after it was assigned to the committee. The measure, filed by Senator Gustavo Rivera, requires the Department of Health to authorize at least one safe drug consumption site. The site/s would provide a safe location for consumers to use drugs such as heroin, with medical personnel on site to prevent overdoses as well as make referrals for treatment.
“Harm reduction works”, says Senator Rivera. “Harm reduction is a modality, a way to approach dealing with an issue which assumes, first, that a person who uses drugs is a person, and that they have to be met where they are. Fact number two, criminalization has not worked.”
He continues: “Over decades of the drug war, it is pretty clear that we have lost said war. The notion that we could arrest our way out of addiction, that we could arrest our way out of overdoses and deaths, has been proven to be a lie based on all of these years of experience.”
The proposed law requires that any safe consumption site provide syringe exchange services, provide naloxone to reverse opioid overdoses and they must educate clients on safe practices for consuming drugs.
New York City opened the first city-authorized safe consumption sites in late 2021, although it remains illegal on the state level. | Drug Discoveries |
ExclusiveNationalCoronavirus pandemicThe pandemic has caused a surge of fatal cardiac arrests in Australia, as delayed care and COVID’s damaging effect on the heart drives a major uptick in serious heart issues.More than 10,200 Australians died of ischemic heart disease in the first eight months of 2022 – that is about 17 per cent higher than would be expected in a normal year.Cardiologists believe increased deaths from ischemic heart disease are likely linked to the damaging effects of COVID, but also delayed diagnoses, prevention and treatment through the pandemic.Credit:Jason SouthAccording to an analysis of mortality data by the Actuaries Institute, about 2300 deaths from ischemic heart disease over 2021 and 2022 are considered excess, which means they fall outside the expected natural range.“Deaths with ischemic heart disease really involve blockages of the blood vessels. And when you have blockages in the blood vessels you then damage heart muscle, and your heart fails, and it can go into cardiac arrest, which means that it essentially stops,” said Professor Steve Nicholls, director of the Victorian Heart Hospital.Leading heart disease experts say the death statistics are concerning but not surprising. For years, cardiac deaths have been the leading cause of death in Australia. The pandemic has only increased the risk factors.Loading“It’s kind of the last straw,” said Professor Tom Marwick, director of the Baker Heart and Diabetes Institute.“The camel’s back was straining under the burden of risk factors, and then we have an infectious disease on top with a bunch of inflammation, hey presto we get an increase of cardiovascular events.”Coronavirus has been implicated in an increased risk of cardiovascular problems, with a study published in the prestigious science journal Nature finding that rates of heart attacks and stroke were substantially higher in military veterans who had recovered from COVID-19, compared to those who hadn’t had the disease.A recent Australian study also found hospitalisations from myocarditis (inflammation of the heart muscle) and pericarditis (swelling of the membrane surrounding the heart), pulmonary embolism, heart attack and stroke were significantly more frequent after COVID‐19.While rare cases of myocarditis and pericarditis have been linked to COVID vaccines, the Therapeutic Goods Administration says most people get better within a few days. Experts say vaccination is considered especially crucial for those with risk factors for cardiovascular disease.The number of excess deaths in Australia surged to 15,400 in the first part of 2022.While the majority of these deaths were from COVID-19, the nation is also seeing significantly elevated rates of deaths from diabetes, strokes and ischemic heart disease.Cardiologists believe the increased deaths from ischemic heart disease are likely linked to the damaging effects of COVID, but also delayed diagnoses, prevention and treatment through the pandemic.“The camel’s back was straining under the burden of risk factors, and then we have an infectious disease on top ... hey presto we get an increase of cardiovascular events.”Professor Tom MarwickNicholls, a cardiologist, said the heart wards in public hospitals were very busy.“So it’s not just that a lot of people are dying, but we’re seeing a lot of people at a whole range of different stages of [heart] disease,” he said. “One of our concerns early on in COVID was that we were going to miss people early [in heart disease] and then people would tend to present later.”Nicholls said everyone should talk to their GP about getting a heart health check.“We know the major risk factors for heart disease. We know that’s high blood pressure, it’s high cholesterol, it’s diabetes, it’s smoking, it’s obesity, and it’s a family history. You can’t do anything about your family history, but you can do something about everything else.”LoadingDr Amanda Buttery, the Heart Foundation’s clinical evidence manager, said there had been a reassuring surge in 2022 in the number of Australians getting heart checks, following marked decreases through lockdowns and the first Omicron wave.November 2022 saw a record number of heart health checks claimed.However, Buttery said the foundation remained quite concerned about mounting international evidence of a connection between long COVID and cardiovascular disease.“COVID-19 infection worsens pre-existing heart conditions, and increases the risk of developing more than 20 heart conditions including heart attack, blood clots, heart failure and stroke,” she said.Loading“COVID infection in Australia grew substantially in 2022. We are yet to see the full impact of this in health data.”The Actuaries Institute, the body that represents the actuarial profession in Australia and which evaluates and manages the financial risks faced by businesses, has also cited delays in emergency care caused by pressure on hospital systems as a possible factor in the country’s excess deaths. In Victoria, at least 33 people died from emergencies that were linked to delays in answering triple-zero calls or lengthy ambulance waits between December 2020 and May 2022.However, Professor Tom Marwick said data he had seen on heart attack mortality suggested that may not be as big a factor as expected.“Surprisingly, it shows that the mortality is just the same as pre-COVID. In other words, for people that got to the hospital, the outcomes are the same. The issue is, of course, the people that didn’t get to the hospital and the people who missed care and are presenting with more progressive disease now.”Marwick said he remains very concerned that many of those most at risk of a heart attack don’t have a regular GP. He said Melbourne’s west, which has been disproportionately battered by COVID-19 outbreaks, was also one of the hotspots for heart attack. The area has fewer GPs per person.At least 17,717 Australians have died of COVID. There have been 14 deaths linked to COVID vaccines from more than 64 million doses administered in Australia. One of those was a fatal case of myocarditis in a young woman where an expert vaccine safety group concluded a COVID vaccine was likely related, alongside several other factors.The Morning Edition newsletter is our guide to the day’s most important and interesting stories, analysis and insights. Sign up here. | Epidemics & Outbreaks |
lt was recently leaked that the World Health Organization (WHO) is about to change their classification of the artificial sweetener, aspartame, to category 2b – possibly carcinogenic to humans. This has caused some confusion, and has fed existing conspiracy theories about the sweetener. For some reason, even before the web, there was a viral campaign to spread fear and misinformation about aspartame. This took on a life of its own, and could not be quelled by something as pedestrian as evidence.
There must be something about the narrative that resonates – aspartame seems too good to be true. It is 200 times sweeter than sugar, and so can give the foods we love a sweet taste without the calories. Something in our “Simpsons” programmed sensibilities and baseline cynical nature says – it must be unhealthy. Also, the appeal-to-nature crowd that demonizes anything they arbitrarily deem not natural found a convenient target to sow fear and mistrust in mainstream institutions.
Meanwhile, there have literally been thousands of studies, and over 60 scientific and regulatory bodies around the world have reviewed the evidence and found aspartame to be safe for human consumption. There are also many reviews of the evidence in the published literature, generally finding no clear evidence of any link between aspartame consumption and any disease. It always needs to be noted that the one exception is people with phenylketonuria, who should not consume aspartame.
But researching risk is complex and the evidence is often misunderstood and misrepresented. One type of such research is pre-clinical, basic toxicology research. This focuses on whether the chemical in question does stuff to cells or biochemicals. How is it metabolized, what are the breakdown products, does it increase or decrease inflammation or oxidative stress, is it a potential mutagen, and many other assays. This kind of research just tells us if a substance is a potential hazard, but not if will confer a health risk.
The difference between hazard and risk is important to understand in terms of this research. A good analogy I often go to is – a shark in a tank is a hazard, meaning that it can potentially cause harm in the right circumstance. But as long as you don’t swim in the tank with the shark, the risk is zero. Something happening chemically may be a hazard, but we need to know how the substance is metabolized, will it get to the target tissue and in what dose, and what compensatory mechanisms are there? A potential hazard can be of zero risk depending on exposure.
Then we get to animal research, which more directly assesses risk. But in animal research the goal is often to “Mythbuster” the question – stress the system until it breaks, meaning give increasingly higher exposures to a potential hazard to see where it starts to become a risk. Sometimes this is explicitly done in what is called the LD50 test – what is the dose that kills half of test animals? Toxicity is all about dose, and so this research is used to know where the threshold dose of toxicity is. Typically, regulations then build in 1-2 orders of magnitude of a safety buffer.
Finally there is clinical and ecological research – is there any actual increase in a negative outcome (such as disease incidence) from controlled or real-world use? This is the definitive evidence about risk. It doesn’t matter if a substance changes a chemical in a petri dish, or kills rats when given in massive doses. What matters is if there is any net health risk when used by humans in the usual dose.
With aspartame, as with anything that gets studied enough, there is a lot of noise in terms of things that happen at a petri dish level, or in animal research, but there is no apparent risk of any disease when consumed by humans in normal amounts. Actual risk may come into play with levels of consumption that are inhuman – on the order of 60 liters per day of aspartame-sweetened drinks per day every day.
With this as context, how do we make sense of the new WHO classification? We need a bit of further context. The WHO classification system is based on hazard, not risk. They are not determining that something actually causes cancer, only whether or not it is a carcinogen. Further, the classification system is based upon the strength of the evidence, not the magnitude of the effect. Classification 1 is that a substance is carcinogenic to humans. This means the evidence is clear, but it says nothing about the effect size – we could be really confident in a tiny effect size. Classification 2A is probable, and 2B (the apparent new classification for aspartame) is possible. Category 3 is unclassifiable as a carcinogen, and group 4 is probably not carcinogenic.
A lot of things that we consume every day are in category 2B. Drinking hot beverages is in category 2A, above that of aspartame. Here is a full list of 2B.
But even the categorization of 2B is likely to be controversial. Here is the latest review of the question in the published literature, from 2022, which concludes:
Taken together, available evidence supports that aspartame consumption is not carcinogenic in humans and that the inconsistent findings of the RI studies may be explained by flaws in study design and conduct (despite additional analyses to address study limitations), as acknowledged by authoritative bodies.
Even if we can quibble about the evidence and whether or not there is the possibility of a carcinogenic effect from aspartame, it is not controversial that exposure levels would have to be much higher than what most people consume to confer any risk. At the end of the day the evidence still supports the conclusion that aspartame is safe at human levels of consumption. | Nutrition Research |
Thomas snuggles under the covers with me at bedtime, warm and wiggly.
It is our third tour through the “Harry Potter” series, and tonight is like so many others. I pause and ask him to read a few pages of the Dr. Seuss classic “Hop on Pop” before I continue recounting the adventures of Harry, Ron and Hermione.
And like so many times, he refuses. Finally he fumbles through a couple pages, over passages like “Pup Cup. Pup in Cup,” with copious praise. Then he is done.
It all seemed very normal that night last fall. But this was the beginning of third grade, and the Seuss book is sold as “The Simplest Seuss for Youngest Use.”
Thomas has a learning disability, ADHD and epilepsy. And this is hard — harder than I thought possible.
___
Third grade is considered a crucial reading year. Children who can’t read well by the end of this year are more likely to become dropouts. All sorts of bad things are possible, the research shows.
Yet here we are.
I know our situation is extreme. But I also know testing suggests we aren’t alone. The pandemic was tough for these youngest of kids.
In kindergarten when the pandemic started, their schooling was disrupted at a crucial time. And because of their age, virtual learning was particularly hard for them. Kids like Thomas who needed something extra had an especially hard time.
Thomas struggled to learn to talk, so much so that he met with a speech therapist as a preschooler.
I still remember the screening evaluation. The evaluator was giggling. Later she told me that she showed him a picture of a chair. Asked what it was, he responded, “Time out.” Other pictures were entirely mysterious.
I didn’t know it then, but speech delays are often a sign of a future reading problem. With extra help, though, he started talking.
Thomas, the red-headed youngest of three, was clearly bright, obsessed with the Titanic and shipwrecks in general. Once he covered the floor with ice cubes and declared the melting puddles were icebergs.
Still, there were signs. He was picking up letters a little slower than his classmates in kindergarten, and he was so, so wiggly.
We were worried enough that we asked his teacher to fill out a screening form for attention-deficit/hyperactivity disorder. Forgetful: Check. Struggles to sustain attention: Check. While he was inquisitive, the teacher added in her own handwriting, visual learning was a struggle.
But then the pandemic hit. Fifteen days after the teacher handed me the form, the governor of Kansas became the first in the country to shut down schools for the rest of the academic year. My middle child, then 12, had very little schoolwork and was enlisted to homeschool Thomas.
The screening form was forgotten.
___
In my phone, there is still a notes file where I mapped out how we would make it all work. The daily schedule I envisioned included things like reading/story time, recess, gardening and even cooking class. Each was assigned half-hour intervals.
Who did I think I was? Who did I think we were?
I snapped a picture of a desk neatly set up. Hours later, the desk was toppled. That pretty much says it all.
By April, things got worse. Thomas had a seizure, his first.
I initially thought nothing of him lying face-down on the floor, stepping over him as I went to do laundry. My husband was the one to roll him over, to notice him drooling and his left arm moving rhythmically. His eyes were open, but he wasn’t there.
The ambulance arrived minutes later. He was unconscious. The crew suggested we drive him to the hospital, that there could be COVID in the ambulance.
But we didn’t leave for an hour and a half. We were scared, and I watched YouTube videos of puppies on my phone while Thomas lay beside me, unconscious, until the pediatrician’s office called back. A nurse, then a doctor instructed us that this was urgent, that we needed to go.
The delay did no harm; there isn’t much that can be done after a seizure. The emergency room doctor looked him over and sent us home.
Days later, when we met with a neurologist for the first time, Thomas still had a bruise on his forehead from toppling face forward. The doctor scheduled tests and prescribed medication for use if Thomas had a seizure that lasted five minutes or longer.
We might never need it, the neurologist said. But we had to use it just two weeks later when Thomas had a second, frightening seizure hours before an MRI and an EEG to measure his brain waves. Later that day, he was diagnosed with epilepsy, cause unknown.
We were shaken. My parents drove to our house, stood in our yard and said they were sorry. But it was early in the pandemic and we didn’t even hug, too fearful we would expose each other to the virus.
That weekend, I insisted we buy kayaks. Curbside pickup was the only option, so I saw the boats for the first time when the sporting goods staff hauled them to the curb. For 10 of the next 11 days, I floated around on a local lake with a child or two in tow.
It was the only thing that eased the gnawing anxiety.
___
We soon learned that anti-seizure medications are a bit of a science experiment, and the first one was a mess. Although popular, it has a side effect of aggression in some kids. Thomas was among them.
My husband and I tried to work. We tried to do school. But there were daily tantrums. Cellphone screens were smashed, along with a tablet. My daughter threatened to quit watching Thomas while we worked. She demanded raises. Who could blame her? And why the heck were we asking this of her, anyway?
Women were quitting their jobs in droves, and I understood why. It all seemed impossible. At one point, I called his kindergarten teacher. We can’t do school right now, I told her. Things are too much of a mess. He wouldn’t sit through the virtual lessons. She said she understood and told me not to worry.
We switched medications and it helped, but there was still his behavior. He was wild.
When the day camp he was supposed to attend that summer was canceled, my mother started watching him. As a recently retired teacher, she was eager to play academic catch-up with him so he would be ready for first grade.
“We’ll work on sight words,” she told me. I responded with: “Mom, I don’t think he knows his letters.” She was dubious.
But a couple weeks later, she approached me, taken aback: “Thomas,” she told me, “doesn’t know his letters.”
He resisted efforts to learn them, squirming away from flashcards or decodable books. But my mother, persistent as always, bought an online curriculum and plowed through it with him several days a week.
By midsummer, we had our first follow-up with the neurologist. Thomas was a whirling mass of energy, trying to turn the light off in the exam room and climb onto a rolling table designed to hold the doctor’s laptop. Halfway through the appointment, I opened the door and shoved the table into the hallway.
More testing added dyslexia and ADHD diagnoses. The doctors said we should request special education services and armed me with a pile of test results and letters.
___
Our school district was offering a virtual and in-person option that fall. With Thomas’ new string of diagnoses, my mother offered to oversee virtual school. As it began, I dropped him off with her each day.
I recall watching him log on with his virtual classmates one morning. The teacher was helping them download the apps they would use, but many of his classmates couldn’t read. To help them, she announced the first letter of the app, tracing its shape in the air. Some kids had parents sitting beside them; other first graders were on their own, tearful and frustrated. But they trudged on, and most were catching on.
And Thomas: Even with my mother sitting right by his side, he was struggling.
She had to modify almost every assignment. Instead of writing sentences, she wrote them and had him copy or trace over the letters. We met virtually to discuss screening him for special education services.
In late September, he met for the first time with the reading specialist. Within minutes, his head dropped, he got confused and struggled to speak. She rushed him to the office, where my husband was waiting, suspecting a seizure. His neurologist adjusted his meds repeatedly; we did two more EEGs. We were unable to sort out exactly what was happening. Still, I was grateful that he wasn’t having big scary seizures.
The special education team initially decided he wasn’t low enough to qualify for services. But when he continued to struggle so much that one teacher mentioned having him repeat first grade, we asked them to take another look.
Thomas returned to an in-person class for the final weeks of first grade. Just before classes dismissed, we learned he qualified for special education. He would get more small group and one-on-one help.
We sent him to a summer program designed for kids who had struggled, but he still found it a challenge. He refused to get out of the car each morning until we moved him down to the program for kids one year younger. That’s when my in-laws offered to send him to a private school for kids with dyslexia. Classes are capped at 10 students.
It was what he needed. But his progress is slow and uneven. He learns things, but sometimes they don’t seem to stick.
One night, the school offered an event for parents designed to simulate what it feels like to have a learning disability. Parents were assigned impossible tasks — reading texts with missing words, reading sentences printed backwards. All the while, someone walked around with a speaker making school announcements.
I wanted to quit. I guess I understood why he often complained of stomach aches or headaches when he was asked to read.
___
Now, in third grade, he is nowhere near reading at grade level. I told the teacher that at the end of the year, I would like him to be reading like a first grader. She thinks it is doable. And he has made progress, now fighting his way through harder passages as the year progresses.
Maybe we will get there — wherever “there” is. Maybe it is all clicking. The journey is a mix of frustration and laughter.
Once, he informed a bemused librarian that he needs books about dinosaurs, along with ancient Greece and nuclear energy. Chapter books, she asked? I sighed. He often walks up to strangers and demands to know their favorite dinosaur. I’ve come to believe it’s a brilliant question. People who answer T. Rex seem fundamentally different than those who prefer a herbivore like a brachiosaurus.
Another time, Thomas interrogated a crew fixing a power outage, discussing wind turbines and batteries with the indulgent supervisor, a father himself. As Thomas walked home, he turned to my husband and told him: “Don’t ever underestimate the power of my brain.”
Thomas, we will try.
___
The Associated Press education team receives support from the Carnegie Corporation of New York. The AP is solely responsible for all content. | Mental Health Treatments |
One in seven women in their 20s have been classed as disabled, after the census for England and Wales included mental health in its question about disability for the first time.
The number of girls and young women aged 10 to 19 declaring a disability almost doubled and among those aged 20 to 24 it almost tripled in England to 15%. There were hotspots in Lincoln, Norwich and Brighton, places with large student populations. The increase among young males was smaller but still significant.
In response to the Equality Act 2010, the 2021 census stopped asking about “problems related to old age” as it did in previous decades when it was trying to establish disability rates and started asking about “physical or mental health conditions or illnesses lasting or expected to last 12 months or more”. The census was taken in March 2021, during the coronavirus pandemic when depression rates surged.
The results show the overall disabled population in England and Wales is getting younger.
The new count means 1.2 million people aged 10 to 24 in England and Wales now declare themselves disabled – more than double the number a decade earlier. Wales and the north-east of England, are home to the most disabled people, and London, the fewest.
The disability charity Scope described the census as “historic” and welcomed the recognition of the experiences of disabled people with mental health conditions.
“The lack of understanding about less visible conditions means people face a lot of stigma, discrimination and difficulty getting the right support,” said Craig Moss, research manager. “In a cost-of-living crisis, having accurate data is vital for government to make sure those in greatest need are getting enough support.”
Mind, the mental health charity, said the figures were “shocking but sadly not surprising” and said the cost-of-living crisis was taking a toll on young adults with mental health problems.
“Despite the need for support continuing to rise, young people are still left facing an agonising wait in a system that cannot keep up with demand, and the UK government’s response so far has just not been good enough,” said Gemma Byrne, head of health policy and campaigns. “Unless investment in young people’s mental health services is made as a matter of urgency, the UK government is at risk of failing an entire generation.”
The statisticians’ decision to stop asking about old age problems may also explain why the number of older people saying their activities were limited “a lot” by disability fell between 2011 and 2021. There was a sharp fall in the numbers of people over 60 declaring themselves disabled – with 1.1 million fewer people classifying themselves as such. Some of that may be due to disabled people being at greater risk of death during the pandemic, both from Covid and other related causes which triggered excess deaths, the Office for National Statistics said.
“Mental health may have been captured more accurately in the 2021 question, compared with previous years,” said the ONS. “This could have contributed to the increase in disability seen in the younger age groups. Our report into coronavirus and depression in adults found that between January and March 2021, 21% of adults experienced some form of depression, and that this was more than double pre-coronavirus levels.”
The census results also showed that people were twice as likely to be disabled in the most deprived areas of England compared with the least deprived with around one in four in the poorest locations declaring a disability. The pattern was similar but slightly less pronounced in Wales.
In the most deprived areas people aged 40-44 were just as likely to be disabled as people aged 70-74 in the richest areas. In Blackpool, a higher proportion of those aged 40 to 44 were disabled than among people aged 70 to 74 in Windsor and Maidenhead.
Hart in rural Hampshire, rated England’s least deprived council area, had the highest proportion of non-disabled people over the age of 60. | Mental Health Treatments |
Indiana University researchers are collaborating on a novel approach to use neuroimaging and network modeling tools -- previously developed to analyze brains of patients in the clinic -- to investigate Alzheimer's disease progression in preclinical animal models.
The research team, led by Evgeny Chumin, PhD, a postdoctoral research fellow in the College of Arts and Sciences' Department of Psychological and Brain Sciences at IU Bloomington, and Paul Territo, PhD, professor of medicine at the IU School of Medicine, published their findings in Alzheimer's & Dementia: The Journal of the Alzheimer's Association.
More than 6.5 million Americans ages 65 and older are living with Alzheimer's disease, and that number could grow to nearly 14 million by 2060, according to the Alzheimer's Association. While amyloid plaques and tau tangles are the two major hallmarks of Alzheimer's disease, research studies also indicate that Alzheimer's disease alters glucose metabolism in the brain.
This study looked at metabolic network changes in the brains of Alzheimer's disease animal models developed by the Model Organism Development and Evaluation for Late-Onset Alzheimer's Disease (MODEL-AD), a consortium of experts at the IU School of Medicine, Jackson Laboratory, University of Pittsburgh and Sage Bionetworks. The tools developed through this research collaboration, Territo said, provide a translational approach to assess disease progression of Alzheimer's disease in animal models and bolster the consortium's rigorous animal model development and preclinical drug testing pipelines developed to study and treat the disease.
"We now for the first time have created tools to assess mouse models carrying human genes, which are built upon the well-established Brain Connectivity Toolbox used in human studies," Territo said. "We are applying these tools to better understand Alzheimer's disease progression and therapeutic response and are embedding them as a resource in MODEL-AD."
Territo, a primary member of IU School of Medicine's Stark Neurosciences Research Institute and co-principal investigator of the MODEL-AD consortium, said two past studies inspired his research into analyzing how different areas of the brain interact during disease progression.
Olaf Sporns, PhD, a Distinguished Professor in the Department of Psychological and Brain Sciences at IU Bloomington, has previously published papers about network neuroscience, an approach for monitoring disease progression using graph theory and medical imaging -- MRI and PET -- to map, record, analyze and model the elements and interactions of neurobiological systems in humans. This allows scientists to see changes that occur in the brain's subnetworks by elevating how neuroimaging like MRI and PET can be analyzed. Chumin is a postdoctoral researcher in the Sporns laboratory.
Metabolic covariance networks of Alzheimer's disease animal models showed a lower community structure agreement compared to normal models. Agreement quantifies the propensity of regions in the metabolic network to cluster together, with lower values indicative of disruptions in inter-regional relationships of metabolic activity.
The other research is from Mattia Veronese, PhD, a scientist from King's College in London and associate professor at the University of Padua in Italy, who studied human PET imaging data of participants of the Alzheimer's Disease Neuroimaging Initiative (ADNI) to look for brain network changes and disease progression using the network neuroscience approach developed by Sporns. Veronese is also a co-author on the Alzheimer's & Dementia journal article.
"Those two pieces of work led our team to develop tools that would extract additional meaning from images of MODEL-AD mouse models, with the goal of not only providing similar whole brain metrics observed in the previous clinical studies, but to also dive deeper and possibly understand how subnetworks within the brain of these models might shed light on the mechanisms of the underlying biology," Territo said.
Chumin helped develop the tools and resources from the network neuroscience approach of human clinical research to preclinical animal models of MODEL-AD. The investigators analyzed the brain as a whole and also looked at subnetworks within the brain to see how those areas communicate and interact as the disease progresses.
"Using this approach, the research team's analysis of metabolism changes in animal models confirmed previous clinical findings of disease progression in patients with Alzheimer's disease," Territo said.
The animal models showed age-related changes in glucose uptake as well as differences between males and females -- similar to findings from Alzheimer's disease human data.
Territo said MODEL-AD plans to use these network neuroscience tools in their investigations of other preclinical data, including models of late-onset Alzheimer's disease, potential therapeutics for the disease and multi-modal analyses that combine neuroimaging data from PET and MRI.
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Television presenter Fiona Phillips says she believes that early starts while working at GMTV may have played a part in her developing Alzheimer's disease.
The 62-year-old star, who hosted ITV breakfast programme GMTV between 1997 and 2008, revealed that she had the illness earlier this year.
She said she was diagnosed in 2022 after experiencing months of brain fog and anxiety.
Phillips has now admitted that she "refused to recognise" the signs of Alzheimer's in the lead-up to her diagnosis, adding that she thinks her 3.30am starts while working as a TV presenter may have contributed to the disease's progression.
A lack of quality sleep has been linked to the illness, according to the Alzheimer's Society, although evidence is unclear on whether it's a factor in its progression.
"I ask myself why I got this dreadful disease," Phillips said in an interview with Woman and Home magazine.
"I wonder whether all the years of getting up so early when I was working on GMTV contributed to me getting Alzheimer's so young."
The presenter, who is married to This Morning editor Martin Frizell, said she initially put Alzheimer's symptoms such as fatigue and confusion down to menopausal problems.
"Menopause kind of covers everything, doesn't it?" she told the magazine.
"The main thing I had with menopause was this crippling anxiety and brain fog but I knew this was different."
Phillips, who took part in Strictly Come Dancing in 2005, initially got in touch with a menopause specialist who put her on HRT (hormone replacement therapy), which didn't improve her brain fog.
She had months of cognitive tests after the specialist suggested she seek further help, which eventually led to the Alzheimer's diagnosis.
Phillips previously revealed that her mother and father had died of Alzheimer's, as well as her paternal grandparents and her uncle.
Read more:
Alzheimer's diagnosis blood tests could be offered on NHS within five years
1.7m people 'could be living with dementia in England and Wales by 2040'
"I knew it was in my family but I didn't ever let myself think it might affect me too one day, so I refused to recognise the signs," she said.
Phillips, who said she "still has so much to do", said she knows she can "still have a great life" and added: "I am still me."
She is currently part of a trial for the drug Miridesap which is being carried out by the University College Hospital in London.
It is hoped the drug can slow or reverse the progress of the disease.
Alzheimer's is a progressive disease that causes mild memory loss in its early stages.
In late-stage Alzheimer's, individuals lose the ability to carry on a conversation and respond to their environment. | Disease Research |
Syphilis cases in US newborns skyrocketed in 2022. Health officials suggest more testing
Syphilis cases in U.S. newborns again are on the rise
NEW YORK -- Alarmed by yet another jump in syphilis cases in newborns, U.S. health officials are calling for stepped-up prevention measures, including encouraging millions of women of childbearing age and their partners to get tested for the sexually transmitted disease.
More than 3,700 babies were born with congenital syphilis in 2022 — 10 times more than a decade ago and a 32% increase from 2021, the Centers for Disease Control and Prevention said Tuesday. Syphilis caused 282 stillbirth and infant deaths, nearly 16 times more than the 2012 deaths.
The 2022 count was the most in more than 30 years, CDC officials said, and in more than half of the congenital syphilis cases, the mothers tested positive during pregnancy but did not get properly treated.
The rise in congenital syphilis comes despite repeated warnings by public health agencies and it’s tied to the surge in primary and secondary cases of syphilis in adults, CDC officials said. It’s also been increasingly difficult for medical providers to get benzathine penicillin injections — the main medical weapon against congenital syphilis — because of supply shortages.
“It is clear that something is not working here, that something has to change,” the CDC’s Dr. Laura Bachmann said. “That’s why we’re calling for exceptional measures to address this heartbreaking epidemic”
The federal agency wants medical providers to start syphilis treatment when a pregnant woman first tests positive, rather than waiting for confirmatory testing, and to expand access to transportation so the women can get treatment. The CDC also called for rapid tests to be made available beyond doctors’ offices and STD clinics to places like emergency rooms, needle-exchange programs and prisons and jails.
Federal officials again advised sexually active women of childbearing age and their partners to get tested for syphilis test at least once if they live in a county with high rates. According to a new CDC map and definition, 70% of U.S. adults live in a county with high rates. That’s likely tens of millions of people, according to an Associated Press estimate based on federal data.
The CDC’s recommendations are just that; there is no new federal money going out to state and local health departments to bolster testing or access. Some state health departments have already said they’re stretched thin when it comes to treatment and prevention, though Illinois announced last week it was starting a phone line for health care providers to help with record searching, consultation and assistance with mandatory reporting.
Syphilis is a bacterial infection that for centuries was a common but feared sexually transmitted disease. New infections plummeted in the U.S. starting in the 1940s when antibiotics became widely available and fell to their lowest mark in the late 1990s. By 2002, cases began rising again, with men who have sex with other men being disproportionately affected, though the STD is spreading among several demographics.
In congenital syphilis, moms pass the disease on to their babies, potentially leading to death of the child or health problems for the child like deafness, blindness, and malformed bones. Case rates have been rising across racial and ethnic groups.
Dr. Mike Saag, an infectious diseases expert at the University of Alabama at Birmingham, said syphilis can be “a silent infection” in women because it's tricky to diagnose without a blood test — not everyone gets painless sores, wart-like lesions or other visible symptoms.
The CDC has long recommended that all pregnant women should be tested for syphilis at their first prenatal visit, but poor access to prenatal care — largely in rural areas of the U.S. — can make that difficult. Nearly 40% of last year’s congenital syphilis cases involved mothers who didn't have prenatal care, the CDC said.
If syphilis is diagnosed early in a pregnancy, the threat of passing it to the baby can be removed by a single penicillin shot. But experts say the later you get into pregnancy, the more likely you’ll need multiple shots, and they have to be completed at least 30 days before delivery.
“I have had patients who have been on (a three-shot) regimen who then miss a shot,” said Dr. Nina Ragunanthan, an OB/GYN at the Delta Health Center in Mound Bayou, Mississippi. “So they are trying to get their shots, but if they don’t get the three in a row, because of transportation issues, because of job issues, child care issues, any number of reasons that prevent them from coming back, they don’t complete their treatment.”
Plus, the shortage of shots makes the task of getting syphilis numbers down difficult, health officials across the U.S. told the AP. Patients who are not pregnant can use the antibiotic doxycycline to treat syphilis, but health officials are concerned that the 14- to 28-day timeline of treatment is difficult to complete, leaving infected people uncured.
Pfizer is the nation’s sole supplier of the penicillin shot. Earlier this year, company officials said it was in short supply because of increased demand. Pfizer also said the shortage may not be resolved until next year.
The CDC said the shortage didn’t affect the 2022 congenital syphilis case numbers and that, despite the shortage, it isn't aware of patients not getting their needed shots.
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Hunter reported from Atlanta.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content. | Epidemics & Outbreaks |
Nutrition experts have recognized for many years that Western diets rich in fats and sugar may be behind the cause of obesity, but debate has reigned over the primary culprit - intake of too many calories? Specific foods such as carbohydrates or fat? This has led to some groups recommending reducing sugar, some reducing carb intake, while others believe the key is reducing high fat-foods.
A paper published today in the research journal Obesity suggests these theories are not incompatible with each other, and that they can all be brought together in one unified pathway that centers around one true driver: fructose.
According to Richard Johnson, MD, University of Colorado Anschutz Medical Campus researcher, and his colleagues, the primary problem in obesity is fructose, which is present in table sugar and high fructose corn syrup. Fructose can also be made in the body from carbohydrates (particularly glucose). When fructose is metabolized, it lowers the active energy in the body (known as ATP, or adenosine triphosphate) which causes hunger and food intake.
What Johnson calls the “fructose survival hypothesis” brings together most of the dietary hypotheses of obesity, including the two that have been most incompatible with each other– the energy balance theory, which proposes too much food (and primarily fat) drives obesity, and the carbohydrate-insulin model, which puts carbohydrates at the center of weight gain.
“Essentially, these theories, which put a litany of metabolic and dietary drivers at the center of the obesity epidemic, are all pieces of a puzzle unified by one last piece: fructose,” says Johnson. “Fructose is what triggers our metabolism to go into low power mode and lose our control of appetite, but fatty foods become the major source of calories that drive weight gain.”
To unify these theories in particular, Johnson says we can look to hibernating animals as an example. When we’re hungry and low on active energy, we go into survival mode. Animals know to forage for food when energy levels begin to fall; why bears eat fruit to prepare for winter. Fruits are high-fructose foods, and fructose significantly stifles active energy. Fat acts as stored energy, but eating high-fructose foods blocks the replacement of active energy from fat storage, keeping active energy low like a bear preparing for a long winter’s nap.
“This theory views obesity as a low-energy state,” says Johnson. “Identifying fructose as the conduit that redirects active energy replacement to fat storage shows that fructose is what drives energy imbalance, which unites theories.”
While more work is needed to fully validate this unifying hypothesis, this is a hopeful first step in potentially identifying more targeted preventions for obesity and related metabolic imbalance management. | Nutrition Research |
Thursday Bill Gates launched a new podcast called "Unconfuse Me." ("What do you do when you can't solve a problem? I like to talk to smart people who can help me understand the subject better...") Join me on my learning journey as I talk to brilliant guests about Alzheimer's, artificial intelligence, the future of education, plant-based meat, the evolution of language, marijuana, and more.
The first words of the first episode are a clip of Seth Rogen saying "Edibles? I don't mess with that. Snoop Dogg doesn't eat edibles. Like, that's how wild the variation on edibles is, and I do not recommend this."
Then Bill Gates' voice says "I love learning, even if a topic's complex, I like to see if I can figure it out..." People reports that the 67-year-old Microsoft co-founder and former CEO also spoke to Rogen and his wife Lauren Miller about the future of Alzheimer's research: With studies showing that "40% of cases" are preventable, according to Rogen, the "five brain healthy habits" in their framework are important: sleep, exercise, nutrition, mental fitness and emotional well-being.
He even confessed that his being a celebrity encourages people to better care for themselves. "I taught this coursework of brain health, and we've also had a neurologist teach the coursework, and we scientifically proved that people retain information better from celebrities than doctors, which is it's a heavy burden," he joked, adding that this information "was published..."
Miller also shared that she goes to a neurologist and the pair are both "open" with their doctors about their habits, and "no one" in the medical world has told them that smoking weed is bad for their brain health. They even believe its benefits of boosting hunger and relieving stress might be good for preventing Alzheimer's. "It's not federally legal, so there isn't money to fund research," Miller said.
Gates later concluded the podcast with his own funny anecdote, laughing about his first time he ever smoked weed — back when it was a "rebellious" thing to do. "In school out of the, say 105 people in my class I think, there were three or four who didn't smoke," he said. "Because it was kind of a, 'Hey, I'm an adult! Hey I can break the rules!' But I will say, sometimes it's like, I guess I'm doing this to be cool. It wasn't so much smoking for pot's sake."
The first words of the first episode are a clip of Seth Rogen saying "Edibles? I don't mess with that. Snoop Dogg doesn't eat edibles. Like, that's how wild the variation on edibles is, and I do not recommend this."
Then Bill Gates' voice says "I love learning, even if a topic's complex, I like to see if I can figure it out..." People reports that the 67-year-old Microsoft co-founder and former CEO also spoke to Rogen and his wife Lauren Miller about the future of Alzheimer's research: With studies showing that "40% of cases" are preventable, according to Rogen, the "five brain healthy habits" in their framework are important: sleep, exercise, nutrition, mental fitness and emotional well-being.
He even confessed that his being a celebrity encourages people to better care for themselves. "I taught this coursework of brain health, and we've also had a neurologist teach the coursework, and we scientifically proved that people retain information better from celebrities than doctors, which is it's a heavy burden," he joked, adding that this information "was published..."
Miller also shared that she goes to a neurologist and the pair are both "open" with their doctors about their habits, and "no one" in the medical world has told them that smoking weed is bad for their brain health. They even believe its benefits of boosting hunger and relieving stress might be good for preventing Alzheimer's. "It's not federally legal, so there isn't money to fund research," Miller said.
Gates later concluded the podcast with his own funny anecdote, laughing about his first time he ever smoked weed — back when it was a "rebellious" thing to do. "In school out of the, say 105 people in my class I think, there were three or four who didn't smoke," he said. "Because it was kind of a, 'Hey, I'm an adult! Hey I can break the rules!' But I will say, sometimes it's like, I guess I'm doing this to be cool. It wasn't so much smoking for pot's sake." | Disease Research |
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- Sen. Bernie Sanders, I-Vt., has introduced legislation that would fund the expansion of community health centers and train primary care providers as a way to improve access for tens of millions of Americans who, he says, can’t find a doctor.
- Research suggests that 70 million to 100 million Americans could be unable to find a doctor if they want or need one, figures well within Sanders’ claim of "tens of millions."
Sen. Bernie Sanders, I-Vt., has long championed a government-sponsored "Medicare for All" health program to solve long-standing problems in the United States, where we pay much more for health care than people in other countries but are often sicker and have a shorter average life expectancy.
Nevertheless, he realizes his passion project has little chance in today’s political environment.
"We are far from a majority in the Senate. We have no Republican support … and I’m not sure that I could get half of the Democrats on that bill," Sanders said in recent remarks to community health advocates.
Sanders has switched his focus to include, among other things, expanding the primary care workforce.He introduced legislation in July that would invest $100 billion over five years to expand community health centers and provide training for primary care doctors, nurses, dentists and other health professionals.
"Tens of millions of Americans live in communities where they cannot find a doctor while others have to wait months to be seen," Sanders said in a press statement issued when the bill was introduced. He said this scenario leads not only to more human suffering and unnecessary deaths "but wastes tens of billions a year" because people who "could not access the primary care they need" often end up in emergency rooms and hospitals.
Is that true? Are there really tens of millions of Americans who can’t find a doctor? We decided to check it out.
Our first stop was the senator’s office to ask for the source of that statement. But no one answered our query.
So, we poked around on our own. For years, academic researchers and policy experts have debated and dissected the potential scarcity of primary care in the United States, using "primary care desert" and "primary care health professional shortage area" to evaluate the extent of the problem through data.n.
Across the board, however, the numbers suggest that this access to care is a problem issue for many Americans.
The Association of American Medical Colleges projects a shortage of up to 48,000 primary care physicians by 2034, depending on variables like retirements and the number of new physicians entering the workforce.
How does that translate to people’s ability to find a doctor? The federal government’s Health Resources and Services Administration publishes widely referred to data that compares the number of primary care physicians in an area with its population. For primary care, if the population-to-provider ratio is generally at least 3,500 to 1, it’s considered a "health professional shortage area."
Based on that measure, 100 million people in the United States live in a geographic area, are part of a targeted population, or are served by a health care facility where there is a shortage of primary care providers. If all of these people want doctors and cannot find them, that figure would be well within Sanders’ "tens of millions" claim.
The metric is a meaningful way to measure the impact of primary care, experts said. In those areas, "you see life expectancies of up to a year less than in other areas," said Russ Phillips, a physician who is director of Harvard Medical School’s Center for Primary Care. "The differences are critically important."
Another way to think about primary care shortages is to evaluate the extent to which people report having a usual source of care, meaning a clinic or doctor’s office they’d visit if they were sick or needed health care advice. By that measure, 27% of adults said they lack such a location or person to rely on, or that they used the emergency room for primary care in 2020, according to a scorecard published by the Milbank Memorial Fund and the Physicians Foundation, which publish research on health care providers and the health care system.
The figure was notably lower in 2010 at nearly 24%, said Christopher Koller, president of the Milbank Memorial Fund. "And it’s happening when insurance is increasing, at the time of the Affordable Care Act."
The U.S. had an adult population of about 258 million in 2020. Twenty-seven percent of 258 million reveals that about 70 million adults lacked a usual source of care that year, a figure well within Sanders’ estimate.
Still, it doesn’t necessarily follow that all those people want or need a primary care provider, some experts say.
"Men in their 20s, if they get their weight and blood pressure checked and get screened for sexually transmitted infections and behavioral risk factors, they don’t need to see a regular clinician unless things arise," said Mark Fendrick, an internal medicine physician who is director of the University of Michigan Center for Value-Based Insurance Design.
Not everyone agrees that young men don’t need a usual source of care. But removing men in their 20s from the tally reduces the number by about 23 million people. That leaves 47 million without a usual source of care, still within Sanders’ broad "tens of millions" claim.
In his comments, Sanders refers specifically to Americans being unable to find a doctor, but many people see other types of medical professionals for primary care, such as nurse practitioners and physician assistants.
Seventy percent of nurse practitioners focus on primary care, for example, according to the American Association of Nurse Practitioners. To the extent that these types of health professionals absorb some of the demand for primary care physician services, there will be fewer people who can’t find a primary care provider, and that may dent Sanders’ figures.
Finally, there’s the question of wait times. Sanders claims that people must wait months before they can get an appointment. A survey by physician staffing company Merritt Hawkins found that it took an average of 20.6 days to get an appointment for a physical with a family physician in 2022. But that figure was 30% lower than the 29.3-day wait in 2017. Geography can make a big difference, however. In 2022, people waited an average of 44 days in Portland, Oregon, compared with eight days in Washington, D.C.
Sanders’ claim that there are "tens of millions" of people who live in communities where they can’t find a doctor aligns with published data we reviewed. The federal government estimates that 100 million people live in areas where there is a shortage of primary care providers. Another study found that some 70 million adults reported they don’t have a usual source of care or use the emergency department when they need medical care.
At the same time, several factors can affect people’s primary care experience. Some people may neither want nor need a primary care physician; others may be seen by nonphysician primary care providers.
Finally, on the question of wait times, the available data does not support Sanders’ claim that people must wait for months to be seen by a primary care provider. There was wide variation depending on where people lived, however.
Overall, Sanders accurately described the difficulty that tens of millions of people likely face in finding a primary care doctor.
We rate it Mostly True.
Sen. Bernie Sanders, "NEWS: In Remarks to Advocates, Sanders Proposes Major Expansion of Community Health Centers," Feb. 8, 2023.
Sen. Bernie Sanders, "NEWS: Chairman Sanders Introduces Major Legislation on Primary Care and Announces HELP Markup Next Week," July 19, 2023.
Senate bill, "To improve access to and the quality of primary health care, expand the health workforce, and for other purposes," accessed July 21, 2023.
Association of American Medical Colleges, "AAMC Report Reinforces Mounting Physician Shortage," June 11, 2021.
Health Resources and Services Administration, "What Is Shortage Designation?" June 2023.
Health Resources and Services Administration, "Health Workforce Shortage Areas," accessed July 24, 2023.
Health Resources and Services Administration, "Designation of Health Professional(s) Shortage Areas," accessed July 26, 2023.
KFF, "Primary Care Health Professional Shortage Areas (HPSAs)," Sept. 30, 2022.
The Milbank Memorial Fund and the Physicians Foundation, "The Health of US Primary Care: A Baseline Scorecard Tracking Support for High-Quality Primary Care," Feb. 21, 2023.
The Milbank Memorial Fund, "The Effectiveness of Policies to Improve Primary Care Access for Underserved Populations: An Assessment of the Literature," Jan. 24, 2022.
American Association of Nurse Practitioners, "NP Fact Sheet," November 2022.
Meritt Hawkins, "Survey of Physician Appointment Wait Times and Medicare and Medicaid Acceptance Rates," 2022.
Interview with Mark Fendrick, physician and director of the University of Michigan Center for Value-Based Insurance Design, July 21, 2023.
Interview with Christopher Koller, president of the Milbank Memorial Fund, July 21, 2023.
Interview with Jacquelyn Resnik, Teladoc Health, July 21, 2023.
Interview with Russ Phillips, physician and director of Harvard Medical School Center for Primary Care, July 24, 2023.
Interview with Michael Dill, director of workforce studies at the Association of American Medical Colleges, July 24, 2023.
Email interview with Martin Kramer, communications director at Health Resources and Services Administration, July 25, 2023.
Email interview with Jewel Jordan, public affairs specialist, U.S. Census Bureau, July 26, 2023.
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In a world of wild talk and fake news, help us stand up for the facts. | Health Policy |
An estimated 80% of older adults in the U.S. have high blood pressure. Maintaining healthy blood pressure can protect against serious conditions like heart failure, heart attacks, and strokes.
A new study including Linda Pescatello, distinguished professor of kinesiology in the College of Agriculture, Health and Natural Resources, found that adding a relatively minimal amount of movement, about 3,000 steps per day, can significantly reduce high blood pressure in older adults.
Pescatello worked with Elizabeth Lefferts, the lead author of the paper, Duck-chun Lee, and others in Lee’s lab at Iowa State University. They published their findings in a recent issue of the Journal of Cardiovascular Development and Disease.
“We’ll all get high blood pressure if we live long enough, at least in this country,” Pescatello says. “That’s how prevalent it is.”
Pescatello is an expert on hypertension (the clinical term for high blood pressure) and exercise. Her previous research has demonstrated that exercise can have a significant immediate and long-lasting impact on lowering blood pressure in hypertensive adults.
This study sought to determine if older adults with hypertension could receive these benefits by moderately increasing their daily walking, which is one of the easiest and most popular forms of physical activity for this population.
“It’s easy to do, they don’t need any equipment, they can do it anywhere at almost any time,” Lee says.
The study focused on a group of sedentary older adults between ages 68 and 78 who walked an average of about 4,000 steps per day before the study.
After consulting existing studies, Lee determined that 3,000 steps would be a reasonable goal. This would also put most participants at 7,000 daily steps, in line with the American College of Sports Medicine’s recommendation.
“3,000 steps is large enough but not too challenging to achieve for health benefits,” Lee says.
The team conducted the study during the height of the COVID-19 pandemic, which meant they had to do everything remotely.
The researchers sent participants a kit with pedometers, blood pressure monitors, and step diaries for participants to log how much they were walking each day.
On average, participants’ systolic and diastolic blood pressure decreased by an average of seven and four points, respectively, after the intervention.
Other studies suggest decreases of these magnitudes correspond to a relative risk reduction of all-cause mortality by 11%, and 16% for cardiovascular mortality, an 18% reduction in the risk of heart disease, and a 36% risk reduction of stroke.
“It’s exciting that a simple lifestyle intervention can be just as effective as structured exercise and some medications,” Lefferts says.
The findings suggest that the 7,000-step regimen the participants in the study achieved is on-par with reductions seen with anti-hypertensive medications.Eight of the 21 participants were already on anti-hypertensive medications. Those participants still saw improvements in systolic blood pressure from increasing their daily activity.
“In a previous study, we found that when exercise is combined with medication, exercise bolsters the effects of blood pressure medication alone,” Pescatello says. “It just speaks to the value of exercise as anti-hypertensive therapy. It’s not to negate the effects of medication at all, but it’s part of the treatment arsenal.”
The researchers found that walking speed and walking in continuous bouts did not matter as much as simply increasing total steps.
“We saw that the volume of physical activity is what’s really important here, not the intensity,” Pescatello says. “Using the volume as a target, whatever fits in and whatever works conveys health benefits.”
This work was a pilot study, and the researchers hope to use these data to launch a larger clinical trial.
This work relates to CAHNR’s Strategic Vision area focused on Enhancing Health and Well-Being Locally, Nationally, and Globally.
Follow UConn CAHNR on social media | Disease Research |
An international research team led by James Umen, PhD, member, Donald Danforth Plant Science Center has made an unexpected discovery of a biased counting mechanism used by the single-celled green alga Chlamydomonas to control cell division. Chlamydomonas cells can grow very large and then divide multiple times in succession. The team found that the number of divisions a mother cell undertakes to restore its daughters to the correct starting size deviates from the mathematical optimum that was assumed to dictate this process. Instead, mother cells almost never divided just one time -- they either didn't divide at all or divided two or more times. This unexpected bias against a single division has important implications for understanding the evolution of multicellular life and provides a new avenue for engineering algal cells for improved yields of biofuel and high value products.
The article describing these findings titled, "A Cell-Based Model for Size Control in the Multiple Fission Alga Chlamydomonas reinhardtii," was published on November 9, 2023, in the journal Current Biology.
Chlamydomonas cells, like those of many other algae and single-celled protists, can grow very large before they divide. This atypical growth and division pattern lets them make optimal use of light and nutrients, but also creates a problem in size control: Under some conditions cells will just barely double their size before it is time to divide and only need to divide once; but under favorable conditions the same cell might grow more than ten times its starting size and would need to divide multiple times in succession to produce daughters of the correct size. This size variability presents a conundrum which was solved by the evolution of a mechanism in Chlamydomonas that enables cells to assess their size and count out the correct number of cell divisions. "It was always assumed that the division pattern was dictated by a simple relationship between mother cell size and number of divisions, and models that assume this simple relationship can accurately predict the behaviors of entire cell populations," said Umen. "But by looking at division behaviors of thousands of individual cells of varying sizes we found an unanticipated dearth of cells dividing just once." Instead, cells that should have divided once opted to not divide at all, and most cells only became able to divide when they had more than doubled in size.
Faced with this unexpected result, team members Abhyudai Singh, PhD, professor, University of Delaware and César Augusto Vargas-García, PhD, analytics team leader, AGROSAVIA -Corporación colombiana de investigación agropecuaria, Bogotá, Colombia, used mathematical modeling to come up with a more accurate predictive model for the behavior of the cells, while the research team at Danforth Center, spearheaded by Dianyi Liu, PhD, postdoctoral associate, dug deeper to understand the genetic mechanisms that produced the observed counting bias. The team discovered that a well-known, but still poorly-understood genetic mechanism for controlling cell division found in algae, plants and humans -- called the retinoblastoma tumor suppressor pathway -- plays a critical role in preventing just one division.
"While we are just at the start of understanding how the retinoblastoma pathway works in algae, the discovery of a mechanism for introducing bias in cell division behavior immediately suggests a way that cells modified their division behavior as an important step in the evolution of multicellular life," according to Liu.
Multicellular relatives of Chlamydomonas not only skip the option to undergo one division but can prevent division until they have grown many times in size. This enables a single cell to rapidly produce a whole new multicellular individual with hundreds or even thousands of cells, an ability that is critical for fitness and survival. "The bias against one division we observed in Chlamydomonas was very likely present in direct ancestors of its multicellular relatives and was further amplified as they evolved greater size and complexity," speculates Umen. While it remains unclear why the cells evolved a bias against dividing just once, the knowledge of this mechanism and its genetic control has practical implications in algal biotechnology where cell size can impact yields of high value products and even susceptibility to predation of algae by filter feeders in open pond cultures.
Looking forward, the team is now focused on understanding and modeling the specific mechanisms used by the retinoblastoma pathway to alter cell division behavior in algae, work that may lead to advances in algal biotechnology and even shed light on how the retinoblastoma pathway keeps human cells from developing cancer and prevents plant cells from dividing at the wrong time and place.
The team's research success was supported by National Institutes of Health grants R01GM126557 and R35GM148351.
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BBC news editor Carly Appleby was diagnosed with stage three breast cancer in 2017. At that time, she had no idea how gruelling treatment was going to be. Now looking back - and to the future - she reflects on how it has changed her life.
If you had told me six years ago I still would not be finished with my cancer treatment by now, I wouldn't have believed you.
Now, after years of hospital appointments and treatments, I no longer look sick, but this does not mean everything is ok and back to "normal".
At 43, my body thinks I am a women much older than I am.
I still suffer from fatigue and aches and pains that wake me up at night and my memory is terrible.
The veins in my arm will never return to normal after chemotherapy and it is a painful struggle to get a cannula into my veins after years of treatment.
But I feel proud of everything I have overcome with the support of my family and friends and it has made me realise how remarkable our bodies can be.
My daughter is now nearly 10 and I hope to be able to see her grow up.
Every year that passes is a privilege and I will never take my current good health for granted.
'No idea'
It had been a beautiful day in the Cotswolds when I got my diagnosis and my husband and I were stunned. We had no idea what was to come.
Cancer treatment was not quick for me.
It included six rounds of chemotherapy, 15 sessions of daily radiotherapy, a year of targeted therapy of the wonder drug Herceptin, 18 months of injections into my stomach of Zoladex; multiple breast operations, reconstructions and surgery to remove my ovaries.
This all led to two years of hair loss and being plunged into surgical menopause.
I also take a Tamoxifen tablet daily, and will do so for four more years. It is used to lower the risk of early breast cancer coming back.
When I first got cancer, I did not know the disease would prevent me from having more children.
I still feel incredible sadness about having that choice taken away from me. We had wanted another child to complete our family and that will never be possible.
I did not have the chance to freeze my eggs because my cancer treatment needed to start immediately and according to the fertility doctor we were referred to - the process would have been contributed to my cancer growing.
It still hurts when people ask me if I only have one child. But I feel so grateful for my daughter and the opportunity to be a mum.
Now she is older she has stopped asking me why she does not have a brother or sister. I feel guilty I could not provide this for my husband and little girl.
But I am still alive and in remission which means I no longer have cancer - or "no evidence of disease" - a term oncologists prefer to use.
I know I am extremely lucky. It is no longer the first thing I think about in the morning or the last thing I think about before going to sleep at night.
'Not pink and fluffy'
However the fear of cancer returning, becoming incurable and going through active treatments of chemo and radiotherapy again never goes away.
I have lost many young friends to the disease and it is hard not to make comparisons. So what have I learned?
It may be the most common cancer worldwide but breast cancer is not pink and fluffy or the "easy cancer" to be diagnosed with. There needs to be better awareness.
There are around 56,000 new cases of breast cancer every year in the UK - more than 150 cases every day.
More than 11,000 women die from breast cancer each year. Men can also get breast cancer although the numbers are far lower.
How to check your breasts
- Relax - know what's normal for you and check your breasts once a month
- The best time to check is in the shower with soapy hands
- Take a good look in the mirror beforehand and look for any obvious lumps, skin changes, nipple changes or discharge
- Remember to check your armpits
- Be aware that young women especially can have lumpy breasts which are entirely normal
- Breasts can change depending on menstrual cycle but if a lump persists for more than one cycle, see your GP
I no longer have regular appointments, only annual mammograms on my good breast.
Some well-meaning people would tell me about colleagues or friends they knew who had breast cancer in the past and survived.
These stories are good to hear but really they are meaningless because no diagnosis is exactly the same.
Sometimes I was too exhausted to explain that.
Life after cancer is tricky and brings its own challenges. Many people live with pain and side effects from treatment.
Depression, anxiety, fatigue, weight gain, loss of confidence and sleep issues are common and I experienced all of these.
Lack of confidence is a huge factor and many people do not recognise their bodies after treatment. For some women this can be particularly hard.
My eyebrows never returned so I had them tattooed, and my breast cancer nurse was brilliant at tattooing a fake but extremely realistic 3D nipple. Both of these made me feel better.
'Extremely lonely'
I remember feeling both confused and amused by all of the different colours of inks - bottles of pinks, creams and browns.
Halfway through the procedure I started to feel the needles on my numb chest. The nurse asked me if I wanted to continue?
I laughed and said: "You can't leave me with a circle half coloured in, so yes please".
The other thing I quickly realised was cancer can be extremely lonely.
I felt out of place as the young mum in the playground with cancer despite having incredible support from friends and family. You stick out when you have no hair and you look ill.
Despite the many kindnesses we were regularly shown by people, unless you are going through treatment it is hard to understand how scary and stressful the process is - wondering constantly if you are going to live and make it.
You also feel like you cannot do the things you enjoy because physically and mentally you are not able to.
Our world became very small in an attempt to protect me from infection. I was shielding at home well before the pandemic hit.
It is hard to know what is normal after cancer, so I attended a brilliant Where Now? course run by the cancer charity Maggie's, to talk about life after treatment.
It was so helpful to meet people who had different types of cancer but were all dealing with similar issues.
We also did some Nordic walking, which can be particularly beneficial to women who have had breast cancer.
Family and friends may expect you to be able to get back to how you were before treatment, but for some people the fear of cancer and death can be overwhelming.
I did not know many women diagnosed under 40 so I sought out people who understood.
I also attended an ABCDiagnosis cancer retreat. It is run by the incredible Jo Taylor, who has been living with incurable secondary breast cancer and raises awareness through her website and campaigning.
The retreat encourages exercise, holistic therapies and peer support and I am still in touch with many of the women I met there.
I also gain support as a member of the Younger Breast Cancer Network on Facebook.
Reflecting on all I have been through, my cancer diagnosis has made me a stronger person. I am able to cope with pretty much anything.
Living with a serious life-limiting illness makes you realise just how precious and short life is. | Women’s Health |
Imagine being on your period and "forced to beg for pads and tampons".
According to 24-year-old Lara, that's common for her and others on mental health hospital wards in the UK.
Lara is 18 months into a hospital admission and says she's experienced inadequate access to products, a lack of sanitary bins and being watched as she changed a tampon.
When she posted about her experience online, people from across the country responded with their own similar stories.
Mental health hospitals have various rules in place for safety reasons.
These can include limited access to certain items, restrictions on patients leaving wards and lists of what visitors can bring in.
NHS guidance states that period products should be available to anyone who needs them.
Lara says this hasn't always been the case for her.
"I've had a number of hospital admissions to psychiatric units and on one of my first they confiscated my period products," she says.
Lara says she has heavy periods, and when she needed to replace a tampon after two hours staff wouldn't give her another one.
She describes that as "humiliating".
Lara's currently on one-to-one observations for her own safety, which means someone has to escort her to the toilet and watch her change a pad or tampon.
But she says her worst experience was when she's had to wear anti-ligature clothing - again for safety reasons.
"I was forced to remove my pants and sanitary pad - which meant I just had to bleed into the clothing," she says.
"I understand the need for safety to come first, but this experience was unhygienic, traumatising and embarrassing for people to see."
Feeling 'ashamed'
Eleanor is 20 years old and recently spent time in a mental health hospital.
At her "most unwell", she says she didn't have access to her own clothing and had to wear the same special clothing Lara spoke about.
"When I was on my period I didn't have a choice but to wear adult nappies," she says.
"I'd have two or three people watching me changing and even though I know it's for my own safety, it's dehumanising," she says.
Eleanor says that experience, along with limited access to period products, left her feeling "lonely, ashamed and embarrassed".
'It's just not thought about'
Twenty-five-year-old Hat has also spent time in different psychiatric wards, and has had mixed experiences.
"On one ward they'd lock away pads so you didn't have access without asking," Hat says.
"I was so unwell I wasn't able to do that and so I'd just use scrunched-up toilet roll in my pants.
"When you're mentally unwell it impacts your experience of having periods as well. Frankly the last thing on your mind is managing when to change a pad."
Hat, who uses gender-neutral pronouns, started their own research into other patient's experiences of periods on psychiatric wards.
It's being supported by the National Survivor User Network - which helps people who've experienced mental health illness and trauma.
So far Hat's interviewed patients and staff from across the country and says, while experiences completely vary, adequate period provision is often over looked.
"It's just something that isn't always thought about, or that people have different needs," says Hat
"Sometimes hospitals think it's easier just to have the same restrictions for everyone.
"Restrictions should be assessed on an individual basis and dignity taken into consideration - and too often people's period needs are forgotten about."
Hat hopes to produce some guidance for hospitals and staff, based on positive experiences and best practices, so that people have the products they need.
Newsbeat asked a number of unions, organisations and charities to comment on the experiences described but none wanted to provide one.
But one mental health professional, Kasper, did agree to discuss it.
Kasper agrees that safety is always a top priority but adequate period provision is often overlooked."I'm sure all trusts have a policy, but don't think it's always applied - and my observation is that it very much depends on what staff are on shift, especially when there can be lots of agency workers," Kasper says."We do keep products on my ward, but there's not much of a range.
"Patients can't access them and some staff don't know where they are either - so the onus is very much on patients, which can be tricky when they're unwell."
Kasper thinks there has to be a better way forward and believes access to period products for those in hospital should be viewed as a "basic human right".
'Worry at a stressful time'
Lara, Eleanor and Hat - whose surnames BBC Newsbeat has chosen not to use - all come under NHS England, which announced in 2019 that period products would be available to all patients who need them.
Shortly after, the NHS in Wales announced the same, with Scotland and Northern Ireland also doing this from 2022.
An NHS England spokesperson said it expects "all hospitals to give patients access to the essentials of daily life, including sanitary products, which is why we mandated it in their contracts in 2019".
"All patients should be able to request pads and tampons and not face additional stress and worry during what is already a stressful time."
NHS England did not provide a response to Hat, Eleanor and Lara's complaints about anti-ligature clothing and the availability of products.
Lara agrees, and thinks there are two areas that really need improvement - access to suitable products for patients, and also education for staff.
She's also recently had some success at the hospital she's in, which didn't have any sanitary bins for safety reasons.
"After months of campaigning we've finally got a cardboard sanitary bin in one of the bathrooms," she says.
"I hope this shows there's no excuse for poor and undignified sanitation on psych wards and others follow suit". | Mental Health Treatments |
Pop star Jessie J writes beautiful post-baby body message that every mom deserves to hear
"I LOVE my body. It has given me the most magical roommate inside and outside of my body."
For many women, the simple act of feeling good in one’s body is a daily challenge. Internalized misogyny, outdated societal views and capitalism that feeds off of insecurity certainly don’t make it easy. Even truly miraculous experiences, like bringing a small human into this world, are tinged with shame, simply because the body hasn’t instantly “bounced back.”
However, sometimes we get a glimpse of what a new, more loving perspective could be. And hearing one person’s compassionate words can help us instill a new way of thinking.
Jessie J, singer of “Domino” and “Price Tag,” recently gave us a dose of that compassion. After suffering a previous pregnancy loss in 2021, the pop idol announced the birth of her son on May 19, 2023. Like many moms, her body doesn’t look the same way it once did, especially so soon after giving birth.
But rather than chastising her body for the way it looks, Jessie J is praising it for all the wonderful things it accomplished during pregnancy. It serves as a beautiful reminder for all women going through a similar situation.
"I'm writing this for myself as well as anyone else that needs to read this," she began in an Instagram post, along with a black-and-white photo showing her post-baby body.
She dived into what needed to be addressed first—the sheer phenomena of pregnancy that we so often take for granted and all the biological alchemy that takes place.
"Your body was a home for someone else to live in for 9 months. Your organs have moved and need to find their way back to where they were before. Your uterus is still deflating slowly. Your hormones are flying and crashing. Your body is working the hardest it has ever worked. You are exhausted but you are magical. You grew a whole human. A human who is doing this with you and loves you beyond measure."
"Celebrate your new body. It HAD to change. It will be bigger and smaller in different places. IT IS BEAUTIFUL and NATURAL,” she added.
Noting the unrealistic expectations put on many new mothers to whip themselves back into shape, she wrote, “Ignore the whispers of what some people say you should or shouldn’t look like after a certain time. It’s 2023. People need to chill.”
She then encouraged mothers to "take your time," and "be easy on yourself, your body AND your mind,” and perhaps most importantly, to "remember you are in recovery and don’t forget to also remind those around you.”
After all, "It's your journey," she declared. "Your time and YOUR body. It's not the same as anyone else's, and that's what makes it special. You are unique.”
"This was my body 11 days after giving birth and I still look pretty much the same now 35 days on," she added. "I LOVE my body. It has given me the most magical roommate inside and outside of my body. And when it’s ready and able to change again it will. Whatever that looks like. I’m here for it."
Her sweet caption concluded with "You are doing amazing Mamma. You the MVP."
The message clearly struck a chord with moms at all different stages of motherhood, some of whom are currently pregnant and struggling with the thought of a post-baby body and others who are multiple kids in and well aware of Jessie J’s hard-earned wisdom. Regardless of whatever chapter these women were in, they were touched by the powerful words shared
Check out some of these lovely comments:
“I'm currently pregnant and the changes in my body aesthetically are definitely what I'm struggling with. I'm grateful for our baby and cannot wait to meet them, I've just always struggled with body image and this is magnifying that!”
“I fully expected my stomach to be flat (well not flat, more none bump shaped) after having a baby because nobody ever really spoke about the post bump, it’s so refreshing to see more people posting it.”
“My favourite saying: ‘My body looks like I've had children because I have had children. It will never look like I haven't had children.’ I'm about to have my third baby (7th pregnancy) and my body tells the story of all the journeys they and I went through till they become Earthside!”
“Thank you for supporting & empowering all of the mum's out there. You are an inspiration to all new (& not so 'new') mums. It's not just the body that changes with pregnancy, it's the rest of your life too as you so beautifully wrote ❤️”
Our bodies are amazing things at every stage of life. We just need help remembering that from time to time. | Women’s Health |
A national investigation into mental-health inpatient services in England has been announced by the government.
It will examine how trusts can learn from deaths in their care, how to improve young people's care and patients being treated far from home.
There has been huge concern recently over deaths of mental-health inpatients.
Charities welcomed the move, saying patients, families and carers must be closely involved.
It comes as an inquiry investigating deaths of mental-health patients in Essex has been given extra powers, and upgraded into a full public inquiry, to compel witnesses to give evidence.
The national investigation will start in October, when the Health Services Safety Investigations Body (HSSIB) is formally set up.
It will have the power to fine those who refuse to give evidence when they are required to do so.
A number of issues will be looked at, in both NHS and private services, including:
- how providers can learn from deaths in their care
- how to improve care for young people in inpatient mental-health services.
- how out-of-area placements are handled
- how many staff are needed in inpatient services
HSSIB chief investigator Rosie Benneyworth said any evidence would be kept anonymous.
"It is crucial that those impacted by poor care and those working on the front lines of the inpatient settings can share their experiences, reassured that HSSIB will use this information to improve care and not apportion blame or liability," she said.
Speaking in the House of Commons earlier, Health Secretary Steve Barclay said the investigation body would "have teeth and work at speed".
Rethink Mental Illness chief executive Mark Winstanley said there had been "appalling failures" in the standard of care delivered to people at their most vulnerable.
He said the investigation must have powers to issue alerts to improve patient safety but the government must also address "the staffing crisis" in mental health services.
"We believe that only if the government prioritises and urgently acts on these factors, can we prevent more avoidable tragedies and pave the way towards improved, safer care in mental-health inpatient units."
Identify risks
Mental-health charity Mind chief executive Sarah Hughes called the announcement "a crucial step in tackling the serious concerns we have about the state of mental health inpatient care in England".
"It is testament to the families who have fought for change because of the suffering their loved ones have endured in mental-health hospitals," she added.
The government has also published the findings of an independent rapid review into mental-health inpatient settings.
It heard from more than 300 mental-health experts, including carers, nurses, psychiatrists and patients, to determine how data could identify risks to patient safety in mental-health inpatient settings.
Geraldine Strathdee, who chaired the review, said she had been surprised how much of a burden data put on staff.
"Some clinicians reported spending half or more of their time entering data, taking time away from face-to-face therapeutic treatment and care of patients," she said. | Mental Health Treatments |
NEWYou can now listen to Fox News articles! Brooke Burke is determined to help others kick off a healthy lifestyle, especially after losing her beloved brother.The star’s younger sibling, Tommy Burke, affectionately known as "Fatcat" by his loved ones, passed away suddenly on July 20, 2021 – one day after his 44th birthday. According to a GoFundMe created by Tommy’s family, he left behind a wife and 10 children.The former "Dancing with the Stars" host later cited her sibling’s death as morbid obesity."I’m determined to begin and continue this conversation because losing my brother to obesity a year ago – I feel it should not have happened," the 50-year-old told Fox News Digital. "I wish I had a better understanding of the disease back then. I wish I knew what I’m experiencing now. And I think as we begin to open up the dialogue, we can have the conversation and encourage people to understand their body, so they can create change."BROOKE BURKE REVEALS FITNESS ADVICE SHE WISHES SHE GAVE HER YOUNGER SELF: 'SWEAT SMART' Brooke Burke with her late brother Tommy. (Courtesy of Brooke Burke)"It’s not about losing for me," she shared. "It's about living, and that’s part of my commitment, in addition to the tragedy that I went through with my own family. I feel committed to having this conversation, and it goes far beyond the type of work that I do in the health and wellness space. This is really about educating ourselves. It’s about living."Burke is joining Queen Latifah as a panelist on the "It’s Bigger Than Me" tour, which aims to spark conversations about "how we can all support and empower anyone at any stage of their health journey."It cited that more than 40% of adults in the United States, or two out of every five, are living with obesity, which is associated with "at least 60 health conditions." It stressed that obesity is "a health condition, not a character flaw," which is why it’s so essential to uplift those yearning to take charge of their health journey.During an appearance on the "Tamron Hall Show" in October last year, Burke said her brother was never overweight as a child. He dealt with obesity later in life due to lifestyle and economic struggles. Attempting to cope with their father’s addiction was another factor, among others.CLICK HERE TO SIGN UP FOR THE ENTERTAINMENT NEWSLETTERThe fitness guru revealed that at one point, he managed to lose 70 pounds while living with her at various times in his life. She described heartfelt conversations they shared when he admitted to being afraid of losing his life. More than anything, he wanted to live for his family.Burke revealed that many misconceptions still exist regarding obesity. It’s much deeper than food."There are many misconceptions," she explained. "There are medical conditions that sometimes stand in the way of people living a healthier life. So this whole campaign is about educating ourselves and understanding the medical issues that are related to obesity and understanding that obesity is a disease."A lot of people don’t look at it that way. We want to create a comfort level so that people can talk about it and learn… We want to create a safe space with compassion so that people can start educating themselves about their own body and be inspired."CLICK HERE TO GET THE FOX NEWS APP Celebrity host and fitness expert Brooke Burke teaching a pelvic fitness class at The Midtown Loft on Jan. 25, 2017, in New York City. (Mike Coppola/Getty Images for Poise Pelvic Power Class)Burke noted that maintaining a healthy lifestyle can be challenging in itself even after shedding the pounds. That’s why practicing self-care is so vital, she pointed out."I think you have to find things that you enjoy," the mother of four explained. "I like to inspire people to focus on things that they can have rather than what they cannot have. I think building a support is important in the self-care space. I think it's about changing your inner dialogue and the way that you approach things and developing your self-confidence and body confidence, which is a big part of this campaign.""It’s not about body confidence in your size and shape," she continued. "It’s the confidence that you can do the things that you want to do in your life, that you have the energy to live a long life, that you can do things that you enjoy. That’s a big part of the philosophy that I have in my fitness approach. I want to encourage and inspire people to develop a lifestyle that they can maintain to create those desired changes."Before Tommy’s tragic death, Burke launched a fitness app called Brooke Burke Body in 2017. It offers a variety of workouts that can be done from home for all fitness levels. She is known for using objects around her home to show how surprisingly simple an at-home workout can be.BROOKE BURKE REVEALS HOW SHE'S STAYING IN SHAPE INDOORS: 'I'VE ALWAYS TAKEN THE BEST CARE OF MYSELF' In 2017, Brooke Burke launched Brooke Burke Body, a fitness app that offers workout routines that can be done anywhere with our without equipment. (Aaron Poole/E! Entertainment/NBCU Photo Bank/NBCUniversal via Getty Images)"We’ve had so much fun using a stable chair to do step-ups, using water bottles or wine bottles if you don’t have weights, using poles from a mop or broom," she said. "The goal is to use your own body weight with no equipment… We’re trying to eliminate the excuse factor so that people can come into a program and conquer it. I think that creates self-confidence, as well as the desire to want to get up and do it again."Burke said she also created "a very extensive free PDF" that features recipes to complement a revamped lifestyle."If you were to go through my fridge, you would find lots of greens, vegetables, a lot of nut milks, cheese, avocados, fresh meat, salmon and tea – I love tea," she said. "There’s vinegar, Dijon mustard, olives, eggs, spices, lots of spicy sauces. You would also find pre-made quinoa. It’s about being organized and prepared. On Sundays, I’ll make soups and grain bowl supplies. That way we can have everything individually packed for the family so they can pick and choose. They can make a homemade grain bowl. For example, we’ll put greens in there, some chopped-up avocados, mushrooms, olives, sprouts, and vegetables – things already prepared and on hand. It makes it easy for my family and it encourages them to get creative in the kitchen."The star noted that she keeps sugar cravings at bay with cacao, dates and nut butters that can be added to a morning smoothie. Keeping hydrated throughout the day is also important she said, adding it "plays a big part in the hunger experience." She also encourages people to find a workout routine that speaks to them.SUZANNE SOMERS SAYS THIGHMASTER SAVED HER AFTER BEING FIRED: 'I'M STILL STANDING' Brooke Burke, Sugar Ray Leonard and Denise Austin attend the 10th annual Skechers Pier to Pier Friendship Walk on Oct. 28, 2018, in Manhattan Beach, California. (Rachel Luna/Getty Images)"I think fitness can be fun," she said. "But we have to strengthen that mindset. We have to look inward and not be so judgmental, so hard on ourselves for what we see on the outside. On days when I don’t feel my best, I just make myself do it. I have an understanding that when you push through it, you’ll feel really good afterward. It gives me energy and a sense of accomplishment.""I teach classes, so that keeps me honest and committed, but I sometimes schedule workouts with friends," said Burke. "Finding an accountability buddy can help. And it’s all about how I feel that day. Maybe one day I'll take a yoga class where I can do lots of stretching or go on a walk the following day. The digital space is also helpful. The goal is to keep moving."Burke is feeling hopeful about her future and how she can use her platform to help others. And Tommy has always remained on her mind. Brooke Burke is determined to keep her beloved brother Tommy's legacy alive by helping others. (Paul Archuleta/Getty Images)"I think it’s important for people to understand what the issues are," she said. "When we think about obesity, we have to go inside and understand why someone might be struggling. There are other issues we may not be aware of. What works for someone may not work for another. It’s a process.""I miss him," Burke said of her brother. "I’ll always miss him. I wish he was still here. He should still be here. The movie that plays in my mind is long and beautiful memories of our family and children. That will never fade." Stephanie Nolasco covers entertainment at Foxnews.com. | Nutrition Research |
By Maryam AfshangBBC Persian45 minutes agoImage source, WANA/ReutersImage caption, Mohammad Mehdi Karami told his family he was tortured in detentionFour young men have been executed in connection with the nationwide protests that erupted in Iran four months ago, while 18 other people have been sentenced to death. Human rights groups have said they were convicted after grossly unfair sham trials.Sources have told BBC Persian that he had less than 15 minutes to defend himself in court.His story shows how authorities in Iran are using show trials to strike fear into the hearts of the protesters, who are demanding freedom and an end to the clerical regime. 'Don't tell Mum anything'The protest movement began after the death in custody of Mahsa Amini, a 22-year-old woman who was detained by morality police in September for allegedly not wearing the mandatory headscarf "properly". Authorities dismissed the unrest as "rioting" and launched a violent crackdown. At least 481 protesters have been killed by security forces, according to Iran Human Rights, a Norway-based non-governmental organisation.Karami was arrested in connection with the murder of a member of the paramilitary Basij force during protests in the city of Karaj, just west of Tehran, on 3 November.He was later charged with the capital offence of "corruption on Earth" and went on trial before a Revolutionary Court in Karaj on 30 November along with 16 other people, including three children, also accused of involvement in the murder. Defendants are entitled to legal representation in Iran, but in sensitive cases like this one, or in espionage cases, they are not allowed to choose their own lawyers. Instead, the court appoints one from a list approved by the judiciary.Image source, WANA/ReutersImage caption, Sixteen defendants were tried in connection with the murder of a member of the paramilitary Basij forceJournalists and members of the defendant's family are also barred from being in court, so the only window into what happens behind the closed doors is heavily edited footage released by the judiciary.In one such video, Karami appears visibly distressed as he "confesses" to hitting the Basij member on the head with a rock. His court-appointed lawyer does not challenge or dispute this and, instead, asks the judge for forgiveness. Karami then says he was "fooled" and sits down. On 5 December, Karami was convicted and sentenced to death. Four of his co-defendants were also sentenced to death, while the children and eight others were handed lengthy jail terms, according to the judiciary. Normally, defendants' family members come under pressure from authorities to stay silent.But Mohammad's father, Mashaalah Karami, who works as a street vendor selling packets of tissues, gave an interview to the Etemad newspaper. He said his son had called him in tears the day that he was sentenced to death. "Dad, they gave us the verdict. Mine is the death penalty. Don't tell Mum anything," his father recalled, reiterating his son's innocence. Later, opposition activist group 1500 Tasvir published an account on social media alleging that Karami had been tortured.It said he had told his family during a meeting in prison that he had been beaten unconscious by guards. The guards had assumed he was dead and dumped his body in a remote area, but as they left they had realised he was still alive, it added.Karami also told his family that security agents had "touched his genitals every day and threatened to rape him" during interrogations, according to the account.Image source, Social mediaImage caption, Mohammad Mehdi Karami was a karate championUnder Iran's legal system, when a lower court passes a death sentence it is sent to the Supreme Court for approval. But even if the Supreme Court endorses the death penalty, it can still be appealed.Karami's father told Etemad that he had tried to contact the state-appointed lawyer multiple times, but there had been no response. The family then tried to hire one of Iran's most prominent human rights lawyers, Mohammad Hossein Aghasi. "Mohammad called me from prison three times and asked me to represent him. His parents also urged me to represent their son," Mr Aghasi said. Mr Aghasi wrote to the local court and then to the Supreme Court. At every stage, his letters were ignored or rejected. And lodging an appeal against the Supreme Court decision was also ruled out by a judge. Authorities have repeatedly said the fast-track trials of protesters and the harsh sentences handed out are meant as a deterrent. Vulnerable and isolatedSeyed Mohammad Hosseini, a 39-year-old volunteer children's coach, was also hanged on 7 January, after standing trial alongside Karami for the same crime. His parents are dead, so there was no family-led campaign on social media to save his life after he was sentenced. However, many Iranians shared a post saying: "We are all Mohammad's family."Hosseini, who was bipolar, did manage to get independent legal representation after the Supreme Court had upheld his death sentence.Image source, WANA/ReutersImage caption, Seyed Mohammad Hosseini also appeared in a highly edited video released by the authoritiesLawyer Ali Sharifzadeh Ardakani was able to visit him in prison in December and later tweeted about it. "He cried throughout the visit. He talked about torture, being beaten while handcuffed and blindfolded, and being kicked in the head and losing consciousness," Mr Ardakani wrote."[He is] a man whose confessions have all been obtained under torture and have no legal validity." Mr Ardakani submitted papers to appeal the Supreme Court decision and was told to return to court on 7 January. But as he was travelling there, he heard Hosseini had been hanged. The lawyer was later detained by the authorities and is currently out on bail. A source told BBC Persian that he faced a complaint from the Karaj prosecutor related to his tweet alleging that Hosseini was tortured. Nowhere to turnHuman rights groups have condemned Iran's judicial system for relying on "forced confessions". A source has told BBC Persian that the state-appointed lawyers effectively act as "interrogators" during trials, piling the pressure on the accused, rather than defending them.Iran Human Rights reports that at least 109 protesters are currently at risk of execution, having been sentenced to death or charged with capital offences. It has established the ages of 60 of those protesters, and says the average is 27, with three under 18. After Seyed Mohammad Hosseini and Mohammad Mehdi Karami were hanged, Western countries and human rights groups demanded that Iran immediately halt executions.Image source, Social mediaImage caption, Mashaalah Karami, Mohammed Mehdi's father, was filmed mourning beside his graveBut a week later, the judiciary announced that it had hanged British-Iranian dual national Alireza Akbari, a former top Iranian defence ministry official who was convicted of spying for the UK. In an audio recording obtained by BBC Persian last week, Akbari alleged that he had been tortured and forced to "confess" to crimes he did not commit. Meanwhile, yet another heart-breaking symbol of the protest movement was shared on social media. A video showed Maashalah Karami kneeling at his son's grave, wearing what appears to be his son's yellow jumperHe is seen holding a photo of his son in one hand and clutches his own throat with the other hand, mimicking a noose. | Epidemics & Outbreaks |
England's only NHS helpline for coming off antidepressants is to close, after the health service withdrew funding.
In March, NHS England said local health services should support people struggling to come off these drugs.
But the closure of the Bristol Tranquilliser Project will leave no nationwide services, its head says.
The local NHS says alternative provision exists, and that the project was only designed to serve the Bristol area.
NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board (ICB), which funds local health services, said the project was not commissioned to be a national helpline. It will close at the end of September.
'It's very frightening'
More than eight million adults in the country took an antidepressant last year. And despite its name, the Bristol Tranquilliser Project (BTP) takes calls from people around the country.
While it also helps people taking sleeping pills and other prescription medication, half of its work is with people struggling with symptoms from reducing their dose of an antidepressant.
Manager of the project, Jayne Hoyle, says by the time people come to her service, they are often "in extreme distress". They may have seen their GP and been referred to specialists for testing, she says.
"The first thing they experience is relief, because we say 'this is withdrawal from your medication...this is what you need to do'."
Withdrawal can happen when you stop a drug that your body has become used to.
Taking that drug away too quickly, before the brain has had time to adjust, can lead to symptoms including low mood and feelings of anxiety, as well as physical symptoms such as dizziness, fatigue and shaking, many of which can mimic other illnesses.
Official guidance for doctors now recommends that people reduce the dose of their medication in stages, but it does not specify how long it should take.
Mrs Hoyle believes many GPs are still telling people to come off the drugs too quickly. And volunteers and clients say BTP ended up acting as a national helpline, because of a lack of other support available.
It took Angela Clayton more than 18 months to feel her normal self after she stopped taking antidepressants. She was helped by BTP in 2001, and went on to volunteer for the service.
She developed nausea, fatigue, severe feelings of anxiety and depressive symptoms when she stopped her medication in one go. She says withdrawal "makes you feel like you're going mad".
"It's frightening, very frightening. I needed recognition from someone who knew what they were talking about."
Since then, she's worked with hundreds of clients and says their experiences mirror her own, two decades ago - including the fact they've often been unable to get the information they need until they found their way to the helpline.
Stuart Bryan was one of those helped more recently. When he tried to come off his antidepressant, he developed symptoms he'd never had from the conditions he took the drug for.
"I was never once told about any possible withdrawal issues. If I'd been told that, I would have had a different approach to it all," Stuart says. "I was pretty shocked to hear about the Bristol Tranquilliser Project closing down. They were keeping people alive."
Information on stopping antidepressants
- Patients with concerns about their medication should discuss them with their doctor. Stopping an antidepressant suddenly can be dangerous
- Doctors say it is always important to seek advice and treatment for mental health problems and to try to have any medication regularly reviewed
- Visit the NHS, the Royal College of Psychiatrists and Leap For PDD websites for information
Luke Montagu is a member of a cross-party group in Parliament that has been campaigning for a national helpline to support people going through withdrawal from prescription medications.
He says it is "astonishing" the health service does not already have a service to support those people. "There is now much greater awareness of the problem," he says. "And yet the government is still failing to fund and implement these services adequately."
A document published by NHS England in March, said services should be provided to support people going through withdrawal from prescription medication, including antidepressants.
But one of the local board's reasons for withdrawing funding was that it had identified "other existing services that deliver an equivalent or enhanced level of provision". The BBC understands they were referring to a service that focuses on painkillers and sleeping pills, but not antidepressants.
The Department of Health and Social Care (DHSC) has just rejected a submission to fund a national helpline, the BBC understands.
The DHSC has been contacted for comment.
If you are affected by any of the issues in this article you can find details of organisations that can help via the BBC Action line.
Watch: The Antidepressant Story on BBC iPlayer (UK only)
Panorama examines whether the current generation of antidepressant drugs have lived up to their promises, following patients who have suffered serious side effects. | Mental Health Treatments |
Ankylosing spondylitis (AS) came for Lovaine Cohen with speed and force.
Cohen was in her 20s when she gave birth to her first child, a daughter. After she became a mother, Cohenâs lower back began to hurt. Soon, she couldnât walk without a limp. Eventually, Cohen needed a cane to get around.
Then at age 31, after her pain had climbed to her upper back, Cohen learned she had AS, a type of arthritis in the spine. She had tested positive for the human leukocyte antigen B27 (HLA-B27), a gene found in almost everyone with AS.
The news came as a relief âbecause I finally had a name for what was going on with my body,â says Cohen, Â a health and wellness coach in Toronto.
By her late 30s, Cohenâs pain had turned unbearable and she needed heavy medication. Unable to get around easily, she quit her job as a financial service associate. Her rheumatologist sent her to an arthritis hospital for x-rays. They revealed that Cohenâs right hip had very little cushioning cartilage and that her left hip had none left.
Surgery Is Life-Changing
So at age 39, Cohen needed a new left hip. Her surgeon told her it was the worst case of inflammation he had ever seen.
When she woke up from the operation, something was different. The pain was gone.
âIt was life changing because for 4 or 5 years the pain was grating,â she says. âI was depressed. I didnât have good thoughts about my future because of the pain. But the surgery turned everything around.â
Rehabilitation was grueling. Cohen had to relearn how to walk and to build up her muscles strength. For 7 months, she needed physical therapy three times a week. Cohen also required a special pillow to support her posture and to help her heal.
All the while, AS continued on its path of damage. Almost a year later, Cohen needed her right hip replaced too.
New Hips and a New Career
It took time for Cohen to accept that she was a woman in her 40s with two artificial hips.
âI still had a victim mindset,â she says.
She questioned why AS had to happen to her. But as Cohen read more about managing pain and how to co-exist with her disease, her perspective started to shift. She began to focus more on her own role with AS and on the things she could control.
Cohen also adopted a holistic, or whole-body, view of her health. She realized that any aspect of her life could send ripples through everything else. She was no longer excited by her work. In January 2019, she quit her job in the financial services industry and started preparing for a new career as a health and wellness coach. Cohen credits AS for steering her into a new path.
Cohen urges anyone newly diagnosed with AS to educate themselves as much as possible. For example, read about how diet can affect the disease. Cohen knows she feels better when she limits sugar, fruit, carbohydrates, and meat. She gets her blood checked every 3 to 4 months and takes a TNF-inhibitor. She also walks and does low-impact aerobics and strength training every day.
âYou have to start thinking about changing your attitude about your pain,â Cohen says. âThe biggest battle in fighting chronic pain is developing your mind to the point where you can cope with the pain and stress.â
âIâm in the driverâs seat and pain is in the backseat.â
Pain and Doubts From a Doctor
The first signs of Deverell Dotosâs AS showed how sneaky the disease could be.
Dotos, a Jamaican-born New Yorker, was just 22 and working as a project manager at Ernst and Young when he noticed that he was having trouble with simple tasks. He struggled to walk up the subway stairs during his daily commute. He lacked enough strength to easily open doors or pick up a gallon of milk.
Those mysterious initial symptoms moved on to other parts of his body. Dotos fell so often that he couldnât walk without a cane. He consulted his primary care doctor about the stiffness, pain, and intense heat that shot through his body. Dotosâs doctor seemed skeptical about his complaints about pain.
âYou [start to] not trust yourself. I knew my body felt different, but I had to listen to my doctor,â Dotos says. The pain got worse and none of the medications helped. After 2 years, his doctor told him there was nothing more he could do for Dotos, and that it was all in his head
Finally a Diagnosis, but Still No Treatment
âI have an obstinate nature,â Dotos says, âand I was determined to find out what was going on.â
During this 2-year period, Dotosâs unexplained pain and symptoms wore him down physically and mentally. His social life came to a stop as his world shrank to his home. Dotos channeled his precious energy into two things: tending to his pain and finding why he hurt.
He asked his doctor for an x-ray of his spine. It showed damage in his lumbar spine in his lower back and to the cushioning discs between the joints. Next, Dotos joined an online group where he shared his experience. Someone suggested that he get the HLA-B27 test.
Dotos was thrilled when that 2010 test came back positive for the genetic marker for AS. It was 4 years since his first AS symptoms. The diagnosis finally explained why he felt as though his body was falling apart. Elated, Dotos expected he would take pills to treat it. His grim-faced rheumatologist at Mount Sinai explained that AS was a potentially serious disease with no cure.
Dotos tried a wide range of medications to dull his pain. Nothing helped. On his last visit to the rheumatologist, Dotos had trouble sitting in the waiting room. Once again, his doctor said nothing could be done.
A New View of Pain and a Transformation
That devastating verdict proved a turning point.
Dotos decided if he had to live with pain, he wanted to do it someplace beautiful. He sold all of his possessions and bought a one-way ticket to Cape Town, South Africa. He knew no one there. But he had long felt a pull toward Cape Townâs natural beauty and cultural vibrancy.
âFor me, thatâs where the transformation happened,â Dotos says. He spent a lot of time simply sitting, soaking up the view of the ocean, mountains, and people laughing. He felt happy. Instead of feeling like he was dying, Dotos could feel the melding of his mind and body.
Cape Town also is where Dotos recommitted to hot yoga, which he had practiced in New York. The heat and the stretching exercises helped ease his pain and made him more flexible and his spine stronger. In the hot room, Dotos started to rethink his hurting body. He quit using the word pain. Instead, he calls it discomfort.
âYou are on a spectrumâ of pain, he says. âIn discomfort, you can move towards comfort.â
After almost a year, Dotos returned to New York. Instead of going back to a corporate job, he became a certified hot yoga instructor. Before the pandemic, he traveled around the country to teach at various hot studios. Dotos stresses the importance of building a strong core to tighten the stomach muscles and to build a solid cushion to protect the spine.
Intense yoga is Dotosâs only AS treatment. He practices various types of yoga four to five times a week for 90 minutes and sometimes up to 5 hours. He eats a nutritious diet and limits preservatives, starches, and sugars.
It has been 10 years since Dotos learned of his diagnosis. The hopelessness he felt in the early days is long gone.
He now wonders âif AS is a superpower. If we can stop looking at it as chronic pain but as something that we are strong enough to endure.â | Disease Research |
Adults aged 60 and older who spend more time engaging in sedentary behaviors like sitting while watching TV or driving may be at increased risk of developing dementia, according to a study by USC and University of Arizona researchers.
Their study showed the risk of dementia significantly increases among adults who spend over 10 hours a day engaging in sedentary behaviors like sitting — a notable finding considering the average American is sedentary for about 9.5 hours each day.
The study, published Tuesday in JAMA, also revealed the way sedentary behavior is accumulated over the course of the day didn’t matter as much as the total time spent sedentary each day. Whether spent in extended periods spanning several hours or spread out intermittently throughout the day, total sedentary behavior had a similar association with dementia according to study author David Raichlen.
Once you take into account the total time spent sedentary, the length of individual sedentary periods didn’t really matter.
David Raichlen, USC Dornsife
“Many of us are familiar with the common advice to break up long periods of sitting by getting up every 30 minutes or so to stand or walk around. We wanted to see if those types of patterns are associated with dementia risk. We found that once you take into account the total time spent sedentary, the length of individual sedentary periods didn’t really matter,” said Raichlen, professor of biological sciences and anthropology at the USC Dornsife College of Letters, Arts and Sciences.
Researchers used data from the U.K. Biobank, a large-scale biomedical database of participants across the United Kingdom, to investigate possible links between sedentary behavior and dementia risk.
As part of a U.K. Biobank sub-study, over 100,000 adults agreed to wear accelerometers — wrist-worn devices for measuring movement — for 24 hours per day for one week. The researchers focused on a sample of approximately 50,000 adults from this sub-study over the age of 60 who did not have a diagnosis of dementia at the start of the study.
The researchers then applied a machine-learning algorithm to analyze the large dataset of accelerometer readings and classify behaviors based on different intensities of physical activity. The algorithm was able to discern between different types of activity such as sedentary behavior versus sleeping. The accelerometer data, combined with advanced computing techniques, provided researchers with an objective measure of the time spent engaging in different types of sedentary behaviors.
After an average of six years of follow-up, the researchers used inpatient hospital records and death registry data to determine dementia diagnosis. They found 414 cases positive for dementia.
Then, the team adjusted their statistical analysis for certain demographics (such as age, sex, education level, race/ethnicity, chronic conditions and genetics) and lifestyle characteristics (physical activity, diet, smoking and alcohol use, self-reported mental health) that could affect brain health.
Total time spent sedentary each day drives dementia risk
While high amounts of sedentary behavior were linked with increased risk of dementia, the researchers found that there were certain amounts of sedentary behavior that were not associated with dementia.
“We were surprised to find that the risk of dementia begins to rapidly increase after 10 hours spent sedentary each day, regardless of how the sedentary time was accumulated. This suggests that it is the total time spent sedentary that drove the relationship between sedentary behavior and dementia risk, but importantly lower levels of sedentary behavior, up to around 10 hours, were not associated with increased risk,” said study author Gene Alexander, professor of psychology and psychiatry at the Evelyn F. McKnight Brain Institute at the University of Arizona and Arizona Alzheimer’s Disease Research Center.
We were surprised to find that the risk of dementia begins to rapidly increase after 10 hours spent sedentary each day, regardless of how the sedentary time was accumulated.
Gene Alexander, University of Arizona
Raichlen said, “This should provide some reassurance to those of us with office jobs that involve prolonged periods of sitting, as long we limit our total daily time spent sedentary.”
The study builds on their previous research, which used self-reported health data to investigate how certain types of sedentary behavior, like sitting and watching TV, affect dementia risk more than others.
“Our latest study is part of our larger effort to understand how sedentary behavior affects brain health from multiple perspectives. In this case, wearable accelerometers provide an objective view of how much time people dedicate to sedentary behavior that complements our past analyses,” Raichlen said.
More research is needed to establish causality and whether physical activity can mitigate the risk of developing dementia, the authors said.
About the study: In addition to Raichlen and Alexander, other authors of the study include Daniel H. Aslan, M. Katherine Sayre, Mark H.C. Lai and Rand R. Wilcox of USC; Pradyumna K. Bharadwaj, Madeline Ally and Yann C. Klimentidis of the University of Arizona; and Silvio Maltagliati of the Université of Grenoble Alpes, France.
The study was supported by grants P30AG072980, P30AG019610, R56AG067200, R01AG064587 and R01AG072445 from the National Institutes of Health and funding from the state of Arizona, the Arizona Department of Health Services and the McKnight Brain Research Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. | Disease Research |
Researchers analysing wastewater say that routine monitoring at sewage treatment works could provide a powerful early warning system for the next flu or norovirus epidemic, alerting hospitals to prepare and providing public health agencies with vital health information.
In the first large scale and comprehensive wastewater-based epidemiology (WBE) study in the UK, scientists at the University of Bath, Bangor University and the UK Heath Security Agency analysed wastewater from 10 cities for both chemical and biological markers of health, including pesticides, pharmaceuticals and disease-causing viruses.
They collected samples from each location at hourly intervals over 24 hours on nine days in November 2021. The samples for each day were pooled before being processed and analysed for trace chemical markers using mass spectrometry techniques.
The samples were also analysed to detect any genetic material from viruses (SARS-CoV-2, norovirus and adenovirus). The total sampling catchment area equated to a population of around 7 million people.
Detecting trace chemicals
Using highly sensitive chemical analysis that could distinguish between very similar markers, the researchers were able to tell whether pharmaceuticals had passed through the human body or had been directly disposed into the wastewater system.
They could also identify whether chemicals such as pesticides had been ingested through food or had washed into the wastewater system from agricultural land.
The team observed that differences in levels of chemical markers were mostly dependent on the size of population in the catchment area, however there were some outliers.
For example in one city, there was a much higher concentration of ibuprofen found in the water, compared with other cities, suggesting direct disposal from industrial waste.
Identifying disease outbreaks
The researchers detected localised outbreaks of norovirus, Covid-19 and flu, but could also correlate them with spikes in usage of over-the-counter painkillers such as paracetamol.
The results indicate that analysing wastewater on a large scale in this way, dubbed wastewater-based epidemiology, could spot new outbreaks of diseases in communities early on, before large numbers were admitted into hospitals.
Professor Barbara Kasprzyk-Hordern, from the Water Innovation Research Centre and Institute for Sustainability at the University of Bath, led the chemistry work on the project. She said: "Most people reach for the paracetamol when they first get sick, and try to treat their illnesses at home.
"So looking for large spikes in paracetamol use could give an early indication that there may be an infectious disease outbreak in the community.
"We can also detect markers of inflammation and so look for any possible links of poor health with exposure to harmful chemicals, such as pesticides from food or industrial sources of chemicals.
"Our study has shown that only 10 daily samples from 10 wastewater treatment plants are needed to provide anonymous and unbiased information on the health of 7 million people -- this is much cheaper and faster than any clinical screening process.
"This could, therefore, potentially be a very powerful tool for giving a holistic understanding of public health of different communities."
Professor Davey Jones, who led a team at Bangor University analysing the wastewater for viruses, said: "Norovirus and seasonal flu have always been a huge problem in hospitals each winter; now Covid-19 has added to this problem.
"Our proof-of-concept study has shown the potential for Wastewater Based Epidemiology to provide an early warning surveillance system for these and other diseases, which would enable hospitals to prepare for outbreaks in the local area."
Matthew Wade, from the UK Health Security Agency, said: "This has been a fantastic collaboration of chemists, biologists and Government agencies, working with multiple water companies to collect important data on both chemical and biological markers from different parts of the UK.
"We are delighted to be part of this project and look forward to developing the potential of this public health tool even further in the future."
The study is published in the Journal of Hazardous Materials, and was funded by the UK Health Security Agency and the Engineering and Physical Sciences Research Council.
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Health officials have apologised after the launch of a new scheme to cut the cost of Hormone Replacement Therapy (HRT) was hit by technical problems.
The NHS Business Services Authority (NHSBSA) said it was aware of people "experiencing issues" while attempting to access the service online.
The new scheme, which came into force on Saturday, reduces the price of menopause treatments to less than £20 a year.
The plan was announced by the Department of Health and Social Care (DHSC) in February, saying it would save around 400,000 women in England up to £205 annually.
Before the rollout, each prescription for HRT cost £9.35, or £18.70 if a woman needs two types of hormones, and that needed to be paid once a month or every three months.
Now women can get a new HRT prescription prepayment certificate for £19.30 per year to access a list of eligible HRT items, including patches, tablets and topical preparations, whenever they need them.
But women have been unable to sort the certificate online due to issues with the NHSBSA website.
Welsh Labour MP Carolyn Harris posted an image on Twitter which appeared to show the website had crashed and asked "can anyone actually access the site?"
"This has been so hard fought for by women and they can wait no longer," she added.
The NHSBSA said it was working to fix the problem, adding that women will be able to backdate their certificate if they buy it at a later date.
A spokesperson said: "We're aware that some people are experiencing issues when trying to buy an HRT PPC this morning following the introduction of the new service.
"We're working to put a fix in place as soon as possible and we apologise for any inconvenience."
Read more:
HRT prescriptions now cheaper under new scheme
Menopausal symptoms 'forcing women to quit their job'
About 15% of women aged 45 to 64 in England are currently prescribed HRT, according to DHSC figures.
The treatment can help relieve menopause and perimenopause symptoms, including hot flushes, night sweats, brain fog, joint pains, mood swings and vaginal dryness.
It can also reduce the risk of hormone-related health problems, such as osteoporosis and heart disease.
The new certificate can be accessed online or in some pharmacies and will mean women pay once to access treatments as many times as they need throughout the year.
The certificate includes access to eligible HRT items including patches, tablets, pessaries and gels and creams applied to the skin. | Women’s Health |
Research team designs injectable nanoparticles that release naloxone when triggered by blue light
By rapidly reversing the effects of an opioid overdose, naloxone saves lives―if it's available at the right time. To eliminate this element of chance, researchers are exploring ways to have the medication available in the body before it's needed.
In a proof-of-concept study in Nano Letters, a team has designed injectable nanoparticles that released naloxone when triggered by blue light. In experiments with mice, this system was activated a month after injection.
Since it began more than two decades ago, the opioid epidemic has taken an enormous toll on people's lives. In 2022 alone, the U.S. Centers for Disease Control estimates that approximately 80,000 people died of overdoses involving opioids. This class of drugs, which includes both naturally derived and synthetic compounds, binds to specific receptors in the brain, suppressing breathing when taken in large quantities.
Naloxone blocks the effects of opioids by binding to the same receptors. Currently, the medication is delivered as an injection or a nasal spray that needs to be taken as soon as possible after an overdose. Building on research into ways to control the timing of medication delivery, Daniel Kohane and colleagues sought to develop a nanoparticle-based system that health care providers could inject under the skin of someone with opioid use disorder to deliver naloxone, should that person require the medication.
Kohane's team created the nanoparticles by attaching molecules of naloxone to a polymer considered safe for humans, rendering the medication temporarily inert. The connection between naloxone and the polymer was made with a light-sensitive molecule known as coumarin.
Light with a wavelength of 400 nanometers, which the human eye perceives as blue, detached coumarin from the naloxone, which allowed it to freely move to receptors and block the effect of opioids. The intensity of blue light required to split the chemical bond makes it unlikely for sunlight or ambient indoor light to accidentally trigger the system, the researchers say.
After injecting mice with the nanoparticles and the opioid morphine, the researchers found they could reverse the morphine's effects by exposing the skin at the injection site to a blue LED light for two minutes. The team also succeeded in releasing naloxone from the same place on mice three times over 10 days.
Although its effectiveness declined somewhat, the system continued to counteract morphine up to a month after injection. With further development, that timeline could be extended, according to the researchers. They also note that the blue LED needed to release the naloxone could be incorporated into a bracelet and possibly even worn over the injection site to make treatment as efficient as possible.
More information: On-Demand Opioid Effect Reversal with an Injectable Light- Triggered Polymer-Naloxone ConjugateOn-Demand Opioid Effect Reversal with an Injectable Light- Triggered Polymer-Naloxone Conjugate, Nano Letters (2023). DOI: 10.1021/acs.nanolett.3c03426
Journal information: Nano Letters
Provided by American Chemical Society | Drug Discoveries |
Aug. 10, 2023 â More than 3 years into the COVID-19 era, most Americans have settled back into their pre-pandemic lifestyles. But a new dominant variant and rising hospitalization numbers may give way to another summer surge.Â
Since April, a new COVID variant has cropped up. According to recent CDC data, EG.5 â from the Omicron family â now makes up 17% of all cases in the U.S., up from 7.5% in the first week of July.Â
A summary from the Center for Infectious Disease Research and Policy at the University of Minnesota says that EG.5, nicknamed âErisâ by health trackers, is nearly the same as its parent strain, XBB.1.9.2, but has one extra spike mutation.Â
Along with the news of EG.5âs growing prevalence, COVID-related hospitalization rates have increased by 12.5% in the last week â the most significant uptick since December. Still, no connection has been made between the new variant and rising hospital admissions. And so far, experts have found no difference in the severity of illness or symptoms between Eris and the strains that came before it.Â
Cause for Concern?
The COVID virus has a great tendency to mutate, says William Schaffner, MD, a professor of infectious diseases at Vanderbilt University in Nashville.Â
âFortunately, these are relatively minor mutations.â Even so, SARS-CoV-2, the virus that causes COVID-19, continues to be highly contagious. âThere isn't any doubt that it's spreading â but it's not more serious.â
So, Schaffner doesnât think itâs time to panic. He prefers calling it an âuptickâ in cases instead of a âsurge,â because a surge âsounds too big.â
While the numbers are still low compared to last yearâs summer surge, experts still urge people to stay aware of changes in the virus. âI do not think that there is any cause for alarm,â agreed Bernard Camins, MD, an infectious disease specialist at Mount Sinai Hospital in New York City.
So why the higher number of cases? âThere has been an increase in COVID cases this summer, probably related to travel, socializing, and dwindling masking,â said Anne Liu, MD, an allergy, immunology, and infectious disease specialist at Stanford University. Even so, she said, âbecause of an existing level of immunity from vaccination and prior infections, it has been limited and case severity has been lower than in prior surges.âÂ
What the Official Numbers Say
The CDC no longer updates its COVID Data Tracker Weekly Review. They stopped in May 2023 when the federal public health emergency ended.
But the agency continues to track COVID-19 cases, hospitalizations, emergency department visits, and deaths in different ways. The key takeaways as of this week include 9,056 new hospitalizations reported for the week ending July 29, 2023. That is relatively low, compared to July 30, 2022, when the weekly new hospitalization numbers topped 44,000.Â
âLast year, we saw a summer wave with cases peaking around mid-July. In that sense, our summer wave is coming a bit later than last year,â said Pavitra Roychoudhury, PhD, an assistant professor and researcher at the University of Washington School of Medicineâs Vaccine and Infectious Disease Division.Â
âItâs unclear how high the peak will be during this current wave. Levels of SARS-CoV-2 in wastewater, as well as the number of hospitalizations, are currently lower than this time last year.âÂ
For part of the pandemic, the CDC recommended people monitor COVID numbers in their own communities. But the agencyâs local guidance on COVID is tied to hospital admission levels, which are currently low for more than 99% of the country, even if they are increasing.Â
So, while itâs good news that hospitalization numbers are smaller, it means the agencyâs ability to identify local outbreaks or hot spots of SARS-CoV-2 is now more limited.Â
Itâs not just an uptick in hospitalizations nationwide, as other COVID-19 indicators, including emergency room visits, positive tests, and wastewater levels, are increasing across the United States.Â
In terms of other metrics:Â
- On June 19, 0.47% of ER visits resulted in a positive COVID diagnosis. On Aug. 4, that rate had more than doubled to 1.1%.Â
- On July 29, 8.9% of people who took a COVID test reported a positive result. The positivity rate has been increasing since June 10, when 4.1% of tests came back positive. This figure only includes test results reported to the CDC. Results of home testing remain largely unknown.Â
- The weekly percentage of deaths related to COVID-19 was 1% as of July 29. Thatâs low, compared to previous rates. For example, for the week ending July 30, 2022, it was 5.8%.
What About New COVID Vaccines?
As long as you continue to make informed decisions and get the new Omicron vaccine or booster once itâs available, experts predict lower hospitalization rates this winter.Â
âEveryone should get the Omicron booster when it becomes available,â recommended Dean Winslow, MD, a professor of medicine at Stanford University in California.Â
In the meantime, âIt is important to emphasize that COVID-19 is going to be with us for the foreseeable future,â he said. Since the symptoms linked to these newer Omicron subvariants are generally milder than with earlier variants, âif one has even mild cold symptoms, it is a good idea to test yourself for COVID-19 and start treatment early if one is elderly or otherwise at high risk for severe disease.â
Schaffner remains optimistic for now. âWe anticipate that the vaccines we currently have available, and certainly the vaccine that is being developed for this fall, will continue to prevent severe disease associated with this virus.â
Although itâs difficult to predict an exact timeline, Schaffner said they could be available by the end of September.Â
His predictions assume âthat we don't have a new nasty variant that crops up somewhere in the world,â he said. â[If] things continue to move the way they have been, we anticipate that this vaccine ⦠will be really effective and help us keep out of the hospital during this winter, when we expect more of an increase of COVID once again.âÂ
Asked for his outlook on vaccine recommendations, Camins was less certain. âIt is too soon to tell.â Guidance on COVID shots will be based on results of ongoing studies, he said. âIt would be prudent, however, for everyone to plan on getting the flu shot in September.â
Stay Alert and Stay Realistic
Cautious optimism and a call to remain vigilant seem like the consensus at the moment. While the numbers remain low so far and the uptick in new cases and hospitalizations are relatively small, compared to past scenarios, âIt makes sense to boost our anti-Omicron antibody levels with immunizations before fall and winter,â Liu said.Â
âItâs just advisable for everyone â especially those who are at higher risk for hospitalization or death â to be aware,â Camins said, âso they can form their own decisions to participate in activities that may put them at risk for contracting COVID-19.â
We have to remind ourselves that whether they're for the flu, COVID, or even RSV, these respiratory virus vaccines work best at keeping us out of the hospital. They're not as good at preventing milder infections.Â
Schaffner said, âSo if we don't expect perfection, we won't be so disappointed.â | Epidemics & Outbreaks |
Israeli biotech startup Mana.bio has been planning to launch its programmable drug treatment solution for months, and decided to forge ahead in spite of the attacks that happened this past weekend in the country.
The company is using an AI-driven approach called liquid nanoparticles (LNP) to create unique programmable drug treatments. “Mana.bio’s integrated experimental and machine learning platform enables the discovery of smarter, faster, more precise delivery formulations to unlock the field of nucleic acid-based and genetic medicines,” company co-founder and CEO Yogev Debbi said in a statement.
The solution involves RNA-based therapies, which have the potential to treat infectious diseases, cancers and single genetic disorders, but as Debbi explained RNA molecules are highly volatile. “RNA molecules can’t be administered just like that to the human cells, as they fall apart. They have to be protected by a special package (or carrier) until they are inserted into the cells where they can operate,” Debbi said.
Debbi’s company not only came out of stealth this week, it also announced a $19.5 million seed investment led by Andreessen Horowitz Bio + Health, Base4 Capital, NFX, LionBird and Technio.
He was also set to travel to San Diego for the first of two conferences to deliver papers on his company’s approach to drug discovery when the attack happened. The startup has been in stealth researching this approach for several years before this week’s announcement, and while faster drug discovery is something that could benefit everyone, it was not easy to decide how to proceed under the circumstances.
“We started thinking what’s going to be the impact, and should we do it or not,” he said. “Just to give the context, we’re all devastated in Israel. This is the darkest time at least that I can remember [in my lifetime],” he told TechCrunch.
As it turned out, all flights out of Israel were canceled shortly after the attack, so going to America and presenting the paper was no longer on the table, but he says it’s important to be launching in spite of the current challenges because it’s important work.
“We stayed committed to our goals, to our partners and to patients [who could eventually benefit from this approach] because we’re working in drug development,” he said.
Launching a startup is always going to be tough, especially one in an area as volatile as biotech. Doing it in the midst of a wartime situation adds an unimaginable degree of difficulty, but the company is determined to push through, even under such difficult circumstances.
“It’s really, really hard, and even with all the sadness and all the bad news that you hear all day long, we as a company, we have the privilege and also the commitment to really continue pushing forward and continue business as usual,” Debbi said. “And so this is for me, is a very important to signal to the team, to the country and to the world.” | Drug Discoveries |
A new study published in NeuroImage: Clinical explored the relationship between exercise, brain functioning, and major depressive disorder. The findings indicate that individuals with major depressive disorder (MDD) who also exercise tend to have better brain functioning than those with MDD who do not exercise.
Depression is a common mental health disorder that affects millions of people worldwide. It is characterized by persistent sadness, hopelessness, and loss of interest in once enjoyable activities.
Depression can significantly impact an individual’s quality of life, affecting their ability to work, socialize, and carry out daily activities. Physical exercise has been shown to be an effective treatment for depression, with studies suggesting that it can improve mood, reduce symptoms of depression, and enhance cognitive functioning.
“To develop optimized physical exercise treatments that serve as clinically useful additional treatment options for MDD, it is important to gain a better understanding of biological mechanisms of physical activity and their effect on cognitive functions and depressive symptoms,” wrote the authors of the new study.
“Therefore, as a first step, this cross-sectional study is focused on physical activity and individual physical fitness without an intervention. It is thought that antidepressive effects of increased physical activity and fitness are mediated by neuroplasticity that supports cognitive functioning.”
The study recruited 111 MDD outpatients and 56 healthy control (HC) participants. Participants had to engage in less than 90 minutes of vigorous physical exercise per week to be included in the study. Participants underwent tests to assess their physical fitness and neural activity during working memory performance.
Physical fitness was assessed using a graded exercise test on a cycle ergometer, where participants completed an electrocardiogram (ECG) during bicycle ergometry to measure their maximum physical exertion. Neural activity was measured using functional magnetic resonance imaging (fMRI) during a working memory task.
Participants with MDD had lower performance and slower response times on a working memory task compared to healthy individuals. The difficulties were especially prominent when the task required higher mental effort.
Brain scans showed reduced activity in certain regions of the brain associated with working memory in MDD patients. However, higher levels of physical fitness were associated with increased neural activity in the prefrontal cortex during working memory performance in individuals with MDD, suggesting that higher fitness levels may help improve working memory function in MDD.
The findings from this study provide valuable insights into the benefits of exercise for individuals with depression. The results suggest that physical fitness may enhance cognitive functioning in individuals with MDD by increasing neural plasticity in the brain. This has important implications for the treatment of depression, as it suggests that exercise may be an effective adjunct therapy for individuals with depression.
One limitation of this study is the small sample size and cross-sectional design of the study, which may limit the generalizability of the findings. Additionally, the study excluded individuals who exercise more than 90 minutes a day, potentially leaving out data that may be meaningful to the study of how exercise intersects with major depressive disorder.
“To our knowledge, this is the first study dedicated to the relationship between functional brain activity in a [working memory] task and physical fitness in MDD,” the researchers said. “The present results can be used to guide future research on physical fitness or exercise effects on mental health and cognition to develop optimized physical exercise treatments that serve as clinically useful additional treatment options for MDD.”
The study, “Physical fitness is associated with neural activity during working memory performance in major depressive disorder,” was authored by M.K. Schwefel, C. Kaufmann, G. Gutmann, R. Henze, T. Fydrich, M.A. Rapp, A. Ströhle, A. Heissel, and S. Heinzel | Mental Health Treatments |
Police officers in England will no longer respond to concerns about mental health if there is no risk to life or crime being committed, under new plans.
The government says the policy could save a million hours of police time every year.
Senior officers say forces have "lost their way" by dealing with less serious mental health problems.
But mental health charities say they are "deeply worried" at what could be a "dangerous" change.
At the moment, some police forces in England and Wales attend 80% of so-called health and social care incidents.
It is expected this will be reduced to between 20 and 30% within the next two years, under the plans.
The government says it is providing an extra £1bn a year, including £150m for facilities to replace police officers, including:
- specialist mental health ambulances
- extra capacity for treating patients
- "crisis cafes", where people struggling to cope can drop in for help
And 999-call handlers are being trained to assess a request for officers to attend and decide whether:
- someone's life is at risk
- there is a threat to the public
- a possible crime is being committed
But Mind chief executive Dr Sarah Hughes said mental health services were "not resourced to step up overnight".
Dr Hughes told BBC Breakfast that the system wasn't "ready" and that mental health services were "not fully equipped" to help the number of people in need.
"We're nowhere near a situation where services are in a strong enough place to pick up the slack," she added.
The additional funding had been announced in 2021, the charity said, so there was no new money to pay for additional referrals from the police, at a time of growing demand for mental health services.
However, the government's policing minister Chris Philp told the BBC's Today programme he was "confident it will be safe".
"We do need additional mental health capacity," he acknowledged, adding that the government was investing more in mental health provisions.
Mr Philp said the plans won't be rolled out with a "big bang" on day one, but instead will be decided in "discussion with police and the local health partners".
Having tested the policy during the past three years, Humberside Police said it had saved an average of 1,441 hours of police time a month.
Three other forces, Hampshire, Lancashire and South Yorkshire, are also starting to introduce the policy, to be implemented across England within three years.
In Sheffield, 999-response officer PC April Clark was recently called to a man trying to throw himself from a first-floor window.
"It is quite literally in my hands," she said.
"You can't let them go. You can't let anything happen to them. You've got to do what you can for them and their family until the right help comes along."
She has also dealt with a young mother's suicide.
These are both cases in which officers would still attend.
But PC Clark said she also regularly handled calls from NHS staff and members of the public "going home for the weekend in their nine-to-five jobs", asking the police for a ''welfare check" on someone with mental health issues.
Officers can end up sitting with patients for 12 hours and more in hospitals, because no-one else is available and NHS staff are concerned about the risk to the patient, staff or public.
'Feel criminalised'
An early assessment of the impact of the changes in Humberside Police concluded that police turned down requests to carry out welfare checks, or look for patients who had gone "AWOL". They also handed over the care of patients more quickly to the health service.
This meant more patients were seen by health service staff with appropriate training rather than police officers.
Deputy Chief Constable Rachel Bacon, from the National Police Chiefs' Council said the new approach would be better for people in mental health crises who tended to "feel criminalised" when officers turned up to help them. Some mistakenly believed they were under arrest.
Currently, officers are required by law when someone is detained under the Mental Health Act, allowing them to be taken to a place of safety, possibly against their will.
But the National Police Chiefs' Council plans to ask the government to change this.
How do you think urgent mental health issues should be dealt with? Do you have any experience of helping someone suffering a mental health crisis?
You can get in touch by emailing us [email protected].
Please include a contact number if you are willing to speak to a BBC journalist. You can also get in touch in the following ways: | Mental Health Treatments |
The health secretary has invited the Welsh and Scottish governments to discuss how best to tackle NHS waiting lists, as millions wait for hospital treatment across the UK.
Steve Barclay accused them of having worse delays than England in some cases - but they disputed the figures.
Hospital waiting lists in England hit a record 7.57 million people in June.
He also told the devolved governments he was open to Scottish and Welsh patients being treated in England.
NHS services are devolved, meaning Scotland, Wales and Northern Ireland control them in those nations, while the UK government runs them in England.
Prime Minister Rishi Sunak has made cutting waiting lists one of his "five priorities", and he's said people should hold him to account if NHS waiting lists in England do not fall by January 2025.
So far the numbers are not moving in the right direction.
Knowing this could bite when it comes to an election campaign, UK government ministers are keen to argue things wouldn't be better under Labour or the SNP.
The government said under Labour in Wales more than 73,000 people have been waiting at least 77 weeks for treatment, and under the SNP in Scotland more than 21,600 people have been waiting over 78 weeks for outpatient, day-case or inpatient appointments.
But both Scottish and Welsh governments have hit back, saying it isn't comparing like-for-like figures.
Scottish health minister Michael Matheson said: "Rather than attempting to involve themselves in devolved areas, the UK government would be well-served focusing on tackling the many issues in the health service south of the border."
He added after the Scottish government negotiated with junior doctors, his nation is the only part of the UK to avoid NHS strike action this year.
And a Welsh government spokesperson said: "Long waiting times are falling every month in Wales and have more than halved in the past year.
"The overall growth in waiting lists ... has been smaller in Wales than in England over the last 12 months."
In England, the waiting list for hospital treatments in England in June was more than three million higher than it was before the pandemic, hitting 7.57 million people.
Of those on a waiting list, more 383,000 people have been waiting longer than a year.
Official counterparts in Northern Ireland have also been invited to the meeting in the absence of a functioning government.
Mr Barclay has asked UK health ministers to discuss how health data can be made more comparable, and what "lessons can be learnt" from different approaches taken in each nation.
While there may be merits in discussing shared challenges and solutions, health has been used as a political attack line ever since the pandemic.
As it's run by different parties in each part of the UK, seemingly well-meaning letters and meetings between the governments have often been used to take a veiled pop at each others' approach.
For years, UK government insiders have mulled the idea of creating more centrally held, comparable data on NHS performance across the UK. If this happened, it may be easier to see which of these attacks - or not - are really justified.
Labour's shadow health secretary Wes Streeting said: "What's next, the Conservatives offering advice on bringing mortgage costs down?
"The only advice the Tories are qualified to offer is how to wreck the NHS and cause the biggest strikes in its history." | Health Policy |
This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. (Cynthia S. Goldsmith, Russell Regner/CDC via AP) The Chicago Department of Public Health is encouraging residents to take precautions when gathering with others this summer as a handful of monkeypox cases have been confirmed in the city. The department said in a release Monday that officials have been working with the organizers of large summer events to provide information about how to stay safe. Officials are recommending that if someone feels sick or has a rash or sores, they should not attend a gathering and see a health care provider as soon as possible. Anyone attending a festival or other large summer event should consider how much close, skin-to-skin contact might occur, the release states. “While the risk in Chicago remains low, CDPH wants the public to be able to make informed choices about gathering in spaces or participating in events where monkeypox could be spread through close or intimate contact,” Chicago public health department Commissioner Allison Arwady said in the release. The city has identified seven cases as of Sunday and is working with the Illinois Department of Public Health and other local health departments to find other potential cases. There have been 49 confirmed cases in the United States across 16 states and Washington, D.C. Most affected individuals have reported mild symptoms, and no one has died, according to the release. The department created a template letter with advice for staying safe. Event organizers can print it on their letterhead and “palm cards” to pass out at their events with a scannable smartphone code to access more information. The department of public health has been working to support clinical partners to identify infections, contact trace and monitor individuals’ symptoms. Affected individuals might have flu-like symptoms early on in the illness and then develop lesions on one part of the body that spread to other parts. Tags Chicago public health department contact tracing gathering precautions monkeypox | Epidemics & Outbreaks |
“If it bleeds, it leads” has long been a saying used in the media to describe how news stories featuring violence, death and destruction grab readers’ attention — and so dominate the news agenda. And, while many of us are aware of the negative effect that these kinds of story can have on us, it can still be hard to look away. We’re hardwired to sit up and take notice of them.
This “surveillance mode” is thought to be an evolutionary hangover from a time where survival odds were increased when we attended to the threats in our environment.
Research consistently shows bad news can have a negative effect on us. During the pandemic, multiple studies linked news consumption to poorer mental health, documenting symptoms of depression, anxiety, hopelessness and worry. In our research, we found that spending as little as 2-4 minutes on Twitter or YouTube reading about the pandemic affected people’s moods adversely.
However, our latest study has found that looking at positive news stories — specifically, videos and articles featuring acts of kindness — can actually counteract the ill-effects of seeing negative news stories.
Others were shown a negative news story, followed immediately by a positive news story. The positive story featured kind acts such as acts of heroism, people providing free veterinary care for stray animals, or philanthropy towards unemployed and homeless people.
We then asked participants to report how they felt before and after viewing the news content. We also asked them how inclined they were to believe in the goodness of others.
The group that was shown negative news stories followed by positive ones fared far better than people who were only shown a negative news story. They reported less decline in mood — instead feeling uplifted. They also held more positive views of humanity generally.
Curious to know whether there was something special about kindness specifically, we also tested how people exposed to a negative news story followed by an amusing one (such as swearing parrots, award-winning jokes or hapless American tourists) fared.
Amusing news stories certainly helped buffer the effects of bad news and reduce the mood disturbances they caused. But in comparison, participants who’d been shown acts of kindness reported a more positive mood on average, and a greater belief in the goodness of humanity.
This shows us there’s something unique about kindness which may buffer the effects of negative news on our mental health. However, further research is needed to establish whether these are long-term benefits, as we only measured how people felt immediately afterwards.
There are many reasons why kindness may have this protective effect on our mood.
First off, it is valued universally. Seeing acts of kindness may remind us of our connection with others through shared values. It may also help us maintain the belief that the world and people in it are good, which is important for our wellbeing.
Third, seeing others being helped is the resolution to seeing them hurt. So-called “catastrophe compassion“, whereby positive behaviour prevails despite negative circumstances, provides relief to the pain we experience when we see others suffering. Or, as one of our participants explained: “Knowing that there are a lot of people that are genuinely willing to help those affected by this attack somehow gives me a relief.”
Similarly, other research has found that even when children had not caused or were not connected to the suffering of another person, they experienced a reduction in physiological stress simply by seeing the hurt person being helped.
Fourth, countless research has shown that witnessing others’ acts of moral beauty, such as kindness or heroism, triggers “elevation” — a positive and uplifting feeling which experts theorise acts as an emotional reset button, replacing feelings of cynicism with hope, love and optimism.
It will be important for future research to investigate which specific reasons explain why kindness has the protective effect that our research has demonstrated.
It’s clear that kindness is a powerful tool for boosting wellbeing. In my research, I found that doing an act of kindness a day can increase life satisfaction. And more recently, researchers found that selflessness trumps selfishness when it comes to improving your happiness.
Less is known about whether making a conscious effort to notice kindness has the same wellbeing benefits, although one study found that observing others’ kindness is as effective in boosting happiness as performing an act of kindness.
Our latest study shows that kindness-focused news stories can take the sting out of difficult, depressing coverage by replacing feelings of despair with hope. As another participant put it: “I still feel that we’re fundamentally decent…And that’s worth clinging to.”
Perhaps including more kindness-based content in news coverage could prevent “mean world syndrome” — where people believe the world is more dangerous than it actually is, leading to heightened fear, anxiety and pessimism.
Other research has also found that positive news — such as bumble bees making a comeback or peace talks going well — make people feel better and want to do good things, such as voting or donating. This suggests there may be both personal and social benefits to showing positive news.
While it will be up to the media to make the change, our research makes the case for adding more balance to news coverage. Including more stories of kindness may help people feel better able to engage with these stories without perpetuating feelings of doom and hopelessness. | Mental Health Treatments |
Demand for drugs like Ozempic and Wegovy is soaring thanks to their weight-loss benefits, and now pharmaceutical companies are developing new pill versions that could make them even more popular.Currently, these drugs must be injected into the thigh, waist, or upper arm once a week. Pills or tablets could be easier to take and more convenient for many patients. “Having another route of administration would be a huge benefit,” says Michael Weintraub, an endocrinologist and clinical assistant professor of medicine at NYU Langone Health. Many people have a fear of needles, and others may not want to be seen injecting a drug.Last week, Novo Nordisk, which manufactures semaglutide under the brand names Ozempic and Wegovy, announced positive clinical trial results for a tablet form of the drug. In a trial of 667 adults who were overweight or obese, participants lost an average of 15.1 percent of their body weight over 17 months by taking the daily tablet, compared to people who lost 2.4 percent while taking a placebo pill. The results were comparable to a previous trial of weekly injections of Wegovy, in which people lost nearly 15 percent of their weight over the same period of time.“The choice between a daily tablet or weekly injection for obesity has the potential to offer patients and health care providers the opportunity to choose what best suits individual treatment preferences,” said Martin Holst Lange, executive vice president for development at Novo Nordisk, in a company statement. The company plans to seek approval in the US and Europe for its tablet later this year.Semaglutide was initially developed to treat type 2 diabetes. It mimics a hormone called GLP-1, which regulates insulin. But scientists found that it also led to weight loss in both lab animals and people. That’s because GLP-1 also signals to the brain when the stomach is full, so people who take these drugs have fewer cravings and a decreased appetite. Today, Ozempic is approved in the US and other countries to treat type 2 diabetes while Wegovy is specifically indicated for chronic weight management.Novo Nordisk already makes a pill version of semaglutide, but it hasn’t shown the same weight-loss benefits as Ozempic and Wegovy. Called Rybelsus, it was approved in 2019 by the US Food and Drug Administration for type 2 diabetes. That pill is just 14 milligrams, while the tablet that the company is currently testing is 50 milligrams.In the current study, researchers found that the new tablet was safe but that some patients had gastrointestinal side effects—the vast majority of which were mild to moderate and diminished over time, according to the company’s statement. The statement said the side effects were similar to ones patients experience on Ozempic and Wegovy. Those drugs can cause nausea, vomiting, bloating, constipation, and diarrhea. Often these occur in the beginning stages of taking the drug, when the dose is steadily increased, but drop off after several weeks.“People can also get pretty dehydrated with these medications, because not only do you forget to eat but you also forget to drink,” says Kunal Shah, an assistant professor of endocrinology at Rutgers University who specializes in obesity treatment, referring to Ozempic and Wegovy.Shah says a new pill with a higher dosage could potentially cause more frequent or severe instances of these side effects. “This is more than three times higher than what we normally give for oral semaglutide,” he says of the dosage for the experimental tablet. And because the current study compares the high-dose pill to a placebo, it’s not clear how the side effect profile of the new pill will stack up against the injectable version.Novo Nordisk spokesperson Allison Scheider declined to give specifics on the risk of side effects, saying that these details would be presented later in June at a meeting of the American Diabetes Association.Pfizer is also racing to make a weight-loss pill. Last week the company published positive results for its experimental medicine danuglipron, a different molecule that also imitates the GLP-1 hormone.In a trial of 411 adults with type 2 diabetes that tested different doses of the pill, participants taking a high dose lost an average of around 10 pounds over four months, compared to those who received a placebo. The most common side effects were nausea, diarrhea, and vomiting. Most were mild in nature, but 57 participants didn’t continue in the study because of these side effects. As with other GLP-1 drugs, these side effects were more present early on in the treatment course and decreased over time, Pfizer spokesperson Jerica Pitts told WIRED via email. “Proper counseling in advance of the first dose can help patients keep on medication through these initial bumps,” Pitts wrote.A pill version of these weight-loss drugs could come with strict instructions on how to take them. The existing semaglutide pill, Rybelsus, must be taken at least a half hour before any food, drink, or other oral medicines in the morning and can be taken only with a small amount of water. “Without abiding by those strict criteria, the absorption is going to be hindered,” Weintraub says.Pfizer’s pill may have a leg up in this regard, Weintraub says, because its absorption isn’t affected by food, so patients could take it alongside a meal. However, Pfizer’s danuglipron must be taken twice a day, once in the morning and again in the evening. Pfizer has another diabetes pill in development, lotiglipron, that’s designed to be taken once a day. Both are in Phase 2 clinical trials, and Pitts said the company will make a decision by the end of the year about which to move forward into late-stage testing.Semaglutide’s bioavailability—that is, how much of the drug reaches its destination—has been a challenge when formulating it into a pill, says Amy Rothberg, a physician and clinical professor at the University of Michigan Health who specializes in weight management and diabetes treatment. Injecting semaglutide is a more efficient way of getting it to the bloodstream, she says, which is why Ozempic and Wegovy injectors use just a tiny amount of the drug. But swallowing it in pill form means it has to pass through the digestive tract, where much of it is absorbed.She thinks most of her patients would prefer a pill over the current injectable version. ”That being said, people forget their medications all the time. Patients would have to commit to taking something every day,” Rothberg says. After stopping Ozempic and Wegovy, appetite increases again, and many people who go off these drugs regain weight.As for the cost of new weight-loss pills, Shah says they’re likely to be as expensive as the injectable versions—at least at first. “Anytime a new medication or a new version of a medication comes onto the market, the chances that insurance will cover it right away are pretty slim,” he says. While most insurers cover these drugs for diabetes, they’re not always covered for weight loss alone—and Ozempic and Wegovy respectively cost about $900 and $1,300 a month without insurance, according to Novo Nordisk’s list prices.In an email, Novo Nordisk spokesperson Scheider said it’s too early to speculate about the price of a pill version. "Right now it is too early for us to provide comments on a price," Pitts also wrote about Pfizer’s pills in development. | Drug Discoveries |
A large part of the pleasure of imbibing a glass of champagne comes from its effervescence: all those bubbles rising from the glass and ticking the nose and palate. If there's no fizz, there's no fun—and also less flavor and aromas to savor. A recent paper published in the journal ACS Omega found that the size of the champagne bottle is a key factor in determining when the wine inside will go flat.
As we've reported previously, champagne's effervescence arises from the nucleation of bubbles on the glass walls. Once they detach from their nucleation sites, the bubbles grow as they rise to the liquid surface, where they burst. This typically occurs within a couple of milliseconds, and the distinctive crackling sound is emitted when the bubbles rupture. The bubbles even "ring" at specific resonant frequencies, depending on their size, so it's possible to "hear" the size distribution of bubbles as they rise to the surface in a glass of champagne.
Prior studies have shown that when the bubbles in champagne burst, they produce droplets that release aromatic compounds believed to enhance the flavor. Larger bubbles enhance the release of aerosols into the air above the glass—bubbles on the order of 1.7 mm across at the surface. French physicist Gerard Liger-Belair of the University of Reims Champagne-Ardenne is one of the foremost scientists studying many different aspects of champagne and has now turned his attention to exploring how long champagne can age in the bottle before the carbonation dissipates to the point where those all-important bubbles can no longer form.
Per Liger-Belair et al., champagne and other sparkling wines undergo a second in-bottle fermentation process called "prise de mousse" to ensure the beverages are saturated with carbon dioxide. Vintners add selected yeast and a bit of sucrose to start the process in bottles already filled with a base wine. These are then sealed with a crown cap or cork stopper and the bottles are stored in cool cellars. The seals prevent yeast-fermented CO₂ from escaping so it can dissolve into the wine.
For champagne, this is then followed by a second aging period of a minimum of 15 months, known as "aging on lees," which enables dead yeast cells to be in contact with the wine, imparting additional distinct flavors and aroma profiles. Per Liger-Belair, there's a common misconception, even among champagne enthusiasts, that the wine should not age beyond this point, but this yeast autolysis is a slow process, so higher-quality champagnes are allowed to age on lees even longer. "Old vintages of the finest champagne wines can even age on lees for several decades before finally being disgorged to expel the dead yeast sediment and then put on the market," the authors wrote.
But there's a downside to this very long maturation phase. While the crown caps and cork stoppers used to seal bottles of champagne are impermeable to liquids, gases like CO₂ can still slowly diffuse through them, particularly since the internal pressure is close to 6 bars at 12° C. This can decrease the concentration of dissolved CO₂ in the wine, reducing the number and size of bubbles in the glass and that all-important carbonation bite when the bottle is finally opened for drinking. In other words, the champagne gradually loses its fizz.
This could potentially affect the nearly 1 billion champagne bottles of different sizes and capacities currently aging in cellars. which includes hundreds of thousands of prestigious cuvées undergoing prolonged aging on lees. Furthermore, most bottles sealed before the 2000s have crown caps covered with cork discs, which are more prone to CO₂ leakage.
So Liger-Belair and his co-authors decided to determine the contributing factors of the shelf life of champagne in hopes of figuring out how to extend it. They partnered with Champagne Castelnau in Reims, France, which donated a collection of 13 old vintages: 1996, 1995, 1993, 1992, 1989, 1987, 1986, 1985, 1982, 1981, 1979, 1976, and 1974, demonstrating prolonged aging on lees spanning 25 to 46 years. After a few years of aging, the bottles were stored in wood racks in the upside-down position so that the yeasty sediment accumulated in the necks. All vintages except for 1974 were studied in three bottle sizes: the standard 750-milliliter, the 1.5-liter magnum, and the 3-liter jeroboam.
Liger-Belair et al. measured how much CO₂ was in each vintage, from which they could estimate the original amount of CO₂ produced by yeast. This revealed that the amount of CO₂ decreased the longer the vintages had been aged, with the 1974 vintage losing almost 80 percent. They also noted a correlation between CO₂ levels and a bottle's volume. Specifically, larger bottles held on to CO₂ longer than smaller ones. The resulting formula they developed predicted a 40-year shelf life for 750-milliliter bottles, 82 years for 1.5-liter bottles, and 132 years for 3-liter bottles.
"For a cellar master, having chosen a 3-liter jeroboam to produce his champagne nearly triples the possible duration of aging on lees compared to that of the standard 750-milliliter bottle," the authors wrote. "In view of their ability to produce CO₂ bubbles once they have been served in a glass, the shelf life of old champagne vintages is therefore definitely and strongly conditioned by the bottle size." | Nutrition Research |
What is the Marburg virus and where did it come from?
Marburg virus causes the Marburg Virus Disease, formerly known as Marburg hemorrhagic fever. The virus, which belongs to the same family as the Ebola virus, causes severe viral hemorrhagic fever in humans with an average case fatality rate of around 50%. It has varied between 24% to 88% in different outbreaks depending on virus strain and case management.
It was first reported in 1967 in a town called Marburg in Germany and in Belgrade, Yugoslavia (now Serbia). There were simultaneous outbreaks in both cities. It came from monkeys imported from Uganda for laboratory studies in Marburg. The laboratory staff got infected as a result of working with materials (blood, tissues and cells) of the monkeys. Of 31 cases associated with these outbreaks, seven people died.
After the initial outbreaks, other cases have been reported in different parts of the world. Most were in Africa – Uganda, the Democratic Republic of Congo, Kenya, South Africa, and more recently in Guinea and Ghana. Serological studies have also revealed evidence of past Marburg virus infection in Nigeria.
While the host, or reservoir, of the virus is not conclusively identified, the virus has been associated with fruit bats. In 2008, two independent cases were reported in travelers who had visited a cave inhabited by Rousettus bat colonies in Uganda.
How is it spread?
It is spread through contact with materials (fluids, blood, tissues and cells) of an infected host or reservoir. In the case of the monkeys from Uganda imported into Marburg, laboratory staff obviously got infected through contact with the tissues and the blood of the monkeys.
There can also be human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials. This includes materials like bedding, and clothing contaminated with these fluids.
But there's a great deal we don't know: For example, whether contact with bat droppings in caves can cause infections in people.
What are the symptoms? And how bad can they be?
After an incubation period of between 2 to 21 days, there is a sudden onset of the disease marked by fever, chills, headache, and myalgia.
Around the fifth day after the onset of symptoms, maculopapular rash, most prominent on the trunk (chest, back, stomach), may appear. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea may appear. Symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.
The mortality is around 50%, and could be as high as 88% or as low as 20%.
This tells us it's quite a severe infection. The two people infected in Ghana both died.
Can it be treated?
Not really, but early supportive care with rehydration, and symptomatic treatment, improves survival.
What can people do to protect themselves?
Avoid exposure to the virus as much as possible, and protect against discharges from infected people.
Also, because of the similarities in the symptoms of many hemorrhagic fever diseases, especially during the early stages, there is a need for reliable laboratory confirmation of a case of Marburg virus infection. And once that is done – as with Ebola – the person must immediately be isolated and avoid contact with other people.
What should be done to ensure the virus doesn't spread?
There is no holiday from disease outbreaks. That means as a country, surveillance cannot take a break or a holiday.
Given that there have been cases in Ghana, it's time to be on the alert. Proper screening is called for. Arrivals from Ghana and other West African countries must be checked at the ports of entry.
Unfortunately, it doesn't appear as if anybody is thinking of that now. The attitude seems to be: oh, there are only two cases in Ghana.
But I think it's the best time to be on the alert at the ports of entry, especially for people from countries where cases are reported. Studies done in Nigeria in the the 1980s and more recently in the 1990s provide evidence of possible previous infections with Marburg virus – or a related virus – in certain Nigerian populations. This leads me to believe that the virus is probably more widespread than we think it is. We need an improvement in diagnosis which can help us do the detection as quickly, and as efficiently as possible.
On top of this, countries need to improve their disease surveillance and laboratory diagnosis to enhance and improve the capacity for a more definitive diagnosis of viral hemorrhagic fever infections.
This article is republished from The Conversation under a Creative Commons license, where it was originally published in July 2022.
for more features. | Epidemics & Outbreaks |
In the Little Mermaid, Ariel sings a whole song about wanting to be part of a world where people get to walk. Merle Liivand, on the other hand, wanted to do the opposite – and now holds the world record for the farthest swim as a mermaid.Liivand swam 26.22 miles wearing a silicone monofin, in just over 11 hours in choppy waters off the coast of Miami on 7 May.Billing herself as an “eco mermaid”, Liivand set out to use her feet – the fourth time she has set a new record for monofin swimming – to raise awareness about the importance of clean oceans, according to Guinness world records.The record required that Liivand not use her arms: she could only kick with the monofin. Originally from Tallin, Estonia, she told Guinness that she first took up swimming to help her recover from collapsed lungs, the result of auto-immune health problems as a child. She became a competitive ice swimmer and Baltic champion before moving to Florida 11 years ago.She began subjecting herself to long-distance, open-water swims to advocate against marine pollution, which she described as “the plastic pandemic”. She nearly ingested some microplastics during a practice session in open water, which inspired her to do more for the ocean.Long-distance swimming with the monofin was her own idea.“Swimming with the monofin without using my arms is similar to how dolphins and marine animals swim,” Liivand added. “They have a fin and can’t use any arms.”It also mimics the struggle faced by marine animals who become entangled in plastic bags tossed in waters by polluters, she said.Before her recent record-setting swim, Liivand had navigated the Bosphorus, the Golden Gate Straits, the Pacific Ocean and the Baltic Sea. But Miami’s sunny Biscayne Bay presented unique perils, such as the potential for overheating and exhaustion.She trained by waking up at 4am daily for more than a year, and took magnesium and potassium pills to reduce the likelihood of leg cramps. Before the big day, she loaded up on small meals she could easily digest, such as smoothies, baby food and soup.Along the way, she encountered much of the marine life for which she is trying to raise awareness – including a jellyfish that stung her.“I … kept telling myself that it was not the time to cry,” she said.She also collected trash as she swam, handing it up to a friend who followed her in a kayak.“It’s unfair that we have gotten to the point that fish, dolphins and turtles are surrounded by plastic which ends up in their stomachs,” Liivand said. “I feel that we as humans are next.” | Global Health |
Eli Lilly stock and Novo Nordisk stock both skidded Tuesday on a report that most patients taking weight-loss drugs like Wegovy stopped within a year.X
According to an analysis from pharmacy benefits manager Prime Therapeutics, only about a third of patients taking an obesity treatment like Wegovy were still taking it after a year. Meanwhile, total health care expenditures for the group rose markedly, Reuters reported.
The report is bearish for companies like Eli Lilly (LLY) and Novo Nordisk (NVO). Novo sells a pair of weight-loss drugs called Wegovy and Saxenda. Lilly is hoping to follow with its diabetes-turned-obesity treatment, Mounjaro.
And a slew of others are working on similar drugs that rely on the same target: a gut hormone called GLP-1 that controls satiety signals and how fast the stomach empties.
In morning trading on today's stock market, Eli Lilly stock slumped 1.7% near 445.60, while Novo Nordisk stock toppled 2.8% near 152.70.
Eli Lilly Stock: Soaring Health Care Costs
On average, patients were paying $12,371 a year for health care costs before starting Wegovy or a similar weight-loss drug, according to the analysis. After starting to take the obesity treatment, costs soared 59% to $19,657.
For the analysis, Prime counted all new prescriptions in the GLP-1 drug class between January and December 2021 for patients diagnosed with obesity, prediabetes or having a body mass index of 30 or higher. The company excluded patients with type 2 diabetes.
Nearly half of patients were taking Novo's injected drugs, Wegovy or Ozempic. The latter is a type 2 diabetes treatment that has been used off-label as a weight-loss drug. Others received weight-loss drug Saxenda or Rybelsus, an oral diabetes treatment.
Overall, 32% of patients were still taking their weight-loss drugs a year after the initial prescription, spelling bad news for Eli Lilly stock and Novo Nordisk stock. All patients had insurance coverage.
It's unclear why patients dropped their weight-loss drugs. Many patients don't receive insurance coverage for obesity treatment. It's possible these patients might not have been able to foot the continued bill for copays or deductibles. GLP-1 drugs are also tied to gastrointestinal side effects.
Novo Nordisk stock fell to its lowest point since March, sliding out of a flat base with a buy point at 172.97, according to MarketSmith.com. Eli Lilly stock dipped out of a profit-taking zone after breaking out of a cup base with an entry at 375.25 in April.
Novo Nordisk Stock: A New Side Effect?
The report comes on the heels of news that the European Medicines Agency is investigating a potential tie between some of Novo's diabetes and weight-loss drugs and suicidal thoughts.
The Icelandic Medicines Agency noted two cases of suicidal thoughts in patients who used Ozempic and Saxenda, according to Reuters. Another patient on Saxenda reported thoughts of self-injury. Saxenda also impacts GLP-1, but uses a different chemical from Ozempic, Wegovy and Rybelsus. The latter three use an active ingredient called semaglutide.
Eli Lilly stock and Novo Nordisk stock have surged on enthusiasm for their weight-loss drugs. Lilly shares have a strong IBD Digital Relative Strength Rating of 90 out of a best-possible 99. This puts the stock's 12-month performance in the leading 10% of all stocks. Novo shares have an RS Rating of 84.
Follow Allison Gatlin on Twitter at @IBD_AGatlin.
YOU MAY ALSO LIKE: | Drug Discoveries |
A recent report from the Centers for Disease Control and Prevention revealed the fungus Candida auris is spreading rapidly through U.S. health care facilities.
Also known as C. auris, reports of cases linked to the drug-resistant fungus have doubled in 2021.
In addition, the fungus is behind an outbreak in Mississippi that began in November, infecting at least 12 people and potentially responsible for about four deaths, according to figures provided by the state Department of Health to ABC News.
Although C. auris does not present a threat to most healthy people, and infections are rare, it can affect vulnerable groups of people and can be resistant to several classes of drugs.
Here's what to know about the fungus, why these rare cases occur and how Americans can help prevent the spread.
What is Candida auris?
"C. auris is a species of Candida and Candida is the most common yeast that causes human infections," Dr. Shira Doron, chief infection control officer for Tuft Medicine, told ABC News. "People are quite familiar with the term 'yeast infections' or 'thursh'; those are caused by other species of Candida."
According to the CDC, it's a relatively new type of fungus, being first identified in Japan in 2009.
However, studies conducted since then have found samples of C. auris can be dated back to South Korea in 1996.
Public health experts refer to C. auris as an emerging pathogen, which means an organism that has newly appeared or been discovered but has since rapidly spread -- either in terms of cases or countries where it is now reported.
Why is C. auris potentially dangerous?
Dr. Scott Roberts, associate medical director of infection prevention at Yale School of Medicine, told ABC News that C. auris can spread either from person-to-person transmission or by people coming into contact with contaminated surfaces.
"This spreads person to person and we do not think of really any other fungus as spreading person to person in a meaningful way," he said. "And it's really hard to kill. Standard Lysol wipes, disinfectant wipes don't kill it. We need dedicated bleach wipes or additional products geared for Candida auris."
The other issue is there are strains of C. auris that are drug-resistant, meaning infections caused by the yeast will not respond to multiple antifungal drugs commonly used to treat Candida infections.
How is it diagnosed?
Patients with C. auris infections are typically diagnosed after cultures of blood or other bodily fluids are analyzed.
However, experts said this can be difficult because analyzing these cultures requires updated machines or updated libraries, not all labs of which have the capability.
Additionally, it can be hard to identify C. auris on the culture results and it can be confused with other species of Candida.
"The way cultural results come back, first it's like, 'Okay, it looks like yeast,'" said Doron. "Then it's like, 'Okay, it looks like Candida' only it could take days before it's Candida auris and you may be using the wrong drugs."
Who is at risk?
Most healthy people do not need to worry about C. auris infections, experts said.
However, those with weakened immune systems or who are immunocompromised are at risk of hard-to-treat infections.
Additionally, nursing home patients or hospital patients who have or have had lines and tubes in their body -- such as a catheter or a breathing tube -- are also at high risk.
How are C. auris infections treated?
Despite several strains C. auris infections being multi-drug resistant, there is a class of antifungal drugs called echinocandins that can be used and are given intravenously.
According to the National Institutes of Health, echinocandins prevent a key enzyme needed to maintain the cell wall of the fungus.
In some cases, when the infection is resistant to all three main classes of drugs, multiple high doses may be required, the CDC said.
Are C. auris infections fatal?
According to the CDC, studies are limited but anywhere between 30% and 60% of people with C. auris infections have died.
However, many of these patients also had other serious illnesses that also increased their risk of death.
"Unless there's a break in the skin or some sort of deeper systemic infection, the risk of mortality, or some deeper complication, is relatively low unless that fungus gets in a place that it should not be," Robert said. "For example, there's a break in the skin, it gets in the bloodstream and there's a Candida auris blood stream infection, and that can be quite fatal."
He continued. "Candida auris, it sticks to everything. It can stick to heart valves and stick to catheters. I do want to emphasize that's a rare occurrence, though."
What can we do to prevent the spread?
There's not much that can be done on an individual level to prevent the spread of the fungus, but the experts recommend avoiding patients with C. auris infections and that people practice proper hand hygiene when visiting at-risk populations such as hospital patients or nursing home residents.
Doron said people also need to be careful about the overuse of antibiotics. While they can be helpful in treating some infections, these medications can kill off bacteria in the gut and give more room for yeasts like C. auris to grow.
Roberts said there needs to be continued focus on equipping more labs to easily identify C. auris and focus on public health infrastructure that can identify, isolate and group patients who are infected.
"There's many examples of this but, you know, a nursing home, a patient has Candida auris," he said. "They spread it to their roommate, for instance. It's really critical in that standpoint to have a mechanism to test everyone else in the nursing home to see who's infected, put them in an isolated area, like one hallway, and put those who aren't colonized in the other hallway."
Roberts continued, "And if that patient needs to get admitted to the hospital, we let the hospital know this patient should be in Candida auris isolation. Don't reuse blood pressure cuffs on that patient and go to the next patient, for instance."
ABC News' Aerial Petty contributed to this report. | Epidemics & Outbreaks |
Dennis Cook/AP
toggle caption
President George H. W. Bush holds a bag of crack cocaine as he poses for photographers in the Oval Office of the White House, Sept. 5, 1989.
Dennis Cook/AP
President George H. W. Bush holds a bag of crack cocaine as he poses for photographers in the Oval Office of the White House, Sept. 5, 1989.
Dennis Cook/AP
On Sept. 5, 1989, President George H.W. Bush appeared on live television to discuss what he called the nation's "gravest domestic threat." Sitting at his desk in the oval office, Bush held up a bag of crack cocaine that had been seized in a park across from the White House, saying: "It's as innocent looking as candy, but it's turning our cities into battle zones."
Looking back now, author and journalist Donovan X. Ramsey describes Bush's press conference as a form of propaganda designed to create a panic about the crack epidemic and to "demonize drug dealers and also addicts."
"George H.W. Bush really wanted to start his administration with a bang and being tough on crime and was a big part of that," Ramsey says. "His office made a decision that they wanted to give a big address on drugs and they wanted to use crack cocaine as a prop."
In his new book, When Crack Was King: A People's History of A Misunderstood Era, Ramsey examines the crack epidemic of the 1980s and early '90s from the points of view of four people who lived through it — and considers the lasting harm inflicted on the Black community by the government's response. For Ramsey, who grew up in Columbus, Ohio, the story is personal.
"Being a Black man who was born in 1987, the crack epidemic predates me; I've never existed in a world where crack didn't exist," he says. "So I had this real kind of deep yearning to ... fill in what felt like a gap in between the civil rights movement that we hear so much about and where we are today. And the crack epidemic seemed like that missing link."
Ramsey traces the advent of crack to a group of chemistry students at U.C. Berkeley who devised a recipe for freebasing cocaine using water and baking soda. The resulting substance provided a cheap, smokable way for people to get high quickly.
Crack spread "like wildfire" across America, Ramsey says, but it tended to hit Black neighborhoods particularly hard: "What it means to be Black in this society is to be hit first and worst."
As the epidemic took hold, the media presented apocalyptic views of Black neighborhoods transformed by the drug, and warned of a coming wave of "crack babies." Meanwhile, instead of treating the issue as a public health emergency, politicians instituted sentencing guidelines that punished users of crack more harshly than users of powdered cocaine.
"It was originally 100-to-1, meaning that you got essentially 100 times the amount of [prison] time for crack than you would for the same substance in powder form," he says. "That was reduced to 18-to-1 around 2010. But it still exists. With all that we know about crack, with all the compassion that we have now for addicts, we still haven't moved far enough to eliminate that disparity entirely."
Interview highlights
On the government's role in allowing cocaine into the country in the 1980s
We had ongoing efforts in South and Central America, in countries like Nicaragua, where we wanted to support rebels, known as Contras in Nicaragua, to overthrow their government. That was in our political interest. But Congress would not allow the U.S. government to fund a war in another country. So the U.S. government got creative — and this is well documented — through programs to actually deliver weapons to the Contras. And when that was no longer feasible, when that became exposed through Ollie North in the whole Iran-Contra affair, we just allowed them to smuggle drugs.
And so a lot of those drugs, cocaine, ended up in the United States. And this has been investigated by a commission led by John Kerry, by efforts led by Maxine Waters. It's well documented through reporting at the time that there were lots of Contras that were selling cocaine to the two dealers in the United States. And a lot of it ended up in cities on the West Coast, in Oakland and in Los Angeles.
On how the anti-drug campaign spearheaded by Ronald and Nancy Reagan vilified drug users
They helped to fund the partnership for a Drug Free America, which produced lots of those really memorable commercials like the scrambled egg [PSA ad]: "This is your brain on drugs." And there also was a real campaign to ask Hollywood directors and writers to send their scripts to the White House for approval, ways of working in anti-drug messaging. This is how you get Nancy Reagan on an episode of Diff'rent Strokes. This is how you get Jesse on Saved by the Bell saying, "I'm so excited. I'm so excited. I'm so scared," because she's hopped up on speed. ... This is the birth of the "very special episode." And we have them to thank for that.
Look, I'm a kid of the '80s. I remember so much of that messaging. ... It didn't really teach me anything useful about drugs. What it really did was just made me deathly afraid of drug addicts. It made me keep people who I even suspected of being drug addicts — the average houseless person on the street — so far away from me because I was terrified that they were just these zombies that were out to get me and to get me hooked on drugs. It made them untouchables. ... I think that many people will will try to credit Nancy Reagan and the "Just Say No" campaign and DARE and all that stuff for ending the drug epidemic or the crack epidemic. There's no evidence of that. But I do think there's lots of evidence that the propaganda made us not understand addiction in ways that we're still paying for.
On the myth of the "crack baby"
A researcher named Ira Chasnoff in Chicago did one study of a handful of Black mothers who were cocaine users. And what he found after those mothers had given birth was that many of their babies had things like tremors and low birth weight, and they sort of struggled to meet benchmarks in their infancy. And from that, he published a report about cocaine-exposed babies that then launched what became this "crack baby" notion. And lots of reporting was done about these irredeemable babies, mostly Black and Latino children, and how they were going to be a huge weight on society, that they would sort of never be able to come back from what their mothers had done to them.
Charles Krauthammer, a columnist who was writing for the Post at the time, said that death would have been more suitable for these babies than to actually live. And what we've seen through the research, longitudinal studies of cocaine-exposed babies, was that ... the symptoms that Chasnoff were seeing were actually related to premature birth. [Read more on that reasearch here.] That the effect of cocaine is that it can cause complications that then lead to premature birth, and that the tremors and the developmental things that were being seen in infancy were actually associated with the babies being born early, and not necessarily with the cocaine exposure. And then, decades later, there is no measurable difference between those children and their counterparts, children born at the same time raised in the same areas with the same sort of resources. So I say that to say that the "crack baby" myth has been debunked.
On how the "crack baby" myth impacted all Black children
For me, as a Black child growing up in the '80s and '90s, I was treated as though I was a suspect of being a "crack baby," that the ways that teachers treated me and really other Black children in my classes — mainly Black boys — was as though there was something fundamentally wrong with us that we needed to be maybe medicated to be able to be in class, or that any challenge that we presented as students, whether it was talking too much, which was my problem, or if it was not being able to sit still, that that was evidence that something was wrong with us.
On crack providing a way for members of the Black community to escape poverty
I hadn't really considered this when I set out to write the book because in my family, drug dealers had really kind of always been villainized, even though I had relatives that sold drugs. ... For the average, usually young, man, someone like Shawn McCray, who I write about in my book, is that you saw people who had walked holes in their shoes, whose families struggle to pay the rent, be able to provide basic necessities to have some piece of what maybe felt like the American dream. Not most drug dealers got rich, not most were kingpins ... or super predators who were out to get kids hooked on drugs and who were eager to get into gun battles in the middle of streets. Most of them were terrified for their lives. But it was really the only way that they could make money in a period where unemployment was so high, and Black youth unemployment was even higher. And anybody that's been a Black teenager trying to find a job understands just how frustrating that can be.
On how the crack epidemic came to an end
The crack epidemic ended not because the drug warriors rode in on white horses or because Nancy Reagan said, "Just Say No." The crack epidemic ended because the next cohort of young people who would have used crack looked around at their communities and saw the devastation and said, "Not for me." And I think a really important thing to underline, is that .. we didn't celebrate that. So let's celebrate the fact that the crack epidemic is over. Let's celebrate the fact that we survived it without a whole lot of intervention from the government and that it was young people who made the decision to not continue the trend. And that's not according to me. That's according to research by the Department of Justice, where they surveyed the hardest hit cities around the country and interviewed young people and said essentially "Why? Why aren't you doing crack?" And they said, "That whole world is too scary."
On the difficulty of telling this story
In covering Black America, I've also had to cover a lot of tragedy and hear a lot of traumatic things from people. And I had always prided myself on being able to kind take it in and to process it and turn it into something beautiful and meaningful and not be affected. But after five years of putting together this book, I was completely wrecked. I lost 40 pounds. I had a heart tremor where I was getting palpitations and had to wear a heart monitor. Every loud noise scared me. My nerves were completely shot. ...
I had to take seriously what had happened and what had happened to the people that I talked to, and how seriously impactful those events were in their lives and how the stuff that I went through impacted me. I was a kid having to get down on the ground when I heard gunshots. And that was just a normal thing: You're in the middle of play, you hear gunshots, you get on the ground, you get back up and you keep playing. Having my first bike stolen by a crack addict and the fear of having to go home and explain that to my mom, that I had given somebody my bike to fix and he never came back with it. That stuff lived in me and it needed to be excavated.
I want to say that that I'm doing much better now, including having gained the weight back, unfortunately. But I think the message from that for me is that lots of us that lived through that period, we still have some stuff that we have to deal with. We need to ask our family about that aunt or uncle who kind of disappeared and nobody talks about. We need to first learn their stories, then lift their stories up as a part of our stories. ... We won't heal until we make sense of the crack epidemic — not as this aside, but as a part of who we've been and what we've been through.
Sam Briger and Thea Chaloner produced and edited this interview for broadcast. Bridget Bentz, Molly Seavy-Nesper and Meghan Sullivan adapted it for the web. | Drug Discoveries |
The federal government may be in the process of formulating a National Dementia Action Plan (NDAP) for the next 10 years, but advocates want to see more funding for dementia support in this month's federal budget.
Key points:
- Dementia Australia has requested $66 million over the next four years in the 2023 federal budget
- It says dementia will soon surpass heart disease as the leading cause of death in Australia
- The government's National Dementia Action Plan will not be released until 2024
Dementia is the leading cause of death for Australian women and the leading cause of premature death in older Australians.
About 400,000 people of all ages are living with some form of dementia across the nation, which is expected to nearly double in the next 30 years.
In its 2023 pre-budget submission to the government, Dementia Australia chief executive Maree McCabe said it had called for $66 million over the next five years for three key focus areas.
"Number one is workforce," she said.
"It's about mandatory education for all people working in aged care."
Ms McCabe said 70 per cent of the 300,000 people living in residential aged care had dementia, which was why workers in residential aged care and community care needed better education.
The peak body was also prioritising risk reduction programs and creating dementia-friendly communities.
"The research is becoming more compelling, that changes in lifestyle, modifiable life factors, can make a difference to reducing our risk of developing dementia," Ms McCabe said.
She said it was vital Australia had a national plan after the previous National Framework for Action on Dementia expired in 2020.
"We've been involved in that process, supporting people living with dementia having input … so it's important that all governments get behind the plan and support that."
A Department of Health and Aged Care spokesperson said the NDAP's public consultation process between November 18 and January 31 had "attracted a high degree of interest," but the final plan would not be released until 2024.
Dementia impacts increasing
According to provisional data from the Australian Institute of Health and Welfare, dementia will soon take over as the leading cause of death in Australia.
It is currently second to Ischaemic heart disease.
Ms McCabe said its growing impact was a key reason why more research and funding was needed.
"Without a breakthrough of some sort, we're looking at around a million people living with dementia by 2058," she said.
"There just won't be anyone in Australia that doesn't know somebody who is living with dementia."
"One of the most critical things is for carers of people living with dementia to get support because they cannot support their loved one with dementia if they are not getting support."
Managing dementia
Veronica Parker experienced first-hand the struggle of caring for a loved one with dementia and said earlier support would have helped her late mother, Pat Parker.
Ms Parker said her family first started to notice Pat's symptoms when she could not remember her grandchildren.
Pat was diagnosed with early onset dementia in her late 50s.
Her husband Leo Parker became her primary carer and they lived on their Quambatook farm, in rural Victoria, where her condition progressively worsened.
The couple had cleaning support through their local council and a weekly visit from a nurse, but Ms Parker said getting government assistance was challenging.
"Like any governmental thing, you've got to jump through hoops to get the help and if you don't ask for the help you don't know what's out there, and it's hard to find the help unless you know where to ask," she said.
Anaesthetic during hip surgery and a fall only hastened Pat's condition, and she eventually moved into a nursing home half an hour away in Wycheproof.
COVID-19 lockdowns prevented Veronica from seeing her mother throughout much of 2020, but she was by Pat's side when she died in 2021, aged 77.
"Apart from trying to make her comfortable, there's no way you can understand what they're going through," Ms Parker said.
"It's just a horrible disease to see taking over a loved one's life."
Government programs listed
The Health and Aged Care spokesperson said the government had provided $640 million over four years to support people living with dementia, and their carers.
That included funding for a national dementia training program for health and aged care professionals, and specialist support for people experiencing behavioural and psychological symptoms of dementia.
Minister for Health and Aged Care Mark Butler last month announced funding for a range of budget measures to strengthen Medicare, which would contribute to providing additional support for people living with dementia. | Disease Research |
Since the pandemic began in 2020, Zoom video teleconferences have become a new normal for many people’s working life. Now a study finds that these virtual meetings exhaust the brain more than face-to-face communication.
Lockdowns due to COVID-19 led to skyrocketing adoption of Zoom, Skype and other videoconferencing tools as substitutes for face-to-face meetings. For example, as the new research points out, the number of Zoom.us monthly visits went from 71.6 million in December 2019 to an all-time high of 2.8 billion in October 2020, falling to 943 million in March 2023.
This rise in remote work and online learning has revealed a phenomenon often dubbed “Zoom fatigue,” a feeling of exhaustion linked with videoconferencing.
Previous research depended on questionnaires. The new study examined the effects of videoconferencing directly on the brain and heart.
“The personal implications of Zoom fatigue extend far beyond mere tiredness,” says study co–senior author René Riedl, an information systems researcher at the University of Applied Sciences Upper Austria in Steyr and Johannes Kepler University Linz in Austria. “Individuals grapple with increased stress levels, a reduction in productivity, and a pervasive sense of disconnection.”
In addition, “On a broader social scale, the consequences materialize as a potential deterioration in the quality of communication and collaboration, impacting both professional and personal relationships,” says study co–senior author Gernot Müller-Putz, a biomedical engineer at Graz University of Technology, in Austria. “The absence of nuanced nonverbal cues in virtual interactions inhibits the richness of communication, making it challenging for participants to fully engage and connect in a meaningful way.”
Previous research into videoconference fatigue depended on questionnaires. In the new study, Riedl, Müller-Putz, and their colleagues examined the effects of videoconferencing on the brain and heart.
The scientists had 35 university students all take part in 50-minute lectures that were held both in person in a conventional lecture hall and online via videoconferencing. The researchers analyzed the effects of these meetings using electroencephalography (EEG) and electrocardiography (ECG). These methods noninvasively record brain and heart activity using electrodes stuck on the head and chest, respectively. They also gave the volunteers questionnaires asking about fatigue and mood.
“We found that after 50 minutes of videoconferencing, significant changes in physiological and subjective fatigue could be observed.”
—René Riedl, Johannes Kepler University Linz, Austria
The brain and heart readings suggested that videoconferencing led to significantly greater signs of fatigue, sadness, drowsiness, and negative feelings, as well as less attention and engagement, than a face-to-face lecture. The questionnaires also showed the volunteers felt significantly more tired, drowsy, and fed up and less lively, happy, and active from videoconferencing than face-to-face sessions.
When it comes to finding ways to reduce videoconferencing fatigue, “individuals and organizations can adopt practices such as scheduling regular breaks,” Riedl says. “Based on our research results, we recommend a break after 30 minutes, because we found that after 50 minutes of videoconferencing, significant changes in physiological and subjective fatigue could be observed. Moreover, utilizing features like ‘speaker view’ to mitigate the intensity of perceived continuous eye contact could be helpful.”
Videoconferencing tool developers may also investigate “designing platforms that not only facilitate natural communication, but also replicate the nuanced dynamics of face-to-face interactions, thereby reducing the cognitive load associated with virtual meetings,” Müller-Putz says. However, “in our opinion, it is not possible to fully replicate natural face-to-face interactions, for which human evolution has endowed us with specific capabilities, in particular those related to brain function.”
All in all, the scientists do note that it is unrealistic to completely abstain from videoconferencing. Still, they say these findings suggest that videoconferencing should be viewed not as a wholesale substitute for face-to-face communication, but as a complementary tool.
“It is important to underscore how a supportive work culture, rooted in understanding the nuances of virtual interactions, can substantially alleviate the impact of prolonged reliance on digital communication platforms,” Müller-Putz says. “Videoconferencing is just one form of electronic communication. Several other forms, like email communication, social-collaboration platforms in organizations, the extensive use of mobile phones, and communication via avatars in the metaverse, should be studied more extensively in the future. In particular, we recommend investigating the various implications of the use of such communication forms, including stress, cognitive workload, well-being, health, development, satisfaction, and productivity, among others.”
One potential criticism of this work is how much these findings might apply beyond the context of university lectures. “Other research groups are invited to replicate our findings in other contexts, such as the business context,” Riedl says. “Moreover, future studies could also complement our findings by the use of other neuroscience and physiological measurement tools.”
The scientists detailed their findings online 26 October in the journal Scientific Reports. | Stress and Wellness |
Boris Johnson's chief adviser during the coronavirus pandemic, Dominic Cummings, has said he will give evidence to the UK COVID-19 Inquiry later this month.
Mr Cummings used his latest Substack post to reveal he had been going through his statement with inquiry lawyers, describing the process as "painful".
"I finally sent it in on Thursday. I give evidence on 31/10," he wrote.
Mr Cummings was Mr Johnson's closest aide when the pandemic emerged, and the government was forced to defend him after he drove to County Durham beauty spot Barnard Castle during the first lockdown.
But he left Downing Street in November 2020 following infighting in No 10 and has since become a fierce critic of the former prime minister, suggesting he was indecisive in the response to coronavirus.
In his blog, Mr Cummings said he would eventually do a "post-evidence AMA (ask me anything)" on his and other people's statements to the inquiry, but he had been asked not to write about it yet.
He also criticised the pace of the inquiry, which began this summer and has so far heard evidence from significant political figures, including former health secretary Matt Hancock and ex-prime minister David Cameron.
The first part of the inquiry looked at the UK's resilience and preparedness for a pandemic.
The second part of the public inquiry - which focuses on "core decision making and political governance" - started at the beginning of this month and will also see Mr Johnson give evidence.
The inquiry has already heard how Mr Johnson described long COVID as "b*******" and that his wife, Carrie, had been described as "the real person in charge" by the head of the UK's civil service.
Scientific advisers have also given evidence, with Professor Stephen Riley telling the inquiry on Tuesday that there could have been fewer deaths if the UK went into the first lockdown two weeks earlier.
Meanwhile, Professor Neil Ferguson - whose COVID modelling was instrumental to the UK going into lockdown - denied stepping "over the line" and telling ministers they needed to shut down.
Read more:
Up to 200,000 people to be monitored for COVID this winter to track infection rates
COVID vaccine scientists win Nobel Prize in medicine
He said while he is "very much associated with a particular policy... the reality was a lot more complex".
"I don't think I stepped over that line to say: 'We need to do this now'," he said.
"What I tried to do was, at times - which was stepping outside the scientific advisory role - to try and focus people's minds on what was going to happen and the consequences of current trends." | Health Policy |
In late 2016, Hugh Harvey was working as a consultant doctor in the UK’s National Health Service. Harvey had dabbled in machine learning while doing a research degree, and had seen the potential for artificial intelligence to revolutionize health care. But he felt strongly that the introduction of AI into medicine was not going to come from within the NHS—it was going to come from industry. So when an opportunity opened up at a buzzy new health-tech startup, Babylon Health, he applied.Founded in London in 2013 by Ali Parsa, a British-Iranian ex-banker, Babylon had a lofty goal: It wanted to do with health care what Google did with information; that is, make it freely and easily available to everyone. By the time Harvey joined the company in 2016, it was already picking up tens of millions in venture capital funding—even though at that point, all it had built was an app that let patients have video calls with their doctors. Helpful, yes, but not exactly revolutionary. The company’s value was in its grand ambition to add on an AI-powered symptom checker, which would speed up—or even automate—diagnoses.Accustomed to the frugal conditions of the perpetually cash-strapped NHS, Harvey says he was taken in by the lavish setup: laptop waiting for him on his desk, fancy office in upmarket South Kensington, free office beers and pizzas at lunch. But soon, Harvey got to take a peek at the software that was behind all the excitement. What he was shown was a bunch of Excel spreadsheets containing clinical decision pathways written by junior doctors at the company. They had essentially divided the body up into different parts, and depending on which part of the body the user clicked on, the app would follow what they called “clinical flows,” or decision trees. “I was like, well, this isn't really artificial intelligence,” Harvey recalls thinking.But over the next few years, the hype around Babylon just kept growing. It picked up contracts with the NHS and British health insurance providers. Chinese tech giant Tencent signed a deal to offer services through WeChat. Saudi Arabia’s sovereign wealth fund invested $550 million. By the time it went public on the New York Stock Exchange in 2021, Babylon was valued at $4.2 billion. But the wheels were already coming off. The company’s losses were mounting as it spent big to chase growth. Its share price quickly went into free fall. In mid-August this year, after a rescue deal fell apart, it was announced that the UK side of the business was going into administration—a process similar to bankruptcy protection in the US. The company shuttered its US headquarters, laid off scores of employees, and filed for bankruptcy there, too.WIRED spoke to three former employees at Babylon Health to uncover what went so wrong for the darling of the “digital-first” health-tech landscape. What they say about the company’s collapse—at a moment when VC interest in AI and health care is at a fever pitch—is a warning about the dangers of backing hype over delivery.Neither Parsa nor Babylon Health responded to multiple requests for comment.Parsa named his company after the ancient city of Babylon, which, according to the Greek historian Herodotus, had a square where citizens gathered to share tips on how to treat their ailments.Former employees say Parsa was obsessed with “blitzscaling”—the kind of entrepreneurial hypergrowth popularized by LinkedIn cofounder Reid Hoffman. The company went on uncontrolled hiring sprees, ex-employees say, and teams were often working on overlapping projects. Three teams were working on three different, mutually incompatible versions of the symptom checker at one point, says an ex-employee, who spoke on condition of anonymity. The employee says they once found a product manager wandering the building on his second day at the company. He had been left looking for a team to work with because nobody had onboarded him or told him where he should be. “He assumed it was some kind of onboarding ‘challenge’ to just find a team to join,” the employee says.The C-suite experienced lots of turnover. Senior leadership would go on retreats to Antigua, which wasn’t widely known by staff—until it was leaked on a public Slack channel. Parsa “once presented a stand-up from Antigua while pretending to be in his office,” one ex-employee says. Former staff say Parsa’s leadership style was “idiosyncratic” and “occasionally megalomaniacal.” At one point, Parsa tried to ban Microsoft PowerPoint at the company. Workers, whom Parsa referred to as Babylonians, were chastised by the CEO for leaving at 5:30 pm, Harvey says.Parsa’s rush for scale outpaced Babylon Health’s ability to actually put out finished products, according to former employees. After Harvey joined, the company reassured him that its data science team was working on a knowledge graph, which connects bits of knowledge by probabilities. What this looked like was Harvey and his clinician colleagues answering thousands of medical questions, like “What is the probability of someone with jaundice having hepatitis?” The questions progressively became more fine-grained; what's, say, the probability of someone having two weeks of jaundice and having hepatitis B?“The questions just became more and more ridiculous and unrelated,” Harvey says—and it still wasn’t really AI. (Another former employee of Babylon Health, who worked on the AI team, says that it’s likely that the machine learning team just showed Harvey Excel spreadsheets for simplicity, but admits the decision tree model was “not particularly sophisticated.”)At one point, the BBC were scheduled to visit the office to film the technology. But there was one problem: The app hadn’t been finished yet. It had only been modeled for gastroenterology; basically, stomach problems. It had no interface, so Harvey recalls a data scientist having to sleep in the office for several nights and over the weekend as they raced to build something that looked like an app. “But we all knew … that's not the product we're building,” Harvey says. “This is a mock-up of something that has been put together in haste with a lot of man-hours to demonstrate to the BBC.” Harvey’s account was corroborated by another former employee.Babylon’s symptom-checking app, called GP at Hand, was launched in 2017, promising to help tackle the NHS’s long waiting lists by automating some patient inquiries.Harvey’s role at Babylon was to get the go-ahead from regulators that the app could be used to triage patients—a preliminary assessment that ascertains how urgently a patient needs to be seen by a doctor. But this was not the party line. Parsa was publicly saying in 2017 that it could diagnose patients: a much grander statement. Harvey says Parsa would come up to him on a near daily basis to ask whether they had gotten regulatory clearance yet. Harvey would explain that they would get it—but only to triage.Later that year, the company claimed its AI performed better than humans on an exam used to test doctors’ ability to diagnose (a claim that was quickly questioned by experts). By then, Harvey had quit and returned to the NHS as a consultant radiologist. But the GP at Hand app grew in popularity—albeit not without criticism by health care professionals.One of the first people to raise the alarm about the effectiveness of Babylon Health’s AI was a consultant oncologist for the NHS, David Watkins. Tweeting at first under the alias @DrMurphy11, Watkins regularly documented online the unusual departures from the clinical norm the bot would take, like asking a 66-year-old woman concerned about a breast lump whether she was pregnant or breastfeeding, and failing to spot the symptoms of a heart attack. The company dubbed him a “troll” in a public statement. But Watkins’ concerns were also reportedly shared within the company, and, it turned out, by the UK’s medical regulator.A 2017 report from the Care Quality Commission, the regulator of health and social care services in England, called the safety and effectiveness of the company’s services into question—for which Babylon threatened to sue. In 2019, WIRED reported that Babylon was costing the NHS upward of £26 million ($32 million). Then, in 2020, the company admitted that its GP at Hand app had suffered a data breach which meant users were able to see dozens of video consultations done by other patients. And, even as its service was being adopted across the country, Babylon Health was struggling to make its model work financially in the UK. Parsa blamed its failure on structural problems within the NHS that meant it never managed to turn a profit. It quit its final NHS contact in August last year.But Parsa had long held ambitions to go global anyway. The company set up shop in Canada—but sold its operations there in 2021 as part of a licensing deal. The same year, a Canadian government investigation found the app was not compliant with the country’s privacy regulations. Babylon shifted its focus to the US, where it could make more money through health insurance programs Medicaid and Medicare. Parsa even relocated there.But the US venture was also ultimately doomed. It was entering a very crowded market, and wasn’t ready to compete. “There are a lot of scaled telemedicine companies here that have been around a lot longer than Babylon,” says Christina Farr, a health-tech investor at OMERS Ventures in San Francisco.One ex-employee says that Parsa didn’t fully understand that the US was a mature market. The final straw for the employee was when they saw a contract being drawn up to provide telehealth services in Missouri through Medicaid. Essentially, Babylon would be taking on all of the financial responsibility and financial liability of a health insurer, but without any of the sky-high premiums that are required to cover that kind of liability. “I was like, ‘No, absolutely not,’” says the ex-employee. “‘This is going to go tits up, and I don’t want to be around when that happens.’” They quit.Even the company’s stock market debut quickly went south. Within 18 months of listing, its shares had dropped 99 percent. Parsa described the nosedive as an “unbelievable, unmitigated disaster.” It wasn’t that surprising. Although Babylon was generating revenue, it was losing a lot of money. In 2022, the company lost $221 million. In the first three months of 2023, it lost a further $63 million. In May 2023, the company's biggest lender, Albacore Capital, took the company private and tried to merge it with another health-tech company, MindMaze. The merger fell through in early August.Babylon isn’t the first company at the interface of AI and health care to struggle to move from hype to commercial success. Its fate “raises questions around how you commercialize AI in health care,” says David Wong, an associate professor of health informatics and data science at the University of Leeds in the UK. Wong points to another failure: the collapse of Sensyne Health, an AI startup, which cost two NHS trusts $18 million when it was delisted from the London Stock Exchange in 2022. The same year, IBM dumped Watson Health. Olive AI, a health care automation startup valued at $4 billion in 2021, fired a third of its staff in February 2023.The reason companies like Babylon fail, experts say, is simply that it’s hard to replace flesh-and-blood clinicians with an algorithm, and there’s an inherent mismatch between the move-fast-break-things culture of tech startups and that of health care, where caring for patients requires thoughtfulness and context.“I think probably the tricky part of the startup world is there are a lot of people with ideas, and most of them won't work,” Wong says. “And I think if there were more clinicians on board, most of them would be very quick in telling you which ones had a chance of working and which ones didn't.” | Medical Innovations |
Chris Bonnello, 37, was diagnosed with Asperger syndrome in 2011. But these days he just says he’s autistic. “A lot of us did not want to let go originally, it was something that fitted us very nicely,” recalls the teacher turned autism advocate who runs a website called Autistic Not Weird from his home in Nottingham. “But it is better for autistic people if we are all recognised, acknowledged and appreciated together.”
Sarah Weston, 47, received a diagnosis of autism spectrum condition in 2019. Yet in daily life she describes herself as an “Aspie” – an informal, affectionate term for a person with Asperger syndrome. She doesn’t have the complex learning disabilities some autistic people do and which non-autistic people can think of when they hear autism. She says using Aspie or Asperger’s just helps outsiders understand what she’s like and clears up confusion. And she is certain, based on her cognitive and language abilities, that she would have received the Asperger’s label had she been diagnosed earlier.
Weston says she is not trying to separate herself from other autistic people because she thinks she’s special; she would much rather not have the complex struggles that come with her disability. Although she has also learned the hard way it is better to stick to calling herself autistic online, where she has been bullied for using Aspie. “The language police will inform you that you can’t use that term because of the link with Hans Asperger and the Nazis,” she says.
It will be 10 years next month that Asperger’s syndrome was removed as an official diagnosis from the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) – psychiatry’s “bible” which heavily influences how countries including the UK make determinations.
Instead of recognising Asperger’s – a social learning disability in a person who has never had any significant problems with language development and isn’t intellectually impaired – the so-called DSM-5 created the umbrella autism spectrum disorder (ASD) (“disorder” is often replaced with “condition” in the UK). Collapsed into it was Asperger’s along with autistic disorder – which could come with language and intellectual impairment and was sometimes colloquially called “classic autism” when it did – and some other related conditions. Under DSM-5, individuals with an ASD diagnosis are given specifiers – ASD with or without intellectual or language impairment, for example – and their level of required support indicated on a scale of 1 to 3 (very substantial). Previous diagnoses of Asperger’s transferred over as ASD: no one needed rediagnosis.
While the new framing aroused high emotions at the time, a decade on how have things evolved? Given diagnoses matter for support services, is the reconfiguration really proving the best way to help everyone who needs it across the spectrum? “The spectrum is so broad it doesn’t make much sense,” autistic scholar Temple Grandin, told the Observer last year.
Asperger’s syndrome only had one term – spanning 19 years – in the DSM (where it was called Asperger’s disorder). It was included in DSM-IV, published in 1994, having come to prominence after British psychiatrist Lorna Wing, who developed the concept of an autism spectrum, coined the term. Seeing it as a form of autism, she named it based on Austrian paediatrician Hans Asperger, who had published a paper in 1944 that identified children with a specific pattern of behaviour and abilities he called “little professors”. (Asperger’s involvement with the Nazis came to the fore in 2018 with the publication of Asperger’s Children by historian Edith Sheffer, which presented evidence he was involved in the Third Reich’s euthanasia programme that killed children considered to be disabled.)
There were many reasons for Asperger’s removal in DSM-5, notes Francesca Happé, a professor of cognitive neuroscience at King’s College London, who was on the working group that made the changes. One was a lack of robust, replicable evidence to support a diagnostic distinction between Asperger’s syndrome and “high-functioning autism” (a loose term now considered discriminatory, but which was used in the past to describe individuals who had a picture of autism but good current language and general cognition, despite an earlier delay).
But the “nail in the coffin” was a study of major expert diagnostic clinics across the US showing diagnoses weren’t being given uniformly. Whether you were labelled with Asperger’s, autistic disorder or atypical autism (which could be diagnosed when not all the symptoms to meet the others were present and which was also collapsed into ASD) depended first and foremost on the habits and practices of the particular clinic.
The identity loss for people with Asperger’s diagnoses was one of the biggest concerns at the time, recall those caught in the controversy. A lot of self-advocates didn’t want to trade Asperger’s – which they had been working hard to destigmatise – for autism. Whereas Asperger’s could connote gifted and quirky, autism could suggest someone who had trouble participating in society.
But a frame-shift occurred, says Noor Pervez, community engagement coordinator of the US-based Autistic Self Advocacy Network. People got over the hump and started to realise the line was artificial: “drawn from the outside in”. A spectrum did make sense – Asperger’s wasn’t a separate thing – and carving out an elite pocket wasn’t the solution. There was no better or worse form of autism and no higher or lower; there were just different support needs, and Asperger’s too came with complex challenges that were often overlooked. The self-advocates began to claim autism for themselves with the aim of lifting everyone up, becoming more connected to the wider neurodiversity movement and disability rights movement in the process. “[DSM-5] went against the human need to compartmentalise… and it forced everyone to make peace with one another,” sums up Michael John Carley, a US-based autism self-advocate and campaigner.
Autistic Not Weird’s Bonnello periodically surveys the autistic community on a range of autism-related issues (his 2022 survey had more than 11,000 respondents, mostly from the UK and US, about two-thirds of whom were autistic). While in 2018 about 51% said they used Asperger’s syndrome in relation to their own personal situation or when discussing autism, in 2022 it had plummeted to under 19%. The Hans Asperger revelations occurred between the surveys, notes Bonnello, and while it isn’t personally why he moved away from Asperger’s, it was likely a big driver.
Brenda Dater is the executive director of the US-based Asperger/Autism Network non-profit, which offers programmes and services. The organisation originally campaigned to stop Asperger’s being removed from the DSM-5 because of concerns that without the label community members would no longer be able to find one another. What she’s seen over the past decade is an age split. While older people, who were either diagnosed in their youth with Asperger’s or claimed the title later in life, generally find comfort in its identity, young people now not only don’t receive that diagnosis but are actively rejecting the term. The new generation want to be more inclusive and they also don’t want to be associated with a syndrome named after someone with Nazi ties. “I get many more questions about why we still have Asperger’s in our name versus worries we are going to lose the term,” she says.
In the next few months, the organisation is planning to drop the Asperger’s – something Dater says the community absolutely wasn’t ready for five years ago. She would never, she stresses, tell an individual they couldn’t use the term Asperger’s or Aspie “but as an organisation we need to move away from that”. “Asperger’s is on the way out; I expect it will be gone in the next five or 10 years, and it won’t be coming back,” she says.
Yet it would also be wrong to think there aren’t still those flying the flag for Asperger’s – culture changes slowly – and some campaigners suggest perhaps the shift has been less pronounced in the UK than the US.
There is still some stigma around autism compared with Asperger’s in both countries, says Robert Naseef, a US-based clinical psychologist who advises the Autism Society of America. “The stereotype of ‘classic autism’ endures,” he says. When Naseef gives a diagnosis of ASD requiring level 1 support, he’ll often tell people it was formerly called Asperger’s syndrome. “I soften it a little… but I also explain: ‘You have autism, you are autistic and you are part of a group that is now over 2% of the population.’”
The UK charity Action for Asperger’s, set up and run by Elaine Nicholson, provides specialist counselling services for those “with autism/Asperger’s syndrome” or who live with them. Nicholson has been through some angst with the name – first because of the DSM-5 and then the Hans Asperger revelations – but she’s sticking with it. When people hear autism, they think extremes not “functioning people with difficulties”, which is who her service is aimed at, she explains. “It’s finding one’s tribe,” she says. “I get lots of wives writing in saying: ‘I think my husband has Asperger’s.’ It is never: ‘I think my husband has autism.’”
Nicholson follows a small campaign to reinstate Asperger’s syndrome in the DSM spearheaded by Normand Giroux, a Canadian clinical psychologist who represents a Quebec-based parent association. Giroux has made multiple representations to the APA, the last in 2022, arguing Asperger’s should be reinstated as the “Aspie profile” within the broader autism umbrella to recognise autism’s “most mitigated or partial forms”, but so far to no avail. “They say we are bringing clinical perspectives that are not truly scientific,” he says. But the clinical perspective is important too, he argues.
When Sarah Weston got her diagnosis, she turned to Asperger’s Syndrome People into Everything (Aspie), a small charity that provides a centre in Worcester, where she lives, for adults from the West Midlands who identify as Asperger’s types and where they can feel welcome and accepted (diagnostic services in the area direct people to the organisation). For Weston, it helped her come to terms with her diagnosis and connected her with others to develop a social life. With friends she has made through Aspie she’s been on cinema and theatre trips, to a UK Comic-Con and to watch Aspie’s football team, the Aspie Avengers, which plays in various disability leagues. “They think we’re the weirdos but the truth is the weirdos are outside the door,” she jokes.
Aspie is run by Julia Micklewright, following the vision of her late daughter who set it up in 2011 after being diagnosed with Asperger’s and finding a dearth of services. Micklewright doesn’t support the reconfiguration that has occurred with DSM-5 and agrees with Temple Grandin’s sentiment. “To me, it’s a disservice to people not keeping Asperger’s,” she says. The spectrum is a big place to land. Everyone is lumped together but they have such different needs and concerns. “If you are diagnosed with autism it doesn’t explain much about what your actual condition is,” she says. Asperger’s was, and still is, a useful label that helps people orient and understand themselves. Micklewright notes with pride that when she received her British Empire Medal in 2021 it was “for services to People with Asperger’s Syndrome”. “They’ve tried to wipe it out, but Asperger’s exists,” she says.
Yet while many self-advocates now embrace life on the spectrum, there are different views among experts about whether things are working quite as they should, and how to fix them. One issue is whether people who would have been diagnosed with Asperger’s previously are falling through the cracks under the new system. Fred Volkmar, a professor of child psychiatry at Yale University, led the group that first introduced Asperger’s under DSM-IV. (He was originally on the DSM-5 group but resigned over process issues.) A specific problem Volkmar still sees a decade on is that the definition of ASD was effectively made more stringent under DSM-5 – and people at the margins, who might have qualified for Asperger’s or atypical autism, are missing out on a diagnosis as a result. Those people need identifying too so they can get support. The reduction rate in diagnosis under DSM-5 for those with Asperger profiles was recently estimated, based on a meta-analysis of studies, to amount to about 23% – though Volkmar thinks the number is likely to be higher.
Yet Catherine Lord, a professor of psychiatry at UCLA, who was on the DSM-5 group, disputes that a significant minority of people are getting lost. The reality of DSM-5, she says, is that it simply just isn’t very specific. Symptoms, for example, don’t even have to be current (they can be historic). “Almost all of us, by history, would meet some of the criteria for autism,” she says.
“If people are slipping through the cracks, then other people are slipping in,” says Francesca Happé. Diagnosis rates have increased exponentially over the past 20 years in the UK, she says, with the biggest increases in women and people over the age of 19. And the best interpretation isn’t that DSM-5 has necessarily changed much but that diagnosis is being more widely applied and there’s a historical backlog (in the past, adult diagnosis was uncommon and it was seldom considered that women could have Asperger’s or autism).
Yet Lord does see a different issue with DSM-5. While there are specifiers so people can end up with more qualified diagnoses and the right support bracket, in practice they aren’t often used. And, as a result, she has become particularly worried that people with higher support needs are missing out on services.
In 2022, Lord, as part of a group of other experts and parent advocates of autistic children with high dependency, published a proposal in the Lancet that a new term, “profound autism”, be designated to apply to those with autism who need round-the-clock care. Lord acknowledges the irony – having brought the autistic conditions together she now wants to divide them – but the logic behind it, she explains, is that this group got lost in the shuffle when autism became the new catch-all. “The disability rights movement when it calls for self-determination and independence… can blow off the fact that there are those who do need 24-hour care,” she says.
The proposal wasn’t well received among self-advocates. Not only was the language non-inclusive (it could lead to some autistic people being more and less valued) and fuzzy (just who would count?) but it went against the grain of treating people as individuals and getting them the support best suited to them (and of which more is desperately needed across the spectrum). The fight is for all autistic people, says Michael John Carley. And the last thing any significantly challenged kid needs is a label like that.
Yet while “profound autism” clearly missed the mark (Lord now acknowledges it may not have been the best term), the idea of introducing new subgroups to break up what really is a very heterogeneous spectrum could be helpful for both support services and research if it can be done sensitively, argue some experts.
“The singular umbrella concept does not seem to do justice to the huge variability within the spectrum,” says Simon Baron-Cohen, a professor in the departments of psychology and psychiatry at the University of Cambridge who directs its Autism Research Centre. But any move would require both precise language and, importantly, wide discussion with an autistic community that is very against subdividing (labels shouldn’t just be imposed by researchers or clinicians, he says).
Several academic groups, Lord notes, are now working to see if they can come up with some alternative subgroups under the spectrum that may better characterise severity and could be used in the future. “Just exactly how you formulate those is really difficult,” she says.
For Chris Bonnello, neat, few-word categories that can divide up the experiences of so many autistic people will always be elusive. Better, he says, to call everyone autistic and follow it up with a short individual description to make clear someone’s uniqueness and what help they may need: “Chris is autistic: he has historical troubles with anxiety and employment, and he can solve a Rubik’s Cube in less than 15 seconds.” | Mental Health Treatments |
Former Chancellor George Osborne has said his spending cuts meant the UK was better able to cope with the financial pressures of pandemic.
Appearing at the Covid Inquiry, he argued that without austerity Britain would have been "more exposed".
He rejected claims his approach left the health and social care "depleted" ahead of the Covid pandemic.
The inquiry is examining the UK's resilience and preparedness ahead of the coronavirus pandemic.
Former Prime Minister David Cameron and ex-senior minister Sir Oliver Letwin have also given evidence this week.
Last week Sir Michael Marmot, a professor of epidemiology at University College London told the inquiry that the UK had entered the pandemic with "depleted" public services.
Asked by inquiry lawyer Kate Blackwell KC if he agreed with the statement, Mr Osborne said: "Most certainly not, I completely reject that."
He accepted more money could have been spent on the NHS, but said as chancellor he had to balance demands for resources from other public services.
"You can't just say we like public spending to be higher without explaining where you get money from," he told the inquiry.
He said the public had elected the Conservatives to government in 2010 and 2015 knowing the party was planning to cut public spending.
During the period, cuts were introduced in welfare spending, school building programs, local government, police, courts and prisons. There was also an overall squeeze on health spending.
'No planning'
Mr Osborne - who was chancellor from 2010 to 2016 - said: "If we had not done that Britain would have been more exposed, not just to future things like the coronavirus pandemic, but indeed to the fiscal crisis which very rapidly followed in countries across Europe.
"If we had not had a clear plan to put the public finances on a sustainable path then Britain might have experienced a fiscal crisis, we would not have had the fiscal space to deal with the coronavirus pandemic when it hit."
Other organisations have questioned this claim. Writing in a blog, Phil Banfield of the British Medical Association said a "failure to ensure the NHS was properly staffed and resourced in the decade leading up to the pandemic, meant that when it did arrive, there was no capacity to meet the tsunami of demand."
On Monday, the Trades Union Congress (TUC)produced a report which said austerity had led to unsafe staffing in public services leaving the UK "hugely unprepared" for Covid.
During the one hour 20 minute question session, Mr Osborne was also asked about the Treasury's planning for potential national lockdown.
He said the department had plans for an outbreak of influenza but added "given what subsequently happened that was very small scale".
"There was no planning done by Treasury - or any western Treasury - for asking the entire population to stay at home for months and months on end.
"If someone had said to you the UK government should be preparing for a lockdown that might last for months, then I have no doubt the Treasury would have developed schemes it did subsequently develop around the furlough and the Covid loans.
"Planning could have been done for a furlough scheme in advance - I'm not clear that would have made a better furlough scheme than the one we as a country actually saw."
Following Mr Osborne's evidence, England's former chief medical officer Prof Dame Sally Davies addressed the committee.
During her evidence she came close to tears when apologising to the relatives of pandemic victims.
"It wasn't just the deaths, it was the way they died. It was horrible and I heard a lot about it from my daughter on the frontline as a young doctor in Scotland. It was harrowing, and it remains horrible," she said.
'Lasting regret'
Earlier in the day, Sir Oliver Letwin, a senior minister in David Cameron's government, told the inquiry a rapid turnover of staff hindered the government's ability to plan for pandemics.
He said it was "disastrous for the country" that the civil service was based on people moving to new positions, rather than gaining experience in areas such as resilience.
Sir Oliver also warned that the UK was "wildly under-resilient" and said there should be a minister "solely devoted" to the subject.
Labour said the admissions were "too little, too late", adding the Conservatives "cannot be trusted to protect the public from the emergencies of tomorrow".
He also told the hearing his "great regret" was not getting more involved in pandemic planning.
He said he was told the area was being "well-looked after" but felt that if he had examined the issue he might have pushed officials to prepare for pandemics other than flu ones.
"That is actually what I should've done and it's a matter of lasting regret that I didn't."
On Monday, Mr Cameron told the same inquiry that not preparing for a range of different pandemics had been a "failure". | Health Policy |
Sleep is not a state in which we are completely isolated from our environment: while we sleep, we are capable of hearing and understanding words. These observations, the result of close collaboration between teams at Paris Brain Institute and the Sleep Pathology Department at Pitié-Salpêtrière University Hospital in Paris, call into question the very definition of sleep and the clinical criteria that make it possible to distinguish between its different stages. These findings are detailed in a new study published in Nature Neuroscience.
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Sleep is generally defined as a period during which the body and mind are at restâas if disconnected from the world. However, a new study led by Delphine Oudiette (Inserm), Isabelle Arnulf (Sorbonne University, AP-HP), and Lionel Naccache (Sorbonne University, AP-HP) at Paris Brain Institute shows that the frontier between wakefulness and sleep is much more porous than it seems.
The researchers have shown that ordinary sleepers can pick up verbal information transmitted by a human voice and respond to it by contracting their facial muscles. This astonishing ability occurs intermittently during almost all stages of sleepâlike windows of connection with the outside world were temporarily opened on this occasion.
These new findings suggest that it may be possible to develop standardized communication protocols with sleeping individuals to understand better how mental activity changes during sleep. On the horizon: a new tool to access the cognitive processes that underlie both normal and pathological sleep.
A Thousand and One Variations of Consciousness
âEven if it seems familiar because we indulge in it every night, sleep is a highly complex phenomenon. Our research has taught us that wakefulness and sleep are not stable states: on the contrary, we can describe them as a mosaic of conscious and seemingly unconscious momentsâ, Lionel Naccache, a neurologist at Pitié-Salpêtrière University Hospital and a neuroscience researcher, explains.
It is essential to decipher the brain mechanisms underlying these intermediate states between wakefulness and sleep.
âWhen they are dysregulated, they can be associated with disorders such as sleepwalking, sleep paralysis, hallucinations, the feeling of not sleeping all night, or on the contrary of being asleep with your eyes open,â Isabelle Arnulf, head of the Sleep Pathology Department at Pitié-Salpêtrière University Hospital, says.
To distinguish between wakefulness and the different stages of sleep, researchers usually use physiological indicators such as specific brain waves made visible through electroencephalography. Unfortunately, these indicators do not provide a detailed picture of what is happening in the minds of sleepers; sometimes, they even contradict their testimonies. âWe need finer physiological measurements that align with the sleepersâ experience. It would help us define their level of alertness during sleepâ, Delphine Oudiette, a cognitive neuroscience researcher, adds.
A play between unconsciousness and lucidity
 To explore this avenue, the researchers recruited 22 people without sleep disorders and 27 patients with narcolepsyâthat is, people who experience uncontrollable episodes of daytime sleepiness. People with narcolepsy have the particularity of having many lucid dreams, in which they are aware of being asleep; some can sometimes even shape their dream scenario as they wish. In addition, they easily and quickly enter REM sleep (the stage where lucid dreaming occurs) during the day, making them good candidates for studying consciousness during sleep under experimental conditions.
âOne of our previous studies showed that two-way communication, from the experimenter to the dreamer and vice versa, is possible during lucid REM sleep,â Delphine Oudiette explains. Now, we wanted to find out whether these results could be generalized to other stages of sleep and to individuals who do not experience lucid dreams.â
Participants in the study were asked to take a nap. The researchers gave them a âlexical decisionâ test, in which a human voice pronounced a series of real and made-up words. Participants had to react by smiling or frowning to categorize them into one or the other of these categories. Throughout the experiment, they were monitored by polysomnographyâa comprehensive recording of their brain and heart activity, eye movements, and muscle tone. Upon waking up, participants had to report whether they had or had not had a lucid dream during their nap and whether they remembered interacting with someone.
âMost of the participants, whether narcoleptic or not, responded correctly to verbal stimuli while remaining asleep. These events were certainly more frequent during lucid dreaming episodes, characterized by a high level of awareness. Still, we observed them occasionally in both groups during all phases of sleep“, Isabelle Arnulf says.
Challenging the dogma of disconnected sleep
By cross-referencing these physiological and behavioral data and the participantsâ subjective reports, the researchers also showed that it is possible to predict the opening of these windows of connection with the environment, i.e., the moments when sleepers were able to respond to stimuli. They were announced by an acceleration in brain activity and by physiological indicators usually associated with rich cognitive activity.
âIn people who had a lucid dream during their nap, the ability to respond to words and to report this experience upon waking up was also characterized by a specific electrophysiological signature. Our data suggests that lucid dreamers have privileged access to their inner world and that this heightened awareness extends to the outside worldâ, Lionel Naccache explains.
Further research is needed to determine whether the frequency of these windows is correlated with sleep quality and whether they could be exploited to improve certain sleep disorders or facilitate learning. âAdvanced neuroimaging techniques, such as magnetoencephalography and intracranial recording of brain activity, will help us better understand the brain mechanisms that orchestrate sleepers’ behavior,â Delphine Oudiette concludes.
Finally, these new data could help revise the definition of sleep, a state that is ultimately very active, perhaps more conscious than we imagined, and open to the world and to others.
Funding
This study was funded by the French National Research Agency and the French Society for Sleep Research and Medicine.
ReferenceÂ
Türker B. et al. Behavioral and brain responses to verbal stimuli reveal transient periods of cognitive integration of the external world during sleep. Nature Neuroscience (2023).
DOI: 10.1038/s41593-023-01449-7. | Medical Innovations |
Norovirus appears to be at a seasonal high, according to data from the Centers for Disease Control and Prevention.
The rate of norovirus tests coming back positive, averaged over three weeks, exceeded 15% at the end of last week. That’s the highest recorded since late March 2022.
Norovirus is sometimes referred to as the stomach flu, but it is not related to the influenza virus. Rather, it is a highly contagious virus that typically causes gastrointestinal symptoms like diarrhea, vomiting, nausea and stomach pain. Mild fever and aches are possible, too.
Just a few virus particles are enough to make someone sick, and they spread easily via hands, surfaces, food and water. An infected person can transmit the virus for days after they’re feeling better, potentially even up to two weeks, according to the CDC.
Regionally, the Midwest had the highest average test positivity rate for norovirus as of Saturday, at over 19% — higher than any other week in the last year.
The agency tracks norovirus outbreaks via a network of 14 state health departments. Although the network’s data lags, its most recent tally suggests state health departments reported 25 outbreaks as of the first week of January, the most since May. Between August and early January, a total of 225 norovirus outbreaks were reported to the CDC, compared to 172 during the same period last season.
"Norovirus outbreaks and reported cases from both state health departments and clinical laboratories are increasing but remain within the expected range for this time of year," said Kate Grusich, a CDC spokesperson.
"Prevention measures implemented during the Covid-19 pandemic were likely effective in preventing norovirus outbreaks. As pandemic restrictions have relaxed, the number of norovirus outbreaks has returned to levels similar to pre-pandemic years," she added.
Norovirus is the leading cause of foodborne illness in the country. Food can get contaminated if fruits or vegetables are grown or washed with contaminated water. Oysters, too, pose a norovirus risk if they are harvested from contaminated water. In December, a multistate outbreak was linked to raw oysters from Texas, with nearly 300 norovirus cases reported.
Most norovirus outbreaks in the U.S. happen between November and April. On average, the country sees around 20 million cases per year, with nearly 110,000 hospitalizations and 900 deaths, mostly among those who are 65 and older.
There is no treatment for norovirus, but the CDC recommends drinking lots of fluids to prevent dehydration. The illness typically resolves within a few days.
In England, norovirus rates this year are exceptionally high, according to the UK Health Security Agency. As of the end of January, lab reports of norovirus were 66% higher than the average over the five seasons before the Covid pandemic. The agency primarily attributes the increase to higher reporting among people 65 and older. | Epidemics & Outbreaks |
Texas parents Temecia and Rodney Jackson have alleged that after they had a home birth and chose to treat their days-old child at home for jaundice, their pediatrician reported them to authorities, setting off a chain of events that led to Rodney Jackson's brief arrest and the infant being placed in foster care.
The Jacksons, who have two older children and live in Desoto, a suburb of Dallas, elected to do a home birth after Temecia Jackson had two prior Cesarean sections, the couple's midwife, licensed professional counselor Cheryl Edinbyrd, told CBS News. Edinbyrd said that she first began providing care to the Jacksons in September 2022 through The Tree of Life Wellness Center. Their daughter, Mila Jackson, was born on March 21, 2023.
The Jacksons declined to speak with CBS News, but Edinbyrd said that Mila was born at home in the family's bathtub and described the birth as "beautiful." There were no signs of jaundice within the first 24 hours, Edinbyrd said. The midwife, who said she has been present at over 100 births, said that there were follow-ups scheduled for three and five days after Mila was born.
On March 24, the Jacksons brought their daughter to the office of Dr. Anand Bhatt, their pediatrician of 12 years. In a press conference on Thursday, the Jacksons described the visit as for a "newborn checkup."
"Within that visit, we were told 'everything is good, she looks great, the only thing is she has jaundice," said Temecia Jackson. Jaundice is fairly normal in newborns. "A couple hours later, the pediatrician called my phone and wanted us to admit Mila into the hospital."
An affidavit filed by the Texas Department of Family and Protective Services states that Bhatt contacted the agency on March 25. DFPS investigator Brenda Martinez spoke with Bhatt and said that in an interview, he told her that a bilirubin test – which is used to find the cause of health conditions like jaundice, anemia, and liver disease – showed bilirubin levels of 21.7 milligrams. That level, Bhatt told Martinez, was "cause for a lot of concern" and could lead to brain damage, "because the bilirubin can cross the blood brain barrier." According to the American Academy of Pediatrics' website, any level over 20 milligrams in a baby of Mila's age at the time would mean the baby needed treatment.
The DFPS said they could not comment on the case. A representative for the practice Bhatt works at declined to comment, citing patient confidentiality. Bhatt is a board-certified pediatrician who is also affiliated with Baylor Scott and White Medical Center and other local medical facilities.
Edinbyrd did not join the Jacksons at the pediatrician's office, but said that Temecia Jackson called her shortly after they left the office to update her about the bilirubin levels because Edinbyrd was still their care provider. Edinbyrd told CBS News that she saw the bilirubin levels as "high" but not critical.
The Mayo Clinic website says that "mild infant jaundice" often disappears on its own, but warned that for "moderate or severe" cases, children may need to be hospitalized. Home jaundice remedies include enhanced nutrition, light therapy (also known as phototherapy) with specialty devices, or transfusions. Edinbyrd said the family had already ordered a blanket and goggles to provide light therapy. Phototherapy can be done at home or in hospitals. At home it is done using a blanket, also known as a biliblanket, that uses fiber optics to bathe the baby's skin in light, according to instructions from Kaiser Permanente, a healthcare facility, for treating jaundice at home.
According to court documents, when Martinez spoke to Bhatt, he told her that after the Jacksons visited, he decided to secure a bed for Mila at Children's Medical Center of Dallas and asked the family to bring her there. He said he told the family that he would call police for a welfare check if she did not arrive. In the press conference, Temecia Jackson said that she had received multiple calls and texts from the pediatrician, including a call at 11:00 p.m. on March 24 where Bhatt said they were "going against what he felt like we should do for her child" and warning the parents that he would call the Department of Family and Protective Services if they did not bring Mila to the hospital.
"We were woken up by police banging at our door"
Court documents show that at around 4 a.m. on March 25, Martinez and two Desoto police officers went to the Jacksons' home. Rodney Jackson declined to speak with them without a "contract," according to documents, and both Martinez and the officers left. Court documents say the welfare check's "outcome" was "unknown."
An hour later, according to Martinez's notes in the affidavit filed by DFPS, Martinez returned to the home with officers, a fire truck and an ambulance to transport the child. Rodney Jackson again declined to open the door, and the officers departed the home again.
Documents show that a program director from DFPS approved removal of the four-day-old baby. A supervisor directed Martinez to take custody of Mila "due to her health being in immediate danger of serious long-term consequences."
Following the visit, Rodney Jackson called Bhatt, saying he was "very upset" and that he and his wife planned to "take care of their baby naturally," court documents show. He also reportedly told Bhatt that they "didn't believe in modern medicine," which, according to the DFPS affidavit, Bhatt said he understood. Their doctor did, however, once again urge them to go to the hospital.
In their press conference, the Jacksons said they felt "traumatized" by those first visits.
"We were traumatized. We were woken up by police banging at our door at 4:00 a.m. and 5:00 a.m.," Temecia Jackson said.
On March 30, officers returned to the home with a warrant. Rodney Jackson, who was not home at the time, was arrested upon his return. Court documents show he was charged with one count of possession of drug paraphernalia and one count of preventing the execution of a civil process. Desoto police did not respond to multiple requests for comment from CBS News.
The Jacksons and Edinbyrd said that when Rodney Jackson was detained, his keys were removed and police entered the home and took Mila from Temecia Jackson. Since then, the baby has been in foster care.
"I called my husband and let him know there's police outside. He immediately turns around and comes back to the house. He's met by six constables pretty much demanding that he let them into our home, and they had a writ," Temecia Jackson said. "My husband said he would not be allowing them to go into the home but if they have a writ, they can do whatever it is they need to do. He made sure not to block our front door or anything like that. The constables chose to arrest my husband so that they could take his keys and use his keys to unlawfully enter my home and come and take my baby from me."
Temecia Jackson said during the press conference that she feared her baby was "stolen" because the child does not yet have a birth certificate because she was born at home.
"This loving, caring family is terrified"
The warrant used to justify Mila's removal does not list Temecia Jackson's name: It names a different woman as the child's mother, and lists a different man as the child's legal father. Rodney Jackson is named as the baby's "alleged" father. Edinbyrd, who was present at the birth, said Mila's parentage is not in dispute and said that the family does not know the people on the form. CBS News is not naming the people on the document.
"They handed (Temecia) a writ that did not have her name on it ... (The other woman) does not live there. They do not even know who (she) is," Edinbyrd said. "But they took her baby with an affidavit that has (the other woman's) name on it."
The family was meant to have a hearing about their child on April 6, but it was postponed to April 20, two weeks later, because of confusion about who will represent the Jackson family. Edinbyrd said that Temecia Jackson has been able to see her child in supervised visits once a week.
The family's two older children have not been removed from the home.
The Afiya Center, a reproductive and birth justice organization in Texas that is representing the Jacksons and organized their press conference, called the events a "direct attack on Black mothers and parents, Black families and midwifery - and Black midwives in particular" in a statement shared with CBS News.
"Our state already has a ruthless track record of removing Black kids from their homes, which has led to horrific results. Now this loving, caring family is terrified they'll fall into that category," the organization said. "We are devoted to improving maternal and infant health outcomes and families like the Jacksons. We support midwives and the immense role they play in promoting maternal and prenatal and infant health. We are outraged by this clear violation of this family's rights to choose their health care options and we stand in solidarity with them."
for more features. | Women’s Health |
Quick Summary
- In the real world, free will enables us to control what we pay attention to, even in the face of potential distractions
Picture this scenario: You and a friend are walking around your neighborhood when you stop at a crosswalk. As you wait, the noises of the world and your internal thoughts all vie for your attention. Suddenly, you see a motorist nearly hit a bicyclist.
“Whoa, did you see that?” you say to your friend.
“I sure did; that was a fully restored 1967 Ford Mustang,” your friend replies, referring to a car separate from the near-traffic collision.
Despite being in the same place at the same time, and looking at the same scene, you and your friend paid attention to different things.
Why? And how?
One possibility is that different things in the environment attracted your attention differently. But another possibility is that you and your friend made voluntary decisions about what to pay attention to, exerting your free will accordingly.
Funded by a three-year $900,000 grant from the National Science Foundation, Distinguished Professor George R. Mangun, director of the UC Davis Center for Mind and Brain, is launching a project to better understand the cognitive mechanisms behind realistic voluntary attention, or attention directed by an individual’s free will. The project will be conducted in collaboration with engineering colleagues at the University of Florida.
“How we use free will to focus attention influences our momentary awareness and our consciousness.” — Mangun
The role of voluntary attention isn’t just important to understanding healthy brain function, he said. It’s also critical to understanding disorders of the brain.
“Almost every neurological or psychiatric disorder touches some component of attention, and this sometimes involves deficits in free will, such as in Parkinson’s disease,” he said.
Free will without the ‘free’
For decades, neuroscientists have probed the cognitive and neural mechanisms behind voluntary attention by using external cues (simple stimuli such as arrows) to direct their research subjects’ attention to specific locations in front of them. But this is a far cry from how human voluntary attention naturally occurs.
In the real world, our free will enables us to control what we pay attention to, even in the face of potential distractions. To accommodate for this reality, neuroscientists often investigate the concept of free will through voluntary motor actions, asking study participants to push a button of their own volition without prompting from a researcher.
Mangun’s project will bring these two lines of research together. Because orienting attention is a cognitive act and not a motor one, the researchers hope to take an important step forward in understanding both free will and voluntary attention.
Measuring true ‘free will’
Mangun’s project will build upon previous experiments his lab conducted analyzing the neural activity that precedes voluntary decision-making.
In a study published in the Journal of Cognitive Neuroscience in 2014, Mangun and his colleagues recount experiments in which they asked participants to look at a spot in the center of a computer screen. They then prompted the participants to focus attention somewhere else on the screen using free will to choose where but doing so without moving their eyes to look at the attended location directly.
By making this request, the researchers separated the cognitive act of attending from the motor act of moving the eyes to look. Mangun and his colleagues recorded the participants’ brain waves (electroencephalography or EEG signals), both before and after they used free will to focus attention.
“It turns out that the ongoing pattern of brain activity preceding the subject’s free will choices could predict where they were going to later focus their attention,” Mangun said. “Using neuroscience methods, we were able to do a sort of mind reading.”
Improving prosthetics and diversifying research
Mangun’s new NSF grant takes the next step forward by applying machine learning approaches and advanced brain imaging methods to pinpoint the precise neural underpinnings of these predictive brain signals. The highly interdisciplinary project brings together engineers such as postdoctoral scholar Sreenivasan Meyyappan and psychology doctoral candidate John Nadra.
Probing and refining the cognitive mechanisms behind voluntary attention could help improve technological interventions, like prosthetics. Currently, many prosthetics harness peripheral information like muscle activity. This new research could shift those signals from the muscle to the brain itself.
“You can train a person to use a mechanical arm by tapping into the electrical activity of the shoulder muscles and then they learn to contract those muscles to drive that mechanical arm,” said Mangun. “But in addition, one can use the brain’s electrical activity, for example in the motor cortex, directly to do the same. Our research may open doors to tapping into brain signals even earlier in the chain of neural events.”
In addition to its potential broad impacts on health and wellness, the project will open doors to students interested in conducting neuroscience research.
In the grant application, Mangun noted that the project will help advance and diversify STEM education by involving undergraduates, graduates and postdoctoral scholars, recruiting students through the UC Davis Summer Undergraduate Research Program and the Young Scholars Program.
“One of the great benefits of studying at a research-intensive university like UC Davis is the possibility for students to participate in cutting-edge research — it’s part of who we are,” he said.
Media Resources
Media Contacts:
- Greg Watry, College of Letters and Science, 530-754-2222, [email protected]
- Karen Nikos-Rose, News and Media Relations, 530-219-5472, [email protected] | Disease Research |
Many U.S. hospitals are struggling to find chemotherapy drugs, antibiotics and other lifesaving treatments amid an escalating nationwide drug shortage crisis, as experts increasingly call for federal government action.
About 1 in 3 hospitals say they’ve either skipped, delayed or prescribed less medication to patients than was needed because of the supply gaps, according to a survey published Thursday by the American Society of Health-System Pharmacists, a group that tracks U.S. drug shortages. Almost all hospitals in the survey say patient care is affected in some way.
“Drug shortages are having a significant clinical impact,” said Michael Ganio, senior director of pharmacy practice and quality at the group. “It’s just heartbreaking to see that patients are being affected to this level with the shortages.”
The survey’s findings were based on responses from more than 1,100 hospital and health-system pharmacists in the U.S. from June 23 through July 14. Among the hospitals, 41% had 500 beds or more.
All of them, aside from three respondents, said they were experiencing drug shortages, according to the survey.
About two-thirds of the hospitals categorized the current state of drug shortages as “moderately impactful,” meaning that patient treatment was affected, but that they could potentially manage it by switching to an alternative treatment or a different form of the medication.
“It may be that we’ve had to switch you to an oral tablet of an antibiotic sooner than we would have liked because the antibiotic is in shortage,” Ganio said.
One-third of hospitals said the drug shortages were “critically impactful,” forcing doctors to ration, delay or cancel treatments or procedures.
The category of drugs hospitals are running low on include:
- Corticosteroids.
- Oral liquids, like ibuprofen and amoxicillin.
- “Crash cart” drugs used in medical emergencies.
- ADHD medications.
- Injectable opioids.
More than half of the hospitals said they are having a hard time finding chemotherapy treatments — ranking highest on the survey — although it didn’t specify which cancer drugs.
Cisplatin, a chemotherapy drug used to treat cancers of the brain, throat, lungs and ovaries, has been in short supply since February, according to the Food and Drug Administration. A similar chemotherapy medication, carboplatin, is also in shortage, according to the agency, which hasn’t said when it expects the shortages to ease.
“This really shows how widespread the problem of drug shortages is,” said Erin Fox, a drug shortage expert and senior pharmacy director at the University of Utah.
Until the shortages are resolved, hospitals are offering alternative treatments, rationing and choosing which patients qualify for the drugs, the survey found.
“Pharmacists are working very hard behind the scenes to make sure that patients are not impacted,” Fox said.
Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, called for action from the federal government and Congress.
“People in health systems and pharmacists are very clever and very good at adapting and knowing how to replace treatments,” she said. ”The fact that they’re reporting such high levels of concerns suggests we really need to start paying attention.”
Ganio said the pharmacists’ group is urging Congress to enact legislation to reduce disruptions in the supply chain, including diversifying the places where drugs are made.
“We may break the record of the most number of shortages at any given time,” he said. “We’d like to see more movement.” | Drug Discoveries |
Every day, Adrienne Grimmett and her colleagues at Evara Health in the Tampa Bay area see stories of inequity in their patients’ teeth, gums, and palates.
Marked in painful abscesses, dangerous infections, and missing molars are tales of unequal access to care.
All of these ailments — which keep patients out of work because of pain or social stigma, and children out of school because they can’t concentrate with rotting roots — are preventable.
Annual dental checks are essential to overall health. But of the 67 counties in Florida, experts say, only one has enough dentists to treat all patients. Nine counties in Florida have fewer than three practicing dentists apiece. Lafayette County, in north Florida, doesn’t have a single one.
“It’s a social injustice,” said Grimmett, director of dental services at the not-for-profit, which serves Medicaid and uninsured patients in the Tampa Bay region.
“You will never be totally well if you don’t have oral health,” she said.
In Florida and across the nation, vulnerable and marginalized communities — already prone to higher rates of chronic disease and limited access to health care — are left behind in these dental deserts. There, patient volume exceeds the capacity of providers, or too few dentists are willing to serve those on Medicaid or the uninsured.
Constricting the pool of dentists are low — or nonexistent — reimbursement rates for services paid through the state’s Medicaid programs. Meanwhile, costly dental education can make dentists reluctant to work in more rural areas.
About 6 million Floridians live in dental deserts, according to data from the U.S. Department of Health and Human Services. That’s the largest state population living without basic dental care in the U.S.
The consequences can be catastrophic, as people try to navigate a health system with few providers willing to serve them and costs that make services unattainable.
They’re people like Mark Maggs, a 54-year-old Pinellas Park resident diagnosed with cancer last year. He delayed treatment because doctors said he needed to have teeth pulled first. His daughter started a GoFundMe to raise the $3,000 for the extractions.
They’re people like Lisa Lambros, a 40-year-old New Port Richey resident who drives 90 minutes to Tampa for appointments at the county health department. She lost her teeth due to cancer three years ago and desperately needs dentures, but hasn’t been able to afford them. She feels bad for her kids, embarrassed when they bring friends home to meet her.
“I had perfect teeth until I got sick,” Lambros said. “Now people treat me different. They look at me like I’m a bad person.”
Lambros and Maggs both live with daily pain that could be relieved with dental care.
Health equity advocates are fighting for long-term investments in oral health at the local, state, and federal levels to close gaps in care.
Where Are All the Dentists?
Poor dental access is not the result of too few dental school graduates.
Enrollment has been ticking up nationally, with more than 26,000 students in school last year. That’s about a tenth the number of working dentists in the U.S., according to the American Dental Association.
But the majority of those graduates aren’t practicing in underserved communities and don’t accept uninsured patients or those enrolled in federal health insurance plans.
The issue is uneven distribution, said Joe Anne Hart, who’s worked for the Florida Dental Association for nearly two decades.
Recruiting dentists to rural communities, where public infrastructure is typically worse, can be a challenge, Hart said.
And often, she added, there’s a financial reason why dentists choose to practice in more affluent regions: student loan debt.
As of 2020, new graduates left dental school with an average debt of about $300,000, according to the American Dental Education Association.
With fewer patients in mostly poorer rural communities, graduates flock to private practices elsewhere, seeking financial stability. But it’s not just rural residents who struggle to access care. Because Medicaid reimbursements for dental care are paltry, even in urban areas, most dentists opt not to serve Medicaid patients.
Nearly 8 in 10 Florida dentists reported they did not accept Medicaid patients, according to the most recent workforce survey from the state Department of Health. More than 70% of respondents cited low Medicaid reimbursement rates as the main reason why.
In Florida, fewer than 5% of dentists work in publicly funded dental offices and community clinics. The survey found the majority work in private practices.
“When you look at our dental Medicaid funding, we haven’t had an increase since 2012,” said Christopher Bulnes, who practices in Hillsborough County. “We’re at the bottom of the nation.”
In 2020, the Medicaid reimbursement rate for child dental services in Florida was just 42.6% of what private insurance reimbursed on average, according to the American Dental Association. That’s one of the lowest reimbursement rates in the country. In Texas, for example, the rate is 70.3%. Arizona’s reimbursement rate is nearly double that of Florida’s.
For standard adult services, such as preventive cleanings and imaging, there is no benefit in the Sunshine State.
Kimme Heller is a 38-year-old St. Petersburg mom who lost her teeth after pregnancy as she battled infection after infection, a product of unlucky genetics and lack of access to preventive care. Her jawbone is so deteriorated from decay that her face is starting to change shape. It hurts to eat. She’s been looking for a dental surgeon, but availability is limited. Even if she could get in, she couldn’t afford the procedures.
“The rich get their smiles. The poor get disease,” she said.
Representatives of the Florida Dental Association said the state — which controls how much dental coverage is offered under Medicaid — should promote oral health care and increase coverage for vulnerable patients.
Additionally, the organization is lobbying for programs that would encourage dentists to care for underserved communities. One initiative they’ve floated would offer dentists up to $50,000 a year in student loan relief for efforts such as serving Medicaid patients or working in areas without enough providers.
As lawmakers convene in Tallahassee, the association has asked the state to set aside $1.8 million per year to support the Dental Student Loan Repayment Program. But with days to go, lawmakers have yet to act.
A Costly Toll
The percentage of adults and kids who have visited a dentist in the past year is lower in Florida than in any other state.
“We’re talking about quality-of-life issues,” said Grimmett, of Evara Health. “Every day we see patients who weren’t able to move forward with cancer treatment because they needed dental clearance and they weren’t able to get it. We’ve seen patients who have been in pain for long periods of time who can’t sleep or eat and need treatment. We see people without teeth who need dentures.”
Each year, more than $45 billion is lost from the U.S. economy — tallied in work missed and job opportunities lost — because of untreated oral disease, according to the U.S. Centers for Disease and Control and Prevention. Nearly 1 in 5 adults reported that oral disease affected their appearance and hampered their ability to get work. Some struggle to eat through the pain.
Children, meanwhile, miss class.
“I can’t tell you how many times I’ve received calls from a parent or school nurse because a child cannot focus or learn because they are in pain,” said Jacinta Lamontagne, who serves Medicaid patients near Pensacola.
In 2020, fewer than half of people ages 1 through 20 on Medicaid received preventive dental care, such as an annual screening. In Florida, about 67% of kids on Medicaid went without.
Black and Hispanic children are more likely to have untreated oral illness.
For people 65 or older who use Medicare, dental care can also remain out of reach. Medicare does not cover standard services such as cleanings and fillings.
Frank Catalanotto is a founding member of Floridians for Dental Access and former dean of the University of Florida College of Dentistry. His organization is a partnership between nonprofits, individual dentists, and medical centers working to improve health access in the state.
He’s motivated to close disparities — and not just those directly related to health. Oral pain can affect children’s educational outcomes too.
“The literature now documents very clearly that if you are in pain, you’re going to miss school more often than other kids, you’re not going to learn as well,” Catalanotto said. “You’re going to have social issues, because if you’ve got broken-down front teeth, kids are going to make fun of you.”
Catalanotto said there’s also a financial toll. When people don’t have access to local providers and are in pain, they often go to the emergency room.
In 2020, Florida hospitals billed roughly $330 million for more than 100,000 emergency room visits that stemmed from preventable oral health problems, according to analysis of hospital data by CareQuest Institute for Oral Health, a national nonprofit that focuses on health equity.
Much of that burden falls on taxpayers.
And while health care access is limited across medicine — not just in dentistry — Catalanotto stressed that teeth don’t fix themselves.
Some minor ailments, such as colds and viral infections, can simply run their course. A minor dental ailment, he said, does no such thing.
Oral disease is progressive and ongoing and ultimately leads to severe infections.
Until more people have access to preventive care, the most vulnerable are going to continue to get unnecessarily sick.
“We have a crisis in Florida,” Catalanotto said. “That is abundantly clear.” | Health Policy |
England and Wales last year logged their most scarlet fever cases since the 1950s, Government figures have revealed.Leading experts told MailOnline Covid lockdowns are partly to blame for the surge, with children having less immunity against Strep A — the usually-mild bacteria that causes the illness.UK Health Security Agency (UKHSA) bosses recorded 54,430 scarlet fever cases in 2022 in England and Wales.It was more than 20 times the 2,659 seen in the previous year — and the highest on record since 1953, when 61,180 infections were posted. UK Health Security Agency (UKHSA) figures show some 54,430 infections were recorded in 2022. It was more than 20 times the 2,659 seen in the previous year, and the highest on record since 1953, when 61,180 infections were posted MailOnline analysis today shows the North West was the worst-hit region, recording close to 3,000 cases in December. It was followed by the East Midlands (2,890), South East (2,701) and London (2,405). The North East — the least affected area — recorded 769 over the same periodCases exploded towards the end of the year, fuelling panic across Britain as an unusually high number of children were killed by Strep A.Scarlet fever cases peaked at 9,482 in the week ending December 18 in England and Wales.But rates appear to have no slowed down in 2023, which experts said appear to have plunged five-fold over the past few weeks.Cases have started to fall off since mid December, with 2,036 recorded in the week ending January 1.MailOnline analysis today shows the North West was the worst-hit region, recording close to 3,000 cases in December.It was followed by the East Midlands (2,890), South East (2,701) and London (2,405). The North East — the least affected area — recorded 769 over the same period.On a more local level, Caerphilly in south Wales saw the most cases during the period with 282.It was followed by County Durham in England (250), as well as Cardiff (250) and Swansea (188) — both in Wales. Some 109 local authorities did not record a single case during the four weeks. However, not all local authority data is up to date, the UKHSA said. Scarlet fever is a notifiable disease, meaning all doctors must inform local health protection teams of suspected cases.Health bosses yesterday said Strep A alerts issued in early December may have encouraged those infected to come forward, leading to a sharp rise in cases followed by reduced transmission. Dr Sarah Anderson, UKHSA incident director, said: 'The number of scarlet fever notifications we are seeing each week has fallen.'But we are continuing to monitor the data closely as the school term gets underway, and children mix more. 'The bacteria that cause scarlet fever are still circulating at high levels so it is important that we continue to do our bit to stop the spread of germs to vulnerable groups, including the elderly by washing our hands regularly and thoroughly, catching coughs and sneezes in a tissue, and keeping our homes well ventilated.'Scarlet fever is caused by Strep A, which usually causes a mild bacterial infection.While the vast majority of infections are treatable with antibiotics, in exceptionally rare cases the bacteria can cause invasive Group A Streptococcal (iGAS). The UKHSA yesterday noted that there has been a 'drop' in the number of scarlet fever cases it has been notified of, which could point to a 'possible reduction in transmission rates'This occurs when the bacteria it gets into parts of the body where it is not normally found, such as the lungs or bloodstream.Two of the most severe forms of this invasive disease are necrotising fasciitis and streptococcal toxic shock syndrome. Both can kill.Strep A bacteria can cause a range of other infections, including impetigo, scarlet fever and strep throat. There is usually a surge in iGAS cases every three to four years but social distancing during the Covid pandemic is thought to have interrupted this cycle.High rates of other respiratory viruses — including flu, RSV and norovirus — may be putting children at higher risk of co-infections with Strep A, leaving them more susceptible to severe illness, the UKHSA suggested. Thirty-eight deaths have been confirmed among children across the UK, including two in Scotland, five in Wales and one in Northern Ireland. For comparison, 27 died in the last bad year.Victims include Muhammad Ibrahim Ali, a four-year-old boy from Buckinghamshire, and Jax Albert Jefferys, five, from Hampshire.Professor Alastair Sutcliffe, a paediatrician based at University College London, told MailOnline last year's surge was the worst seen since before he started practicing more than 30 years ago.Explaining why the outbreak was so bad, he said: 'Our immune systems need priming — think booster vaccines. 'Whilst during the lockdown our children were safe, the well-known aphorism "there are only two things young children share with others, their bugs and their Mother's age" holds some truth.'So an unintentional consequence of the lockdown was less priming, less exposure, and now we face the upswing. 'Things should return to more average levels after this winter.'Despite the unusually high levels of deaths seen so far this winter, he insisted the bacteria is usually not dangerous if children are diagnosed and treated quickly.Previous outbreaks have also peaked later in the season, making the comparisons skewed. Professor Sutcliffe, who is also a consultant at Greet Ormond Street Hospital in London, said: 'If group A streptococcus infections are recognised promptly and treated accordingly they are not a threat any child. 'Alas, a few of the children who get this infection get an invasive form which can be very scary for families, and their doctors to treat. 'If left it can be fatal or cause permanent tissue injury.'This bacterium fortunately tends to be sensitive to common antibiotics which is good news. 'And perhaps this reflects well on national antibiotic stewardship policies, which have resulted in Group A strep resistance being rare.'In other health news...NHS emergency care crisis laid bare: Heart attack patients face staggering waits of up to six-and-a-half hours with 999 response times worse than ever - as record 1,800 patients spend 12 hours in A&E every day Make-shift MORGUES built during Covid crisis are being reopened to house dead bodies amid surge in fatalities over festive period Being stressed, nervous or exhausted in middle-age may increase risk of dementia, study claims From the 'bubbly' seven-year-old whose father desperately tried CPR to save her, to the four-year-old who loved exploring: The victims of Strep A so far Muhammad Ibrahim AliThe four-year-old boy attended Oakridge School and Nursery in High Wycombe, Buckinghamshire.He died at home from a cardiac arrest in mid-November after contracting a Strep A infection.He was prescribed antibiotics.His mother Shabana Kousar told the Bucks Free Press: 'The loss is great and nothing will replace that. 'He was very helpful around the house and quite adventurous, he loved exploring and enjoyed the forest school, his best day was a Monday and said how Monday was the best day of the week. Muhammad Ibrahim Ali, who attended Oakridge School and Nursery in High Wycombe, Buckinghamshire, died after contracting the bacterial infectionHannah Roap The 'bubbly' and 'beautiful' seven-year-old is the only child to have died from Strep A in Wales so far.Her devastated parents told how their 'hearts had broken into a million pieces'. The first signs of the infection were mild. Hannah's father Abul took his daughter to the GP after a cough got worse overnight. She was prescribed steroids and sent home, but she died less than 12 hours later. Mr Roap recalled how he desperately tried to resuscitate his child: 'She stopped breathing at 8pm but we were not immediately aware because she was sleeping.'I did CPR, I tried to revive her but it didn't work. Paramedics arrived and continued the CPR but it was too late.' Mr Roap said the family was 'utterly devastated' and awaiting answers from the hospital.The family believe she might have lived if she was initially given antibiotics. Hanna Roap, who attended Victoria Primary School in Penarth, Wales, died after contracting Strep A last month. Her family say they have been 'traumatised' by her deathStella-Lily McCorkindaleFive-year-old Stella-Lily McCokindale died following a Strep A infection, the first death from the infection in Northern Ireland. She died on December 5 at Royal Belfast Hospital.In a tribute on social media, her father Robert said the pair had 'loved every minute' of being together as they went on scooter and bike rides.'If prayers, thoughts, feelings and love could have worked she would have walked out of that hospital holding her daddy's hand,' he said. Stella-Lily attended Black Mountain Primary School, which said she was 'a bright and talented little girl' and described her death as a 'tragic loss'. Five-year-old Stella-Lily McCokindale who attended Black Mountain Primary School in Belfast died in early December after contracting Strep A Jax Albert JefferysA five-year-old boy who died of Strep A was misdiagnosed as having flu, his family has said.Jax Albert Jefferys, from Waterlooville, Hampshire, died on December 1.His mother Charlene told how she had sought medical advice three times during the four days leading up to Jax's death and was told he was suffering from influenza A. She described Jax as a 'cheeky little chappy'. Later tests revealed he actually had Strep A. Jax Albert Jefferys, a five-year-old from Waterlooville, Hampshire, died on , December 1, from Strep A | Epidemics & Outbreaks |
The Centers for Disease Control and Prevention warned doctors Thursday to be aware of two growing outbreaks of Marburg virus disease in Africa, and will begin reaching out to some arriving travelers to the U.S. to watch for symptoms of the Ebola-like viral hemorrhagic fever.
This new CDC alert comes as cases have climbed in the wake of Equatorial Guinea and Tanzania declaring outbreaks of Marburg earlier this year. The outbreak is the first declared for each country, and ranks as among the largest on the continent in a decade.
"Currently, the risk of MVD [Marburg virus disease] in the United States is low; however, clinicians should be aware of the potential for imported cases. It is important to systematically assess patients for the possibility of viral hemorrhagic fevers," the CDC's alert urges.
What is Marburg virus, and what are the symptoms?
Marburg is a virus that can infect humans who come into contact with its animal host, a type of bats native to Africa. It can then be transmitted from an infected person to others through contact with blood or bodily fluids.
Similar to its close relative Ebola, Marburg begins with common symptoms like fever and headaches before progressing to increasingly severe issues like diarrhea, "massive hemorrhaging" and organ failure. Around half of patients with identified cases die in outbreaks, on average, the World Health Organization estimates.
Symptoms can begin as early as two days after exposure to as late as three weeks after.
So far, local authorities have tallied 14 confirmed cases in Equatorial Guinea since the outbreak was declared on February 13, with 10 dead. An additional 23 probable cases have been identified, the WHO said Thursday.
The CDC says eight cases have been confirmed in Tanzania, with five dead.
Most experts think the two outbreaks stemmed from separate so-called "spillover events" from animals to humans, the CDC says.
Authorities have warned that cases in Equatorial Guinea have been detected across a wide swath of the country with no known links between patients, suggesting that the virus is spreading undetected among people in the region.
"Though we do not know yet the origin of the Marburg outbreaks in Equatorial Guinea and Tanzania, we do know that there continues to be increased capacity in Africa to recognize and test samples for viral haemorrhagic fevers like Marburg and Ebola," the World Health Organization's Dr. Tieble Traore said April 4 in a post.
Travel and other precautions
There are no direct flights from either country to the U.S. However, the CDC says it has begun sending text messages to arriving travelers who had been in Equatorial Guinea or Tanzania, urging them to contact authorities if they develop Marburg symptoms within 21 days after their trip.
"Currently, no enhanced domestic travel measures are recommended, as the overall risk in the United States is considered low at this time," the CDC's alert says.
The agency says it is also working with nongovernmental organizations in the areas with guidance echoing their Ebola recommendations for avoiding infections and screening workers after they return. The CDC has previously been updating its guidance for Ebola to include Marburg as well, in addition to stepping up its travel alert over the outbreak.
In Tanzania, the White House says the U.S. has been providing personal protective equipment as well as "technical support in epidemic management."
In Equatorial Guinea, CDC responders first began deploying in the wake of the outbreak being declared in February. The U.S. laboratory was stood up on March 10, and is now training local authorities to diagnose suspected cases of Marburg.
Work on possible vaccines
There are no approved vaccines or treatments for Marburg, although manufacturers of several potential vaccine candidates – including one U.S. government-backed option from the Sabin Vaccine Institute – have readied some experimental shots that could be deployed.
750 doses from that vaccine, based on a chimpanzee adenovirus, are ready to be deployed in trials for the current outbreak. WHO officials have previously said shots may be administered in a "ring" approach around the contacts of each case who are at-risk in hopes of helping to stem transmission.
The WHO said Thursday that there is no agreed-upon date for when the country will greenlight test vaccinations to begin, but that Equatorial Guinea has cleared visas for its experts to arrive ahead of shots potentially going into arms.
"When the conditions may be favorable, the trials may be initiated. So right now is building the basics of good alert management and case management and other basics of the outbreak response. And at a future date may be considered, but as of now, we don't have a firm date for when it will start," the WHO's Dr. Abdi Mahamud told reporters.
for more features. | Epidemics & Outbreaks |
Bill Gates says some of the world's governments have handled the spread of Covid-19 better than others, but the billionaire won't give any country a perfect mark."I wouldn't say any country got it totally right," Gates said in a recent interview at the Lowy Institute, a think tank in Sydney, Australia, adding: "Nobody ... gets an 'A' on this one."The Microsoft co-founder and health care philanthropist has both praised and criticized multiple world governments' responses to the pandemic since the coronavirus's initial spread in late 2019.As early as March 2020, Gates argued that the U.S. "did not act fast enough" to take extreme quarantining measures, like shutting down businesses and issuing stay-at-home orders. He also said the country's rollout of effective and accessible Covid tests was too slow.The U.S. has proceeded to log a higher rate of Covid deaths per capita than any other of the world's wealthiest nations since the start of the pandemic."In the future, countries need to have dedicated personnel, and they need to practice how they connect up with the PCR diagnostic industry," Gates said on Monday.Gates, who published a book last year called "How to Prevent the Next Pandemic," said he expects federal governments across the world to make those responses much easier before the next global viral outbreak. Poor Covid responses inspired government spending on future pandemic preparedness in multiple countries, he observed.Some Covid responses have been better than others, Gates argued. He cited Australia "and about 7 other countries," which he did not publicly name, noting that Australia's rate of Covid deaths per capita is still among the lowest in the world. It's currently just 21% of the U.S.'s coronavirus death rate, according to Johns Hopkins University's data.The countries that drew Gates's praise "did population-scale diagnostics early on, and had quarantine policies associated with that [which] kept the level of infection low," he explained. Gates also applauded Australia's pandemic response last year, noting that the country quickly closed its international borders in March 2020.The U.S. received high marks from Gates in one category: spending more than $30 billion to fund the research and development for coronavirus vaccines. The U.S. gave that money to companies in multiple countries, resulting in multiple effective Covid vaccines.Gates's advocacy for strong pandemic preparation isn't new. In a 2015 TED Talk, he warned that an infectious virus could pose greater risk to the world's population than nuclear war.Yet on Monday, he said he wasn't entirely surprised by the world's relatively sluggish response to Covid's spread: "Pandemics come along so rarely that it's easy to be incompetent."Pandemic preparedness budgets in the U.S. were repeatedly cut in the decade leading up to 2020. In Gates's ideal scenario, that won't happen again in the U.S. or anywhere else.Each five years, governments should run a "really comprehensive exercise at both country and regional levels" with groups like the World Health Organization to prepare for potential quarantining and diagnostics measures, Gates said."Epidemics, hopefully this will get us to take them seriously, at least for the next 20 or 30 years," he added.Sign up now: Get smarter about your money and career with our weekly newsletterDon't miss:Bill Gates's goal to ensure 'that Covid-19 is the last pandemic'Bill Gates: 'Conspiracy theories that unfortunately involve me' are keeping many Americans from the Covid vaccines | Epidemics & Outbreaks |
Although proponents of secret science like to focus on examples in which it has benefited society, insiders from the very beginning of the Cold War worried that the best minds would not be drawn to work that they could not even talk about. Secrecy protected those involved from embarrassment or criminal prosecution, but it also made it much harder to vet experimental protocols, validate the results, or replicate them in follow-up research.
One research manager at a Department of Energy weapons lab would later admit, “Far more progress is actually evidenced in the unclassified fields of research than the classified ones.” The physicist Robert McCrory, whose own lab received millions in funding in partnership with Lawrence Livermore, Sandia, and Los Alamos National Laboratories, was even more blunt: “Some of the work is so poor that if it were declassified, it would be laughed off the face of the Earth.”
We can only guess what, specifically, McCrory had in mind when he said this. There are all too many possibilities. Collectively, they lend credence to the oft-stated concern that secret programs became a refuge for second- and third-rate minds. The wizards of Langley, for instance, considered it a “remarkable scientific achievement” when they managed to prove that cats could be “trained to move short distances.” According to a CIA veteran, Victor Marchetti, this achievement was part of a program to determine whether cats could be turned into surveillance devices:
A lot of money was spent. They slit the cat open, put batteries in him, wired him up. The tail was used as an antenna. They made a monstrosity. They tested him and tested him. They found he would walk off the job when he got hungry, so they put another wire in to override that. Finally they’re ready. They took it out to a park and pointed it at a park bench and said, “Listen to those two guys. Don’t listen to anything else—not the birds, no dog or cat—just those two guys!” They put him out of the van, and a taxi comes and runs him over. There they were, sitting in the van with all those dials, and the cat was dead!
The CIA nevertheless commended the “energy and imagination” of the team, and considered them potential “models for scientific pioneers.”
It could be argued that a sprawling research program purposely designed to push the envelope will, over several decades, inevitably produce some strange and low-quality research. But in some cases it is possible to make a side-by-side comparison of US government research with research commissioned by another country that had fewer resources but the same goal.
For instance, during World War II, American and British forces both used dogs to detect mines. It was delicate, dangerous work, and the dogs sometimes proved unreliable. Both governments therefore mounted research projects in the early 1950s to evaluate and improve dogs’ ability to locate mines.
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The Declassification Engine: What History Reveals about America’s Top Secrets by Matthew Connelly has been shortlisted for the 2023 Cundill History Prize.
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The British just wanted “the facts” and sought out a “trained scientist.” They selected Solly Zuckerman, an anatomist expert in animal behavior. He designed the experiment to eliminate the possibility that human handlers were unconsciously influencing the dogs’ performance.
This required systematically isolating the specific biochemical and physiological factors that might explain success or failure, since either could prove important when mines were odorless. Zuckerman had a strong personal motivation—he had seen the devastating impact of blast injuries when he conducted wartime physiological research with the survivors. His larger agenda was to develop more rigorous experimental methods in animal research. Zuckerman found no solid evidence that dogs could be relied on to detect buried mines.
The U.S. Army, on the other hand, hired a “parapsychologist” named J. B. Rhine. It is not clear why—all the army records were later destroyed. Though his training was in botany, Rhine had become famous for his experiments—never replicated— in extrasensory perception (ESP) and psychokinesis. For Rhine, the study was an opportunity to prove that ESP really existed; he had already gathered a collection of amazing stories of animal ESP. Rhine once again convinced himself that dogs possessed special powers.
Army officials found in follow-up work that the results were random, and another study proved to be a complete failure, marked by a “rather conspicuous refusal of the dogs to alert.” But Rhine used the army money to seed new research, and found new customers. The Office of Naval Research funded a decade of work on ESP in homing pigeons. In other studies, one of Rhine’s colleagues tried to influence a cat telepathically to select one dish of food over another. But here, too, even Rhine admitted that the results were “not spectacular.” Alas, the cats proved “elusive.”
The US government would spend several decades on the larger program of mind-control research. And Rhine was a paragon of scientific rigor compared with some of the other researchers on the government payroll, who espoused theories of extraterrestrial and ghostly visitations to explain ESP, and were hired by the US Army to consult on psychedelic mushrooms.
The CIA’s Project MKUltra involved a whole series of experiments on unwitting subjects, using a range of different drugs in order to manipulate them into saying and doing things against their will. It was given carte blanche to operate without the normal Agency accounting controls or need for written contracts. Once again, researchers rapidly escalated their trials with little understanding of the effects. In the first round of an experiment conducted at the New York State Psychiatric Institute, one of the patients, Harold Blauer, was given 0.4 mg of methylenedioxyphenyl-isopropylamine, a drug similar to ecstasy. The next dose was sixteen times stronger, and Blauer was dead in thirty minutes.
When the family took legal action, government lawyers threatened witnesses with prosecution under the Espionage Act. Decades later, CIA Director Stansfield Turner admitted that “some unwitting testing took place,” but testified to Congress that the subjects were “criminal sexual psychopaths confined at a State hospital.” In fact, Blauer was a tennis pro who voluntarily sought treatment for depression after a divorce.
The CIA also experimented on its own personnel. In one case, the head of MKUltra, a chemist named Sidney Gottlieb, dosed the attendees of a joint Agency-army retreat with LSD. One of the unwitting subjects, an army biochemist named Frank Olson, was traumatized by the experience. Until then, Olson had been an outgoing and devoted family man. Afterward, he sank into depression, overcome with feelings of shame, and would not return home. He told his army supervisor that he wanted to quit or be fired.
Gottlieb was likely alarmed upon being warned about this situation. MKUltra had been approved by the CIA director himself, Allen Dulles, who called the program “ultra-sensitive.” But Gottlieb reportedly had not obtained prior authorization before drugging Olson and the others. As an internal Agency report later noted, participants in this work well understood that their methods were “professionally unethical” and legally dubious, and would provoke “serious adverse reaction” from the public if ever revealed. Gottlieb therefore had a powerful motivation to make certain Olson told no one about what the CIA had done to him.The government’s venture into the paranormal proved useless for any legitimate intelligence purposes.
Gottlieb and his deputy decided to take Olson to see a New York doctor. The man had no psychiatric training but did have a top-secret CIA security clearance and experience with LSD. The doctor plied Olson with bourbon and sedatives, and took him to see a performance by a magician, whom Gottlieb was interested in hiring to help dose more unwitting targets. Olson’s public behavior became increasingly erratic, and he said that the Agency was “out to get him.” The doctor said he would take Olson to a sanitarium to be treated by CIA psychiatrists. But that night, Olson “fell” from the tenth floor of the Statler Hotel in Manhattan.
Gottlieb’s deputy was sharing the room with him, and claimed to have been asleep when it happened. His story was that Olson had just crashed right through the window, without opening it first, or even raising the shade. We may never know what happened in that hotel room. But at the time, the CIA was training its assassins to first ply their victims with drugs or alcohol, and advised, “The most efficient accident, in simple assassination, is a fall of 75 feet or more onto a hard surface.”
The CIA was clearly prepared to kill innocent American citizens. Six weeks after the Agency covered up what happened to Olson, a CIA mind-control team went on its first foreign assignment. The mission was to slip “artichoke”—likely LSD—into the drink of another unwitting subject and induce him to attempt an assassination of a prominent politician or American official. The artichoke team was primed for action, proudly noting that they “were ready when called upon for support, even though the operation did not materialize.”
Most of the MKUltra records were later destroyed, so we cannot know what other missions might have aimed to achieve. But CIA mind-control research went on for more than a decade, involved some eighty different institutions, and would eventually cost approximately ten million dollars—about a hundred million in today’s dollars.
A whole new mind-control program started up in 1972, this time led by the Defense Intelligence Agency (DIA). The goal of this new program was “to determine whether anomalous mental phenomena (i.e. extrasensory perception and psychokinesis) existed and the degree to which such phenomena might be applicable to problems of national interest.” Like MKUltra, it went on for many years, and cost many millions of dollars. How many exactly is still difficult to determine. But a single California contractor, SRI International, would eventually receive $11.3 million (or about thirty-six million in today’s dollars).
Even escape artists and magicians saw that the government was being rooked, and patiently explained to officials how timeworn tools of their trade could easily trick someone into believing in ESP. So, too, did the scientists at DARPA, who concluded that the Israeli illusionist Uri Geller, the DIA’s star pupil, was a “charlatan.” They thought it was “ridiculous” that Geller had fooled the US government into using taxpayer dollars to see whether he could bend spoons with his brain. They pointed to a host of problems with the ESP and psychokinesis experiments, above all the fact that the people paid to conduct them had a financial incentive to produce positive results.Under the cloak of secrecy, their hubris and magical thinking ran wild.
In 1985, the army commissioned a blue-ribbon panel from the National Research Council to evaluate the program. The panel concluded there was “no scientific warrant for the existence of parapsychological phenomena” such as “remote-viewing”—sensing the location or appearance of things through sheer mental effort—or psychokinesis.
Nevertheless, over the following decade the army conducted between fifty and a hundred more such experiments. In 1995, another review of the remote-viewing program was commissioned, this time by the American Institutes for Research (AIR). Once again, the reviewers found that, because of flaws in the research designs, there was no clear evidence demonstrating the existence of the paranormal.
But the AIR report found something even more damning. After some twenty-five years of experiments, the reviewers concluded, “In no case had the information provided ever been used to guide intelligence operations.” Even if some people really do have ESP that cannot be explained by science, the point of the program was not to use government resources to explore the Twilight Zone. It was to support actual missions that would safeguard national security. Yet, despite all the time and money spent—not to mention the human costs—the government’s venture into the paranormal proved useless for any legitimate intelligence purposes.
Why, then, did the intelligence community and the Pentagon go to extremes in pursuing such embarrassing “research”? For the same reason why they felt they had license to control the weather and alter the upper atmosphere: because, under the cloak of secrecy, their hubris and magical thinking ran wild. Moreover, controlling people’s minds was a prize that was just too tempting to resist. And although the government may have given up on telekinetic spoons, it did not give up on that larger goal.
During the first decade of the “Global War on Terror,” the CIA pursued mind control through more direct methods—i.e., “enhanced interrogation.” The program employed psychological abuse, stress positions, and waterboarding not just to make people talk, but also to discover scientifically rigorous and reproducible methods for compelling subjects to submit to the will of interrogators and lose all sense of personal agency. Just like MKUltra, the enhanced-interrogation program was conducted as a series of “experiments.” Here is how the CIA’s Office of Medical Services, in a top- secret 2004 document, described the protocol for recording the application of “treatments” to “subjects”:
In order to best inform future medical judgments and recommendations, it is important that every application of the waterboard be thoroughly documented: how long each application (and the entire procedure) lasted, how much water was used in the process (realizing that much splashes off), how exactly the water was applied, if a seal was achieved, if the naso- or oropharynx was filled, what sort of volume was expelled, how long was the break between applications, and how the subject looked between each treatment.
The CIA hired a retired air-force psychologist named James Mitchell to enact these methods. Mitchell, too, saw himself as a scientist. As an informed source recounted to the journalist Jane Mayer, after Mitchell took over a case, he told the FBI agents that an interrogation “was like an experiment, when you apply electric shocks to a caged dog, after a while, he’s so diminished, he can’t resist.” When the agents argued that the subject of this experiment was a human being and not a dog, Mitchell retorted, “Science is science.”
Waterboarding, “diapering,” and stress positions ultimately proved no more effective than ESP or psychokinesis, as the CIA’s own internal reviews concluded. Many of the victims had already provided valuable intelligence to their interrogators before they were tortured, and once the waterboarding began, many offered false information in order to make it stop. But the waterboarding did not stop until Mitchell’s company was paid eighty-one million dollars.
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Excerpted from The Declassification Engine: What History Reveals about America’s Top Secrets by Matthew Connelly. Copyright © 2023. Available from Pantheon, a division of Penguin Random House, LLC. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. | Medical Innovations |
In June 2021, 32-year-old Alyssa Maness was diagnosed with POTS, a nervous system disorder that her doctors believe was triggered by Covid.
POTS, or postural orthostatic tachycardia syndrome, caused numbness throughout her arms and legs, a pins-and-needles sensation and sudden drops in her heart rate.
Because her heart problems didn't go away, in early 2022 her doctors began conducting a series of lab tests in an attempt to better understand her long Covid symptoms.
When Maness submitted the testing to her insurance — Anthem Blue Cross — the provider deemed the testing medically unnecessary and declined to cover the cost. She’s now on the hook for the medical bills, which have already cost her more than $10,000 out of pocket.
“I’m kind of at the point sadly where I’ve just given up,” said Maness, a Ph.D. student in Sacramento, California. Many of her insurance appeals have been denied. “I don’t have the mental bandwidth to even battle this anymore, because it’s become clear that it is most likely going to be unsuccessful.”
Maness is among several long Covid patients in the United States interviewed by NBC News who say their insurance providers are declining to provide coverage related to their illness.
But there are likely many more. Up to 4 million full-time workers are out of the labor force due to long Covid, according to research from the Brookings Institution, a Washington-based think tank.
NBC News has asked insurance providers for comment.
For some, the care they need to manage their chronic illness has left them in medical debt, which can easily balloon into the thousands or even tens of thousands of dollars, experts say. It's unclear how many are being denied coverage, but a paper published in May in JAMA Health Forum estimated that the individual medical costs of long Covid could come to roughly $9,000 a year.
Part of the problem, experts say, is the ambiguity of long Covid symptoms, which can range from extreme fatigue to loss of taste and smell to debilitating heart palpitations. There's no official test to diagnose the condition, nor is there any specific recommended treatment. That makes it more difficult for doctors to come up with a proper treatment.
Before they pay, insurance companies often want to know if the treatment is proven to work.
Long Covid patients can fight the denied claims through appeals or going to court — a time-consuming and draining approach for any patient, let alone those who may suffer from fatigue and brain fog, said Michele Johnson, the executive director of the Tennessee Justice Center, a legal aid group that has helped long Covid patients get health coverage.
“They’re trying to keep their job or keep caring for their family," she said, "and there’s so much bureaucracy and red tape that they’re just drowning in it."
'Medical necessity'
Experts say insurance companies will often deny claims for care related to long Covid because they don't see it as a “medical necessity.”
The term is what insurance companies use to assess whether they should approve or deny a claim, said Linda Bergthold, a former health policy researcher at Stanford University’s Center for Health Policy.
The term has been thrown around by insurance companies for decades, but it wasn’t given a formal framework until the late 1990s, which Bergthold helped develop.
In order for the care a patient receives to be deemed medically necessary by an insurance provider, there has to be substantial research or evidence that shows that it works, she said.
That's "a key issue for long Covid," she said, because the illness is so new and still poorly understood.
"Research, just like everything with Covid, is all new," she said. "Nobody really quite knows what works and nobody really understands why some people have it longer than others."
To be sure, as of 2021, there are diagnostic codes for long Covid — key tools used by doctors to characterize medical diagnoses for insurance coverage, said Dr. Alan Kwan, a cardiologist at Cedars-Sinai Medical Center in Los Angeles. Those codes, however, don't always cover the myriad health problems linked to long Covid, he said.
POTS, for example, does not have a standardized diagnostic code and has only recently been linked to Covid.
Doctors may work hard to get a patient a formal diagnosis for long Covid to help with insurance, though there isn't an official test for long Covid and the testing that is done may not be covered by insurance.
Some patients may eventually get coverage after submitting an appeal to their insurance, but usually not before shelling out hundreds of dollars, Kwan said.
Others may not be so lucky and may be forced to pay for most of their care out of pocket.
That's what happened to Amy Cook, 51, of Orange County, California.
In May 2022, she got Covid, which caused her multiple long-term health problems including chest congestion, erratic heart rate, headaches and visual impairment.
Cook, who works a full-time job as a chief operating officer for a consulting agency, said she was bedbound for four months because of her long Covid symptoms.
Around October, her doctor recommended that she try naltrexone, a drug used for opioid addiction that has shown promise in lifting long Covid symptoms, as well as hyperbaric oxygen. Both therapies are being tested in clinical trials as potential treatments for the condition, though neither is approved by the Food and Drug Administration for the illness.
Aetna, her insurance provider, declined to cover most of the cost of the treatments.
“I’m at $28,000 to date and I have more treatments coming up,” Cook said of her out-of-pocket expenses.
Cook said she’s currently in a financial position to be able to self-fund the treatments, although she still hasn’t recovered from her illness and the expenses could easily grow.
“I don’t know when I’ll be able to stop,” she said.
In a statement, Alex Kepnes, a spokesperson for Aetna, said there is no single definition for long Covid and that coverage decisions "are based on medical necessity and evidence-based guidelines."
"We are focused and committed to providing our members with access to care and treatments for medically necessary services to help them address their conditions and improve their health," he said.
What can be done?
Johnson, of the Tennessee Justice Center, said a patient can improve their chances of insurance approving their claim by making sure they have a plan before they even enter the doctor's office.
Her guidance:
- Ask how much the care will cost.
- Ask the doctor to explain clearly on insurance paperwork exactly why the care was needed.
Working with a doctor can be "very effective," Johnson said, as they are usually trained to know what meets insurance providers' standards for coverage.
If that doesn't work, and insurance denies the patient's claim, the patient can appeal the decision, she said. Under the Affordable Care Act, all health insurance must have an external appeal process that allows a patient to challenge the provider's verdict.
“The idea that you could deny services without an opportunity for appeal is no longer true,” she said.
If still unsuccessful at this point, patients may begin to panic, Johnson said, because the outstanding bill can be taken to collections and patients can take a hit on their credit score. Providers often provide a very short time window for payment, and appeals often take months.
Maness, of California, said she's panicked at least once when her insurance provider took too long to get back to her on an appeal and ended up shelling out hundreds of dollars toward her bill.
What a patient does after that will depend on their health insurance, Johnson said.
People with Medicaid, for example, can take the claim to court if they feel the denial was unjustified. For people on private insurance, it's less clear what they can do, but one option is to contact the state's Department of Commerce and Insurance, which regulates insurance companies.
Johnson suggested patients frame their complaint saying, "You've licensed this insurance to do this in our state and they're denying essential benefits consistently." | Health Policy |
- U.S. health care providers wrote more than nine million prescriptions for Ozempic, Wegovy and similar and obesity drugs during the last three months of 2022, according to a new analysis.
- The report also shows that prescription volumes for those drugs increased 300% between early 2020 and the end of last year.
- The data further confirms the rise in demand for GLP-1s, which have fueled a frenzy for their ability to cause significant weight loss.
U.S. health care providers wrote more than nine million prescriptions for Ozempic, Wegovy and similar diabetes and obesity drugs during the last three months of 2022, according to a new analysis released Wednesday.
The report, from analytics firm Trilliant Health, shows that quarterly prescriptions for those drugs increased 300% between early 2020 and the end of last year.
Novo Nordisk's weekly diabetes injection Ozempic accounted for more than 65% of total prescriptions as of the end of 2022, and was primarily prescribed off-label for its ability to help patients lose weight.
The data further confirms the rise in demand for that group of drugs, which have fueled a frenzy among Americans and on Wall Street for their ability to cause significant weight loss. Those treatments, known as GLP-1s, mimic a hormone in the gut to suppress a person's appetite.
But the rate of future prescription volumes will largely depend on whether manufacturers of those drugs, Novo Nordisk and Eli Lilly, can resolve widespread supply shortages affecting most of their treatments in the U.S., among other factors, according to the report.
The analysis is based on insurance claims data for about 300 million Americans. Among the other drugs prescribed are Eli Lilly's diabetes drug Mounjaro and an older GLP-1 drug from Novo Nordisk called Saxenda, which isn't as effective for weight loss as Ozempic and Wegovy.
But the total number of GLP-1 prescriptions is likely an undercount since some health plans don't cover weight loss treatments like Wegovy, leaving some patients to pay for them out of pocket.
Some people, such as Hollywood celebrities and billionaire tech mogul Elon Musk, are wealthy enough to pay for the drugs themselves.
Ozempic's list price tops $935 per monthly package, and its weight loss counterpart Wegovy is about $1,300. The drugs are meant to be taken indefinitely to keep weight off, just like cholesterol-lowering drugs or blood pressure medications that have to be taken for life.
Other drugmakers are jockeying to capitalize on the budding weight loss industry. And analysts say Eli Lilly's Mounjaro has the potential to overtake drugs from Novo Nordisk after its approved in the U.S. for weight loss.
More than two in five adults have obesity, according to the National Institutes of Health. About 1 in 11 adults have severe obesity. | Drug Discoveries |
The very real story of how one woman prevented a national tragedy by doing her job
Frances Oldham Kelsey believed thorough research saves lives. She was so right.
Dr. Frances Oldham Kelsey had only been with the Food and Drug Administration for about a month when she was tasked with reviewing a drug named thalidomide for distribution in America.
Marketed as a sedative for pregnant women, thalidomide was already available in Canada, Germany, and several African countries.
It could have been a very simple approval. But for Kelsey, something didn't sit right. There were no tests showing thalidomide was safe for human use, particularly during pregnancy.
Kelsey in her office at the FDA in 1960.
Image by the U.S. Food and Drug Administration.
When Chemie Grünenthal released thalidomide in West Germany years earlier, they called it a "wonder drug" for pregnant women. They promised it would treat anxiety, insomnia, tension, and morning sickness and help pregnant women sleep.
What they didn't advertise were its side effects.
Because it crosses the placental barrier between fetus and mother, thalidomide causes devastating — often fatal — physical defects. During the five years it was on the market, an estimated 10,000 babies globally were born with thalidomide-caused defects. Only about 60% lived past their first birthday.
In 1961, the health effects of thalidomide weren't well-known. Only a few studies in the U.K. and Germany were starting to connect the dots between babies born with physical defects and the medication their mothers had taken while pregnant.
At the outset, that wasn't what concerned Kelsey. She'd looked at the testimonials in the submission and found them "too glowing for the support in the way of clinical back up." She pressed the American manufacturer, Cincinnati's William S. Merrell Company, to share research on how their drug affected human patients. They refused. Instead, they complained to her superiors for holding up the approval. Still, she refused to back down.
A sample pack of thalidomide.
Image by Stephen C. Dickson/Wikimedia Commons.
A sample pack of thalidomide sent to doctors in the U.K. While more than 10,000 babies worldwide were born with thalidomide-related birth defects, FDA historian John Swann credits Dr. Kelsey with limiting the number of American babies affected to just 17.
Over the next year, the manufacturer would resubmit its application to sell thalidomide six times. Each time, Kelsey asked for more research. Each time, they refused.
By 1961, thousands of mothers were giving birth to babies with shocking and heartbreaking birth defects. Taking thalidomide early in their pregnancy was the one thing connecting them. The drug was quickly pulled from shelves, vanishing mostly by 1962.
Through dogged persistence, Kelsey and her team had prevented a national tragedy.
Kelsey joins President John F. Kennedy at the signing of a new bill expanding the authority of the FDA in 1962.
Image by the U.S. Food and Drug Administration.
In 1962, President John F. Kennedy honored Kelsey with the Federal Civilian Service Medal. He thanked her for her exceptional judgment and for preventing a major tragedy of birth deformities in the United States:
“I know that we are all most indebted to Dr. Kelsey. The relationship and the hopes that all of us have for our children, I think, indicate to Dr. Kelsey, I am sure, how important her work is and those who labor with her to protect our families. So, Doctor, I know you know how much the country appreciates what you have done."
But, she wasn't done yet. Later that year, the FDA approved new, tougher regulations for companies seeking drug approval, inspired in large part by Kelsey's work on thalidomide.
Reached via email, FDA historian John Swann said this about Kelsey's legacy: "[Her] actions also made abundantly clear to the nation the important public health role that drug regulation and FDA itself play in public health. The revelation of the global experience with that drug and America's close call indeed provided impetus to secure passage of a comprehensive drug regulation bill that had been more or less floundering during the time FDA was considering the application."
Kelsey continued to work for the FDA until 2005. She died in 2015, aged 101, just days after receiving the Order of Canada for her work on thalidomide.
Bureaucratic approval work is rarely thrilling and not often celebrated. That's a shame because it's so critical.
People like Kelsey, who place public health and safety above all else — including their career — deserve every ounce of our collective respect and admiration.
This story originally appeared on 05.20.16 | Drug Discoveries |
Ozzy Osbourne, 73, to undergo major surgery that could 'determine the rest of his life', says wife Sharon as she jets to Los Angeles to be by his sideOzzy was last publicly seen in May with the frail singer leaning on a cane as he walked The rocker has Parkinson's disease and previously suffered a nasty fall and dislodged metal rods placed in his spine following a quad-bike accident in 2003 Ozzy previously opened up about his Parkinson's diagnosis in a candid interview on US TV, in which he admitted the condition is 'just another thing on my plate'He said: 'Well the one question from me was, 'Is it a terminal illness?', and the guy says, 'No, but life is' Published: 19:10 EDT, 12 June 2022 | Updated: 12:04 EDT, 13 June 2022 Ozzy Osbourne is having major surgery on Monday, which will 'determine the rest of his life'.The Dreamer hitmaker's wife Sharon revealed her plans to head back to Los Angeles from London to be there for her spouse as he undergoes the life-changing operation. The 73-year-old rocker, who was diagnosed with Parkinson's disease in 2019, was last publicly seen in May - with the frail singer leaning on a cane as he walked.Speaking on the UK's The Talk on TalkTV, Sharon said: '[Ozzy] has a very major operation on Monday, and I have to be there. Medical attention: Ozzy Osbourne, 73, is having major surgery on Monday, which will 'determine the rest of his life' (pictured May 2022)'It's really going to determine the rest of his life.'MailOnline has contacted a representative for Ozzy for comment. During her show Sharon, 69, added that the star still had plenty to look forward to after his operation as their son Jack's baby daughter with fiancée Aree Gearheart is due 'in about three weeks'.Meanwhile, the music manager and Ozzy will be celebrating their 40th wedding anniversary on July 1. Couple: The Dreamer hitmaker's wife Sharon has revealed she is heading back to Los Angeles from London to be there for her spouse as he undergoes the life-changing operation next week (pictured January 2020) Honest: Speaking on the UK's The Talk on TalkTV, she said: '[Ozzy] has a very major operation on Monday, and I have to be there'Ozzy revealed in January 2020 that he had been diagnosed with Parkin 2 - a form of Parkinson's which he said is the cause of nerve pain and leaves his legs cold. The No More Tears hitmaker's operation comes after the musician previously suffered a nasty fall and dislodged metal rods placed in his spine following a quad-bike accident in 2003.However, it was already known that he was due to undergo one more surgery. In May, he told Classic Rock Magazine: 'I'm just waiting on some more surgery on my neck. I can't walk properly these days. 'I have physical therapy every morning. I am somewhat better, but nowhere near as much as I want to be to go back on the road.' In April, Piers Morgan asked pal Sharon on Piers Morgan Uncensored on TalkTV: 'How is Ozzy, my great man? Born to perform: Ozzy, pictured here on stage with Black Sabbath in 1978, was fired from the band in 1979 due to alcohol and drug problems Making music: Ozzy went on to have a successful solo career, releasing 12 studio albums, and has since reunited with Black Sabbath on numerous occasions (pictured 2010)'He is just one of my favourite people in the world. Been through the health wars a bit, how's he doing?' PARKINSON'S: THE INCURABLE NERVE DISEASE THAT AFFECTS MILLIONS Parkinson's disease affects one million Americans a year. It causes muscle stiffness, slowness of movement, tremors, sleep disturbance, chronic fatigue, an impaired quality of life and can lead to severe disability.It is a progressive neurological condition that destroys cells in the part of the brain that controls movement.Sufferers are known to have diminished supplies of dopamine because nerve cells that make it have died.There is currently no cure and no way of stopping the progression of the disease, but hundreds of scientific trials are underway to try and change that. In the US, physicians consider it largely one type of condition with various stages; young onset Parkinson's or atypical Parkinson's. In Europe, some doctors and researchers specify different types of the condition. Treatment is mostly made up of medication. In some cases, doctors perform Deep Brain Stimulation surgery to try to hit the nerves more directly. Sharon said the Black Sabbath rocker is keen to move back to England after his latest surgery.She replied: 'He's doing okay, he sends you his love. He's got one more operation left to do and then he's dying to come back home.'Sharon's Ozzy health update comes after it was reported that they've applied for permission to build a rehab wing at their home in the UK.The Crazy Train hitmaker lodged an application requesting the green light for renovations at his Buckinghamshire mansion.The extension will feature a self-contained nurse's flat as well as 'discreet grab rails and aids' and 'an abundance of stopping and sitting spaces'.The plans also include a 'health and exercise studio' as well as a 'pool house orangery' and 'garden room'.Architect Lynne Walker wrote in the plans: 'It is the ambition that the design creates a transition of flowing inside outside garden spaces, largely lit by natural light with folding doors opening up views.'A spokesperson for the Paranoid hitmaker has yet to comment on the renovation reports, but confirmed Ozzy - who was badly injured following his fall at home three years ago - is gearing up for another surgery on his 'back or neck'.Sharon recently admitted she now has to care for Ozzy 'a lot' because of his health issues.She said: 'It's very difficult, because the combination of the Parkinson's and his accident, you go, well, which one is this? Why's this happening? Why's that happening?'Ozzy previously opened up about his Parkinson's diagnosis in a candid interview on US TV, in which he admitted the condition is 'just another thing on my plate'.He said: 'Well the one question from me was, 'Is it a terminal illness?', and the guy says, 'No, but life is'.'It's just another thing on my plate I have got to deal with. I'm not in the slightest worried about it. I've not got any secrets. The initial shock is I've got Parkinson's.'Nobody knows what the f*** it is. I didn't know anything about it apart from the name.'Ozzy was previously diagnosed with Parkin Syndrome in 2005. It has similar symptoms to Parkinson's. Making changes: Sharon, 69, said the Black Sabbath rocker is keen to move back to England after his latest surgery (pictured with daughter Kelly in January 2020) Advertisement | Disease Research |
A "fit and healthy" dad-of-four who went to doctors after suffering stomach pain has been told he only has days to live.
Jonathan Nicols, 45, began suffering from stomach aches, fatigue and weight loss out of the blue last summer.
More than a year on from the problems he found out the tragic news he had leukaemia and his treatment wasn't working, Manchester Evening News reports.
His wife Kimberley explained how she and her husband, who was fit, healthy and a keen runner, got the news from doctors that he only had weeks to live.
Jonathan ended up getting his bloods and other tests done after Kimberley urged her husband to go to the doctors after his symptoms continued for a while.
The 47-year-old explained: “He went in there really positive thinking everything was fine to be fine. It was going to be nothing.
“He was told a consultant was coming over from Manchester. That gave him concern – that someone was coming over on a Saturday afternoon. By this time, I was ringing and upset. I wanted to know what was going on.”
While at hospital, Jonathan accidentally text Kimberley his medical notes. That’s how she found out Jonathan had chronic myeloid leukaemia.
Jonathan, who is from Leeds but now lives in Formby, Merseyside, immediately started treatment, which seemed to be going well as he he was putting on weight and started "looking healthier".
But the treatment stopped working, leading doctors to try every method possible in an attempt to fight the cancer.
Kimberley added: “They tried all lines, but nothing worked.
“They gave him harsh chemotherapy to give him the best chance.
However, no treatment worked and Jonathan was told at the end of January he only had week to live.
“I knew, I kind of just knew,” his heartbroken wife explained.
“I just had that gut feeling. I was in Jonathan’s room and he always had his blinds open. I could see them all meeting and talking.
“They all came in together and I knew it wasn’t good news. The consultant bent down on his knees, held his hands and said his condolences.”
With nothing more medics could do, Jonathan returned home, where he received palliative care.
Kimberley said: “They palliative team rang me and I asked them, ‘Are we still talking weeks?’.
“They said it was days and I didn’t tell a soul. I didn’t tell anyone that information.”
Now five weeks on, Jonathan is still surprising doctors who have been left “mesmerised” by his inspiring positivity.
The academy trust chief executive hasn't take a day off work since his diagnosis.
He and Kimberley met while they were on a weekend away in Dublin nearly two decades ago.
“The amount of messages I’ve had saying what an impact he’s had on their lives and how he’s motivated them to be a better person,” Kimberley added.
“When he was having his transplant, he had his laptop open and was doing Zoom calls while attached to chemo. It’s not like he’s saying, ‘Look at me,’ it’s about his love of his job. It’s about doing better for education and every child.”
Kimberley and her children Joshua, 28, Joel, 22, Oliver, 13 and Tabatha, eight, now appreciate every moment they have with Jonathan while he is with them at home.
She added: “It’s been horrific. If someone were to tell us at the time that it would be days, you’d crave these weeks. But they’ve been really difficult.
“We’ll cherish them. We had a fish and chip night and sat in the bedroom together and he managed to do letters for everyone, he’s written birthday cards.
“Life has been cruel and every time I feel like we’ve got over a day, the next day gets harder. His one wish was that he always wanted to be at home and not a hospice.
“He has two young children and I don’t want their memories of their dad to be that way. I wouldn’t wish this part on anyone to go through.”
Jonathan’s son Joshua is now set to run the Manchester Marathon to raise money for the Clatterbridge Cancer Charity, which helped care for Jonathan during his time at the Clatterbridge Cancer centre. | Disease Research |
In 2020, a high-profile children's charity was closed down. Just two years earlier, its young founder had died in mysterious circumstances, leaving everyone involved desperate for answers. Only now is the truth becoming clear - a story of medical deception and celebrity obsession, exposed by a group of concerned parents determined to protect the cancer community from imposters.
On 10 August 2015, crowds of fans cheered and waved as two members of pop band One Direction posed for photos outside a fundraising ball at London's Natural History Museum. But inside, the real stars were a group of very ill children - dressed up in gowns and suits, some accompanied by their carers, others midway through chemotherapy.
For Megan and her mother Jean, this "Cinderella Ball" was another chance to raise money for their fast-growing charity, Believe in Magic. Over the past two years they'd granted hundreds of wishes to seriously-ill children, including parties and trips to Disneyland.
The guests also knew that Megan - who was just 20 - had organised the ball while very publicly battling a brain tumour of her own. It's an "incredible privilege" to work with Believe in Magic, One Direction's Louis Tomlinson told attendees. But behind the ball gowns and themed masks there was a secret involving one of the medical profession's most mysterious syndromes.
Megan
Believe in Magic was inspired by Megan's own struggle with illness. After her parents separated when she was very young, Megan lived with her mother Jean, sharing a fairly normal suburban life. But aged 13, Megan was diagnosed with Idiopathic Intracranial Hypertension - a build-up of pressure on the brain.
A couple of years later, Jean told friends Megan had also been diagnosed with a brain tumour. The experience inspired Megan, then 16, to start Believe in Magic, to bring some joy to desperately unwell children.
Despite Jean's regular online posts about Megan's daily cocktail of drugs and frequent hospital visits, the pair worked tirelessly for their charity. Megan, Jean, and their charity became famous for their glitzy parties and support of One Direction.
"It was out of this world," said Lucy Petagine, whose daughter Luna attended several events. "Every single child felt like they were so important and they weren't poorly."
In 2015, Megan was given an award by then-UK Prime Minister David Cameron, who praised her "extraordinary courage".
At the height of Believe in Magic's success, however, Jean announced Megan's brain tumour had worsened, and she needed to raise £120,000 for emergency life-saving treatment in the US. Megan's supporters rushed to help and they reached the target in less than 48 hours.
But one group of concerned parents in the child cancer community didn't think Megan was as ill as she claimed.
Parents turned detectives
When Jo Ashcroft first saw Megan's JustGiving appeal on Facebook in early 2015, it brought back painful memories. After her son was diagnosed with neuroblastoma - a cancer of the nervous system - Jo had raised £250,000 for successful cutting-edge treatment in the US.
Something about Megan's appeal didn't sit right with Jo. It didn't mention any specific doctor or hospital. "I was a bit suspicious," she recalls. "I just wanted to make sure the money was going to the right place."
When Jo spoke to three friends whose children had also been diagnosed with neuroblastoma, they agreed it was unusual. But they advised caution - wrongly accusing someone of lying about a brain tumour was unthinkable.
Gentle questions to Jean and other supporters went unanswered, so Jo went back to running the family business and looking after her three children. Then, a year later, Jo saw Megan and Jean were fundraising again - Jean said Megan was seriously unwell in hospital in America, and needed more money.
Jo and the other concerned parents vowed that this time, they'd uncover the truth. "It became all-consuming," she says. "I don't want people being ripped off, especially not in the cancer community."
She adopted a pseudonym and even pretended to be a journalist writing a story about Megan - although again got nowhere. But one of the group used their computer skills to work out where Jean and Megan were opening their emails. It wasn't a hospital. It was a luxury hotel at Disney World in Orlando, Florida.
Private investigator
A few weeks later, Megan and her mother Jean disembarked the Queen Mary II ocean liner at Southampton docks.
According to Jean, they were lucky to be back at all. Throughout the summer, she'd asked supporters to help her raise money - explaining Megan had "16 sources of infections" and severe sepsis. At one point, she said, doctors gave Megan a 10% chance of surviving the next seven days.
Thanks to their hard work though, she said, Megan's condition had stabilised and the specialists in Florida had allowed her to return home, armed with five cases of medical kit and a "huge oxygen concentrator".
But waiting at the cruise terminal as they arrived was a private investigator. Jo was so determined to discover the truth, she paid £1,000 for him to take photos of the pair.
The photos showed Megan and Jean walking off the ship like a couple of happy tourists. There were no oxygen tanks. According to the investigator, they were laughing and chatting as they strolled straight past the porters, pushing luggage trollies piled high with cases.
We asked Jean via email why she and Megan were staying at a Disney resort at a time they claimed Megan was seriously ill in a US hospital. She did not respond, although said, "it is very easy to get sucked into social media lies."
Armed with this new evidence, the concerned parents contacted every authority they could think of, but it seemed like nobody would intervene. So they decided to set up a Facebook group called: "The Truth About Meg And Jean" - where they shared their discoveries. But most of Meg and Jean's supporters refused to believe it. Many had seen Megan's poor health first-hand - the intravenous tubes in her arm and medication.
Jo was bombarded with hateful messages, but she was confident she'd done the right thing. Then, in early 2018, Jo's phone buzzed. Megan was dead.
The inquest
Megan had died on 28 March 2018 at the National Hospital for Neurology and Neurosurgery in London.
"All I kept saying is, 'Darling, if you want to go, please go and be happy,'" wrote her mother on Facebook.
Jo was stunned. "It wasn't supposed to end like this," she says.
For Megan's supporters, there was little doubt who was to blame. "She was hounded to death," wrote one on Facebook. But Jo remained convinced that Megan didn't have a brain tumour.
When the cause of someone's death is unclear, a coroner investigates what has happened. In late 2018, an inquest into Megan's death took place.
In early 2022, we were granted permission to attend the coroner's court and listen to a recording of what had been heard at the inquest four years earlier.
For two hours, we listened to doctors explain what they had seen. Megan had certainly been unwell - over the years she had suffered from several conditions, but all in theory manageable.
But the inquest dealt a shocking blow to the claims Megan and Jean had made over the years. Jo was right - there was no mention of a tumour. According to the forensic pathologist, her brain had been "morphologically normal".
Several doctors however listed other worrying details. One had concerns about the validity of Megan's medical history. Another noted Megan's "opiate-seeking" behaviour. There was an attempt to obtain morphine using a forged prescription. Megan repeatedly missed medical appointments and hopped from doctor to doctor.
It wasn't a tumour that killed Megan, but an abnormality of the rhythm of the heart - acute cardiac arrhythmia - due to fatty liver disease, likely related to Megan's high body mass index.
Jean did not want to be interviewed, but told us via email that Megan did have a pituitary microadenoma - a type of non-cancerous brain tumour which, while not typically life-threatening, can be harmful.
The sisters
Megan had four older half-siblings, Jean's children from a previous marriage. "I was 12 when Meg was born," says Megan's half-sister Kate, whose name we've changed. "I just adored her."
According to Kate, Megan and Jean had a strange relationship with illness. If someone they knew was unwell, sooner or later they'd hear Megan had the same.
Kate remembers family dinners laced with danger. Jean piled tins precariously on top of empty food cupboards which would roll off and hit the dining table directly below - so often that it was covered in dents and divots.
"Jean wanted one of us to have an accident," believes Kate. "The whole thrill of it. The attention."
For Megan's other half-sister Rachel - whose name we've also changed - it's even more personal. When she was nine, she was affected by a rash that caused kidney problems. Over the years, her condition deteriorated, and she needed a transplant.
After Megan died, Rachel had vivid memories of being fed cups and cups of salty Bovril as a child - even though high salt content is something you should avoid with kidney problems.
She now wonders: "Only I got Bovril. So, was it a deliberate thing?"
Munchausen
In 1951, a physician called Richard Asher published a ground-breaking paper in the medical journal The Lancet. While running a mental observation unit, he noticed a small but consistent number of patients complaining of various symptoms, but on closer inspection were perfectly healthy.
He called it "Munchausen syndrome". It differs from hypochondria. Hypochondriacs exaggerate and panic, but really do think they're ill. Munchausen patients know they aren't, but seek treatment anyway.
Prof Marc Feldman is one of the world's most renowned experts on factitious disorders like Munchausen syndrome. He also studies Munchausen by proxy, now known in the UK as Fabricated or Induced Illness (FII), a rare form of child abuse where a parent or carer exaggerates or deliberately causes symptoms of illness in the child. Because it involves deception, he thinks the condition is more widespread than people realise.
Prof Feldman never met Megan or Jean, and hasn't seen Megan's medical records. But based on our detailed account of what we've discovered, he says Megan's case "screams" of FII.
Megan was 23 when she died, so legally an adult. But she was still a child when the charity was started. We will never know for sure who was driving this behaviour, or what Megan really thought of it all.
Feldman explains the line between child and consenting adult might be clear in legal terms - but not always in practice: "If you learn throughout your whole lifetime that there are certain things you're allowed to say and think⦠you become cooperative."
One Direction
People fake illness - either in themselves or others - for lots of reasons. Some do it for money. Sometimes it's a wish to be listened to or looked after. For parents, it can be a desire to be the heroic caregiver. Sometimes it's a mixture.
For Megan and Jean, one motive might have been to run a much-loved charity - Megan being seen as having a life-threatening brain tumour herself may have helped Believe in Magic reach more children. At a Believe in Magic event at the Tower of London, a former friend recalls Jean observing: "The sicker Meg is, the more attention we get, the more money we make."
More recently, Prof Feldman has spotted a new trend - people faking conditions to meet celebrities. A serious condition, he says, "allows someone to emerge out of the pack of people who are infatuated with this celebrity".
Megan's sister Kate thinks that the brain tumour and Believe in Magic were partly driven by a desire to rub shoulders with celebrities. After repeatedly tweeting members of One Direction, the band became supporters of the charity, allowing Megan and Jean to meet the stars.
The Kingston review
In 2017 - a year before Megan died - the Charity Commission opened an investigation into Believe in Magic, following several tip-offs from Jo.
They found more than £100,000 was unaccounted for, and that charity money had been transferred into Jean's personal bank account. In 2020, the charity was dissolved and Jean agreed not to be a trustee or in a senior management position in any charity for five years.
Just a few months after Believe in Magic was shut down, Jean disappeared from public view. She moved to France for a while, before returning to the UK last year.
But that was not the end of the story. In November 2022, Kingston Council - where Megan had been living - published a "Safeguarding Adult Review" into what had happened. These are rare investigations into cases where people may have been let down by the authorities. As is standard, the names are all changed, but because of how much we've learned about the case, we have no doubt it's about Megan.
It concluded: "Despite there being no formal diagnosis of FII (Fabricated or Induced Illness) in this case, the presentation and coroner's conclusion lead all involved to think it was likely to have been FII."
This review does not suggest that FII caused Megan's death. It cites the cause of death given in the coroner's inquest: cardiac arrhythmia, due to fatty liver disease. But it nevertheless highlights how the FII in Megan's case could have been missed.
FII is recognised as something that can happen to children, because parents attend their medical appointments, and are responsible for giving consent for treatments. There's far less understanding about how it can happen to vulnerable adults too. Because Megan was an adult for much of this story, doctors and social workers lacked the training and tools to identify her situation as a case of FII while she was still alive.
We asked Jean to respond to the findings of the Kingston review. She did not directly address what was found, but did say: "I loved and cared for my daughter. Suggesting I might have harmed her in any way at all is absolutely sickening."
It's too late for Megan, but according to FII expert Dr Danya Glaser, this review could change how similar cases are understood and managed.
"The Kingston review is extremely significant," she explained. "It brings to people's attention the fact that FII can continue into adulthood."
A few days after the review was published, we visited Kate and Rachel to tell them about it - even Megan's sisters had no idea it had taken place. Neither have spoken to their mother for several years. When they asked her difficult questions about Megan and Believe in Magic, Jean cut them out of her life, they say.
"It's a good thing to have. It's all there in black and white," says Rachel, reading the report. "We thought it had all been forgotten." She thinks back to her kidney transplant and wonders what this report means for her too.
They both hope it might help prevent something similar happening again.
"Megan was a victim," says Kate. "She was groomed for this." | Disease Research |
MoneyWatch June 14, 2022 / 4:49 PM / MoneyWatch El-Erian says inflation could hit 9% El-Erian says inflation could hit 9% 08:59 Seniors and other Social Security recipients in the U.S. are being hit hard by inflation, which has outpaced increases in their benefits this year. Now, some lawmakers have a plan to boost Social Security payments by $2,400 per recipient annually, while also shoring up the program financially. The Social Security Expansion Act was introduced on Thursday by Rep. Peter DeFazio, a Democrat from Oregon, and Senator Bernie Sanders, an Independent from Vermont. The plan comes after the Social Security Administration earlier this month said Americans will stop receiving their full Social Security benefits in roughly 13 years without actions to shore up the program.Social Security recipients receive one cost-of-living adjustment, or COLA, each year, which is based on inflation and is supposed to keep their benefits in line with rising prices. But this year, beneficiaries are seeing their purchasing power wane as inflation overtakes their latest COLA increase of 5.9%. Inflation in May rose 8.6% from a year ago, a four-decade high that pushed up the cost of food, shelter, energy and other staples. The new bill would seek to lessen the strain on people collecting Social Security by boosting each recipient's monthly check by $200 — an annual increase of $2,400. "Many, many seniors rely on Social Security for the majority, if not all, of their income," said Martha Shedden, president of the National Association of Registered Social Security Analysts. "$200 a month can make a significant difference for many people." Federal Reserve expected to announce aggressive interest rate hike Wednesday 03:55 The average monthly Social Security check is about $1,658, so a $200 increase would represent a 12% boost. The bill would also make several additional changes to the program, including buttressing the program's funding by applying the Social Security payroll tax on all income above $250,000. Currently, earnings above $147,000 aren't subject to the Social Security tax. Although the bill would likely face obstacles in Congress, lawmakers are likely to take steps to shore up Social Security given the eventual shortfall, which would result in a cut to monthly benefits by about 20% starting in 2035, Shedden said."I'm confident changes will be made," Shedden said. "I don't know if this is the bill that will pass, but there is more and more movement on it."Here's what to know about the Social Security Expansion Act. A benefits boost: $200, plus COLA changesAnyone who is a current Social Security recipient or who will turn 62 in 2023 — the earliest age at which an individual can claim Social Security — would receive an extra $200 per monthly check. There are some additional tweaks that would boost benefits over the long-term. One of the primary changes would be to base the annual COLA on the Consumer Price Index for the Elderly (CPI-E), rather than the current index that the Social Security Administration uses for its calculation — the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). The CPI-E more accurately reflects seniors' spending patterns, according to experts on Social Security. For instance, it puts more weight on health care expenses, which can be considerable for senior citizens. If the CPI-E had been used to index the annual COLA for Social Security, a senior who filed for Social Security benefits over 30 years ago would have received about $14,000 more in retirement than compared with the CPI-W, according to the Senior Citizens League.The bill would also boost benefits for the lowest income earners in the U.S., who receive benefits under a program called the Special Minimum Benefit. Under the legislation, it would be indexed so that it is equal to about 125% of the federal poverty line, or about $1,400 a month. In 2020, the Special Minimum Benefit paid about $900 per month, according to the Social Security Administration. More help for children of deceased workersSome people may not be aware that Social Security provides benefits to children of disabled or deceased workers if they are full-time students. The legislation would raise the eligibility age for students to collect benefits to 22, provided the individual is a full-time student in college or a vocational school. Currently, the program ends for children of disabled or deceased workers when they turn 19 years old or before that age if they are no longer a full-time student. The lawmakers say extending this benefit would help ensure that the children of deceased or disabled parents can continue their education beyond high school. Would a tax increase pay for all this?The bill would increase the Social Security payroll tax on higher-income workers. Currently, workers pay the Social Security tax on their first $147,000 of earnings. To be sure, most Americans earn less than that. But higher-income workers who make more than $147,000 annually don't pay the Social Security tax on any earnings above that level. Under the bill, the payroll tax would kick in again for people earning above $250,000. Only the top 7% of earners would see their taxes go up as a result, according to DeFazio.However, there's one quirk about this arrangement: It would create a "donut hole" in which earnings between $147,000 and $250,000 would not be subject to the payroll tax, Shedden noted. The bill would also extend the Social Security payroll tax to investment and business income, an issue that could face resistance. "I'm leery about that," she said. "Social Security was set up to be based on contributions on earned income, and this mixes up the basket of earned and unearned income."Would those changes fix the program's funding shortfall?Expanding the payroll tax would boost the Social Security Administration's trust fund, ensuring its solvency through 2096, according to DeFazio. Whether this bill moves forward or not, boosting payroll taxes in some fashion is viewed as a way to guarantee that current and future retirees don't lose benefits after 2035. For instance, the Congressional Research Service said in a 2021 report that "raising or eliminating the cap on wages that are subject to taxes could reduce the long-range deficit in the Social Security trust funds." In: Social Security Administration Thanks for reading CBS NEWS. Create your free account or log in for more features. Please enter email address to continue Please enter valid email address to continue | Health Policy |
Beth Matthews was 26 when she took her own life in a psychiatric unit run by The Priory - an inquest jury has found she was failed by the hospital. After Beth died, her family discovered she had helped countless people by writing honestly about her mental health problems. In the weeks after his daughter's funeral, Chris Matthews spent many mornings at her grave, nestled in a country churchyard, as he struggled to come to terms with her death. One morning, as he tidied away some flowers that were beginning to fade, he discovered a fresh bouquet. Attached was a note which read: "I probably should explain why a completely random stranger left this card and flowers on Beth's grave. Over the past year, her tweets and her blog have kept me alive."Information and supportIt was written by Robert, who had travelled 200 miles from London to Beth's grave, overlooking the River Tamar in Cornwall. He had never met Beth, but wanted to thank her. Beth had written a blog which documented her mental health journey - including how she had survived and was recovering from a suicide attempt.Robert discovered it on a particularly dark day, when he had decided to take his own life. Image caption, Robert says he believes Beth helped thousands of people like him"Instead, I couldn't stop reading it," he says. "And when I finished, I was very sad, but the suicidal moment had gone. I thought, 'If Beth can get through this, then surely I can.'"In a typical tweet to her 26,000 followers, Beth wrote: "Suicide is not the answer. To anyone out there that is struggling, please believe me when I say things CAN and WILL get better."Robert says she saved his life. "I would imagine, going through her tweets and replies, that there were probably thousands of people like me," he adds. On the surface, Beth's childhood was idyllic. Growing up by the sea, she loved sailing, becoming one of the youngest competitors in the renowned competition named after the Fastnet Rock off southern Ireland, which the race course rounds. "I can still hear her squeal of delight when she was doing anything a little bit mischievous," remembers her sister Lucy.But despite her extrovert persona, Beth secretly struggled with her mental health for many years, and made a number of suicide attempts. Then on 8 April 2019, she was badly injured trying to take her own life. She was airlifted to hospital and spent two weeks in a coma, but remarkably survived and started rebuilding her life.Image caption, Beth's first post on social media about her mental health struggles went viralBeth first spoke publicly about her recovery in a post on Facebook. "She felt understandably nervous and anxious about it," recalls Lucy. "She was writing about how she'd fought to be here and how much she wanted to be here. And she wrote so well."The post went viral. She started a Twitter account and a blog. The blogger who gave others hope, Beth Matthews, took her own life at 26."I think she realised that there were people out there who were benefiting from her knowledge and understanding," says Chris.Another one of those people was Melanie, who was struggling with "horrific" insomnia. "I'd sit on the settee all the way through the night, while my hubby and my kids were asleep, and just feel like the loneliest person in the whole world, with plans to end my life, trying not to act on those plans," she explains. Image caption, Melanie is compiling a book of messages from Beth's Twitter friendsMelanie would message Beth on Twitter, asking for support. And Beth would reply. "No matter what Beth was going through, even when she was in hospital, she was messaging me at 2am… telling you it's worth it, telling you you're worth it," she says. Melanie, from Sheffield, is compiling a book of messages from Beth's Twitter followers for her family. "There aren't just a handful of us who think about Beth on a daily basis," she says, showing a tattoo she has to remind her of Beth.The chief executive of charity Mental Health UK, Brian Dow, says Beth had a special ability to explain the "raw, really challenging moments" that many people face. "The effect of that was that thousands of other people who felt the same, stopped feeling alone," he says. "We know that kind of willingness to share actually saves people's lives."Image caption, Beth's sister Lucy says writing her blog gave Beth purposeTelling her story was part of Beth's attempt to move forward. She also bought a paddleboard and posted videos of herself, back on the water. "I've been given a second chance at life," she wrote. "I'm going to seize it."Her sister Lucy says writing her blog and helping others on Twitter gave Beth purpose.Her father Chris agrees. "She was wise beyond her years," he says, choking back tears. "She became such an enormous part of peoples' lives, people that she'd never met before." The power of Beth's writing comes from the unvarnished honesty of the pain she had experienced.In one tweet, she shares shocking images of the X-rays of her broken pelvis, saying they are a "gentle reminder" of why people should not try to harm themselves. "When somebody is willing to think of others and to share their pain in such a raw manner, I think that takes a level of courage that frankly most of us don't possess," says Mental Health UK's Brian Dow.Image caption, Beth with PC Jessica Floyd, who had held her hand after her suicide attemptAs part of her recovery, Beth met members of the Devon Air Ambulance team who had come to her aid, plus the police officer who had held her hand that day.PC Jessica Floyd - who says she will never forget the incident - wanted to speak in Beth's memory to urge anyone who was also struggling to talk to someone."Tell somebody how you feel. Know that you're not alone," she says. "And whilst you feel very trapped in that situation, there are people out there who are there to talk to and to help you."Beth also used her experience to educate people in person. She told her story to young people at a Cornwall mental health unit. She helped train police negotiators in dealing with those threatening suicide, organised by an officer from Staffordshire Police who saw her online profile."We'd never had that insight before," says Sgt Nigel Roberts. "It was electrifying. She was just resolute that she would do anything she could to help other people, help it not happen to them."Sgt Roberts and his team now routinely use knowledge and experience they learned from Beth when dealing with high-risk situations.Image caption, Beth, pictured here with her boyfriend Matt, had told her family she wanted to liveYet while she was doing so much to help others, Beth was still suffering with physical pain from her injuries and mental health struggles. Her family sought NHS funding for treatment at a mental health unit run by The Priory Group - one of the UK's biggest private mental health care providers. Beth moved to the Priory Hospital Cheadle Royal near Stockport in November 2021. She tweeted in excitement: "The funding for the specialist unit has been approved. I'm going to grab this opportunity with both hands."Beth's father remembers breathing a huge sigh of relief that, at least there, his daughter would be safe. Her family insist she could have got better, with the right care and treatment. "When I last saw her, she said 'I do want to be here,'" says Lucy.But Beth took her own life, on 21 March last year, after taking poison which she had ordered online and told staff was protein powder.An inquest jury concluded that Beth, who was being treated for a personality disorder, died from suicide contributed to by neglect.It found there had been "inadequate care of a highly vulnerable patient," adding "it was evident there were serious inconsistencies across all levels of her care plan".The Priory said it fully accepted the jury's findings and acknowledged "far greater attention should have been given to Beth's care plan".A spokesman said: "At the time of Beth's unexpected death, we took immediate steps to address the issues around how we document risk and communicate patients' care plans, alongside our processes for receiving and opening post."We want to extend our deepest condolences to Beth's family and friends for their loss."Beth's family feel let down and angry. But they take some comfort in her achievements."It wasn't until after her passing that we realised the impact she'd had on individual lives, when people came forward and left us notes and messages of support," says Lucy."It's just full of sadness that she didn't do the same for herself." | Mental Health Treatments |
Legendary singer Tony Bennett, who died on July 21 in New York at age 96, had a history of health issues over the years, culminating in his seven-year battle with Alzheimer’s disease.
Although no cause of death was indicated in the announcement of Bennett’s passing, his publicist, Sylvia Weiner, mentioned his 2016 Alzheimer’s diagnosis.
The Alzheimer’s Association, with which Bennett partnered to raise awareness and funds for the disease, also released a public statement.
"The Alzheimer’s Association joins the world in mourning the loss of Tony Bennett, a great friend and champion of the cause," said Joanne Pike, president and CEO of the Alzheimer’s Association in Chicago, Illinois, in the statement.
"For decades, Tony inspired the world with his music and, after being diagnosed with Alzheimer’s disease, he continued to use that powerful voice to make a very real difference in inspiring action and change."
Several neurology experts shared with Fox News Digital the key points people should know about late-stage Alzheimer’s — and its potentially fatal complications.
Alzheimer’s: Most common form of dementia
Alzheimer’s disease is a cognitive disorder that causes damaging proteins to build up in the brain, according to the Mayo Clinic.
Around 6.5 million people 65 and older are living with Alzheimer’s in the U.S., with the disease comprising up to 70% of all dementia cases.
Over time, the disease causes brain shrinkage and kills brain cells, resulting in a gradual cognitive decline.
There is currently no cure for Alzheimer’s, although a new drug called Leqembi, which works to remove plaque from the brain, recently received FDA approval.
Early signs of Alzheimer’s include episodes of short-term memory loss. It eventually leads to memory loss and an inability to function.
There is currently no cure for Alzheimer’s, although a new drug called Leqembi, which works to remove plaque from the brain, recently received FDA approval.
"The drug has been shown to slow down disease progression in the early stages of the disease," Dongxu Sun, PhD, an Alzheimer’s research expert in San Francisco, told Fox News Digital.
"Leqembi, like all other plaque-removing drugs, can lead to side effects such as brain swelling and bleeding because it removes plaques through enhancing neuroinflammation."
Late-stage Alzheimer’s disease
During the advanced stages of Alzheimer’s, patients experience severe cognitive decline, according to Dr. Rehan Aziz, a geriatric psychiatrist at Jersey Shore University Medical Center in Neptune, New Jersey and associate professor of psychiatry and neurology at Hackensack Meridian School of Medicine.
"In this stage, individuals may lose the ability to recognize familiar people, including family members and friends," he told Fox News Digital.
"They may have difficulty communicating their needs."
People with late-stage disease often need help with routine activities like getting dressed, eating and cutting food, showering, combing their hair or brushing their teeth, using the toilet and even walking, the doctor said.
They may also experience behavioral and psychological changes.
"Individuals can develop a number of psychological symptoms, including apathy, depression, difficulty sleeping at night and aggression," Aziz said.
These patients often require 24-hour care, either at home with the appropriate services or in a skilled nursing facility, the doctor said.
"Caregivers have high rates of depression, as well as increased chances of becoming physically sick," he warned.
"It is important that caregivers take care of themselves and seek support."
Aziz often refers caregivers to Alzheimer's support groups as well as to mental health clinicians if needed, he said.
When does Alzheimer’s become fatal?
Unlike cancer or Lou Gehrig's disease, Alzheimer's disease is not a direct cause of death, according to Dr. Arif Dalvi, director of the Memory Disorders Center at St. Mary's Medical Center in West Palm Beach, Florida.
"However, as the disease state progresses, the patient's ability to take care of themselves, even with help, declines considerably," he told Fox News Digital.
"This general deconditioning leads to complications that are directly responsible for death."
The average life expectancy for someone with Alzheimer's disease is around 8-10 years, according to the Alzheimer’s Society. Longevity is shorter for those who are diagnosed in their 80s or 90s.
"Based on a person’s health condition and lifestyle, some patients decline quickly and succumb to the disease within a few years — while others can live for many years after diagnosis," said Sun of San Francisco.
Typical cause of death for Alzheimer’s patients
In addition to causing memory loss, Alzheimer’s also leads to a decline of the immune system, the cardiovascular system and others, said Sun.
"These declines can lead to the development of fatal complications like aspiration pneumonia, stroke or heart disease," he explained.
Dalvi commonly sees Alzheimer’s patients succumb to infections, which can be fatal.
"A combination of disease progression, general debility from aging and decline in hygiene due to an inability to take care of themselves leads to susceptibility to infections," he explained.
"Pneumonia is the most common, although urinary tract infections also are seen fairly often," he continued. "In the debilitated person, this can lead to sepsis and death."
"Some patients decline quickly and succumb to the disease within a few years, while others can live for many years after diagnosis."
Other potential causes of death include malnutrition as a result of not eating or having trouble eating, accidentally inhaling foods or liquids or falls/accidents caused by weakness or wandering.
That's according to Dr. Jasdeep S. Hundal, a board-certified clinical neuropsychologist and associate professor of psychiatry and neurology at the Hackensack Meridian School of Medicine in New Jersey.
Caring for people with late-stage Alzheimer’s
Maintaining adequate nutrition and hydration is extremely important for those with advanced dementia, Dalvi, said, as it supports general well-being and immune function.
Because patients with Alzheimer’s can forget to eat, the doctor said their weight should be monitored on a regular basis.
"Feeding should be supervised, as difficulties with swallowing can lead to aspiration pneumonia," he warned.
"Minimizing unnecessary medications and regular medication review is also important."
Additionally, he emphasized the need to minimize fall risk.
"It is also important to take care of the emotional needs of the caregivers and family during the late stage of the condition," Dalvi added. | Disease Research |
On the morning of September 11, critical care specialist Anoop Kumar was presented with an unusual situation. Four members of the same family had been admitted to his hospital—Aster MIMS in Kozhikode, Kerala—the previous day, all similarly sick. Would he take a look?
He gathered his team of doctors to investigate. Soon they were at the bedsides of a 9-year-old boy, his 4-year-old sister, their 24-year-old uncle, and a 10-month-old cousin. All had arrived at the hospital with fever, cough, and flu-like symptoms. The 9-year-old was in respiratory distress, struggling to breathe properly, and had needed to be put on a noninvasive ventilator, with air pumped through a mask to keep his lungs expanded.
Their symptoms were concerning and mysterious—none of the team could pinpoint what was wrong. But delving into their family history, Anoop and his colleagues soon uncovered a clue. The father of the two young siblings, 49-year-old Mohammed Ali, an agriculturalist, had died less than two weeks previously. And when the team at Aster MIMS got in touch with the hospital that had treated Ali, they found that he had been admitted with similar symptoms, pneumonia and fever.
Digging deeper, they learned from the other hospital that Ali had also had some neurological symptoms, which had seemingly been overlooked by his doctors—he’d had double vision, suffered seizures, and spoken with slurred speech. Despite this, Ali’s death had been attributed to “multi-organ failure,” a vague diagnosis with no indication of the cause. Alarm bells started ringing in Anoop’s head.
Ali’s case reminded Anoop of May 2018, when he’d diagnosed five patients with a combination of flu-like symptoms, respiratory distress, and neurological problems. Those patients had been suffering with a rare but deadly zoonotic virus called Nipah.
Believed to be spread to people from bats, Nipah has a fatality rate in humans of somewhere between 40 and 75 percent. In the 2018 outbreak in Kerala, India’s first ever, 18 people caught the virus. Seventeen died.
“You can contract it with direct contact with infected animals, such as bats or pigs, or from food or water contaminated with their body fluids,” says Thekkumkara Surendran Anish, associate professor for community medicine at the Government Medical College in Manjeri, Kerala, who leads the state’s Nipah surveillance team. “Close contact with an infected person and their bodily fluids can expose you to Nipah as well.” The virus has since emerged multiple times in Kerala.
Anoop and his team knew they had to act swiftly—there are no authorized treatments for Nipah, nor are there vaccines for protection. If the virus were to take hold or spread outside of the local area, the effects could be catastrophic. But first they needed confirmation.
The cluster of mysterious cases in these patients, their connection to Ali, his concerning neurological symptoms, his lack of a proper diagnosis—“We had strong reason to suspect Nipah again,” Anoop says. “Another red flag was the rapid decline of the patient,” Anoop says of Ali. Within a matter of days, he had fallen sick and died. And then there was one final alarm: “Ali lived close to the epicenter of Kerala’s 2018 Nipah outbreak.”
Fearing the worst, the team immediately isolated the patients and sent the family nose-and-throat swabs for testing. No sooner had they done this than another patient was admitted with similar symptoms. Forty-year-old Mangalatt Haris, who lived in Ayanchery, Kozhikode, arrived at Aster MIMS in critical condition. He died later that day. His nasal swab samples were sent to test for Nipah as well.
The results came back the following day—three of the patients had tested positive for the virus: Ali’s 9-year-old son, his 24-year-old uncle, and the seemingly unrelated Haris. The hospital where Ali had been treated had taken nasal swabs from him to rule out COVID and various other infections. These, too, were sent for testing, and turned out to be Nipah-positive, seemingly establishing Mohammed Ali as the first case in this outbreak.
But was he? Haris had no link with Ali’s family, nor did he live in the same neighborhood. He might have picked up the virus from someone unknown. Ali might not be the first case, just the earliest to have been spotted so far. Also on Anoop’s mind was the incubation period. The virus takes hold over 14 to 21 days, meaning weeks can pass between getting infected and showing signs of being ill. If others out there were involved in this outbreak, the virus could already have spread widely, unnoticed.
Code red
The gravity of the situation wasn’t lost on the state authorities. With these positive Nipah diagnoses confirmed, Kerala’s public health mechanism swung into overdrive. On September 13, health authorities divided the district into containment zones and instituted strict lockdown measures across them, just like they did for COVID. Schools, offices, and public transport were shut down, travel into and out of the zones was restricted, and only essential shops were allowed to stay open, and for limited hours. As a precaution, people had to use masks, practice social distancing, and use hand sanitizers. State health workers then set about the arduous task of contact tracing. They isolated anyone with a fever and traced 1,233 contacts of the cases—anyone who had come into contact with Mohammed Ali, his family, and the second patient Haris when they were likely to be infectious. One health worker tested positive.
Meanwhile, doctors were studying the family history of the second patient, Haris, to try to draw a link between the cases. Poring over his every move before he was admitted to Aster MIMS, they eventually made a breakthrough, thanks to some CCTV footage.
“We learned that Haris had accompanied his sick father-in-law, who was admitted in the same hospital [as Ali], and was in an emergency ward next to Ali’s,” says Anish. The two wards shared a health worker, whom authorities suspect may have spread the virus between the two. | Epidemics & Outbreaks |
Study validates pyrvinium as treatment to prevent stomach cancerOct. 5, 2023, 3:01 PM
by Tom Wilemon
A study published Oct. 4 in Gastroenterology further validates that pyrvinium, a drug that has been used for decades for intestinal pinworms, can be repurposed as a preventative treatment for stomach cancer.
Eunyoung Choi, PhD, assistant professor of Surgery, and colleagues have demonstrated in human organoids and mouse models that the drug induces cell death in precancerous lesions. Pyrvinium blockades both the MEK/ERK and STAT3 signaling pathways. In another study she led, which was published last year in Gastroenterology, the researchers demonstrated that pyrvinium blocked regeneration of dysplastic stem cells.
Choi has published a series of studies that have delved into the mechanisms by which gastric cancer forms through dysplasia, the abnormal growth or development of cells. Globally, gastric cancer is the fifth most common cancer and the third deadliest. The current standard of treatment for gastric dysplasia is limited to endoscopic resection or surgical excision of small lesions.
“Our study suggests that pyrvinium can lead to mucosal recovery from metaplastic and/or dysplastic to normal by targeting a stem cell population through a dual MEK/ERK and STAT3 inhibition. Thus, pyrvinium is a unique candidate for potential therapeutic prevention of gastric cancer in patients with high-risk precancer,” said Choi, the study’s senior author.
Pyrvinium has been used for over 70 years for intestinal pinworms and has a known safety profile. Recent preclinical studies have reported that the drug can also impede the growth of colorectal, breast, lung, liver and pancreas cancers by inhibiting crucial signaling pathways. Choi’s lab, however, is the first to identify the specific dysplastic stem cells that are a key source of clonal evolution of dysplasia to gastric cancer.
In this latest study, the researchers revealed through scRNA-seq data analyses that pyrvinium targeted the CD133+/CD166+ stem cell populations as well as proliferating cells in dysplastic organoids. The drug also inhibited metaplasia progression to dysplasia and promoted the regeneration of normal gastric mucosa by contributing to an anti-inflammatory microenvironment. This effect suggests a lower likelihood of potential adverse effects on tissue regeneration.
“With the pyrvinium’s possible advantages including its well-characterized lack of side effects, a next step to move forward would be an early phase trial of pyrvinium to reverse the metaplastic gastric mucosa in patients with high-risk precancer with a clinical research group,” Choi said.
The study’s lead authors are Hyesung Kim, PhD, and Bogun Jang, MD, PhD. Other Vanderbilt authors of the study are Changqing Zhang, BS; Brianna Caldwell, BS, MBA; and James Goldenring, PhD, MD. Other collaborators are scientists from Seoul National University College of Medicine.
The research received support from National Institutes of Health grants CA244970, CA272687, and DK101332, the AGA Research Foundation, the Robert & Sally Funderburg Research Award in Gastric Cancer, the Gastric Cancer Foundation, and the Department of Veterans Affairs Merit Review Award IBX000930, the Department of Defense CA190172 and the National Research Foundation of Korea. | Drug Discoveries |
The positive test comes just days after Trudeau met with President Joe Biden.Canadian Prime Minister Justin Trudeau speaks during a plenary session at the Summit of the Americas pn June 10, 2022, in Los Angeles.Marcio Jose Sanchez / APJune 13, 2022, 4:57 PM UTC / Updated June 13, 2022, 6:35 PM UTCCanadian Prime Minister Justin Trudeau said Monday that he has tested positive for Covid-19, announcing the result just days after he met with President Joe Biden.U.S. Health and Human Services Secretary Xavier Becerra, who attended the same summit as Trudeau and Biden, has also tested positive for the virus, his office said. Trudeau announced his positive test on social media. "I feel okay, but that’s because I got my shots. So, if you haven’t, get vaccinated — and if you can, get boosted," Trudeau said in a tweet.Trudeau met with Biden in a bilateral meeting in Los Angeles at the Summit of the Americas on Thursday. The White House said the pair discussed the Russian assault on Ukraine "and joint efforts to make our supply chains and economies more resilient to external shocks." The pair and other leaders attending the summit also took a “family photo” together on Friday. A White House spokesperson said the 79-year-old Biden, who is at a higher risk from the virus because of his age, was not considered a “close contact” of the prime minister’s.Trudeau met with 82-year-old House Speaker Nancy Pelosi on Friday as well, and they were photographed holding hands standing close to each other without masks.Becerra, meanwhile, tested positive for the virus on Monday morning, his office said. “He is fully vaccinated and boosted against Covid-19, and is experiencing mild symptoms. He will continue to perform his duties as HHS Secretary, working in isolation," said an agency spokeswoman, Sarah Lovenheim. She said he was not considered a close contact of the president's. Becerra also tested positive for the virus last month while on a trip to Germany. Trudeau previously tested positive for the virus in January. He said then was “feeling fine,″ which he attributed to being fully vaccinated.Dareh Gregorian is a politics reporter for NBC News. | Epidemics & Outbreaks |
If you were planning on a shore vacation this year, you might have kept track of great white sharks. The apex predator made famous by Jaws (and, OK, by The Meg and Sharknado) has been spotted on East Coast beaches from South Carolina up past Cape Cod, leaving potential beachcombers worried by accounts of close encounters and attacks.But many marine biologists are worried about a much smaller—in fact, microscopic—threat. They are tracking an unprecedented surge in ocean-going bacteria known as Vibrio, which recently killed three people and sickened a fourth in Connecticut and New York, at least two of them after swimming in the coastal waters of Long Island Sound.For swimmers and fishermen in the Gulf of Mexico, Vibrio is a known summer foe. It is one of the reasons for the old saying that you shouldn't eat oysters in months that don’t have an R in their name: Warmer water encourages bacterial growth, and oysters accumulate these organisms when they feed. The bacteria is also an infection hazard for anyone who gets a cut while cleaning up soaked debris after a hurricane. But Vibrio appearing in the waters of the upper East Coast is a new and unfamiliar problem, fueled by the rapid ocean warming of climate change.Researchers worry Vibrio is going to become a persistent threat to whether people can safely enjoy the beach—and physicians who work in areas where it is already common wonder whether their northern colleagues will be alert to its potentially fatal risks. “We are used to certain diseases in our area, but they are something that clinicians in the Northeast, for example, may not be as familiar with,” says Cesar Arias, a professor and chief of infectious diseases at Houston Methodist Hospital. “All these changes in climate that we are seeing, including the tremendous heating of the oceans, is making the geography of infectious diseases change.”Already, the Centers for Disease Control and Prevention estimates that there may be 80,000 illnesses and 100 deaths caused by Vibrio species in the US each year; about 52,000 of them come from eating seafood. But because shellfish safety is tightly policed by federal agencies, it’s the other portion of Vibrio infections, caused by the species Vibrio vulnificus, that is raising so much concern right now. These infections happen when bacteria-laden seawater infiltrates a break in the skin. In an average year there are believed to be 28,000 cases, but that’s widely considered an undercount.Those infections can be treated, if people get antibiotics quickly. But without rapid attention, they can cause necrotizing fasciitis—flesh-eating disease—that can only be arrested by amputation, and also can put people into septic shock in as few as two days. The bacteria can enter the body through very minor injuries: a cut from stepping on a shell, a pinch from a crab’s claws, water touching the incision created by a new piercing or tattoo. Up to one-fifth of those who contract vibriosis from wound infections die.The risk is serious enough that, on Friday afternoon, the CDC sent out an alert to health departments and physicians, urging them to consider the possibility of V. vulnificus if they learn of wound infections in anyone who has been in the water in the Gulf of Mexico or on the East Coast. The alert emphasizes how fast these infections turn septic and asks doctors to send cultures to a lab—but it also urges them to start patients on antibiotics immediately, without waiting for lab results or consultation with a specialist.Vibrio are on the move. In March, a research team based at the University of East Anglia in the United Kingdom used records of diagnoses combined with models of climate warming to define the situation in the US now and forecast what might come next. They found that, just for V. vulnificus wound infections, cases increased eightfold between 1988 and 2018. Every year, they were recorded about 30 miles (48 kilometers) further north.Then, using several computer models based on predicted levels of greenhouse gas emissions combined with population movements, the group plotted the bacterium’s possible further shift. Under a conservative low-emissions scenario, they found that Vibrio—already present in the Chesapeake Bay—might extend its range to the middle of the New Jersey shore by 2060. In the outer bound of a high-emissions scenario, it might move as far north as the coast of southern Maine by 2100.Elizabeth Archer, an environmental scientist who led the work as a doctoral student, says it was a mild shock to discover, via news of the recent Connecticut and New York cases, that V. vulnificus had already reached the edge of New England. “Our model had predicted that area to be in the main distribution of infections by mid-century,” she says. “So it was perhaps a bit surprising that it came so soon—but also not surprising, given the trends in ocean warming and air temperatures.”In a few scientific circles, there has been concern for years that temperature anomalies are permitting Vibrio to surge out of its historic areas. Bacterial surges have been documented on the coasts of the Netherlands and Poland, and isolated from tidal flats in northern California—all places where the water ought to be too cold for Vibrio to grow. And over the past decade, Vibrio has increased in Atlantic coastal waters off Florida and the Carolinas, not only contaminating seafood but also posing a hazard to people who fish or boat in marshes and in-shore waterways.This year, the unprecedented warming of ocean water, which fueled the rapid intensification of Hurricane Idalia the night before it struck Florida’s Big Bend, is changing marine environments all the way up the Atlantic Coast. Both Long Island Sound—where two of the Connecticut victims were apparently infected—and waters off New England have reached record-high temperatures in the past few years.“V. vulnificus is only active at a temperature that's above 13 degrees Celsius, and then it becomes more prevalent up until the temperature reaches 30 degrees Celsius, which is 86 Fahrenheit,” says Karen Knee, who is an associate professor and water-quality expert at American University and an open-water swimmer accustomed to ocean conditions. “I was looking at the sea surface temperature maps, and everywhere south of Cape Cod is getting into territory that's above 20 degrees Celsius, which is when [Vibrio] really starts to become more infectious. And that's most of the swimming waters on the East Coast.”There’s more going on than just temperature shifts. Geoffrey Scott, the chair of environmental sciences at the University of South Carolina’s Arnold School of Public Health who leads a research consortium on oceans and climate change, says changes in water quality are whomping up Vibrio’s ability to cause severe illness. Those changes are driven by people relocating to coasts, which increases nutrient flows into the ocean via wastewater.Vibrio used to be a late-summer hazard, but is now turning up earlier—and also later— in the year. “We've gone from them being mainly an issue from late July through early October, to being present April through November,” says Scott, who formerly supervised several coastal laboratories in the National Oceanic and Atmospheric Administration. “And in some cases, they have been seen overwintering in North Carolina, around the Outer Banks.”To the problems of V. vulnificus being more virulent, in more places, for longer, you can add that more people may be exposed: first, because hot weather naturally sends more people to the beach, and second, because some of those people may not realize how vulnerable they are. “[Vulnificus] predominantly seems to impact people who have liver disease much harder than those who do not,” says Scott Roberts, an infectious-disease physician and assistant professor at the Yale School of Medicine. “And in general, being in an immunocompromised state. That could be from age, could be from chemotherapy, or if there's some sort of underlying disease.”Many people won’t know they are in danger. Every state with a shellfish industry participates in the National Shellfish Sanitation Program run by the Food and Drug Administration, which dictates standards for every aspect of shellfish production, including screening for contamination by Vibrio. That’s out of self-interest: Any hint of the organism’s presence can shut down a state’s shellfish economy. (In fact, since the recent deaths, the home page of the Connecticut Department of Agriculture has been topped by a highlighted banner declaring “Connecticut shellfish have never been associated with Vibrio vulnificus infections.”)But there’s no national program that can warn swimmers or surfers of Vibrio’s presence in the ocean; no testing regime like ones that look for coastal E. coli; no system of flags like the ones that announce strong surf and rip tides. These hazards are local knowledge, shared among people who have lived alongside them.“People down here may have a buddy who got cut on a shell or while fishing, and their finger’s a little red and swollen, and somebody will be like, ‘Don't sleep on that. I had a buddy who waited till the next morning and he lost his hand,’” says Brett Froelich, a microbiologist and assistant professor at George Mason University in Virginia. “Other people in other locations don't know that. They will absolutely think, ‘Well, I hope it gets better in the morning,’ and in the morning, their hand is black.”This poses a problem: How to make the public in newly endemic areas conscious of their new risks. No one—especially not researchers at publicly funded universities—wants to be perceived as hurting coastal tourism. “We don’t want to scare people away from beaches,” Froelich says. “You don't need to avoid [them]. You just need to be aware.” | Epidemics & Outbreaks |
- STAT Health on Tuesday announced its new 24/7 in-ear wearable, called STAT, which measures blood flow to the head.
- When users stand up, the earpiece automatically tracks changes in their heart rate, blood pressure and blood flow. It has also proven to predict fainting minutes before it happens.
- Users can track their metrics in an app on their cellphone and glean insights into how their lifestyle choices affect their symptoms.
Digital health startup STAT Health has designed a device to help people better understand why they're experiencing symptoms like dizziness, fainting and brain fog.
STAT Health on Tuesday announced its new in-ear wearable, the STAT, which measures blood flow to the head. When users stand up, the earpiece automatically tracks changes in their heart rate, blood pressure and blood flow, which are useful insights for patients who commonly experience dizziness and fainting spells as a result of illnesses like long Covid and postural orthostatic tachycardia syndrome (POTS), among others.
Users can track their metrics in an app on their cellphone and glean insights into how their lifestyle choices affect their symptoms. The STAT earpiece has also proven to predict fainting minutes before it happens, according to peer-reviewed findings published in Journal of the American College of Cardiology this year.
STAT Health CEO Daniel Lee said the wearable is not diagnostic and it is not a form of treatment but that it can serve as a resource for a patient population who are often told their symptoms are not real.
"This population, a lot of doctors actually can't measure that anything is necessarily wrong with them," Lee told CNBC in an interview. "They're told it's just in their head because there's not a way to measure it. But there is a way to validate that there's something wrong and their experiences are legit."
Lee said the STAT will help give patients access to real-time insights to help them decide when they can push themselves, and when they should take it easy.
Lee co-founded STAT Health in 2020 with Paul Jin, with whom he previously ran Bose's Health Product Innovation Group. Lee said he set out to build the company after his father, who faints regularly due to heart problems, passed out and broke six ribs.
"He just pushes through it and he ends up not being able to predict when it happens, that's why he keeps hurting himself pretty badly," Lee said. "So that's where we started, that's what inspired us to say, 'Let's try to see if we can measure something.'"
The Boston-based startup has grown to around a dozen employees, and the company has raised $5.1 million in seed funding to date, in addition to separate grant funding it received from the U.S. Air Force.
The STAT wearable is small and sits in the upper nook of the ear. Its placement means it is compatible with most other devices like headphones or glasses that sit in or around the ear. Lee said the device is meant to be comfortable, and users can leave it on while they are in the shower or sleeping.
The earpiece is made up of an optical sensor, an accelerometer, a pressure sensor and temperature sensors. The battery life lasts over three days, but it is also fitted with a small solar panel, which means some users might not even need to take it off to charge.
"It's just supposed to be comfortable, stable, get good signal quality in the midst of your normal daily activities," Lee said.
STAT Health said it is targeting a $50 a month subscription for its device, and it will aim to decrease the cost over time for long-term subscribers. Pricing is still subject to change, but the company is taking preorder reservation deposits of $1 for the earpiece starting Tuesday. The deposits will save a spot in line for earlier access.
Lee said he thinks the STAT device will ultimately help patients learn about their bodies and what works best for them. "The goal is, give them a tool to measure what matters so that they can live a normal life more of the time," he said. | Medical Innovations |
A "game changer" weight loss injection used by celebrities including Twitter boss Elon Musk is to be made available through the NHS amid warnings that the drug is not a "quick fix".
In a "pivotal moment", thousands of people living with obesity in England are set to be offered Wegovy, also known as semaglutide, on prescription after health officials approved its use.
Billionaire Musk said he used Wegovy to keep in shape, while reality TV star Kim Kardashian has denied rumours that she used the drug.
Last October, Musk was asked by a Twitter user on the platform what his secret was to looking "fit, ripped, and healthy" to which he replied "fasting" and "Wegovy".
Patients on the NHS will inject themselves weekly using a pen and the drug works by making people feel full, meaning they eat less and lose weight.
It suppresses the appetite through mimicking the hormone glucagon-like peptide-1 (GLP-1) which is released after eating.
A previous study found people who were given the medicine saw their weight drop by 12% on average after 68 weeks.
Another study said side-effects included nausea and diarrhoea but these were typically mild-to-moderate in severity and subsided with time.
Adults with at least one weight-related condition and a body mass index (BMI) score of at least 35 would be eligible for the drug, which is made by Novo Nordisk.
Such conditions include type 2 diabetes, prediabetes, high blood pressure, dyslipidaemia (unbalanced or unhealthy cholesterol levels), obstructive sleep apnoea and heart disease.
Those with a BMI of 30 and over may be able to access the drug in some cases.
People will only be given Wegovy on prescription as part of a specialist weight management service involving input from several professionals, and for a maximum of two years.
It is to be used alongside a reduced-calorie diet and increased physical activity, stated the National Institute for Health and Care Excellence (Nice), which approved it.
Read more:
Elon Musk donated £1.6bn in Tesla stock to charity last year
Twitter 'set to make millions' as ads appear next to once-banned users
Nice's Helen Knight said: "For some people losing weight is a real challenge which is why a medicine like semaglutide is a welcome option.
"It won't be available to everyone. Our committee has made specific recommendations to ensure it remains value for money for the taxpayer, and it can only be used for a maximum of two years."
Professor Nick Finer, from the National Centre for Cardiovascular Prevention and Outcomes at UCL, said: "The efficacy of semaglutide is a true game changer for the medical treatment of obesity, a chronic disease that shortens life through its many complications."
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And Alex Miras, professor of endocrinology at Ulster University, said: "This decision made by Nice is a pivotal moment for the treatment of people living with obesity.
"The weight loss that can be achieved with this safe medication is substantial and likely to lead to the improvement of obesity-related complications in a large number of patients."
But Dr Stephen Lawrence, associate clinical professor at the University of Warwick, cautioned: "It is important to note, however, that this medication is not a quick fix or a replacement for following a healthy lifestyle, which includes regular physical activity and healthy eating."
In February, it emerged that some high street chemists in England will prescribe the drug, if suitable, through their online doctor services.
A spokesperson for Novo Nordisk said: "Novo Nordisk welcomes the final Nice recommendation for Wegovy (once-weekly semaglutide 2.4mg), as an option for weight management within the NHS.
"We are working to make Wegovy available in the UK as soon as possible." | Drug Discoveries |
NEWYou can now listen to Fox News articles! The Supreme Court Wednesday again prolonged the wait for its opinion which is expected to overturn the federal right to an abortion.Last month, Politico published a leaked draft opinion which indicated the Supreme Court is set to overturn Roe v. Wade, the 1973 case that established a federal right to an abortion. The justices released a handful of decisions Wednesday, but not in the case Dobbs v. Jackson Women's Health Organization. A ruling is expected to come by either late June or early July. Supreme Court Police officers guard a barrier between pro-choice and pro-life protesters outside the court building in Washington, Dec. 1, 2021. (Reuters/Jonathan Ernst)Decisions were released Wednesday in the cases American Hospital Assn. v. Becerra, George v. McDonough, Ysleta del Sur Pueblo v. Texas, Golan v. Saada, Viking River Cruises, Inc. v. Moriana, and Arizona v. City and County of San Francisco. There are less than 20 cases left to be decided before the term ends.The Dobbs case stems from a dispute over a Mississippi law which bans abortion after 15 weeks. Argued in December, the case is seen as the biggest test yet for how the new 6-3 Republican-appointed majority on the court – capped with the confirmation of Justice Amy Coney Barrett in 2020 – will handle major controversial issues.As the Supreme Court continues to finalize its ruling in Dobbs and several other cases before its summer recess, the investigation into who leaked the draft opinion by court officials is ongoing. "To the extent this betrayal of the confidences of the Court was intended to undermine the integrity of our operations, it will not succeed. The work of the Court will not be affected in any way," Chief Justice John Roberts said in a statement in May. next A crowd gathers outside the Supreme Court, Monday night, May 2, 2022, in Washington following reports of a leaked draft opinion by the court overturning Roe v. Wade. (AP Photo/Anna Johnson) prev Members of the Supreme Court, seated from left, Justices Samuel Alito and Clarence Thomas, Chief Justice John Roberts, Justices Stephen Breyer and Sonia Sotomayor, and, standing from left, Justices Brett Kavanaugh, Elena Kagan, Neil Gorsuch and Amy Coney Barrett, gather for their official portrait on April 23, 2021. (Erin Schaff/The New York Times via AP, Pool)"This was a singular and egregious breach of that trust that is an affront to the Court and the community of public servants who work here," he added. "I have directed the Marshal of the Court to launch an investigation into the source of the leak."ARMED SUSPECT ARRESTED NEAR JUSTICE KAVANAUGH HOME IDENTIFIEDThe probe intensified in recent days, a source familiar with it confirmed to Fox News. Officials were "in the process" of having law clerks turn over personal cellphone records and sign affidavits. It was unclear the precise extent and scope of the information being sought of the clerks. Also unclear is whether there has been compliance, or whether some clerks will resist and seek legal representation.Vandals targeted pro-life crisis pregnancy centers across the U.S. since the leak of the draft opinion, and Catholic churches have been threatened and vandalized.In addition, Nicholas John Roske was charged last week with the attempted murder of Supreme Court Justice Brett Kavanaugh.CLICK HERE TO GET THE FOX NEWS APPRoske of Simi Valley, California, was carrying a gun, ammunition, a knife, pepper spray, a screwdriver, zip ties, and other gear when he was arrested by Montgomery County Police Department officers last week near Kavanaugh’s Maryland home, according to a criminal complaint.Roske told detectives that "he was upset about the leak of a recent Supreme Court draft decision regarding the right to an abortion as well as the recent school shooting in Uvalde, Texas," and believed Kavanaugh "would side with Second Amendment decisions that would loosen gun control laws," according to the affidavit. House Democrats last week pushed off the consideration of Senate-approved legislation that would offer additional protection to Supreme Court justices – just a day after the man was charged. The House finally voted on the legislation Tuesday afternoon and the bill passed in a 396-27 vote. All 27 "no" votes were cast by Democrats.The bill provides for 24-hour protection for Supreme Court justices' families, similar to what is already provided for some members of the executive and legislative branches.Fox News' Shannon Bream and Bill Mears contributed to this report. Tyler Olson covers politics for Fox News Digital. You can contact him at [email protected] and follow him on Twitter at @TylerOlson1791. | Women’s Health |
Iranian authorities are investigating reports that hundreds of schoolgirls have been intentionally poisoned by noxious fumes wafting into classrooms at predominantly all-girls schools.
Dozens of schoolgirls in Iranian cities like Qom and Borujerd have reportedly been hospitalized as a result of the attacks. About 30 schools in the region have been targets of the poisonings, according to reports by local media.
Iran’s deputy education minister Younes Panahi confirmed Sunday to the state-run IRNA news agency that “some people wanted all schools, especially girls’ schools, to be closed.” He added that “a large percentage” of the chemicals used to allegedly poison students are “treatable.”
The Guardian spoke to Masih Alinejad, an Iranian human rights activist based in New York, who claimed the attacks are possibly “revenge by the Islamic Republic” against school-aged girls who have been at the forefront of the country’s ongoing protests.
Large protests have persisted in Iran since September when 22-year-old Mahsa Amini died in the custody of the country’s theocratic “morality police.” Amini was accused of violating the country’s modesty laws. Initial protests following Amini’s death focused on Iran’s strict dress code dictating what women can wear, though they have since expanded into broader calls for a regime change. Thousands of people are in prison for participating in the protests.
The first reported instance of the alleged school poisonings came in November at the Noor Yazdanshahr Conservatory in Qom, about 125 kilometres from Iran’s capital, Tehran. In December, students at the conservatory were reportedly poisoned again.
As recently as Tuesday another all-girls school in Pardis, just over 40 kilometres from Tehran, experienced a suspected attack.
Allegedly, at least one boy’s school has also been targeted in the string of poisonings.
Those apparently affected by the noxious fumes have complained of headaches, heart palpitations, feeling lethargic or being unable to move. Fears of carbon monoxide poisoning in schools have been dismissed.
Parents of students in the affected regions have confronted education officials in an attempt to gain information about the poisonings, as per Bloomberg.
There are no known suspects. The attacks have raised fears that the schoolgirls could have been poisoned apparently just for seeking an education — something that’s never been challenged before in the over 40 years since the 1979 Islamic Revolution. Iran itself also has been calling on the Taliban in neighbouring Afghanistan to have girls and women return to school.
Attacks on women have happened in the past in Iran, most recently with a wave of acid attacks in 2014 around Isfahan, at the time believed to have been carried out by hard-liners targeting women for how they dressed. But even in the chaos surrounding the Islamic Revolution, no one targeted schoolgirls for attending classes.
— With files from The Associated Press | Epidemics & Outbreaks |
George Osborne told Matt Hancock “No one thinks testing is going well” in a WhatsApp message sent in the depths of the Covid pandemic.
In a November 2020 radio interview the former chancellor urged Boris Johnson to make testing his “absolute number one priority”, which Mr Hancock took as a personal slight.
“What was this for?” Mr Hancock messaged Mr Osborne, referring to an enclosed tweet promoting the interview.
Mr Osborne, who was at the time editor of the London Evening Standard, replied: “Trying to spread the responsibility from you to Number 10 – I’ve said it before.”
The ever-optimistic Mr Hancock retorted: “Ok but mass testing is going v well – I fear this looks like you asked for me to be overruled…”
Mr Osborne did not sugar-coat his response. “No one thinks testing is going well, Matt,” he said. “If I wanted a test today I can’t get one, unless I fake symptoms – and XXXX [redacted by The Telegraph] is still waiting test results from 3 weeks ago (XXXX went private in the end).
“My point has been that DS [Downing Street] has not thrown the weight and resources of government behind your heroic efforts. And that’s why we entered second lockdown. And btw thousands of civil servants are still working on lorry parks in Kent because this government has no sense of priority.”
Mr Hancock said: “Hmm I don’t think this is right but I can see where you’re coming from.”
When Mr Osborne was shadow chancellor, Mr Hancock worked as his chief of staff and since then Mr Osborne has been described as something of a mentor to his former colleague.
NHS Test and Trace was launched in May 2020, but faced problems over lack of kit and appointments until the following year.
In his Times Radio interview, Mr Osborne had disclosed that Sir John Major, David Cameron, Gordon Brown and Sir Tony Blair had all written privately to Mr Johnson in July 2020 about the need to get a grip on testing.
Mr Osborne said the former prime ministers told Mr Johnson that testing was “the absolute number one overwhelming priority facing the country”.
Instead of becoming a Downing Street priority, Mr Osborne said: “I still feel it’s been too much something that has been given to the health department, given to the NHS, and the rest of Government has not thrown the full weight of the British state behind it.”
On Nov 10, 2020, the day after the exchange with Mr Osborne, Mr Hancock announced that lateral flow tests - the standard home swab test kit still in use now – would be rolled out across England following a successful trial in Liverpool.
At a televised press conference on Nov 16, Mr Hancock trumpeted that “we’ve already built the largest coronavirus testing capacity in Europe” and said capacity had reached more than half a million tests per day. | Epidemics & Outbreaks |
FILE – This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. WHO’s top monkeypox expert Dr. Rosamund Lewis said she doesn’t expect the hundreds of cases reported to date to turn into another pandemic, but acknowledged there are still many unknowns about the disease, including how exactly it’s spreading and whether the suspension of mass smallpox immunization decades ago may somehow be speeding its transmission. (Cynthia S. Goldsmith, Russell Regner/CDC via AP, File) GENEVA (AP) — The World Health Organization will convene an emergency committee of experts to determine if the expanding monkeypox outbreak that has mysteriously spread outside Africa should be considered a global health emergency. WHO Director-General Tedros Adhanom Ghebreyesus said Tuesday he decided to convene the emergency committee on June 23 because the virus has shown “unusual” recent behavior by spreading in countries well beyond parts of Africa where it is endemic. “We believe that it needs also some coordinated response because of the geographic spread,” he told reporters. Declaring monkeypox to be an international health emergency would give it the same designation as the COVID-19 pandemic and mean that WHO considers the normally rare disease a continuing threat to countries globally. The U.K. said Monday it had 470 cases of monkeypox across the country, with the vast majority in gay or bisexual men. British scientists said last week they could not tell if the spread of the disease in the U.K. had peaked. The meeting of outside experts could also help improve understanding and knowledge about the virus, Tedros said, as WHO released new guidelines about vaccinating against monkeypox. Dr. Ibrahima Soce Fall, WHO’s emergencies director for Africa, said case counts were growing every day and health officials face “many gaps in terms of knowledge of the dynamics of the transmission” — both in Africa and beyond. “With the advice from the emergency committee, we can be in a better position to control the situation. But it doesn’t mean that we are going straight to a public health emergency of international concern,” he said, referring to WHO’s highest level of alert for viral outbreaks. “We don’t want to wait until the situation is out of control to start calling the emergency committee.” The U.N. health agency does not recommend mass vaccination, but advises the “judicious” use of vaccines. It said controlling the disease relies primarily on measures like surveillance, tracking cases and isolating patients. Last month, a leading adviser to WHO said the outbreak in Europe and beyond was likely spread by sex at two recent rave parties in Spain and Belgium. Scientists warn that anyone, regardless of sexual orientation, is susceptible to catching monkeypox if they are in close, physical contact with an infected person or their clothing or bed sheets. WHO has been working with partner countries to create a mechanism by which some vaccines for smallpox — a related disease — might be made available to countries that are affected, as research continues into their effectiveness against the new outbreak. Tedros said more than 1,600 cases and nearly 1,500 suspected cases have been reported this year in 39 countries, including seven where monkeypox has been reported for years. A total of 72 deaths have been reported but none in the newly affected countries, which include Britain, Canada, Italy, Poland, Spain and the United States. The ongoing outbreak of monkeypox in Europe and elsewhere marks the first time the disease has been known to spread among people who have no travel links to Africa. | Epidemics & Outbreaks |
Labour has ruled out introducing a self-ID system to allow people to change their legal sex without a medical diagnosis.
Leader Sir Keir Starmer has previously said his party would introduce such a system if it wins power.
But shadow women and equalities secretary Anneliese Dodds has now said medical diagnosis upholds "confidence in the system".
She added that the requirement also helps people access NHS support.
In a article for the Guardian, she wrote that Labour would streamline the current medical diagnosis rules, calling them "demeaning".
The new Labour position appears to be a compromise that has emerged from a party event in Nottingham over the weekend to discuss policy.
It opens up a split with Scottish Labour, which has previously voted to remove the medical diagnosis requirement and has since confirmed it "continues to support the de-medicalisation of the process in Scotland".
Under current rules, people who want to change legal sex need to provide a medical report showing a diagnosis of gender dysphoria.
This is defined by the NHS as a "sense of unease that a person may have because of a mismatch between their biological sex and their gender identity".
Applicants also have to provide evidence of living full time in their acquired gender for at least two years.
Some campaigners say the the requirement is excessively bureaucratic and invasive, and have long argued for a non-medical process - known as self-identification - instead.
The government ruled out adopting this approach in 2020 after a consultation, but has reduced the fees and moved the process online.
'Mistakes'
Labour pledged to introduce a self-identification system under previous leader Jeremy Corbyn and the policy was in the party's 2019 general election manifesto.
Sir Keir reaffirmed the 2019 manifesto commitment to "introduce self-declaration" in a June 2021 video for LGBT website Pink News.
However, Ms Dodds has now confirmed that the party would keep the need for a gender dysphoria diagnosis, calling it an "important part" of the process for obtaining a gender recognition certificate.
"Requiring a diagnosis upholds legitimacy of applications and confidence in the system," she wrote.
She said that it also helped refer trans people into the NHS for support services, citing low levels of awareness about how to access them.
She added that Labour wanted to avoid the "mistakes" made by the Scottish government, whose new law to ditch medical reports is subject to an ongoing legal wrangle with the UK government.
Scottish ministers' legislation - endorsed by Scottish Labour in the Scottish Parliament - showed a "cavalier approach", she added.
However, she added the current requirement to apply to an "anonymous" panel to obtain a certificate should be replaced, calling it "demeaning for trans people and meaningless in practice".
Instead, she said it "should be enough" for registrars to sign off the application, based on diagnosis from one doctor.
'Signalling a retreat'
The LGBT+ Labour group said the party's new position would be a "huge step forward" for trans people over the current government stance.
But it added the party was "signalling a retreat on their policy of de-medicalised self-ID for the trans community at the next general election".
Labour MP Lloyd Russell-Moyle, a patron of the group, told the BBC it would push for further changes, including giving non-medical professionals such as social workers the power to "externally verify" someone's acquired gender.
Rosie Duffield, who had threatened to quit as a Labour MP over the party's previous stance, said she welcomed the retention of medical reports, calling it the "core thing" demanded by women's groups.
Ms Duffield, the MP for Canterbury, has opposed self-ID as a way for trans people to gain access to single sex spaces such as domestic violence refuges and prisons.
Speaking to BBC Radio 4's Today programme, she called for more clarity on the party's position ahead of the general election, expected next year, adding it still included a "bit of confusion and a bit of fence-sitting".
Women and Equalities Minister Kemi Badenoch said Labour's new position is a "copy and paste" of the government's position.
Adding that some Labour MPs had previously attacked the Conservative position as prejudiced, she accused the party of "bare-faced hypocrisy". | Health Policy |
You went to the doctor, got swabbed, and then you see the results: You have an STI (sexually transmitted infection). You're one of the millions of cases in the U.S. or elsewhere a year, so you're far from alone, but it still can feel scary to test positive. Mashable spoke to a sex and relationship expert about what to do if you get an STI.
How often should I get tested for STIs?
This depends on your lifestyle. If you're in a long-term, monogamous relationship — and it's staying that way — then maybe there's no need for you to be tested. If you're just entering a relationship, however, both of you should get tested before having unprotected sex.
If you have multiple partners and especially if you have unprotected sex with them (without condoms or dental dams), then you should be tested more often. Depending on how many partners and how often you have sex unprotected, test anywhere from every four weeks to two months. And don't worry, you can take an STI test during your period.
It's also possible for you and your partner to have different STI results. This doesn't mean someone cheated; everyone's body and immune systems are different.
While some STI symptoms appear days or weeks after exposure, others don't show up until long after — and in some cases, STIs are asymptomatic. This is why it's imperative to get repeated screens.
Where should I get tested for STIs?
This also depends — on where you live and your health insurance. Unfortunately, these tests can run for thousands of dollars without insurance, but check if there's a sexual health clinic in your area that would test you for free.
Zachary Zane, sex and relationship expert for Archer, a dating app for queer men, and author of Boyslut: A Memoir and Manifesto, told Mashable that sexual health clinics could be more beneficial than say, an urgent care facility, because they're more equipped for STI testing. In addition to blood and urine testing, sexual health clinics may swab your mouth and genitals, which a standard urgent care may not be able to do.
An alternative is at-home STI tests, but your best bet is to be tested by a professional.
What should I do if I get an STI?
Firstly, don't freak out, said Zane. According to the CDC, there are millions of STI cases per year, meaning many others are in your position.
STIs are stigmatized and associated with being "dirty," so even if someone has one, they may not be public about it. The reality is that STIs are a part of life. Unless you knowingly had unprotected sex with an STI, you didn't do anything wrong. Further, some STIs can be spread through skin-to-skin contact, like syphilis and genital warts, so you aren't completely protected by condoms. This means sex — protected or not — involves risk, and getting an STI happens.
Get treated immediately for an STI, especially if it's bacterial like chlamydia, gonorrhea, and syphilis, and requires antibiotics to heal. Note that you can't just take any antibiotics to treat STIs — you need the specific ones that target whatever infection you have.
Leaving an STI untreated can result in serious side effects later on. For example, untreated gonorrhea or chlamydia can cause pelvic inflammatory disease in women, the CDC notes, or a painful condition in tubes attached to testicles.
Don't have sex again until you've completed treatment. Wait seven days after finishing the medication (or however long your doctor tells you) and make sure your symptoms are gone before being intimate again.
How do I tell my partner I got an STI?
Perhaps the hardest part is telling your partners because of STI stigma. If someone lashes out, know that's based on their fears — and STIs are feared in our society due to engineered stigma.
"The stigma surrounding STIs is designed," Zane wrote in Boyslut. "It's designed to keep you from having sex. It's designed to make you feel shame for something normal and healthy."
Despite the fear, be honest and let every partner you've had since your previous STI-free testing know that you tested positive. Zane offered a simple script for a text (no need to call them or meet them in person, unless you're really jonesing to): "Hey, I want to give you a heads up that I tested positive for [insert specific STI] so you can get tested and treated if necessary."
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Don't just say "an STI," because different STIs require different treatments. Also, you don't need to go on an apology streak about how sorry and horrible you are. Again, if you didn't willingly pass an STI, you didn't do anything wrong.
STI shame has been used throughout history to perpetuate xenophobia, racism, and homophobia. Zane points to syphilis as an example. A 2014 paper on a brief history of syphilis in the Journal of Medicine and Life states, "Each country whose population was affected by the infection blamed the neighboring (and sometimes enemy) countries for the outbreak." People who live in what's now Italy, UK, and Germany called it the "French disease," while French people called it "the Neapolitan disease," and so on.
A more modern example is the AIDS epidemic. In the early days of AIDS, it was called "gay cancer" or the "gay plague," and homophobic people used the disease to justify their hatred. Ronald Reagan's press secretary even joked about it.
"When you shame someone for getting an STI, you're engaging in a lot of other shaming," Zane continued in Boyslut.
You don't need to feel ashamed for contrasting an STI. You do need to get treated, tell your partners, and keep getting tested in the future. | Epidemics & Outbreaks |
When a fragrance wafted through the bedrooms of older adults for two hours every night for six months, memories skyrocketed. Participants in the study by neuroscientists reaped a 226% increase in cognitive capacity compared to the control group.
The University of California researchers in Irvine said the finding transforms the long-known tie between smell and memory into an easy, non-invasive technique for strengthening memory and potentially deterring dementia.
The study which was published in Frontiers in Neuroscience involved men and women aged 60 to 85 without memory impairment. All were given a diffuser and seven cartridges, each containing a single and different natural oil. People in the enriched group received full-strength cartridges. Control group participants were given the oils in tiny amounts. Participants put a different cartridge into their diffuser each evening prior to going to bed, and it activated for two hours as they slept.
People in the enriched group showed a 226% increase in cognitive performance compared to the control group, as measured by a word list test commonly used to evaluate memory. Participants also reported sleeping more soundly.
Brain imaging revealed better integrity in the brain pathway called the left uncinate fasciculus. This pathway, which connects the medial temporal lobe to the decision-making prefrontal cortex, becomes less robust with age.
Scientists have long known that the loss of olfactory capacity, or ability to smell, can predict development of nearly 70 neurological and psychiatric diseases—including Alzheimer’s and other dementias, Parkinson’s, schizophrenia and alcoholism. Evidence is also emerging about a possible link between smell loss due to COVID and ensuing cognitive decrease.
Researchers have previously found that exposing people with moderate dementia to up to 40 different odors twice a day over a period of time boosted their memories, enhanced language skills, eased depression, and improved their olfactory capacities.
The UC-Irvine team decided to try turning this knowledge into an easy and non-invasive dementia-fighting tool.
“By making it possible for people to experience the odors while sleeping, we eliminated the need to set aside time for this during waking hours every day,” said project scientist Cynthia Woo, the study’s first author.
The researchers say the results bear out what scientists learned about the connection between smell and memory.
“The olfactory sense has the special privilege of being directly connected to the brain’s memory circuits,” said Michael Yassa, professor and James L. McGaugh Chair in the Neurobiology of Learning & Memory. The director of CNLM, he served as collaborating investigator.
“All the other senses are routed first through the thalamus. Everyone has experienced how powerful aromas are in evoking recollections, even from very long ago.”
Over the age of 60, the olfactory sense starts to fall off, along with cognition.
“But, unlike with vision changes that we treat with glasses and hearing aids for hearing impairment, there has been no intervention for the loss of smell.”
The team would next like to study the technique’s impact on people with diagnosed cognitive loss. The researchers also say they hope the finding will lead to more investigations into olfactory therapies for memory impairment.
A news release from the University said a product based on their study for people to use at home is “expected to come onto the market this fall”.
SHARE This Sweet Smell of Success With Aging Friends on Social Media… | Medical Innovations |
World Sight Day 2023: Date, Theme, History, Significance And All You Need To Know
The leading causes of vision impairment and blindness at a global level are refractive errors and cataracts.
World Sight Day observed annually on the second Thursday of October, will be celebrated on October 12 this year. It is a global event meant to draw attention to blindness and vision impairment.
Globally, at least 2.2 billion people have a near or distance vision impairment, according to the World Health Organization. The global health body says that in at least 1 billion of these, vision impairment could have been prevented or is yet to be addressed.
The leading causes of vision impairment and blindness at a global level are refractive errors and cataracts.
WHO’s work is guided by the recommendations of the WHO World report on vision (2019) and the resolution on "integrated, people-centred eye care, including preventable blindness and vision impairment" adopted at the Seventy-third World Health Assembly in 2020.
The key proposal is to make integrated people-centred eye care (IPEC) the care model of choice and to ensure its widespread implementation. It is expected that by shaping the global agenda on vision and eye care, the report and resolution will assist Member States and their partners in their efforts to reduce the burden of eye conditions and vision.
Here's all you need to know about World Sight Day, which is also known as World Eye Day or World Vision Day.
World Sight Day 2023: Theme
'LOVE YOUR EYES AT WORK' is the theme of this year's World Sight Day.
"This World Sight Day, our focus is on helping people understand the importance of protecting their vision in the workplace and calling on business leaders to priorities the eye health of workers, everywhere," the Ministry of Social Justice & Empowerment said in a statement.
World Sight Day 2023: Significance
This year's World Sight Day campaign is aimed at encouraging employers to make eye health initiatives standard practice and promote eye health habits that will benefit the well-being, safety and productivity of millions of employees.
World Sight Day 2023: History
The Lions Club Foundation reported started the World Sight Day in October 1984. Then, it was integrated into VISION 2020 and is coordinated by the International Agency for the Prevention of Blindness (IAPB) in cooperation with the World Health Organization.
According to the information on its website, IAPB was founded in 1975 and is the premier eye health body which brings together a unique network of members and membership bodies from across the world.
"IAPB is recognised as a global leader in eye health advocacy, co-ordinating major campaigns such as World Sight Day (WSD) and leading initiatives like 2030 In Sight, the UN Friends of Vision group, VISION 2020 and Vision for the Commonwealth," the website says.
World Sight Day 2023 In India
The Department of Empowerment of Persons with Disabilities (DEPwD) under the Ministry of Social Justice and Empowerment, Government of India is the nodal department to look after all the development agenda of Persons with Disabilities of the country.
With the vision to create awareness about Visual impairment among the masses, the Department is observing World Sight Day on October 12, through the institutions associated with it by conducting various events across the country.
How To Celebrate World Sight Day
There are several ways to participate in World Sight Day:
Schedule an Eye Exam: If you haven't had an eye exam in the past year, consider making an appointment with an eye doctor.
Spread Awareness: Talk to your friends and family about the importance of eye health and encourage them to get regular eye exams.
Attend Local Events: Participate in community events focused on eye health and access to eye care services.
Basic Tips For Eye Protection
Maintaining good eye health is essential. Here are some simple tips:
Regular Eye Exams: Schedule routine eye check-ups to monitor your eye health.
Sunglasses: Protect your eyes from harmful UV rays by wearing sunglasses when outdoors.
Healthy Lifestyle: Maintain a balanced diet and engage in regular physical activity.
Quit Smoking: Smoking is harmful to your eyes; quitting can reduce the risk of eye-related diseases.
Digital Devices: Take breaks when using computers and other digital devices to reduce eye strain.
Adequate Rest: Ensure you get enough sleep to support overall eye health. | Global Health |
As the third anniversary of the first national lockdown approaches, the true human and financial cost of the policy is still emerging.
Missed operations, economic scarring, compromised schooling and damage to people’s mental health were just some of the problems stored up for the future by shutting down the country three times in 2020 and 2021.
The ministers and officials behind lockdowns were well aware of the possibility - and then the reality - of collateral damage being caused to millions of lives as they pushed ahead with the controversial policy, despite warnings that the cure would be worse than the disease.
WhatsApp conversations contained in The Telegraph’s Lockdown Files show that those running the country privately acknowledged the “terrible” price of lockdowns and twice reimposed the national shutdowns, even as they discussed the damage they were causing to physical and mental health, children’s prospects and mental health.
In April 2020, a month into the first lockdown, Matt Hancock, the then health secretary, was already coming under pressure over cancelled NHS operations and became personally involved in an individual case described as “tragic”.
It involved a 17-year-old girl who had had part of her skull removed in January 2020 following a brain haemorrhage and needed surgery to reconstruct her skull after developing life-threatening complications.
The case was garnering national media attention and Steve Baker, the girl’s local MP, asked Mr Hancock to step in.
Mr Hancock forwarded Mr Baker’s message to a colleague – also called Steve – and urged them to “get right on this”.
In December of that year, shortly after the month-long “circuit breaker” lockdown and with the four nations of the UK adopting a “tiers” system of graded localised restrictions, Mr Hancock was again getting involved in a case where Covid rules were causing a personal tragedy.
Jacob Young, the Redcar MP, had raised the issue of a boy with a brain tumour, who had been given no more than two years to live, being blocked from holidaying at Center Parcs with his family.
Mr Hancock forwarded Mr Young’s message to Allan Nixon, the then health secretary's special adviser.
Even before the lockdown restrictions had been reimposed following an easing of the rules over the summer of 2020, Simon Case, the Cabinet Secretary, was discussing the “terrible” cost of lockdowns in a WhatsApp group that included Boris Johnson, Mr Hancock, England’s Chief Medical Officer and the Chief Scientific Adviser.
For many people, the worst knock-on effects of lockdowns were on children, whose physical and mental health and future prospects were all impacted by the closure of schools and the squeeze on the NHS.
By May 2021, when the last of the lockdowns were over, ministers were increasingly seeing the extent to which children had become collateral damage.
One topic of conversation was child deaths in mental health units, raised by a civil servant on May 14.
Three days later, Ms Dorries raised the issue of deaths among children being seen by the Child and Adolescent Mental Health Service (CAMHS).
Late that night, a civil servant sent in Mr Hancock’s private office sent him a WhatsApp message alerting him to a child respiratory virus that was expected to surge in the summer months as a result of the virus being suppressed during lockdown - known in Whitehall as an NPI, or non-pharmaceutical intervention.
The concerns proved to be well-founded. The virus, which usually causes symptoms similar to a common cold, causes an average of 29,000 hospitalisations and 83 deaths per year in the UK, mainly in infants.
Because so few children were exposed to RSV during lockdown, there was an “unprecedented” surge in cases in 2021, according to a paper published by Lancet Infectious Diseases.
During the summer of 2021, there were more than 12,000 cases of RSV, compared with the average of fewer than 900 in a typical summer.
Aside from the health problems being stored up for children, there were also discussions that month about university entrants “taking the hit” from the exams fiasco.
Ofsted has since warned that nearly all children fell behind during the pandemic and that loneliness, boredom and misery became “endemic” among children, whose physical and mental health declined as a result.
Lockdowns also contributed to an NHS backlog that the British Medical Association has said will take years to clear. By December 2022, there were 7.2 million people on NHS waiting lists, compared with 4.43 million in February 2020.
Meanwhile excess deaths – the number of deaths over and above a long-term average – were greater in October 2022 than during the pandemic years of 2020 and 2021.
Lord Bethell, then a health minister, warned about this in September 2020 but only made what he called a “gentle” challenge to a policy of cancelling an information campaign urging people to seek medical help even for minor symptoms of illness.
Lord Bethell, Mr Hancock, Ms Dorries, social care minister Helen Whately, junior health minister Jo Churchill and special adviser Emma Dean discussed the problems being stored up for the NHS in a lengthy WhatsApp chat in May 2021.
Their conversation ranged from online GP appointments to NHS backlogs to receptionists triaging patients despite having no medical training.
Ms Dorries, whose brief as a health minister covered mental health and suicide prevention, was also concerned that as the authorities became increasingly stretched by the demands of the pandemic, the number of suicides was being underestimated – something the Government was reluctant to admit.
As early as July 2020, with the first lockdown still in place, Ms Whately was worried that one of the knock-on effects of lockdown was that care home residents would have been neglected following the suspension of inspections by the Care Quality Commission (CQC).
Ms Whately had hoped the issue had been avoided through emergency arrangements but Kate Terroni, chief inspector of adult social care, did not share her optimism.
There were also knock-on effects from a legal point of view. In April 2021 Allan Nixon, Mr Hancock’s special adviser, was worried about the Government being sued by the families of those who had died because of the backlog on cancer care and elective treatments.
The ongoing inquiry into the pandemic response, which will begin hearing from witnesses later this year, will consider, among other things, the impact of the pandemic on the mental health and well-being of the nation, and the impact of the pandemic on children and their education.
Its terms of reference do not, however, specify that the inquiry will examine the knock-on effects of lockdowns or whether using lockdowns was the right policy at all. | Mental Health Treatments |
CARROLLTON, Ala. — Annie Jackson can’t know whether her sister Grena Prude might have survived had an ambulance been more readily available when she went into cardiac arrest on May 10. But Jackson is convinced her sister would have at least had a chance.
Prude, 55, died at the steps of Carrollton City Hall, less than a half-mile from her county’s only ambulance station. When someone called 911 to get her help, two ambulances were on duty: One was transporting a patient to Tuscaloosa, Alabama, 45 minutes away, and the other a patient to Columbus, Mississippi, a 30-minute drive.
“It was a horrible situation,” said Vicky McCrory, supervisor of the nonprofit Pickens County Ambulance Service, but not an isolated one. There have been multiple similar tragedies.
That single ambulance station in Carrollton serves all of Pickens County, dispatching one and sometimes two ambulances to serve just under 20,000 residents spread across 900 square miles. The farthest reaches of the county line are 25 to 30 miles away on two-lane country roads.
In rural areas where hospitals have shuttered, like Pickens County, the nearest surviving facilities are long drives away, ambulance coverage is sparse, and residents in the throes of medical emergencies often find their situations even more precarious.
In May, the rural health research and policy centers released the results of an effort by the Maine Rural Health Research Center to document coverage gaps in the availability of ambulance services across the country — what the researchers refer to as “ambulance deserts.” They define those deserts as places where people live more than 25 minutes from the nearest station.
The study found that in the 41 states for which data was available, 4.5 million people lived in an ambulance desert. Six in 10 lived in the South. Alabama had 315,000 people living at such a distance, ranking second highest behind North Carolina.
But a closer look into emergency services in Pickens County reveals a grimmer situation. In March 2020, the 56-bed Pickens County Medical Center shut its doors, with administrators citing an unsustainable financial situation and a declining patient volume.
Those living along the periphery of Pickens County must wait nearly a half-hour for an ambulance to arrive. Patients must then ride up to an hour to reach a hospital, in either Tuscaloosa or Columbus.
State Route 86 runs through downtown Carrollton, past the courthouse and City Hall. To the north are the tapering hills of Appalachia; to the south, the Black Belt region.
“Everybody here knows everybody,” said Terrence Windham, mayor of Aliceville, a town roughly 10 miles south of Carrollton. And, seemingly, everyone has heard of the death of Grena Prude.
Julia Boothe is a longtime family physician in the town of Reform, situated about 10 miles north of Carrollton, and a recent president of the state medical association.
Boothe said it’s not uncommon for people to decide there’s no point in calling 911. Some instead show up in her office in a condition well beyond what “a family medicine practice in a rural area of 1,500 people” is equipped to handle.
“People don’t understand the severity of what’s going on” in these rural areas, she said.
At one time, the county had the resources to deploy three ambulances.
“Now,” McCrory said, “we’re lucky to have one unit.” The closure of the hospital, she said, has meant a loss of some $250,000 a year in revenue for the ambulance service.
Further, Boothe said, “the stress and strain” of working in the county make it difficult to recruit emergency medical crews — not to mention health care providers of any specialty.
This critical shortage of services reflects what’s happened to so many rural communities across the U.S. after decades of dwindling resources.
In 1979, when Bill Curry returned home to Pickens County to practice medicine, funeral homes provided the only ambulance service.
“A hearse, literally, would come to the scene of an auto accident or to somebody’s house or wherever there was a need for somebody to get transported to a hospital,” recalled Curry, now a professor emeritus of medicine at the University of Alabama-Birmingham. “The training was pretty minimal, and the interventions were almost none. It was just pick up and go.”
“When we developed the hospital, we said, ‘Well, we really need a modern ambulance service, and so that’s how we came up with what they have today,” Curry said.
James Parker grew up in Pickens County; his dad ran a feed-and-seed store and raised cattle. Parker had mentors growing up, including Curry, who were prominent in the community and pillars of the hospital. They allowed him to shadow them and nudged him into medicine. He returned home after graduating from medical school in 2000 and has been practicing there since. He laments the loss of the hospital.
“You know, folks love to call a little hospital a band-aid station, but that’s a big band-aid that worked,” Parker said. “So many success stories of our little hospital.”
But with advances in medical technology — allowing more procedures to be performed on an outpatient basis — and an unfavorable payer mix, the old model was deemed no longer feasible.
Community leaders believed they had a viable plan to revitalize the hospital. “I thought it was an excellent option,” Boothe said. They requested $10 million from the state legislature — which then became $8 million — to reopen the emergency room and operate an adolescent mental health facility that would serve kids from across the state.
Here, it seemed, was the answer to a need for Pickens County and beyond. Boothe has had young patients who “sat in emergency rooms for over seven days waiting on an admission to an adolescent bed.” Some ultimately had to be transferred out of the state.
The $8 million was still in the state budget when it passed the House in April, but, in the eleventh hour, the Senate scuttled the cash infusion.
The issues related to the need for rural emergency care highlight another concern. The authors of the May report on ambulance deserts wrote that the “declining numbers of rural hospitals and ambulance services imply that remaining ambulance services are being tasked to play a greater role in delivering more sophisticated emergency services.”
“Ambulance services were never intended to take the place of emergency departments,” McCrory said. “I just feel like health care all the way around is failing here, and in other rural areas, too.”
The researchers also noted the fragmented nature of ambulance services, particularly in rural areas.
Boothe talks of a potential solution whereby three ambulance stations would be spaced across Pickens County and Lamar County, on its northern border. But that’s not an easy maneuver.
“Of all the poorly designed aspects of our health care system,” said Alan Morgan, CEO of the National Rural Health Association, “EMS is tops.”
On a sweltering day in late July, several dozen Pickens County residents and officials traveled 2½ hours to the Alabama Statehouse in Montgomery. They stood on the steps to protest lawmakers’ decision not to fund their hospital.
Aliceville Mayor Windham was among them. There’s a sense in Pickens County that rural communities such as his don’t show up on the radar in Montgomery, he said. He and his neighbors’ ongoing mission “is to let the Alabama Legislature know that we are real, live human beings — and we are really suffering.”
Morgan, of the rural health association, has witnessed the ripple effects of the loss of essential rural health care services — the consequences for a community’s health and the health of its economy. “Rural health care,” he said, “is like a tundra. You trample on it, it’s really tough to get it to come back.”
Annie Jackson joined her neighbors on the steps of the state Capitol that July morning. After traveling hours away from home, she stepped off a chartered bus in downtown Carrollton, less than a hundred yards from where her sister Grena died. She paused and pointed up the road toward the nearby West Alabama Animal Hospital.
“We have our animal hospital up here,” Jackson said. “The animals have a hospital. But we do not. What does that say for us?” | Global Health |
9 astounding photos this mom took to keep herself calm while giving birth.
Birth is intense. It's also beautiful.
When San Francisco photographer Lisa Robinson was about to have her second child, she was both excited and nervous.
Sure, those are the feelings most moms-to-be experience before giving birth, but Lisa's nerves were tied to something different.
She and her husband already had a 9-year-old son but desperately wanted another baby. They spent years trying to get pregnant again, but after countless failed attempts and two miscarriages, they decided to stop trying.
Of course, that's when Lisa ended up becoming pregnant with her daughter, Anora. Since it was such a miraculous pregnancy, Lisa wanted to do something special to commemorate her daughter's birth.
So she turned to her craft — photography — as a way to both commemorate the special day, and keep herself calm and focused throughout the birthing process.
Normally, Lisa takes portraits and does wedding photography, so she knew the logistics of being her own birth photographer would be a somewhat precarious new adventure — to say the least.
She initially suggested the idea to her husband Alec as a joke.
Photo by Lisa Robinson/Lisa Robinson Photography.
"After some thought," she says, "I figured I would try it out and that it could capture some amazing memories for us and our daughter."
In the end, she says, Alec was supportive and thought it would be great if she could pull it off. Her doctors and nurses were all for Lisa taking pictures, too, especially because it really seemed to help her manage the pain and stress.
In the hospital, she realized it was a lot harder to hold her camera steady than she initially thought it would be.
She had labor shakes but would periodically take pictures between contractions.
Photo by Lisa Robinson/Lisa Robinson Photography.
"Eventually when it was time to push and I was able to take the photos as I was pushing, I focused on my daughter and my husband and not so much the camera," she says.
"I didn't know if I was in focus or capturing everything but it was amazing to do.”
The shots she ended up getting speak for themselves:
Lisa's husband Alec.
Hello Doc.
Photo by Lisa Robinson/Lisa Robinson Photography.
Warm and encouraging smiles from the nurse.
Photo by Lisa Robinson/Lisa Robinson Photography.
Hello, baby Anora!
An overcome father.
Newborn Anora's first experience with breastfeeding.
Photo by Lisa Robinson/Lisa Robinson Photography.
"Everybody was supportive and kind of surprised that I was able to capture things throughout. I even remember laughing along with them at one point as I was pushing," Lisa recalled.
In the end, Lisa was so glad she went through with her experiment. She got incredible pictures — and it actually did make her labor easier.
Would she recommend every mom-to-be document their birth in this way? Absolutely not. What works for one person may not work at all for another.
However, if you do have a hobby that relaxes you, figuring out how to incorporate it into one of the most stressful moments in your life is a pretty good way to keep yourself calm and focused.
Expecting and love the idea of documenting your own birthing process?
Take some advice from Lisa: "Don't put pressure on yourself to get 'the shot'" she says, "and enjoy the moment as much as you can.”
Lisa's mom took this last one.
Mom and daughter earned the rest.
Photo via Lisa Robinson/Lisa Robinson Photography.This article originally appeared on 06.30.16 | Stress and Wellness |
The U.S. could see a renewed surge of mpox infections even worse than last year, new federal modeling has concluded, based on data showing most American communities remain far short of vaccination rates needed to fend off outbreaks in at-risk groups.
With "moderate confidence," the CDC's modelers said in a report published Thursday that most parts of the country have a "greater than 35%" risk of mpox, formerly known as monkeypox, resurging over the coming months.
"It's not us saying get more people vaccinated because we think it's a good idea. We need to get more people vaccinated because we know there's a linear relationship between how many people are vaccinated and the chance of not having an outbreak," Dr. Demetre Daskalakis, deputy coordinator for the White House's mpox response, told CBS News on Thursday.
The CDC estimates that just 23% of the "at-risk population" for mpox, like men who have sex with men and people with multiple sex partners, have been fully vaccinated. Vaccination rates are in the single digits across many states.
Authorities are now ramping up outreach ahead of the return of travel, and events in the warmer months could fuel the renewed spread of the virus, alongside other sexually transmitted infections.
"This is the time to do that little health check, that tune-up before we get into summer to make sure that we have all our ducks in a row," said Daskalakis.
He pointed to a new webpage created by the agency that embeds the mpox vaccine locator alongside other information, like travel warnings and a locator for getting HIV pre-exposure prophylaxis. Instead of pop-up clinics manned by health departments, many sexual health clinics are now offering Jynneos doses.
"This is getting embedded into the fabric that we do to prevent sexually transmitted infections, like HIV. So it's moved back into a space that's more routine," said Daskalakis.
Cases of mpox have so far slowed nationwide, according to the CDC's tally, down from a peak of more than 450 infections per day in August. Today, only around one case per day is reported on average around the country and only a handful of jurisdictions have spotted mpox in their recent wastewater surveillance.
Data suggests the rollout of Jynneos vaccine doses last year blunted the risk of mpox last year after the first shot, with bigger reductions in risk after getting the second.
However, other factors likely played a role in the outbreak slowing last year. New mpox infections had already begun to dip before the rollout of the two-dose Jynneos vaccine. Countries that did not deploy any doses at all also saw slowdowns in infections.
"That first sort of deflection down I think had to do with the fact that we, not just CDC and federal public health, but the community really mobilized itself to make changes in behavior to be able to reduce transmission," said Daskalakis.
The CDC's modelers also think people who survived mpox infections will likely have some protection from reinfection for years, similar to people who survived a related virus: smallpox. But the risk of reinfection could climb as time passes, as well as if the virus mutates to evade immunity.
At the height of mpox spreading last year, authorities had raised concern when some people were infected by strains that had evolved a "significant deletion" which evaded some tests.
"Now when the cases are down, this is when it helps to try to get people vaccinated so we can prevent the outbreaks," said Daskalakis.
For people who had already gotten both doses of vaccine, Daskalakis said that he thinks they will still have that "sort of level 10 force field, the best we can get." But he also acknowledged officials are continuing to study the issue.
The CDC's Advisory Committee on Immunization Practices is expected to weigh the "need for longer-term vaccination strategy" later this year.
"People with two doses should feel pretty confident that they're protected. But then always remember, if you have a lesion that's concerning, you should get tested because nothing is perfect," said Daskalakis.
for more features. | Vaccine Development |
Tehran, Iran – Iran’s supreme leader, Ayatollah Ali Khamenei, has called for the perpetrators of schoolgirl poisonings to be punished as attacks spread across the country.
Speaking on the sidelines of an annual tree-planting ceremony on Monday, Khamenei said the poisonings are a “major and unforgivable crime” and the perpetrators must face the “harshest punishment” for incidents that have spread fear among parents and throughout Iranian society.
“If there are people who have a hand in this – and there are those that undoubtedly do in some way – then responsible organisations, including intelligence and law enforcement, need to find the origin of this crime,” he said.
Khamenei offered no clue as to who or what groups may be behind the poisonings.
Shortly after Khamenei’s comments, Iran’s judiciary chief promised the courts will act swiftly and suggested those responsible would face the death penalty.
“Based on the definition that the law has, the perpetrators are undoubtedly guilty of ‘corruption on earth’,” said Gholamhossein Mohseni Ejei, referencing a formal charge the Iranian judiciary uses that carries a death sentence.
Deliberate attempts
The first case of schoolgirls showing poisoning symptoms occurred in the religiously significant city of Qom in late November with dozens of girls taken to the hospital. Many similar cases continued to take place in primary and secondary schools there before spreading to the capital Tehran and at least two other cities at the start of March.
The attacks increased over the past week across Iran after the issue received increasing media attention inside and outside Iran, and a health official said the poisonings were deliberate attempts at keeping girls from going to school.
Authorities have not provided any figures, but numerous incidents likely affecting several thousand students have been reported.
The incidents bear the same hallmarks, mostly affecting schoolgirls who experience symptoms including shortness of breath, headaches, nausea, heart palpitations, and numbness of the limbs. Some victims reported smelling strange odours such as rotten fruit, strong perfumes or a burning smell. Most cases have not been severe, but many students have had to be hospitalised.
The interior ministry said in a statement last week it found “suspicious samples” at the schools and investigation results will be announced at a later date.
The driver of a truck carrying chemicals that was seen near several affected schools has been arrested, state television said last week. But no other arrests have been confirmed and authorities have not provided a definitive explanation of the poisonings.
Local media reported on Sunday that Ali Pourtabatabaei, a journalist covering news in Qom who was following up on the attacks, has been arrested. Authorities have not commented on his arrest.
Khamenei’s comments could potentially put an end to a wide variety of reasons provided by some officials, lawmakers and media outlets for the poisonings, including speculation of “mass hysteria”.
The supreme leader, however, did not discuss whether the poisonings originated from inside or outside the country – something senior officials have commented on.
President Ebrahim Raisi has blamed a “conspiracy” by the foreign enemies of the Islamic Republic.
He has not named any countries, but Iran has regularly accused Western powers and Israel of being behind unrest within its borders, including months of protests that spread across Iran last September after the death of 22-year-old Mahsa Amini in police custody. | Epidemics & Outbreaks |
California vs. Florida: The surprising answer to which state handled COVID better
When California Gov. Gavin Newsom and Florida Gov. Ron DeSantis take the stage Thursday for their much-hyped televised debate, it will be perhaps the starkest visual representation of the divide between the two states.
While many social, political and economic factors contribute to that gulf, perhaps no topic better encapsulates the bicoastal conflict than the states’ respective responses to the COVID-19 crisis — the ramifications of which are still resonating and being debated half a year after the end of the pandemic’s emergency phase.
On one side was California, which “trusted in science and data,” as Newsom has put it, and was “the first state to issue a stay-at-home order, which helped us avoid the early spikes in cases.” It was part of a strategy the Democratic governor reasoned was worth the sacrifice: “People are alive today because of the public health decisions we made.”
And on the other was Florida, whose approach DeSantis touted as mindful of economic health — attacking temporary business closures and vaccine mandates.
“We refused to let our state descend into some type of ‘Faucian’ dystopia, where people’s rights were curtailed and their livelihoods were destroyed,” the Republican governor said during a March speech at the Ronald Reagan Presidential Library in Simi Valley, referencing Dr. Anthony Fauci, one of the architects of the nationwide COVID-19 response, who has since retired.
Though the controversy over stay-at-home orders and mask mandates preoccupied the minds of many early in the pandemic, the deeper, more lasting debate surrounding COVID vaccines may be the most notable distinction between the states.
By the first winter wave of the pandemic, COVID-19 rampaged through swaths of California, sending patients to the hospital in droves, overwhelming Los Angeles’ morgues with bodies and prompting officials to issue new stay-at-home orders.
Florida, with its more laissez-faire approach, seemingly saw a less severe winter, prompting supporters to take something of a victory lap.
But over the next year, as Florida officials adopted a more critical view of COVID-19 vaccines, the Sunshine State’s fortunes waned. The following summer’s surge, fueled by the Delta variant, was particularly deadly — despite vaccines being widely available.
Florida was hailed as a model for battling the coronavirus, with many favorably comparing it with California. Then the Delta variant hit and Florida fell behind California in many key metrics, especially deaths.
Given how different California and Florida are — in terms of the age of their populations, overcrowded housing and the like — it’s hard to establish a definitive scorecard of who handled COVID-19 better in terms of policy. Structural factors may have provided one state an advantage at any point in time.
But in raw terms, significantly more Floridians died on a per capita basis during the COVID-19 emergency than Californians. Of the four most-populous states, California had the lowest cumulative COVID death rate: 2,560 for every 1 million residents. Florida’s rate was 60% worse, with 4,044 COVID fatalities for every 1 million residents, according to a Times analysis of Johns Hopkins University data through early March, when the university ended its data tracking.
In other words, Florida’s raw death tally — 86,850 in early March — came close to California’s total, 101,159, despite California having roughly 18 million more residents.
The overall death toll, however, may not tell the whole story.
When factoring in demographics, another estimate has Florida with an age-adjusted COVID mortality rate that’s only slightly higher than California’s. And when adjusting for how Florida’s population is relatively unhealthier than California’s, another estimate actually ranks Florida better.
Such caveats cut both ways, though. The pandemic revealed just how rapidly COVID can carve through overcrowded settings. That proved to be a big vulnerability in California, particularly in Los Angeles County, where more homes are overcrowded than in any other large U.S. county, according to a Times analysis of census data published last year.
More homes are overcrowded in L.A. than in any other large U.S. county, a Times analysis of census data found — a situation that has endured for three decades.
And Florida’s status as a state with one of the oldest populations in the country might have, counterintuitively, prevented the coronavirus from spreading as quickly in the pre-vaccine era. Many of Florida’s seniors may have strictly avoided gatherings during that first winter while younger, restriction-weary Californians could have been more apt to travel, socialize and potentially pass the virus to more vulnerable family members.
DeSantis’ message on COVID shots evolved from boasting about his state’s high vaccination rate among seniors in early 2021 to this year accusing federal agencies of using “healthy Floridians as guinea pigs.” He asserted that the latest inoculations “have not been proven to be safe or effective,” despite strong evidence cited by the U.S. Centers for Disease Control and Prevention and U.S. Food and Drug Administration that they are.
Some health experts say Florida could’ve curbed its deadly 2021 summer surge had more younger adults gotten vaccinated and different mitigation policies been implemented.
By mid-June 2021, about 3 in 4 seniors in both Florida and California had completed their primary vaccination series. But just 43% of Florida’s younger adults had completed theirs, compared with 54% in California.
Earlier in the pandemic, only 20% of COVID-19 deaths in Florida were people younger than 65. But that share climbed to 40% during the peak of the Delta wave, according to Jason Salemi, associate professor of epidemiology at the University of South Florida.
“That was an astonishing number,” he said.
The lower vaccine uptake in younger adults probably played a role.
A new study shows that, contrary to GOP mythmaking, lockdowns reduced the spread of COVID, saving millions of lives worldwide. Ron DeSantis calls that “a mistake.”
“It didn’t need to be as bad as it was — because I felt like if we would have all kind of read the tea leaves and seen what was happening and started to ... do [more] mitigation efforts ... I think it would have resulted in a much lower morbidity and mortality rate during the Delta wave,” he said.
As documented by Florida journalists, DeSantis changed his tone on COVID vaccines by spring 2021 and since has elevated voices skeptical of them.
Florida had an enviable early-vaccination rate among its seniors. But when it came to boosters — which first became available in fall 2021 — the state had one of the nation’s worst coverage rates for older adults by the end of the pandemic emergency in spring 2023.
By early 2022, as the highly infectious Omicron variant spawned what eventually would prove the second-deadliest surge of the pandemic nationally, 69% of California’s seniors had received their first booster, compared with 59% of Florida’s seniors, according to data from the CDC.
As of early May, 48% of California’s seniors had received an updated booster formulated specifically to combat Omicron, compared with 31% of Florida’s seniors.
DeSantis and his crackpot surgeon general attack COVID vaccination with misinformation, cherry-picked data and lies. They’re a menace to public health as long as they have jobs.
That shift accelerated after DeSantis appointed a new health secretary and surgeon general, Dr. Joseph Ladapo, who has issued a number of recommendations and statements that have been roundly criticized by other medical officials and experts.
The CDC and FDA went so far as to write an extraordinary public letter rebuking some of Ladapo’s claims — such as his recommendation that young men not receive mRNA vaccines because of an increased risk of cardiac complications. The CDC and FDA said the assertion was “incorrect, misleading and could be harmful to the American public” and said the risk of stroke and heart attack are actually lower in vaccinated people, not higher.
Ladapo reiterated his critical stance on the latest COVID-19 vaccine formulation in September, and recommended against the shots for those younger than 65. That defied official federal recommendations, which called for virtually everyone 6 months and older to get an updated vaccination this autumn.
COVID-19 continues to pose a “risk at all age groups,” CDC Director Dr. Mandy Cohen said in an interview with the “In the Bubble with Andy Slavitt” podcast when asked about Florida’s recommendations. “We also see a very safe vaccine.”
Experts say California’s brutal winter COVID-19 surge is largely driven by complacency on masking and distancing. One calls it ‘COVID resentment.’
California health officials have defended their approach to the pandemic as appropriately rooted in science, and ultimately effective.
“Do I think California did better than Florida? I think your crude numbers show that we did,” said Dr. Mark Ghaly, California’s health and human services secretary.
But, he added, “Do I think if you really got small and granular, whether it’s age adjustment, or other adjustments, and add layers of comorbidity ... can you split this even further? Absolutely.
“I guess the question for me is: What does it tell you?” he said. “And in California, I think the data does speak for itself.”
California and Florida had similar cumulative COVID-19 death rates in the first few months of the pandemic. But Florida’s rate accelerated faster starting in summer 2020 as the state more quickly loosened restrictions.
California saw its own cumulative death rate rise at a faster pace than Florida’s during the first pandemic winter, and the gap between the two states narrowed. Still, for virtually the entire pandemic, California’s cumulative death rate has remained below Florida’s.
With the emergency phase of COVID-19 over, a Los Angeles Times analysis shows how the pandemic took different tolls on L.A. County and New York City.
A Times analysis of the unadjusted COVID mortality rate, based on the Johns Hopkins University tally, shows that Florida had the highest rate of the four most populous states — and the 12th-worst of the 50 states. California’s rate was 11th lowest of all states.
A separate calculation, which adjusts for age in a database run by the CDC, had Florida with a slightly worse ranking than California — the 34th highest age-adjusted COVID mortality rate versus the 38th highest.
A third analysis, published in the medical journal the Lancet earlier this year, looked at COVID-19 death rates through the end of July 2022 and calculated Florida as having a 43% worse unadjusted death rate than California. But when adjusted for differences in age, the gap was narrower — with a 12% worse death rate in Florida. When also factoring in how Florida’s population as a whole is unhealthier than California, in addition to the age adjustment, the roles reversed and California had a 34% worse adjusted death rate.
But California and Florida may be outliers. A broader look at data from the Lancet report show that states in the South, Southwest and Rocky Mountains had a worse COVID death rate, even when adjusted for age and health conditions, compared with the Northeast and Pacific Northwest.
“Our results suggest that vaccine coverage is linked to fewer COVID-19 deaths, and protective mandates and behaviors were associated with fewer infections,” the Lancet analysis said. “The states that implemented and maintained more mandates were statistically associated, on average, with higher mask use and greater vaccine coverage rates, which in turn were associated with fewer infections.”
Generally, the Lancet analysis found that poverty, lower educational attainment, higher rates of chronic health conditions, limited access to quality healthcare services and lower rates of “interpersonal trust” — trust that people have in one another — were statistically associated with worse COVID-19 mortality rates.
Some experts are wary about comparing death rates, given how vastly different states can be. Any state-level analysis may also paper over regional differences — L.A. County’s death rate, for instance, was much higher than the San Francisco Bay Area’s.
The San Francisco Bay Area fared better during the COVID-19 pandemic than many other populated areas thanks in part to early stay-at-home orders, mask mandates and high uptake of vaccines, experts suggest.
The University of South Florida’s Salemi called such comparisons “apples and oranges.”
“There’s so many factors at play that help a county or state navigate a pandemic. ... It’s not just about these policies, it’s not just about vaccination uptake — although all of those things certainly matter. It’s just such a challenging thing to isolate the independent effect of each,” Salemi said.
In terms of overall judgment of policymakers in how they tried to tackle the COVID crisis, Dr. Robert Wachter, chair of the Department of Medicine at UC San Francisco, said he thought California was following the scientific evidence “better than many other states, including Florida.”
“When you looked at the early curves of death rates, it was substantially lower in California than in many other states. I think a lot of lives were saved at that stage,” he said.
There’s lately been a lot of hindsight history, with some questioning whether the tough measures early in the pandemic were an overreaction, Wachter said. But generally, he said, “I don’t know how you say that when you have well over a million Americans that have died.”
Had Florida been in a vaccine-skeptical mood earlier, “there would be many, many, many more deaths in Florida,” Wachter said. “So I’m grateful that — in part because my mother lives there, and she’s older — that the early message at least was in keeping with what the science tells us to do.”
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High metabolism is an early sign of Alzheimer’s disease
An early phase in the process of developing Alzheimer’s disease is a metabolic increase in a part of the brain called the hippocampus, report researchers from Karolinska Institutet in a study published in Molecular Psychiatry. The discovery opens up for new potential methods of early intervention.
Alzheimer’s disease is the most common form of dementia and strikes about 20,000 people in Sweden every year. Researchers now show that a metabolic increase in the mitochondria, the cellular power plants, is an early indicator of the disease.
The teams behind the study used mice that developed Alzheimer’s disease pathology in a similar way to humans. The increase in metabolism in young mice was followed by synaptic changes caused by disruption to the cellular recycling system (a process known as autophagy), a finding that was awarded the Nobel Prize in Physiology or Medicine in 2016.
After a time, metabolism in the Alzheimer brain usually declines, which contributes to the degradation of synapses. This the researchers could also see in the older mice, which had had the disease for longer time.
“The disease starts to develop 20 years before the onset of symptoms, so it’s important to detect it early – especially given the retardant medicines that are starting to arrive,” says Per Nilsson, researcher at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet. “Metabolic changes can be a diagnostic factor in this.”
Maria Ankarcrona, researcher at the same department continues:
“Interestingly, changes in metabolism can be seen before any of the characteristic insoluble plaques have accumulated in the brain. The different energy balance tallies with what we’ve seen in images of the Alzheimer brain, but we’ve now detected these changes at an earlier stage.”
The study was conducted in close partnership between both researchers’ groups, who analysed the part of the mouse brain called the hippocampus, a structure that plays an important part in short-term memory and that is affected early in the pathological process.
RNA sequencing was used
Applying the technique of RNA sequencing to see which genes are active in the cells of the hippocampus during different stages of the disease, the researchers discovered that one of the early stages of the disease is an increase in mitochondrial metabolism.
The researchers studied the changes that then appeared in the synapses between the brain’s neurons using electron microscopy and other techniques, and found that vesicles called autophagosomes, whereby spent proteins are broken down and their components metabolised, had accumulated in the synapses, disrupting access to functioning proteins.
The researchers will now be studying the role of mitochondria and autophagy in the development of Alzheimer’s disease in more detail – for example, in mice whose disease provides an even better model of the Alzheimer brain.
“These findings highlight the importance of retaining functional mitochondria and normal protein metabolism,” says Dr Nilsson. “Going forward, we’ll be able to do tests on mice to see if new molecules that stabilise mitochondrial and autophagic function can retard the disease.”
The study was financed by grants from the Swedish Research Council, the Swedish Alzheimer’s Foundation and the Swedish Brain Fund and through private donations. The researchers have declared no conflicts of interest.
Publication
”Mitochondrial hypermetabolism precedes impaired autophagy and synaptic disorganization in App knock-in Alzheimer mouse models” Luana Naia, Makoto Shimozawa, Erika Bereczki, Xidan Li, Jianping Liu, Richeng Jiang, Romain Giraud, Nuno Santos Leal, Catarina Moreira Pinho, Erik, Berger, Victoria Lim Falk, Giacomo Dentoni, Maria Ankarcrona, Per Nilsson. Molecular Psychiatry, online November 1, 2023, doi:10.1038/s41380-023-02289-4 | Disease Research |
New research suggests that Eli Lilly’s tirzepatide can boost existing efforts to lose weight. The company’s latest clinical trial found that people who dropped at least 5% of their weight before taking the drug went on to lose substantially more weight than those who took a placebo. Those in the treatment group ultimately lost 25% of their baseline weight on average, or about 60 pounds, over a 16-month period.
Tirzepatide is the active ingredient in Eli Lilly’s type 2 diabetes drug Mounjaro, approved by the Food and Drug Administration last year. It combines two synthetic versions of hormones key to controlling our hunger and metabolism, GLP-1 and GIP. The FDA is expected to approve tirzepatide as a treatment for obesity in the coming months, based on large-scale, randomized, and controlled clinical trials showing its effectiveness in helping people with obesity lose weight.
Earlier published trials of the injectable drug have found that people taking it generally lose around 20% of their baseline weight on average. On Sunday, researchers published results from another of these studies in the journal Nature Medicine, the SURMOUNT-3 trial.
This trial tested how people might respond to the drug if they first underwent an “intensive lifestyle intervention”—in other words, a calorie-restrictive diet and exercise program. It involved over 500 overweight and obese people who successfully lost at least 5% of their weight during a 12-week program. These people were then randomly assigned to either take tirzepatide or a placebo over the next 72 weeks, or about 16 months.
By the end of the study, the treatment group experienced about 21% additional weight loss on average, amounting to a total weight loss of 25%. The placebo group, on the other hand, gained some of their weight back, ending at a total weight loss of 4.8% on average. Three-quarters of the participants on tirzepatide also kept at least 10% of their weight off, compared to less than 10% of the placebo group. Adverse events linked to the drug were similar to those seen in past trials, with the majority being mild to moderate gastrointestinal issues like nausea, vomiting, and diarrhea.
“This study says that if you lose weight before you start the drug, you can then add a lot more weight loss after,” lead study author Thomas Wadden, a obesity researcher at the University of Pennsylvania, told the AP.
The findings reaffirm how difficult it can be to achieve and sustain even modest weight loss through diet and exercise alone, while also being the latest to show that tirzepatide and similar drugs represent a new era in anti-obesity medication. Tirzepatide seems to be more effective than Novo Nordisk’s semaglutide, which was approved by the FDA to treat obesity in 2021. In clinical trials, people taking semaglutide for obesity have lost around 15% of their weight on average. And there are yet more drugs in the pipeline that might help people lose even more weight than either option, or could offer other advantages such as being easier to take via a pill.
Like all drugs, however, these medications have negatives that have to be evaluated against their expected positives. In addition to common gastrointestinal issues, they have been linked to rare complications like the temporary paralysis of stomach or gut muscles. The longer-term risks of these drugs, which many people might need to take for life to maintain weight loss, are still being studied, as are their other potential benefits. Recent studies have found that semaglutide can reduce heart problems and kidney disease in obese people vulnerable to these conditions, for instance. | Drug Discoveries |
In a Facebook group for parents, a mother asks for advice following the recent rise in measles cases.
She’s received a letter from the NHS asking her to take her young daughter for the MMR vaccine, which protects against measles, mumps and rubella, as it’s “dangerous not to have it”.
But she doesn’t know who to trust. “I’ve done some research but feel like a lot of the info on the web is pro-vaccine,” she writes.
Another mother is equally unsure. She’s trying to decide whether she should take her eldest for their childhood jabs and wants to work out which ones are “worth the risk”. “Just trying to learn about it all and make the right decisions. Thank you in advance,” she writes.
Within minutes, both posts have been flooded with replies – almost all of which give the same advice.
“No no no. Avoid them all,” one person says. “Once they’re injected into the bloodstream, the metals and toxins have access to the brain and every organ!” she claims falsely. “Arm yourself with information to decline because they will pressure you.”
Others share stories of children they claim have been damaged by the MMR vaccine. Some advise the parents to “just ignore” communications from the NHS. “I keep getting letters for all my kids. It’s scaremongering. I’ve threatened my surgery with harassment if they don’t stop sending me letters,” another person says.
The onslaught of anti-vaccine comments seems to have the desired effect. Both mothers say thanks for the help. The one who received the NHS letter urging her to take her daughter for the MMR vaccine has made up her mind. “I definitely won’t be letting her have it,” she writes.
It’s perhaps unsurprising that these conversations would take place in a Facebook group where discussions about wellness and holistic health are common. But misinformation about the MMR vaccine is not confined to an obscure corner of the internet.
Last week, several articles about the heightened risk of UK measles outbreaks – posted on social media by major outlets such as Sky and ITV News – were deluged with laughing face emojis and sceptical comments such as “More fear porn”, “They want to jab the kids”, “Fearmongering bullshit” and “More fear so they jab their kids with MMR and poison them at best”. Many comments indicated mistrust of the media, health services and the government. “Rule of thumb, anything the MSM [mainstream media] push, you do the opposite,” said one. Anti-immigration rhetoric about the uptick in measles cases was also common. “It’s coming from the small boat invasion,” one person wrote.
At the same time, influencers who gained large followings during the pandemic – including those at the forefront of sowing doubt about the Covid vaccines – appear to have refocused some attention on MMR.
Amid a fall in childhood immunisation rates, the resurgence of misinformation is alarming health experts. The latest NHS figures show the MMR vaccine uptake is the lowest since 2010-11, with only 84.5% of children having received both doses by age five – well below the WHO recommended rate of 95%. Measles is also rising, with 149 lab-confirmed cases this year compared with 54 in 2022.
Dr Selvaseelan Selvarajah, a GP in east London, is on the frontline of the fight to reverse this trend. Alongside his main practice in Tower Hamlets he is a clinical lead in Hackney, where MMR uptake is the lowest in England – with only 56.3% of five-year-olds having had both doses.
Part of the problem, said Selvarajah, is that there is a “massive overhang” from the days of Andrew Wakefield, who in the late 1990s pushed the debunked theory that the MMR vaccine causes autism – leading uptake to plummet. Those false claims still circulate in some parent circles, he added. General scepticism about vaccines has also risen post-pandemic: “Since Covid we’ve seen a lot more hesitancy. Theories about the MMR and Covid vaccines have merged.”
While for some the anti-vaccine views are deeply entrenched, others are “not anti-vaxxers but they want more information”. In Hackney, there are particular challenges due to the makeup of the borough, which includes traditionally under-vaccinated groups, such as Orthodox Jewish and Somali communities, as well as a section of the “white middle class” who favour “more organic, holistic living and don’t believe in vaccines”. But pressures on the wider health system mean that where before Selvarajah could spend 30 minutes speaking to a vaccine-hesitant parent, now he cannot. “We don’t have the time,” he says.
Instead, Selvarajah and colleagues are trialling initiatives including holding community talks and paying junior doctors to ring up the parents of unvaccinated children to more gently encourage them to come in. He also believes campaigns in nurseries and schools are needed, as well as increased “peer support”. A parent sharing the message that their child had the MMR vaccine and was fine – or caught measles and was not – “is a much more powerful message than expecting an overstretched GP system to do it”, he said.
Such a strategy would effectively be playing anti-vaxxers at their own game. “What anti-vaxxers have been very good at is they’re on Facebook, they’re on Instagram, they’re on TikTok,” said Callum Hood, who leads research at the Center for Countering Digital Hate. “Part of the strategy is to be really approachable and easy to access.” Facebook generally permits such discussions, only removing misinformation it thinks is “likely to directly contribute to the risk of imminent physical harm”.
Modelling by the UK Health Security Agency (UKHSA) suggests failing to improve vaccine uptake could have severe consequences. While the risk of a nationwide epidemic is low, it believes an outbreak of between 40,000 and 160,000 cases could occur in London due to low vaccine uptake in the capital.
Dr Vanessa Saliba, measles lead at the UKHSA, said her team was increasing its work with councils and local health teams to improve uptake of MMR and other childhood vaccinations, including “tailoring and targeting” interventions in “disenfranchised communities”. Early next year, it plans to write to the parents of every unvaccinated child. Staff are also monitoring misinformation online, some of which was “amplified” during the pandemic – however, Saliba is cautious not to overstate the impact of such content. Recent polling of 1,000 parents by the UKHSA suggests opinions of childhood vaccinations remain positive overall. “Parents tell us they see all kinds of information about vaccines from different sources, such as social media, but they don’t trust those sources,” she said.
With measles outbreaks in other parts of the world, she said it was probably only “a matter of time” before UK cases “take off again in quite a big way”. But she said there was now a “window of opportunity” to ensure “every child” was protected.
“One in 10 children who get measles will get complications, and sometimes it can be fatal,” she said. “But it’s completely preventable with a vaccine. Every case we get is a real shame.” | Vaccine Development |
People who have a natural preference for staying up late tend to have poorer health habits, including sleep habits, which in turn is associated with reduced wages, according to new research published in Economics and Human Biology. The findings shed light on the links between people’s natural sleep patterns, known as chronotypes, and their financial well-being in midlife.
While previous research has shown varying associations between sleep duration and wages, there have been inconsistencies and a lack of understanding about the underlying mechanisms driving these relationships. The researchers aimed to provide a more comprehensive and nuanced understanding of how sleep, as indicated by chronotype, affects wages and the potential pathways involved.
Chronotype refers to an individual’s natural preference for the timing of their daily activities, particularly their sleep-wake cycle. It is closely related to an individual’s internal circadian rhythm, which is the internal biological clock that regulates various physiological and behavioral processes over a roughly 24-hour period. This circadian rhythm influences when we feel most alert, awake, and productive, as well as when we feel more inclined to sleep.
People exhibit different chronotypes based on their inherent circadian rhythms. These can be broadly classified into three categories:
Morning Types (Larks): Morning types are individuals who naturally prefer to wake up early in the morning and are most alert during the early hours of the day. They tend to feel tired and ready for sleep earlier in the evening.
Evening Types (Owls): Evening types are individuals who naturally prefer to stay awake and active during the late hours of the night. They tend to feel more alert and awake in the evening and may struggle with early morning activities.
Intermediate Types: Some individuals fall in between morning and evening types, with a chronotype that falls somewhere in the middle. They may feel more alert during the daytime hours but not as early as morning types, or they might stay awake later than morning types but not as late as evening types.
To better understand the mechanisms linking chronotype and wages, the researchers proposed a theoretical framework that combines economic models related to human capital, social capital, and health capital. This framework suggests that an individual’s chronotype can influence their accumulation of these different types of capital, which subsequently impact their productivity and wages.
The data used for the study come from a population-based cohort survey, known as the Northern Finland Birth Cohort 1966, allowing for a robust analysis of the links between chronotype, various forms of capital, and wages. Human capital was assessed through factors such as work experience and educational attainment, health capital was measured through behaviors like smoking and sleep patterns, and social capital was measured by analyzing trust and prosocial behavior. The final sample included 2,231 men and 2,789 women.
“My coauthors and I have worked on similar types of Behavioral Economics research, looking at the relationship between biological and/or psychological characteristics and economic outcomes,” said study author Andrew Conlin, a postdoctoral researcher at the Aalto University School of Business
“Given the unique data available in the Northern Finland Birth Cohort 1966, we thought we could contribute to the literature on the economic consequences of sleep. Using wages as the main outcome measure in this paper builds on a previous paper we published on the relationship between chronotype and self-assessed work ability.”
The researchers found that having an evening chronotype had indirect effects on wages. In other words, having an evening chronotype isn’t directly related to lower wages, but it is related to other factors that are associated with earning less money.
The biggest impact on wages came from health capital. For example, evening chronotypes tended to engage in unhealthy behaviors more often, such as being less physically active, smoking, and consuming more alcohol. They also were more likely to experience poor sleep outcomes, such as insomnia and sleeping less than 7 hour per night. The researchers showed that these factors together can explain why evening chronotypes might earn less money than morning chronotypes.
“Sleep matters,” Conlin told PsyPost. “That’s not surprising, we all know that. But we try to show potential mechanisms by which sleep is related to wages. Being an evening-chronotype person (an ‘owl’) seems to be associated with higher rates of poor health outcomes, which in turn are associated with lower wages.”
But the study, like all research, includes some caveats. The participants’ chronotype was assessed at one specific point in time when they were 46 years old. While the study can confidently draw conclusions about how being an evening person at age 46 is associated with work productivity, it cannot prove causal effects.
“The major caveat is that we can only show an indirect association between chronotype and wages; we are unable to make any claims about evening chronotype causing lower wages or causing poor health outcomes (think of the line ‘correlation is not causation’),” Conlin explained. “We were unable to use analysis methods that would have allowed us to test for such causation.”
“I think further research on the causal mechanisms would be very informative. Does a mismatch between chronotype and work schedule really cause lower productivity? Why is evening chronotype associated with poorer health outcomes – is there a common underlying biological factor?”
The study, “The association between chronotype and wages at mid-age“, was authored by Andrew Conlin, Iiro Nerg, Leena Ala-Mursula, Tapio Räihä, and Marko Korhonen. | Stress and Wellness |
Scientists have developed tiny robots using human cells that could one day patrol our bodies, searching for and healing diseased cells and tissue.
So-called 'anthrobots,' assembled from human cells can repair damage to brain cells in a dish, according to a study published Thursday in the journal Advanced Science.
Scientists at Tufts University in Massachusetts developed the SIZE robots to heal diseases, but foresee the technology repairing cell and tissue damage from conditions such as Alzheimer's.
These bots - whose name means 'human robots' - were made from human airway cells.
To build the anthrobots, scientists started with samples of the cells that line human lungs. Then they put them into a dish and coaxed the cells to grow into clumps.
The clumps developed cilia, tiny hairlike projections all around the outside of the cells, that help them get around. Lung cells naturally grow cilia, which is a big part of why the scientists chose to use them.
Observed on their own, the clumps of cells moved around without any help - self-propelled anthrobots.
Next the team put the anthrobots to the test, in a simulation of what it might look like for them to repair human brain tissue.
In a dish of lab-grown brain cells, the team slashed a wound down the center, severing the connections between neurons.
But then they placed the anthrobots into the dish and let them get to work.
At first, the tiny bots moseyed down the center of the slash, like they were walking down the street.
But once they plopped a larger clump of anthrobots down onto the gap between the brain cells, forming a temporary link, something amazing happened: The nerve cells started regrowing, stretching across to bridge the gap.
The new work builds on previous research from the same team, who built xenobots from frog embryo cells.
In that case, embryonic cells provided a great starting place to grow the bots, but for use in humans, human cells were necessary to ensure that a person's body didn't treat them as a foreign invader and attack, triggering a potentially dangerous immune response.
But since human embryo cells can't be used for research, they had to make do with the lung cells. Fortunately, due to the explosion in human respiratory disease research since the COVID-19 pandemic, these types of cells had become plentiful.
Their next steps include testing the anthrobots in tissue that models human disease like dementia, to see if the bots can repair damage.
Putting them into humans is a long way off, they said, but they are optimistic that one day the anthrobots will play a role in precision medicine. | Medical Innovations |
A personal trainer has revealed how he 'built his body back up' after he lost 17 kilograms when he contracted a bacterial infection from drinking tank water and ended up in hospital.
Dylan Rivier, 40, from Sydney, posted on Instagram recalling the experience that took place in 2013 when he was working at a music festival in Byron Bay.
He said he shed 17kg of muscle in just four weeks when he was 'in hospital sick AF', and it took him 'almost a full 12 months to get back my strength and fitness'.
Dylan wrote: 'The first picture is me almost 10 years ago, in hospital sick AF after drinking water that had a nasty bacteria in it. The second photo is what I looked like exactly eight weeks earlier'.
He added: 'I hadn't weighed that little since High School. My mineral levels and protein were rock bottom, my blood pressure was 90/40 and my HR was 96 - all big problems in personal trainer land.'
Dylan said: 'It took me almost a full 12 months to get back my strength and fitness, I cleaned up my diet and had to take my training back to level one, but I got there in the end and haven't stopped.'
In order to 'build his body back up', the Bondi Beach personal trainer said he made his nutrition a priority like 'never before'.
'I shopped at the farmers' markets for fresh produce, and made sure everything I bought was organic and locally-sourced,' he previously told FEMAIL.
'I also treated myself like one of my clients, starting their fitness journey right from the very beginning.'
Dylan added apple cider vinegar to his diet, which he has with some sort of 'greens powder' first thing in the morning.
Elsewhere, he prioritised plenty of protein through the day, by way of poached eggs, snacks of tins of tuna, grilled chicken salads and Greek yoghurt.
'You can be training your butt off, but if you're not complementing that with good nutrition - or you're drinking too much - you're not going to see much progress at all,' Dylan previously told FEMAIL.
'I do a bunch of ab exercises to help to strengthen and tone my mid section, but if there's a layer of fat over my abs then I won't see them.'
He added: 'If you want to see your abs, you need to cut down on refined sugar, watch your alcohol consumption.
'And keep your diet pretty balanced when it comes to fat, carbs and protein.
'My advice to people who want to see results is to find what works for you and stick with it,' Dylan said.
Dylan complemented his clean diet with training sessions between five and six times a week.
He said he had to build up to this frequency as when he first started recovering, he couldn't train more than three times each week.
Nowadays, Dylan does a variety of workouts, including HITT sessions, steady state soft sand running, outdoor workouts combining pull ups, push ups, squats, straight leg raises and runs.
Dylan says you can 'achieve the body of your dreams simply by using your own body weight and one or two props':
'I like HIIT or steady state soft sand running on my home beach at Bondi to shift stubborn stomach fat,' he said.
The 37-year-old also loves doing an outdoor workout combining pull ups, push ups, squats, straight leg raises and runs, and does frequent circuit training using his own bodyweight as a prop.
'If you live in Australia, we're already blessed with some of the most incredible outdoor training locations in the world,' Dylan said.
'I guess the point of all this is to serve as a reminder to anyone who has fallen off the fitness bandwagon and is unsure of how to get back on it.
'It's definitely possible, even though sometimes you feel like there's just no way. At the end of the day, our fitness journeys should be life long. They're not just 12-week programmes or six-month memberships.
'They're something you should be able to do for the rest of your life - and that's what I plan on doing.' | Nutrition Research |
In the New Jersey city of Camden, the battle againstis a daily fight.
First responders told CBS News that on average, they use, an overdose-reversing drug that works on opioids like fentanyl and heroin, about three times a day. The area has one of the highest overdose and drug-related fatality rates in the state.
"They would come in at 7:00 in the morning, they would go out, they would reverse an opioid overdose and, by the end of their shift, they were going out and reversing the same patient with another opioid overdose," said Dr. Rick Rohrback, an EMS medical director.
As overdose deaths nationwide more than doubled in the past decade, it's become clear that naloxone isn't enough. Instead, medical professionals at Cooper University Health Care, one of the largest healthcare systems in the area, are trying a novel way to get people who use or overdose on drugs into medical treatment.
"When the data started coming out, that every overdose we see has a one in ten chance of dying in the next year, that kind of put it all in perspective for us," said EMS medical director Dr. Gerard Carroll, who said that in the past decade the emergency room saw a major increase in drug-related admissions.
Carroll and his colleagues launched a study using the medication. Called "bupe" for short, the medication is taken orally and treats opioid withdrawal and stabilizes patients. Carroll's study found that by equipping ambulances with buprenorphine and training paramedics to start patients on it after reviving them with naloxone, they could get almost six times as many people into drug treatment within the following month.
In 2019, the New Jersey Department of Health approved a $250,000 grant to fund paramedics to carry and offer buprenorphine on calls.
For first responders, this means that once an overdose has been reversed, oxygen is given, and the patient is fully awake and responsive, it's "game on," Carroll said. Paramedics like Laith Shubbar and Corey Dipatri will sit with patients, who are usually disoriented and confused, and offer them the medication. If they take it, paramedics will stay with them until it takes effect.
"It's not a solution to the opioid crisis, so I don't want to overstate anything," Carroll emphasized. "But when patients take (bupe), and ... I think our uptake is somewhere around one in 10, one in 12, but of those, about 30 percent to 40 percent make their first and second appointments and are in treatment at about 30 days."
When people go to those appointments, they met Dr. Kaitlan Baston, the head of Cooper University's Center for Healing, where more than just treatment is offered.
"We basically ask what their needs are that day," Baston said. "Food, clothes, shelter, you know, community and engagement and love, which is a basic need, and medication. If you don't have your basic needs met, it's really hard to engage well in therapy or work on your trauma."
The center also offers help with mental health and basic needs, and services that can connect people with housing and employment resources. The efforts are part of a revamped approach to treating addiction, Baston said.
"We saw paramedics and EMTs and frontline workers, police officers, nurses … giving them emergency naloxone over and over and over again, and they felt like the patients were failing. But we never gave those patients treatment, we just reversed them," Baston said. "It'd be like if someone had a heart attack and we immediately stabilized them, but then gave them no medicines to prevent the next heart attack. And they were like 'Weird, they had a heart attack again.'"
There has been some pushback to the buprenorphine and treatment programs, Baston and Rohrback said, but the data shows that their approach is working.
"In Camden County, we actually saw overdose rates stay stable or go down a little bit while overdose rates were still skyrocketing in every other county in New Jersey," Baston said.
The treatment process means that people have time to get through the withdrawal process and then treat their trauma, offering a chance at healing.
"The brain can heal, but you need time," she said.
for more features. | Drug Discoveries |
A gene variant that helps regulate body weight could aid in tackling obesity, scientists have said.
The ZFHX3 gene mutation - thought to exist in 4% of people - has been found to control parts of the brain responsible for appetite.
Scientists at Nottingham Trent University and MRC Harwell uncovered the mechanism which allows the mutated gene to play a key role in regulating appetite, weight and the insulin hormone in mice.
They found it can affect a region of the brain known as the hypothalamus - which controls appetite, food intake, hunger and thirst - by switching on and off the function of other genes there.
Researchers said understanding this pathway, which has been reported in the journal FASEB (Federation of American Societies for Experimental Biology), could pave the way for new targeted weight loss therapies.
Dr Rebecca Dumbell, a researcher in Nottingham Trent University's School of Science and Technology, said: "For the first time, we have demonstrated a role for this gene to alter growth and energy balance with a protein altering mutation similar to a variant found at low frequency in the human population.
"There is a big genetic component related to our appetite and growth but it's not fully understood.
"Understanding what is happening in those who have the mutation paves the way to exploring potential new weight loss intervention targets for all people."
Dr Dumbell believes the ZFHX3 mutation, which plays a similar role in mice and people, may "explain a way in which some people have a smaller appetite, and so tend not to gain as much weight as others".
While everyone has the gene, the specific mutation to be driving this mechanism is thought to exist in just 4% of people.
Read more:
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Dr Dumbell said: "It is likely one of many different mutations that make people different in their natural ability to stick to a diet in the first place."
For the study, the researchers monitored the food intake of mice with the mutated ZFHX3 gene alongside those who did not have the gene variation.
They found those with the mutation had a lower food intake, a shorter body length, and lower levels of insulin and another hormone known as leptin, which helps to regulate body weight.
The mice also ate about 12% less, and at age one weighed about 20% less than those without the mutation.
The researchers said the lower insulin levels suggest the mice with less body fat have healthier blood sugar regulation and, therefore, are less likely to be at risk from conditions such as type 2 diabetes and heart disease. | Disease Research |
Politics June 15, 2022 / 1:39 PM / CBS News President Biden will announce several executive actions Wednesday afternoon to address discriminatory laws and practices against LGBTQ children and adults, as several states enact anti-LGBTQ measures, according to a senior administration official. "President Biden always stands up to bullies, and that's what these extreme MAGA laws and policies do. They bully kids. Hateful, discriminatory laws that target children are out of line with where the American people are," the official said. The executive actions, which will be unveiled at a White House Pride event on Wednesday afternoon, direct the Health and Human Services Department to work with states to expand gender-affirming care and access to youth mental health counseling, strengthen non-discrimination protections in the foster care system and clarify that federally funded programs cannot offer "conversion therapy," the widely discredited practice of trying to change a person's sexual orientation or gender identity. The official didn't point to any specific use of federal funds for conversion therapy but said the executive action will help HHS lawyers enforce any future attempts. HHS will also be charged with releasing "new sample policies for states on how to expand access to comprehensive healthcare" for LGBTQ patients, the official said. The Department of Education will be similarly directed to release a "full inclusion" policy at schools. On his first day in office, Mr. Biden issued an executive order clarifying that gay and transgender people are protected against discrimination at school, work and other areas. He directed federal agencies to review existing policies and regulations that prohibit sex discrimination, and amend them as needed to underscore that discrimination because of sex includes sexual orientation and gender identity. LGBTQ rights, particularly for transgender children and teens, have been a focus of Republican lawmakers, with states proposing limiting participation in sports, as well as discussions of gender identity and sexual orientation in classrooms. In: Biden Administration Joe Biden LGBTQ+ Bo Erickson Bo Erickson is a reporter covering the White House for CBS News Digital. Twitter Thanks for reading CBS NEWS. Create your free account or log in for more features. Please enter email address to continue Please enter valid email address to continue | Health Policy |
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