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The alleged gang rape of a woman in a park in Pakistan has enraged women’s rights activists who are protesting against what they see as “increasing sexual barbarism” in the country.
The woman, 24, was with a male colleague in the capital Islamabad’s Fatima Jinnah park – known locally as F9 park and the largest in the city – last Thursday when they were allegedly attacked by two armed men, according to a statement she filed with the police, seen by CNN.
The woman alleged the men forced the pair toward a “jungle area” of the park where they ripped off her clothes and raped her.
She said the men told her she should not have been in the park at night and asked about her connection to her colleague.
“When I responded, I was slapped. My hair was pulled and I was thrown on the floor,” the woman said in her police statement.
The incident has sparked outrage in the country of 220 million, which is highly patriarchal and where violent attacks against women and girls frequently make headlines.
Scores of protesters have tied their dupattas – scarves worn by South Asian women – to the railings of the park, alongside messages imploring change.
“Please don’t let another sister suffer,” one note read. “Save the women and kids of Pakistan,” read another.
The rights group, Aurat Azadi March (Women’s Freedom March), said in a statement, “There is an increasing sexual barbarism in Pakistan, and criminal silence on it by the state and society is unacceptable.”
“We are enraged. We are in pain. And we will not let this be forgotten.”
A spokesperson for Islamabad police told CNN no arrests had been made in the case so far.
Fatima Jinnah park is a sprawling oasis spread across the center of Islamabad in an affluent part of the city, and has a high security presence. It is often likened to New York’s Central Park as families often gather for festivals and children play at the park throughout the day.
Media ban and rape crisis
The government on Sunday ordered domestic television channels not to report on the alleged assault, citing the need to protect the woman’s identity.
In a statement, Pakistan’s Electronic Media Regulatory Authority said any broadcast of news reports was “prohibited with immediate effect.”
More than 5,200 women reported being raped in the country in 2021, according to Pakistan’s Human Rights Commission, but experts believe the actual number is much higher as many women are afraid to come forward due to social stigma and victim blaming.
Fewer than 3% of sexual assault or rape cases result in a conviction in Pakistan, Reuters reported in December 2020, citing Karachi-based non-profit War Against Rape.
In December 2020, Pakistan toughened its rape laws to create special courts to try cases within four months and provide medical examinations to women within six hours of a complaint being made. But activists say Pakistan continues to fail its women and does not have a nationwide law criminalizing domestic violence, leaving many vulnerable to assault.
In 2021, the beheading of Noor Mukadam, a Pakistani ambassador’s daughter, sent shockwaves through the country with protesters calling on the government to do more to protect women.
Her killer, Zahir Jaffer, the 30-year-old son of an influential family and a dual Pakistan-US national who knew Mukadam, was sentenced to death by an Islamabad judge last February. | Women’s Health |
The UK had one of the worst increases in death rates of major European economies during the Covid pandemic, BBC analysis has found.
Death rates in the UK were more than 5% higher on average each year of the pandemic than in the years just before it, largely driven by a huge death toll in the first year.
That was above the increase seen in France, Spain or Germany, but below Italy and significantly lower than the US.
Comparing death rates across countries
Back in April and May 2020, the UK was seeing one of the worst waves of Covid deaths in the world.
But Prof Sir Chris Whitty, England's chief medical officer, warned against international comparisons of Covid deaths too early in the pandemic.
Instead, he recommended looking at deaths for any reason, since they do not depend on what a country calls a Covid death.
And he said analyses should take account of the age profile of each country, which can explain a lot of differences in death rates.
We have built a database of those figures, collecting data for the last eight years from a range of European countries, as well as the US and New Zealand.
Now the UK's long-awaited Covid inquiry is under way and Sir Chris is about to give evidence for the first time.
And as the World Health Organization has declared an end to the global health emergency, we have looked back at three years of pandemic deaths, starting in March 2020.
We compared countries by measuring how much their death rates rose from those seen in the five years before the pandemic.
Over the three years to February 2023, the UK's death rates went up by more than 5%, which is more than France, Germany and Spain (all up between 3% and 4.5%), but by less than Italy's (up more than 6%).
The US and Eastern European countries like Poland were even harder hit, with death rates more than 10% above their pre-pandemic levels over the three years to February 2023.
In contrast, death rates fell in countries like Sweden and Norway and also New Zealand, who contained the virus successfully before its vaccination programme took off.
The year-by-year figures tell different stories for each country.
For the UK, they point to early losses followed by significant success in 2022.
How do the UK's deaths compare each year?
The UK was one of the worst-hit countries in the first year of the pandemic, with death rates running 15% above those before it started.
The combination of a terrible first wave and the rapid spread of the alpha (or Kent) variant just as the vaccine rollout was getting going contributed to a huge death toll.
Many eastern European countries like Poland avoided the spring 2020 wave but overtook the UK in numbers of deaths in the winter of 2020-21.
The US continued to have steadily increasing death rates during the summer of 2020 and by the end of the year, it passed the UK's total.
Death rates fell in many European nations in the second year of the pandemic as vaccine programmes got under way.
The UK's vaccine rollout is regarded as a "global exemplar", says Prof Devi Sridhar of University of Edinburgh.
That is not just number of doses, it was also getting them to the people most at risk.
And the UK looked better than any major European economy bar Spain in that second year - with death rates below historical averages.
In the third year, death rates rose in many countries as they opened up again.
Some of the largest rebounds we found were in countries like Germany, New Zealand and Norway, who had fared better in the first two years of the pandemic (and well overall).
Norway had far fewer deaths than Sweden in the first year of the pandemic but over the three years the two countries look more similar.
It is hard to read straight across from Scandinavian countries to the UK, cautions Prof Sridhar, arguing "we'd never look like either Sweden or Norway", and describing them as "healthier, wealthier and more equal" countries that are very different to the UK.
Lessons for the UK
It would take many inquiries to tease apart the effect of all the possible reasons behind every nation's pandemic outcomes: preparedness, population health, lockdown timing and severity, social support, vaccine rollout and health care provision and others.
But some argue that there are lessons for the UK that need to be learned even before we think about future pandemics.
The UK's heavy pandemic death toll "built on a decade of lacklustre performance on life expectancy" says Veena Raleigh, of the King's Fund, a health think tank. She argues that government action to improve population health and turn that around has "never been more urgent".
Methods
We collected data on deaths in five-year age groups and population estimates/projections from Eurostat, the Office for National Statistics, National Records of Scotland, the Northern Ireland Statistics Research Agency, the Centre for Disease Control, United States Census Bureau and Stats NZ.
We calculated the death rate in each age group and combined them to form an age-adjusted death rate using the 2013 European Standard Population.
Some nations did not have the full set of age bands. For example, US figures used 10-year age bands between five and 24 and above 55. Broader age bands can exaggerate excess mortality figures like the ones we calculated, in the order of a percentage point.
Additional journalism by Callum Thomson, Isabella Worth, Jana Tauschinski, Liana Bravo and Wesley Stephenson
Sign up for our UK morning newsletter and get BBC News in your inbox. | Epidemics & Outbreaks |
Dame Kate Bingham, the Government’s vaccines tsar, was branded “totally unreliable” and “wacky” by ministers after she questioned the need to inoculate the entire population.
The Lockdown Files suggest behind-the-scenes tensions between Dame Kate, who led the UK Vaccine Taskforce (VTF), and ministers and officials in the Department of Health and Social Care.
Dame Kate was given a damehood in recognition of the success of her program to acquire Covid vaccines, enabling the UK to become the first Western country to begin vaccinating citizens in Dec 2020.
But Matt Hancock, then the health secretary, clashed with her over the rollout, including Dame Kate’s refusal to back a plan to buy tens of millions of vaccines from India.
Advisers to Mr Hancock flagged up their concerns in Oct 2020 after Dame Kate gave an interview to the Financial Times in which she said that the vaccination of the entire population was “not going to happen”. She explained: “We just need to vaccinate everyone at risk.”
It is understood that she was following government policy at the time.
In leaked WhatsApp messages obtained by The Telegraph, Damon Poole, Mr Hancock’s media special adviser, said: “This is unhelpful,” and included with it a link to the article.
Mr Hancock protested that he did not have a subscription and then said: “But is that Kate?... If so we absolutely need No10 to sit on her hard. She has view and a wacky way of expressing them & is totally unreliable. She regards anything that isn’t her idea as political interference.”
Mr Poole, who had previously worked in Downing Street, promised to raise the interview with the prime minister’s advisers.
Dame Kate was appointed chairman of the Vaccine Taskforce by Boris Johnson, the former prime minister. She answered to the Department for Business, Energy and Industrial Strategy (BEIS).
“I had a blazing row with her when I was at no10. I’ll speak with them, it’s not her call and it is deeply unhelpful,” Mr Poole messaged Mr Hancock.
Two days later, in a further sign of tensions, Mr Hancock and his advisers suspected Dame Kate of leaking vaccine rollout plans to The Economist magazine.
Mr Hancock asked Mr Poole on Oct 6 2020 if the leak was from the vaccines tsar. Mr Poole replied: “Well I don’t know that for sure but I have some evidence to suggest it might have been. I.e - the fact she had a meeting yesterday with the journalist who has the leak. But it’s an old NHS plan apparently, I’ve not seen the document yet.”
A month later, The Sunday Times reported that Dame Kate had spent £670,000 on public relations consultants.
In a WhatsApp message to Mr Poole on Nov 7 2020, Mr Hancock admitted to being aware of the use of consultants but said he had not realised they were being paid for by the taxpayer.
Mr Hancock said: “Who the hell signed this off? ... I knew she had these consultants. I was cross about them and asked for it to stop. But I had absolutely no idea taxpayers were paying for them. Unreal.”
Mr Poole said the use of advisers was “bonkers” and “pretty appalling”. At the time, BEIS said “specialist communications support was contracted by the Vaccine Taskforce for a time-limited period” and “in line with existing public sector recruitment practices”.
It is understood that the communication consultants were contracted by BEIS to create a registry on the NHS website to recruit people onto clinical trials to test the vaccines.
Dame Kate agreed to take on the unpaid role as chairman of the taskforce for six months, staying for seven months until the deals had been made for proven vaccines in enough quantities for the UK. In Dec 2020 she left and was replaced by Dr Clive Dix, her deputy.
In Feb 2021 – at a time when the Government had earned plaudits over the vaccine rollout – Mr Hancock asked Nadhim Zahawi, then the vaccines minister, to arrange a meeting to explain to Dr Dix that “he knows to expect that I’m not going to give him executive authority but DO think he has a huge role”.
Mr Zahawi reported back that Dr Dix is “all sorted”. But two days later, on Feb 18 2021, the taskforce chairman told the minister he wanted to make a “personal decision” on whether the UK had enough vaccine doses or needed to procure more from India.
That prompted Mr Hancock to question whether Dr Dix might quit.
“He can’t threaten to reisgn and continue in post. Either you accept the principle of ministerial decisions making, or you don’t,” Mr Hancock said in a message to Mr Zahawi.
Later that day, just after 11pm, Mr Hancock sent Mr Johnson a message accusing Dame Kate and Dr Dix of blocking the purchase of vaccines from the Serum Institute of India (SII) four months earlier in Oct 2020.
“Nadhim & I have got to the bottom of why we didn’t get the SII doses when they were first offered in October,” Mr Hancock told then prime minister.
“Turns out it was blocked by Kate & Clive Dix. That’s why we kept getting b—---t excuses. Thankfully it is nearly over the line now - but they’ve cost us six months on this one and the comms will need handling.”
Dame Kate said: "I stood down as chair of the VTF in December 2020 after serving for seven months having initially agreed to do it for six months. I left after deals had been made to secure vaccines, two of which were approved by then with one of these (Pfizer) being administered.
"Before I left, the VTF had discussed buying vaccines from India but was persuaded against doing so as the VTF did not think the MHRA would be able to approve vaccines from India on the required timescale.
"These vaccines had been funded by international organisations to provide vaccines to low-income countries, including India itself. The vaccines from India were originally intended for developing countries. The second half of the vaccine order from India that was placed in 2021 (after I left the VTF) was halted by the Indian government.
"When it came to who to vaccinate, the advice was always determined by the JCVI and the vaccination policy that Matt Hancock and the Government were committed to at the time. I never questioned these - I only ever repeated government policy at the time in 2020. My role was to follow government policy not to create it. The VTF sought to procure vaccines based on the number of people that the JCVI and the Government advised should be vaccinated at that time in 2020.
"BEIS contracted communications support to launch and drive sign-up to the NHS registry of clinical trials volunteers. 500,000 people signed up. This was critical to establishing that Covid-19 vaccines worked and were safe. I also participated in Covid 19 vaccine trials through this registry.
"These WhatsApps suggest that Matt Hancock was not aware of the published and agreed government vaccine procurement policy, did not read the reports by and about the work of the Vaccine Taskforce, and did not understand the difference between complex biological manufacturing and PPE procurement.
"When I stood down as chair, the VTF shared recommendations for the Government – one of which was that Government needs a pandemic adviser who understands the pandemic threat, science when it comes to viruses, bioengineering – what is involved in the development and manufacture of vaccines – and has relationships with industry to be called upon when needed. I have continued to call for this ever since. These WhatsApps starkly reveal the need for this." | Vaccine Development |
An international team of researchers has provided valuable insights into the brain's noradrenaline (NA) system, which has been a longtime target for medications to treat attention-deficit/hyperactivity disorder, depression, and anxiety.
Equally important beyond the findings is the groundbreaking methodology that the researchers developed to record real-time chemical activity from standard clinical electrodes which are routinely implanted for epilepsy monitoring.
Published online in the journal Current Biology on Monday (Oct. 23), the research not only provides new insights into the brain's chemistry, which could have implications for a wide array of medical conditions, it also highlights a remarkable new capacity to acquire data from the living human brain.
"Our group is describing the first 'fast' neurochemistry recorded by voltammetry from conscious humans," said Read Montague, co-corresponding and senior author of the study, the VTC Vernon Mountcastle research professor at Virginia Tech, and director of the Center for Human Neuroscience Research and the Human Neuroimaging Laboratory of the Fralin Biomedical Research Institute at VTC. "This is a big step forward and the methodological approach was implemented completely in humans -- after more than 11 years of extensive development."
About the method
Voltammetry techniques for making real-time electrochemical readings in rodents and other laboratory models have yielded deep insights into brain function for about 30 years, but there was no clear path to use the techniques in humans, because they require electrodes to be inserted into the brain.
"Instead, we focused on what's already being used in patients for medical procedures," said Montague, who is also a professor in the Department of Physics at the Virginia Tech College of Science and in the Department of Psychiatry and Behavioral Medicine at the Virginia Tech Carilion School of Medicine. "When are surgeons already putting a wire in someone's brain? And could we design a method to piggyback on that?"
The team's initial approaches required the insertion of exclusive carbon-fiber electrodes designed at the Fralin Biomedical Research Institute into awake patients receiving deep brain stimulation surgery for Parkinson's disease or other disorders.
The research team has now demonstrated that electrochemistry can be performed with electrodes that are already in place and in standard clinical use, opening a window to never-before-seen brain activity.
About the noradrenalin system
The electrodes were in the amygdala, a brain region deeply intertwined with emotional processing and profoundly influenced by NA signals.
The NA system originates in a small midbrain nucleus known as the locus coeruleus (LC), and it has long been a focal point for developing medications aimed at addressing conditions like ADHD, depression, and anxiety.
"The LC-NA system is believed to regulate arousal and attention and is a pharmacological target in multiple clinical conditions, but our understanding of its role in health and disease has been impeded by a lack of direct recordings in humans," said co-corresponding and lead author Dan Bang, associate professor of clinical medicine and Lundbeck Foundation Fellow at Aarhus University, Denmark, and adjunct associate professor at the Fralin Biomedical Research Institute. "We addressed this problem."
In the study, three patients viewed neutral, checkerboard images mixed with emotionally charged images from the International Affective Pictures Database, shedding light on how the NA system responds to various emotional states.
As expected, NA levels correlated with emotional intensity, particularly during encounters with unexpected images, underscoring the NA system's significance in conditions like ADHD.
"This is groundbreaking work that represents a significant technical advance in our ability to understand human brain activity," said Wael Asaad, director of Functional and Epilepsy Neurosurgery at Rhode Island Hospital and vice chair for research in the Department of Neurosurgery at Brown University, who was not involved in the research.
"While it has been possible to record electrical brain activity in humans in a variety of settings for many years, this gives us only half the picture. How those neurons communicate with neurotransmitters in real-time, at short-timescales, has generally been much more difficult to study," Asaad said. "In addition to the scientific value of this study, the techniques it demonstrates will be of tremendous value for a broad range of studies. It represents a milestone in our efforts to understand the functions of human brain circuits."
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New Booster Dose Should Work Against Current, Future Covid Strains: Randeep Guleria
His comments come at a time when the country is witnessing a rise in Covid cases.
The Covid vaccines in use in India are providing cover for the original Wuhan strain but if the need for another booster dose is felt as new variants emerge, it should be able to provide protection against all circulating as well as future strains, according to former AIIMS director Randeep Guleria.
During an interview to PTI, he stressed on the need for two data sets-first to ascertain whether the degree of immunity is waning and secondly if the vaccines need to be tweaked when asked if it is time for another precaution dose almost a year after the first one amid the recent uptick in Covid cases.
"Currently the vaccines that we have in India are covering for what was originally the Wuhan strain. After that we had so many variants. And therefore if we have to have a new vaccine, it should provide cover for the circulating strains like we do for influenza," he said.
The renowned pulmonologist, who was part of the national Covid task force, highlighted the need for research on developing vaccines which will cover not only the current circulating strains but also from the emerging variants.
His comments come at a time when the country is witnessing a rise in Covid cases. Prime Minister Narendra Modi held a high-level meeting on Wednesday to review the Covid situation and also took stock of the public health preparedness.
Terming the new XBB.1.16 variant as a 'new kid on the block' that could be driving the recent rise, Dr Guleria said new variants will keep coming as the virus keeps on mutating over the time but 'as long as they don't lead to severe illness, hospitalisation and deaths, it is alright because it helps in giving some degree of immunity to the population if they have mild illness'.
On whether XBB 1.16 has the potential to drive a fresh wave of cases or lead to significant rise in cases in the next few days, he said, "even if we see a surge, there is no need to worry, as long it does not translate into hospitalization and deaths." Asked whether Covid is now an endemic, he said, "in my opinion, Covid has more or less become endemic. We have a good amount of immunity. Cases will continue and it's going to be here. We will continue to have some waves of cases coming and going but it is not going to cause the kind of waves we saw in the last two years. We will have to learn to live with it."
"On the surge in cases of H3N2, which is a subtype of seasonal influenza virus along with rise in Covid cases", Dr Guleria said H3N2 is part of the influenza family.
The influenza virus has been around for quite a long time.
"We had the H1N1 pandemic in 1918 also. Therefore this virus has been there but it keeps changing and the current circulating strain is H3N2," he said.
It behaves very similarly to flu-like syndrome and one gets fever, sore throat, body aches, and a runny nose along with a cough that can be persistent and troublesome.
And some people in the high risk group can also have pneumonia, which can be more serious and need hospital admissions, he said.
Everyone who comes in contact with an infected patient is at risk of getting influenza, he said.
"So we all will get influenza on and off but then there is a group which is at risk of getting severe infection and which may need hospitalisation and sometimes even cause death."
Those who are elderly and have co-morbidities are prone to getting more severe infection, he said.
"On the implications of H3N2 infections on those who were infected by Covid in the past and on the health scenario in general", Dr Guleria said it should not be a problem for those who had Covid because they have now recovered.
"But we have a small group of people who had Covid-19 which caused lung damage and they had lung fibrosis. So their lungs were already compromised to some extent and in some the immunity is also low. So in this small group of people who had Covid and have residual effects of Covid, they again fall in the high risk category and can have more severe infection," he said.
Coming to the implications of outbreaks of H3N2 as far as the health scenario is concerned, he said, "India is already having a huge burden as far as health is concerned, in terms of hospitals, ICUs, beds and then we have an outbreak where there is a surge in cases."
Dr Guleria, who headed AIIMS-Delhi at the peak of the pandemic, highlighted the need for developing a strategy for ensuring day-to-day management of other diseases are not disrupted while managing an environment.
"One of the downside or the collateral damage we saw in Covid was that a lot of patients suffering from other diseases such as cancer and tuberculosis suffered a lot as the focus was only on managing Covid-19."
"We were not able to manage these illnesses amid outbreak. Patients were not diagnosed at the right time. The treatment was not being provided on time. So we develop a strategy where we can manage the outbreak but at the same time our health systems, the policies and programmes continue and do not suffer," he said.
Besides, Dr Guleria stressed on being prepared and deploy active surveillance.
"So that if there is a surge in number of cases, be it of influenza or Covid or any other new viral disease, we should be able to pick it up early and say that there is an outbreak that is happening," he said.
He also underlined the need for good laboratory networks so that samples can be tested in case of an outbreak and surveillance system which is hospital and clinical based. If there is a cluster of cases in a particular place, and a doctor or a healthcare worker notices a large of people coming with peculiar types of symptoms, he or she should immediately report that this may be an outbreak that is developing so that investigation can be done, it can be managed and prevented from spreading, Dr Guleria said.
Then there is sentinel surveillance wherein hospital admissions are looked at to see if there are more hospital admissions and deaths happening amid rise in cases.
For both Covid and influenza, Dr Guleria said the precautions in terms of Covid- appropriate behaviour will protect against all these viruses. "If you have a definite diagnosis, for influenza there is a definite antiviral drug that is available which we used a lot even during the H1N1 pandemic... it is available as oseltamivir (Tamiflu) which is useful against influenza virus. So that drug can be given to a high risk group in case of a definite diagnosis besides symptomatic treatment," he elaborated.
"Finally if you are in the high risk group then you have a vaccine which is there both for influenza and Covid," he said.
Asked if were better prepared now three years after the pandemic, Dr Guleria said "We are better prepared than we were in the past because we have a learnt a lot from Covid. The challenge of course is that we keep implementing what we have learnt as we move forward and the memory of Covid fades."
Noting the country has seen lot of outbreaks in the last 23 years such as swine flue or H1N1, Covid, Nipah virus and monkeypox, he said, "We should learn from what we have seen in the last two decades that we need to prepared. The preparedness has to be in terms of good surveillance, an action plan on how do we upscale our health facilities both in terms of human resources and infrastructure." | Vaccine Development |
Council bosses have said attempts to patch up the social care system have “run out of road” and are demanding urgent help for England’s “utterly exhausted” army of 4.7 million unpaid carers.
“Never in my professional career have I seen the adult care system so close to breaking point,” said Sarah McClinton, the outgoing president of the Association of Directors of Adult Social Services (ADASS), which commissions care services. “Millions of people are in pain or distress because they aren’t getting the care they need and family and friends picking up the pieces are being pushed to the edge.”
Amid crumbling confidence in government promises to reform social care and frustration at piecemeal funding announcements, ADASS will launch its own reform plan on Wednesday, urging pay parity between care workers and the NHS, a more universal system of care and a right to paid carers leave.
This month, ministers cut by 50% a planned fund to boost the social care workforce, which is struggling with 165,000 vacancies, sparking concern among social care experts wanting reform. Last year, the government announced £7.5bn in new funding for social care – covering places in care homes and at home – but this was only half the minimum amount that MPs have said is needed.
Meanwhile, councils estimate they have had to find £1.8bn in savings in the last three years despite increasing demand for social care help in an ageing population wrestling with more complex needs and rising dementia.
“We don’t expect the government to wave a magic wand, but we do need the political will to invest in a long-term plan to ensure good care is available to everyone, everywhere,” said McClinton, who is the director of health and adult services for the borough of Greenwich in London.
ADASS’s report argues that unpaid carers – more than a quarter of whom are disabled – are owed a right to paid carers leave. A bill offering one week of paid leave is going through parliament.
Beverley Tarka, the incoming ADASS president, who is also one of the UK’s millions of unpaid carers, said she agreed “things have never been so bad” in social care and said a recent government announcement to halve £500m in funding to boost the workforce was disappointing.
“As a society we have asked a huge amount of carers and during the pandemic we asked more again,” she said. “They rose to the challenge – as they always do – but they are now utterly exhausted. We owe them not just our thanks, not just our respect, but real, meaningful support that will help them carry on and will give caring the status it deserves.”
Tarka, the director of adults, health and community for the London borough of Haringey, also urged a “change away from the dominant government narrative [about the purpose of social care] aligned to hospital discharge, where social care is often maligned and cast as the root of system failures.”
This week, the Guardian revealed that trust in care homes had slumped, with half of the British public lacking confidence that friends or family would be well looked after. Nationwide polling revealed that nine out of 10 older people believe there are not enough care staff and half have lost confidence in the standard of care homes since the start of the pandemic.
The Department of Health and Social Care has been approached for comment. | Health Policy |
Europe’s health systems face an existential threat if they can’t solve the workforce crisis — they’ll end up like the U.S., warn health leaders.
A series of devastating shockwaves — from the COVID-19 pandemic to the war in Ukraine, soaring inflation and the energy crisis — have pushed health workers to their limits. Hundreds of thousands of doctors and nurses are striking while others are going part-time to manage the strain of their careers.
Those that can no longer bear it are leaving the public health system altogether. Some are taking early retirement; others are opting for a full career change.
But a large chunk is jumping ship from the public service to the private sector — a trend that has Europe’s most senior health policy leaders worried.
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“This big hoovering into the private sector … brings inequity,” warned Sandra Gallina, head of DG SANTE, last month.
It's a worry in Austria, where the fastest growing health sector is the private outpatient service sector, said Clemens Martin Auer, special envoy of health in the Austrian health ministry. Weaknesses in public health systems lead to social inequalities, which in turn lead to increasingly undermined and underfunded public health systems, he said.
“When public health systems fail, the private sector will fill in the gap — of course because that’s business ... But if you treasure like I do solidarity systems, you should be worried that the private sector might take over the health systems. Because private health systems are not the solution, they are creating new problems," Auer said.
One market stands out for being largely privatized: the U.S. health system. "I’m just back from the U.S., where I see a system I don’t want," cautioned Gallina.
How did we get here?
Europe’s health workforce crisis is not new. But the current shocks have landed after years of belt-tightening in health care and lack of investment in the workforce.
Staff shortages have been creeping up year on year. Some areas of Europe have always struggled to recruit medics, especially rural parts, which are now becoming medical deserts. Other areas, particularly Eastern and Southern Europe, lose their trained staff to countries that pay better.
Today, there are around 1.8 million health worker vacancies in Europe. “That’s not a gap, it’s a gulf,” said Hans Kluge, head of WHO Europe, speaking alongside Gallina and Auer at the European Health Forum Gastein.
In addition, European countries, which rely on a mix of public health systems and social insurance schemes to fund their health care, have faced severely constrained budgets.
Add to this, welfare systems that fail to properly help the poor, inadequate mental health services, failing social care systems blocking hospital beds, and a pandemic, and it’s clear why workers are burnt out.
“Health systems are in crises because our societies are in crises,” said Ilona Kickbusch, founder of the Global Health Centre at the Graduate Institute, in Geneva. “You start to become the garbage can for societal problems that are not addressed.”
It’s little surprise that in a recent survey of health workers in Europe, 70 percent reported burnout symptoms. And it’s all pushing people out of the sector.
Save the system
Unfortunately, there’s no easy fix.
European countries need to “address those deep issues in our society,” said Kickbusch. That includes helping people out of poverty; supporting the most vulnerable; and tackling obesity and ill health through policies on the commercial determinants of health by regulating the food, alcohol and tobacco industries, she said.
“Unless our health policy becomes focused on health promotion, on prevention, on trying to address problems in a different way,” Europe’s public health systems risk failing, she said.
In addition, health systems need to urgently address staff retention by making the public sector more appealing, rewarding and enjoyable. The first step is to address some core human needs, said Michael West, from The King’s Fund health policy think tank in London.
“Staff need to have autonomy and control, to have a voice and influence, rather than working in cultures of fear and blame,” he said. They need to feel belonging, valued, respected and cared for by their peers and managers, and to be seen to make a high contribution, while also having more control over their work-life balance, West said.
To do this, health systems need to create cultures that reflect the core value of health care workers, which is the value of compassion, he said. "After all, compassion is the single most powerful intervention we have in health care.”
Technology can also help, Ran Balicer, chief innovation officer at Clalit, the largest of Israel's four health care providers, told the Gastein audience at the end of September.
“In traditionally operated health care systems, there’s no way that supply (of health care workers) can meet the demand, even if we ferociously train new providers,” he said. “AI and digital innovation is the only hope that we have as health care systems to become sustainable.”
In Israel, they have tried to redesign the system in a way that is driven by digital data and AI. For example, in primary care — where GPs are paid more than surgeons — doctors see a prioritized list of patients on their computers, ranked over the risk of a future ill-health event and the need to bring patients into the clinic. And in radiology, where there are not enough specialists, an AI system ranks images according to the risk of an anomaly being identified, and the highest risk images are reviewed by physicians.
The trick, he said, is to identify which technologies create efficiencies and do away with those that don't.
Meanwhile, a little privatization here and there isn’t all bad, said Gallina, especially in providing services that support the public health system. But it's a delicate balance. Go too far, and the public health system will collapse.
Brazil is an unfortunate case study of this, pointed out Kickbusch. The South American country had “a fantastic public health system,” she said, with strong family care services and a centralized GP system. But, when public investment started to crumble, the middle classes opted for private care. “The result was that that excellent system also crumbled,” she said.
Europe, take heed. | Health Policy |
Doctors made medical history by successfully transplanting a whole eye. The donated eye has reportedly survived inside the patient for six months with no major issues so far and shows signs of good health. At this point, however, the patient has not regained any functional sight as a result.
A surgical team at NYU Langone Health carried out the procedure in May, as first reported by Reuters Thursday. The team originally set to perform a partial face transplant on 46-year-old Aaron James, a military veteran who suffered a high-voltage electrical accident at work that injured much of the left side of his body and face, including his eye. They then decided to try grafting an entire eyeball as part of this surgery, mainly for cosmetic purposes.
Currently, only the cornea—the frontmost, transparent layer of the eye—can be transplanted as a functional replacement for a damaged or diseased one. The team’s primary objective of this procedure was only to show that it was possible to attach an entire donated eyeball to a recipient’s body and have it survive long-term. That said, they did try to improve the odds of the eye communicating with James’ brain through his optic nerves (a prerequisite for sight) by injecting the donor’s harvested stem cells into the optic nerve at the same time. The surgery took 21 hours to complete.
“If some form of vision restoration occurred, it would be wonderful, but... the goal was for us to perform the technical operation,” lead surgeon Eduardo Rodriguez told Reuters.
So far, the organ does seem to be staying alive and well six months later. The team detected well-functioning blood vessels supplying the eye and a “promising-looking retina,” according to Reuters. But James has not reported any sight in the eye, and the team hasn’t spotted any communication between the eye and his brain.
It’s still possible that some eyesight could be restored, Rodriguez says, and the team plans to keep monitoring James’ progress. But even if it doesn’t, the lessons learned from this transplant could very well lead to new breakthroughs. The team also believes that it’s possible to someday combine the procedure with other emerging technologies intended to restore vision, such as electronic implants that mimic how optic nerve cells talk to the brain. And James himself appears to be grateful for having gone through the transplant.
“I told them, ‘Even if I can’t see... maybe at least you all can learn something to help the next person.’ That’s how you get started,” James told Reuters. “Hopefully this opens up a new path.” | Medical Innovations |
The NHS has teamed up with Morrisons supermarket to put extra labels in underwear reminding people to see their GP if they spot potential symptoms of breast or testicular cancer.
People should look out for lumps and bumps or "anything unusual".
The Nutmeg-branded boxer shorts and crop-top bras will be in 240 stores in England in the coming months.
A QR code on the packaging and tags directs customers to more detailed health information on the NHS website.
Symptoms of breast cancer can include a lump or change in the look, shape or feel of one or both breasts. Although rarer than in women, men can get breast cancer too.
Testicular cancer may present as a painless swelling or a lump in one of the testicles or any change in shape or texture of the testicles. Not all lumps will be cancer, but they need checking out.
NHS England's National Director for Cancer, Dame Cally Palmer, said: "This is the first time the whole of the NHS has worked with a national supermarket brand to put health messaging on clothing, with the aim of encouraging thousands more people to be body aware, so they can spot new or unexplained changes that might be cancer symptoms early, and contact their GP practice for checks if concerned.
"Cancer survival is at an all-time high - survival for both breast and testicular cancers has improved significantly over the last 50 years and we're seeing more people than ever before diagnosed at an early stage - and this partnership with Morrisons is just one of the many ways we are ensuring people are aware of potential cancer symptoms.
"I want to urge everyone to be aware of their own bodies - please look out for lumps and bumps or anything else that is unusual for you - and get checked out early. It could save your life."
Former Morrisons employee Edward Solly, who is 35 and from Kent, has modelled for the new range of underwear.
He was diagnosed with testicular cancer in his 20s after seeing a doctor for an unrelated sports injury. Scans, tests and a biopsy revealed there was a cancerous mass and that it had already progressed to his abdomen.
He is cancer-free thanks to surgery and chemotherapy, and he now spends a lot of his free time giving talks to boys in schools about the importance of checking yourself: "As a cancer survivor myself, I know that a daily reminder to be body aware really could save your life ⦠who knew a pair of undies could hold so much power?"
Testicular cancer
Around 2,300 men are diagnosed with testicular cancer each year in the UK.
Although it is relatively uncommon overall, it is the most common type of cancer to affect men between the ages of 15 and 49.
With treatment, nearly all men can survive testicular cancer.
To find out more visit the NHS website.
How to check your testicles
- A good time to check your testicles is after a warm bath or shower, when the skin is relaxed
- Cup your hand under them and check for swelling and lumps
- Roll each testicle between your finger and thumb and feel the weight
- The NHS says most men's testicles are around the same size, although it is common for one to be slightly bigger than the other or hang lower
- The testicles should feel smooth, without any lumps or bumps, and firm but not hard. You may feel a soft tube at the back of each testicle, which is called the epididymis - this is entirely normal
- There might be something wrong though, if you find a hard lump on the front or side of a testicle, a testicle is swollen or if there's pain or discomfort in a testicle or in the scrotum (the sack that holds the testicles)
- If you notice any changes or anything unusual about your testicles, you should see a GP
Source: NHS
Sign up for our morning newsletter and get BBC News in your inbox. | Disease Research |
Elon Musk has told people he microdoses ketamine for depression, The Wall Street Journal reported.
The billionaire also takes full doses at parties, the publication said.
On Monday, Musk said on Twitter that ketamine is a "better option" than traditional drugs.
Elon Musk has told people he is taking small doses of ketamine to treat depression and has been seen taking the drug recreationally as well, according to a recent report from The Wall Street Journal.
The publication said the billionaire takes full doses of the drug at parties, citing individuals who have seen Musk use ketamine as well as other people with direct knowledge.
Musk did not respond to a request for comment from Insider ahead of publication. But, the Tesla CEO tweeted about the use of ketamine to treat depression less than two hours after The Journal's report was published.
"Depression is overdiagnosed in the US, but for some people it really is a brain chemistry issue," Musk tweeted in the early hours of Tuesday morning. "But zombifying people with SSRIs for sure happens way too much. From what I've seen with friends, ketamine taken occasionally is a better option."
Ketamine is a "dissociative drug" that can impact an individual's visual and auditory senses, as well as produce "detachment from reality," according to the Alcohol and Drug Foundation. The drug is commonly used in the medical field as an anesthetic, but can also be used illegally as a party drug. The drug can be sold as a white powder, dissolved into a liquid, or sold in pill form.
The use of ketamine to treat depression has been studied in some clinical trials and it could prove to be a new frontier for treatment. The US Food and Drug Administration hasn't officially approved ketamine for treating mental health issues, but for over a decade some medical professionals have prescribed the drug off-label to some patients.
Musk is reportedly one of several executives in Silicon Valley to try his hand at psychedelics. Google cofounder Sergey Brin has taken psilocybin mushrooms, The Journal reported, citing people familiar with his use of the drug. Insider previously reported that Brin attended a party in Los Angeles last summer where guests openly consumed psychedelic mushrooms and has been said by peers to have an interest in psychedelic drugs in general. Similarly, members of the Founders Fund — an elite San Francisco venture capital firm that has invested in major companies like SpaceX, Airbnb, and Spotify — have been known to throw parties with psychedelics, the publication said.
Spokespeople for Brin and the Founders Fund did not respond to a request for comment ahead of publication. But, a spokesperson for the Founders Fund told The Journal: "Research shows that psychedelics can provide significant mental health benefits, and we support public and private sector efforts to make these drugs safely and legally available."
Microdosing, the practice of taking very small amount of a drug, has become a common practice in Silicon Valley, where executives take tiny amounts of drugs like LSD to in an effort to boost their creativity and focus. Insider previously reported that the jury is out on whether the drugs are effective. Though, many psychedelics are illegal.
Musk has gotten in hot water in the past for using drugs. In 2022, the billionaire said he and the "whole of SpaceX" had to be drug tested for a year after he smoked weed on a podcast with Joe Rogan in 2018. And Tesla board members expressed concern when the CEO told The New Times in 2018 that he'd begun using Ambien to sleep.
Last year, The New York Times reported that the billionaire often likes to discuss the benefits of psychedelic drugs with friends and has gone to nearly every Burning Man festival for the past 20 years.
"I have been with him on mild exploratory journeys," David Marglin, a Bay Area lawyer who met Mr. Musk at Burning Man and has been his friend for 20 years, told the Times in 2022. "And he appreciates the value of those journeys. Nothing out of control or wild, but it's all night, and there's dancing and revelry."
Read the original article on Business Insider | Mental Health Treatments |
An anonymous reader shared this report from the Washington Post: Most research shows that over-the-counter fish oil supplements don't offer cardiovascular benefits, but that hasn't stopped marketers from touting them for heart health, a new study shows.
The sale of fish oil supplements is a multibillion-dollar industry, and many people take fish oil capsules daily, believing the omega-3 fatty acids they contain are good for their overall health, particularly for their heart. While it's true people who eat seafood regularly are less likely to die of heart disease, studies have not shown that taking fish oil as a supplement offers the same benefit. Even so, fish oil marketers continue to make health claims that imply a wide range of benefits, according to a study published Wednesday in JAMA Cardiology.
The researchers analyzed labels from more than 2,000 fish oil supplements that made health claims. They found more than 80 percent used what is known as a "structure and function claim," which is a general description that describes the role of omega-3 fatty acids in the body — such as "promotes heart health" or "supports heart, mind and mood." Cardiovascular health claims, which accounted for 62 percent, were most common.
Fish oil contains two omega-3 fatty acids, EPA and DHA, found naturally in fatty fish such as salmon. Higher levels of these omega-3s have been associated with a lower risk of cardiovascular disease, but the observational findings are based on omega-3 levels in the diet, not from supplement use, some experts say. Two recent large clinical trials showed that over-the-counter fish oil supplements do not improve cardiovascular outcomes. But the vagueness of the wording used by fish oil marketers could lead to misinformation about the role of the dietary supplement, said Ann Marie Navar, associate professor of cardiology at the University of Texas Southwestern Medical Center, who was senior author of the study.
Navar says in the article "It is true that omega-3 fatty acids are present in the brain and are important for all sorts of brain functions.
"What has not been consistently shown with high-quality trials is that taking more of it in the form of a fish oil supplement leads to improved performance or prevention of disease."
The sale of fish oil supplements is a multibillion-dollar industry, and many people take fish oil capsules daily, believing the omega-3 fatty acids they contain are good for their overall health, particularly for their heart. While it's true people who eat seafood regularly are less likely to die of heart disease, studies have not shown that taking fish oil as a supplement offers the same benefit. Even so, fish oil marketers continue to make health claims that imply a wide range of benefits, according to a study published Wednesday in JAMA Cardiology.
The researchers analyzed labels from more than 2,000 fish oil supplements that made health claims. They found more than 80 percent used what is known as a "structure and function claim," which is a general description that describes the role of omega-3 fatty acids in the body — such as "promotes heart health" or "supports heart, mind and mood." Cardiovascular health claims, which accounted for 62 percent, were most common.
Fish oil contains two omega-3 fatty acids, EPA and DHA, found naturally in fatty fish such as salmon. Higher levels of these omega-3s have been associated with a lower risk of cardiovascular disease, but the observational findings are based on omega-3 levels in the diet, not from supplement use, some experts say. Two recent large clinical trials showed that over-the-counter fish oil supplements do not improve cardiovascular outcomes. But the vagueness of the wording used by fish oil marketers could lead to misinformation about the role of the dietary supplement, said Ann Marie Navar, associate professor of cardiology at the University of Texas Southwestern Medical Center, who was senior author of the study.
Navar says in the article "It is true that omega-3 fatty acids are present in the brain and are important for all sorts of brain functions.
"What has not been consistently shown with high-quality trials is that taking more of it in the form of a fish oil supplement leads to improved performance or prevention of disease." | Nutrition Research |
By Francesca GillettBBC NewsPublished1 hour agocommentsCommentsImage source, PA MediaImage caption, People relax in the sun on the grass at the Royal Crescent, Bath, on MondayParts of England and Wales are set to swelter this week with the hottest days of the year so far. Temperatures are forecast to reach 33C (91.4F) in the south-east of England on Friday as hot air spreads up from Spain, Portugal and north Africa.The Met Office has warned sunbathers to "avoid overdoing it" and stay out of the sun in the midday hours.And a health alert has been issued warning that the high temperatures could affect the public's health."[It will be] the first hot spell of weather of the year for some parts of the country," said the Met Office's Alex Deakin. "But quite a contrast, it's not going to be hot and sunny everywhere."He said temperatures will be "ticking up day on day" from Wednesday, with highs of 28C (82.4F) expected across the South East - although just 15C (59F) across the far north-west of the UK. The peak of the temperatures is set to be Friday, when the South East could see up to 33C (91.4F) around north London and Cambridge, accompanied by high UV levels and high pollen levels. In the east of Scotland, temperatures could hit the mid-20s.But temperatures would need to beat 35.6C (96.1F) to break the record for the UK's hottest June day, which was recorded in Southampton in 1976.It comes as parts of Europe are also experiencing extreme heat - with Spain in the grip of a heatwave as temperatures top 40C, and the hot weather set to spread to parts of southern France from Tuesday.A level two heat health alert has been issued for a large part of southern and central England, while northern England is covered by a level one alert.The alerts - issued by the Met Office and the UK Health Security Agency - are for health and emergency workers to prepare for conditions potentially posing a threat to health.Image source, Joe GiddensImage caption, Endangered Asian elephants Beth and her mother Karishma cool down in their pool at Whipsnade Zoo in BedfordshireImage source, StormChaserLiam/BBC Weather WatchersImage caption, A BBC Weather Watcher sent in this picture from Loose in Kent on Tuesday morningThe hottest day of the year may come as early as Wednesday or Thursday, BBC Weather's Sarah Keith-Lucas said.But from Saturday the picture is more uncertain, she said, with a cold front sweeping in from north to south pushing away the hot air and threatening heavy downpours and thunderstorms."However, the timing and detail of the change to cooler, wetter weather is still uncertain at this stage," she said. "The heat may linger for a day longer in the South East." An official heatwave is not out of the question, which is when at least three consecutive days have daily maximum temperatures meeting or exceeding the heatwave temperature threshold. The threshold varies by county, and in the UK's is between 25C and 28C depending on the part of the country. The threshold was raised by 1C in some areas earlier this year.Experts say that while heatwaves are extreme weather events, scientific research shows that climate change is making these events more likely.The Met Office has not yet issued a weather warning for extreme heat, which it did for the first time ever last July.But animal charities have urged pet owners to be careful. The RSPCA warned of the dangers of walking dogs hot weather, while the Blue Cross urged cat owners to be careful when leaving windows open after a kitten fell from three storeys and fractured her leg.Media caption, Heatwaves: BBC Weather's Matt Taylor explains the heatwave thresholdMet Office forecaster Craig Snell previously told the PA news agency: "Very high UV levels are expected in the south this week, meaning people should really avoid being in the sun during the midday hours."Wearing sunglasses, a shirt, a hat and sunscreen are essential to protect the eyes and skin, and drinking lots of water is important - long exposure to the sun can be dangerous."People should avoid overdoing it. We all love the sunny weather, but being sensible can help you avoid a nasty sunburn."Lifeboat charity the RNLI is urging anyone heading to the coast to choose a beach where there are lifeguards and to swim between the red and yellow flags."If you get into trouble in the water, Float to Live: lean back, using your arms and legs to stay afloat. Control your breathing, then call for help or swim to safety," it said. "In a coastal emergency, call 999 or 112 for the Coastguard."'If you get into trouble in the water, Float to Live: lean back, using your arms and legs to stay afloat. Control your breathing, then call for help or swim to safety. In a coastal emergency, call 999 or 112 for the Coastguard.'The Royal Life Saving Society UK which promotes water safety has issued a plea to those looking to cool off in water, urging people to understand the dangers of drowning.Lee Heard of RLSS UK said: "Ahead of the expected 30C temperatures in the coming week and with June, July, and August proving to be the months with the most fatalities, it is vitally important that everyone has an understanding of water safety, especially during the summer months."We have seen a rise in the number of drownings over the last few years, with peaks during the summer." | Epidemics & Outbreaks |
Washington — Law enforcement agencies have so far seized over 55 million pills ofthis year and more than 9,000 pounds of powder containing the deadly drug, Attorney General Merrick Garland told dozens of families whose loved ones died after ingesting fentanyl. And the Drug Enforcement Administration is on pace to seize more fentanyl in 2023 than in any previous year, a yield that continues to grow annually, according to DEA Administrator Ann Milgram.
"Violent drug cartels are manufacturing and moving fake pills designed to look exactly like brand name drugs and instead, they contain deadly fentanyl," Garland said, highlighting what he said are the dangers posed by the work of theand cartels in Mexico.
"They are fueling this epidemic," the attorney general alleged, "The Justice Department is attacking every aspect of the cartels' operations."
Fentanyl, a strong opioid about 50 times more powerful than heroin, has become increasingly present in the U.S. drug supply and has caused a wave ofamong people who consume it or use drugs they didn't realize were tainted with the substance.
Garland, Milgram and approximately 150 individuals affected by the growing proliferation of fentanyl on America's streets gathered at DEA headquarters outside of Washington, D.C., Tuesday for the second annual Family Summit on Fentanyl.
In 2022, 110,757 Americans lost their lives to fentanyl, Milgram said.
The event coincided with recent attempts by law enforcement and Justice Department officials to tackle the opioid and fentanyl problem facing the U.S. and pressure transnational organizations that fund and traffic deadly drugs.
Earlier this month, the U.S.of Ovidio Guzmán López, son of notorious drug trafficker and former Sinaloa cartel leader, .
López and other sons of El Chapo were, along with nearly two dozen members and associates of the Sinaloa Cartel for allegedly orchestrating a transnational fentanyl trafficking operation into the U.S.
Investigators said the defendants — part of the "Chapitos" network — facilitated the purchase of the precursor chemicals of fentanyl from China, manufactured the deadly drug in Mexico, and then smuggled it into the U.S., where it was sold on the street.
Garland's mention of López's arrest prompted applause from the families of fentanyl victims gathered at DEA Headquarters on Tuesday. He hasto federal charges that include allegations of drug trafficking and money laundering.
Federal investigators also charged four Chinese nationals with supplying the Mexican cartels with the precursor chemicals that make up the fentanyl drug in April, a prosecution that is the first of its kind. The charges allege the four sold the chemicals to the cartels — fully aware that the chemicals would be used to concoct the deadly substance.
Milgram said the challenge for the DEA is not just combating those who sell the chemicals and smuggle the drugs into the U.S. Law enforcement must also fight what she characterized Tuesday as the "last mile," which targets individuals are selling fentanyl to victims, some of whom may not be aware that the drugs they're buying contain fentanyl.
In the last year, the DEA administrator said over 3,000 individuals were charged with trafficking and selling drugs for the cartels inside the U.S. Currently, according to the DEA, there are 600 active investigations into the deaths of people who died of fentanyl overdoses, a number Milgram conceded Tuesday is not enough, but continues to expand.
"We are facing and confronting a threat that is ever-growing. It has never been more deadly or dangerous," Milgram warned. "We are talking about billions of dollars that are crossing the globe today that profit from fentanyl."
Two people wereand charged in connection to the suspected opioid death of a 1-year-old boy at a Bronx home-based daycare center where three other children were found possibly exposed to drugs.
To boost education and awareness around fentanyl and curb purchases of the drug, Garland announced the Justice Department is dedicating $345 million in grants in the coming year for training, increasing access to treatment medications and focusing on those who are at risk for drug abuse.
"No one, especially no young person, should have to face this threat alone," the attorney general said.
Just outside the auditorium where the U.S. officials addressed the victims' families, pictures of Americans who had lost their lives to fentanyl and opioids covered the walls, creatinga growing memorial and a reminder of the dangers the drugs pose.
for more features. | Epidemics & Outbreaks |
A new type of bioprinted skin could revolutionize how we replace human skin going forward. The new skin was made by combining the six primary skin cell types with additional hydrogels, allowing them to create thick and multilayered skin. When transplanted successfully, the skin can heal wounds faster and with far less scarring.
Having a breakthrough like this could make skin grafts and transplants much more reliable and easier to blend in. That’s because faster healing means less time the patient has to spend nursing the printed skin back to health, and less scarring means less evidence of the transplant in the first place.
We’ve previously seen researchers creating living skin for robots, but this breakthrough shows that creating the full thickness of human bioengineered skin is both possible and worthwhile, promoting quicker healing and more natural appearances after the bioprinted skin is applied.
When testing the skin, researchers transplanted it onto mice wounds and found that the printed skin formed skin patterns, blood vessels, and even showed normal tissue development. This all allowed the wound to heal faster with less skin contraction, the researchers note in their new paper.
The full details of the new bioprinted skin were published in the journal Science Translational Medicine, and it presents a huge breakthrough for the skin transplant industry, especially if these claims of faster healing times and less scaring can be scaled up to work on humans, too. Of course, the only tests we have to go off right now are those based on animals.
But, if human trials go successfully, we could see a replacement for how skin transplants are handled right now, making them much more likely to succeed and heal more naturally. Even if the trials require some finesse to get things 100 percent right, this breakthrough at least shows that it is possible to create a full-thickness skin like this. | Medical Innovations |
What IS bacterial meningitis? Everything you need to know about bug that kills up to one in 10 people who catch it after death of legendary guitarist Jeff BeckJeff Beck died 'peacefully' last night after contracting bacterial meningitis The 78-year-old had recently finished touring with actor Johnny Depp Experts estimate that up to 1 in every 10 cases of bacterial meningitis is fatal Bacterial meningitis symptoms strike suddenly and worsen very quickly Published: 07:41 EST, 12 January 2023 | Updated: 07:46 EST, 12 January 2023 Legendary British guitarist Jeff Beck died 'peacefully' last night after contracting bacterial meningitis, it was revealed yesterday. The 78-year-old, who just weeks ago finished touring the US and Europe with actor Johnny Depp, was so revered that his fingers and thumbs were famously insured for £7million. A representative said that Beck - an eight-time Grammy winner - had been ill over the Christmas period and passed away at a hospital close to his home in Surrey, after suddenly contracting the infection. Bacterial meningitis, which requires urgent hospital treatment, affects the membranes that affect the spinal cord and brain Jeff Beck passed away peacefully last night at the age of 78. Pictured above, Beck performing at a Crystal Palace garden party event in London in 1972 His sudden death comes just weeks after the former Yardbirds star finished a transatlantic tour with Johnny Depp as they promoted their debut album '18'British rockers including Rod Stewart and Mick Jagger led tributes overnight.Bacterial meningitis, which requires urgent hospital treatment, affects the membranes that affect the spinal cord and brain. The World Health Organization estimates that up to 1 in every 10 cases of bacterial meningitis is fatal.Experts say one of the reasons behind its lethality is that it is hard to spot early. Meningitis symptoms strike suddenly and worsen very quickly. These can include headaches, a fever, stiff neck, nausea, vomiting and drowsiness. Photophobia - sensitivity to light - and developing a skin rash are other tell-tale signs of infection. Caused by bacteria that enters the bloodstream, when the membranes become infected, they swell and press on the spinal cord or brain. This can cause life-threatening problems. But if treated promptly in hospital, bacterial meningitis is less likely to become lethal. It usually needs to be treated in hospital for at least a week, through antibiotics and fluids given directly into a vein and oxygen through a face mask. According to experts, at least 1.2million cases of bacterial meningitis are estimated to occur every year around the world. While it can affect anyone of any age, it is more common in babies and young children as their immune system is not yet fully developed. Teenagers and young people are also at increased risk, particularly during their first year at university. Infection can be spread through coughing, sneezing and kissing, as it is usually caught through people who carry the bacteria in their throat or nose, but are not actually ill themselves. Most people with bacterial meningitis who are treated quickly will also make a full recovery. But in some rarer cases, people may be left with serious long-term problems, including recurring seizures, vision or hearing loss, problems with memory or concentration or even amputation of limbs. The eight-time Grammy winner was also inducted into the Rock and Roll Hall of Fame twice – as a solo artist and as a member of The Yardbirds. Pictured, Jeff Beck and guitarist Eric Clapton performing at the 2010 Crossroads Guitar Festival in Bridgeview, IllinoisVaccines are the most effective way to protect against certain types of bacterial meningitis, there is no vaccine that protects against all types of meningitis. These vaccines are offered to babies, from the age of eight weeks and over and to teenagers and students. Viral meningitis - which is far more common - is caused when viruses enter the bloodstream. But it tends to be treated at home and gets better on its own within seven to ten days. In other health news...NHS emergency care crisis laid bare: 999 response times are worst ever - with heart attack victims facing waits of up to four hours, as 1,800 patients spend 12 hours in A&E every day From Michelle Pfeiffer and Jamie Lee Curtis, to Jared Leto and Martin Freeman: As study reveals people who look older than they are face higher risk of conditions like cataracts, the 12 surprising celebrity pairs who are the SAME age Millions MORE Brits to get statins: Health chiefs recommended even patients at low risk of heart attacks are offered the cheap cholesterol-busting pills WHAT IS MENINGITIS?Meningitis is inflammation of the membranes that surround and protect the brain and spinal cord.Anyone can be affected but at-risk people include those aged under five, 15-to-24 and over 45.People exposed to passive smoking or with suppressed immune systems, such as patients undergoing chemotherapy, are also more at risk.The most common forms of meningitis are bacterial and viral.Symptoms for both include:Pale, blotchy skin with a rash that does not fade when compressed with a glassStiff neckDislike of bright lights Fever, and cold hands and feetVomitingDrowsiness Severe headache Headache is one of the main symptomsBacterial meningitis Bacterial meningitis requires urgent treatment at hospital with antibiotics. Some 10 per cent of bacterial cases are fatal.Of those who survive, one in three suffer complications, including brain damage and hearing loss. Limb amputation is a potential side effect if septicaemia (blood poisoning) occurs.Vaccines are available against certain strains of bacteria that cause meningitis, such as tuberculosis.Viral meningitis Viral is rarely life-threatening but can cause long-lasting effects, such as headaches, fatigue and memory problems. Thousands of people suffer from viral meningitis every year in the UK. Treatment focuses on hydration, painkillers and rest.Although ineffective, antibiotics may be given when patients arrive at hospital just in case they are suffering from the bacterial form of the disease. Source: Meningitis Now Advertisement | Epidemics & Outbreaks |
Can how you feel about your favorite celebrities be related to how you feel about yourself? A study published in The Journal of Social Psychology suggests that based on attachment style, individuals assimilate ideas about different types of celebrities to feel better about themselves.
In today’s world of social media, celebrities are no longer distant figures. They are easily accessible through tweets, pictures, news, and livestreams. As a result, people get to know both the positive and negative aspects of their favorite singers, actors, sports professionals, or influencers. This has led to a rise in mixed opinions about famous individuals, known as ambivalent celebrities, rather than just having positive opinions. The study aimed to understand how comparing oneself to both positive and ambivalent celebrities could vary based on attachment style and its impact on self-esteem.
Attachment styles refer to the way people emotionally bond and interact with others, often shaped by early life experiences and relationships. Attachment avoidance refers to a person’s inclination to avoid emotional intimacy and closeness in relationships. Individuals with high attachment avoidance tend to downplay the importance of emotional connection. Attachment anxiety refers to a person’s tendency to worry excessively about the availability and responsiveness of their romantic partners. Individuals with high attachment anxiety often fear rejection, abandonment, or being unimportant to their partners.
Elaine Paravati of the University at Buffalo and her colleagues conducted three studies to explore these relationships. In Study 1, they surveyed 170 undergraduate students, gathering information about their attachment style, interest in celebrities in general, desire to follow celebrities, preference for positive celebrities, and how much they enjoyed criticizing ambivalent celebrities.
Study 2 involved 119 female undergraduate students who were asked to write about a celebrity they admired and felt connected to (to manipulate positive celebrity exposure) or complete a control writing task. Afterward, participants were assessed on their self-esteem and attachment style.
In Study 3, the researchers recruited 181 female undergraduate participants. They were asked to write about an ambivalent celebrity figure they felt connected to but had mixed feelings about, or they could complete a control writing task. Following this, participants were assessed on their self-esteem and attachment style.
The results showed that attachment style plays a role in how people feel about celebrities. Those with anxious attachment tended to be more interested in both positive celebrities and celebrities in general, which aligns with previous research indicating that anxious individuals tend to form more parasocial relationships. On the other hand, people with high avoidant attachment were more likely to enjoy criticizing ambivalent celebrities.
In Study 2, anxious attachment was linked to lower self-esteem in the control condition (without thinking about their favorite celebrity), but this effect was not observed when participants thought about their favorite celebrity. Avoidant attachment, however, did not show any significant relationship with self-esteem in this context.
In Study 3, thinking about an ambivalent celebrity positively influenced the self-esteem of participants who had high avoidant attachment but low anxiety. This suggests that celebrity-related information can affect how people feel about themselves, particularly for those with specific attachment styles.
The researchers noted that just as people approach real-life relationships differently based on their attachment style, the same seems to apply to their relationships with celebrities. Positive celebrities appear to boost self-esteem for those high in anxiety because these individuals tend to see themselves as similar to others. On the other hand, ambivalent celebrities improve self-esteem for individuals low in anxiety and high in avoidance because these individuals tend to contrast their negative qualities with others.
“This work suggests that individual differences can impact how people feel about themselves after thinking about celebrities, and therefore has important implications for the way individuals can use their bonds with celebrities to improve their own self-image,” the researchers wrote. “Not all individuals will respond the same way to celebrity content.”
“For those with high anxiety, reading about a beloved celebrity may give them a boost in self-liking. With this in mind, they may want to scroll their favorite celebrity’s social media profile, watch them on television, or read about them in a magazine on a day they need a self-esteem boost.”
“On the other hand, individuals low in anxiety and high in avoidance may want to seek out an ambivalent celebrity, rather than a positive one, when they need a self-esteem boost. For these individuals, reading a gossip magazine about ambivalent celebrities may be a better strategy for increasing their self-liking than reading about positive celebrities.”
The study sheds new light on how feelings about celebrities can impact self-esteem. However, there are some limitations to consider. The study mainly involved undergraduate students, and in Studies 2 and 3, only female participants were included. Future research could benefit from a more diverse and broader sample. Additionally, this study focused on positive and ambivalent celebrities, omitting negative celebrities. Exploring the relationships with celebrities people feel negatively about could be an interesting avenue for future research.
The study, “Social comparison, parasocial relationships, and attachment style: how and when do celebrities improve self-liking?“, was authored by Elaine Paravati, Shira Gabriel, Jennifer Valenti, Kylie Valent, and Anneke Buffone | Mental Health Treatments |
A nurse from Exeter has won a $250,000 (£200,000) global award for her work on improving diabetes care in the UK.
Margaret Shepherd, from Exeter, was left "shaking" after winning the Aster Guardians Global Nursing Award 2023 on International Nurses Day on Friday.
She set up a national network of diabetes nurses in 2022 to help raise awareness of the condition and prevent misdiagnosis, which can often lead to unnecessary insulin injections.
Ms Shepherd has been described as one of the leading nurses for monogenic diabetes in the UK and is used as a consultant around the world.
Accepting the award at a glitzy ceremony in London's Queen Elizabeth II Centre, she said: "I am shaking. I'm truly honoured.
"In 1981 I started my nursing career at King's College London and I was working on a diabetes ward.
"Little did I know that my career would continue in this field... I was the first diabetes specialist nurse looking at rare genetic forms of diabetes to ensure the correct diagnosis.
"As healthcare professionals, we are privileged to be able to make a positive impact on the lives of our patients, and I feel blessed to be part of such a rewarding profession.
"This award not only recognises my personal achievements but also highlights the importance of nursing as a critical component of healthcare."
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Asked how she plans to spend the money, Ms Shepherd said: "I would like to put a donation from my prize to those countries who cannot afford genetic testing for diabetes - so that it is free, and they can be diagnosed as necessary with neonatal diabetes.
"This will make a huge and very real difference for those individuals."
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Other winners on the night included medical staff from Tanzania, India, Kenya and Panama.
The award was launched in 2021 on International Nurses Day, which aims to recognise the support of nurses around the world.
Dr Azad Moopen, founder, chairman and managing director of Aster DM Healthcare, said of Ms Shepherd: "She has exemplified the highest standards of patient care and dedication - that is inspirational, and it deserves global recognition.
"Each one of the top 10 finalists have done phenomenal work and the grand jury had a tough time assessing and selecting the final winner." | Disease Research |
A crowd of protesters was squaring off against a battalion of riot police on a city boulevard as plumes of tear gas and dust clouded the afternoon light. It could have been Hong Kong or Santiago in 2019, Minneapolis or Portland in the summer of 2020, Tehran or Shanghai in the winter of 2022. But at this particular eruption of unrest in the spring of 2021—in Popayán, Colombia, a small city about 250 miles southwest of Bogotá—the basic grammar of protest and retaliation was about to take a harsh new shift.Scores of young demonstrators were crouching behind a line of homemade shields, trying to hold back the authorities. Colombia had been in the midst of a general strike for more than two weeks, triggered by a series of tax increases handed down in the middle of a debilitating Covid shutdown. But as nationwide protests escalated in tandem with the state’s response to them, police brutality became the demonstrators’ main grievance. On the front line that afternoon in Popayán, a 22-year-old engineering student named Sebastian Quintero Munera took cover behind a piece of plywood spray-painted with the phrase “Alison We Are With You”—referring to a local teen who had died by suicide the previous morning after alleging that she’d been sexually assaulted in police custody. On the other side of those shields, officers in riot gear were spread out across the width of the street in groups of two. Behind them, on the tree-lined median that divided the boulevard, another group of officers huddled around an unusual box with an array of metal tubes pointing out of it, mounted on a small tripod. It looked a little like the kind of equipment used to launch fireworks in a big New Year’s pyrotechnic display. But the tubes were aimed at the street, not the sky.Without warning, a rapid succession of deafening blasts echoed down the block. A barrage of blunt, barely visible projectiles ricocheted against the shuttered windows of second-story apartments, off trees and light posts, shields and bodies, as the street filled with a dense fog of tear gas. The effect on the crowd was almost instantaneous. Gasping for air, protesters scrambled over each other to retreat. They tripped on abandoned shields, motorcycle helmets, and other make-do armor. Within seconds, the officers reloaded the contraption and fired again. The box on the tripod was a remote-controlled launcher called a Venom, made by the US firm Combined Systems. Long used by the US Marine Corps for combat operations in Iraq, Venom is capable of firing up to 30 tear-gas or flash-bang canisters at a time. According to José Miguel Vivanco, who was the director of Human Rights Watch’s Americas division at the time, Colombia’s clampdown against demonstrators in 2021 marked the first time Venom had been used in Latin America, and it was one of the most brutal examples of its indiscriminate use by police against civilians anywhere in the world. Combined Systems’ products were used against protestors across Colombia in 2021.
Photograph: Wil SandsThe launcher’s deployment in Colombia represented a new high-water mark for a pervasive but often overlooked industry. Venom is now marketed to militaries and police forces around the world as a top-tier “less-lethal” weapons system. Sales of such weapons have quietly grown over the past few decades and are now estimated to be a multibillion-dollar business. Demand has inched up alongside a historic rise in economic inequality, political turmoil, and mass demonstrations. According to numerous researchers, the past decade or so has seen nearly unprecedented protests worldwide, and less-lethal weapons are the chief technologies devised to contain them. The theory behind all less-lethal crowd-control devices, from the simple billy club to the infrared laser dazzler, is that they allow security forces to suppress a riot without committing a massacre. Law enforcement and military experts have described them, again and again, as a “humane” alternative to conventional arms—and often as the frontier of high-tech innovation. Perpetually just around the corner, it seems, is the widespread adoption of futuristic weapons like sticky foam, net guns, and heat rays. That rhetoric obscures how remarkably stagnant the main menu of less-lethal crowd-control weapons has remained. Tear gas has been around for about 100 years, rubber bullets for 50, flash-bang grenades for 45, and Tasers for 30. The language has also masked how brutal these weapons can be, and how much they’ve been neglected by oversight bodies. Tear gas—probably the most important less-lethal weapon for crowd control—has been prohibited for use in war since the 1925 Geneva Protocol. But no international treaty bans countries from using it against their own citizens. Less-lethals are also specifically excluded from the 2013 Arms Trade Treaty, a binding agreement that prohibits the sale of weapons to countries with documented human rights abuses. And in the United States, the world’s leading producer of less-lethals, no federal legislation specifically regulates their manufacture. Unhindered by the kind of oversight on production, sale, use, and export that applies to typical small arms, the less-lethals industry has been left pretty much to its own devices. It is to the armaments trade what dietary supplements are to the pharmaceutical industry: a supposedly more benign sector that is, in practice, largely unsupervised and often slipshod. The effects of these weapons are not minor. Even if they are designed not to kill, the less-lethals most commonly used in crowd control—tear-gas canisters, rubber bullets, flash-bang grenades—can easily break limbs, shatter skulls, burn and lacerate skin, destroy eyesight and hearing, concuss brains, and contuse flesh. “They are as dangerous as the person firing them wants them to be,” says physician and human rights activist Rohini Haar. And as a growing body of research shows, these weapons have left a distinct trail of injuries in the wake of movements like the Arab Spring, the Hong Kong protests of 2019, and the Black Lives Matter demonstrations of 2015 and 2020. In the huge protests that swept Chile in 2019, ocular wounds from rubber bullets and other projectiles were so rampant that eye bandages became a nationwide symbol; the Chilean Ophthalmology Society called it the largest outbreak of such injuries ever registered in a conflict zone. I know the impact of less-lethal weapons all too well: I was shot in the face with one while covering a protest outside the White House in 2020. And sometimes the violence these weapons do to protesters’ bodies is even more severe. When the smoke cleared from the streets of Popayán last May, Sebastian Munera was lying on the ground with a fist-sized hole in his neck, bleeding out onto the pavement.The Venom multi-launchers used by Colombia’s riot police were assembled nearly 3,000 miles away, in the Rust Belt of western Pennsylvania—a region that has served as an unusually important node in the global less-lethal weapons market for the better part of a century. Combined Systems, Venom’s manufacturer, is one of the biggest less-lethal companies in the US. It’s based in the tiny borough of Jamestown, near the Ohio border. A couple hours’ drive to the southeast, in Homer City, is a smaller manufacturer called NonLethal Technologies. Until 2018, the Institute for Non-Lethal Defense Technologies, funded by the Department of Defense, was located on the campus of Penn State University.All of those manufacturing entities trace their roots to the US Army’s Chemical Warfare Service (CWS), which was formed during World War I after Germany unleashed chlorine gas on British trenches. By the end of the war, according to historian Gerald J. Fitzgerald, the CWS was producing gas in “an amount greater than the production of Germany, Great Britain, and France combined.”NonLethal Technologies’ factory in Western Pennsylvania, a region that has been a manufacturing hub for the less-lethal industry for decades.
Photograph: Wil SandsIn her 2017 book Tear Gas, historian Anna Feigenbaum argues that CWS leaders, cognizant of the overwhelming public revulsion toward gas attacks, correctly anticipated that the 1925 Geneva Protocol would prohibit chemical weapons in war. So they began looking for ways to repurpose parts of their arsenals for the civilian market. In the early 1920s, the Chemical Warfare Service lent critical support to newly established private firms to rebrand some of the terrifying gases of trench warfare as harmless tools for everyday use. Generals furnished these nascent less-lethal companies with product samples. One early manufacturer developed bank vaults with tear-gas trip wires and home security alarms. Ultimately, the real commercial opportunity lay elsewhere: In 1921, the Chemical Warfare Service provided tear gas to the Philadelphia police for an early experiment. Two hundred volunteer police officers walked away from the test choking and crying, but they were enthusiastic about the technology’s potential for their work. As one organizer of the test reported, the demonstration showed “that gas, intelligently used, was not only a most effective but a most humane method of dispersing rioters, mobs, or other unlawful elements.” Soon, law enforcement officers around the country were using tear gas. The leading manufacturer during this period was a company called Federal Laboratories, or FedLabs, which built its flagship plant in Saltsburg, Pennsylvania, outside Pittsburgh. Federal Laboratories’ CWS-trained chemists developed new munitions that would be deployed during labor strikes, anti-war protests, and marches for civil rights from the 1920s through the ’60s and ’70s. Then Federal Laboratories was dissolved in a buyout by Mace Security International in 1994, and its plant in Saltsburg was shuttered shortly thereafter. With that, the industry’s dominant player was succeeded by a fleet of smaller manufacturers with nonunionized workforces. Munitions from test firings found on private property next to a Combined Systems facility.
Photographs: Wil SandsCombined Systems, the eventual maker of the Venom launcher, was founded in 1981. The company quickly grew its stock list by designing its own products and buying up existing patents. Law enforcement clients quickly snapped those offerings up, thanks in part to federal legislation in the ’80s and early ’90s that transferred billions of dollars in military hardware to local police forces across the United States. Combined Systems opened its Jamestown plant in 1995. In addition to a healthy business in the US, the company secured contracts with the Israeli military and the Egyptian police, among other foreign clients. Production expanded beyond tear gas. In 2009, Combined Systems bought out Penn Arms, a local manufacturer of shotguns, adding launchers to its inventory. Rising political and economic turmoil in the 2010s spurred even more growth. Larry Gearhart, who worked at Combined Systems for more than a decade before retiring in 2012, recalls that demand increased dramatically with the Arab Spring. “When these riots broke out, they loved it,” he says. “Every time something broke out somewhere, we got the orders: Rush, rush, rush ’em out.”Back in World War I, soldiers weren’t the only casualties of chemical warfare; the laborers who filled shells with toxic gas also suffered overwhelming injury rates. Today, making chemical munitions is still a dangerous job. Line workers experienced burning, irritated eyes and throats while working in the “gas house” at Combined Systems, says Gearhart. Former employees say worker safety was often compromised in the company’s effort to meet growing demand and save costs. “A glorified sweatshop is all that place is,” Gearhart says.The US Occupational Safety and Health Administration cited Combined Systems 27 times between 2009 and 2016, for violations including storing propane tanks in locations used for test-firing munitions, failure to appropriately train employees in safety standards, and not providing mandated safety equipment to employees working with known toxins. In 2020, OSHA found that poor safety management had led to a “chain reaction of explosions” that injured five workers at Combined Systems. That’s just one of many fires—at least five, according to local newspaper reports—that have broken out at the plant since 2011. Combined Systems has also faced a lawsuit from a neighbor who accuses the company of trespassing and of violating the Clean Air Act. The family alleges that for years they have found spent munitions littering their property along Combined System’s fenceline. They have also been rattled by the daily racket of explosions and the occasional cloud of tear gas drifting across their yard, as documented in the many videos the family recorded and submitted as evidence. (Combined System did not respond to multiple requests for comment.)NonLethal Technologies, in Homer City, is an even more direct successor to the Federal Laboratories legacy. Founded by FedLabs chemists in 1994, NonLethal has remained relatively small compared to Combined Systems. But it too has been accused of slipshod operations by multiple sources. “Think Breaking Bad, but instead of meth it’s tear gas,” says Shawna McCutcheons, who worked as a secretary at NonLethal Technologies for 12 years before quitting in 2017. A brochure on NonLethal Technologies’ website says “testing of all our products in specially designed test chambers at our facilities insure the highest reliability and performance of our end products and strict conformity to our printed specifications.” A former employee says it was standard operating procedure to test flash-bangs and other explosive less-lethals in a burn barrel outside the buildings used for manufacturing. “They would just walk out that door and drop it in there. Boom. And from the percussion grenade, the wall on the inside [of the building], like the insulation, would move,” says Kyle Stump, a 23-year-old former employee. He says he wasn’t warned to put on hearing protection before tests. Stump claims he has permanent hearing loss in his left ear, and he is convinced his two years as a line worker are to blame. NonLethal told WIRED that it conducts product testing in a “safe and effective manner.”Tom Stutzman, director of the county Emergency Management office that oversees Homer City, says he has responded to multiple building fires at NonLethal Technologies over the years. “When you burn tear gas at certain temperatures, it turns into cyanide,” he says. To protect the public from the risk of cyanide exposure during fires at the plant, Stutzman says he and the local fire department adopted a special response strategy: Set up air monitoring on the downwind side of the fire “to make sure that we’re allowing the residents of that downwind area to shelter in place or get the hell out.”NonLethal sells a range of tear-gas canisters, flash-bang grenades, and rubber bullets. The company also offers its own version of a Venom-like weapon, a multi-launcher called the IronFist, designed “to rapidly deploy a blanket of less lethal munitions into, or over, a hostile crowd.”Like manufacturers of firearms, Combined Systems and NonLethal Technologies have federal firearm licenses and federal explosive licenses. However, there is no federal regulation that distinguishes lethal from less-lethal firearms, and all firearms are exempted from the Consumer Product Safety Commission. When Combined Systems and NonLethal Technologies market their weapons as less lethal, there are no regulatory structures to ensure the reduced lethality of their products. They face no stipulations on the chemical makeup of their patented tear-gas recipes or other chemical irritants, for example, or safety guidelines on the speed and accuracy of the projectiles they develop.Nor, for that matter, are there any federal guidelines on how less-lethals should be used by police in the line of duty. In the absence of such rules, individual law enforcement agencies have developed their own protocols. Activity that could get you shot with a rubber bullet in one city might not in another. The landscape outside the US is similarly piecemeal. In lieu of international agreements specifically regulating the manufacture, sale, and use of less-lethals, the United Nations published the Guidance on Less-Lethal Weapons in Law Enforcement in 2020. The document doesn’t have anything to say about best practices for manufacturing and sales, and instead focuses on establishing use-of-force guidelines. It is also completely nonbinding.Talk to many law enforcement officers and they’ll tell you that less-lethal weapons are a saving grace that keep demonstrations from becoming even bloodier. At the height of the 2020 Black Lives Matter protests, Bob Swartzwelder, president of the Pittsburgh Fraternal Order of Police, argued that without tools like tear gas and rubber bullets, “the police would be forced to [do] what you saw in the ’68 riots in Chicago, along with canines biting individuals, swinging of batons.” Swartzwelder’s stance was echoed by police chiefs around the US. But in fact, history offers another alternative to the brutal police tactics employed in Chicago, Birmingham, and on “Bloody Sunday” in Selma during the 1960s. Those displays of violence sparked a presidential commission, which in turn gave rise to a newer model of protest policing—sometimes called “negotiated management”—that would hold sway in many US departments for decades. Under that model, police set out to preserve both public safety and demonstrators’ First Amendment rights; officers announced what they would and wouldn’t tolerate from protesters and described how they’d respond if those lines were crossed. At times, they’d even plan arrests with protest organizers in advance.Then in 1999, at the Seattle WTO protests, a group of demonstrators rejected the “choreographed” plan for the march and broke through police barricades, and police chief Norm Stamper approved the indiscriminate use of tear gas and other less-lethals. Scenes from the melee dominated the news, and the “negotiated management” model was widely understood to have broken down. Stamper would come to regret his decision, calling it “the worst mistake of my career. We used chemical agents … against nonviolent and essentially nonthreatening protesters.” But across the US, negotiated management fell out of favor, and reliance on less-lethals has increased.Actual research on the benefits of less-lethal weapons is scarce: One widely cited 2009 study showed police departments that incorporated Taser-like devices and pepper spray into their daily police work did see significantly fewer injuries to officers and civilians. Those findings are narrow, however; they don’t address the context of protests and crowd control, nor the weapons—tear gas, rubber bullets—that are used most heavily in those situations.Research on the damage done by less-lethals, by contrast, has piled up in recent years—much of it tracking injuries from physical impact. Tear gas is often delivered via metal canisters fired into crowds at high speeds. Flash-bang grenades can also be launched as high-speed projectiles. Rubber bullets, pepper balls, and bean bag rounds are often fired directly at protesters, and these can fly erratically. “When I talk with police chiefs, I tell them, ‘Unless your officers have a specific target, then don’t take the shot. And the grenades that explode into rubber pieces—don’t use them,’” says Brian Castner, a former airman who has become a weapons expert for Amnesty International. “These weapons are abused when they are shot randomly at crowds.”In 2017, The British Medical Journal systematically reviewed 27 years of literature on deaths, injuries, and permanent disabilities caused by rubber bullets and other less-lethal projectiles; the review turned up 53 deaths cited in 26 different studies around the world. Since 2018, Amnesty International has verified over 500 videos from 31 countries of tear gas being misused, including incidents in which it was fired directly at protesters or deployed in confined spaces. Both practices increase the potential lethality of the less-lethal weapon and were flagged as “potentially unlawful” by the UN guidance in 2020. A 2015 ProPublica investigation found that at least 50 Americans had been seriously injured, maimed, or killed by flash-bangs since 2000. In 2020, the American Academy of Ophthalmology called on law enforcement to cease use of rubber bullets, citing victims in the US and around the world who have been blinded by police. While most efforts to rein in the use of less-lethal weapons have focused on how police use them, some are aimed at manufacturers. In 1991, the surviving relatives of eight Palestinians who died after Israeli soldiers used tear gas on them sued Federal Laboratories and another Pittsburgh-area manufacturer of less-lethals called TransTechnology. The families alleged that the companies were liable for their loved ones’ deaths because they had negligently sold tear-gas canisters to a government that was known to use them in dangerous and reckless ways (firing canisters into enclosed, crowded areas, for example). The case was dismissed a few years later by a judge who cited the United States’ lack of jurisdiction. Activists have also protested against manufacturers, including Combined Systems and NonLethal Technologies, which continue to sell tear gas and other less-lethals to countries with poor human rights records. After Hong Kong police used tear gas made by NonLethal Technologies and other American companies against pro-democracy demonstrators in 2019, Congress passed a law banning the export of certain crowd-control equipment to Hong Kong. Other countries, however, are still fair game—and so is the US itself.Following widespread use of tear gas to quell the 2020 protests for racial justice, members of the US House of Representatives Committee on Oversight and Reform opened an investigation and sent letters out to the top three US manufacturers: Pacem Defense, Safariland, and Combined Systems. The lawmakers concluded that there is too little data to say definitively that tear gas has no lasting health impacts, that the industry is insufficiently regulated, and that manufacturers are exploiting a legal void to maximize profits. The committee did not make any recommendations for action.Dozens of Colombians suffered eye injuries during the general strike in 2021.
Photographs: Wil SandsMy own encounter with less-lethal weapons in 2020 changed my life forever. On May 30, I was working as a photojournalist covering protests in Washington, DC, following the murder of George Floyd. That day, a crowd of a few thousand demonstrators gathered just outside the White House at Lafayette Park. As the evening drew on and people began to leave, a line of officers blocked 16th Street, closing off the area of permitted protest. The police fired a variety of less-lethal projectiles into the crowd, and one of them struck me in the face. I fell to the ground, grasping at my right eye. When I took my hand away, my left eye could see. But my right eye was completely sightless. The impact of the projectile had partially detached my retina and caused a litany of other injuries. Two years, surgery, and a permanent implant later, I’m left with an eye that can’t see much more than silhouettes. It was my dominant eye, the one I relied on most as a photojournalist.In the years since then, I’ve sought out other people blinded by less-lethal weapons around the country and then the world—as part of my recovery, and as a journalistic mission. That’s how I found out about Sebastian Munera.Munera and his friends had been protesting nonstop in the streets of Popayán for weeks that spring. Then on May 13 came a new outrage: A local 17-year-old girl named Alison Melendez posted on Facebook that she had been sexually assaulted while in police custody; later that morning, she took her own life. As news of her suicide spread, Popayán erupted. The next day Munera went alone to protest in the historic heart of the city. His friends were too tired from the previous days’ demonstrations to join him. “Don’t worry,” he said. “I’ll go for you.” What began as a peaceful march of high school and university students ended in deadly clashes between protesters and Colombia’s notoriously violent anti-riot police. “They carried him hacia el pescao, like we say here, by his feet and arms, and put him down where there wasn’t any smoke or tear gas,” Gustavo Gonzalez said, passing me a cell phone with a shaky video of his friend’s final moments. “When I saw that video, that’s when I knew he was dead.”A portrait of Sebastian Munera hangs prominently next to a painting of Jesus Christ.
Photograph: Wil SandsStreet medics attempted to resuscitate Munera, but the wound in his neck was too severe. That night, Munera’s friends and family gathered for a candlelight vigil in the pavilion next to his apartment. When the police showed up, Munera’s father pleaded with them to go. “Your institution killed my son,” he said, trying to maintain his composure. “If you don’t want to have a problem, leave here!” The situation quickly devolved into a neighborhood-wide street fight that lasted until 2 am.Within weeks of Munera’s death, a local law firm filed a formal complaint on behalf of victims of police brutality. The complaint sought a judicial order prohibiting the Colombian National Police from using the Venom launcher in Popayán. Unlike in the United States, Colombian judges can use their position as guarantors of constitutional rights to issue judicial decrees in the absence of legislation. On June 2, 2021, a Popayán judge sided with the victims and ordered the police to suspend their use of Venom in Popayán, at least until officers were trained properly. A month later the decree was lifted. The lawyers who brought the suit argue that the focus shouldn’t just be on what killed Munera, but on the wider abuses of power committed by Colombia’s National Police. Fifty-seven people were killed by the police during the first month of the general strike last year, according to the Institute for the Study of Development and Peace, a Colombian NGO. In an echo of what happened in Chile, Colombia saw a dramatic spike in traumatic ocular injuries.Daniel Jaimes, an aspiring tattoo artist, is among the 28 people who were blinded by those traumatic injuries. On April 30, 2021, he was manning a protest barricade in Bogotá, the capital city, when the federal riot police appeared. Jaimes and his friends jeered the officers. The riot police responded with tear gas. One of the canisters shot into the crowd hit Jaimes in the face. It exploded his right eye, caused hemorrhaging in his left, and broke multiple bones in his face. Lying in a hospital bed, he told his mother, “If I end up completely blind, I’m gonna kill myself.” Doctors removed portions of his skull to reconstruct his orbit and nose. His right eye was lost, and vision in his left was severely damaged. It was a painful and slow recovery. Emotionally traumatized, Jaimes says it has been hard to hold down a job. He has survived on the solidarity of friends and family. After months of healing, Jaimes says the sight in his left eye is gradually improving and he is hopeful that he will eventually be able to tattoo again.Critics say that Combined System’s Venom and similar multi-launchers from other manufacturers are, by their nature, especially indiscriminate. The weapons are meant to be mounted at a specific angle so that rounds don’t hit crowds directly. “But what did they do in Popayán? They set it up on the ground. This made it so the projectile wasn’t parabolic,” says David Anaya, a childhood friend of Munera’s. “Being repressed with this weapon, you start to question if the government really wants to kill us, blind us, shut us up one way or another.” A week after Sebastian Munera was killed, Amnesty International called on US secretary of state Antony Blinken to immediately halt exports of conventional arms and less-lethal equipment to Colombia. “The United States’ role in fueling ceaseless cycles of violence committed against the people of Colombia is outrageous,” said Philippe Nassif, Amnesty’s advocacy director, in a statement.Friends and family of Sebastian Munera painted a mural as a memorial in the pavilion where he spent his youth.
Photograph: Wil SandsSebastian Munera’s community banded together in the months following his death, organizing fundraisers for protesters who are still in jail and developing proposals to improve neighborhood infrastructure. A cement public sports pavilion now bears a mural depicting Munera and his pitbull, Pava. In red, 4-foot letters it declares, “SEBAS LIVES.”Nearly 100 years ago, the Chemical Warfare Service launched its PR campaign to sanitize the reputation of weaponized gas. Today, less-lethal weapons are employed by law enforcement agencies and militaries across the globe. And though the weapons have come under mounting scrutiny over the years, the most powerful, lasting mark of that propaganda campaign is the binary that’s still implicit in the very concept of less-lethal weapons: as if the only two options were these munitions or lethal force. That false binary has given cover to a brutal, shadowy industry—one that has remained unaccountable to basic regulation for decades as it profits from the tensions in fraying democracies. Even by conservative estimates, the less-lethal industry is predicted to grow by more than $3 billion over the next decade.This article was supported in part by the Pulitzer Center.Let us know what you think about this article. Submit a letter to the editor at [email protected]. | Epidemics & Outbreaks |
One-hour training is enough for people to carry a task alone with their supernumerary robotic arms as effectively as with a partner, study finds.
A new study by researchers at Queen Mary University of London, Imperial College London and The University of Melbourne has found that people can learn to use supernumerary robotic arms as effectively as working with a partner in just one hour of training.
The study, published in the journal IEEE Open Journal of Engineering in Medicine and Biology, investigated the potential of supernumerary robotic arms to help people perform tasks that require more than two hands. The idea of human augmentation with additional artificial limbs has long been in science fiction, like in Doctor Octopus in The Amazing Spider-Man (1963).
“Many tasks in daily life, such as opening a door while carrying a big package, require more than two hands,” said Dr Ekaterina Ivanova, lead author of the study from Queen Mary University of London. “Supernumerary robotic arms have been proposed as a way to allow people to do these tasks more easily, but until now, it was not clear how easy they would be to use.”
The study involved 24 participants who were asked to perform a variety of tasks with a supernumerary robotic arm. The participants were either given one hour of training in how to use the arm, or they were asked to work with a partner.
The results showed that the participants who had received training on the supernumerary arm performed the tasks just as well as the participants who were working with a partner. This suggests that supernumerary robotic arms can be a viable alternative to working with a partner, and that they can be learned to use effectively in a relatively short amount of time.
“Our findings are promising for the development of supernumerary robotic arms,” said Dr Ivanova. “They suggest that these arms could be used to help people with a variety of tasks, such as surgery, industrial work, or rehabilitation.”
Watch the video of the experiment there: https://youtu.be/z79_UQnD-ag
The study was funded by the EU H2020 NIMA (FETOPEN 899626), TRIMANUAL (MSCA 843408) and CONBOTS (ICT 871803) grants.
For media information, contact: | Medical Innovations |
There are very few winners in the climate crisis, but scientists are pretty sure there’s going to be at least one: Mosquitoes.
These insects – annoying at best, deadly at worst – thrive in warmth and humidity. As climate change ushers in more frequent and more severe heat waves, as well as storms and floods that leave behind pools of stagnant water in which most breed, it’s boom time for mosquitoes.
For the first time in decades, the US Centers for Disease Control and Prevention is warning of several locally acquired cases of malaria in the United States – news that has thrust mosquitoes into the spotlight. While it’s too soon to know whether these specific cases are connected to climate change, scientists have been warning that malaria could become more common in the US as temperatures rise there.
It has raised fresh concerns about mosquitoes pushing into regions they have not been in for generations – or ever – and what that might mean for the spread of the deadly diseases they transmit.
Rising temperatures allow mosquitoes to grow faster and live longer. Whereas before they would die out during harsh winters in many places, now they have a greater shot at surviving and more time to build up their populations. Heat also speeds up the time it takes for a parasite or virus to mature inside a mosquito.
“The hotter the temperature gets, the shorter that process becomes. So not only are these mosquitoes living longer, but they’re potentially becoming infectious sooner,” said Oliver Brady, an associate professor at the London School of Hygiene and Tropical Medicine.
They gain other benefits from heat, too. When it’s hotter, more people tend to be outside in the morning and late in the afternoon – prime time for mosquitoes.
Heat is also pushing cities to increase their amount of green space, which has a vital cooling effect but could also provide ideal new breeding grounds for the blood-sucking insects.
In the US, the number of “mosquito days” – those with the hot and humid conditions they love – has increased across the country, according to a recent analysis from Climate Central, a nonprofit research group.
Researchers looked at data spanning more than four decades in nearly 250 locations and found that more than 70% of them had become more hospitable to mosquitoes.
While most of the approximately 200 mosquito species in the US are harmless, there are about a dozen which can pass on diseases to humans, including chikungunya, dengue, zika and West Nile viruses.
While serious mosquito-borne diseases remain rare in the US, other countries are not so lucky.
In sub-Saharan Africa, where malaria has had devastating consequences, climate change is helping mosquitoes expand their range significantly, according to recent research.
Malaria-transmitting Anopheles mosquitoes have, on average, moved to higher elevations by around 21 feet a year and southward by nearly 3 miles a year, a Georgetown University report found.
It’s a pace that follows climate change and could have significant consequences for areas that have never experienced malaria before and are likely to be unprepared, said Colin Carlson, a global change biologist at Georgetown University and co-author of the report.
Dengue fever is another potentially deadly disease, which is poised to increase in a warmer world.
Also known as “breakbone fever,” it causes fever, nausea, vomiting, fatigue and diarrhea and, in some cases, internal bleeding and death. There is no cure or specific treatment for dengue, leaving sufferers little choice but to ride out the symptoms.
Peru is currently grappling with the worst outbreak of mosquito-borne dengue fever on record, which has infected around 150,000 people and killed more than 250.
Experts have said that unusually high levels of rainfall and warmth have provided ideal conditions for the mosquitoes. While scientists are yet to assess the role climate change has played in the outbreak, Carlson said the links seem clear.
“I’m not a betting man, and I would put money on when we go and do that study, it will be climate change,” he said.
Now dengue is knocking on the door of Europe and the US.
“A billion new people will be exposed to the right weather conditions for dengue transmission, and most of those people are in Western Europe and the United States and temperate China,” said Carlson.
There have been locally spread outbreaks in Texas, Florida, Hawaii and Arizona. And last week, the European Centre for Disease Prevention and Control warned that the Aedes albopictus species – which can transmit dengue and chikungunya – is pushing northwards and westwards in Europe as climate change grips the world’s fastest warming continent.
“What is surprising is the speed of the spread,” Celine Gossner, principal expert in emerging and vector-borne diseases at the ECDC, told CNN. In just a decade, the number of regions where this mosquito is established has increased three-fold, she said.
Even with this new exposure, however, the US and Europe are unlikely to see huge outbreaks, or large numbers of fatalities from dengue virus.
“The story of future change is really more about big increases in areas that already have dengue, that’s going to get much worse,” Brady said. He pointed to China and parts of India as particularly at risk. “That’s a really scary situation because vast numbers of people live in these areas and even minor changes could potentially be catastrophic,” he said.
Communities already on the front lines of the climate crisis are always going to be most affected by mosquito-borne disease, and that is where investment should be directed, said Shannon LaDeau, a disease ecologist at the Carey Institute of Ecosystems Studies.
But the shift of mosquito-borne diseases into regions like the US and Europe is still likely to be a shock.
“Folks that live in the temperate zone are going to see their way of life change pretty dramatically because they’ve never had to worry about it before,” LaDeau told CNN.
The climate crisis is not all upside for mosquitoes. Some places may simply be getting too hot.
“There’s some threshold after which the chemistry in their body just doesn’t function anymore,” LaDeau said. The bad news is that these places are likely to be getting too hot for humans, too.
There is still much that remains unknown about how mosquitoes will react to the climate crisis. The relationship between climate change and disease is complex, Gossner said.
We know a lot about how temperature changes mosquitoes’ ability to transmit disease, a small amount about how quickly mosquitoes are moving to new places and very little about whether overall mosquito populations are growing, Carlson said.
Scientists are working to develop tools to be able to better assess the link between mosquito-borne diseases and climate change.
In the meantime, there are ways people can protect themselves from risk, including wearing mosquito repellent, putting screens on windows and doors and getting rid of any stagnant water from places like flowerpots and gutters.
Scientists are also working on high-tech methods to reduce populations. A project in Florida has been trialing a genetically modified mosquito designed to pass on a lethal gene that kills female mosquitoes – which are the ones that bite.
Other experiments involve using wolbachia bacteria, which can prevent viruses replicating inside a mosquito, making them less likely to transmit viruses.
There are also vaccines on the horizon for diseases such as dengue and malaria. “That’s a really big deal,” said Carlson. But whether these will be shared equitably around the world is another question, he added.
“It’s a long road to try to understand how better to use those tools. But there’s a lot of hope on the horizon,” Brady said.
Ultimately, tackling climate change will have a huge impact.
The path the world takes on reducing planet-heating pollution will lead to very different futures for mosquito-borne diseases, Brady said. “Aggressive [climate] mitigation would be by far the lowest risk.” | Epidemics & Outbreaks |
Doctors have said coughs are lasting a long time this winter and it might be due to people picking up one infection after another.Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, said doctors have noticed the current round of respiratory infections are taking longer than usual to clear, but added most people will recover without any medical attention.
She said lockdowns during the pandemic may have reduced the public's "resistance to infections" - but admitted it is "not clear" why so many coughs and colds linger for so long.Research shows that rates of lower and upper respiratory tract infections are well above the average usually seen so far in winter, she added.This is supported by weekly data from the UK Health Security Agency (UKHSA), which has found high rates of flu and other respiratory viruses.
This month, the UKHSA warned adults to stay at home if they feel unwell - or wear face coverings when going outside to minimise spreading infections.Prof Hawthorne said: "It's not clear why some of the current respiratory infections going around do seem to be lasting longer than usual - this has been noticed by doctors as well as patients, but we are not entirely sure why this is happening.Read more on Sky News:Pharmacies reveal shortage of cough medicinesCold snap 'could case strokes and heart attacks'"Most of the public have been socially isolated during the last two winters and this appears to have reduced their resistance to infections - this seems to make it more likely they will pick up infections than in previous years. "So, in some cases, it may be a matter of picking up one infection after another. They are all different and getting over one type of infection does not give immunity against another one."We'd encourage patients to do what they can to keep themselves well this winter, including practising good public hygiene such as regular handwashing, or using hand gels if that isn't possible, and throwing tissues away once they've been used."'Antibiotics for viral infections will not help'Prof Hawthorne also recommended regular paracetamol for any temperature, sore throat or earache, keeping warm, getting plenty of rest, and drinking lots of fluids."We'd encourage patients to understand that giving antibiotics for viral infections will not help, as they only help with bacterial infections," she said."Most upper respiratory tract infections are due to viruses."If a cough is particularly persistent, or bringing up discoloured phlegm, has severely worsened with shortness of breath, or if a patient is experiencing chest pain or losing weight for no reason, they should seek a medical opinion."Prof Hawthorne said GPs are seeing a huge increase in demand for appointments, including from people whose physical and mental health is suffering as a result of the rising cost of living."It goes without saying that if patients are struggling to eat healthily or heat their homes or are living in damp conditions, then this will have an impact on their health - and the added stress of struggling financially will undoubtedly take its toll on people's mental health," she said.She also urged the government to "address the severe and chronic workforce shortages in general practice" alongside cutting red tape, so GPs can spend more time with their patients. | Epidemics & Outbreaks |
Bernie Sanders Grills Biden-Appointed NIH Director Nominee Over US Drug Prices
The Vermont senator has long been a proponent of lowering drug costs
Monica Bertagnolli, M.D., faced off with Sen. Bernie Sanders (I-VT) and the senate’s health committee Wednesday in her bid to become the next leader of the National Institutes of Health (NIH).
The committee is chaired by Sanders, a firebrand independent politician who caucuses with the Democratic party. The Vermont senator has centered the high cost of drugs in the United States as his signature issue.
Sanders reportedly refused to schedule the hearing for months, first demanding the Biden administration make reasonable progress towards lowering drug prices. Finally in September, Sanders added the confirmation hearing to his schedule.
Dr. Bertagnolli, who currently serves as leader of the National Cancer Institute, was appointed to the top role at the NIH by President Biden in May. The role requires confirmation from the senate, making her appearance in front of the committee for Health, Education, Labor & Pensions (HELP) an important step.
Sanders asked Dr. Bertagnolli, who was diagnosed with breast cancer in December and is an oncologist herself, how she feels about the staggering high costs of treatment for the disease.
“I have sat in clinics next to patients of my own who for one reason or another could not afford their treatment,” she said. “It is a tragedy.”
A 2016 study found that a woman diagnosed with breast cancer could face bills between $60,000 to $135,000 on average within the first year of treatment, with more severe cases costing more to treat. Within the first 24 months, costs can range from $71,000 to $182,000.
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While insurance covers a large portion of these bills for a majority of Americans, cancer care can still be financially ruinous. Insurance deductibles and monthly premiums are rising in the U.S., and the expensive price of care across the entire population causes these costs to rise even more.
Sanders pointed out that the NIH – which receives funding from U.S. taxpayers – helps pay for the research and development of many of these drugs. Despite this, American taxpayers generally pay much higher rates for these medications than peers in other developed countries.
Sanders also pointed to Xtandi, a prostate cancer drug sold by Astellas and Pfizer. In Japan, a patient will pay $20,000 annually for the drug, compared to $160,000 for Americans.
The senator demanded Dr. Bertagnolli pledge to a “reasonable price clause,” forcing any company that takes NIH funds for drug research to charge Americans a price on par to what they charge other countries.
The NIH appointee did not make a concrete pledge, but reiterated that making sure Americans can access lifesaving drugs was a priority.
“My focus is on making sure the American people have access, availability and can afford the healthcare that can save lives, and that is what I can make a commitment to,” she said.
The role of NIH director has remained vacant for nearly two years since Francis Collins, M.D., an Obama appointee who stayed on board through the Trump Administration, stepped down in December 2021. Lawrence Tabak, M.D., has served as acting NIH director since.
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"I remember my wife, Dora, coming home one day and telling me she had a problem while driving," said Bill Collier, a marketing professional living near Harrisburg, Pennsylvania. "She said she stopped at an intersection and suddenly couldn't remember where she was going."
That was in August of 2015. Then things got worse. Within months, Collier said Dora began experiencing nervous breakdowns and hallucinations on a nightly basis.
"She freaked out at me, at the world, at God — you name it," he told VOA. "Most nights we both ended up in tears because we didn't know what was going on or why it was happening."
It wasn't until nearly six years later, in February 2021, that Dora, now 57, was finally diagnosed with Alzheimer's disease, a progressive mental deterioration most commonly suffered by the elderly, but which can also strike middle-aged people. The disease, the sixth leading cause of death in the United States and the only one in the top 10 without a cure or potentially reversible treatment, causes brain cell connections and the cells themselves to degenerate and die.
The eventual result is the destruction of memory and other important mental functions.
"The day we got the diagnosis felt like getting a death sentence," Collier said. "Dora is still alive, but it's been the eight toughest years of my life. Alzheimer's is like a slow motion, everyday horror movie with a senseless plot that haunts my thoughts each hour I'm awake."
Diagnosing the disease
"Alzheimer's disease is a public health crisis, and it's growing at a rapid rate," explained Ruby Dehkharghani, director of public policy at the Alzheimer's Foundation of America (AFA).
According to the Alzheimer's Association, 6.5 million Americans live with the disease, including roughly one in nine senior citizens. The Centers for Disease Control and Prevention (CDC) projects that number to more than double to 13.8 million people by 2060.
Family members of those with Alzheimer's say one major problem is how long it can take to diagnose the issue and begin treatment.
"On one hand, it's hard to get doctors and health care systems to take family members seriously during the early, undiagnosed stages of Alzheimer's," Collier said. "On the other hand, you have patients themselves avoiding getting tested and lying to the doctor because they don't want to admit what amounts to a horrible truth."
This is what Krista Patrick-Brown, a school principal in New Orleans, Louisiana, experienced with her father.
"My dad was diagnosed in the fall of 2020, when it was obvious to the rest of us that something was going on and he needed to be tested," Patrick-Brown told VOA.
It was only when the family gained access to his medical records at the time of diagnosis that they learned he had expressed concern to his doctor three years earlier because he was struggling to perform his job.
"I think he was scared to tell anyone, or maybe the realization that it could be something serious made him avoid learning more," she continued. "Either way, he didn't follow up until it was unavoidable, and I can't help but imagine how starting his medicine years earlier might have slowed his deterioration."
Drugs have recently been developed that can slow but not stop the progression of Alzheimer's, if administered in the early stages of the disease. Such treatments are expensive and can have side effects. While drugmakers race to develop and test what is hoped will be more effective treatments, there is no indication that a cure is on the horizon.
"The current medications for Alzheimer's have very, very modest benefits," said Colleen Kenny, a nurse who works with dementia patients at a hospital outside of Chicago. "Families should temper their expectations for how well they should work."
A nightmare
Patrick-Brown said her father's loss of independence has been one of the more difficult aspects of the disease for him.
She said they tried to encourage him to stop driving on his own, for example, but he resisted. Once her father's doctor reported his diagnosis to the state, he had to either pass a driver's test or forfeit his license.
"It was awful. He spent weeks trying to study for the test, but he couldn't process the information," Patrick-Brown remembered. "His anxiety increased and he didn't seem to even completely grasp why he was being asked to take the test in the first place."
"I think that's when our roles flipped indefinitely," she said. "From then on, my father would always be child-like to me and my brother, and we are now his parents."
It's common for patients with dementia — of which Alzheimer's is the most common type — to exhibit behaviors found in younger children, such as mood swings, tantrums, irrationality, forgetfulness, vocabulary problems, fear, and extreme dependence on family members.
"They get angry, sensitive, and irrational," said Margarita Hernandez, an aide for Alzheimer's patients in Commack, New York, "but of course it's not their fault. They didn't choose this. They are innocent and we need to respond by giving them love, attention, and help."
Life of a caregiver
Dehkharghani of the AFA notes that Alzheimer's patients aren't the only ones severely impacted by the disease.
"Many of the things that make it challenging for the person living with Alzheimer's are what also make it challenging for family members providing care," she said. "Caregivers will be expected to provide greater assistance to their loved ones as the disease progresses, and they'll carry the emotional impact of watching their personalities change. It's not something someone should be expected to do alone."
Alexandra Magiera, who works in education in Chicago, Illinois, and is a volunteer for the Alzheimer's Association, said she was just 15 years old when her mother, Lizzie, was diagnosed with the disease.
For Lizzie, it started with what appeared to be small things such as confusion about where she was supposed to be, but Magiera said it quickly got worse.
"A year later she had trouble remembering my name, and a few years after that she no longer knew who I was," she said. "That, plus there were times she was getting angry and combative. It was all heartbreaking."
When Magiera left for college, the responsibility of caregiver for her mother fell even more squarely on her father's shoulders.
"She was the love of my dad's life and he cared for her as best as he could," she said, "but the physical and emotional demand was too much and eventually he had to place her in a nursing home. I know it was one of the hardest decisions he ever had to make."
During the last two years of Lizzie's life, Magiera's dad couldn't stand it anymore.
"He told a friend, 'I'm bringing Lizzie home; I miss her too much,' and that's what he did," Magiera said. "I think he relished every moment he was able to spend with her."
Moving forward
According to the CDC, more than 11 million Americans care for a loved one with Alzheimer's. For many, it's not possible to be the sole caregiver.
"I hate to say it, but unfortunately money is key," explained Kenny. "In-home health aides aren't often covered by insurance, and a decent nursing home for my father, who had dementia, cost $7,000 per month. There aren't easy solutions."
Magiera said her father had been retired for 20 years, but after her mother died in 2011, he had to go back to work to help pay for his wife's medical bills.
"I can't even imagine what would have happened if he hadn't been on such solid financial footing to start," Magiera said.
The heartbreak this disease has caused so many Americans and their families has stirred Washington to action.
When the National Plan to Address Alzheimer's Disease was released in 2011, initial funding totaled approximately $500 million a year, far below the $2 billion goal that leading scientists had estimated was necessary to find a treatment or cure by 2025. More recently, however, politicians have worked together to increase federal research investment to more than $3.4 billion last year.
"It's encouraging to see such a bipartisan effort, but we're not across the finish line yet," said Dehkharghani. "There are still so many unanswered scientific questions when it comes to Alzheimer's, but researchers are working very hard to discover answers and to hopefully find the breakthrough that will lead to the treatment and cure we're all hoping for."
In the meantime, things have been learned to stave off the effects of Alzheimer's, including cardiovascular exercise, maintaining a healthy blood pressure, continuing a consistent level of socialization and, of course, early diagnosis.
"I sometimes wonder what we'd be doing right now if my wife had early treatment," Collier told VOA. "Would we be traveling the world? Would we be checking items off her bucket list?"
"Instead, I go to her senior living facility every day," he continued, "because I want the nurses to know this woman who has been reduced to shuffling and mumbling is still my Dora — she's a Navy veteran and a very accomplished woman, and I want them to know her story." | Disease Research |
National exemptions are in place to provide critical care during strike action by nurses, a union leader has insisted, telling Sky News staff would never leave patients unsafe or create more risk.
Royal College of Nursing (RCN) general secretary Pat Cullen was speaking to Sophy Ridge On Sunday ahead of a 28-hour walkout by members over pay.
The industrial action will run from 8pm on Sunday until 11.59pm on Monday night after voting to reject the latest government offer.
Politics latest: Union leader says nurses are pushed to the brink
The union initially said it would not agree to derogations - broad areas of care where staffing is guaranteed despite industrial action - fuelling concerns about patients being put at risk.
It led Great Ormond Street Hospital (GOSH) among other organisations to declare a "business continuity incident" until it was confident it could staff its services over the strike.
The RCN subsequently offered assurances after the hospital raised "serious concerns".
But Ms Cullen told Ridge wider, national exemptions were in place.
She said: "Our nurses, as I've said time and time again, will never leave their patients unsafe or create more risk that's already in the system at this point in time."
She added: "There are national exemptions in place for a range of services, for emergency departments, for intensive care units, for neonatal units, paediatric intensive care units, those really acute services.
"In fact, it was the Royal College of Nursing contacted NHS England to ask for a process to be put in place so that we could make sure that the strike was safe for our patients."
Defending the latest walkout she added: "They're going on strike because patients' lives are being put at risk every single day, and why? Because we have tens of thousands of vacant nursing posts."
Ms Cullen also urged hospital managers to "think carefully about what they are saying".
She said: "None of those people, I believe, have walked in the shoes of our nursing staff.
"I would say to them as well, it's interesting that they've come today to talk about the risk that's posed as a result of our nurses taking strike action, for the very reason that I've said, because of the crisis within the health service.
"And I would ask them, for those other 364 days of the year, speak up for their nursing staff - tell what the risk is that they are carrying every single day."
Health workers across the NHS have gone on strike several times in past months in disputes over pay and conditions.
Unions including Unison and the GMB have voted in favour of a government pay offer to end the strikes, while Unite and the RCN have voted against.
Nurses make up a quarter of NHS staff and are the biggest proportion of the health service workforce.
NHS England warned that staffing levels for some areas of the country will be "exceptionally low, lower than on previous strike days".
It added the number of rescheduled appointments due to strike action is set to hit half a million next week.
A High Court judge ruled on Thursday it would be unlawful for the RCN strike to continue into Tuesday as originally planned, meaning it will now end just before midnight on Monday. | Health Policy |
Fall has arrived, flu shots are rolling out in pharmacies, and pediatricians are watching for an uptick in respiratory syncytial virus, or RSV. In other words, it’s virus season. Covid deaths and hospitalizations also began rising at the end of July, and wastewater surveillance that looks for the virus has been on a slow upward trend.So do we have a “Covid season” now? It’s an important question, because knowing when cases will surge could help public health officials and health care administrators plan for vaccines, treatments, and hospital staffing—and might prompt everyone else to be a little more self-protective.But experts on the front lines and doing data analysis say it’s too soon to declare that Covid has achieved seasonality. Looking back over the previous three years, they do see patterns: a spike at some point in the summer, such as the arrival of the Delta variant in 2021, and a spike sometime in the late fall or winter, such as the Thanksgiving surge of Omicron later that year. But those spikes haven’t occurred at the exact same time from year to year, and it’s possible they didn’t all arise for the same reasons.“You might look at that data and think, maybe this is just a biannual virus, compared to flu and RSV, which have single seasonal peaks,” says Cameron Wolfe, an infectious disease physician and professor at the Duke University School of Medicine. “But that gets much harder to say when you factor in that as a society we behave very differently, seasonally. And that we've behaved differently in different years of the pandemic, according to how restricted we were in terms of our movements, how much mitigation we were actually performing, and how immune we were, either by vaccine or native infection.”In other words, what looks like a season might be an artifact created by our behavior, not the virus’s. The way our bodies react to SARS-CoV-2 might also be playing a role in pushing it around the calendar.“As we get more used to seeing this virus, our immunity builds up a little more and a little more—so the time between the winter surge and the summer surge gets longer and longer,” says David Dowdy, a physician and professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “What may eventually happen is that it gets longer and longer, until it's every winter. It may be very interesting this year to see if we have the same winter surge of Covid, because we had such a late summer surge. There's going to be a fair amount of immunity still in the population.”In fact, the latest data may reflect that. Epidemic curves posted by the US Centers for Disease Control and Prevention that showed a steady upward trend for two months have begun turning down; between September 10 and 16, hospitalizations shrank 4.3 percent (though deaths increased, by 2.7 percent). That downturn can’t have been created by the newest Covid boosters, because they were only released September 13.But the degree to which people accept the new shots might control whether and when a winter surge arrives. “We know from this virus, year over year, people's immune response to each vaccine or boost starts waning at that six- to eight-month time point,” says Mark Cameron, an associate professor of population and quantitative health sciences at Case Western University.Ashish Jha, a physician who is the dean of the Brown School of Public Health and served for 14 months as the White House’s Covid-19 response coordinator, said at a media briefing last week, “My expectation is we're going see a further decline for probably the next month or two, and then we're going to see the virus starting to rise again, as we get into the holidays and beyond.”To say that a virus is seasonal seems self-evident: at a particular point in the year, cases begin; at some further point, they subside. But “seasonality” conceals mysteries, even for the flu. Environmental changes—in ambient temperature, humidity, or the duration of UV light—might combine to create optimal conditions for the flu’s return. So might anatomical responses to those changes, such as the effect of colder or drier air on mucous membranes and the epithelium of the respiratory tract. Equally, so might behavioral shifts: crowding indoors to escape the colder weather, and sharing spaces that offer less air circulation than the summertime outdoors.If the complex effects of all those influences aren’t well-understood for influenza, one of the most-studied viruses, imagine the knowledge gaps that exist for Covid. They include not just the conditions that influence the flu and winter colds (caused by an array of pathogens including other coronaviruses), but also the evolutionary behavior of SARS-CoV-2 itself. It is still a mystery why the Delta variant emerged when it did, and why the much more divergent Omicron variant took over from it. It is even more mysterious why the Omicron variant has remained so dominant nearly two years later.“The question is: Why has it settled on that and not made another major seismic move to a brand-new variant?” asks Robert Bednarczyk, an infectious disease epidemiologist and associate professor at Emory University’s Rollins School of Public Health. “If we can understand where that stability is coming from, it will be very helpful to plan moving forward.”If Covid were stable and seasonal—or at least gained predictable periodicity in arrival and mutation—planners could follow the decades-old model built for the flu. A large, global, durable infrastructure—led by the World Health Organization but assisted by national governments and academic researchers—detects, analyzes, and forecasts the evolution of influenza viruses early enough to formulate vaccines for the following season. That infrastructure can only operate because of the predictability of the flu's annual return.A similar infrastructure could be built to prepare for Covid, too. Predicting the virus’s likely arrival could ensure that fresh boosters are developed and shipped well in advance of a surge, and get to where they are needed. Trustworthy predictions of Covid’s future behavior could also exert more subtle effects, allowing drug manufacturers to envision demand and hospitals to stress-proof capacity.“Paxlovid and other antivirals, monoclonal antibodies, whatever we're using to treat Covid—we’d want to start ramping up production of those drugs in the late summer, so we have them around in the winter, within their shelf life,” says Jacob Simmering, a health economist and assistant professor at the University of Iowa’s Carver College of Medicine, and coauthor of a March analysis that found reliable seasonal spikes in cases in the United States and Europe. “That should influence production decisions. And it also has implications for the healthcare system: making sure we have resources, staff availability, beds.”That’s not to say such planning doesn’t happen now—but those plans are made with incomplete information about a virus that hasn’t settled into predictability. We might never be able to stop Covid from coming back. But if it became seasonal, we could be ready to meet it.Emily Mullin contributed to this reporting. | Epidemics & Outbreaks |
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It was only a matter of time.
Soaring demand for a drug touted by online influencers to help lose weight, but whose supplies in Europe are restricted, has caused a surge in fake and potentially dangerous concoctions of the injection, putting lives at risk.
In the first seven months of this year, Ireland alone has seen a fivefold increase in illegal imports of semaglutide — the active ingredient in diabetes drug Ozempic and weight loss drug Wegovy — compared with the whole of 2022. In France patients are presenting fake prescriptions to try to get the drug, while rogue spas have been selling semaglutide seemingly without the need for a prescription, making it illegal and potentially fake.
Amid severe supply restrictions for Ozempic and Wegovy, patients are turning to social media and online pharmacies in a desperate bid to get their hands on the drugs, which hold the potential to revolutionize the treatment of obesity. In a clinical trial, patients with obesity lost some 15 percent of their body weight over 68 weeks, compared with those on a placebo.
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Influencers on TikTok, Facebook and X, formerly Twitter, jumped on the news. It ignited a frenzy of online sellers, offering cheaper counterfeit versions of the drug, re-selling prescribed medication or offering raw ingredients to mix at home.
While some buyers might get their hands on the real drug — possibly a dispensed injection pen re-sold illegally — the majority of semaglutide bought online is likely to be either a counterfeit version from an unlicensed source with all manner of unknown toxicities or, worse, a total fake containing anything from sugar water to deadly heavy metals and rat poison.
Yet Europe's drugs regulator, which ensures medicines in the bloc are both safe and effective, said it has no responsibility over fake injections being mailed to European citizens from fraudulent online pharmacies and labs.
The European Medicines Agency told POLITICO that “dealing with falsified or counterfeit medicines is a matter for law enforcement and this is outside the scope of EMA’s responsibilities.” When asked if they had received reports of fake semaglutide, they didn't provide any. Instead, they suggested contacting Europe’s crime agencies — which we did.
A spokesperson at Europol told POLITICO: “We are aware of this phenomenon and currently supporting operational activities targeting the trafficking of such illegal substances. As operational activities are currently ongoing … we are not able to communicate further at this point in time.”
Buying semaglutide online
In Europe, Wegovy and Ozempic are only available on prescription. While Ozempic has been available since 2018 for diabetes, weight loss drug Wegovy has only launched in Denmark, Norway, Germany and the U.K. Outside Europe, it's available in the U.S.
Demand is so high for the drugs, which people have to take long-term, that their maker, Novo Nordisk, is limiting further launches and countries are restricting prescriptions to the most needy patients.
So people are searching for alternative sources.
Research by POLITICO found numerous online sites in Europe offering "semaglutide" for sale at prices from around €100 to several hundred euros for a week’s supply. One site, based in the U.K., even shows users how to mix two ingredients together to purportedly make the drug.
But the chances of the clear liquid actually being semaglutide are slim. A study by the Alliance for Safe Online Pharmacies (ASOP Global) found that, out of 33 medicines bought online, 62 percent was fake or substandard.
POLITICO contacted multiple European regulators about fake Ozempic and Wegovy. Ireland’s Health Products Regulatory Authority (HPRA) said that, alongside the Irish customs agency, it had seized 159 units of semaglutide in the first seven months of 2023, compared with 32 units in 2022. “The online supply of these medical products to Ireland places their provenance outside the legitimate supply chain and therefore cannot be assured,” the HPRA said, adding it was closely monitoring the situation.
Illegal sales of semaglutide have also been detected in Belgium and Denmark, but regulators say these are mostly genuine products sold illegally online.
However, drugs regulators in Germany, Italy and France passed the buck. Germany said when it comes to the illegal supply chain, such as through the internet, the medicines regulator is not involved; the responsibility lies with the police and customs authorities. Italy directed POLITICO to the World Health Organization’s falsified medical products officer, and France merely shared its latest update on misuse of Ozempic by patients who do not meet the criteria to use the drug.
Stronger safeguards
The EU does have rules to protect people against fake medicines sold online, including an EU logo to identify legitimate pharmacy websites and track-and-trace barcodes on packages — but these are unlikely to protect people who are trying to beat the system.
“There is zero percent [fake drugs] going through the legal channels,” said Martino Canonico, public affairs manager at the European Association of e-Pharmacies (EAEP). “The issue of course is with the illegal channels.”
The surge in fake drugs has led some in the sector to question whether the current EU regulations are fit for purpose, especially in an age where scammers can set up fake online outfits with ease and purport to supply legitimate medicines.
More than 100,000 new domain names were registered online containing terms like “COVID,” “corona” and “virus,” in March 2020 alone, with criminal gangs exploiting the public health emergency. Today, they’re exploiting an online frenzy for semaglutide and, often, young people feeling pressured to look thin.
To Mike Isles, head of the Alliance for Safe Online Pharmacies (ASOP Global) in Europe, stronger safeguards are needed to protect patients when they buy meds online. He wants all online pharmacies globally to have a common domain name, ensuring they are vetted and legit. This is “my vision for the future,” he said. “So if it's an online pharmacy in Germany, it's .apotheke; if it's in Spain, Portugal or Italy its .farmacia and for France its .pharmacie etc,” he said.
Oksana Pyzik, a lecturer at University College London’s School of Pharmacy, agrees — but also wants stronger rules requiring social media companies to report dodgy sellers to law enforcement, and much fiercer deterrents.
“Falsified medicines is a $200 billion dollar industry. It is in many ways the perfect crime with high rewards and low risk/penalties,” she said highlighting there are longer jail sentences for selling heroin than dangerous fake drugs.
“This is not like buying furniture off Amazon; unsafe fake prescription drugs can kill,” she said. | Drug Discoveries |
About 49,500 people took their own lives last year in the U.S., the highest number ever, according to new government data posted Thursday.
The Centers for Disease Control and Prevention, which posted the numbers, has not yet calculated a suicide rate for the year, but available data suggests suicides are more common in the U.S. than at any time since the dawn of World War II.
“There’s something wrong. The number should not be going up,” said Christina Wilbur, a 45-year-old Florida woman whose son shot himself to death last year.
“My son should not have died,” she said. “I know it’s complicated, I really do. But we have to be able to do something. Something that we’re not doing. Because whatever we’re doing right now is not helping.”
Experts caution that suicide is complicated, and that recent increases might be driven by a range of factors, including higher rates of depression and limited availability of mental health services.
But a main driver is the growing availability of guns, said Jill Harkavy-Friedman, senior vice president of research at the American Foundation for Suicide Prevention.
Suicide attempts involving guns end in death far more often than those with other means, and gun sales have boomed — placing firearms in more and more homes.
A recent Johns Hopkins University analysis used preliminary 2022 data to calculate that the nation’s overall gun suicide rate rose last year to an all-time high. For the first time, the gun suicide rate among Black teens surpassed the rate among white teens, the researchers found.
“I don’t know if you can talk about suicide without talking about firearms,” Harkavy-Friedman said.
U.S. suicides steadily rose from the early 2000s until 2018, when the national rate hit its highest level since 1941. That year saw about 48,300 suicide deaths — or 14.2 for every 100,000 Americans.
The rate fell slightly in 2019. It dropped again in 2020, during the first year of the COVID-19 pandemic. Some experts tied that to a phenomenon seen in the early stages of wars and natural disasters, when people pull together and support each other.
But in 2021, suicides rose 4%. Last year, according to the new data, the number jumped by more than 1,000, to 49,449 — about a 3% increase vs. the year before. The provisional data comes from U.S. death certificates and is considered almost complete, but it may change slightly as death information is reviewed in the months ahead.
The largest increases were seen in older adults. Deaths rose nearly 7% in people ages 45 to 64, and more than 8% in people 65 and older. White men, in particular, have very high rates, the CDC said.
Many middle-aged and elderly people experience problems like losing a job or losing a spouse, and it’s important to reduce stigma and other obstacles to them getting assistance, said Dr. Debra Houry, the CDC’s chief medical officer.
Suicides in adults ages 25 to 44 grew about 1%. The new data indicates that suicide became the second leading cause of death in that age group in 2022, up from No. 4 in 2021.
The CDC is expanding a suicide program to fund more prevention work in different communities. And there’s growing awareness of the issue and that it’s OK to ask for help, health officials say.
There was a more than 8% drop in suicides in people ages 10 to 24 in 2022. That may be due to increased attention to youth mental health issues and a push for schools and others to focus on the problem, CDC officials said.
But even the smaller number masks tragedy for families.
Christina Wilbur lost her 21-year-old son, Cale, on June 16 last year. He died in her home in Land O’ Lakes, Florida.
Cale Wilbur had lost two friends and an uncle to suicide and had been dealing with depression. On that horrible morning, he and his mother were having an argument. She had confronted him about his drug use, his mother said. She left his bedroom and when she returned he had a gun.
“I was begging him not too, and to calm down,” she said. “It looked like he relaxed for a second, but then he killed himself.”
She describes her life since as black hole of emptiness and sorrow, and had found it hard to talk to friends or even family about Cale.
“There’s just this huge 6-foot-2 hole, everywhere,” she said. “Everything reminds me of what’s missing.”
It’s hard to find professionals to help, and those that are around can be expensive, she said. She turned to support groups, including an organization called Alliance of Hope for Suicide Loss Survivors that operates a 24/7 online forum.
“There’s nothing like being with people who get it,” she said. | Mental Health Treatments |
By Alexandria Edwards, as told to Keri Wiginton
I have severe, refractory MG. Iâm 25 now. But my symptoms started when I was 15. I was at school, and my speech started to slur. My legs collapsed. I felt really weak. They thought maybe I had a stroke. One doctor guessed it might be migraines.
I actually had myasthenia gravis. But I didnât learn about my condition, or get the right treatment, until several years later.
How Was I Diagnosed With Myasthenia Gravis (MG)?
My MG symptoms came and went all through my late teens and early 20s. I dealt with episodes of slurred speech, droopy eyes, double vision, and muscle weakness. I would drop things randomly or fall down. I thought I was just clumsy.
Things got a lot worse when I was 22. I started to have trouble chewing, swallowing, and breathing. One time my voice completely disappeared. I went to the emergency room, but no one knew what was going on. They told me to follow up with my regular doctor.
My primary care physician (PCP) suspected MG, but my antibody tests came up negative at the time. I left without clear answers.
A month later, I ended up back in the hospital.
It was the day after Thanksgiving. I went to the bathroom and got stuck on the toilet. My legs wouldnât work. I struggled to breathe. My head dropped, and the slurred speech came back. I had full body weakness.
My family rushed me to the ER. We learned I was in a myasthenia gravis exacerbation. I started taking a low dose of a drug that helps nerves communicate with muscles. They also put me on a steroid that suppresses my immune system.
I thought everything would be fine after that. But no one explained how I needed to change my daily life to live with MG. Over the next year, there were more trips to the ER. I even went into respiratory failure and had my first MG crisis.
But eventually, I found good neuromuscular specialists whoâve helped me form a long-term plan.
What Do My Mornings Look Like?
I wake up at 8 a.m. and take my first dose of medication. I canât get out of bed and function without it. I lay in bed for about an hour while I wait for it to kick in. Then Iâll get up and make myself coffee and breakfast. I love french fries and eggs Benedict with a side of hash browns.Â
Iâll take the rest of my pills when I eat. They include another drug that suppresses my immune system.Â
After breakfast, Iâll get dressed. That can be tiring. Iâll need to rest after. When I feel up to it, Iâll watch my 5-month-old niece so my mom can make her breakfast. My niece weighs 15 pounds, so I canât hold her for very long. But I play with her the best I can.
I like to take a walk outside sometime in the morning, maybe to the mailbox. But only if itâs cool enough. My symptoms flare in the heat.
Then Iâll take some time to go on Facebook and check MG community groups. I like to offer helpful advice when I can. For example, people may have problems getting diagnosed or trouble with their IVIg treatment. Thatâs an infusion I get through a vein in my arm. It affects how my antibodies work.
What Is My Afternoon Schedule?
I take my medication every 3 1/2 hours, which means itâs time for the second dose around 11:30 a.m. Then I eat lunch. Iâll make it myself if Iâm not too tired. If Iâm not up for it, my mom will help. My energy depends on where Iâm at in my IVIg cycle.
On a good day, I can eat pretty much whatever I want. But that doesnât include really crunchy things. And big burgers or tough steaks arenât a part of my meal plan.
But sometimes I canât swallow very well. On those days Iâll make soup or something soft. Or Iâll cut everything up into really small pieces.
If I canât swallow at all -- that happens about once a day -- Iâll get all of my nutrition and meds through a feeding tube. I had one surgically put in through my stomach. I need it because even with treatment, the swallow issue has never fully resolved.
I might go shopping in the afternoon. If I do, Iâll bring my walker. I can walk short distances without a break, like to the mailbox, but I canât stroll around a grocery store for a long time without some help.
And if I have to go to something like an all-day graduation ceremony, Iâll take my wheelchair.
Where Do I Spend My Time?
Iâm at home a lot, but thereâs plenty for me to do. Iâm very close with my family. We do a lot of different things together. We watch TV, play board games, or play video games.
Plus, I help care for my niece; babies take up a lot of time.
My days arenât spent at a job. But I did go to cosmetology school before my symptoms got really bad. Iâm big into skin care and self-care. I like to experiment with hair and face treatments. I do that for my mom, too. Thatâs my love language and one way I show her appreciation.
What Tips and Tools Are Helpful for Living With MG?
I modify a lot of my daily tasks. But Iâm good at adapting.
Take cooking, for example. Itâs fun, and I use it as a creative outlet. But it helps to make meals in stages. Iâll do the prep and put everything in the fridge. The actual cooking comes later, and Iâll lean on my walker or rest in a chair by the stove.
Then thereâs bathing. I think most people jump in the shower and think nothing of it. But itâs not that simple for me. It takes a lot of energy to get clean.
But I find showers really relaxing, especially if Iâm feeling stressed or down. My shower chair has made all the difference. Before, I had to sit in the tub and ask for help when I needed to get out.
If you have MG, donât be afraid to get tools thatâll help you get through your day.
These things arenât a sign youâre giving up. Youâre just taking control of your life to make things a little easier.
Every Day Is Different
I have a flare-up quite often. While every part of my treatment plays a role in keeping me well, medication hasnât cured my disease.
I may always need to bookend activities with breaks. But itâs a good day whenever I can move around and get things done. On a bad day, Iâm completely bedbound. Serious flares like that usually donât get better until I get my infusions. Iâm very lucky to get those at home about every 2 weeks.
MG is a serious illness. But donât assume we canât take part in fun things. Invite us out. We may feel well enough to go. I know I appreciate the choice of whether to say yes or no. Sometimes I may surprise you.
Show Sources
Photo Credit: courtneyk / Getty Images
SOURCES:
Alexandria Edwards, myasthenia gravis advocate.
Myasthenia Gravis Foundation of America: âIntravenous Immunoglobin (IVIg).â | Disease Research |
Change in clinical practice would have clear benefits for patients undergoing major bowel surgery, according to analysis conducted by researchers from UCL and the Royal Devon and Exeter Hospital.
The study, published in The British Journal of Surgery, provides evidence that giving iron intravenously before colorectal surgery improves outcomes for patients, reducing the need for blood transfusion by 33%.
Anaemia is a common problem in patients undergoing bowel surgery due to bleeding from the gut and blood loss during the operation. Anaemia is also associated with feeling tired and unwell, a slower recovery and other complications after surgery.
Blood transfusion is used when blood levels are low, but there has been concern that colorectal cancer patients may have higher rates of complications and cancer recurrence if they’ve had a blood transfusion. Iron is commonly used to treat anaemia, with a full course of treatment being administered intravenously in 15-30 minutes. To date intravenous iron infusion has been used sparingly, with a question remaining whether treating patients before major surgery would reduce the need for blood transfusion.
In this study, a meta-analysis of five randomised controlled trials was conducted by researchers from UCL, focusing on a subset of patients from those trials who had undergone bowel surgery. In these trials, patients were split into two groups, a control group and a group who received iron intravenously prior to surgery.
The analysis showed that patients who had received iron infusion were 33% less likely to require a blood transfusion during or after surgery.
Professor Toby Richards, senior author of the study from UCL Division of Surgery & Interventional Sciences, said: “This is the first time that clinical trials have shown a patient benefit from treatment with an iron infusion before surgery, which has the potential to treat anaemia and reduce the need for blood transfusion. Previous studies had not shown this benefit for all patients undergoing surgery in the NHS, but this analysis identifies a subset of patients undergoing bowel surgery who will see a benefit.”
Professor Neil Smart, colorectal surgeon from the Royal Devon and Exeter Hospital and co-lead of the study, said: "With over 20,000 major colorectal cancer resections per year in the UK, the findings of this study have the potential to improve outcomes for the second most common cause of cancer mortality. In the past, surgeons were uncertain whether the benefits of iron infusion could be realised in the short time frames of cancer care and consequently the uptake of this treatment was limited. Our findings show that improved outcomes can be achieved if iron infusion is given in the period between cancer diagnosis and surgery."
As well as reducing the risk for patients, fewer blood transfusions would be good news at a time when there are blood supply shortages in the UK.
Sue Pavord, Vice President of British Society for Haematology, said: “The recent shortage of blood supply in the UK means it is more important than ever to focus on ways to avoid blood transfusions and their associated risks. This analysis shows a reduction of over one-third in blood transfusions when anaemic patients are treated with intravenous iron before their colorectal surgery. If we could combine this insight with others from the previous PREVENTT study, then hospital readmissions could potentially be cut even more, which would be important for both patients and the NHS.”
Notes to Editors:
For more information, please contact:
Dr Matt Midgley
+44 (0)20 7679 9064
Publication:
Hans Lederhuber et al. ‘Preoperative intravenous iron and the risk of blood transfusion in colorectal cancer surgery: a meta-analysis of randomised controlled trials’ will be published in The British Journal of Surgery and is strictly embargoed until 23 November 2023 at 00:01 GMT / 22 November 2023 19:01 ET.
About UCL – London’s Global University
UCL is a diverse global community of world-class academics, students, industry links, external partners, and alumni. Our powerful collective of individuals and institutions work together to explore new possibilities.
Since 1826, we have championed independent thought by attracting and nurturing the world's best minds. Our community of more than 50,000 students from 150 countries and over 16,000 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.
The Times and Sunday Times University of the Year 2024, we are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.
We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.
For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.
We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.
Journal
BJS (British Journal of Surgery)
Method of Research
Meta-analysis
Subject of Research
People
Article Title
Preoperative intravenous iron and the risk of blood transfusion in colorectal cancer surgery: a meta-analysis of randomised controlled trials’
Article Publication Date
23-Nov-2023 | Medical Innovations |
Bangkok — A Japanese tourist reaches into a baggie of cannabis he's just bought in a central Bangkok weed shop, pulling out a gram of buds to chop down in a small black grinder, before rolling them neatly into a joint.
Only the slight spillage onto the smoking lounge's table — and his cough as he lights up and inhales deeply — betray the fact that until two weeks ago, he'd never tried marijuana.
Most Asian nations have strict drug laws with harsh penalties, andlast year has brought a wave of tourists from the region like the visitor from Japan, intrigued by the lure of the forbidden leaf.
"I was curious about how I would feel after smoking," said the 42-year-old tourist who spoke on condition that his name not be used, for fear his experimentation in Bangkok could lead to legal issues at home.
"I wonder why Japan bans it?" he pondered. "I wanted to try it."
Even as more countries around the world legalize marijuana, Thailand has been the outlier in Asia, where several countries still have the death penalty for some cannabis offenses. Singapore has already executed two people this year for trafficking marijuana and its Central Narcotics Bureau has announced plans to randomly test people returning from Thailand.
Japan does not have the death penalty for drug offenses, but has warned that its laws on cannabis use may apply to its nationals even when they are abroad.
China's embassy in Thailand has warned that if Chinese tourists consume marijuana abroad and are "detected upon returning to China, it is considered equivalent to using drugs domestically. As a result, you will be subject to corresponding legal penalties." It issues similar warnings for travel to other countries where marijuana is readily available, such as the United States, Canada and the Netherlands.
On a recent flight from the Chinese city of Shanghai, passengers were cautioned not to "accidentally" try marijuana in Bangkok, with an announcement that in Thailand "some food and drink can include cannabis, so please pay attention to the leaf logo on the package of food."
Neither Chinese nor Singaporean authorities would detail how frequently they test citizens returning from countries where marijuana has been decriminalized, responding to queries from the AP simply by reiterating their previously announced policies.
It's no wonder that weed dispensaries in Bangkok say that customers from Singapore and China are among the most cautious, asking questions about how long traces of the drug remain in the system and whether there are detox products.
But many remain undeterred, and Thailand's cannabis industry has grown at lightning speed, with weed dispensaries now almost as common as the ubiquitous convenience stores in some parts of the capital. Through February, nearly 6,000 licenses for cannabis-related businesses have been approved, including more than 1,600 in Bangkok alone, according to official figures.
There are no government figures on how many tourists come specifically to smoke marijuana, but Kueakarun Thongwilai, the manager of a weed shop in central Bangkok, estimates at least 70%-80% of his customers are foreigners, primarily from Asian countries like Japan, Malaysia, China and Philippines, and some from Europe.
Most cannabis shops, including his, now only hire employees who speak English, the lingua franca of the industry.
"You don't need to speak perfect English, but you need to communicate with foreigners," Thongwilai said.
About half of his customers are first-time weed users and most of them are Asians, he said.
Some want to try edible cannabis products, but Thongwilai said he tries to steer them toward smoking.
"Edibles take more time to take effect, and during that time people may eat more and more, leading to an excessive experience for beginners," he said.
Not all are new to the drug, said Thongwilai, remembering a Malaysian customer who snuck away from a meal with his wife and daughter at a nearby restaurant. The man said he smoked marijuana secretly at home, but had heard the Thai product was better quality and wanted to try it.
"He bought the cheapest weed in our shop and tried it in a mall, and then he came back and bought more," Thongwilai recalled.
Not far from Thongwilai's shop at Dutch Passion, a newly opened retail branch of a Netherlands seed distributor that has been in business for more than three decades, about half the customers are also first-time users, said Theo Geene, a Dutch shareholder in the business.
Cannabis has been available in coffee shops in the Netherlands since the 1970s, and Geene said he has used his experience to train his staff how to serve those unfamiliar with the drug.
"For beginners, it's not good to use a bong," he said. "It's too much for them. We don't want anyone to pass out here."
Most customers refused to talk about their experiences, with the Japanese tourist in Geene's shop the only one who agreed to — and only on the condition his name not be used.
Most of the shop's Asian customers are similarly discreet, choosing to smoke their purchases inside rather than on the streets like many Westerners do, which is common but a violation of Thai regulations, Geene said.
"They are more cautious and afraid," he said. "They don't want to be seen when they smoke weed."
Before he embarked on his trip to Thailand, the 42-year-old Japanese tourist said he researched extensively online and determined that while customs might randomly check bags and luggage for marijuana being smuggled into Japan, there was no testing going on in line with government policy.
Since his first puff two weeks ago, he said he's been smoking every day, visiting different shops, comparing prices and trying different strains.
Dispensary staffers taught him how to grind buds and roll a joint and he's been having fun perfecting the technique.
"I practice it every day," he said, looking down at the joint he was rolling and repeating the word "practice" twice before bursting into laughter.
for more features. | Global Health |
International travelers can now contribute valuable data to COVID-19 surveillance efforts in the United States from above the clouds.
San Francisco International Airport has launched a new program to test airplane wastewater for variants of SARS-CoV-2, the virus responsible for COVID-19, the airport announced May 9. The program is the first in the country to continuously monitor sewage from airplanes, after previous studies demonstrated the potential value of this work.
Airplane wastewater is a key source for COVID-19 surveillance because international travelers frequently bring new variants into the country, experts say. As fewer people get their noses swabbed in health care facilities, the U.S. Centers for Disease Control and Prevention is looking for new ways to keep tabs on how the coronavirus mutates. Searching for genetic material in airplane bathroom waste can help fill that data gap — and even provide early warnings for future health crises (SN: 5/28/20).
“We know variants have been imported from around the globe,” says Alexandria Boehm, an environmental engineer at Stanford University who leads WastewaterSCAN, one of the biggest wastewater surveillance programs in the United States. Testing airplane waste “can give us a sense of which variants are being imported and help us prepare.”
For the new project, the San Francisco airport is collaborating with the CDC and Concentric by Ginkgo, a biosecurity and public health team in Boston.
Testing started on April 20, according to a spokesperson for the airport. Airport workers are taking samples from vacuum trucks that suck waste out of airplane bathrooms, using an automatic machine that plugs into a central dumping point. “We’re basically creating a composite sample of the trucks, which themselves are a composite sample of aircraft,” says Andrew Franklin, director of business development at Concentric.
The San Francisco airport has one dumping point dedicated to international flights, which are a priority for testing because passengers are more likely to use the restroom — and deliver solid samples — when they spend many hours on the plane. The airport is shipping one composite sample per day, six days a week, back to a lab, where scientists isolate the coronavirus’ genetic material and put the results through machines that map the virus’ genes.
The resulting data are complicated, says Casandra Philipson, director of bioinformatics at Concentric, as each sample includes hundreds of passengers from around the world. “Trying to figure out how to determine actual frequencies of mutations or variants” in the sewage samples will be a challenge, she says, though simply seeing certain variants pop up in the data will warn health officials about what to watch out for.
Concentric has worked with the CDC on monitoring COVID-19 among international travelers since fall 2021, when the company started offering free PCR tests to people returning from long flights. About 170,000 travelers have contributed to the program, which has picked up new variants before they spread widely in the United States.
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But wastewater surveillance is more efficient than voluntary nose swabs, leading scientists to focus on this approach for future monitoring efforts (SN: 9/29/22). In August and September 2022, Concentric and CDC researchers ran a pilot program at John F. Kennedy International Airport in New York City to test the idea. Out of 88 samples collected from airplane bathrooms, the team was able to perform PCR tests on 80, and 65 of those tested positive for SARS-CoV-2, the scientists reported in the Feb. 24 Morbidity and Mortality Weekly Report. Analysis of genetic material from 25 samples turned up a variety of coronavirus variants.
Other research projects and pilot programs have similarly demonstrated this technique’s potential for detecting variants. The European Commission has issued guidance for airports in the European Union that may want to try it out. As with other forms of wastewater surveillance, though, scientists are still working to understand how they might interpret and act on the data. “It will be a new data stream that we’ll have to learn to use as it evolves,” Boehm says.
In addition to tracking coronavirus variants, scientists hope that future programs like the one at the San Francisco airport can lay the groundwork for monitoring new diseases that might enter the United States through international airports. “It’s easy to also test the samples for other emerging pathogens,” says Colleen Naughton, an environmental engineer at the University of California, Merced.
The Concentric team is excited about this potential and looking for other types of health data that might come out of airplane waste. “We’re building this future technology,” Philipson says, “to expand the toolkit for pathogens of public health concern.” | Epidemics & Outbreaks |
The government has yet to deal with misinformation, according to Trade Secretary Kemi Badenoch, and struggled to stop some people from believing it during the pandemic.
The cabinet minister was giving evidence at the COVID inquiry today, having served as equalities minister during the pandemic, and spoke about the damage done by conspiracy theories.
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Ms Badenoch said: "Even as a constituency MP, the number of people who come up to me in the street and tell me that I am part of a grand conspiracy to infect them, and 'so-and-so died' because of the material that we were putting out.
"I don't think government has got a handle on dealing with misinformation. I don't think that we have adapted to this age of social media, where information travels at lightning speed across the world.
"I don't know how we solved it, but in terms of gaps, I think there is a lesson in the pandemic that this is an area that needs some addressing."
She added that, if work is going on in government to tackle disinformation, she has not seen it.
Ms Badenoch was also asked extensively about how the government approached some groups suffering worse outcomes from the virus than others.
During her evidence, she highlighted that, while many affected people saw a report saying there was a disparity of outcomes due to COVID and judged it to be due to "prejudice, discrimination, racism", the government was finding something different.
She explained how the government concluded it was not that being from a certain ethnicity increased someone's vulnerability to the virus, but rather that someone being from a certain ethnicity increased the likelihood someone was likely to have another reason to be more vulnerable - for example, their job or their living situation.
The cabinet minister said there were fears in some communities that government vaccine plans, for example, were part of a "secret conspiracy" aimed at "culling the population".
Part of this was due to people coming from countries where the government could not necessarily be trusted, and this carried over to the UK, she said.
Read more:
Mass gatherings in March 2020 were 'logically incoherent'
COVID laws were confusing and fines were disproportionate
Families accuse inquiry of 'doubling down' on racism decision
Ms Badenoch also explained how she felt the term BAME - which stands for black and minority ethnic - was unhelpful.
She said this was because it treats all groups - for example, black African, Pakistani and Bangladeshi communities - the same, which makes it harder to understand how the individual groups are being impacted.
She also said it comes from a point of starting with white people being the norm.
Ms Badenoch told of how COVID outcomes for black people got better between the first and second waves of the virus, but stayed the same or got worse for Pakistani and Bangladeshi people.
She said this was mainly down to multi-generational households, and there were also issues around compliance with measures like social distancing.
There was also an overlap with people from certain minority backgrounds being employed in jobs - like care, taxi drivers, or security - which were more at risk.
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Earlier in the day, Dame Angela McLean gave evidence to Lady Hallett's inquiry.
Dame Angela, who is currently the chief scientific adviser to the government, was the second most senior adviser during the pandemic.
The professor of mathematical biology described how September 2020 was the "worst" moment of the pandemic, as scientists were telling the government that action needed to be taken to stop growing infections.
But instead, nothing was done, and this itself increased the spread of COVID, with no one gripping the situation.
"We said - you should do something now. But nothing happened," she told the inquiry.
Dame Angela - who dubbed Rishi Sunak "Dr Death" in the pandemic over the Eat Out to Help Out scheme - said she would have advised against the policy if she were asked about it.
Eat Out to Help Out encouraged people back into bars and restaurants by subsidising meals. | Epidemics & Outbreaks |
Image source, Family photos Image caption, Gareth Roberts and Dominga David both died in the opening months of the Covid-19 pandemicTwo nurses who died with Covid probably became infected at work, an inquest has concluded.Gareth Morgan Roberts fell ill days after the first lockdown began in March 2020 and died on 11 April. Dominga David died on 26 May 2020 after being sent home ill from Penarth's Llandough Hospital on 31 March.Coroner Graeme Hughes said it was "more likely than not" both were exposed to the Covid-19 virus while at work and ruled they died of industrial disease."On the balance of probabilities, exposure more likely happened at work and infection happened as a result of that exposure," Mr Hughes told the inquest at Pontypridd Coroner's Court. The family of Mr Roberts had argued for a conclusion of death by industrial disease, while the health board had made the case for ruling both deaths were from natural causes.Image source, Family pictureImage caption, Gareth Roberts, pictured wife Linda, died with Covid on April 11 2020Mr Roberts retired in 2015 after working in the NHS for more than 40 years, but returned to work casual ward shifts. He told colleagues he did not want to work on a Covid ward at University Hospital of Wales in Cardiff because of his age and due to him living with diabetes. He also cared for his grandson and told a colleague Jodie Davies he could not risk it.He was working 12-hour shifts in Cardiff in the days leading up to March 25 when he fell ill - two days after the UK announced its first lockdown.Colleagues described Mr Roberts as "hard-working" and someone "who never let anyone down".His family said in a statement he was a "much-loved husband, father, and grandfather" and "one of the heroes of the pandemic"."Gareth touched so many lives, and when he died we received over 1,800 cards of condolence," they said.Ms David, originally from the Philippines, died on 26 May, almost two months after becoming infected with Covid. She had been working long shifts at the Llandough Hospital in Penarth, Vale of Glamorgan. Image source, Family photoImage caption, Dominga David came to the UK in 2004 to work as a nurseHer ward manager, Jane Linton, who gave evidence during the week-long hearing, described her as "a fantastic person and a brilliant nurse".Ms David, 63, had pre-diabetes but was in otherwise good health and died from complications such as an ischemic bowel, arising from Covid-19, the inquest found. Coroner Mr Hughes said: "It is more likely than not that she (Ms David) was exposed to the Covid-19 virus at work, was infected as a consequence, and died due to complications of acquiring the disease."The inquest was told when Mr Roberts and Ms David caught Covid, ward nurses in the Cardiff and Vale University Health Board only used PPE while directly treating patients.It also heard also shift handovers took place in small cubicles where people did not wear masks. At the time, patients were also not routinely swabbed for Covid.Helen Whyley, director of the Royal College of Nursing in Wales, said in a statement after the inquest: "We were very concerned about the lack of personal protective equipment (PPE) and guidance on its use, in healthcare settings in Wales during the Covid-19 pandemic."She said union members were concerned about the lack of PPE in a survey of May 2020. The coroner, Mr Hughes, concluded that Mr Roberts died from Covid-19 and that his type 2 diabetes had contributed to his death.He concluded Mr Roberts and Ms David, who lived in hospital accommodation, both died as a result of industrial disease. | Epidemics & Outbreaks |
Scared of spiders? You might want to look away now.
In a bizarre medical case, a woman in Taiwan got a nasty shock when doctors discovered a spider about 0.1 inch (0.25 centimeters) long crawling in her left ear canal. At first glance, it looks like there are two spiders scuttling around in there, but the second arachnid is actually just the spider's molted hard outer shell, or exoskeleton.
The 64-year-old woman had visited an ear, nose and throat clinic at the Tainan Municipal Hospital in Taiwan after spending four days hearing weird sounds in her left ear.
The day her symptoms started, she was woken up to a strange feeling that a creature was moving inside her ear. She then began to hear incessant beating, clicking and rustling sounds that were so bad, she struggled to sleep.
A woman with hypertension presented to the clinic with a 4-day history of abnormal sounds in her ear. On examination, a small spider was seen moving within the external auditory canal of the left ear. The molted exoskeleton of the spider was also present. https://t.co/dye2sbbiL9 pic.twitter.com/SfeNBBGQS8October 25, 2023
At the hospital, doctors discovered that a small spider with bulging, brown eyes was moving within the ear's external auditory canal, the passageway that links the outside of the ear to the eardrum. They also saw that the spider had molted its ghostly white exoskeleton — something that spiders normally do when they grow so that it can be replaced with a new one.
"She didn't feel pain because the spider was very small. It's just about 2 to 3 millimeters [0.07 to 0.12 inch]," Dr. Tengchin Wang, co-author of the report and director of the otolaryngology department at Tainan Municipal Hospital, told NBC News.
The case report, published Oct. 21 in The New England Journal of Medicine, didn't note the species of spider or how the critter might have gotten into the woman's ear. Although these instances are rare, there have been documented cases of spiders crawling into people's ears, and it happens with insects, too: Live insects account for about 14% to 18% of cases of the foreign objects that doctors find in the external auditory canal. This is likely because the area is warm and dark, so it provides a welcoming space for these critters.
Dr. David Kasle, an otolaryngologist at ENT Sinus and Allergy of South Florida who was not involved in the woman's case, told NBC News that the average ear, nose and throat specialist will see "tens, if not more, of bugs or some sort of arthropod" in ear canals throughout their career. However, he said this particular case was "unusual and disturbing."
Wang had seen insects — such as ants, moths and cockroaches — in people's ears before, but he'd never come across a spider that had shed its exoskeleton inside a person's ear canal, NBC News reported.
Wang and his team successfully removed the spider and its exoskeleton from the woman's ear by sucking it out with a thin tube, called a cannula, placed through an otoscope, a tool doctors use to look into the ear. The woman's symptoms vanished after the arachnid was removed. For bigger spiders or insects, a local anesthetic should be used to kill the critter before it's removed to "prevent excessive movements and subsequent damage to the structures of the ear," the case report authors wrote.
However, liquids should never be used if the eardrum has been pierced and has holes in it, the authors cautioned; this wasn't the case for women in Taiwan. Wang told NBC News that, to be on the safe side, anyone who experiences any of these symptoms should see a doctor even if they think the bug or spider has exited their ear, just in case an antenna or exoskeleton got left behind.
This article is for informational purposes only and is not meant to offer medical advice.
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Emily is a health news writer based in London, United Kingdom. She holds a bachelor's degree in biology from Durham University and a master's degree in clinical and therapeutic neuroscience from Oxford University. She has worked in science communication, medical writing and as a local news reporter while undertaking journalism training. In 2018, she was named one of MHP Communications' 30 journalists to watch under 30. ([email protected]) | Medical Innovations |
Mother, 40, dies in her sleep after going to bed with 'food poisoning' and is found by her distraught 17-year-old daughterKerry Gleeson, from Stockport, died suddenly just four days after ChristmasHer family waited four weeks to find out she died from a pulmonary embolism Published: 07:19 EST, 28 January 2023 | Updated: 07:19 EST, 28 January 2023 The family of a 40-year-old mother have been left 'absolutely devastated' after she went to bed with suspected food poisoning only to be found dead by her 17-year-old daughter an hour later having suffered a pulmonary embolism.Kelly Gleeson, from Stockport, Greater Manchester, went to bed at 6pm on December 29 after spending most of the day throwing up.But her 17-year-old daughter found the care worker unresponsive an hour later, Manchester Evening News reports.Paramedics were called after daughter Madison made the discovery while at home with her and her father, Jerry. Kelly Gleeson, 40, from Stockport, died on December 29 after believing she had food poisoning Paramedics were unable to resuscitate Ms Gleeson (right), who was at home at the time with her husband (left) and daughter MadisonTragically paramedics were unable to revive Ms Gleeson, and it was four weeks before they discovered her cause of death.A pulmonary embolism occurs when a blood clot gets stuck in an artery in the lung, blocking blood flow to part of the lung. It is often very sudden and can be life-threatening if not treated quickly.Her death came just five years after her brother Daniel died from cancer.Ms Gleeson's husband Jerry told Manchester Evening News he is 'absolutely devastated.'He added: 'To say I'm heartbroken is an understatement. 22 wonderful years we had together – well, when I wasn't annoying her. I was good at doing that. Kelly's husband Jerry (left) has been left 'absolutely devastated' by his wife's death What is a pulmonary embolism? A pulmonary embolism is the term for when a blood clot becomes trapped in the lungs, blocking an artery.Clots tend to begin in the leg before travelling up towards the lungs.It can be very serious and even life-threatening if treatment is not given quickly.Symptoms include chest or upper back pain, difficulty breathing, coughing up blood and vomiting.The NHS tells the public to call 999 or go to A&E if a person has severe difficulty breathing, their heart is beating very quickly or they have passed out.'I never stopped loving you and I will always love you. I promise I'll look after our baby girl. The dog is lost. She keeps sitting on the rug staring up at the door, waiting for you to come home.'Daughter Madison added: 'My mum was my best friend and we did everything together no matter what. She was the loudest in the room no matter where we were or who she was with.' Ms Gleeson's sister Jade Rothwell has set up a GoFundMe page to raise funds for her funeral, saying she wants to 'give my sister the best send-off she deserves'.She described her as the 'most loving, most beautiful, caring person', describing how she 'screamed' when she heard the news of her sister's death.The mother-of-five rushed to her sister's house to find paramedics had been unable to resuscitate her, and says it has been 'lonely and quiet' without her. Friends of Ms Gleeson have shared their heartbreak over their loss, with one writing the day after her death: 'You really were the light in every room. You never failed to make everyone laugh. 'Always wished the best upon everyone, made me smile through some of my worst days without even knowing it. You impacted so many people just by being you. 'I hope you have found peace and I hope to god that you can feel the love that everybody is sharing today. Love you always.'On January 6 friends and family gathered in Stockport and released balloons in Ms Gleeson's memory. Advertisement | Disease Research |
Story at a glance
- Candida auris, or C. auris, has been detected in more than half of U.S. states.
- It is often resistant to anti-fungal drugs, making it hard to treat infections.
- While it usually isn’t a significant threat to healthy people, the CDC said, Candida auris outbreaks are a big threat in health care settings, where the fungus can enter patients’ bloodstreams and cause severe, deadly infections.
(NEXSTAR) – A fungus that poses “an urgent antimicrobial resistance threat,” according to the Centers for Disease Control and Prevention, has already been detected in more than half of U.S. states.
Candida auris, or C. auris, is so concerning because it is often resistant to anti-fungal drugs, making it hard to treat infections. It can also be hard to identify with standard lab tests, making it even more difficult to treat properly and early.
The fungus was first detected in the United States in 2016. The fungus “spread at an alarming rate” between 2020 and 2021 in health care facilities, the CDC wrote in a memo released Monday, and has continued to spread in 2022.
By the end of 2022, there were more than 8,000 instances of Candida auris identified across 28 states and Washington, D.C. The map below shows confirmed cases of the fungus, with states shaded in red having the most infections.
While it usually isn’t a significant threat to healthy people, the CDC said, Candida auris outbreaks are a big threat in health care settings, where the fungus can enter patients’ bloodstreams and cause severe, deadly infections.
Sick people, those staying in the hospital long-term, and patients with invasive medical devices (like catheters or IVs) are most vulnerable.
The strain put on the health care system by the COVID-19 pandemic may have allowed the fungus to spread more quickly.
“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” CDC epidemiologist Meghan Lyman said in a press release.
See the chart below for the number of clinical cases of Candida auris by state, according to CDC data:
While Iowa had zero clinical cases of Candida auris in 2022, it still had some “screening cases,” the CDC explained. That means the fungus was detected, but wasn’t known to be actively causing infection.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Epidemics & Outbreaks |
Trevi Therapeutics, Inc. (NASDAQ:TRVI) Q3 2023 Earnings Call Transcript November 12, 2023
Operator: Good afternoon and welcome to the Trevi Therapeutics Q3 2023 Earnings Conference Call. At this time all participants will be in a listen-only mode. [Operator Instructions] After today's presentation, there will be an opportunity to ask questions. [Operator Instructions] Please note this event is being recorded. Various remarks that management makes during this conference call about the company's future expectations, plans and prospects constitute forward-looking statements for purposes of the Safe Harbor provisions under the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the Risk Factors section of the company's most recent quarterly report on Form 10-Q, which the company filed with the SEC this afternoon.
In addition, any forward-looking statements represent the company's views only as of today and should not be relied upon as representing the company's views as of any subsequent date. While the company may elect to update these forward-looking statements at some point in the future, the company specifically disclaims any obligation to do so even if its views change. I would now like to turn the conference over to Jennifer Good, Trevi's President and CEO. Please go ahead.
Jennifer Good: Good afternoon, and thank you for joining our third quarter earnings call and business update. Joining me today on this call are my colleagues, Lisa Delfini, Trevi's Chief Financial Officer; and David Clark, Trevi's Chief Medical Officer. Lisa and I have some prepared remarks. Then we will open it up for questions. We have continued to advance our clinical development plans for Haduvio in both of our chronic cough indications, including idiopathic pulmonary fibrosis and refractory chronic cough as well as the human abuse potential study. Let me provide a brief update on each of these programs. I will begin with our Phase 2a refractory chronic cough study that was recently initiated. We have named this the RIVER study.
Refractory chronic cough, or RCC, affects up to 10% of the adult population and is defined as a persistent cough lasting greater than eight weeks despite treatment for an underlying condition or when no cough associated conditions can be identified. RCC is caused by cough reflex hypersensitivity in the central and peripheral nerves and has a significant impact on patients physically, psychologically and socially. 72% of high and moderate coughers report their cough being uncontrolled. There are currently no approved therapies for RCC in the US, EU or UK. The key point of differentiation for Haduvio in chronic cough is the mechanism of action, which works both centrally in the brain and peripherally in the lungs. We believe Haduvio's central and peripheral mechanism has the potential to work in more patients than peripheral-only mechanisms like the P2X3 and potentially provide a stronger response and cough reduction.
When we look at the competitive landscape in RCC, a number of other mechanisms have been studied with little success. Even the P2X3 inhibitors have mixed results, but there are two P2X3 therapies in late stages, one being reviewed by the FDA and the other in Phase 3 trials. However, importantly, both of these compounds have been shown to have non-statistically significant effects in RCC patients with moderate cost frequencies of 10 to 19 coughs per hour. We believe that based on the data from our IPF cough trial and the drug's mechanism of action that Haduvio may work in both the moderate and high cough frequencies. When you look at the RCC patient distribution, 44% of the patients are estimated to have moderate cough frequency, whereas only 29% have high cough frequency.
So there's a potential Haduvio may address close to 3/4 of the RCC market, whereas P2X3s may only be effective in less than 1/3 of the market. The RIVER trial is the standard Phase 2a crossover design that has been run in all the cough trials. It is a double-blind, randomized, placebo-controlled, two-period crossover study, evaluating the reduction of cough in approximately 60 subjects. These subjects will be randomized with a 1:1 stratification between those with 10 to 19 coughs per hour, moderate frequency coughers, and those with greater than or equal to 20 coughs per hour, high-frequency coughers. Each treatment period will last 21 days separated by a 21-day washout period. Subjects on Haduvio will have the twice-a-day dose titrated weekly from 27 milligrams up to 108 milligrams across the dosing period.
The primary efficacy endpoint is the relative change in the 24-hour cough frequency at day 21 from the treatment period baseline for Haduvio compared to placebo as measured by an objective cough monitor. This study will also explore secondary endpoints, including patient-reported outcome measures for cough and quality of life. We are excited to have initiated this study and expect to report top line data in the second half of next year. Next, a brief update on our lead program in idiopathic pulmonary fibrosis, or IPF, chronic cough. IPF is a serious end-of-life disease. Chronic cough is reported by approximately 85% of patients suffering from IPF and has similar physical, psychological and social impacts to that of RCC but may also be a risk factor that plays a role in the progression of IPF.
The constant lung injury, micro tears and potential inflammation caused by persistent coughing may lead to worse health outcomes for patients, such as increased respiratory hospitalizations, mortality or need for transplant. With no currently approved treatment options for chronic cough and IPF, patients and providers have an urgent need for new therapies. We are planning to conduct two studies in parallel during this next phase of development in our IPF chronic cough program. The first is a four-arm Phase 2b dose-ranging trial that will study three active doses of Haduvio and placebo. We are planning for a six-week trial in approximately 160 subjects. We plan to conduct this study in multiple countries and sites to be able to complete enrollment in a timely manner.
A scientist in a lab wearing a protective gear, working with a microscope on a biopharmaceutical drug.
We are on schedule with our regulatory interactions and have received approvals to proceed in some of our planned countries. We expect this trial to be initiated in the fourth quarter of 2023 and will provide top line guidance when we announce the trial. In parallel, we are planning for a Phase 1b respiratory physiology study in IPF patients that have varying levels of disease severity. The purpose of this study is to determine if we see clinically significant impacts on respiratory depression in any subgroups. This study will help define the patient population for our pivotal program and ultimately the label. We expect to initiate this study in the first quarter of 2024. Finally, we're able to make progress on reinitiating the human abuse potential study, which is required for the NDA filing.
Recall that we had two hurdles we had to clear. The first was getting FDA's agreement with the proposed IV butorphanol dose we plan to dose in the likability portion of the study. We received that agreement from the FDA during the quarter. Second, we were working to secure supply of IV butorphanol from the single source supplier in the US, which we were also able to do. The final portion of the HAP study is a randomized, double-blind, active and placebo-controlled five-way crossover design to determine the abuse potential of three doses of oral nalbuphine relative to the selected dose of butorphanol and placebo. The primary objective is to evaluate the likability of nalbuphine as compared to both placebo and butorphanol, and the primary endpoint is a drug-liking VAS scale.
We expect to begin dosing this study in the first quarter of 2024 with data expected in the second half of 2024. As you can see, it is a busy time clinically for the company bringing up these four studies. And we look forward to conducting and reporting results on all of these trials. I will now turn it over to Lisa to review our financial results. Then we will open it up for any questions you may have.
Lisa Delfini: Thank you, Jennifer, and good afternoon, everyone. The full financial results for the three months ended September 30th, 2023, can be found in our press release issued ahead of this call and our 10-Q, which was filed with the SEC today after the market closed. For the third quarter of 2023, we reported a net loss of $7.7 million compared to a net loss of $8.3 million for the same quarter in 2022. R&D expenses were $6.3 million during the third quarter of 2023 compared to $5.8 million in the same quarter in 2022. The increase was primarily due to start-up costs and consultant services associated with our chronic cough programs as well as an increase in personnel-related expenses. These increases were partially offset by a decline in clinical development expenses related to our completed Phase 2b/3 PRISM and Phase 2 CANAL trials as well as decreased purchases of clinical trial supplies.
G&A expenses were $2.7 million during the third quarter of 2023, essentially flat compared to $2.6 million in the same period of 2022. Offsetting these increases in expenses was an increase in other income net, which was $1.3 million in the third quarter of 2023 compared to $100,000 in the same period of 2022. This change was primarily due to an increase in interest income and reduced interest expense due to the payoff of the SVB term loan in May of 2023. As of September 30th, 2023, our cash, cash equivalents and marketable securities totaled $88.9 million compared to $120.5 million as of December 31st, 2022. We expect cash burn to ramp a bit over the next several quarters as we conduct the trial that Jennifer discussed today. Our cash runway guidance that we will have cash, cash equivalents and marketable securities into 2026 remains unchanged and we believe is enough to fund all the trials Jennifer just discussed and gives us good cash runway after the last readout.
This concludes our prepared remarks and I will now turn the call back over to the operator for Q&A.
To continue reading the Q&A session, please click here. | Drug Discoveries |
A baby girl who was born with a cleft lip and palate has captured the hearts of thousands after her cherubic portraits went viral.
Courtney and Gavin Gardner, from Texas, welcomed their nine-week-old daughter, Sutton, in mid-December and enlisted photographer Shannon Morton to take the newborn's first professional photos.
'We didn't do maternity or newborn photos with our son and really regretted not having that done,' Courtney, 35, told DailyMail.com. 'So when we got pregnant with Sutton, I knew from the very beginning that I didn't want to have that experience with this pregnancy.'
Morton shared an angelic photo of a sleeping Sutton curled up in a cream sash and a matching flower headband on her business's Facebook page after the shoot.
'So. Many. Smiley babies in the studio recently! This is sweet Sutton, the cutest little redhead!' she captioned the image.
The next day, she shared another sweet portrait of baby Sutton wearing a flower crown on her head while sleeping with her chin in her hands.
Courtney was initially apprehensive about how people would react to her daughter's photos, knowing how cruel strangers can be online, but they received nothing but love and support from commenters.
'They were all just really kind and thoughtful, sweet messages, just saying how beautiful she was,' the mom shared. 'Some people started posting about [how] they had relatives or friends who had cleft-affected children.'
Since Morton's first post was shared on January 26, it has received more than 728,000 likes and nearly 7,000 comments.
The Gardners, who also have a three-year-old son, Asher, were admittedly not expecting their daughter's portrait to go viral, but they were 'absolutely thrilled' by the positive reaction.
Courtney and Gavin told DailyMail.com they didn't know what to expect when Sutton was diagnosed with a right-sided unilateral cleft lip and palate at their 20-week ultrasound.
A cleft lip and cleft palate are openings or splits in the upper lip and the roof of the mouth that occur during pregnancy, according to the Centers for Disease Control and Prevention.
Courtney was worried about their daughter having other health issues and spent the night before their appointment praying her heart would be healthy. She recalled letting out a sigh of relief when they were told her heart screening looked normal.
'The last part that they did was the ultrasound of her face, and that's when the ultrasonographer basically said, "Oh, she does have a cleft lip,"' she explained. 'I remember being completely blindsided and shocked by that because it wasn't even on my radar of a possibility that could happen.'
Courtney had assumed that a cleft lip and palate were genetic, but the causes of the birth defects in most infants are unknown. About 1 in every 1,600 babies is born with a cleft lip and palate in the U.S. each year.
She was so caught off guard, she burst into tears as questions and concerns raced through her mind. The doctor wasn't able to give them many answers, and their fears about their unborn daughter's condition only increased.
'We didn't feel like it was handled that well,' Gavin, 30, said of his daughter's initial diagnosis. 'It was kind of like, "Okay, this is what it is."'
The Gardners were referred to specialists at Texas Children's Pavilion for Women in Houston, which is about an hour and a half away from their home.
'They were able to let us know how treatable it actually is, and how these kids can have amazing lives and are able to overcome this through their support,' she said.
Courtney started seeing an obstetrician at the hospital about 36 weeks into her pregnancy and joined the Cleft Mom Support group on Facebook, where she was able to interact with other parents who understood what she was going through.
'To be able to ask those moms those questions and just follow their children's journey was a thing that brought me so much comfort and encouragement,' she recalled.
After Sutton was born, she had to stay in the neonatal intensive care unit (NICU) for 18 days because her cleft palate made bottle feeding difficult.
Gavin said the comments they received on Facebook after their baby girl's photos went viral were a 'big encouragement' to them following their time in the NICU.
Sutton is scheduled for her first surgery to repair her lip in March, and she will have a second surgery to close her palate when she is closer to her first birthday.
'She's just strong-willed and a little bit stubborn,' Courtney said. 'But you can tell she's gonna be a really social baby. She just loves being held. She loves any type of attention. Whenever her brother's around, she loves it when he comes over and brings her stuff, and she starts to smile every time he comes near her.'
Gavin added that their baby girl also loves to listen to music, which they started playing for her in the NICU.
The Gardners are both grateful for the care Sutton has received at Texas Children's Hospital and the online community that has supported them since her diagnosis.
Their daughter's viral photo has inspired them to share her story on their Facebook page, My Cleft Cutie, in the hopes of offering comfort to others in similar situations.
The couple agreed that they want parents whose children are diagnosed with cleft lips or palates to know that 'it's all going to be OK.'
'Even though things are scary, and they may seem dark in that initial fresh period of diagnosis, it's actually a beautiful thing that is 100 percent able to be treated and managed,' Courtney said. 'These kids are just phenomenal, strong children that overcome so much at a young age.' | Medical Innovations |
A community group in the west Highlands claims some people could have to make 140-mile round trips to see a dentist after their local practice closes.
Skye and Lochalsh Dental Practice in Kyle of Lochalsh is shutting because the firm that runs it is up for sale.
The dentists who work there are either retiring, or leaving the area.
NHS Highland said patients would transfer to a practice on Skye, but Kyle Collaborate said some have been told they may need to go to Dingwall.
The community group claims the Ross-shire town, which is more than 67 miles away, had the nearest available dentists, if patients could not be seen on Skye.
NHS Highland said patients would automatically transfer to a practice in Portree, 34 miles from Kyle. It said some patients may choose registration or treatment from another practice.
Maggie Byrne, of Lochalsh Collaborate, said: "When the dental practice shuts down there will be over 4,000 people without a dentist.
"They've been advised by NHS Highland to go to Portree or Dingwall, which is not at all suitable.
"There are many people here who live very far away from both Portree and Dingwall, and who may not have their own transport."
NHS Highland said there would be an automatic transfer of registered dental patients to Portree Dental Care.
The health board said there was a public dental service clinic at Kyle Health Centre three-days-a-week, providing dental care for priority patient groups.
It added that it was trying to recruit a full-time public dental service dentist to work between Kyle and Dunvegan Health Centre on Skye.
A spokesman said: "Unfortunately the national shortage of NHS dentists has significantly reduced access to NHS dental services in many health board areas.
"Within NHS Highland many practices have been unable to recruit to vacancies for dentists and this issue has intensified since the beginning of the Covid-19 pandemic.
"This has resulted in many patients having access to only emergency care whilst their practice continues to make efforts to recruit replacement dentists." | Health Policy |
More than 150,000 adults and children with type 1 diabetes in England and Wales are to be offered an artificial pancreas on the NHS, which experts are hailing as a “gamechanger” that will “save lives and heartbreak”.
The groundbreaking device, also called a hybrid closed-loop system, uses a hi-tech algorithm to determine the amount of insulin that should be administered and reads blood sugar levels to keep them steady. A world-first trial on the NHS showed it was more effective at managing diabetes than current devices and required far less input from patients.
Final draft guidance from the National Institute for Health and Care Excellence (Nice) recommends that people in England and Wales should benefit from the wearable device if their diabetes is not adequately controlled by their current pump or glucose monitor. The decision to give the go-ahead for widespread use of the artificial pancreas was announced on Tuesday at Nice’s annual conference in Manchester by Dr Sam Roberts, its chief executive.
There are about 290,000 people living with type 1 diabetes in England and Wales. More than half of them will now become eligible because their diabetes is not controlled with their current device.
The artificial pancreas has been found to be better at keeping blood sugar levels within a healthy range, cutting the risk of people suffering complications from diabetes. It works via a continuous glucose monitor sensor attached to the body which transmits data to a body-worn insulin pump.
This pump then calculates how much insulin is needed and delivers the precise amount to the body. Hybrid closed-loop systems mean people do not need to rely on finger-prick blood tests or injecting insulin to control their blood sugar levels.
Living with type 1 diabetes can be relentless, health experts say, and requires intense management 24 hours a day. Hundreds of individual treatment decisions must be made around the clock as extreme blood glucose highs and lows can be fatal. By automating what is currently a manual process, the artificial pancreas could lift the relentless burden and risk of burnout.
Nice said it had agreed with NHS England that all children and young people, women who are pregnant or planning a pregnancy, and people who already have an insulin pump will be first to be offered a hybrid closed-loop system as part of a five-year rollout plan.
The technology will then be rolled out to those adults with an average HbA1c reading of 7.5% or more and those who suffer abnormally low blood sugar levels. Nice guidelines recommend people should aim for an HbA1c level of 6.5% or lower.
Prof Jonathan Benger, the chief medical officer at Nice, said: “With around 10% of the entire NHS budget being spent on diabetes, it is important for Nice to focus on what matters most by ensuring the best value for money technologies are available to healthcare professionals and patients.
“Using hybrid closed-loop systems will be a gamechanger for people with type 1 diabetes. By ensuring their blood glucose levels are within the recommended range, people are less likely to have complications such as disabling hypoglycaemia, strokes and heart attacks, which lead to costly NHS care.
“This technology will improve the health and wellbeing of patients, and save the NHS money in the long term.”
Nice said that, due to the need for extra staff alongside specialist training for patients and staff, it had accepted a request from NHS England for a rollout over five years.
Karen Addington, the chief executive of JDRF UK, a type 1 diabetes charity, hailed the announcement, saying it would transform the lives of children and adults. “Hybrid closed-loop defines a new era for medicine,” she said.
“It’s a beautiful algorithm, which will save lives and heartbreak, as well as in the long term saving NHS the cost of cardiovascular and retinal surgery, kidney dialysis and transplantation.”
She added: “Today’s announcement makes Great Britain the first country in the world to make hybrid closed-loop widely available, as England and Wales follow the lead of Scotland, who approved the use of HCL earlier in 2022.”
Colette Marshall, the chief executive of Diabetes UK, said the artificial pancreas had the potential “to transform the lives of many people with type 1 diabetes”, improving both health and quality of life.
Yasmin Hopkins, who took part in trials of the artificial pancreas, said: “From day one it was amazing. Before the closed-loop system, I would experience a lot of highs, which I’d then overcorrect, go low and eat a lot of sugar. All of that has been eradicated.
“This technology gives me the freedom to get on with my life and live without fear of what might happen in a few hours, days or years.” | Medical Innovations |
The NHS is set to undergo the "largest expansion in training and workforce" in its history, Rishi Sunak has said.
Speaking to the BBC, the prime minister said the plans would reduce "reliance on foreign-trained healthcare professionals".
It comes at a time of record-high waiting lists in the NHS and junior doctors set to stage a five-day strike next month.
The full plans are expected to be published next week.
Writing in the Sunday Times, he said the NHS Long Term Workforce plan would take place over 15 years.
He said it would involve technology like artificial intelligence and "innovations such as virtual wards".
The new package of measures could see apprentice-doctor roles brought in to fill NHS staffing gaps in England.
It would mean school leavers could enrol to become doctors without having to pay to go to university.
The plan also aims to expand the nurse apprenticeship scheme that already exists.
On the BBC's Sunday with Laura Kuenssberg show, he said the plans would "mean people can have confidence that the doctors and nurses and GPs that we all need will be there".
Mr Sunak said the "long-term workforce plan" would mean the NHS can recruit doctors, nurses and GPs "not just today but for years into the future to provide the care that we all need".
Pushed on the length of time it would take to see the results of the changes, he accepted it could take "five, ten, fifteen years for these things to come through", but that did not mean it was not the right thing to do.
Reducing waiting times in the NHS is one of the five pledges announced at the start of the year by the prime minister.
In the first half of this year, the number of patients waiting for consultant-led elective care in England grew to 7.4 million, up from 7.2 million in January.
In March 2020, at the start of the pandemic, there were about 4.4 million people in the UK on an NHS waiting list.
Mr Sunak was pushed by the BBC on failing to secure a pay deal which would avert the strike action by junior doctors.
The action by the BMA union is the longest yet, and is being held between 13 and 18 in protest over pay. It has rejected at 5% pay rise, which it describes as not "credible".
He said had he had reached agreements with "over half a dozen NHS unions" and was required "to make difficult decisions as prime minister".
"When it comes to public sector pay, I'm going to do what I think is affordable, what I think is responsible," he said. | Health Policy |
Long Covid patients are twice as likely to experience life-threatening heart problems, a major study has found.
The condition, which refers to Covid symptoms that persist long after the initial illness has cleared, affects about two million people in the UK, often leaving them suffering breathlessness, fatigue and muscle aches.
There are about 600,000 people in the UK who have had long Covid symptoms for more than two years, according to Government figures.
Last year, The Mail on Sunday was the first British newspaper to report suspicions that the symptoms may be due to hidden blood clots in heart arteries.
Now, a study due to be presented at the prestigious American College of Cardiology, which reviewed the health records of 5.8 million people, has shown a clear link between the two conditions.
The research found that patients with long Covid were significantly more likely to experience chest pain and palpitations than those who did not have the condition. They were also more likely to show signs of heart disease in scans and diagnostic tests.
Researchers involved in the study are now calling on doctors to check for heart problems in everyone with long Covid.
'Clinicians should be aware that cardiac complications [of long Covid] can exist and should investigate further if a patient complains of these symptoms, even a long time after contracting the virus,' said Joanna Lee, a medical student at David Tvildiani Medical University in Tbilisi, Georgia, who led the study.
She added: 'For patients, if you had Covid-19 and you continue to have difficulty breathing or any kind of new heart problems, you should go to the doctor and get it checked out.'
While millions of people have been living with long Covid since the start of the pandemic, the exact cause of the condition is still unknown. This also means that there is no cure.
Experts have proposed a number of possible explanations, including the idea that the virus continues to live on in the body long after the initial infection.
However, when we investigated the worrying reports of long Covid patients suffering heart problems, several doctors argued the virus was causing inflammation and clots within blood vessels, making it harder for oxygen to reach the heart.
In particular, cardiologists pointed to a heart condition called microvascular angina as a possible cause of long Covid symptoms. The disease, which is notoriously difficult to diagnose, occurs when the smallest vessels supplying the heart become blocked. The most common symptoms are shortness of breath, fatigue and chest pain.
Researchers involved in the new study, which was carried out by a group called the Global Remote Research Scholars Program, also pointed to the inflammation triggered by the Covid virus as a cause of the heart problems. The study notes that diagnostic tests show that long Covid sufferers have persistently high levels of inflammation in the body.
Researchers analysed data from across 11 studies that included data on cardiovascular outcomes among people with long Covid, as well as a control group of people who had never had the virus. Only heart conditions that occurred following infection were counted, in order not to count long Covid patients who were already suffering from a heart problem.
Of the more than 5.8 million participants included across the studies, almost 450,000 experienced new cardiac complications. Among those with long Covid, the rate of heart problems was more than double that of those without.
Some experts argue that it is likely that many of these people would have gone on to develop a heart condition later in life, but that Covid hastened the onset of symptoms.
'Viruses always have an inflammatory effect on the human body, but Covid appears to have some direct impact on the heart,' said Dr Malcolm Finlay, a consultant cardiologist at Barts Heart Centre in London.
'It's possible that many of these people would have developed a heart problem in five years' time, but after getting Covid that issue came in just two years due to the extra stress.
'It's important that we continue to follow these heart problems in the coming years, to see what the long-term effect of long Covid is.'
The good news is that microvascular angina can be treated with medication, helping to alleviate symptoms. Other forms of heart disease can be treated too, experts add. | Disease Research |
Key points
- When a parent is overwhelmed by information, they feel more confused than knowledgeable.
- Parents who experience information overload feel like less effective parents.
- Parents who are less confident are more likely to need to search for more and more information online.
A new study published in August 2023 looked at “information overload” in parents (translation: when a parent feels overwhelmed and stressed by the amount of information available, resulting in feeling more confused than knowledgeable). When a parent experiences information overload, they may have more difficulty making informed decisions. Information overload can happen when there is too much information, when the information is too complex, or when it is contradictory.
This study included 214 parents of children under four years old in Sweden and examined how parents’ online search habits were related to their self-efficacy and experience of information overload.
The Main Findings
This study found that parents with lower levels of parenting self-efficacy (aka lower parenting confidence) showed increasing rates of searching for parenting information online over time. However, the relationship didn’t go the other way—more searching online wasn’t related to increased self-efficacy in a parent.
Translation: parents who are less confident are more likely to feel like they need to search for more and more information online but this online research doesn’t lead to parents feeling more confident. The authors state that “parents might need help to digest, understand, and apply the information gathered online for it to strengthen their [parenting self-efficacy].”
Experiencing information overload also predicted lower parental self-efficacy and significantly increased online searching a year later. Translation: parents who experienced information overload felt like less effective parents and were still looking for the answers they needed a year later. The researchers suggested that “parents who lack the tools to deal with online information might feel overwhelmed by it, and the confusion and stress it generates may lower their feelings of self-efficacy.”
Does the Quality of the Website Matter?
The study also asked parents about what types of websites they visited for parenting information and compared parents who used only reputable government-run websites to those who also used non-governmental websites for information (which may be more likely to be inaccurate or provide conflicting information). This study was conducted in Sweden, which has many helpful government-run websites. Parents who used both governmental and non-governmental websites reported higher levels of information overload than those who only used governmental websites. In addition, in parents who used only government websites, information overload did not predict lower levels of self-efficacy.
Translation: parents who use more reputable and accurate websites may be less likely to experience information overload from online searching which helps to preserve their parenting confidence.
Researchers suggested that parents who access a wide variety of sources may not only be exposed to more information, but also to more conflicting information. This may make them feel less confident about what the ”right” parenting approaches might be. Additionally, if parents are getting more information from unreliable sources, they might try ineffective parenting strategies, which could fail and harm their confidence in their own parenting skills. This might create a negative cycle in which conflicting or confusing information online makes parents feel less effective which then leads to more online searching, which only increases the experience of information overload which further harms their parenting confidence.
The researchers also suggest that nongovernmental websites may be less practical and more likely to promote “intensive parenting” which “can be stressful for parents because it places high demands on being a ‘perfect’ parent, without offering clear advice that can be helpful.”
Limitations
This was a small study based on an online survey—it included mostly highly educated mothers so may not represent the average parent. Because data came from an online survey, it may have been more likely to include parents who search online more frequently. The researchers also did not look at the child’s behavior problems—a more challenging child could lead to both more online searching and feeling less effective as a parent. All data was also based on self-report which is likely biased. For example, most people over-report time spent online. The data was also collected during the pandemic—when more parents were likely to be overwhelmed and searching for information online due to a lack of social support.
Another limitation of this study is that it did not distinguish between reliable and unreliable nongovernmental websites. It’s likely that some of the parents using both government and non-governmental websites were still only getting information from reputable sources, which would affect their group’s outcome. Parents who use websites that are not based on reliable sources and professional knowledge may show even higher rates of information overload and lower parental self-efficacy than this study suggests.
This study was conducted in Sweden, which has a popular government-run website providing accessible health and parenting information. In countries without such government-provided websites, other reputable sources that are fact-checked and run by experts serve a similar role to the governmental websites in this study.
How to Find Reputable Information
So how do you find reputable information online without getting overwhelmed?
- Focus on reliable, evidence-based sources. Look for websites with information written or reviewed by licensed and/or credentialed medical and mental health professionals. Ideally, the website should cite research from peer-reviewed journals to back up the information provided.
- Limit how many sources you use. Focus on a few websites, apps, or books that you trust to provide you with high-quality information and search for answers from them, rather than doing a Google search and sifting through millions of results.
- Avoid undirected browsing. Try to focus your searches on specific information or advice you need, and limit the amount of time you spend browsing to avoid spending hours looking at content that might leave you more confused or stressed.
- Remember that you are the expert on your child. Even the most reliable and accurate websites do not know your child or your unique family situation. Trust yourself to make the decisions that are right for your child and your family. | Stress and Wellness |
International Yoga Day: 8 Benefits Of Yoga As Shared By Ministry of Youth Affairs and Sports
India gears up to celebrate the 9th International Yoga Day with a theme of a healthier and happier. society
On June 9, the Department of Youth Affairs shared an informative message on the upcoming International Yoga Day on June 21.
The post highlighted several benefits of yoga such as boosted energy, improved physical and mental health, and body postures. The post aimed to encourage individuals to start their yoga journey.
What Are The Benefits Of Yoga?
Here are the 8 incredible benefits of Yoga as stated by the Ministry of Youth Affairs and Sports
Improved flexibility and range of motion
Increased strength muscle tone
Reduced stress and anxiety
Improved sleep quality
Reduced risk of energy
Improved cardiovascular health
Increased energy and vitality
Enhanced immune health
Discover the incredible benefits of yoga! ð§ââ︗ YAS Ministry (@YASMinistry) June 9, 2023
Experience improved flexibility, increased strength, reduced stress, better sleep, lower risk of injury, enhanced cardiovascular health, boosted energy, and a strengthened immune system. Start your yoga journey today!#IYD2023 #YogaDay pic.twitter.com/K6SdMRefwJ
Days before the 9th International Yoga Day, On May 31, PM Modi reminded citizens of the significance of this practice through his Twitter post.
International Yoga Day 2023 Theme
This year’s theme is Yoga for Vasudhaiva Kutumbakam which aims at a healthier and happier society.
As we gear up for the #InternationalDayofYoga2023, Hon'ble Prime Minister, Shri Narendra Modi encourages the masses to celebrate the ancient practice of yoga for metal and physical well-being of all, keeping with this year's theme #YogaforVasudhaivaKutumbakam @MIB_India pic.twitter.com/Ud0pW7Jpeo— Ministry of Ayush (@moayush) June 2, 2023
What are the different International Yoga Day themes since 2015?
In the last eight years, International Yoga Day revolved around the following themes:
Yoga for Harmony & Peace (2015)
Connect the Youth (2016)
Yoga for Health (2017)
Yoga for Peace (2018)
Climate Action (2019)
Yoga for Health- Yoga at Home (2020)
Yoga for Wellness (2021)
Yoga for Humanity (2022)
This day is celebrated with the aim of worldwide awareness of the benefits of practising yoga. The consistent efforts of PM Narendra Modi led the United Nations General Assembly to declare June 21 as International Yoga Day.
The United Nations General Assembly endorsed that "Yoga provides a holistic approach to health and well-being apart from striking a balance between all aspects of life.
The wider dissemination of information about the benefits of practising Yoga would be beneficial for the health of the world population."
This initiative was further endorsed by 175 member states. As per the UN, “the importance of individuals and populations making healthier choices and following lifestyle patterns that foster good health.”
The late B. K. S. Iyengar, a practitioner stated, “Yoga cultivates the ways of maintaining a balanced attitude in day-to-day life and endows skill in the performance of one’s actions.” | Stress and Wellness |
19 October 2023
A 2000-year-old practice by Chinese herbalists – examining the human tongue for signs of disease – is now being embraced by computer scientists using machine learning and artificial intelligence.
Tongue diagnostic systems are fast gaining traction due to an increase in remote health monitoring worldwide, and a study by Iraqi and Australian researchers provides more evidence of the increasing accuracy of this technology to detect disease.
Engineers from Middle Technical University (MTU) in Baghdad and the University of South Australia (UniSA) used a USB web camera and computer to capture tongue images from 50 patients with diabetes, renal failure and anaemia, comparing colours with a data base of 9000 tongue images.
Using image processing techniques, they correctly diagnosed the diseases in 94 per cent of cases, compared to laboratory results. A voicemail specifying the tongue colour and disease was also sent via a text message to the patient or nominated health provider.
MTU and UniSA Adjunct Associate Professor Ali Al-Naji and his colleagues have reviewed the worldwide advances in computer-aided disease diagnosis, based on tongue colour, in a new paper in AIP Conference Proceedings.
“Thousands of years ago, Chinese medicine pioneered the practice of examining the tongue to detect illness,” Assoc Prof Al-Naji says.
“Conventional medicine has long endorsed this method, demonstrating that the colour, shape, and thickness of the tongue can reveal signs of diabetes, liver issues, circulatory and digestive problems, as well as blood and heart diseases.
“Taking this a step further, new methods for diagnosing disease from the tongue’s appearance are now being done remotely using artificial intelligence and a camera – even a smartphone.
“Computerised tongue analysis is highly accurate and could help diagnose diseases remotely in a safe, effective, easy, painless, and cost-effective way. This is especially relevant in the wake of a global pandemic like COVID, where access to health centres can be compromised.”
Diabetes patients typically have a yellow tongue, cancer patients a purple tongue with a thick greasy coating, and acute stroke patients present with a red tongue that is often crooked.
A 2022 study in Ukraine analysing tongue images of 135 COVID patients via a smartphone showed that 64% of patients with a mild infection had a pale pink tongue, 62% of patients with a moderate infection had a red tongue, and 99% of patients with a severe COVID infection had a dark red tongue.
Previous studies using tongue diagnostic systems have accurately diagnosed appendicitis, diabetes, and thyroid disease.
“It is possible to diagnose with 80% accuracy more than 10 diseases that cause a visible change in tongue colour. In our study we achieved a 94% accuracy with three diseases, so the potential is there to fine tune this research even further,” Assoc Prof Al-Naji says.
Media contact: Candy Gibson M: 0434 605 142 E: [email protected] | Medical Innovations |
The Department of Health and Human Services (HHS) is now recommending that marijuana be moved to a lower-risk classification under federal law, a move that could have major implications for medical research into cannabis as well drug legalisation efforts.
The agency is offering a non-binding recommendation to the Drug Enforcement Administration (DEA) to downgrade marijuana from its current status as a Schedule I drug, indicating a treatment with high abuse potential and no medical value, to a lower Schedule III status under the Controlled Substances Act, Bloomberg reports.
Schedule I drugs include heroin and LSD, while Schedule III drugs include anabolic steroids and testosterone, according to the DEA.
Cannabis would still be prohibited under federal law, but moving it to a lower-risk status would make it much easier for researchers to investigate its properties.
The recommendation came in a letter from Assistant Secretary for Health Rachel Levine to the DEA, according to Bloomberg, and was based on extensive Food and Drug Administration analysis.
President Biden ordered HHS to conduct a scientific review regarding cannabis last year as part of a large initiative that included federal pardons to combat what the president called the “failed approach” of the US War on Drugs.
“Sending people to prison for possessing marijuana has upended too many lives and incarcerated people for conduct that many states no longer prohibit,” Mr Biden said at the time.
While cannabis remains prohibited at the federal level, it’s legal in large parts of the US under state law.
Medical marijuana is legal in 40 states and the District of Columbia, while recreational marijuana is legal in 23 states and the Dirstrict of Columbia, according to Marijuana Business Daily. | Drug Discoveries |
Mint Images/Getty Images/Mint Images RF
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Since 2010, 150 rural hospitals have closed in the United States. Hospital leaders say that Medicare Advantage pays slowly and sometimes not at all and that this could push more hospitals to the brink.
Mint Images/Getty Images/Mint Images RF
Since 2010, 150 rural hospitals have closed in the United States. Hospital leaders say that Medicare Advantage pays slowly and sometimes not at all and that this could push more hospitals to the brink.
Mint Images/Getty Images/Mint Images RF
Jason Bleak runs Battle Mountain General Hospital, a small facility in a remote Nevada gold-mining town that he describes as "out here in the middle of nowhere."
When several representatives from private health insurance companies called on him a few years ago to offer Medicare Advantage plan contracts so their enrollees could use his hospital, Bleak sent them away.
"Come back to the table with a better offer," the chief executive recalls telling them. The representatives haven't returned.
Battle Mountain is in north-central Nevada, about a three-hour drive from Reno and four hours from Salt Lake City. Bleak (whose name is pronounced "Blake") suspects insurance companies simply haven't enrolled enough of the area's seniors to need his hospital in their network.
Medicare Advantage insurers are private companies that contract with the federal government to provide Medicare benefits to seniors in place of traditional Medicare. The plans have become dubious payers for many large and small hospitals, which report that the insurers are often slow to pay or don't pay.
Private plans now cover more than half of those eligible for Medicare. And while enrollment is highest in metropolitan areas, it has increased fourfold in rural areas since 2010. Meanwhile, more than 150 rural hospitals have closed since 2010, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. States such as Texas, Tennessee and Georgia have had the most closures.
Medicare Advantage growth has had an outsize impact on the finances of small, rural hospitals that Medicare has designated as "critical access." Under the designation, government-administered Medicare pays extra to those hospitals to compensate for low patient volumes. Medicare Advantage plans, on the other hand, offer negotiated rates that hospital operators say often don't match those of traditional Medicare.
"It's happening across the country," says Carrie Cochran-McClain, chief policy officer of the National Rural Health Association, whose members include small-town hospitals.
"Depending on the level of Medicare Advantage penetration in individual communities, some facilities are seeing a significant portion of their traditional Medicare patient or beneficiary move into Medicare Advantage," Cochran-McClain says.
Kelly Adams is the CEO of Mesa View Regional Hospital, another rural hospital in Nevada. He says he applauds Battle Mountain's Bleak for keeping Medicare Advantage plans out of his hospital "as long as he has."
Mesa View, which is a little more than an hour's drive east of Las Vegas, has a high percentage of patients enrolled in Medicare Advantage plans.
"Am I going to say I'm not going to take care of 40% of our patients at the hospital or the clinic?" Adams says, adding that it would be a "tough deal" to be forced to reject patients because they didn't have traditional Medicare.
Mesa View has 21 Medicare Advantage contracts with multiple insurance companies. Adams says he has trouble getting the plans to pay for care the hospital has provided. They are either "slow pay or no pay," he said.
In all, the plans owe Mesa View more than $800,000 for care already provided. Mesa View lost about $1.3 million taking care of patients, according to its most recent annual cost report.
Cochran-McClain, of the National Rural Health Association, says the growth in the plans also narrows options for patients because "the contracting that is happening under Medicare Advantage frequently has an influence on steering patients to specific types of providers." If a hospital or provider does not contract with a Medicare Advantage plan, then a patient may have to pay for out-of-network care. That generally wouldn't happen with traditional Medicare, which is widely accepted.
At Mesa View, patients must drive to Utah to find nursing homes and rehabilitation facilities covered by their Medicare Advantage plans.
"Our local nursing homes are not taking Medicare Advantage patients because they don't get paid. But if you're straight Medicare, they'd be happy to take that patient," Adams says. (Medicare pays for limited nursing home stays post-surgery or injury. Long-term care is covered only by Medicaid, for those who qualify.)
David Allen, a spokesperson for AHIP, an industry trade group formerly known as America's Health Insurance Plans, declined to respond to Bleak's and Adams' specific concerns. Instead, he says enrollees are signing on because the plans "are more efficient, more cost-effective, and deliver better value than original Medicare."
Sara Lonardo, press secretary for the Centers for Medicare & Medicaid Services, says CMS has acted to ensure "that private insurance companies are held accountable for providing quality coverage and care."
The reach of private Medicare Advantage plans varies widely in rural areas, says Keith Mueller, director of the Rural Policy Research Institute at the University of Iowa's College of Public Health. If recent trends continue, enrollment could tip to 50% of rural Medicare beneficiaries in about three years — with some regions like the Upper Midwest already higher than 50% and others lower, such as Nevada and the Mountain States, but trending upward.
In June, a bipartisan group of Congress members, led by Sen. Sherrod Brown, D-Ohio, sent a letter urging federal agencies to do more to force Medicare Advantage insurers to pay health systems what they owe for patient care.
In an August response, CMS Administrator Chiquita Brooks-LaSure wrote that a final rule issued in April made "impactful changes" to speed up care and address concerns about prior authorization — when a hospital and patient must get advance permission for care to ensure it will be covered by an insurer. Brooks-LaSure noted another proposed rule that, once finalized, could mandate that insurers provide specific reasons for denying care within seven days.
Hospital operators Adams and Bleak also want more federal action, and fast.
Bleak at Battle Mountain says he knows Medicare Advantage plans will eventually move into his area and he will have to contract with them.
"The question is," Bleak says, "how can we match the reimbursement so that we can sustain and keep our hospitals in these rural areas viable and strong?"
KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling and journalism. | Health Policy |
George Kittle’s wife, Claire, shared the heartbreaking news of a January miscarriage.
The San Francisco 49ers tight end learned about the miscarriage during an ultrasound appointment Jan. 10. Claire was believed to have been around seven weeks pregnant at the time.
She revealed the news Tuesday in an emotional Instagram post. She noted that the pregnancy was ectopic.
The couple discovered they were pregnant Christmas Day and celebrated with family.
"On Christmas morning George and I took a pregnancy test while the rest of our family waited to open presents downstairs," Claire wrote. "We were about to see the greatest gift, a positive test. "
But, a few short weeks later, they received the devastating news.
"Fast forward to Jan 10th I had a routine ultrasound putting me right around 7.5 weeks pregnant. The nurse giving my ultra sound went silent for awhile and I asked ‘I’m still early there’s probably nothing to see yet right?’ "She responded with ‘I see a pregnancy here it’s just not in the correct place, it’s ectopic…’ I felt my soul leave my body as I knew exactly what that meant."
Claire explained that she underwent surgery on the same day her and George learned about the miscarriage.
"After hours of evaluating options and speaking with doctors in the ER. the decision was made to go into surgery that night," Claire wrote. "This type of pregnancy is extremely dangerous for the mother if not found early.
"I’m so thankful for the nurses and doctors who found this soon enough and to the Niners for allowing George to sprint out of the building at any given moment. George was my strength when I had none. We leaned on each other like we never have before. I’m thankful my mom, dad and George’s parents were all here to help us."
Claire said she wants her situation to bring more awareness to ectopic pregnancies and asked for support.
"The point of sharing this is not for pity, but to acknowledge something extremely personal, hard and emotional that has taken place in our life," Claire said. "To simply talk about it because I felt alone when I got the news, I never knew anyone else who had an ectopic pregnancy before. So here’s my direct line to you, I’ve had one, you’re not alone. It sucks, It’s hard, be strong. There’s strength in stories and I hope you can find comfort in ours. These types of things need to be talked about more often.
"Please keep George and I in your prayers as we don’t really know what to expect moving forward. I do know God gives us exactly what we need when we need it."
Kittle recently finished his sixth season with the 49ers. He had a strong 2022 campaign, catching 60 passes for 765 yards and a career-high 11 touchdowns. | Women’s Health |
Three years since the Trump administration first declared the COVID-19 pandemic a national emergency, children and teenagers are still experiencing the lasting effects of pandemic-era lockdowns and disruptions to daily life, from exacerbated mental health problems to increased vulnerabilities to other diseases.
Health providers are warning that trends, such as a drop in coverage among kindergartners for state-required vaccines, unusual surges in respiratory syncytial virus or RSV, and mental health problems among children aren't subsiding even as pandemic disruptions move further into the past.
"We already knew that there was growth in the need for mental health care among children and adolescents in our country, and even back then we were thinking about different influences like social media, increased time spent online, school and social pressures that seemed to be already increasing,” said Karin Price, chief of psychology at Texas Children’s Hospital, the largest children's hospital in the country. “COVID really took all of those things that we were already seeing as risk factors and kind of put them into high gear and then added increased pressure on top, of course, in terms of adapting to virtual schooling, dealing with illness and death in their families and in their communities, and really withdrawing them from social supports.”
Prior to the pandemic, Texas Children's Hospital would see anywhere from 50 to 100 children in mental health crisis come into the hospital's emergency centers in Houston per month. Since 2020, the hospital has seen between 400 to 500 patients coming in each month, and in January, they surpassed 500 patients for the first time, according to Price.
Numerous reports have documented the toll that the pandemic disruptions had on children's mental health nationally, though concerns were present prior to the pandemic. In 2021, nearly three in five teenage girls felt persistently sad or hopeless, a rate that increased nearly 60% over the 10-year period from 2011 to 2021, according to a recent report by the Centers for Disease Control and Prevention.
“When we think about this getting better as the impact of the pandemic recedes a little bit, as kids are back connected to their social networks, we're really not seeing the mental health concerns decrease in the way that we would hope," Price said.
It comes as COVID-19 cases and hospitalizations have remained relatively stable for months after spiking in early 2022 from a surge in the highly transmissible omicron variant. As of March 1, there were over 226,000 new COVID-19 cases weekly, lower than the more than 370,000 new cases reported during the same period last year, according to CDC data. The Biden administration recently announced it plans to let the public health emergency expire in May.
As COVID-19 cases have trended down, it has opened up room for other respiratory viruses, including RSV, to gain a foothold, especially among young children in the United States who may not have been exposed to the viruses in recent years.
A surge in cases of RSV, flu, and COVID-19, deemed the "tripledemic," strained children's hospitals in many states last fall as inpatient beds filled up and emergency rooms were overwhelmed with patients.
"The COVID-19 pandemic caused atypical respiratory virus circulation, including for RSV, for the last two years. That means children — especially those ages two years and younger — may not have been exposed to these viruses before,” a CDC spokesperson said in a statement to the Washington Examiner. "As people congregate more and let up on mitigation efforts that they used during the pandemic, it’s not surprising to see an increase in respiratory disease circulation."
The Children's Hospital Association and the American Academy of Pediatrics had urged President Joe Biden last November to issue an emergency declaration due to the uptick in respiratory viruses.
The COVID-19 pandemic and the later surge in respiratory viruses among children last fall has also had a downstream effect on the vaccination coverage of kindergartners across the country. Coverage of four state-required vaccines for public and private schools, including the measles, mumps, and rubella vaccine (MMR); diphtheria, tetanus, and acellular pertussis vaccine (DTaP); poliovirus vaccine (polio); and varicella vaccine (chickenpox) fell by 1 percentage point to roughly 93% in the 2021-2022 school year among kindergartners compared to the prior school year, according to CDC data.
The latest data show that despite most schools returning to in-person learning, vaccination rates have yet to catch up with pre-pandemic levels. Health officials and the CDC have indicated that vaccine hesitancy toward the COVID-19 vaccine may have had an impact on routine childhood immunizations. States have also reported that lower response rates from schools, extensions or grace periods for enrollment requirements, and reduced access to vaccination appointments due to the COVID-19 pandemic affected immunization rates and data collection.
“When we look at the fall of 2021 when kids were coming into school, if they were coming into school, the school nurses that are usually the ones in charge of ensuring that kids are meeting those vaccination requirements were completely overwhelmed with contact tracing and case investigation and just trying to help kids be able to stay in school,” said Dr. Michelle Fiscus, chief medical officer at the Association of Immunization Managers. “There was just no capacity for school nurses to be able to look at those records, to make sure everyone is up to date, to make sure that kids didn't come to school if they weren't fully vaccinated. “
While the CDC has noted that vaccination coverage still remains high, recent outbreaks of vaccine-preventable diseases have raised concerns that more could pop up in the future if vaccination coverage continues to decline. A recent measles outbreak in Ohio infected more than 80 children, with the majority of cases being among unvaccinated school-aged children, per state data.
“We haven't seen a lot of cases of measles or mumps or chickenpox in the last years because of vaccines, and so parents have forgotten how children suffer when they get infected with these vaccine-preventable diseases,” said Fiscus.
Fiscus noted that there is hope that vaccination numbers will rise in the coming year if the number of COVID-19 cases and other respiratory viruses continues to wane. | Epidemics & Outbreaks |
No Fresh Positive Cases Of Nipah, Results Of 51 Samples Awaited: Kerala Government
Kerala Health Minister Veena George, at a press briefing in the evening, said that in a relief for the state, no fresh positive cases were reported during the day.
In a relief for the Kerala government, no fresh positive cases of Nipah virus were reported on Saturday in the state even as five more persons, who came into contact with those infected, showing some symptoms of the disease were admitted in isolation at the medical hospital here.
Kerala Health Minister Veena George, at a press briefing in the evening, said that in a relief for the state, no fresh positive cases were reported during the day.
However, results of 51 samples sent for testing were awaited, she said.
The minister also said five more persons, who had come into contact with the infected persons, were admitted in the hospital, after showing symptoms of Nipah infection.
"Their samples have also been sent for testing," she said.
At present, six cases of Nipah infection have been confirmed in the state.
Of the six, two persons have died bringing the number of active cases to 4.
The minister said the number of people who were suspected of coming into contact with those infected has risen to 1,192, with 97 persons being traced today.
Additionally, house surveillance was carried out in 22,208 homes in the containment zones till date, she said.
George also said that all the cases so far have emanated from the first person infected -- the index case -- who died on Aug. 30.
"So, as of now, there is no secondary wave. That is welcome news," she said at the press briefing which was also attended by State Tourism Minister PA Mohamed Riyas.
Earlier in the day, George said that with the identification of the patient zero or index case of the Nipah virus outbreak in Kerala, the state government has begun looking for the source and place from where he got infected by seeking details of his mobile tower locations.
She said that while the state government was trying to determine where and how the man got infected, the central team was collecting bat samples to ascertain the viral load.
She also claimed that the state's efforts to combat the virus outbreak were appreciated by the central team.
Everyone, including a nine-year-old boy on a ventilator, who is under treatment for the virus or is in isolation is stable, she had said.
The minister had also said that all those infected are part of the first wave of the infection which has manifested in two clusters -- one being the two family members of the man who was the index case and the second being the persons who came into contact with him at the hospital he went for treatment.
Regarding the monoclonal antibody, the only viable therapeutic against the virus, the minister said in the morning that according to the Centre it was 50-60% stable and it has asked the state government to explore the possibility of getting a new version of the antibody.
"Presently, according to the doctors, the patients under treatment do not require it," she had said.
However, the state requested the Centre's support for expediting the process required for importing the monoclonal antibody and the same was assured.
Riyas, who was present with George at the morning press briefing, had said the control room, call centres and volunteers were doing an excellent job of instilling confidence in the public and creating awareness among them about the virus.
Kozhikode city Mayor Beena Philip, meanwhile, said all the wards where the man, who was the index case, went have been declared as containment zones.
"He has moved around a lot. Therefore, the contact list is expected to get bigger," she said.
Kozhikode District Collector A Geetha said that arrangements have been made for online classes in educational institutions for the coming week and instructed students not to engage in holiday-related celebrations.
The Collector also said that Beypore harbour will remain closed till further orders as it falls in one of the containment zones and provided two alternative locations for landing fishing vessels and sale of the catch.
The Centre on Friday decided to procure from Australia 20 more doses of monoclonal antibody through the Indian Council of Medical Research (ICMR) for treatment of those infected by Nipah.
The ICMR's National Institute of Virology (NIV) in Pune had sent its mobile BSL-3 (Biosafety Level-3) laboratory to Kozhikode to test the samples for the virus in the district.
This is the fourth time the viral infection has been confirmed in the state. It was detected in Kozhikode in 2018 and 2021 and in Ernakulam in 2019.
The World Health Organisation and ICMR studies have found that the entire state, not just Kozhikode, is prone to such infections. | Epidemics & Outbreaks |
Researchers with links to tobacco and vaping industries are failing to disclose their potential conflicts of interest in work published in respected academic journals, prompting calls for journals to tighten their policies and consider penalties for inadequate declarations.
Research published in The Australian and New Zealand Journal of Public Health on Thursday analysed how often authors who directly or indirectly received funding from the tobacco industry declare this in their research.
Curtin University’s Prof Jonine Jancey, a co-author of the research, said she and her colleagues asked tobacco control experts from around the world to nominate tobacco and vaping researchers they thought potentially had conflicts of interest.
They focused on the 10 most frequently nominated researchers and looked up their published research in the scientific database, Scopus. They also looked up the LinkedIn and academic profiles of those researchers, and drew on information from the University of Bath’s “Tobacco Tactics” database in the UK.
“We went through all of the research papers from the top 10 and their declared conflicts of interest to see if they had been transparent,” Jancey said.
“We identified 553 academic papers between them, and of those more than half had incomplete declarations or no declaration of conflicts of interest. When you think that people who work in the scientific community should be objective, it is incredibly disappointing and concerning.”
She said conflict-of-interest declarations are important because academic papers inform public health practices and government policy, and influence public discourse around issues such as vaping.
“We really need to be vigilant about this issue because we cannot afford industry tactics to distract us from good science,” Jancey said.
“Tobacco industries are renowned for using front groups – organisations that aim to represent one agenda while serving some other party or interest. In the academic world this is happening with third-party research organisations that are used to disguise funding from the tobacco industry.”
In March, Guardian Australia revealed some organisations and executives with known links to big tobacco and vaping companies failed to declare these affiliations in submissions to the federal government’s consultation on vaping reforms. The reforms are aimed at protecting children from nicotine addiction.
A study led by the NSW Cancer Council and the University of Sydney, published in May, found almost half (48%) of internal tobacco company lobbyists held positions in state, territory or federal government before or after working in the tobacco industry.
Prof Terry Slevin, the CEO of the Public Health Association of Australia, said academic journals need to tighten their policies on conflict-of-interest declarations, and that journalists, governments and political parties must remain sceptical of evidence and arguments presented to them.
“Academic journals may need to consider penalties for researchers who are found to misreport or underreport conflicts of interest,” Slevin said. “That may include retractions, or to refuse to publish future work from those found to inadequately declare their conflicts of interest.”
There is a long history of the tobacco industry lying about its products. In 1994, tobacco industry executives swore in the US Congress that nicotine was not addictive, Slevin said.
“One of their established tactics is to fund and promote research favourable to their commercial interests,” Slevin said.
“When conducting research in an area of commercial interest – something that might influence the thinking about, policy around or sales of products like tobacco or e-cigarettes, it is vitally important that any connection to the industry profiting from sale of those products is declared. That allows those reading the research to assess the extent to which they believe that research is objective and how much weight to place on it.” | Health Policy |
The Wall Street Journal reports , based on the most recent intelligence, such is the considered judgment of senior analysts at the U.S. Department of Energy, as well as at the FBI. If true, that Chinese lab leak unleashed a deadly global pandemic that killed nearly 7 million people , including more than 1.1 million Americans.
Communist Chinese officials insisted the pandemic originated in “nature.” Their stubborn refusal to cooperate with international research teams to provide relevant information has hindered the production of definitive evidence concerning the pandemic’s origins.
Beijing has instead perpetuated conflict and division within scientific and governmental circles in the West. In February 2020, the World Health Organization, which faced restricted access to the Wuhan lab, nonetheless concluded that the coronavirus had a natural origin. In 2021, President Joe Biden’s Office of National Intelligence report on the pandemic’s origins was inconclusive. Among scientists, the debate on the origins remains unresolved.
Given the pandemic’s massive death and economic destruction (an estimated $10 trillion ), Congress must pursue an inquiry into COVID-19’s origins. As difficult as it will prove to be, that probe must be aggressive and deep.
Congress must not only determine what federal officials knew, and when they knew what they knew, but also correct any deficiencies in America’s response to prepare for the next public health crisis. As analysts with the Government Accountability Office observe , “This understanding could help inform preparation and response to future epidemics and pandemics.”
The Select Subcommittee on the Coronavirus Pandemic of the House of Representatives, chaired by Rep. Brad Wenstrup (R-OH) will soon hold its first public hearings on the topic. The subcommittee should not only summon Energy Department and FBI analysts to testify on their recent assessments, but also officials of the State Department who issued a similar assessment of the origins of COVID-19 during the early stages of the pandemic in April 2020.
Examining five potential scenarios, State Department officials then concluded, “There is no direct, smoking gun evidence to prove that a leak from Wuhan labs caused the pandemic, but there is circumstantial evidence to suggest such is the case.” State Department officials then further noted that Chinese authorities sealed off the Wuhan lab in January 2020, and Huang Yanling, a lab employee rumored to be “patient zero,” disappeared.
Beginning on Jan. 3, 2020, Chinese communist officials, while insisting on the natural origin of the coronavirus, forbade the release of any information related to the pandemic without government approval. Nonetheless, America’s top federal public health officials, National Institutes of Health Director Francis Collins and Dr. Anthony Fauci , seemed morally certain that COVID-19 had a natural origin and NIH-funded scientists fell into line.
For example: On March 7, 2020, The Lancet, a prestigious British medical journal, published a remarkable letter proclaiming “solidarity” with Chinese colleagues combating COVID-19 and decrying “conspiracy theories” that hinder international cooperation. The letter was signed by 26 scientists, including Peter Daszak, president of EcoHealth Alliance, the firm that had worked closely with the Wuhan Institute of Virology and had received $8 million in American taxpayer funding.
On March 17, 2020, Nature Medicine, a professional journal, published an article concluding that the novel coronavirus was not a “laboratory construct.” That article was signed by six scientists, including Dr. Kristian Andersen of the Scripps Research Institute, another recipient of substantial NIH funding .
On March 26, 2020, NIH chief Collins followed up with a blog post , highlighting the March 17 Nature Medicine article, and condemning “outrageous” claims that the novel coronavirus was engineered in a lab.
Following this aggressive public relations offensive, in an April 2020 email, Collins told Fauci that they still had to find some way to “put down this very destructive conspiracy.” Collins warned that the emergence of the “lab leak” theory could damage “science and international harmony.” Fauci responded that the lab leak theory was a “shiny object” that would fade with time.
Viral “gain of function” research—that is, research that genetically engineers a virus to make it more lethal and more transmissible—is a critical piece of the puzzle. In sworn testimony before the Senate last year, Fauci steadfastly denied that NIH funded “gain of function” research in China. In recent sworn testimony before the House of Representatives, Dr. Lawrence Tabak also denied that NIH had funded such research.
Yet, the April 2020 State Department memo makes clear : Dr. Shi Zheng Li—the so-called Bat Woman of China—“conducted genetic engineering of bat virus to make it easily transmissible to humans.” Shi functioned as a “subcontractor” of EcoHealth Alliance, the firm that had gotten substantial grant funding from NIH and also collaborated with Dr. Ralph Baric of the University of North Carolina, as well as other scientists, on research ( reviewed by the NIH ) into the potential of bat coronaviruses to infect humans.
From a practical perspective, lawmakers drilling down on the pandemic’s origins need to enlist the assistance of scientists who specialize in evolutionary virology in assessing the evidence. They must also call prominent independent virologists, especially those who have been publicly engaged on the issue, to provide congressional testimony. Furthermore, lawmakers must also determine what role, if any, that federal officials may have played in funding research that might have contributed to the pandemic.
Among the key questions:
- If the novel coronavirus emerged in nature, is there any hard evidence of any animal having SARS-CoV-2 before the first cases of human infection?
- With the shutdown of any information coming out of Communist China without government approval on Jan. 3, 2020, how could federal health officials—particularly Collins and Fauci—be morally certain that the pandemic was not the product of a lab leak? Had they come into possession of any scientifically verifiable evidence since January 2020 to support such a conclusion?
- What new evidence did Scripps’ Andersen and Robert Garry of Tulane Medical School, both of whom expressed strong skepticism about the natural origins of the coronavirus to NIH officials, have in their possession that caused them to change their initial assessment?
- Did either Collins or Fauci, or anyone on their staffs, suggest, encourage, provide comments to, or review the multiple authors’ correspondence in The Lancet or the article in Nature Medicine?
- How many of the 26 authors of The Lancet correspondence, or the six authors of the Nature Medicine article, had then been recipients of NIH grant funding?
- Given NIH’s poor oversight, plus the failure of EcoHealth Alliance to provide NIH with timely information on the Wuhan experiments, as Rep. Debbie Lesko, R-Ariz., has observed , how could federal officials know for sure that there was no taxpayer funding of “gain of function” research?
- When NIH officials were debunking the lab leak theory as a “conspiracy theory” in April 2020, were they also aware that State Department personnel had arrived at a very different conclusion at roughly the same time? Given the gravity of the subject, was there sufficient interagency communication? Was the White House made aware of these divergent assessments among career civil servants?
As for Fauci’s “shiny object,” it just got brighter. If top NIH officials and their media allies had hoped to dismiss the laboratory origins of the novel coronavirus as a silly “conspiracy theory,” they clearly failed. Bolstered by new intelligence, analysts at the Department of Energy and at the FBI have reinforced the initial assessment of State Department personnel made three years ago: The “circumstantial evidence” indicated that the pandemic emerged from a lab.
Congress must keep digging.
This article originally appeared in the Daily Signal and is reprinted with kind permission from the Heritage Foundation. | Epidemics & Outbreaks |
Disaffected junior doctors on strike in the UK have found themselves at the centre of a "cheeky" recruitment drive aimed at luring them halfway across the world to ease pressure on Australia's stretched health system.
Key points:
- Billboards encouraging doctors to move to SA have been parked outside UK health sites
- The tactic has been timed to coincide with a strike by junior doctors in the UK
- SA Health has also been directly appealing to individual UK doctors on Twitter
Billboards spruiking the work and lifestyle advantages of migrating to South Australia were parked outside hospitals in the UK overnight, Australian time, SA Health Minister Chris Picton said.
SA Health has also been directly responding to British medics on Twitter, amid a 72-hour strike over pay by thousands of junior doctors, sending them links to a tourism website and a video promoting the state.
"Not only are we replying to tweets but we've also, overnight, had some trucks out with electronic billboards outside their protests and their picket lines outside hospitals," Mr Picton told ABC Radio Adelaide's Stacey Lee and Nikolai Beilharz.
"This is now being picked up and tweeted around the UK with lots of very positive comments from UK doctors. They are in the midst of a strike at the moment.
"What better time to make sure that they know about the offer of potentially coming to South Australia."
Mr Picton said the recruitment drive was being carried out in the UK at the behest of SA Health.
"A few weeks ago, a number of our junior doctors who work in SA Health came to me," he said.
"[They] really enjoy working here and want to see more people from the UK make the trip here and suggested we step up our game in terms of these more cheeky tactics."
South Australian Salaried Medical Officers Association chief industrial officer Bernadette Mulholland conceded attempting to poach another nation's medical staff might be considered "ruthless", given the demand for doctors in the UK, but said that medics are now part of "an international market".
"It's pretty clear, the desperation across the world in trying to obtain trainee doctors — it is pretty cold, it's pretty ruthless," she said.
"But it just demonstrates to everybody how short we are on trainee doctors, how short we are in doctors in South Australia.
"Grass isn't always greener on the other side, but it is a bit greener certainly here in South Australia."
But Ms Mulholland said the state "shouldn't have to resort to these tactics" and called for more incentives aimed at boosting the number of graduates at local level.
"Importantly, we need to start to look at: What are we doing in our universities ... to build our own workforce here in South Australia and across Australia," she said.
Opposition health spokeswoman Ashton Hurn said the SA government had not done enough to incentivise retention.
"This just underscores how far behind the eight ball we are here in South Australia because, whilst this type of campaign has a part to play, every other state has financial incentives on the table," she said.
"We're certainly hopeful we'll see something in the state budget today."
Yesterday, the SA government announced $130 million in new funding for virtual health care services with the aim of freeing up hospital beds.
Mr Picton said he wanted the federal government to lift a cap on the number of people studying at university to become doctors, but that, in the meantime, recruiting from overseas was a necessary strategy.
"We're giving people the opportunity and the choice, and saying that here in South Australia you've got the benefits of working in a system where we will reward doctors and value them," he said.
"If you go to ... our emergency departments across Adelaide, you'll meet a number of doctors who have come from the NHS [National Health Service] in the UK who say that they absolutely love the choice that they've made in terms of coming over here." | Health Policy |
RiVive, made by Harm Reduction Therapeutics, is the second over-the-counter naloxone product approved by the FDA this year.
Naloxone is a medicine that can help reduce opioid overdose deaths and when administered timely — usually within minutes of the first signs of an opioid overdose — can counter the overdose effects.
The company said it anticipates RiVive will be available in early 2024, primarily to harm-reduction organizations and state governments at a lower price than other opioid reversal nasal sprays.
The nonprofit said it is focused on supplying RiVive to communities that need it most and will make at least 200,000 doses — 10 percent of projected initial annual product production — available for free.
“We are grateful that FDA granted RiVive approval so we can now achieve what most thought impossible and no other company has: broad delivery of a lower-cost nasal naloxone product without a prescription to save lives that could otherwise be lost to opioid overdose,” Michael Hufford, co-founder and chief executive officer of Harm Reduction Therapeutics, said in a statement.
Unlike other naloxone products, Harm Reduction Therapeutics said it will make RiVive available for free or at low break-even cost, which the company previously said was about $18.
Narcan is the most common naloxone product, and the FDA approved an over-the-counter version in March.
But price can be a significant barrier because a two-pack of the prescription version can cost $130 to $150, depending on the retailer. Even the discount price of around $50 can still be a barrier. | Drug Discoveries |
A secretive government unit worked with social media companies in an attempt to curtail discussion of controversial lockdown policies during the pandemic, The Telegraph can reveal.
The Counter-Disinformation Unit (CDU) was set up by ministers to tackle supposed domestic “threats”, and was used to target those critical of lockdown and questioning the mass vaccination of children.
Critics of lockdown had posts removed from social media. There is growing suspicion that social media firms used technology to stop the posts being promoted, circulated or widely shared after being flagged by the CDU or its counterpart in the Cabinet Office.
Documents revealed under Freedom of Information (FoI) and data protection requests showed that the activities of prominent critics of the Government’s Covid policies were secretly monitored.
An artificial intelligence firm (AI) was used by the Government to scour social media sites. The company flagged discussions opposing vaccine passports.
Many of the issues being raised were valid at the time and have since been proven to be well-founded.
The BBC also took part in secretive meetings of a government policy forum to address the so-called disinformation.
On Friday, MPs and freedom of speech campaigners condemned the disclosures as “truly chilling” and “a tool for censoring British citizens” akin to those of the Chinese Communist Party.
Much of the Government’s wider work on disinformation is shrouded in secrecy for “national security” reasons. Large parts of official documents are still redacted.
In America, Twitter has released similar information showing how the US government also introduced a secretive programme to curtail discussion of Covid lockdowns.
It can now be revealed that the activities of Prof Carl Heneghan, the Oxford epidemiologist who has advised Boris Johnson, and Dr Alexandre de Figueiredo, a research fellow at the London School of Hygiene and Tropical Medicine (LSHTM), were monitored by government disinformation units.
Molly Kingsley, who set up a campaign to keep schools open during the pandemic, also had her social activity monitored.
As well as the CDU, the Government operated a Rapid Response Unit (RRU) in the Cabinet Office that hunted online for content it considered disinformation.
The CDU, which is still operating, was embedded in the Department for Culture, Media and Sport (DCMS).
The department has “trusted flagger” status at social media companies including Facebook and Twitter, which means that requests for content to be removed are fast-tracked for consideration.
In some cases, individuals whose social media posts were recorded by the units have subsequently faced sanctions by Twitter and Facebook. Ministers denied asking for posts by Prof Heneghan, Dr de Figueiredo or Ms Kingsley to be removed.
The Government has said that the CDU “is focused on helping the Government understand online disinformation narratives and understand attempts to artificially manipulate the information environment”.
The Government also ran a Counter-Disinformation Policy Forum, which brought together civil servants from the DCMS and technology giants - including Facebook and Google - as well as the BBC to discuss how to limit the spread of what was considered Covid-19 disinformation.
This forum and the two units were not the only way the Government tried to apply pressure on social media companies during the pandemic.
The Lockdown Files, published by The Telegraph earlier this year, revealed that Matt Hancock, the former health secretary, repeatedly lobbied Sir Nick Clegg, the former deputy prime minister and now a Facebook executive, about vaccine misinformation.
Facebook has been open about its efforts to tackle misinformation about Covid. During the pandemic, it removed posts and in April 2020 alone put warning labels on about 50 million pieces of content.
The CDU was established in 2019 and was focused on the European elections before turning to focus on the pandemic.
During Covid, the unit worked closely with the Cabinet Office’s now defunct RRU, whose responsibilities included tackling “purported ‘experts’ issuing dangerous misinformation”.
The RRU has admitted in an FoI obtained by Big Brother Watch and passed to The Telegraph that it made requests for social media posts to be taken down.
As part of its work, the Cabinet Office also passed the CDU “media monitoring” reports.
Documents revealed that the material flagged to the CDU included articles published by The Telegraph.
One of these was a piece by Ms Kingsley published in February 2022, arguing that it was “indefensible” that children’s lives were still not back to normal when the rest of society was. She urged ministers to make a clear statement that children’s extracurricular activities should not be subject to additional curbs.
One of Ms Kingsley’s tweets from December 2020, in which she said it would be “unforgivable to close schools”, was also passed to the CDU.
Sir Gavin Williamson, then the education secretary, closed schools days later. However, he has since admitted that the decision caused a major row with Mr Hancock and that he considered resigning.
When the dispute was exposed by The Telegraph’s Lockdown Files investigation, Sir Gavin said the closure “wasn’t done for the right reasons” and that he regretted agreeing to it.
The RRU also logged articles by Prof Heneghan published in The Telegraph and The Spectator.
One of these questioned the science behind the rule of six – later abandoned by Government – and discredited the data used by the Government to justify the second lockdown.
He had social media posts about face masks and the accuracy of coronavirus death data removed after the technology giants raised concerns about Covid disinformation.
The CDU has also commissioned reports from an external artificial intelligence firm, Logically, which uses AI to trawl the internet.
The company has been paid more than £1.2 million by the DCMS since January 2021 for work that included helping to “build a comprehensive picture of potentially harmful misinformation and disinformation”.
In one of the firm’s reports for the CDU, a post by Dr De Figueiredo, the LSHTM researcher who also works for the Vaccine Confidence Project, was flagged.
He wrote: “People who think we should be mass vaccinating children against Covid-19 poorly understand at least one of the following: (a) risk, especially absolute risk (b) ethics (c) natural immunity (d) vaccine confidence (e) long Covid.”
When Dr De Figueiredo made the comment, the Joint Committee on Vaccines and Immunisation had opted not to recommend mass vaccinations for children.
Nadhim Zahawi, the former minister for Covid vaccines deployment, said he believed the Government included Dr De Figuerido’s tweet because of “c--k-up rather than conspiracy”.
He added in an interview for The Telegraph’s forthcoming podcast, The Lockdown Files, that the CDU was there to combat “clearly completely wrong or false information”.
Miriam Cates, a Conservative MP, said: “Any attempt by governments to shut down legitimate debate is hugely concerning, but to discover that DCMS actively sought to censor the views of those who were speaking up for children’s welfare is truly chilling.
“It is becoming increasingly clear that many of the foundations of our democracy – such as free speech and parliamentary scrutiny – were completely disregarded during the pandemic.”
Silkie Carlo, director of Big Brother Watch, said: “The very concept of ‘wrong information’ dictated by a central authority is open to abuse and should be considered far more critically, lest we mirror Chinese-style censorship.
“Whilst everyone would expect the Government and tech giants to act against foreign hostile disinformation campaigns, we should be incredibly cautious about these powers being turned inwards to scan, suppress and censor the lawful speech of Brits for wrongthink, as is shockingly the case right now.”
A Whitehall source said the comparison with China was “just plain wrong”.
The source added: “On the contrary, the unit was set up to counter the threats disinformation poses to, among other things, UK national security, much of which is spread by hostile states.”
Jacob Rees-Mogg, the former Cabinet minister, called for the Covid inquiry to investigate government disinformation units.
“The inquiry clearly ought to investigate the oppressive methods used to override dissent,” he said.
“It is clear from Hancock’s messages that steps were taken to manipulate public opinion and now it appears underhand methods may have been employed to stop free speech.
“This is not what ought to happen in a free country.”
A government spokesman said: “The unit’s purpose is to track narratives and trends using publicly available information online to protect public health and national security.
“It has never tracked the activity of individuals and has a blanket ban on referring journalists and MPs to social media platforms.
“None of the people named in this report were ever referred to social media platforms by the Government and any claim otherwise is objectively false.
“The RRU, which closed in July 2022, tracked government policies and important issues – not individuals. It used publicly available information, including material shared on social media, to assess UK disinformation trends and narratives.”
A BBC spokesman said the broadcaster attended the Counter-Disinformation Policy Forum in an observer-only capacity. | Epidemics & Outbreaks |
- Although type 2 diabetes can potentially be reversed, there is currently no cure for type 1 diabetes.
- Research into both focuses on the pancreatic islets, a type of cell that produces insulin, and there have been various attempts over the years to create them in the lab for implantation into the body.
- Researchers have now developed a microscopic device containing islets cells that can be implanted into the eye in mice without the use of stitches.
In a new study, researchers from the KTH Royal Institute of Technology and Karolinska Institutet in Sweden have developed a tiny device that can be implanted into the eye to treat both types of diabetes and potentially other diseases.
The findings were published in the journal
For this study, the researchers developed a microscopic device for implantation into the eye.
The device is 3D printed, wedge-shaped, and is about 240 micrometers long. It is designed to be placed in the space between the iris and cornea called the anterior chamber.
The scientists reported that this new device allows specific microorganisms to be delivered directly through the eye without the need for sutures.
“The eye is, as we say, the ‘only window into the body’ where we can noninvasively monitor the transplant,” Dr. Anna Herland, senior lecturer in the Division of Bionanotechnology at SciLifeLab at KTH Royal Institute of Technology and the AIMES research center at KTH Royal Institute of Technology and Karolinska Institutet, and co-lead author of this study explained to Medical News Today about what makes the eye a good candidate for this type of treatment.
“The eye is also immune privileged and avoids first immune reactions,” she detailed.
The purpose of the tiny eye implant is to deliver microorganisms for disease treatment. The device was designed to have a micro-cage with a “flap door technique” to release the microorganisms.
In the case of treating diabetes, researchers used
“Cell transplants hold the promise of curing the disease and thereby avoiding lifelong treatments and the severe consequences of the disease. New technologies are, however, needed to drive the development of cell therapies for diabetes efficiently,” Dr. Herland said.
During the study, researchers tested the eye implant device in a mouse model. They reported the device maintained its position in the eye for several months. When released, the microorganisms quickly integrated into the host animal’s blood vessels and were able to detect glucose.
Dr. Herland said the progress of the therapy released into the eye by the device can be monitored through both normal blood sugar monitoring and observations through the cornea.
The researchers stated this microdevice could be a method to deliver cell-based treatment for other diseases through the eye.
“Ours is a first step toward advanced medical microdevices that can both localize and monitor the function of cell grafts. Our design will enable future integration and use of more advanced device functions such as integrated electronics or drug release.”
— Dr. Anna Herland
“This is a part of a larger effort where we are pushing device technology to monitor the function of transplanted islets,” she continued.
“We have prototypes that can monitor islet function in vitro with electro-optical methods. We are now taking these prototypes for in vivo evaluations. We are also exploring how we can use the devices for drug release locally in the eye, thereby avoiding possible side effects at other sites in the body,” she added.
For both type 1 and 2 diabetes, the main goal of treatment is to achieve a healthy blood sugar level in the body.
With type 1 diabetes, this is mainly through injections of insulin as well as additional medications.
Treatment for type 2 diabetes may also include medications and/or insulin therapy.
Doctors advise these
A person’s eyes are connected to the nerves and blood vessels that run throughout the rest of the body.
For this reason, an optometrist or ophthalmologist can detect signs of several diseases and health issues when performing an eye exam, including:
- aneurysm
- high blood pressure
- cardiovascular issues
- thyroid problems
- multiple sclerosis
- rheumatoid arthritis
- Sjögren’s syndrome
- vitamin A deficiency
Additionally, an eye exam can find signs of diabetes. When the body has too much sugar in the blood, it can damage the blood vessels and nerves throughout the body, including the eyes.
Types of diabetic eye diseases are:
Medical News Today also spoke with Dr. David Geffen, director of optometric and refractive services at the Gordon Schanzlin New Vision in La Jolla, CA, about this study.
He said this study is a transformative investigation and may change the nature of diabetic treatment.
“The ability to implant a device in the eye to manage and produce the proper amount of insulin for patients will be a life-changing event. Diabetic patient compliance is a very big problem and the ability to manage this within the body is a huge step in preventing long-term damage typical in these individuals. The eye is the widow of many systemic diseases,” Dr. Geffen added.
“Diabetic retinopathy is a major cause of
vision lossin the world. Controlling sugar and insulin levels is paramount to keep the eye and other organs in proper shape. The next steps will be to determine that this implant has no side effects within the eye, as well as how well controlled the patient’s levels will be maintained.”
— Dr. David Geffen | Medical Innovations |
To control our behaviour, the brain must be able to form associations. This involves, for example, associating a neutral external stimulus with a consequence following the stimulus (e.g., the hotplate glows red - you can burn your hand). In this way, the brain learns what the implication of our handling of the first stimulus are. Associative learning is the basis for forming neural connections and gives stimuli their motivational force. It is essentially controlled by a brain region called the dopaminergic midbrain. This region has many receptors for the body's signaling molecules, such as insulin, and can thus adapt our behaviour to the physiological needs of our body.
But what happens when the body's insulin sensitivity is reduced due to obesity? Does this change our brain activity, our ability to learn associations and thus our behaviour? Researchers at the Max Planck Institute for Metabolism Research have now measured how well the learning of associations works in participants with normal body weight (high insulin sensitivity, 30 volunteers) and in participants with obesity (reduced insulin sensitivity, 24 volunteers), and if this learning process is influenced by the anti-obesity drug liraglutide.
Low insulin sensitivity reduces the brain's ability to associate sensory stimuli.
In the evening, they injected the participants with either the drug liraglutide or a placebo in the evening. Liraglutide is a so-called GLP-1 agonist, which activates the GLP-1 receptor in the body, stimulating insulin production and producing a feeling of satiety. It is often used to treat obesity and type 2 diabetes and is given once a day. The next morning, the subjects were given a learning task that allowed the researchers to measure how well associative learning works. They found that the ability to associate sensory stimuli was less pronounced in participants with obesity than in those of normal weight, and that brain activity was reduced in the areas encoding this learning behavior.
After just one dose of liraglutide, participants with obesity no longer showed these impairments, and no difference in brain activity was seen between participants with normal weight and obesity. In other words, the drug returned the brain activity to the state of normal-weight subjects.
"These findings are of fundamental importance. We show here that basic behaviours such as associative learning depend not only on external environmental conditions but also on the body’s metabolic state. So, whether someone has overweight or not also determines how the brain learns to associate sensory signals and what motivation is generated. The normalisation we achieved with the drug in subjects with obesity, therefore, fits with studies showing that these drugs restore a normal feeling of satiety, causing people to eat less and therefore lose weight," says study leader Marc Tittgemeyer from the Max Planck Institute for Metabolism Research.
"While it is encouraging that available drugs have a positive effect on brain activity in obesity, it is alarming that changes in brain performance occur even in young people with obesity without other medical conditions. Obesity prevention should play a much greater role in our healthcare system in the future. Lifelong medication is the less preferred option in comparison primary prevention of obesity and associated complications," says Ruth Hanßen, first author of the study and a physician at the University Hospital of Cologne.
The study was conducted at the Max Planck Institute for Metabolism Research and supported by the CECAD Cluster of Excellence for Ageing Research at the University of Cologne and the University Hospital of Cologne.
Journal
Nature Metabolism
Method of Research
Experimental study
Subject of Research
People
Article Title
Liraglutide restores impaired associative learning in people with obesity
Article Publication Date
17-Aug-2023 | Drug Discoveries |
A team of researchers may have found an effective treatment for one of the more common symptoms of long covid: a chronically changed sense of smell. In a small study, the team found that many patients improved after undergoing a minimally invasive procedure often used to treat pain and circulation problems. In some cases, people’s symptoms disappeared altogether.
People will often experience smell and taste changes as a result of having a respiratory infection, though it took some time for this to be widely recognized as a common symptom of covid-19. Anywhere from 30% to 80% of covid-19 sufferers can develop smell alterations. These include anosmia (a partial or full loss of smell), parosmia (a distorted sense of smell, such as having once-pleasant things smell foul), and phantosmia (smelling things that aren’t there).
Thankfully, smell-related changes caused by covid-19 are typically self-limiting and go away after a few weeks. But a noticeable percentage of people will continue to experience smell and taste problems for months or even longer. A November 2021 study estimated that up to 1.6 million Americans had developed covid-related chronic anosmia within the first two years of the pandemic, for instance. Other studies have suggested that chronic anosmia/parosmia is one of the most common symptoms of long covid.
Though there are possible interventions that might be able to prevent a permanent loss of smell if used early enough, such as smell training, there are no established treatments for covid-related chronic anosmia/parosmia. But in a new study set to be presented later this month at the annual meeting of the Radiological Society of North America (RSNA), researchers say that they may have found one.
The team decided to treat patients with a stellate ganglion block, a procedure in which local anesthetic is injected into a bundle of nerves located around the neck (the stellate ganglion). These nerves are part of the sympathetic nervous system, which in turn is part of the autonomic nervous system. The autonomic nervous system governs our body’s involuntary functions, while sympathetic nerves regulate our “fight or flight” response to stressful situations. The stellate ganglion is responsible for sending many of the sympathetic nerve signals to your head, neck, and arms.
Stellate ganglion blocks are commonly used to treat symptoms caused by nerve-related conditions, such as shingles, phantom limb pain, or certain types of migraines. The team theorized that these nerves might also play a role in people’s covid-related smell disturbances.
The study involved 54 patients diagnosed with post-covid parosmia who had been referred to the authors by ear, nose, and throat specialists. The patients were initially given a stellate ganglion block on one side of the neck, with a prior CT scan used to find the best position for insertion. The injection also included a small dose of steroids, which the researchers speculate might help relieve any nerve inflammation caused by the coronavirus.
The authors were able to follow-up with 37 patients who received the procedure. Of these, 22 patients (59%) reported an improved sense of smell one week after the injection, while 18 patients reported continued progress a month later. Twenty-six patients also returned for a second injection on the other side of the neck six weeks later, and most of those who improved after the first dose saw continued improvement after the second.
Overall, the average improvement in symptoms among the responders during the three-month period of the trial was 49%, though some people seemed to experience a complete recovery.
“The initial patient had a tremendously positive outcome, almost immediately, with continued improvement to the point of symptom resolution at four weeks,” said lead author Adam Zoga, professor of musculoskeletal radiology at Jefferson Health in Philadelphia, Pennsylvania, in a statement from the RSNA. “We have been surprised at some outcomes, including near 100% resolution of phantosmia in some patients, throughout the trial.”
The findings are based on a very small sample size and have yet to go through the typical peer-reviewed process. So they should be viewed with added caution for now. And even in the best possible light, it’s likely that stellate ganglion blocks will not be able to help everyone who’s lost their normal sense of smell due to covid-19. But given the lack of available options, this potential treatment certainly seems to be worth further investigation, the study authors say.
“Other treatments have failed to date,” Zoga said. “This injection is working.” | Disease Research |
More than 2,600 NHS staff in Scotland have been forced to take time off due to long Covid, new figures show.
Freedom of information requests by the Scottish Liberal Democrats revealed at least 2,603 doctors, nurses and midwives were recorded as having taken time off due to long Covid, some for more than two years.
The vast majority of absences were seen in nurses, with 2,414 taking time off, compared to 128 doctors and 61 midwives.
NHS Greater Glasgow and Clyde suffered worst, with a total of 1,298 staff forced to take leave due to long Covid, according to the figures.
The longest recorded absence was found in the NHS Grampian area, where one member of staff was off for 957 days.
In NHS Fife, a worker spent 882 days on leave, and another in NHS Highland was side-lined for 798 days.
The total figure is likely to be higher as NHS Forth Valley did not provide the information, NHS Western Isles was unable to do so, and NHS Lothian provided data for the whole-time equivalent staff lost to long Covid.
Scottish Lib Dem leader Alex Cole-Hamilton said the data is a “damning verdict of the Scottish Government’s complete lack of care for long Covid victims”, calling on ministers to increase funding to help those with the condition.
“Long Covid is an enormously debilitating condition which disrupts and devastates lives,” he said.
“This nationalist Government’s response has been so poor that many Scots would be better off moving to England where more robust care pathways are available.
“Our NHS is already at boiling point and if this lacklustre approach from the SNP and Greens continues, we will see even more staff absences, even more pressure on services.
“Nurses and other long Covid sufferers cannot afford to be put on hold any longer without solutions.
“These sky-high absences must propel the Government into action.
“Scottish Liberal Democrats are calling on Humza Yousaf to improve funding for long Covid.
“We need to see dedicated long Covid clinics set up across the country and Scotland-wide access to physiotherapy and multi-disciplinary rehab. Otherwise, nurses and their patients will pay the price.”
The Scottish Government allocated £3 million from its £10 million long Covid support fund for the last financial year, but no further allocations have yet been announced.
NHS Grampian said it could not comment on individual cases, but that it follows nationally set absence rules.
A spokesman for NHS Greater Glasgow and Clyde said its workforce – totalling around 41,000 people – accounts for around one quarter of NHS staff in Scotland, adding: “The health and wellbeing of our staff is of paramount importance to us and throughout the pandemic we introduced a number of new interventions to support staff and managers in terms of absence, health and wellbeing, and new guidance was developed to assist in managing the previously unknown condition of long Covid.
“Through HR and occupational health teams we have expanded resources to focus on supporting those with Covid and long Covid, while introducing specific peer support as part of our wider mental health and wellbeing action plan.”
A Scottish Government spokesman said: “We recognise the significant impact long Covid can have on the health and wellbeing of those most severely affected and assessment and support is being provided across Scotland.
“We are making available £3 million from our £10 million long Covid support fund over this financial year to support NHS boards to increase the capacity of existing services, develop these into more clearly defined local pathways and provide a more co-ordinated experience.
“This is in addition to what our healthcare system – supported by record funding of more than £19 billion – is already delivering in caring for people with long Covid across our full range of NHS services.
“All NHS staff are fully supported in accordance with the Once for Scotland attendance policy where health impacts their ability to be at work.”
The Government said that for the fortnight ending May 23 2023, a daily average of 365 NHS staff were absent due to Covid-related illness – 0.20% of the total workforce. | Epidemics & Outbreaks |
Over the past two weeks, Minnesota and Vermont took steps to explicitly legalize, fund, and expand drug-checking resources. These are major developments for drug policy. Tools like mass spectrometers and fentanyl test strips provide people with real-time information about what’s in their drugs, which can help them make more informed decisions and reduce the possibility of an overdose. What’s more, they help public health and harm reduction workers understand what is in the drug supply, a necessary prerequisite for them to respond to crises and reduce risk. More lawmakers and local organizations must follow in the footsteps of Minnesota and Vermont and implement policies that emphasize drug checking as an instrument for harm reduction, and expand its use as a community-based tool.In addition to drug checking, we can find out what’s in the drug supply through drug supply surveillance. Most of this surveillance data is collected through law enforcement drug seizures, drug screening in clinical settings or following a death, and urine-based drug screening of people in drug treatment programs. In short, this information is often collected through punitive measures. A positive urine drug screen can result in loss of custody of a child, denial or loss of employment, and incarceration. We have baked this discrimination into law with legislation like the 1988 Drug-Free Workplace Act, which requires that employers who receive federal contracts drug test their employees. Some lawmakers have gone further, pushing to drug test people who receive government supports like food stamps and housing. And choices around who to test are often discriminatory. A study published earlier this year, for example, found that hospitals are more likely to drug test Black women who are pregnant than white women, despite no difference in rates of testing positive.When you know what might be in the drug supply, you can be better prepared to reduce harm. You might choose to use smaller amounts, avoid mixing drugs, or not use alone. You might start carrying naloxone. But for this to be possible, we need timely and accurate communication about local drug supplies, which requires approaches that aren’t punitive or discriminatory. Along with others at Brown University Medical School and Rhode Island Hospital, we run a pilot drug surveillance project called testRI, which takes donated samples of drugs and used paraphernalia from people across the state and tests them using a comprehensive machine at the hospital’s toxicology lab. This gives us a detailed list of all the substances that were in the sample, and allows us to understand what is in the local drug supply. Our testing data is then compiled, posted online, and distributed in the community, along with information on what substances were detected and how to reduce risk. In March, for instance, someone told us they thought they were buying fentanyl, but when we tested the sample we found xylazine, a powerful animal tranquilizer, as well. This drug can cause severe wounds and lead to prolonged sedation, which can complicate overdose responses. Once we documented the presence of xylazine, we created and distributed a zine to people in the community with information about what the drug is, how it’s showing up locally, and how people can take care of the skin wounds it causes and respond to overdoses. We aren’t the only ones taking this kind of approach. A lab at the University of North Carolina at Chapel Hill runs a mail-based drug-checking program, where people across the country can mail in substances to be tested. And the New York City Department of Health and Mental Hygiene offers drug-checking programs at three sites, allowing people to see what’s in the substances they have on hand and giving them advice on how to reduce risk. Pairing drug-checking programs with comprehensive drug supply surveillance efforts is critical for rapidly understanding—and responding to—changes in the supply. But for these efforts to be effective, they need to be community-driven, with the goal of reaching people where they already are. When we worked with local partners to post on Instagram and Twitter and distribute zines and other printed materials, it led to funding for wound care kits that are distributed by harm reduction agencies in the state, and additions to the state’s overdose dashboard.However, to do any of this on a larger scale, we must first expand and legalize drug-checking services across the United States as part of a broader push to expand harm reduction initiatives. Testing services need to be authorized across more jurisdictions; right now, many states’ paraphernalia and possession laws are written in a way that either explicitly prohibits drug testing or creates a legal gray area. Federal and state governments should include drug checking and surveillance programs within overdose prevention budgets, as Minnesota and Vermont have done. Running these non-punitive programs comes at a cost and requires high-tech equipment, and existing harm reduction programs often operate on shoestring budgets.Drug-checking technologies should not be utilized to punish people who use drugs or those who may have supplied the drugs to them. Minnesota and Vermont lawmakers seem to understand this. Other states are moving in the right direction as well, decriminalizing fentanyl test strips and putting Good Samaritan protections in place to shield from arrest those who call to report an overdose. We need similar legal immunity for those who use drug-checking services across jurisdictions. Drug checking should not be used to focus attention and resources on drug war tactics, but rather to center discussions around public health. Vermont and Minnesota took an important step forward by legalizing drug checking and paraphernalia, but explicit protections from arrest would go even further. We should be using checking and surveillance data to implement evidence-based harm reduction services like overdose prevention centers, and to distribute more wound kits and naloxone instead of allocate more funds to law enforcement efforts. Punitive drug testing has always been part and parcel of the war on drugs in the United States. But to meaningfully combat the overdose crisis, we must reimagine testing systems to ensure that they support community safety and harm reduction, rather than invoke anxiety and fear.WIRED Opinion publishes articles by outside contributors representing a wide range of viewpoints. Read more opinions here. Submit an op-ed at [email protected]. | Drug Discoveries |
Hospital patients in Somerset can now use specialist units to make sure they are more prepared to return home.
Musgrove Park and Yeovil District Hospitals have been running Ready To Go Units to support patients.
The idea is to use activity to avoid patients returning to hospital or needing extra care when they leave.
"We want people to be as independent as possible," said Jannine Hayman, senior matron for integrated and urgent care at Musgrove Park.
She said the units were a "new concept" for the NHS in Somerset.
"The reason it has been set up is that we have many patients who are medically fit for discharge. We are looking at the benefits for our patients so we can reduce the number of days they stay in hospital."
'Used to outside world'
Gwendaline Bawden, 86, from Exmoor, said: "There's a young lady comes in and we do exercises with rubber balls and all sorts of things."
She believed it would be helpful as she prepared to go home.
"It's getting you used to the outside world," she said.
Michelle Purnell, a fitness instructor with Age UK Somerset, makes regular visits to the unit and encourages patients to go on short walks and practise grip strength training. She also uses music and interaction.
"I come on to the ward just to get people moving, to encourage them to just not sit by their beds the whole time.
"We try to get them to engage with each other - talk a bit more to their neighbours on each side - and to mobilise."
She said the response had been "brilliant and really positive".
"Seeing the difference in people from when you first come on to the ward when they're just sat there in their own little world, and then they change while I'm here which is really nice," she said.
Joanna Jackson, senior physiotherapist on the Ready to Go unit at Musgrove Park, said getting people back into being active was key.
"What we find with our older population is that if they haven't got a reason to get up and get busy and be active it's all too easy in a hospital setting that you just sit by your bedside," she said.
"They're going to decondition really quickly, they're going to become weaker, less able, and then when the services are available for them to go home, the patients are no longer physically able enough to get home.
"That's where we've been able to intervene and put lots of activity in place." | Medical Innovations |
Lori Girard
toggle caption
Howard Girard got hospital-at-home care for covid, COPD and congestive heart failure. Though he has since died, his daughter Lori says it likely extended his life and helped him enjoy himself.
Lori Girard
Howard Girard got hospital-at-home care for covid, COPD and congestive heart failure. Though he has since died, his daughter Lori says it likely extended his life and helped him enjoy himself.
Lori Girard
For the past four years, Chad Semling has coped with serious illness, including chronic infections, a weakened liver and a damaged heart. He became a regular visitor at his local hospital in Eau Claire, Wisconsin, where he and his wife, Clare Semling, got to know the downsides of hospital care a little too well: The isolation. Poor sleep, interrupted by bells and alarms. The food.
In the spring of 2020, Chad was back at the Eau Claire Mayo Clinic emergency department for a flareup of cellulitis, a skin infection that can be serious. He was dreading yet another hospital stay. Instead, they said he was eligible for a new "hospital-at-home" pilot program that would outfit his house with equipment and send clinicians to make visits. "He was all for it, because he hates being in the hospital," says Clare.
She was interested, too. During Chad's stints in the hospital, it would fall upon her to work, care for their two children, and check in on him. It was exhausting. Maybe this would be easier.
So they tried it out, joining one of the fastest-growing experiments in American health care. Hospital-at-home programs are for people sick enough to need the attention a hospital provides, but stable enough to be cared for at home.
Research on outcomes is not conclusive, yet, but shows promise that it can provide good care and save health care dollars. But a big question looms: What about the family? Are unpaid, untrained family caregivers ready to take on the responsibility of overseeing a critically ill person at home — even with backup from visiting clinicians? "We've got to look at the consequences for family caregivers," says Susan Reinhard, director of AARP's Public Policy Institute.
This question is about to become more important. For decades, hospital-at-home was a small-scale experiment. During the COVID pandemic, the idea went mainstream. In November 2020, the federal government changed rules so that hospitals could be paid the same amount to treat patients at home. Today, 290 hospitals in 37 states have signed up.
Diagnoses often include chronic obstructive pulmonary disease, heart failure, pneumonia, or as with Semling, an infection. In addition to twice-daily nurse visits and daily telemedicine sessions with a doctor, services like physical therapy or blood tests can be brought to the house. A nurse is available for advice via tablet computer. Oxygen machines, drugs and infusions can be delivered. After Semling fractured his back last summer, he got a Wi-Fi enabled pill box that dispensed painkillers and other meds on schedule.
For him, there's no debate. "Being able to be home made all the difference in the world," he says. He sleeps better and heals faster. He's now had five stints with hospital-at-home, and both the Semlings prefer it. But Clare has words of caution for caregivers: "There is a lot of responsibility on your shoulders."
Chad Semling
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Chad and Clare Semling have had five stints with hospital-at-home related to Chad's serious illnesses. They both prefer it to Chad being in the hospital, but say it's important to know what to expect.
Chad Semling
Chad and Clare Semling have had five stints with hospital-at-home related to Chad's serious illnesses. They both prefer it to Chad being in the hospital, but say it's important to know what to expect.
Chad Semling
It was overwhelming in the beginning, especially because he was weak from a previous hospital stay. She was up and down all night getting him whatever he needed. And while hospital-at-home programs often can deliver frozen meals, Chad was fed up with institutional food. So when he was too weak or unsteady, she'd make his lunch in the morning while also getting the kids off to school and getting herself ready for her 12-hour shift at the manufacturing company she works for. He was supposed to track everything he ate and drank, and how often he used the bathroom, and she helped stay on top of that, too.
Then, during the workday, she'd worry. A nurse or paramedic visited twice a day, but otherwise he was on his own. "In the hospital, if something happens, they know how to take care of it," she says. "Now it's on you."
That said, Clare says she'd absolutely recommend hospital-at-home. Caregivers just need to know what they're signing up for.
Caregiver, or nurse's aide?
For a caregiver, hospital-at-home eliminates the hardship that comes with a loved one's stint in the hospital, everything from overpriced parking to hours spent at bedside waiting for a doctor to make rounds. But it brings new concerns.
These programs don't ask caregivers to handle medical tasks like dealing with an IV. But they might need to bring glasses of cold water in the middle of the night, help a weak person turn over in bed, change clothes, or get to the bathroom. In the hospital, nursing aids do those tasks. Programs can arrange home health aides for help, but usually for limited hours. It could be part of the reason why between 10 and 62 percent of people turn down the option to participate in these new programs.
"The data are fairly sparse, in terms of what the effects are" on caregivers, says Albert Siu, a pioneer of hospital-at-home who directs the program at Mount Sinai in New York City. One research survey at Brigham Health in Massachusetts and another focused on cancer treatment found that stress and burden were similar between traditional hospitalization and hospital-at-home.
That's not necessarily good news, given the copious research documenting caregiver strain and distress. "As family members, we always will say yes," says Donna Benton, an assistant dean and professor of gerontology at the University of Southern California who studies caregiving. "But we don't know what that means."
A recent AARP policy briefing delved into the implications. Hospital-at-home has strong potential, but the effects on caregivers need more attention, the report advises. "The family caregivers are completely invisible," says Reinhard of AARP. "They're not turning to wife, daughter, or husband, and saying: Can you handle this? That's the discussion we think needs to happen." The briefing recommends federal policymakers require programs to make sure family members know exactly what will happen and are on board with it.
Currently, that's not a federal requirement. But five hospital-at-home directors interviewed by NPR said they bring family caregivers into the decision-making process. "A huge part of the process is making sure that both patients and their caregivers have a really good idea of what they're getting into," says Margaret Paulson, who directs the program the Semlings joined at the Mayo Clinic Health System in Wisconsin.
The Centers for Medicare & Medicaid, which oversees these programs, is considering adding rules to clarify caregivers' responsibilities. "CMS makes it very clear that during the hospital-at-home stay, hospitals are not to use family members, support persons, or caregivers to provide care that would otherwise fall to nurses or other hospital staff during an inpatient admission," said CMS chief medical officer Lee Fleisher in a statement provided to NPR. "Caregivers should have time to focus on a patient's emotional needs and overall well-being throughout the healing process." In April, an executive order from President Biden also nudged the agency to set clearer expectations.
Simply getting more data on how caregivers are coping would be a good start, says Reinhard. For instance, research in other nations suggests that hospital-at-home might actually be cheaper for families, because they avoid expenses like cafeteria meals and travel. But in the U.S., we just don't know.
Advice for caregivers
Sometimes, hospital-at-home is exactly what the doctor ordered—for the patient and the family. Lori Girard's father Howard was a flinty New England Yankee, a farmer who smoked a pack of Marlboros every day. Her parents "weren't big medicine-takers," says Girard. "They ate good, worked hard."
That no-nonsense approach served him for a long time. But in his 80s he developed both chronic obstructive pulmonary disease (COPD)—a common chronic lung ailment—and congestive heart failure (CHF), in which the heart struggles to pump enough blood.
Then in November he got Covid. By December, he was wracked by constant coughing. Lab tests showed that his blood sugar was high, and his blood pressure low. His doctor wanted him to go to the emergency room.
That was not going to happen. Back in 2018 he had signed forms spelling out his wishes: No life-saving emergency treatment. Definitely no hospitals. "To be confined in a hospital bed, with people waking you up, poking and prodding you, it wasn't his way to be," says Girard. She and her mother felt helpless.
Luckily, his lung doctor suggested hospital-at-home, in this case organized by the new company Medically Home, which provides logistical and technical services in partnership with hospitals . The team brought a mobile X-ray machine to the house, which wowed her parents. Girard lives just three doors down, so she helped them with medications, and reminded them how to use the iPad once. Otherwise they managed fine on their own. "I felt OK," she says now. "Better than OK. I slept good."
He made a full recovery. "They hit it out of the park with him, and he's a tough customer," she says. He enjoyed life for several more months, taking her mother out for trips and visiting the casino, until he passed away in March.
For Girard, it was clear. "I don't know if he would've lived, if they hadn't come," she says.
She echoes the advice of others: Ask plenty of questions, and be sure you understand the implications. Find out in advance what to do if the responsibility becomes overwhelming, suggests Siu. "It's a very family specific decision," he says.
Mayo's Paulson has similar suggestions: "If you're the caregiver, is it going to drive you crazy if people are going in and out of your home, or are you OK with that?" Also, if you live in a rural area, a nurse or paramedic may take up to 30 minutes to arrive, which could be scary in some situations. .
Even with those drawbacks, says Semling, it's a big improvement over hospital-as-usual. "For us, though, it definitely has been a blessing," she says. "At least we're home."
Kat McGowan is a freelance writer in California focused on caregiving. This story was produced with support from the Alicia Patterson Foundation. | Medical Innovations |
In response to the ongoing shortage of ADHD medications, the U.S. Food and Drug Administration (FDA) has approved several generic versions of Vyvanse (lisdexamfetamine dimesylate) for the treatment of attention-deficit/hyperactivity disorder in people 6 years and older.
Vyvanse is available in capsules and chewable tablets, according to the FDA’s announcement.
Dr. Barry K. Herman, a board-certified psychiatrist and the chief medical officer for Mentavi Health, a mental health assessment provider in Grand Rapids, Michigan, is hopeful that these new generic drugs will help address the persistent ADHD medication shortage.
"The FDA made the review and approval of these generics a priority, and hopefully manufacturing will now scale up rapidly to meet this pressing need," he told Fox News Digital.
These generic medicines are designed to work in the same way and provide the same benefit as the brand-name versions.
"Generic drugs are approved based on their bioequivalence to the brand drug," Herman said. "In theory, that would make them work the same, but in some cases, patients may feel that they do better on the branded drug."
Potential side effects are likely the same as with the brand-name drug, he noted, though some may experience different side effects on the generic version.
Fourteen companies have now been approved to manufacture and sell generic Vyvanse.
"That should help address the medication shortage, especially of Adderall," Herman said. "It may take some time, however, for the manufacturing and distribution of the generic drug to catch up to the shortage."
The cost of the generic Vyvanse should be considerably less than the brand-name ADHD drugs, Herman said.
"Having many companies manufacture and sell the drug will generally drive the cost down," he said. "Costs may differ depending on whether you have insurance, the pharmacy you use and the dose of the drug."
The FDA first announced the shortage of ADHD medication — primarily Adderall — in October 2022.
Adderall (amphetamine mixed salts) is the medication that's most affected by the shortage, along with variations of methylphenidate, sold under the brand names Ritalin or Concerta.
Vyvanse is also intended to treat moderate to severe binge-eating disorder (BED) in adults.
"This should help many people who are currently struggling with the drug shortage," said Herman.
"Having a generic drug available that is approved for both ADHD ages 6 and up, and for adults with moderate to severe binge-eating disorder, could not come at a more opportune time." | Drug Discoveries |
A four-year-old girl almost died after her suspected Strep A infection turned into a flesh-eating bug. New pictures show Reign Passey, from Dudley in the West Midlands, in her hospital bed as she battled the extremely rare infection.
Reign spent three weeks in hospital after suspected Strep A bacteria triggered necrotising fasciitis - a rare disease that can occur after a wound is infected that can result in death.She underwent a four-hour operation to remove dead tissue to prevent the infection from spreading further which resulted in a large scar, according to MailOnline.Reign's mother Leanne said she had to argue with doctors just to get an examination during her daughter's illness."It's horrendous, you never expect it to happen to you until it does," the 31-year-old said."I just want people to understand that it's so serious." More on Strep A At least 30 children in UK have died from invasive Strep A Two children die with Strep A in Scotland Strep A: Five more children confirmed to have died in England from the bacterial infection It is believed the infection may have entered Reign's body through a chickenpox sore.Three days after contracting chickenpox last July, Ms Passey noticed her daughter was fatigued, had a temperature and a red ring around one of the sores. Image: Reign Passey with mum Leanne Passey. Pic:SWNS A GP advised that Reign go to A&E immediately.But medics at Russells Hall Hospital told Ms Passey to go home because Reign's chickenpox was highly contagious and they had no beds available."By this point the red ring had almost tripled in size," Ms Passey said."They were adamant they were too busy, she was too contagious and I needed to take her home."I said the only way I was leaving was if they kicked me out - she was deteriorating by the second."The mother and daughter eventually went to a second hospital, Birmingham Children's Hospital.But they were told to wait outside to avoid infecting others with chickenpox."We got to the hospital at 9.30pm - we sat there until 3.30am," Ms Passey said."Between those times, her temperature had gone up to almost 42C, she was hallucinating and talking to me."She'd gone past the point of screaming and was lying there almost lifeless."Read more:Can the NHS survive?Patients should be charged for GP and A&E visits, says ex-health secretaryAfter an 11-hour wait at the hospital, Reign was finally seen by doctors and rushed to have emergency surgery.As well as cutting away a large amount of dead tissue, surgeons had to keep the wound open for cleaning and examination to ensure every trace of the bacteria had been removed.Reign was put into an induced coma for the pain and breathing support. But then the young girl contracted sepsis and after recovering was sent to the hospital's burns unit for skin grafts for the wound.A spokesperson for Birmingham Women's and Children's NHS Foundation Trust, which manages Birmingham Children's Hospital, defended its decision to make Reign and her mother sit outside but told MailOnline they hoped she was recovering well.Meanwhile, a spokesperson for Malling Health, which operates the Dudley Urgent Care Centre at the Russells Hall Hospital said they were "sorry to hear" about Reign's experience but could not comment on specific cases due to patient confidentiality. | Disease Research |
The Biden administration is rethinking how it classifies marijuana under a federal list of drugs, a move that could allow the cannabis industry to save potentially billions in federal taxes each year because it would allow producers to write off their business expenses.
The proposal, recommended by the Department of Health and Human Services and under consideration by the Drug Enforcement Administration, also would open up the possibility that medical researchers could study the benefits and risks of marijuana as a potential drug.
Industry advocates called the proposal a welcome development, but one that still falls short of reconciling the federal government's ban on the drug and state laws that accept marijuana use.
"The only way to fully resolve the myriad of issues stemming from the federal conflict with state law is to remove cannabis from the Controlled Substances Act and regulate the product in a manner similar to alcohol," said National Cannabis Industry Association CEO Aaron Smith in a statement.
Under the plan, which could take months to more than a year to finalize, the DEA would no longer regard marijuana as a Schedule I drug. That designation puts marijuana in the same camp as heroin and LSD -- a drug with a high potential for abuse and no medical use. The new plan, if approved, would drop marijuana to Schedule III, easing restrictions and putting it on par with drugs like Tylenol with Codeine.
The change though would not alter the drug's status though as illegal under federal law.
Bloomberg first reported the HHS recommendation on Wednesday. A senior administration official confirmed the recommendation to ABC News Thursday.
Last fall, President Joe Biden said reducing penalties tied to marijuana was a priority.
"While white and Black and brown people use marijuana at similar rates, Black and brown people have been arrested, prosecuted, and convicted at disproportionate rates," he said in October.
Andrew Freedman, executive director of the Coalition for Cannabis Policy, Education, and Regulation, said he expects the change would actually do very little to change how marijuana is treated in criminal cases for the average person. That's because such prosecutions tied to marijuana possession are mostly at the state level.
In recent years, the Justice Department hasn't made enforcing a federal law banning marijuana as a priority.
The much bigger impact, Freedman said, would likely be economically. By reclassifying the drug, cannabis would no longer be subject to an IRS rule that specifically prohibits tax write-offs for businesses "trafficking" controlled substances. According to the National Cannabis Industry Association, cannabis pay tax rates as much as 70%.
Beau Whitney, an economist who specializes in researching the cannabis industry, said he estimates that marijuana businesses could save as much as $2 billion a year or more in their federal tax bill if businesses can deduct their expenses on their tax returns.
Freedman said that tax benefit is much more likely to be a consequence of rescheduling the drug under the DEA.
"Listen, anytime that there's any progress on cannabis in the United States over the last 100 years -- it's a big, huge momentous day," he said. And this announcement by a federal agency said "yeah, we were not treating this rationally," he added.
But the change won't provide production standards, universal labeling or childproof packaging.
"There's a lot more the federal government needs to be stepping in on and this is not any of that," he said.
ABC News' Luke Barr and Molly Nagle contributed to this report. | Drug Discoveries |
Researchers have identified a 'guard mechanism' for a protein which attacks microbes in infected cells, opening the possibility of new treatments for Toxoplasma, Chlamydia, Tuberculosis and even cancer.
A study, led by the University of Birmingham and published today (5th October) in Science has discovered the lock and key mechanism that controls the attack protein GPB1. GBP1 is activated during inflammation and has the potential to attack membranes within cells and destroy them.
The research has revealed how the attack protein is controlled through a process called phosphorylation, a process in which a phosphate group is added to a protein by enzymes called protein kinases. The kinase targeting GBP1 is called PIM1 and can also become activated during inflammation. Phosphorylated GBP1 in turn is bound to a scaffold protein, which keeps uninfected bystander cells safe from uncontrolled GBP1 membrane attack and cell death.
The newly discovered mechanism prevents GPB1 from attacking cell membranes indiscriminately, creating a guard mechanism that is sensitive to disruption by the actions of pathogens inside the cells. The new discovery was made by Daniel Fisch, a former PhD student in the Frickel lab working on the study.
Dr Daniel Fisch said: "This was a fantastic project to work on for the past six years and involved many research groups from all over the world. None of this would have been possible without help from our colleagues and friends at The Francis Crick Institute in London, EMBL in Grenoble (France), ETH Zurich (Switzerland) and Osaka University (Japan)."
Dr Eva Frickel, Senior Wellcome Trust Fellow at the University of Birmingham, who led the study explained: "This discovery is significant for several reasons. Firstly, guard mechanisms such as the one that controls GBP1 were known to exist in plant biology, but less so in mammals. Think of it as a lock and key system. GPB1 wants to go out and attack cellular membranes, but PIM1 is the key meaning GPB1 is locked safely away."
"The second reason is that this discovery could have multiple therapeutic applications. Now we know how GBP1 is controlled, we can explore ways to switch this function on and off at will, using it to kill pathogens."
Dr Frickel and her team conducted this initial research on Toxoplasma gondii, a single-celled parasite that is common in cats. Whilst Toxoplasma infections in Europe and Western countries are unlikely to cause serious illness, in South American countries it can cause reoccurring eye infections and blindness and is particularly dangerous for pregnant women.
The researchers found that Toxoplasma blocks inflammatory signalling within cells, preventing PIM1 from being produced, meaning that the "lock and key" system disappears, liberating GBP1 to attack the parasite. Switching PIM1 'off' with an inhibitor or by manipulating the cell's genome also resulted in GPB1 attacking Toxoplasma and removing the infected cells.
Dr Frickel continued: "This mechanism could also work on other pathogens, such as Chlamydia, Mycobacterium tuberculosis, and Staphylococcus all major disease-causing pathogens which are increasingly becoming more resistant to antibiotics. By controlling the guard mechanism, we could use the attack protein to eliminate the pathogens in the body. We have already begun looking at this opportunity to see if we are able to replicate what we saw in our Toxoplasma experiments. We are also incredibly excited about how this could be used to kill cancer cells."
PIM1 is a key molecule in the survival of cancer cells, while GPB1 is activated by the inflammatory effect of cancer. The researchers think that by blocking the interaction between PIM1 and GPB1 they could specifically eliminate cancer cells.
Dr Frickel said: "The implication for cancer treatment is huge. We think this guard mechanism is active in cancer cells, so the next step is to explore this and see if we can block the guard and selectively eliminate cancer cells. There is an inhibitor on the market which we used to disrupt PIM1 and GPB1 interaction. So, if this works, you could use this drug to unlock GPB1 and attack the cancer cells. There is still a very long way to go, but the discovery of the PIM1 guard mechanism could be a massive first step in finding new ways to treat cancer and increasingly antibiotic-resistant pathogens."
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Norovirus levels across the UK are "the highest we have seen at this time of year in over a decade", a doctor at the UK Health Security Agency (UKHSA) has warned.
Cases of the highly infectious stomach bug have surged in recent weeks, with hundreds of NHS hospital beds filled by people with symptoms.
Lab reports of norovirus are more than double the five-season average before the coronavirus pandemic, according to the UKHSA.
It said reporting has increased across all age groups, most notably those aged 65 and older.
The virus is known as the "winter vomiting bug" because it is notorious for spreading rapidly during the colder months.
The NHS says symptoms include feeling or being sick and diarrhoea, and those infected may also experience a high temperature, headaches and aching arms and legs.
Most people will fully recover within two to three days, but those with the illness are urged to drink plenty of fluids to prevent dehydration, especially the very young, elderly or those with weakened immune systems who are most at risk.
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While the majority of outbreaks continue to be reported in care homes, cases in hospitals are also increasing, but remain below the five-season average.
Outbreaks reported in care homes increased from 47 in the week beginning 6 February, to 54 in the week beginning 13 February, representing the highest number of outbreaks reported in a week so far this season.
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Dr Lesley Larkin, surveillance lead of gastrointestinal infections and food safety at UKHSA, said the increase represents "the highest (levels) we have seen at this time of year" in more than 10 years.
"Most reported cases are in the over 65s and we're also seeing an increase in reported outbreaks, particularly in care home settings," Dr Larkin added.
"Please stay at home if you are experiencing norovirus symptoms and don't return to work (particularly if you work with vulnerable people or food) or send sick children to school or nursery until 48 hours after symptoms have cleared.
"If you have a loved one in a care home or hospital, please avoid visiting until 48 hours after symptoms have cleared.
"Regular hand washing is really important to help stop the spread of this bug, but remember, alcohol gels do not kill off norovirus so washing with soap and warm water is best." | Epidemics & Outbreaks |
© Provided by The National Yasmine Ezz, Egyptian television presenter. Photo: @yasminezzmbc / Instagram Two of Egypt’s top women’s rights authorities have filed legal complaints against a television presenter on a private Saudi Arabian channel for content that they say promotes violence against women.Prominent women’s rights activist Nehad Abol Komsan, who heads the Egyptian Centre for Women’s Rights, on Wednesday published a photo of the official complaint she filed with the country’s prosecutor general against MBC presenter Yasmine Ezz, whose statements about women’s role in the home put her at odds with Egypt’s feminist groups.Ezz presents a nightly talk show on MBC Masr, Kalam El Nas (or Talk of the People) during which she interviews celebrities and discusses social issues. The 34-year-old presenter has repeatedly stirred up controversy with unsolicited advice on her talk show urging women to be more obedient to their husbands and continually asserting that women’s rights movements have gone too far and are destroying the family unit.In one episode, she told viewers: "When did we forget to glorify our husbands? If your husband is named Mohamed, you can't just call him Mohamed, you have to call him Mr Mohamed."In another episode, she urges wives to use their "winter voices" on their husbands, which by her own description denotes a "surrender to your husband that makes him feel that there is an innocence about you that you haven't lost".Her comments are repeatedly criticised by those she interviews, most of whom are prominent celebrities.In the complaint, Ms Abol Komsan, known for a moderate, religious brand of feminism that is much more palatable to Egypt’s conservative populace than more extreme takes on the subject, called on the National Council for Women (NCW), a state-affiliated centre for women’s rights, and the Journalists’ Syndicate to step in and halt broadcasting of Ezz’s show in Egypt.NCW president Maya Morsy on Tuesday made a sharply critical social media post addressing “a female trend journalist on a non-Egyptian channel” in which she urged her to consider that what she broadcasts is being heard by a new generation of impressionable young men and women whose respect for each other could be seriously affected by it.But Ezz was named in an official complaint filed by the NCW and submitted to the Egyptian Ministry of Information calling for the halting of her show in Egypt.“Your children and grandchildren will see your statements and they will not be proud,” Ms Morsy wrote on Facebook. “Content published in the electronic sphere is a permanent mark on your person that will never go away.”Ms Morsy urged her unnamed presenter to practise better journalistic ethics and called on the network who hosts her show to stop broadcasting “these kinds of jokes that cannot be called journalism”. She said that she believes the presenter says such things only to be shocking and to go viral on social media.Later on Tuesday, Ezz made a scathing post of her own on her official Facebook page.There she argued that she had the right to present what she thinks is correct on her talk show and that she knew and was proud that her children would see her show because “I say what I say to preserve the family unit”.“I grew up in a stable family built on mutual respect and morality and I have always pledged to promote those values as a journalist,” Ezz wrote, “I am proud to be Egyptian. My society taught me these values and I have preserved them.”Ms Morsy and Ms Abol Komsan’s positions on Ezz were backed by prominent members of Egypt’s arts world, including screenwriter Medhat El Adl, who applauded Ms Morsy in a Facebook post for “standing up to someone trying to send women back to the era of the harem”.But there were those who defended Ezz too, including director Omar Zahran, who chastised Ms Morsy in a Wednesday Facebook post. He said Ezz is “merely promoting more respect between a man and his wife”. | Women’s Health |
Brit healthcare body rapped for WhatsApp chat sharing patient data
Time for a proper secure clinical image transfer system, perhaps?
Staff at NHS Lanarkshire - which serves over half a million Scottish residents - used WhatsApp to swap photos and personal info about patients, including children's names and addresses.
Following a probe, the UK Information Commissioner's Office (ICO) has now issued a heavily redacted official reprimand to the organization, which oversees three hospitals plus clinics and more across rural and urban Lanarkshire in the Central Lowlands of Scotland. It said a group chat created in March 2020 – just as the UK government issued the first COVID lockdown – was in breach of Article 58 of the UK GDPR.
It did not recommend a fine, but rather an overhaul of the healthcare group's data protection practices, but the document, an official reprimand [PDF], is nonetheless eye-opening.
Information was shared between 26 staff for more than two years – from 1 April 2020 to 25 April 2022 – over hundreds of entries within the WhatsApp group that included adult and child patients' names, plus hundreds of patients' phone numbers, many dates of birth, and at least 28 home addresses, "15 images, three videos, and four screenshots." Some of this info included clinical information, and therefore "special category" data in breach of Article 9 of the UK GDPR.
The staffers were using copies of WhatsApp downloaded directly via NHS Lanarkshire's portal on their work phones, it emerged, but someone, whose name was redacted, was added to the group "in error." That "unauthorised individual" was given access to "four students' names and student numbers, one child's name, and two children's names and addresses."
The ICO noted that since WhatsApp stated it was an encrypted platform, staff thought it would be secure. This, the watchdog said, "demonstrates that information governance expectations regarding WhatsApp were not understood by staff involved in the WhatsApp Group."
Staff were using WhatsApp from their work-issued phones, which were subject to security controls. At the heart of COVID-19 lockdowns, clinicians trying to exchange info to treat their patients could hardly be comparable certain prime ministers saying they've forgotten their iPhone passcodes or bankers discussing trades off the books on forbidden platforms. Nevertheless the ICO considered that NHS Lanarkshire's policies "should have been more specific to prevent an incident such as this occurring."
As mitigation, the document also states that "in terms of photographs and videos, no staff would have access to this in normal practice as there is no secure clinical image transfer system in NHS Lanarkshire and no screenshots of clinical records are permitted."
Many of the staff concerned were working remotely because of COVID lockdowns.
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The watchdog said policies did not clearly reference messaging apps like WhatsApp and "there was no specific policy in place directly for WhatsApp."
The ICO said the organization should have completed a "risk assessment prior to making WhatsApp available to download via NHS Lanarkshire's portal, to identify any potential risks relating to personal data such as the risk that staff use the application to inappropriately share personal data."
It added:
Communications were sent to both all staff and Teams with the instruction not to use WhatsApp for sharing personal data. NHS Lanarkshire subsequently seized the phones of staff involved which was completed by ███. All phones were deprovisioned, which NHS Lanarkshire confirmed deleted the chat, and staff have been issued with new phones.
Ever suspected bankers used WhatsApp comms at work? $1.8b says you're rightREAD MORE
The ICO said the organization should "consider whether it is necessary and/or required to implement a secure clinical image transfer system."
We've asked NHS Lanarkshire for comment, including on whether it planned to put a secure clinical image transfer system into place in the near future.
In a statement sent to The Reg, Trudi Marshall, Nurse Director Health & Social Care North Lanarkshire, said: “We have received a formal reprimand from the ICO for the use of WhatsApp by one of our community teams to exchange personal patient data during the pandemic.
“We recognise that the team took this approach as a substitute for communications that would have normally taken place in either a clinical or office setting, but was not possible at that time due to Covid restrictions. However, the use of Whatsapp was never intended for processing patient data.
“We offer our sincere apologies to anyone whose personal details were shared through this group." She added: “We have already taken a number of steps including looking at alternative apps that can be introduced for the transfer and storage of images and videos within a care setting. This is being taken forward while considering the risks relating to the storage of any personal data.”
The Information Commissioner, incidentally, is another aspect of regulatory oversight that will be impacted if the UK government overhauls the post-Brexit data regime in the way it wishes to do so with the DPDI II bill. The bill, a controversial proposed replacement for the UK GDPR, currently going through the House of Commons, proposes to "abolish the office" of Information Commissioner, and replace the function with a new board, the "Information Commission."
According to the latest draft, the Secretary of State can use a statutory instrument to change, add or remove "the databases which the Board is required to oversee," rename the Board; or "require or authorise the Board to issue a code of practice or guidance" – a situation which would undermine the regulator's independence and influence its guidance and priorities. ® | Health Policy |
A drug which stops HIV infecting the body has proved to be a highly effective "real-world" preventative treatment, a study has confirmed.
The results of the research on 24,000 people taking it across England, have been described as "reassuring".
Thousands of people are already taking PrEP through sexual health clinics.
HIV charity the Terrence Higgins Trust wants easier access to the drug, since many people, including women, do not know it exists.
The UK Health Security Agency (UKHSA), which led the PrEP Impact Trial with the Chelsea and Westminster Hospital NHS Foundation Trust, said it was the largest ever real-world study of its kind.
It was carried out at 157 sexual health clinics across England between October 2017 and July 2020.
The study found use of PrEP, also known as pre-exposure prophylaxis. reduced the chances of getting HIV by 86%. Clinical trials suggested it was 99% effective.
Dr John Saunders, a consultant in sexual health and HIV who worked on the study, said: "This trial has further demonstrated the effectiveness of PrEP in preventing HIV transmission and has, for the first time, shown the protective effect reported by earlier trials, but at scale, and delivered through routine sexual health services in England."
The Terrence Higgins Trust HIV charity welcomed the study's publication, but said there was "more to be done" to increase access to, and awareness of, the drug, particularly among some minority groups.
Debbie Laycock, head of policy, said: "We think that there are certain communities and individuals at the moment who could benefit from PrEP but aren't accessing it."
"Many women just don't know PrEP exists," she added.
She said the charity was calling for PrEP to be made available in pharmacies and online to widen access to it.
Dr Saunders said that although the clinical success of the drug had been proven, this study revealed other important information about how it is used.
"Before, we didn't know how many people would want it, take it, or how long they would stay on it for," he said.
"Now we know who is being prescribed it and we can work with clinics to try and get more people to take it."
He said that "real-world effectiveness" was dependent on many factors, particularly whether the drug is taken correctly.
'Liberating'
Harry Dodd, who has taken part in several PrEP trials, said taking the drug has been "empowering" for him as he no longer fears catching HIV.
"I haven't thought about that for the best part of a decade and that's liberating. I have had long-term partners who have HIV since [taking the drug] and that would not have been on my radar before. I now have the confidence to love freely."
However, Mr Dodd, 33, from north London, said he believed there was a "stigma" attached to the drug as it was "sexually related and historically connected to gay communities".
The UKSHA said the effectiveness of the drug would help achieve the government's aim of zero HIV transmissions by 2030, but that more people needed to take it.
Dr Saunders said that while gay and bisexual men were most likely to use the drug, many people from other groups, such as straight women, would benefit from taking it.
PrEP, which contains existing HIV treatment drugs tenofovir disoproxil and emtricitabine, works by stopping HIV from entering the body and making copies of itself.
It can either be taken as a daily pill or an "event" basis before sexual intercourse.
The decision to make the treatment widely available on the NHS in England in 2020 was partly based on earlier findings from this research, as well as results of earlier clinical trials.
The results of this study, published in the Lancet HIV, have only just been released because of the large sample size and the time taken to peer review it.
NHS England has been approached for comment. | Drug Discoveries |
Edit StoryJun 14, 2022,06:32am EDT| NurPhoto via Getty Images Hoping to avoid the child-wellbeing controversies that have dogged Instagram, Meta will roll out several features meant to increase safety for pre-teens in its virtual-reality realm. In addition, it will add to existing ones on Instagram, intending to tamp down on the debate about the app’s effects on kids. Through the software controlling Meta’s Quest VR headset, parents will be able to approve or deny purchases, block apps, view the apps a teen user owns and receive notifications about any purchases. The parental controls, which activate only when a teen has linked an account to a parent’s, also allow parents to view a child’s screentime, see who the child has added as a friend and block content from a PC to the VR headset. “We're adding in more in-app interventions to encourage teens to have more positive experiences online with a diversity of content,” says Vaishnavi J, Meta’s head of youth wellbeing. “And to also just be more mindful about the time that they're spending online.” Meta has come under fire from politicians recently for how it handles young people. Most prominently, lawmakers have criticized the lack of safeguards around Instagram, citing internal research from Meta released by a whistleblower that shows the company’s own concerns about teen use and mental health while using the app. Meta has responded by releasing new safety tools and attempting to discredit the leaked research. The company has several new measures meant to bolster child safety. On Instagram, parents will now be able to set times during the week to limit the app’s use and view the information around any post a child reports. Plus, Instagram will begin sending so-called “nudges” to teen users, notifications meant to curb time spent on one topic—potentially a harmful one—and migrate to another. It will even do this if a teen user spends too much time with one genre of Reels, the short-form videos Instagram has centered its app around, eager to seize back popularity and viewership from TikTok. Follow me on Twitter. Send me a secure tip. Editorial StandardsPrintReprints & Permissions | Mental Health Treatments |
Sir Chris Whitty advised against imposing a lockdown "sex ban" because couples were "not likely to listen" to orders to stay apart, leaked WhatsApp messages reveal.
England's chief medical officer (CMO) said a "bit of realism" would be needed when telling people not to see their partners unless they lived together in the spring of 2020.
However, the government went on to issue pandemic guidance that became known as a "sex ban" for couples living in separate households - who were told to move in together or stop seeing each other while restrictions were in place.
The revelation is the latest from more than 100,000 WhatsApp messages leaked to The Telegraph by journalist Isabel Oakeshott after she helped former health secretary Matt Hancock write his book, Pandemic Diaries.
According to the newspaper, Sir Chris was asked to give "the official CMO love advice" on non-cohabiting couples during a WhatsApp discussion on 24 March - the day after then prime minister Boris Johnson ordered the nation into its first lockdown.
James Slack, then Mr Johnson's spokesman, asked: "Sorry for this, but the biggest Q of the day for our finest political journalists is: 'Can I see my boyfriend or girlfriend if we don't live in the same household?'"
Sir Patrick Vallance, the chief scientific adviser, replied saying that if contact between households was to be broken, the "strict answer is that they shouldn't meet or should bunker down in the same house".
"But Chris can give the official CMO love advice," the adviser reportedly added.
Sir Chris suggested the guidance could be more relaxed for those who did not live with a vulnerable or older person.
"I think a bit of realism will be needed," he replied in the group conversation.
"If it's a regular partner I don't think people are likely to listen to advice not to see them for three weeks or maybe more.
"We could say; if they can avoid seeing one another they should, and if either of them has an older or vulnerable person in the house they must."
Later that day, Sir Chris's deputy, Dr Jenny Harries, told a press conference that social distancing guidance should apply to non-cohabiting partners.
Speaking alongside Mr Hancock, Dr Harries said: "If you are two individuals, two halves of the couple, living in separate households then ideally they should stay in those households."
She said couples could "test" their relationship and move in together while the clampdown on movement was in place.
Mr Hancock said: "There you go. Make your choice and stick with it."
The most high-profile breach of the guidance on couples living separately was by Professor Neil Ferguson, who resigned from the government's scientific advisory group for emergencies (SAGE) after it emerged that a woman reported to be his lover had visited his home in lockdown.
The so-called "sex ban" stayed in place for almost three months, when rules were relaxed to allow some couples to see each other without following social distancing restrictions.
In June 2020, new "support bubbles" allowed people living alone to combine with another household and stay overnight.
But many restrictions remained in place for another year and proved to be the downfall of Mr Hancock, who was forced to resign as health secretary after being caught breaking social distancing rules to pursue an affair with an aide.
The Department of Health and Social Care (DHSC) said it did not comment on leaks.
A government spokesman said: "We have always said there are lessons to be learnt from the pandemic.
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"We are committed to learning from the COVID inquiry's findings, which will play a key role in informing the government's planning and preparations for the future."
Mr Hancock repeated his response that there was "absolutely no public interest case for this huge breach" and said the national inquiry was the "right, and only" place for government pandemic decision-making to be "considered properly".
Hancock's secret plan to 'bring COVID patients from France to UK during second wave'
There has been a steady stream of leaks since the first story broke last week.
The messages have reignited rows about the government's handling of the pandemic, even as Mr Hancock and others have described them as only a "partial" account.
New messages also published on Monday evening reveal Mr Hancock planned to bring COVID patients from France to the UK for treatment while the country was in its second wave of the pandemic.
The former health secretary wanted to offer "spare" intensive care beds in England to French President Emmanuel Macron as Europe grappled with a new surge of infection, according to The Telegraph.
Lockdown had been reintroduced in England at that time in a bid to prevent a "medical and moral disaster".
But on 13 November 2020, Mr Hancock shared a letter with his top advisers that he proposed to send to French health minister Olivier Veran claiming to have "spare capacity in London and the south".
The plan is not thought to have been implemented, but Mr Hancock reportedly said: "We may need to make a similar offer to Italy". | Epidemics & Outbreaks |
Oonagh Cousins is accepting of the cards life dealt her but the emotions around what might have been remain raw.
Pre-selected for the Tokyo Olympics, her biggest ambition was on the verge of being ticked off when in March 2020, she contracted Covid.
Three years on, such have been the lasting effects of her diagnosis of long Covid, she has been forced to retire from rowing.
Yes, there is grief for the sporting life and experiences she could have had. But there's peace too.
She feels "lucky" she had the opportunity to give everything to her chance of a comeback. She's thankful British Rowing supported her - medically and financially - throughout her illness. She is also grateful she had the welcome support of a friend going through the same thing.
Yet, understandably, there will always be that question of 'what if?'.
"If there hadn't been a global pandemic, I probably would have gone to the Olympics," Cousins tells BBC Sport. "I probably would still be a full-time athlete.
"That's something that I have to handle for the rest of my life."
BBC Sport first spoke to Cousins in November 2020, when the conversation around long Covid was still in its infancy. Today, the 28-year-old is one of an estimated 1.9m people in the UK living with the condition.
She took a year and a half off training, a period of time in which her symptoms - mainly fatigue, though it's a word she feels underplays its severity - meant she could do little more than four hours of "basic tasks" a day like cooking or showering, a short walk at an absolute push.
But come September 2021, she felt she had "turned a corner" and started a slow, steady return, able to increase her load to the point at which her doctors gave her the all-clear and she was training 10-11 times a week.
"For most people with long Covid, that's like a million miles away," she notes. In late summer 2022, she felt it was time to return to the British Rowing programme.
"It was massive," she says. "It was such a victory but at that time, I think it was actually also my emotional blind spot, I was actually getting more ill at that point and I was ignoring the warning signals.
"I thought I was coming to the end of my long Covid journey and I'd made it back. I was just so desperate for normality.
"I missed being a rower so much, and actually what was happening was my rowing career was coming to an end."
Two months after her return, Cousins suffered a big relapse, and she made the decision to retire over Christmas.
She feels she has "paid the price" in pushing herself for too long. Her symptoms of dysautonomia - a disorder of the autonomic nervous system - worsened significantly, while she has also been diagnosed with reactive hypoglycaemia (poor blood sugar regulation), histamine intolerance (an impaired ability to metabolize ingested histamine) and oestrogen dominance, which causes problems with her hormones.
These conditions all fall under the umbrella of long Covid, and while each phase of Cousins' illness has differed, all have turned her life "upside down".
Missing out on Tokyo was "devastating" and Cousins acknowledges that next summer will be difficult, when she could have been on the start line at the Paris 2024 Olympics.
"There's a lot of grief," she adds. "I was new to the team, I felt like I was just starting my international career.
"I really did think I was planning my life to go towards Paris and Los Angeles [in 2028]. I do think that's where my life would have gone. And so there's this big loss of the life that you envisioned not being there anymore.
"But there's also a lot of peace. I think long ago I did accept that I contracted this virus and it developed into a really severe disease. I fully gave myself to the process of trying to return, I did everything I could.
"However, that means that now I can walk away and know I tried my best and there was nothing else I could have done."
'We need to talk about long Covid'
According to the World Health Organisation (WHO), studies have shown that between 10-20% of people infected with Covid will go on to develop symptoms that can be diagnosed as long Covid.
It is estimated that more than 17m people across the WHO's European region experienced long Covid during the first two years of the pandemic - and yet there is still so much unknown about the condition.
Collective forgetting may have set in for those who want to move on from Covid, but Cousins - on behalf of all those still struggling - is keen to keep the conversation going.
"I, as much as anyone, would love to not be talking about Covid anymore, I'm sick of it," she says.
"But it [long Covid] is a massive issue and it's affecting so many people, and it's an extremely debilitating illness. So as much as I understand that people don't want to talk anymore, we need to talk about it and we need to address it."
She adds: "Massive investment went into the vaccines and how to manage the acute phase of Covid, but that kind of attention has just not been given to long Covid and we need that, we need the research.
"We need to find out what's going on because although I was well supported and well understood, there's nothing anybody can really do to help me."
So what comes next for Cousins? Recovery, more than anything, is the priority, and she is confident she will one day return to a "very good level" of health.
"I try not to live life too much with a plan because long Covid has taught me that there are things out of your control, and if you become too invested in one plan, it can make it very difficult when something happens to switch on to something else," she says.
"It was out of my control. I can choose to let that go or I can choose to carry that around. And I'm choosing to let it go."
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A woman who was in seemingly good health has described how a hard-to-detect case of sepsis resulted in her having both legs amputated.
Beth Budgen, from Newbury in Berkshire, thought she just had a cold when she woke up feeling ill on Christmas Eve.
But she started developing agonising pain the next day, vomited blue liquid and was rushed to A&E in Basingstoke.
The 46-year-old spent seven months in hospital but is now back at home trying to adapt to her new way of life.
Warning: This story contains a graphic image that some readers may find upsetting.
She told BBC Radio 5 Live she wanted to share her shocking story to raise awareness so others could spot the symptoms earlier.
A few hours after arriving at hospital, doctors told her family to "prepare for the worst" as she was put into an induced coma for six weeks.
"It think it all kind of happened pretty quickly from there... by Boxing Day I had a complete organ failure," she said.
Ms Budgen was not responding to life support and medics soon established that - as well as flu and pneumonia - she had contracted the strep A bacterial infection that ultimately led to sepsis.
When she came out of the coma her feet were black and doctors told her she had to have both legs amputated.
"I can't honestly tell you how that felt," she told BBC Radio 5 Live.
"I think I was just so utterly shocked by it."
She underwent surgery at Southampton General Hospital, where she also had parts of her hands removed.
"It's surreal. At first everything is bandaged... you can see everything is shorter but you can't really see what they look like," she said.
It was only when the bandages were taken off that reality sunk in.
But Ms Budgen said she considered herself lucky and has "always been an optimistic person".
Returning home after the amputation, however, has presented her with difficult challenges.
"First night I was here on my own in my own house I made the mistake of leaving my medication downstairs, so having made the 30-minute trip getting upstairs I realised I didn't have my medication - and that was my first meltdown," she said.
"I am pretty determined to wear my [prosthetic] legs as much as I can. It's just exhausting."
What is sepsis?
- Sepsis is known as the "hidden killer" because it can be so hard to detect.
- It is caused by the immune system going into overdrive. Instead of just fighting an infection, it starts attacking other parts of the body too.
- Ultimately it causes organ failure. Even survivors can be left with long-term damage and disability.
- Bacteria and viruses that cause diarrhoeal infections or lung diseases are the leading triggers of sepsis.
- The symptoms include: loss of consciousness, severe breathlessness, a high temperature, slurred speech, nausea and vomiting, diarrhoea, severe muscle pain.
"If this happened to me it can happen to anyone that you love," Ms Budgen said.
"People really need to be aware of the signs of sepsis and educate themselves."
Ms Budgen's family has launched a campaign to help her raise money for everything else she will need, from various adaptions to her home to a bespoke pair of legs. | Disease Research |
A new study published last week suggests the psychedelic drug MDMA, also known as Ecstasy or Molly, can reduce symptoms of post-traumatic stress disorder, and some expect the treatment to be approved by 2024.
The Multidisciplinary Association for Psychedelic Studies (MAPS), a non-profit research and educational organization that was formed in 1986 and focuses on the medical, legal and cultural contexts for how people can benefit from the "careful" uses of psychedelics and marijuana, sponsored the study.
"Thanks to the combined efforts of dozens of therapists, hundreds of participants who volunteered in MAPS-sponsored trials, and many thousands of generous donors, MDMA-assisted therapy for PTSD is on track to be considered for approval by the FDA in 2024," MAPS founder and president Rick Doblin said.
The results for the third phase of the study were published in Nature Medicine on Sept. 13, 2024.
During the study, researchers measured the symptoms and results of 104 people suffering from PTSD, who were randomly assigned to be prescribed MDMA or a placebo pill over the course of three sessions, one month apart. Both groups, the study notes, were given talk therapy during the process.
One person dropped out of the MDMA group during the study, and some of the side effects felt in the MDMA group included nausea, sweating, muscle tightness and a decreased appetite.
A standard PTSD assessment measuring things like flashbacks, nightmares and insomnia found that 86% of the MDMA group improved, compared to 69% in the placebo group.
Once the study was complete, 72% of those in the MDMA group no longer met the criteria to be diagnosed with PTSD, compared with 48% of the people in the placebo group.
In July, Australia became the first country to allow psychiatrists to prescribe certain psychedelic substances to patients with depression or PTSD.
The approval of the therapy meant Australian physicians could now prescribe doses of MDMA, while psilocybin, the psychoactive ingredient in psychedelic mushrooms, can now be given to those with hard-to-treat depression.
The U.S. Food and Drug Administration designated psilocybin as a "breakthrough therapy" in 2018, a label that’s designed to speed the development and review of drugs to treat a serious condition. Psychedelics researchers have benefited from federal grants, including Johns Hopkins, and the FDA released draft guidance late last month for researchers designing clinical trials testing psychedelic drugs as potential treatments for a variety of medical conditions.
Still, the American Psychiatric Association has not endorsed the use of psychedelics in treatment.
Medical experts in the U.S. and elsewhere, Australia included, have cautioned that more research is needed on the drugs’ efficacy and the extent of the risks of psychedelics, which can cause hallucinations.
The Associated Press contributed to this report. | Mental Health Treatments |
- Bristol Myers Squibb reported quarterly adjusted earnings that topped expectations and posted revenue in line with estimates.
- But sales of the company's popular blood cancer drug Revlimid plummeted due to generic competition.
- Bristol Myers will hold an earnings call with investors at 8 a.m. E.T. on Thursday.
Bristol Myers Squibb on Thursday reported quarterly adjusted earnings that topped expectations and posted revenue in line with estimates, even as sales of the company's popular blood cancer drug Revlimid plummeted due to generic competition.
Bristol Myers, one of the world's largest pharmaceutical companies, raked in $10.96 billion in revenue for the third quarter, down 2% from the same period last year.
The drugmaker said that decline was due to lower sales of Revlimid, which generated $1.43 billion for the quarter. Bristol Myers has been under pressure to launch or acquire new drug products as Revlimid – and eventually, other top-selling treatments such as blood thinner Eliquis and cancer immunotherapy Opdivo – competes with cheaper generic versions.
Revlimid sales, which fell 41% from the third quarter of 2022, also dropped due to an increase in patients receiving the drug at no cost through the company's patient assistance foundation, Bristol Myers said.
The company reported a net income of $1.93 billion, or 93 cents per share. That compares with a net income of $1.61 billion, or 75 cents per share, for the year-ago period. Excluding certain items, adjusted earnings per share were $2 for the period.
Here's what Bristol Myers Squibb reported for the third quarter compared with what Wall Street was expecting, based on a survey of analysts by LSEG, formerly known as Refinitiv:
- Earnings per share: $2 adjusted vs. $1.76 expected
- Revenue: $10.96 billion vs. $10.96 billion expected
Shares of Bristol Myers fell nearly 5% in premarket trading Thursday. The stock is down more than 21% for the year through Wednesday's close, putting the company's market value at roughly $118 billion.
The company narrowed its full-year adjusted earnings outlook to $7.50 to $7.65 per share, from a previous forecast of $7.35 to $7.65 a share. Bristol Myers also reiterated its full-year revenue guidance of a low single-digit percentage decline.
Notably, the company hiked its full-year revenue projection for Revlimid to $6 billion from $5.5 billion in July, even as the drug sees falling sales.
Bristol Myers said both older and new drug products helped offset the lower sales of Revlimid for the third quarter.
Eliquis raked in $2.71 billion in sales for the quarter and Opdivo generated $2.28 billion, up 2% and 11% from the year-ago period, respectively. However, both drugs fell short of analyst estimates compiled by FactSet.
Eliquis, which Bristol Myers shares with Pfizer, is among the first ten drugs selected to face price negotiations with the federal Medicare program.
Meanwhile, a portfolio of several newer products booked $928 million in sales for the quarter, up 68% from the year-ago period. Bristol Myers said that growth was primarily driven by higher demand, including for prescription anemia medication Reblozyl, which generated $248 million in sales for the quarter.
Skin cancer drug Opdualag also raked in $166 million in sales for the third quarter, which is up 98% from the same quarter a year ago. Those two drugs missed analyst sales estimates compiled by FactSet.
Bristol Myers will hold an earnings call with investors at 8 a.m. E.T. on Thursday.
During the call, executives will likely be asked about the company's plan to acquire cancer drugmaker Mirati Therapeutics for up to $5.8 billion. | Drug Discoveries |
- Eli Lilly said supply of its blockbuster diabetes drug Mounjaro has recently improved in the U.S. after widespread shortages.
- However, the pharmaceutical giant noted that it is still working to increase production capacity for the treatment and other drugs.
- Demand for the treatment is soaring, largely due to its off-label ability to cause weight loss.
However, the pharmaceutical giant noted that it is still working to increase production capacity for the treatment and other drugs.
The remarks suggest that Eli Lilly's efforts to expand manufacturing capacity for Mounjaro are paying off. Demand for the treatment is soaring, largely due to its off-label ability to cause significant weight loss. U.S. regulators could potentially approve the drug for weight loss this year, which could push up demand even more.
During an earnings call Thursday, Eli Lilly executives said the company experienced tight supply for Mounjaro throughout most of the third quarter. Mounjaro raked in $1.4 billion in sales for the quarter, helping the company beat expectations on both the top and bottom lines.
But U.S. product shipments of Mounjaro have recently increased, and inventory levels at U.S. drug wholesalers have improved, according to Eli Lilly CFO Anat Ashkenazi.
She noted that all doses of Mounjaro are now listed as available on the Food and Drug Administration's shortage database. Meanwhile, Mounjaro supply remains tight internationally, Ashkenazi added.
Eli Lilly is on track to achieve its goal of doubling production capacity for drugs like Mounjaro and its other diabetes treatment Trulicity, Ashkenazi said. Both drugs work by mimicking hormones produced in the gut called incretins to suppress a person's appetite and regulate blood sugar.
Ashkenazi pointed to the company's new facility in North Carolina, which is now "online" to provide additional drug assembly capacity. Eli Lilly has also invested more than $3 billion to build two new manufacturing sites in its home state of Indiana.
But Eli Lilly CEO David Ricks said during the earnings call that the company is still "aggressively planning" further production build-up for Mounjaro and other drugs.
He noted that the company has been inking third-party manufacturing agreements with a "diverse portfolio" of contractors, with Eli Lilly "buying up as much capacity as available" in their systems.
"This is really all-hands-on-deck," Ricks said. "It's a problem we work on every day. So we're not at all happy with the capacity."
Eli Lilly's main rival in the weight loss drug space, Novo Nordisk, is still navigating its own supply constraints of diabetes drug Ozempic and obesity treatment Wegovy.
Ozempic and Wegovy sparked the weight loss industry gold rush last year, pushing Eli Lilly and other companies like Pfizer to ramp up their investments in the space.
Initial studies have suggested that Eli Lilly's Mounjaro may be even more effective at reducing weight than Wegovy and Ozempic. | Drug Discoveries |
California Gov. Gavin Newsom vetoed two bills Saturday that would have made California the first U.S. state to, and would have decriminalized the possession and personal use of several hallucinogens, including psychedelic mushrooms.
Thewould have allowed those 21 and older to possess psilocybin, the hallucinogenic component in what's known as psychedelic mushrooms. It also would have covered dimethyltryptamine (DMT) and mescaline.
Newsom said the caste bill was unnecessary, saying California already has protections in place.
Why did the decriminalization of hallucinogens, including psychedelic mushrooms bill get vetoed?
The bill would not have legalized the sale of the substances and would have barred any possession of the substances on school grounds. Instead, it would have ensured people are neither arrested nor prosecuted for possessing limited amounts of plant-based hallucinogens. Newsom, a Democrat who championed legalizing cannabis in 2016, said in a statement Saturday that more needs to be done before California decriminalizes the hallucinogens.
"California should immediately begin work to set up regulated treatment guidelines — replete with dosing information, therapeutic guidelines, rules to prevent against exploitation during guided treatments, and medical clearance of no underlying psychoses," Newsom's statement said. "Unfortunately, this bill would decriminalize possession prior to these guidelines going into place, and I cannot sign it."
Even if California made the bill a law, the drugs would still be illegal under federal law.
In recent years,, including post-traumatic stress disorder. The Federal Drug Administration designated psilocybin as a "breakthrough therapy" for treatment-resistant depression in 2019 and recently published a draft guideline on using psychedelics in clinical trials.
Public opinion on psychedelics, which have been mostly associated with 1960s drug culture, has also shifted to support therapeutic use. Supporters of the legislation include veterans, who have talked about the benefits of using psychedelics to treat trauma and other illnesses.
"Psilocybin gave me my life back," Joe McKay, a retired New York City firefighter who responded to the 9/11 attacks, said at an Assembly hearing in July. "No one should go to jail for using this medicine to try to heal."
But opponents said the drugs' benefits are still largely unknown, and the bill could lead to more crimes - though studies in recent years have shown decriminalization does not increase crime rates. Organizations representing parents also worry the legislation would make it easier for children and young people to access the drugs.
Why did the caste discrimination bill get vetoed?
Earlier this year, Seattle became the first U.S. city to add caste to its anti-discrimination laws. On Sept. 28, Fresno became the second U.S. city andbased on caste by adding caste and indigeneity to its municipal code.
In his message, Newsom called the bill "unnecessary,""already prohibits discrimination based on sex , race, color, religion, ancestry, national origin, disability, gender identity, sexual orientation, and other characteristics, and state law specifies that these civil rights protections shall be liberally construed."
"Because discrimination based on caste is already prohibited under these existing categories, this bill is unnecessary," he said in the statement.
A United Nations report in 2016 said at least 250 million people worldwide still face caste discrimination in Asia, Africa, the Middle East and Pacific regions, as well as in various diaspora communities. Caste systems are found among Buddhists, Christians, Hindus, Jains, Muslims and Sikhs. Caste is a division of people related to birth or descent. Those at the lowest strata of the caste system, known as Dalits, have been pushing for legal protections in California and beyond. They say it is necessary to protect them from bias in housing, education and in the tech sector - where they hold key roles.
In March, state Sen. Aisha Wahab, the first Muslim and Afghan American elected to the California Legislature, introduced the bill. The California law would have included caste as a sub-category under "ethnicity" — a protected category under the state's anti-discrimination laws.
Opponents, including some Hindu groups, called the proposed legislation "unconstitutional" and have said it would unfairly target Hindus and people of Indian descent. The issue has divided the Indian American community.
for more features. | Drug Discoveries |
By Ashley Ann Lora, as told to Stephanie Watson
I was diagnosed with atopic dermatitis when I was 2 years old. I don't remember much of it at that age, but my parents sure do. The redness and bumps on my face are obvious in almost every photo of me from back then. It's very clear from those pictures just how much the condition truly affected me.
I remember sleeping with my parents to try to keep myself from scratching my skin all night. I missed a lot of days of school, especially when it got severe.
There were so many things I felt like I couldn't do because of eczema. It stopped me from playing sports, hanging out with my friends, and doing what "normal" kids do. I shed a lot of tears during that time.
Finally, there was a moment when the eczema went dormant. It was the best 2 years of my life up to that point. For the first time, I was able to grow out my nails and wear short-sleeved shirts. I truly believed that my eczema was gone. But then, on a family trip to an amusement park, I got super sick and the eczema came back with a vengeance. My dream of being eczema-free was gone in a matter of hours.
Tests and Treatments
Because eczema and allergies are closely related, I went through allergy testing. My doctor made all these little pricks on my back and applied different substances to see if I was allergic to them. There must have been 50 or 60 different marks on my back. I was allergic to almost every one of them, including trees, grass, and even certain types of rubber.
I went to a lot of doctor appointments from elementary school all the way up to high school. But from high school to college, I had given up on doctors because every visit was the same. I'd go into the exam room, the doctor would look at my skin, and within 5 minutes I'd walk out with a prescription for topical steroids.
The steroids would help temporarily, especially when my atopic dermatitis got really bad. But it felt like a Band-Aid, because eventually it would come back even worse. Then I'd have to go through the whole process again.
I had a love-hate relationship with mirrors growing up. I didn't feel good about myself for a very long time. It was hard. Eczema affected me physically, socially, and psychologically. It felt very lonely because I thought I was the only one in the world living with this condition.
My Healing Journey
November 2014 was the beginning of my healing journey. I was in the middle of one of the worst flares of my adult life. I tried going through the same routine of using topical steroids, but this time it didn't work.
I said, "enough is enough" and started doing my own research on eczema. I learned about topical steroid withdrawal and started to go through that process. It was rough. I had used steroids for more than 20 years. When I went off them, I had severe withdrawal symptoms that left me bedridden for almost a year and a half.
I lost half of my hair and part of my vision. My skin looked like a combination of snake and elephant skin. I shed so much that I constantly had to vacuum my bed and every corner of my house. It was like my body was going through a process of transforming itself.
In the middle of withdrawing from steroids, I got into a clinical trial of the biologic drug dupilumab (Dupixent). That was a game-changer. With that drug, I was finally able to start enjoying life. My skin was the clearest it had ever been. I felt normal!   Â
In 2017, my skin was doing so well that I started to withdraw from dupilumab. I wanted to see how my skin would do without it. I wouldn't recommend that approach for everybody, but I had confidence that my body could heal itself.
I'm currently not taking any medication. I've been focusing on more holistic practices like meditation, therapy, exercising, and eating foods that make me feel good. I've learned what works for me by seeing what has worked for other people.
Regaining Control
The biggest lesson I've learned during my journey is that my eczema is correlated with my emotions. A lot of people say stress triggers their eczema. For me, anger, sadness, and depression trigger it, too. As I've become more aware of my emotions, I see how they affect me and I've learned to control them through meditation and breathing.
Years ago, I let eczema take over my life. I would get into an itching cycle and my whole world would crash down around me. I lost a lot of who I was because of it. I don't remember much of my childhood because the eczema was so traumatic and it consumed so much of what was good about my life.
I've done a full 180 since then. When I began accepting my eczema and figuring out how I could work with it, I got my life back. There was even a point when I began referring to my eczema as "she." She became my best friend. When she flared up, I would ask her how we could work together to heal. By personifying my eczema and relating to her instead of seeing her as my enemy, I started healing more quickly.    Â
I still flare up, but atopic dermatitis no longer controls what I get to do on a particular day. My condition is no longer the deciding factor in what I wear, where I go, and who I hang out with.
In 2015, I started calling myself an eczema warrior. I am a warrior, in a sense, because Iâve courageously conquered my eczema (mentally more than physically) and continue to do so. I've come to terms with my eczema. I'm proud of her and I'm proud of how far we've come together. Â Â Â Â Â
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Photo Credit:Â ViDi Studio / Getty Images
Ashley Ann Lora, Garfield, NJ | Disease Research |
Scientists at Harvard Medical School have shown for the first time that a common skin bacterium -- Staphylococcus aureus -- can cause itch by acting directly on nerve cells.
The findings, based on research in mice and in human cells, are reported Nov. 22 in Cell. The research adds an important piece to the long-standing puzzle of itch and helps explain why common skin conditions like eczema and atopic dermatitis are often accompanied by persistent itch.
In such conditions, the equilibrium of microorganisms that keep our skin healthy is often thrown off balance, allowing S. aureus to flourish, the researchers said. Up until now, the itch that occurs with eczema and atopic dermatitis was believed to arise from the accompanying inflammation of the skin. But the new findings show that S. aureus single-handedly causes itch by instigating a molecular chain reaction that culminates in the urge to scratch.
"We've identified an entirely novel mechanism behind itch -- the bacterium Staph aureus, which is found on almost every patient with the chronic condition atopic dermatitis. We show that itch can be caused by the microbe itself," said senior author Isaac Chiu, associate professor of immunology in the Blavatnik Institute at HMS.
The study experiments showed that S. aureus releases a chemical that activates a protein on the nerve fibers that transmit signals from the skin to the brain. Treating animals with an FDA-approved anti-clotting medicine successfully blocked the activation of the protein to interrupt this key step in the itch-scratch cycle. The treatment relieved symptoms and minimized skin damage.
The findings can inform the design of oral medicines and topical creams to treat persistent itch that occurs with various conditions linked to an imbalance in the skin microbiome, such as atopic dermatitis, prurigo nodularis, and psoriasis.
The repeated scratching that is a hallmark of these conditions can cause skin damage and amplify inflammation.
"Itch can be quite debilitating in patients who suffer from chronic skin conditions. Many of these patients carry on their skin the very microbe we've now shown for the first time can induce itch," said study first author Liwen Deng, a postdoctoral research fellow in the Chiu Lab.
Identifying the molecular spark plug that ignites itch
Researchers exposed the skin of mice to S. aureus. The animals developed intensifying itch over several days, and the repeated scratching caused worsening skin damage that spread beyond the original site of exposure.
Moreover, mice exposed to S. aureus became hypersensitive to innocuous stimuli that would not typically cause itch. The exposed mice were more likely than unexposed mice to develop abnormal itching in response to a light touch.
This hyperactive response, a condition called alloknesis, is common in patients with chronic conditions of the skin characterized by persistent itch. But it can also happen in people without any underlying conditions -- think of that scratchy feeling you might get from a wool sweater.
To determine how the bacterium triggered itch, the researchers tested multiple modified versions of the S. aureus microbe that were engineered to lack specific pieces of the bug's molecular makeup. The team focused on 10 enzymes known to be released by this microbe upon skin contact. One after another, the researchers eliminated nine suspects -- showing that a bacterial enzyme called protease V8 was single-handedly responsible for initiating itch in mice. Human skin samples from patients with atopic dermatitis also had more S. aureus and higher V8 levels than healthy skin samples.
The analyses showed that V8 triggers itch by activating a protein called PAR1, which is found on skin neurons that originate in the spinal cord and carry various signals -- touch, heat, pain, itch -- from the skin to the brain. Normally, PAR1 lies dormant but upon contact with certain enzymes, including V8, it gets activated. The research showed that V8 snips one end of the PAR1 protein and awakens it. Experiments in mice showed that once activated, PAR1 initiates a signal that the brain eventually perceives as itch. When researchers repeated the experiments in lab dishes containing human neurons, they also responded to V8.
Interestingly, various immune cells implicated in skin allergies and classically known to cause itch -- mast cells and basophils -- did not drive itch after bacterial exposure, the experiments showed. Nor did inflammatory chemicals called interleukins, or white cells, which are activated during allergic reactions and are also known to be elevated in skin diseases and even in certain neurologic disorders.
"When we started the study, it was unclear whether the itch was a result of inflammation or not," Deng said. "We show that these things can be decoupled, that you don't necessarily have to have inflammation for the microbe to cause itch, but that the itch exacerbates inflammation on the skin."
Interrupting the itch-scratch cycle
Because PAR1 -- the protein activated by S. aureus -- is involved in blood-clotting, researchers wanted to see whether an already approved anticlotting drug that blocks PAR1 would stop itch. It did.
The itchy mice whose skin was exposed to S. aureus experienced rapid improvement when treated with the drug. Their desire to scratch diminished dramatically, as did the skin damage caused by scratching.
Moreover, once treated with PAR1 blockers, the mice no longer experienced abnormal itch in response to innocuous stimuli.
The PAR1 blocker is already used in humans to prevent blood clots and could be repurposed as anti-itch medication. For example, the researchers noted, the active ingredient in the medicine could become the basis for anti-itch topical creams.
One immediate question that the researchers plan to explore in future work is whether other microbes besides S. aureus can trigger itch.
"We know that many microbes, including fungi, viruses, and bacteria, are accompanied by itch but how they cause itch is not clear," Chiu said.
Beyond that, the findings raise a broader question: Why would a microbe cause itch? Evolutionarily speaking, what's in it for the bacterium?
One possibility, the researchers said, is that pathogens may hijack itch and other neural reflexes to their advantage. For example, previous research has shown that the TB bacterium directly activates vagal neurons to cause cough, which might enable it to spread more easily from one host to another.
"It's a speculation at this point, but the itch-scratch cycle could benefit the microbes and enable their spread to distant body sites and to uninfected hosts," Deng said. "Why do we itch and scratch? Does it help us, or does it help the microbe? That's something that we could follow up on in the future."
The work was funded by the National Institutes of Health (grants R01AI168005, R01AI153185, R01NS065926, R01NS102161, R01NS111929, R37AI052453, R01AR076082, U01AI152038, UM1AI151958, R01AI153185, R01JL160582, F32AI172080, T32AI049928, 1R21AG075419), Food Allergy Science Initiative (FASI), Burroughs Wellcome Fund, Drako Family Fund, Jackson-Wijaya Research Fund, Canadian Institutes of Health Research (CIHR) (grants 376560 and 469411), and ANR-PARCURE (PRCE-CE18, 2020).
Chiu serves on the scientific advisory board of GSK Pharmaceuticals. Provisional patent application Serial No. 63/438,668, in which some coauthors are listed as inventors, was filed based on these findings.
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An algorithm that takes into account how long patients have been on the waitlist, where they live, their financial circumstances, and their ethnicity to help determine where they should be placed on a surgery waitlist has raised debate in New Zealand this week.
Key points:
- An algorithm to adjust where patients sit on elective surgery waitlists has been used in parts of Auckland since February
- There are reports that some surgeons were ethically opposed to using ethnicity as a factor
- The Opposition leader says "race shouldn't play any part in determining surgical need"
An algorithm to adjust where patients sit on elective surgery waitlists has been used in parts of Auckland since February, however, many were not aware of it until this week.
The algorithm gives Indigenous Māori and Pacific Island patients a higher priority on the list, pushing down white New Zealanders and other ethnicities with the idea to balance out longstanding inequities in the public system.
"At the moment, there is clear evidence Māori, Pacific, rural and low-income communities have been discriminated against by the health system," Prime Minister Chris Hipkins said.
On Monday, radio station Newstalk ZB reported that some surgeons were ethically opposed to using ethnicity as a factor.
In an election year, the issue has quickly become a hot political topic, with conservative opposition parties coming out strongly against it.
"It's pretty simple," Opposition Leader Christopher Luxon said on Monday.
"Race shouldn't play any part in determining surgical need."
The libertarian ACT Party has started a petition against what it describes as "race-based waitlists".
Following the backlash, Mr Hipkins quickly put plans to use the algorithm more broadly across New Zealand's healthcare system on ice.
Mr Hipkins said he asked Health Minister Ayesha Verrall to take a closer look at the tool to ensure "we're not replacing one form of discrimination with another".
Ms Verrall said some aspects of the debate had disappointed her.
"I think it is important that we address the inequalities that we have in life expectancy and health services for Māori," she said.
"I think it's disappointing the tone that it's taken."
She said one example of existing bias in the healthcare system was that Māori with the same heart conditions as white people get prescribed fewer medications.
Professional healthcare organisations have expressed mixed reactions to the tool.
Groups representing nurses have backed it, while a group representing surgeons said it was too simplistic.
About 10 per cent of New Zealand's 5 million people were among those currently covered by the algorithm.
Patients affected include those attending Auckland City Hospital and Greenlane Clinical Centre.
Jo Gibbs, who directs hospital system delivery at Health New Zealand, said those who were sickest or most in need of care were treated first.
Beyond that, she said, the algorithm was helping reduce barriers and inequities in the health system.
"We will evaluate the tool to check it is achieving its purpose," she wrote in a statement to The Associated Press. "It has not been rolled out nationally."
AP/ ABC | Health Policy |
SACRAMENTO, Calif. — California is the first state to ban doctors and medical examiners from attributing deaths to the controversial diagnosis known as “excited delirium,” which a human rights activist hailed as a “watershed moment” that could make it harder for police to justify excessive force.
Democratic Gov. Gavin Newsom signed a bill Oct. 8 to prohibit coroners, medical examiners, physicians, or physician assistants from listing excited delirium on a person’s death certificate or in an autopsy report. Law enforcement won’t be allowed to use the term to describe a person’s behavior in any incident report, and testimony that refers to excited delirium won’t be allowed in civil court. The law takes effect in January.
The term excited delirium has been around for decades but has been used increasingly over the past 15 years to explain how a person experiencing severe agitation can die suddenly through no fault of the police. It was cited as a legal defense in the 2020 deaths of George Floyd in Minneapolis; Daniel Prude in Rochester, New York; and Angelo Quinto in Antioch, California, among others.
“This is a watershed moment in California and nationwide,” said Joanna Naples-Mitchell, a lawyer with the New York-based Physicians for Human Rights, who co-authored a 2022 report on the use of the diagnosis.
“In a wrongful death lawsuit, if excited delirium comes up, it’s a big hurdle for a family getting justice if their family member was actually killed by police,” Naples-Mitchell said. “So, now it will be basically impossible for them to offer testimony on excited delirium in California.”
Even though the new law makes California the first state to no longer recognize excited delirium as a medical diagnosis, several national medical associations already discredited it. Since 2020, the American Medical Association and the American Psychiatric Association have rejected excited delirium as a medical condition, noting the term has disproportionately applied to Black men in law enforcement custody. This year, the National Association of Medical Examiners rejected excited delirium as a cause of death, and the American College of Emergency Physicians is expected to vote this month on whether to formally disavow its 2009 position paper supporting excited delirium as a diagnosis. That white paper proposed individuals in a mental health crisis, often under the influence of drugs or alcohol, can exhibit superhuman strength as police try to control them, and then die from the condition.
In the case of Quinto, his mother, Cassandra Quinto-Collins, had called Antioch police two days before Christmas because her son was experiencing a mental health crisis. She had subdued him by the time they arrived, she said, but officers held her 30-year-old son to the ground until he passed out.
In a harrowing home video taken by Quinto-Collins, which was broadcast nationally after his death, she asked police what happened as her son lay on the floor unconscious, hands behind his back in handcuffs. He died three days later in the hospital.
The Contra Costa County coroner’s office, part of the sheriff’s department, blamed Quinto’s death on excited delirium. The Quinto family has filed a wrongful death lawsuit against the county and is seeking to change the cause of death on his death certificate.
Quinto-Collins also testified in favor of the bill, AB 360, introduced by state Assembly member Mike Gipson, a Democrat. It sailed through the legislature with bipartisan support. No organization formally opposed the measure, including the California Police Chiefs Association, whose executive director declined to comment this week.
“There’s a lot more work to be done, but it is a unique window into some of the corruption, some of the things that we’ve allowed to happen under our noses,” said Robert Collins, Quinto’s stepfather. “I think it’s really telling that California is ending it.”
Part of the problem with an excited delirium diagnosis is that delirium is a symptom of an underlying condition, medical professionals say. For example, delirium can be caused by old age, hospitalization, a major surgery, substance use, medication, or infections, said Sarah Slocum, a psychiatrist in Exeter, New Hampshire, who co-authored a review of excited delirium published in 2022.
“You wouldn’t just put ‘fever’ on someone’s death certificate,” Slocum said. “So, it’s difficult to then just put ‘excited delirium’ on there as a cause of death when there is something that’s underlying and driving it.”
In California, some entities already had restricted the use of excited delirium, such as the Bay Area Rapid Transit Police Department, which prohibits the term in its written reports and policy manual.
But these changes confront decades of conditioning among law enforcement and emergency medical personnel who have been taught that excited delirium is real and trained how to handle someone suspected of having it.
“There needs to be a systematic retraining,” said Abdul Nasser Rad, managing director of research and data at Campaign Zero, a nonprofit group that focuses on criminal justice reform and helped draft the California law. “There’s real worry about just how officers are being trained, how EMS is being trained on the issue.” | Health Policy |
- E-cigarette usage among U.S. high school students has fallen as the government pursues aggressive action against companies selling illegal vape products.
- The decline comes as overall tobacco smoking among this group hits an all-time low, according to the Food and Drug Administration and the Centers for Disease Control and Prevention.
- Still, for middle schoolers, there was an increase in current overall tobacco product use to 6.6% from 4.5%.
E-cigarette usage among U.S. high school students has fallen as the government pursues aggressive action against companies selling illegal vape products that appeal to young people, federal health regulators said Thursday.
The findings, a part of the 2023 National Youth Tobacco Survey, showed that from 2022 to 2023 e-cigarette use among high school students declined to 10% from 14.1%, a drop representing about 580,000 fewer high schoolers.
The decline comes as overall tobacco smoking among this group hits an all-time low, according to the Food and Drug Administration and the Centers for Disease Control and Prevention. Current use of any tobacco product by high school students declined by an estimated 540,000 students, to 1.97 million in 2023 from 2.51 million in 2022.
"It's encouraging to see this substantial decline in e-cigarette use among high schoolers within the past year, which is a win for public health," Brian King, director of the FDA's Center for Tobacco Products, said in a release.
E-cigarette usage has been the most commonly used tobacco product among both high school and middle school students for a decade. For middle schoolers, grades 6 to 8, there were no significant changes in e-cigarette use from 2022 to 2023. Still, for middle schoolers, there was an increase in current overall tobacco product use to 6.6% from 4.5%.
Curbing e-cigarette usage among the country's youth has been a top priority for U.S. health regulators. In recent months, the issue has become more cumbersome as newer vaping devices flood the market from overseas and circumvent existing tobacco regulation. The biggest culprit, the Chinese brand Elf Bar, can still be found on shelves despite being banned by the FDA.
Among students currently using e-cigarettes, Elf Bar was the most commonly reported brand at 56.7%, followed by Esco Bars, Vuse, JUUL and Mr. Fog, the report found.
The report reiterated that youth use of tobacco products remains unsafe.
King said the agency has more work to do to crackdown as "bad actors place profit over the health of our nation's youth."
"The FDA remains concerned about youth tobacco product use, and we cannot and will not let our guard down on this issue," King said. "The agency has an array of enforcement tools at our disposal, and we're committed to using them as appropriate."
Over the past year, the FDA said it has issued more than hundreds of warning letters to manufacturers, distributors and retailers of unauthorized e-cigarettes, including several distributors of Elf Bar. | Epidemics & Outbreaks |
A newborn baby has been credited with saving his mum's life after a brain tumour was found a week after she gave birth.
Abi Naylor, 28, from Congleton, Cheshire, thought her migraines were down to life with a new baby.
When they became "excruciating" she was admitted to hospital and operated on within 48 hours.
Doctors said the tumour may have gone undetected had it not grown due to pregnancy stress and hormones.
After going through the ordeal in October 2022, Mrs Naylor said she and her husband Ross, along with baby Roman, are now "just trying to be a normal family".
Mrs Naylor said she first noticed a headache when her son was a week old.
"I just thought it was from sleepless nights and breastfeeding...since puberty I've always suffered from migraines so just thought this must be a whopping one," she said.
Days later, Mrs Naylor went to an out-of-hours doctors where she was told it was probably side effects from having an epidural during labour, but was told to go to A&E to have a scan and get painkillers.
Mrs Naylor said things started to get worse and when she woke up the next day she "couldn't walk or use my right side".
After a ten-hour wait in A&E, Mrs Naylor said she was eventually given a scan which showed she had a 2.75in (7cm) brain tumour.
"You have doctors telling you what they are going to do next with scans, but you don't hear any of that," she said.
"I just thought I'm not going to see my husband or see my baby grow up," she said.
After being taken to Salford Royal Hospital by ambulance for MRI scans, Mrs Naylor was then told she needed the tumour removed as soon as possible.
"It was a whirlwind," she said.
Mrs Naylor said she also owes a lot to her husband.
"With a newborn he was doing the night feed while looking after me and having a really positive mindset. He is just the most incredible man I've ever met," she said.
Mrs Naylor said all her scans have now come back clear and that she is recovering well. | Medical Innovations |
Mouse embryos grown in space for first time: Japan researchers
Mouse embryos have been grown on the International Space Station and developed normally in the first study indicating it could be possible for humans to reproduce in space, a group of Japanese scientists said.
The researchers, including Teruhiko Wakayama, professor of University of Yamanashi's Advanced Biotechnology Centre, and a team from the Japan Aerospace Space Agency (JAXA), sent frozen mouse embryos on board a rocket to the ISS in August 2021.
Astronauts thawed the early-stage embryos using a special device designed for this purpose and grew them on the station for four days.
"The embryos cultured under microgravity conditions developed" normally into blastocysts, cells that develop into the fetus and placenta, the scientists said.
They also said there were no significant changes in condition of the DNA and genes, after they analyzed the blastocysts that were sent back to their laboratories on Earth.
This is "the first-ever study that shows mammals may be able to thrive in space," University of Yamanashi and national research institute Riken said in a joint statement on Saturday.
It is "the world's first experiment that cultured early-stage mammalian embryos under complete microgravity of ISS," the statement said.
"In the future, it will be necessary to transplant the blastocysts that were cultured in ISS's microgravity into mice to see if mice can give birth" to confirm that the blastocysts are normal, it added.
Such research could be important for future space exploration and colonization missions.
Under its Artemis program, NASA plans to send humans back to the moon in order to learn how to live there long-term to help prepare a trip to Mars, sometime towards the end of the 2030s.
Journal information: iScience
© 2023 AFP | Medical Innovations |
The mosquito-borne illness malaria has sickened five U.S. residents with no recent travel history, meaning they caught the disease locally, the Centers for Disease Control and Prevention (CDC) warned Monday (June 26).
Before these cases, locally acquired mosquito-borne malaria had not been reported in the U.S. for 20 years, since 2003 when eight people in Palm Beach County, Florida caught the disease, according to the CDC health advisory.
The five recent cases took place within the past two months. Four happened in "close geographic proximity" in Sarasota County, Florida. The remaining case was in Cameron County, Texas, the Texas Department of State Health Services reported. The CDC advisory notes that the cases were "mosquito-transmitted," meaning those affected got malaria from mosquito bites, which is the most common way of catching the disease.
Each year, about 2,000 people test positive for malaria in the U.S., but the vast majority have recently traveled internationally to regions where the disease is endemic, meaning it regularly spreads there, the CDC notes. However, because mosquito species that can carry malaria live in the U.S., there's a potential risk for local mosquitoes to pick up malaria parasites from an infected person and thus reintroduce the disease in the area.
(Malaria was eliminated in the U.S. in the 1940s and 1950s, thanks to a campaign largely aimed at eliminating mosquito breeding grounds and spraying mosquito-killing pesticides.)
Since malaria was eliminated in the U.S., outbreaks of locally acquired disease have been "small and relatively isolated," the CDC states. When outbreaks do occur, they're considered public health emergencies and the CDC works with local health departments to identify additional human malaria cases and coordinate with ongoing mosquito control and surveillance programs, as necessary.
Mosquitoes in the genus Anopheles carry malaria-causing parasites and spread them to humans through their bites. The pests initially pick up the parasites by biting a person already infected with malaria. (Very rarely, people can get malaria via blood transfusions, organ transplantation or unsafe needle-sharing practices, the CDC notes. If picked up in pregnancy, malaria parasites can also pass through the placenta to fetuses or infect babies during birth.)
Five species of Plasmodium parasites can cause malaria in humans. The parasite identified in the recent U.S. cases is called P. vivax, according to the CDC, and it's less likely to cause fatal disease than another, more dangerous species called P. falciparum.
The five people recently infected with P. vivax have "received treatment and are improving," the CDC advisory notes. Treatment for malaria depends on several factors, including the parasite species and the severity of the patient's illness.
Typically, within a week to a month of being bitten by a mosquito carrying the malaria-causing parasite, people experience an initial "attack" that lasts hours and has several stages of symptoms, including cold and shivering; then fever, headaches and vomiting; and finally, sweating and fatigue. Additional signs of malaria that doctors look for include an enlarged spleen, mild jaundice (yellowing of the skin and eyes), enlargement of the liver and increased breathing rate.
Severe malaria can cause kidney injury, inflammation in the lungs that hinders oxygen exchange, the destruction of oxygen-carrying red blood cells, and serious neurological symptoms, including seizures and coma, among other serious symptoms.
Some species of malaria parasite, including P. vivax, can go dormant, lurk in the liver and then reactivate months or years down the line. Treatments can lower the likelihood of this reactivation, the CDC notes.
"Malaria is a medical emergency and should be treated accordingly," the CDC advised in its notice. "Patients suspected of having malaria should be urgently evaluated in a facility that is able to provide rapid diagnosis and treatment, within 24 hours of presentation."
To limit their risk of malaria, iIndividuals can take steps to prevent mosquito bites and control mosquitoes at home, the CDC advises. People traveling to a place where malaria is endemic should consult a health care provider about taking preventive medicine while abroad. (Again, malaria is not endemic anywhere in the U.S.)
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Nicoletta Lanese is the health channel editor at Live Science and was previously a news editor and staff writer at the site. She holds a graduate certificate in science communication from UC Santa Cruz and degrees in neuroscience and dance from the University of Florida. Her work has appeared in The Scientist, Science News, the Mercury News, Mongabay and Stanford Medicine Magazine, among other outlets. Based in NYC, she also remains heavily involved in dance and performs in local choreographers' work. | Epidemics & Outbreaks |
|Trampoline, Tumbling and DMT World Championships|
|Venue: Birmingham Dates: Thursday, 9 November to Sunday, 12 November|
|Coverage: Live on BBC iPlayer, BBC Red Button and BBC Sport website and app.|
"I'm absolutely loving being a mum," Olympic trampoline gymnast Laura Gallagher says with a beaming smile, while cradling her daughter.
Although she quickly adds: "I'm just about managing some sleep!"
After an often "horrendous" pregnancy and 36-hour labour, which resulted in an unplanned Caesarean section, Edie arrived in January.
Gallagher is, by her own admission, "surprised" to now be in the position to make a major competitive comeback.
The World Championships in Birmingham, which run from 9-12 November, will be the 34-year-old's first event since finishing 15th at the Tokyo Olympics two years ago.
"Having Edie has taught me more than ever that time is precious and you don't get it back," she tells BBC Sport.
'Becoming an Olympian after all those years of giving absolutely everything is something I'm incredibly proud of; it wasn't the outcome I wanted though and I didn't feel finished.
"My priorities have shifted now, obviously Edie's well-being and quality-of-life always comes first, but I still have that desire to compete."
'We actually have an athlete mums WhatsApp group'
While returning to elite sport after pregnancy is not a new concept, with Liz McColgan, Paula Radcliffe and Kim Clijsters among those to claim major titles after becoming mothers, it was far less commonplace during the last century and early 2000s.
Olympic champions Dame Jessica Ennis-Hill, Dame Laura Kenny, Elinor Barker and Helen Glover, as well as international stars such as Shelly-Ann Fraser-Pryce and Serena Williams, have subsequently proved what is possible.
Gallagher herself drew inspiration from their competitive comebacks, as well as the knowledge and shared experiences of other British athletes who have given birth in recent years.
"We actually have an athlete mums WhatsApp group," she says.
"We've got women from hockey, rowing, para-sport, athletics, judo, and what I learned very quickly is that with pregnancy, everyone has such a very individual experience.
"I was sick and felt horrendous most days, which limited what training I could do, but it was really useful to share experiences, get tips, know you're all having similar feelings and are not alone."
Backing pelvic floor health and 'mummy MOTs'
According to research published in 2018, female athletes are 177% more likely to experience urinary incontinence symptoms than inactive women, with those involved in high-impact sports at the greatest risk.
Pregnancy and child birth can also further weaken the strength of a woman's pelvic floor muscles.
Gallagher says it is not something she experienced directly, but is aware of "lots of athletes who struggle" with their pelvic floor health.
As such, she took precautions ahead of childbirth and before returning to trampolining in order to reduce her prospect of medical complications as a mother.
"We talk about it openly with female health specialists in British Gymnastics and they suggested I went to a pelvic health physiotherapist during my pregnancy, who I also saw afterwards," Gallagher says.
"I was in labour for quite a long time, probably 36 hours as she just wasn't moving, so there will probably have been some damage, but seeing the specialist, going to Pilates classes and taking up the 'couch to 5k' was all really beneficial.
"Having a C-section probably helped me out a little bit too, even though it was not planned that way, but I'll be honest the initial couple of weeks afterwards were quite brutal."
'They call it a mummy MOT'
Gallagher would like to see more girls and women made aware of the importance of pelvic floor health from a young age, not just around pregnancy.
"I'm not going to lie, it's not something I enjoy talking about, but I do really feel is important," she says.
"I actually run a baby gym group now and a number of mums who come in are nervous about not even jumping, but walking on the trampoline and joke about crossing their legs when they sneeze.
"We need to take away any embarrassment and communicate about these issues more openly."
The Olympian added: "I think they call it a 'mummy MOT', which I had after giving birth and I'd like to see more women offered this check-up because it's a real shame many don't have access to the support which would really help them."
Pushing for Paris 2024?
The World Championships in Birmingham represent the first opportunity for athletes to secure one of 16 berths - eight for men and eight for women - for their respective nations at next year's Olympic Games in Paris.
Gallagher finished sixth at her last Worlds in 2019, but is realistic about her prospects following a rapid post-pregnancy return and two years without a competition.
"I have a different routine now, so reaching the final might be a bit of a stretch, but I take a lot of confidence from where I've managed to get to in a short time," she says.
"The prospects of a home World Championships really pushed me to come back and I feel a bit emotional actually about thinking about it.
"I underestimated the changes in my body from breast feeding with high impact training and fuelling for both in the right way.
"Mentally, I think the biggest challenge has been going with the flow, but I've learned a lot of life lessons this year and have no regrets.
"Next year, we'll see how things progress and my body adapts, but I'm feeling comfortable and like I've got a lot more to give."
The four-time world medallist laughs when asked about the prospect of continuing in her sport long enough for daughter Edie to not only watch, but appreciate what she is doing.
"Maybe, but I'm looking at her now and she hasn't a clue what's going on," says Gallagher.
"I've surprised myself with what I've been able to do, but I hope that that proves that you're capable of more than you think.
"You've just got to celebrate the wins, no matter how small and if I can do it, others can too!" | Women’s Health |
A hidden world of sex abuse and exploitation by men working as "spiritual healers" has been uncovered by BBC Arabic.
Spiritual healing, also known as "Quranic healing", is a popular practice in the Arab and Muslim world. It is mostly women who visit healers - believing that they can solve problems and cure illness by expelling evil spirits known as "jinn".
Testimonies gathered by the BBC from 85 women, over a period of more than a year, named 65 so-called healers in Morocco and Sudan - two countries where such practices are particularly popular - with accusations ranging from harassment to rape.
We spent months speaking to NGOs, courts, lawyers and women, gathering and verifying stories of abuse. An undercover reporter who underwent treatment with one such healer for our investigation, was herself inappropriately touched before fleeing the scene.
Warning: Readers may find some of the details below distressing.
Dalal (not her real name) sought treatment for depression from a spiritual healer in a town near Casablanca a few years ago, when she was in her mid-20s. She says the healer told her the depression was caused by a "jinn lover" who had possessed her.
At a one-to-one session he asked her to smell a scent he said was musk - but which she now believes to have been some kind of drug, because she lost consciousness.
Dalal, who had never had any sexual experience before, says she woke to find her underwear had been removed, and realised she had been raped. She says she began screaming at the raqi (Quranic healer), asking him what he had done to her.
"I said: 'Shame on you! Why did you do this to me?' He said: 'To make the jinn leave your body.'"
She says she didn't tell anyone what happened, as she was so ashamed and was sure she would be blamed. When she discovered a few weeks later that she was pregnant, she was terrified.
She even thought about taking her own life.
When she told the healer about the pregnancy, he replied that the jinn must have impregnated her. Dalal says she was so traumatised by her experience that when her baby was born, she refused to look at her, hold her, or even give her a name, and gave her up for adoption.
She told us that if her family found out what had happened to her, they would kill her.
Many of the women we spoke to said they feared they themselves would be blamed if they reported their abuse, and therefore very few had told their families, let alone the police. Some said they also worried that reporting what had happened might provoke the jinn to take revenge on them.
In Sudan, a woman named Sawsan told us that when her husband left the family home to live with a second wife - as is his right under Sharia (Islamic law) - she found herself destitute, and approached a healer for help. She said she hoped he could give her some kind of medicine for her husband which would make him treat her better.
But she was not expecting his suggested treatment.
"He said he would have sex with me and use the resulting body fluids to concoct a potion I should feed to my husband."
His recommendation suggested he was "fearless", she said.
"He was confident I would not report him to the police or the courts or even my husband."
Sawsan says she left the session immediately and never returned. She did not report his behaviour.
Three of the 50 women we spoke to in Sudan about exploitation or abuse named the same religious leader - Sheikh Ibrahim. One of the women, who we are not naming, said he manipulated her into having sex with him. Another, Afaf, told us she had to push him off her when he asked to have sex with her. She said she felt powerless.
"People don't accept that sheikhs say and do these things. They don't believe it. How can I find witnesses? No-one saw me in the room with him."
So, an undercover journalist working with our team agreed to visit Sheikh Ibrahim in a bid to collect more evidence.
The reporter, who we are calling Reem, posed as a client suffering from infertility.
Sheikh Ibrahim said he would say a prayer for her, and prepared a bottle of "healing water" - known as "mahayya" - for her to take home and drink.
Reem says he then moved to sit extremely close to her, and put his hand on her stomach. When she asked him to take his hand away, she says, he simply moved it down her body, over her clothes, to her genitals. She ran from the room.
"I was really shaken by him," she told us afterwards. "He had a worrying look about him."
She says she felt that his manner suggested this was not the first time he had behaved in this way.
The BBC questioned Sheikh Ibrahim about what had happened to Reem. He denied that he sexually harassed or assaulted women seeking his help, and abruptly ended our interview.
One woman who is offering an alternative to those who would like spiritual healing, without the risk of exploitation, is Sheikha Fatima.
Based near Khartoum, she has opened a female-only healing centre. For 30 years, this has been one of the few places where women can experience ruqyah or healing from other women.
We were given unique access to this private space. During our visit, it was intense watching women around me losing all awareness of their surroundings. Sheikha Fatima tells me how women can be vulnerable in this state, which allows other healers to take advantage of them.
"Many women told us that they believed the sheikh is extracting the devil by touching them. They thought it was part of the treatment," she says. "It's shocking what you hear from these women."
We approached political authorities in both Morocco and Sudan with our evidence.
In Sudan, Dr Alaa Abu Zeid, head of the family and society department at the Ministry of Islamic Affairs, was initially reluctant to believe that so many women had reported experiences of abuse to us. But he did admit that the lack of regulation in spiritual healing meant that it was "causing chaos", and that the role was being used as "a profession for those who have no job".
He told the BBC that he had explored its regulation in the past, but that the country's political instability meant it was not currently a priority.
In Morocco, Minister of Islamic Affairs Ahmed Toufiq said he did not believe there was a need for any separate legislation regarding spiritual healers.
"It is hard to intervene legally in these matters. The solution lies in religious education and preaching," he told us.
Despite all the evidence we have gathered, Moroccan and Sudanese authorities are reluctant to take action. So the burden remains on women to speak up against those hiding behind a healing profession. | Mental Health Treatments |
If you thought Covid-19 was dead and gone, think again. Early signs indicate that the UK may be at the start of a new wave of Covid infections driven by BA.4 and BA.5 – while new data suggests these variants may have evolved to re-favour infecting lung tissue, which could potentially make them more dangerous.So what can we expect in the coming weeks and months?Although BA.2 continues to account for the bulk of UK infections, data from the Office for National Statistics up to 2 June suggested that Covid cases might be starting to rise again in England and Northern Ireland, driven by an increase in BA.4 and BA.5 infections. The trends were uncertain in Wales and Scotland.Also gaining ground in the UK are BA.5.1 (a child of BA.5), and the BA.2.12.1 subvariant (the USA’s dominant Covid strain), which the UK Health Security Agency is monitoring.BA.4 and BA.5 were officially designated variants of concern (VOC) in the UK on 20 May, having first been detected in South Africa during January and February of this year.According to the latest ONS data, about 1 in 70 people in England were estimated to have Covid in the week leading up to 2 June. In Northern Ireland it was about 1 in 65; in Wales, about 1 in 75; and in Scotland, about 1 in 40.In South Africa, BA.4 and BA.5 have been responsible for a second wave of Omicron infections beginning at the start of May, which now appears to be flattening off. However, South Africa wasn’t hit by the highly transmissible BA.2 variant in the same way the UK was, and scientists had hoped that high levels of immunity from recent infection with BA.2 and booster vaccines, might be enough to prevent these newer variants gaining a significant foothold here.However, with immunity from third vaccine doses waning in most population groups, and only the over-75s, and extremely vulnerable groups having been offered “spring booster” doses, this cannot be guaranteed. Neither is recent infection with the BA.1 or BA.2 Omicron variants necessarily protection against reinfection with BA.4 or BA.5.According to research published in Science on Tuesday, natural infection with Omicron doesn’t produce a strong immune response, regardless of whether scientists look at antibodies or T cells – meaning that people who have already recovered from an Omicron infection can quickly become reinfected. The findings, by Prof Danny Altmann at Imperial College London and colleagues may help to explain why infection levels have remained high in countries such as the UK, despite so many already having been infected with it.According to preliminary data by Kei Sato at the University of Tokyo and colleagues, BA.4, BA.5 and BA.2.12.1 may have evolved to re-favour infection of lung cells, rather than upper respiratory tract tissue – making them more similar to earlier variants, such as Alpha or Delta. The propensity of earlier Omicron variants to prefer infecting non-lung tissue may be one reason why infections tend to be milder in most people.“It looks as though these things are switching back to the more dangerous form of infection, so going lower down in the lung,” Griffin said.Sato’s experiments indicate that BA.4, BA.5 and BA.2.12.1 replicate more efficiently in human lung cells than BA.2, while further experiments in hamsters suggest that BA.4 and BA.5 may cause more severe disease.Sign up to First Edition, our free daily newsletter – every weekday morning at 7am BSTThese variants also appear to have a higher reproduction number than BA.2, while further experiments by Sato’s lab indicate that BA.4 and BA.5 may be resistant to immunity induced by earlier Omicron infections(similar to Altmann’s findings).“Altogether, our investigations suggest that the risk of [these] Omicron variants, particularly BA.4 and BA.5, to global health is potentially greater than that of original BA.2,” Sato said.It also put paid to the idea that the virus is on the verge of merely turning into common cold. “It clearly isn’t, and there’s no pressure on it to do that, really,” said Griffin.Even so, the rise of BA.4/5 and other subvariants by no means puts us back to square one. The UK’s population is, by and large, highly vaccinated, and previous infection with other variants will also count for something. Those who haven’t been vaccinated remain vulnerable, however.Prof Tulio de Oliveira, the director of the Centre for Epidemic Response and Innovation at Stellenbosch University in South Africa, pointed out that the BA.4/5 wave has been less deadly than any of the previous waves to have hit his country. In part, this could be because hospital Covid wards were largely empty when it started, but it is also probably the result of high levels of population immunity.However, hospitalisations and deaths are only part of the picture. Long Covid cases continue to rise in the UK. According to the latest ONS data, 2 million people in the UK are thought to be living with long Covid – the highest figure since official surveys began.So, what to do about it? Data on the efficacy of boosters against these newer subvariants is still lacking, but if previous experience is anything to go by, they are likely to largely reinstate immune protection – at least against hospitalisation and death. A fourth dose is expected to be offered to the over-65s, frontline health and social care workers, care home residents and staff, and the clinically vulnerable from the autumn.With luck, BA.4 and BA.5 will present just a minor blip in the UK’s transition out of the Covid crisis. But their emergence is a reminder that smooth sailing is by no means guaranteed. | Epidemics & Outbreaks |
By Ann Marie Johnson, as told to Shishira Sreenivas
I was diagnosed with relapsing-remitting multiple sclerosis (RRMS) on New Yearâs Eve in 2002. I was 32. At that time, I had just started embarking on my career in Brooklyn, NY. I just graduated from grad school and had started my new job, and I was an independent woman. I was always on the move. It's funny because people often could hear me before they could see me. I'm a petite woman that used to wear 5-inch stilettos. Any given day, you could hear the clackity-clack as I was coming down the street or hallway. Life was pretty good.
One particular day while I was at work, I noticed that the pen I was using to write my notes with kept falling out of my hands. At first, I was like, OK, what's going on here? But it kept happening. I started feeling these funny feelings inside of my body. My supervisor was with me that day, so I said to her, âLook, I don't feel right. Something is not right.â She let me go home and told me to finish up later.
When I donât feel good, I make a cup of tea. So I did that and went to sleep. When I woke up, the funny feelings had shifted to waist down. It felt like pins and needles when your hand falls asleep. I also had numbness and my legs didnât move. I fell to the floor when I tried to move.
Thankfully my roommate came to help and took me to the ER. There, I spoke to the neurologist. Fast forward a little. After a series of exams, tests, spinal tap, EKG, and an extended trip to the hospital right before Thanksgiving, more than 2 weeks later, after more workup and just a few days after my birthday, I was diagnosed with MS.
I didn't know much about it at the time. All I knew was Montel Williams and Richard Pryor had it. And my thoughts were: What does that mean to me? I was just a poor girl from Brooklyn, NY. I don't have any money, I'm not married, will anybody ever want me? Would I be able to have kids? Will I be able to go back to work? These were the things swirling in my head.
Use Assistive Devices and Find What Works for You
As I learned to live with MS, I was also learning what that was going to mean for me. As in what does it mean for my walking? For that I have canes. I use a folding cane, and I have one with wood carving.
In terms of the emotional aspect of this illness, I figured if I'm going to have mobility devices, I'm going to look good with it. So I got a leopard cane to match my leopard print shoes. For the holidays, I have a black and white cane. I also have my African queen cane. So instead of people hearing me from the clack-clack-clack of my shoes, now they heard me because of the clack-clack-clack of my cane.
When I have good days, the cane stays in the car. On days when itâs a little challenging, I'll take it out.
Strategize and Plan Your Day Ahead of Time
Different symptoms are definitely going to give you reminders that you have MS. And then depending on what you're doing in your day, you have to strategize. Because of my fatigue, I don't really function that well early in the morning. Anybody that knows me, like my friends, they know, "Do not call Ann Marie to go anywhere in the morning!" Because I'm like a wet noodle. I am at my best in the afternoon.
I also started to write everything down, especially at the doctorâs office, because there was no way I was able to remember everything and notify the doctor. I started to write about things like how I feel or what I ate. I would write about the time and about my temperature. From all of that, I was able to see patterns. Using that, I was able to modify certain things in my life.
For example, I work long hours. I found that it's best for me to eat small meals because if I have a big breakfast and then have a big lunch, it exacerbates my fatigue. If I have small meals stretched out during the course of my day, it maintains my energy level to a point where I can function, and I'm not nodding off at work.
MS causes me to have frequent urination. I have to be mindful of how I get my fluids. I know I can't get that cup of coffee in the morning and then travel to get to my destination because I won't make it. So instead of nursing a drink, I try to drink things in one setting. That way, when it's time to dispel it, I do it in one shot.
But again, these were changes I was able to make when I started writing and started seeing the patterns. I was able to make real change in my life. However, Iâm still learning.
Join a Support Group
The first couple of years were really spent on trying to figure out me and what MS is going to look like for me because everybody's MS is different. I was looking for information, and I contacted the National MS Society. They helped me get into support groups. Through this, I started to facilitate my own groups. I like to say I took the âIâ from chronic illness and added âWe,â and made it wellness.
I found others like me. I could hear othersâ stories about how they are coping or exchange little cheat sheets. Find out where to get canes from, or what drugstores have really good canes. Find social media groups or discuss what different diets people are using.
It gave me the opportunity to discuss or see how this guy works with this or that person and to get tips on how to live with MS. But also, I got to hear about people who travel, or get a doctorate, or get a raise, get married, or have babies. Just regular life events for people who just happen to have MS. That is the greatest level of support, and that really sparked wellness. It made me feel better. And when you feel better, you do better.
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Ann Marie Johnson, Brooklyn, NY. | Disease Research |
Baylor Scott & White is making plans for a high-rise health complex in fast-growing and hospital-dense Frisco.The largest nonprofit hospital system in Texas is seeking rezoning of 47.4 acres just east of the Dallas North Tollway, near where the PGA headquarters development is under construction. It bought the property from Jerry Jones’ Blue Star Land in June 2021.Detailed plans for the new facility are still in the works and rezoning is the first step, according to a hospital spokeswoman.“We are constantly evaluating ways to expand access to care for Texans, especially in our fastest growing communities. Our plans are not yet finalized, and we look forward to sharing more in the coming months,” Baylor Scott & White said in a statement.The land is zoned for retail and industrial use, but multi-story health care buildings require a special office designation that permits unlimited height development for professional, financial and medical service providers.The rezoning request says that designation is appropriate for the area given its location at the intersection of the tollway and PGA Parkway. The filing also notes that no residential districts border the property and adjacent properties are compatible with non-residential zoning.The Frisco planning and zoning board will consider the request Tuesday.Texas has more hospitals than any other state in the U.S. in part because it does not require a state-approved certificate of need, and Frisco is no stranger to that trend.If the rezoning is approved, Baylor Scott & White’s new center will join a growing list of health care facilities along the tollway, including a sports medicine facility just 10 miles and a few highway exits away at The Star, the Dallas Cowboys’ headquarters and mixed-use project.Competitor Texas Health Frisco will be even closer, just five miles south of the proposed facility. That $270 million collaboration between Texas Health Resources and UT Southwestern was a hallmark project in 2019.Baylor Scott & White’s project could become the next stepping stone in creating a medical district of the north serving Collin County’s rapidly growing communities. Collin County’s population is expected to double to 2.4 million by 2050.The medical center also has the potential to tap into a large base of insured customers. Compared to a statewide 18.4% uninsured rate, only 12.5% of Collin County residents are uninsured, the lowest rate in the entire D-FW metroplex. In Frisco zip codes, the uninsured rate is even lower at only 6.8%.Maggie Eastland, Business reporter. Maggie is a junior at the University of Notre Dame, covering a variety of business stories at the DMN. She previously worked at the Mackinac Island Town Crier and still works at The Observer Student Newspaper as Assistant Managing [email protected] @eastland_maggie | Health Policy |
Justin Sullivan/Getty Images
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Coca-Cola began blending aspartame into Diet Coke in the 1980s. The artificial sweetener is used in lots of products from diet sodas, to low-sugar jams, yogurts, cereals and chewing gum.
Justin Sullivan/Getty Images
Coca-Cola began blending aspartame into Diet Coke in the 1980s. The artificial sweetener is used in lots of products from diet sodas, to low-sugar jams, yogurts, cereals and chewing gum.
Justin Sullivan/Getty Images
A committee of 25 international experts has determined that aspartame may "possibly" cause cancer in people, according to a report released Thursday by the World Health Organization.
This new classification, which is based on a review of "limited evidence," does not change the recommended limit on the daily intake of the artificial sweetener.
"Our results do not indicate that occasional consumption should pose a risk to most consumers," said Dr. Francesco Branca, director of the Department of Nutrition and Food Safety at the WHO, during a press conference in Geneva. He said the problem is for "high consumers" of diet soda or other foods that contain aspartame. "We have, in a sense, raised a flag here," Branca said, and he called for more research.
But the U.S. Food and Drug Administration says it disagrees with this new classification, pointing to evidence of safety. In a written statement, an FDA official told NPR that aspartame being labeled by the WHO "as 'possibly carcinogenic to humans' does not mean that aspartame is actually linked to cancer."
The WHO has long set the acceptable daily intake, or ADI, of aspartame at a maximum of 40 milligrams per kilogram of body weight per day. So, a person who weighs 60 kilograms (about 130 pounds), could consume up to 2,400 milligrams per day, which is roughly equivalent to 12 cans of Diet Coke — much higher than most people consume.
While the WHO is not changing the acceptable daily intake, Branca says "we're just advising for a bit of moderation." If people consume aspartame as a way to avoid sugar and control weight, "the benefit is not there," Branca says.
Based on a review from 2022 showing there's no clear consensus on whether sweeteners are effective for long-term weight management, the WHO now recommends against the use of non-sugar sweeteners to control body weight.
Aspartame was approved for use as a sweetener in the U.S. in 1974. Coca-Cola began blending the artificial sweetener into Diet Coke in the 1980s and popularized the zero-calorie drink with splashy ad campaigns, promoting the taste of it. But for all its popularity, there have long been skeptics and critics, and in recent years, small studies suggest that artificial sweeteners may increase food cravings in some people and alter the microbiome. In addition, a few recent studies point to potential cancer risks, which is why the World Health Organization set out to review all the data.
Two separate World Health Organization committees examined the evidence on aspartame. The International Agency for Research on Cancer used a classification system to rank the potential of aspartame to cause cancer in humans, landing on 2B, which translates to "possibly carcinogenic to humans."
The agency found "limited" evidence that aspartame may cause liver cancer, based on a review of several studies that used intake of artificially sweetened beverages as a proxy for aspartame exposure. It also reviewed the evidence from a large French study, the NutriNet-Santé study, published in 2022, that found people who consumed the most aspartame had about a 15% increased risk of cancer, including breast and obesity-related cancers, compared with people who didn't consume aspartame.
The research agency concluded that these were "high-quality" studies, however it could not rule out that the findings weren't due to chance, bias, or "confounding variables,'' meaning it wasn't sure that the increase in cancer was due to aspartame. It could be explained by other lifestyle habits or exposure to other carcinogens. "Thus, the evidence for cancer in humans was deemed "limited" for liver cancer and "inadequate" for other types of cancers, according to the analysis published in Lancet Oncology.
A second committee, the Joint Expert Committee on Food Additives, or JECFA, also reviewed the evidence and concluded that "the evidence of an association between aspartame consumption and cancer in humans is not convincing," according to a summary released by the WHO. The group pointed to inconsistent evidence and determined the acceptable daily intake levels should remain in place.
In its written response, the FDA said it disagrees with the conclusion that studies support classifying aspartame as a possible carcinogen to humans. "FDA scientists reviewed the scientific information included in the [International Agency for Research on Cancer's] review in 2021 when it was first made available and identified significant shortcomings in the studies," an FDA spokesperson wrote in an email. "We note that JECFA did not raise safety concerns for aspartame under the current levels of use and did not change the Acceptable Daily Intake ...."
Scientists have called for more long-term research, pointing out that it can take decades for cancer to develop after exposure to carcinogens. "I think there's actually been very little long-term research, surprisingly," says Dr. William Dahut, chief scientific officer at the American Cancer Society.
People want a simple yes or no answer on whether aspartame consumption can increase their cancer risk. "We don't have the evidence yet," he says. Most of the studies in people have not actually tracked the amount of aspartame people consume over time, so there's a gray area.
One link that warrants further evaluation is whether aspartame increases inflammation in the body, which could increase the risk of cancer. "We are actually doing our own research in that area," Dahut says.
Dahut says the possible link to cancer from aspartame is far less clear than it is for things like obesity and smoking, but he says it makes sense to be cautious about your intake. "Since there is a possible link, it is certainly reasonable to limit one's intake until more definitive studies are available," Dahut advises.
The American Beverage Association, a lobbying group that includes The Coca-Cola Co., PepsiCo and Keurig Dr Pepper, says the decision by the WHO to leave in place the previously established "acceptable daily intake" reinforces the position of the FDA. "Aspartame is safe," says Kevin Keane, interim president and CEO of American Beverage, in response to the World Health Organization review of aspartame.
There's conflicting evidence on whether diet soda helps people manage their weight or cut back on calories. Studies have gone both directions. Though the WHO analysis points to a lack of long-term benefits, some studies have shown that swapping caloric beverages for zero-calorie alternatives can be helpful.
"For people who are presently consuming diet soda, the worst possible decision would be to switch to regular sugar-sweetened soda," says physician Walter Willett of the Harvard T.H. Chan School of Public Health. Sugary drinks can raise the risk of obesity and Type 2 diabetes. "The best beverages for daily consumption are water, coffee and tea," Willett says.
Willett finds the evidence linking aspartame to cancer in people to be weak, and despite the uncertainties over long-term consequences, he does see a role for diet soda for people trying to manage their weight and limit sugar intake. He likens diet soda to a nicotine patch: "Possibly helpful for some people to transition from dependence, but not the best long-term solution." | Nutrition Research |
Tens of thousands of women in England could benefit from a drug that helps prevent breast cancer.
Anastrozole, used for many years to treat the disease, has now been licensed as a preventative option.
Recent trials show the drug can reduce the incidence of breast cancer by almost 50% in post-menopausal women at increased risk.
An estimated 289,000 women at moderate or high risk of breast cancer could be eligible for the drug.
And if one in four of these come forward, it could help prevent 2,000 cases of breast cancer in England.
It could save the health service £15m in treatment costs, NHS England says.
And any woman worried about breast cancer can contact their GP, who can refer them to a specialist for a full risk assessment taking into account family history.
Anastrozole is off-patent, which means more than one company can make it and it can be distributed fairly cheaply.
First recommended as a preventative option by the National Institute for Health and Care Excellence, in 2017, its use in this way has now been licensed by the Medicines and Healthcare products Regulatory Agency as part of NHS England's medicines-repurposing programme.
Lesley-Ann Woodhams, 61, has just completed a five-year course of one tablet a day.
Taking it was "an easy decision, as I'd watched my mum battle breast cancer", she says.
"I could live a life without constantly worrying or giving a thought to what could be if I'd developed breast cancer," Lesley-Ann says.
"It really was a gift - it gave my family and myself peace of mind and, more importantly, a continued future to look forward to."
Breast cancer is the most common cancer in England, with more than 47,000 people diagnosed each year.
Health Minister Will Quince said he was "delighted" the drug had now been approved to "help prevent this cruel disease".
"We've already seen the positive effect Anastrozole can have in treating the disease when it has been detected in post-menopausal women and now we can use it to stop it developing at all in some women," he added.
Anastrozole works by blocking an enzyme called aromatose to reduce the hormone oestrogen.
Patients suffering from side effects should speak to their doctor or pharmacist - the most common include:
- hot flushes
- feeling weak
- pain or stiffness in the joints
- arthritis
- skin rash
- nausea
- headache
- osteoporosis
- depression | Drug Discoveries |
Motor racing legend Sir Jackie Stewart has offered to talk to Bruce Willis and his family as he understands exactly what they are going through.
The Die Hard star has been diagnosed with frontotemporal dementia (FTD), a rare form of the brain condition, which is also known as Pick’s Disease.
Sir Jackie’s wife Lady Helen, 82, has been living with the illness herself since 2014 and recently lost the ability to walk.
“Bruce is a great man, and he can still be a great man, even with dementia,” says Sir Jackie, who has offered his help through this newspaper if the actor and his family wanted to make contact for advice and reassurance. “I don’t know to what extent he’s got dementia. But I’d love to give him a call. He’s a wonderful actor - a superstar. Like us, he’s lucky to have the resources for round-the-clock care. But very few people have those privileges.”
Lady Helen, who has been married to Sir Jackie for over 60 years, needs 24-hour specialist care at home, which costs the couple close to £7million a year.
She now uses a wheelchair and must stay close to a hospital in case she falls and injures herself, which has prompted the couple to move to a property in Switzerland that’s within 200 metres of a top-notch clinic.
While she has kept her sense of humour - “she likes to have a good laugh” - Sir Jackie says his wife’s short-term memory has deteriorated greatly. The razor-sharp woman, who used to time-keep for her husband to the millisecond while he was tearing around the Formula One track, can no longer shower, eat or go to bed independently, “It’s a terrible thing to sit and watch,” says Sir Jackie quietly.
“She doesn’t recognise she’s got dementia. I’ve just finished having lunch with her, we had a great conversation together. But she will not remember what we said. I told her I have to go to Lichtenstein at the weekend, then to Bahrain for the Grand Prix, and she was unhappy about me leaving. But she will have forgotten that already.”
Dementia will kill one in three people born today, but funding for research into the condition falls significantly short of funds for other illnesses like cancer. Sir Jackie’s charity Race Against Dementia, which he set up after Helen’s diagnosis, aims to help change that, by supporting the research of top academics from top medical institutes around the world, including buying high-spec equipment for their clinics.
“Right now, the medical world is not doing enough,” he says, sternly. “The pharmaceutical industry is not doing enough. So we hope to find a cure to this in my lifetime. I’m 83 right now, 84 in June, but I want to do it in my lifetime. I would love to find it in Helen’s time. I will never feel good about the work we’re doing until we find a cure.”
Sir Jackie’s call to action echoes that of Bruce Willis’s family - his wife Emma Heming, ex Demi Moore and his daughters Rumer, Tallulah, Scout, Evelyn and Mabel - who noted FTD is “a cruel disease that many of us have never heard of and can strike anyone”. Early last year Bruce was diagnosed with aphasia, a cognitive disorder that affects communication, and announced his retirement from acting after four decades.
“Dementia is a curse,” says Sir Jackie, who employs five neuro nurses to look after his wife. “It gets worse, and eventually the person you once knew is not able to speak.”
For the three-time motor racing world champion, the worst possible outcome would be for Helen to become so ill she has to move into a specialist care home. It’s happened to a number of their friends - his best friend Sean Connery lived with dementia for two years before his death in 2020.
“I go to visit a lot of those homes. I don’t cry easily. But every time I leave one of those homes, I’m in tears. At the loss for the family, for the condition, for their pain,” says Sir Jackie, who has to take a breath to clear the emotion from his throat.
“Helen is still a beautiful woman,” he says proudly. “And we’ve been married for 60 years and we’ve had a great marriage. We’ve got two wonderful children and we’ve got nine grandchildren. And they all love their grandmother. So I’m hopeful that the publicity that is already being expressed globally by this very famous movie star helps to make people realise: it doesn’t matter who you are or what you’ve got, dementia absolutely destroys that person’s life.”
“Helen was my timekeeper, my lap charter, she didn’t go to the Grand Prix to look like a pretty lady. She went there to do a job for me and Ken Tyrrell and for the people I drove for,” he adds softly. “She was more than ‘only’ a wife and a mother. So this is why I’ve got to look after her in as deep and strong a way as I possibly can.” | Disease Research |
Image source, Family pictureImage caption, Mr Roberts' wife Linda told the coroner at Pontypridd she believes her husband caught Covid while working in hospitalA hospital nurse died after getting Covid in the early stages of the pandemic, an inquest has been told.Gareth Roberts, 65, from Aberdare was working extra shifts at Llandough Hospital in Cardiff in the period before his death in April 2020.He had late onset type 2 diabetes but was generally in good health, the inquest in Pontypridd heard.A friend has previously claimed he "paid the ultimate price" for a lack of personal protective equipment (PPE). Gareth's wife Linda told the coroner in a statement her husband was working long hours as a nurse on a single ward in the hospital in March, getting up at 05:00 and not returning home until 20:30.The only contact he had outside of work at that time, she said, was taking his mother to church and shopping for groceries once a week.In his work on the ward Mrs Roberts said the only protective equipment nurses routinely wore were "plastic aprons, paper masks and rubber gloves".Image source, Family pictureImage caption, Gareth Roberts devoted 40 years of his life to caring for people as a nurseShe told the inquest staff were not routinely tested for Covid in the hospital at that time, . Mrs Roberts said she did not know where else he could have got the disease except from the hospital."If appropriate risk assessments had been carried out, he might have been withdrawn from the front line," she added. Mr Roberts, who worked as a nurse across the Cardiff and Vale health board area for more than 40 years, first started to complain about having to clear his throat frequently, his wife said. The following day he was sent home from work with a fever and a cough. He spent the next few days sleeping a lot, Mrs Roberts said.Five days later, the inquest was told, he became increasingly unwell and was unable to use the stairs. Mrs Roberts said he was "mumbling, confused and agitated".His condition deteriorated until he was taken by paramedics to Prince Charles Hospital in Merthyr Tydfil on 2 April. The following day he was taken to the intensive care unit in a critical condition where he was sedated and intubated. Image source, Family pictureImage caption, Mr Roberts was also a grandfather to ZacMrs Roberts told the coroner on the night of 10 April, she received a call from the hospital saying she should come as quickly as she could. When she arrived she said she was given full PPE and taken to see her husband. "They told me his kidneys had stopped functioning, his heart stopped. Everything stopped while I was there," she said of her husband, who was also a father and grandfather.Mrs Roberts said she had been unwell in January 2020 for three weeks with a temperature cough and a loss of taste. "In hindsight it was likely I had Covid, but at the time it didn't cross my mind," she said.She said she did not believe she gave Covid to her husband because of the length of time between when she was ill and when he started having symptoms. | Epidemics & Outbreaks |
A longitudinal study of a large group of older adults showed that regular internet users had approximately half the risk of dementia compared to their same-age peers who did not use the internet regularly. This difference remained even after controlling for education, ethnicity, sex, generation, and signs of cognitive decline at the start of the study. Participants using the internet between 6 minutes and 2 hours per day had the lowest risk of dementia. The study was published in the Journal of the American Geriatrics Society.
Public discussions about internet use often revolve around problematic internet use, particularly among children and adolescents. Studies often link large amounts of time spent on the internet with various adverse conditions. However, the internet also forms the backbone of modern economy and entertainment. It provides lots of cognitively engaging contents that is relatively easy to access.
Studies have shown that online engagement can make individuals more resilient against physiological damage to the brain that develops as people age. This can, in turn, help older adults compensate for brain aging and reduce the risk of dementia. In this way, internet use can help extend the cognitively healthy lifespan.
Indeed, previous studies have shown that internet users tend to have better overall cognitive performance, verbal reasoning, and memory than non-users. However, most of these studies did not track changes over time or tracked them for very short periods. Thus, it could not be determined whether internet use helps maintain cognitive functioning or whether individuals with better cognitive functioning were more likely to use the internet.
Study author Gawon Cho and his colleagues wanted to examine how the risk of developing dementia is associated with whether adults regularly use the internet. They were also interested in how this association changes over time and how the total period of internet use in late adulthood is associated with the risk of dementia. Finally, they wanted to see if there might be an adverse effect of excessive internet use by examining the association between the risk of dementia and the daily number of hours spent on the internet.
They analyzed data from the Health and Retirement study. The Health and Retirement Study is an ongoing longitudinal survey of a nationally representative sample of U.S. older-age adults. This study reports being representative of U.S. adults aged 50 and over.
The study authors analyzed data of 18,154 participants from this study. All were born before 1966. They were aged between 50 and 65 years at the start of the analysis period. The median follow period of participants whose data were analyzed in this study was 8 years, but it went up to 17 years with some. Data were mostly collected between 2002 and 2018.
The study interviewed participants every second year since 2002 about their internet usage (“Do you regularly use the World Wide Web, or the Internet, for sending and receiving e-mail or for any other purpose, such as making purchases, searching for information, or making travel reservations?”). Additionally, participants were asked about their daily hours of internet usage.
Assessments of dementia were also conducted every second year through a telephone interview (the modified Telephone Interview for Cognitive Status). Study authors calculated how long participants survived without dementia i.e., their age when they developed dementia. They used various demographic data about participants in their analysis as well.
Results showed that around 65% of participants were regular internet users and 35% were non-regular users. 21% changed their internet use habits during the study period, 53% did not change them. The remaining 26% either dropped out, died during the follow-up period or developed dementia. 5% of participants developed dementia during the study period, 8% died or experienced another event due to which they were excluded from further analysis.
Participants who were regular internet users at the start of the study had a 1.54% risk of developing dementia. In non-regular users of internet this risk was 10.45%. When time until the development of dementia was analyzed, results showed that the risk of dementia of regular internet users was 57% of the risk non-regular users had of developing dementia.
When analyses were limited to adults without signs of cognitive decline at the start of the study the risk of dementia of regular internet users was 62% of the risk of non-regular users. Finally, the relationship between dementia risk and daily hours of internet usage was U-shaped. Adults using the internet between 6 minutes and 2 hours per day had the lowest risk of dementia. This risk was much higher in adults who did not use internet at all (0 hours of use), but also increased gradually with more daily internet use beyond 2 hours.
“Our findings show evidence of a digital divide in the cognitive health of older-age adults. Specifically, adults who regularly used the internet experienced approximately half the risk of dementia than adults who did not, adjusting for baseline cognitive function, self-selection into baseline internet usage, self-reported health, and a large number of demographic characteristics,” the study authors concluded.
The study sheds light on the relationship between internet use and cognitive functioning. However, it also has limitations that need to be taken into account. Notably, the dementia assessment used in this study might not completely agree with clinical diagnoses of dementia. Additionally, the study included only individuals without dementia at the start of the study. This excluded individuals who developed dementia early. Results might not have been the same if such individuals, who are part of the general population, were included in the study.
The study, “Internet usage and the prospective risk of dementia: A population-based cohort study”, was authored by Gawon Cho, Rebecca A. Betensky, and Virginia W. Chang. | Mental Health Treatments |
Like a lot of 21-year-olds, Gracie Nuttall has just finished university and is looking forward to her future.
But unlike most people her age, she's just lost her big sister.
Laura Nuttall was diagnosed with glioblastoma multiforme - the most aggressive form of brain cancer - in 2018.
Told she had 12 months to live, she constantly surprised doctors with her positive attitude, living life to the full right up until she died last month.
She was just 23.
For Gracie, Laura's ability to defy expectations is what makes it so difficult to get used to her not being around any more.
"We'd been told for so long 'this is it'," Gracie tells BBC Newsbeat.
"And then the amount of times that she came back with a force... she did a full-on 'hold my beer'.
"I think you end up with hope which is the worst part because you actually believe that she will get better.
"Right up until the last day I didn't think she was going."
Gracie says her sister's death has been like losing her "other half".
"You're fine until something gets you," she says.
Gracie means little reminders. Like getting home and realising Laura's bedroom light is off.
Or seeing something funny online and looking forward to sharing it with her.
Until she remembers that she can't.
"It just feels like there's a gaping hole in the house and I can't get my head around the fact that she isn't coming back," says Gracie.
"It feels like losing a future as well as losing a sibling."
'I expected her to be at my wedding'
Laura became quite well-known thanks to news reports about the bucket list she made after her diagnosis.
She met Michelle Obama, had a go at commanding a Royal Navy ship and even convinced Peter Kay to perform for the first time in years.
Gracie was 16 years old when Laura was diagnosed, and has been by her side, ticking things off together to raise money and awareness about brain tumours.
The whole time, she's been known as "Laura's sister".
"I think the last five years have broken down into 'how was Laura'," says Gracie.
"So when she was going through radiotherapy that's how I see my life - through how well she was."
Gracie's also achieved a lot in the last five years, including finishing school and getting a 2:1 in film production from the University of Salford.
And she's honest about what it's been like to juggle that with the situation back home.
"At the start it was terrifying," she says.
"I was trying to do my A-levels, I was 16 and I took about six months off college."
She says her mum and dad did an "amazing" job of caring for Laura at the family home in Lancashire, but admits their relationship "was quite strained at some points".
"A lot of things I had to just keep to myself," she says.
"Going to uni was hard, coming back every weekend and having to switch on and off into different modes."
Her mum Nicola admits it was difficult to focus on both sisters when Laura was ill.
"I think siblings get really neglected through this process," she says.
"People didn't always stop to think: 'How is Grace?'.
"Actually the grief of a sibling is more long-lasting really, you're expected to have your sister to the end."
It's clear Gracie has fond memories too - her face lights up when she talks about the fun the sisters had together.
But she has advice for anyone going through something similar - be sure to take time for yourself.
"Everybody tells you to spend time with them, and the worst phrase, 'make memories'," she says.
"Definitely do that if you can but make sure that you're not doing only that and make sure that you are looking after yourself.
"If you need 10 minutes or a day, take it.
"There's no handbook for how to deal with this but I was expecting everything to be bad and it's not.
"Some things are really good still and you can't beat yourself up for still enjoying little bits of life."
Gracie admits she's nervous about her own graduation next month following Laura's own ceremony last summer.
"I think I am kind of dreading it because she was always going to be there and now she's not," she says.
"It's going to be a very emotional day for many different reasons.
"But we'll have to find a way to take her with us and to do something special."
Gracie has plans after graduation, but admits thoughts of her sister are never far away.
"The idea of a future without Laura, as much as we'd been told to prepare for, I've never been prepared for," she says.
"Even after her diagnosis, I expected her to be at my wedding and be the auntie to my children and that's just not going to happen.
"So I don't really know what the future looks like any more, because I've spent 21 years thinking that's what it would be and it's been snatched out from under me."
One thing Gracie is sure about is though, is adopting some of her sister's positivity.
"Laura was the bravest and the kindest person," she says.
"When she was told she was going to die, she decided she was going to have fun and she did.
"She did all the things that she wanted to do in such a short space of time.
"So what's our excuse? We haven't got a time limit so why don't we just do those silly things? Let's jump out of a plane... all those things."
And how does "Laura's sister" feel about the last five years?
"It hasn't been massively easy," she says.
"But I would definitely go back to that and have every conversation start with 'how's your sister?' if that meant she'd still be here." | Disease Research |
By Daniel Drachman, MD, as told to Stephanie Watson
Myasthenia gravis (MG) has been treatable for nearly 100 years. In 1934, the Scottish doctor Mary Broadfoot Walker, MD, discovered that the drug physostigmine improved muscle function in people with the disease.
In myasthenia gravis, abnormal antibodies reduce the number of receptors for acetylcholine on muscle cells. You need acetylcholine receptors for your muscles to function normally. The antibodies interfere with the sending of the chemical signal from the nerve to the muscle that makes the muscle contract.
Today, pyridostigmine (Mestinon), a drug that's a relative of physostigmine, is used to slow the breakdown of acetylcholine. It helps with the symptoms of MG, although it doesn't treat the underlying autoimmune problem. It's a sort of like a bandage.
We also have drugs that suppress the immune system, including the steroid prednisone, azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), mycophenylate mofetil (CellCept), and tacrolimus (Prograf). These drugs effectively counteract the autoimmune problem. But they need close watching and careful management by a doctor because of their side effects.
Plasmapheresis, also called plasma exchange, is used for people who are seriously ill and haven't responded to other treatments. During this procedure, the fluid part of the blood (plasma) that contains the abnormal antibodies is removed and replaced. More recently, we've used intravenous immunoglobulin (IVIg), which is an infusion of blood antibodies purified from donors.
Thymectomy
Thymectomy is surgery to remove the thymus gland. It has been around for a long time, but only in 2016 did a thorough study confirm that it works for myasthenia gravis.
The thymus is an important part of the immune system, and it's abnormal in about 75% of people with myasthenia gravis. By removing the thymus, you remove one of the main sources of autoimmunity that causes myasthenia gravis. After thymectomy surgery, many patients gradually improve. Thymectomy is the only treatment that sometimes leads to a cure.
Monoclonal Antibodies
These newer medications target specific parts of the immune system. Eculizumab (Soliris) blocks the part of the immune system called the terminal complement cascade, which binds to antibodies and damages the junction between the nerve and muscle (neuromuscular junction). Sometimes the effects of this drug are dramatic.
Rituximab (Rituxan) is another monoclonal antibody. It lowers levels of B cells, immune cells that produce antibodies. Rituxan isn't FDA-approved for myasthenia gravis, although it is approved for lymphoma.
Belimumab is another new monoclonal antibody on the horizon. It blocks something called B-cell activating factor and may suppress antibody production.
New Class of Medicine
Another new drug is called efgartigimod. It leads to the rapid removal of antibodies, including the autoantibodies that cause myasthenia gravis. It has an effect similar to plasma exchange, but it uses an antibody to remove the autoantibodies that your body has made to attack the acetylcholine receptor. In fact, I've called this drug "plasma exchange in a bottle."
Efgartigimod has another benefit. Unlike Rituxan and other immunosuppressive treatments, it doesn't damage the immune system cells that make antibodies. Patients who receive Rituxan don't mount a good antibody response when they receive the COVID-19 vaccine. People who receive efgartigimod can be effectively vaccinated against COVID-19.
This drug also works faster than many current treatments. Imuran and CellCept typically take many months to work. Because of its effectiveness and speed, efgartigimod could turn out to be one of the best treatments for myasthenia gravis. It might even replace steroids.
Much Less Serious
We now have a large group of treatments for myasthenia gravis and more coming down the pipeline. Nearly everybody with this condition can now be well treated and managed.
One day, we might even be able to cure myasthenia gravis. A few years ago, I figured out a way to turn off the immune response to acetylcholine receptors specifically, without affecting any other part of the immune system.
We genetically engineered certain cells of the immune system, which we called "guided missiles." When injected into the body, those cells targeted and killed the specific T cells that were involved in producing harmful antibodies. When we injected those cells into mice with myasthenia gravis, they essentially stopped the disease without reducing the overall immune response. This procedure is too complicated to use in humans yet, but the point is, our research proved that it can be done.
Show Sources
Photo Credit: LL28 / Getty Images
SOURCES:
Daniel Drachman, MD, professor of neurology, neuroimmunology, and neuroscience, Johns Hopkins University, Baltimore.
Journal of the History of Neurosciences: "The contribution of Dr. Mary Walker towards myasthenia gravis and periodic paralysis whist working in poor law hospitals in London."
FDA: "FDA Approves New Treatment for Myasthenia Gravis." | Disease Research |
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For months, Sen. Bernie Sanders (I-VT) refused to hold a hearing on Dr. Monica Bertagnolli's nomination to lead the National Institutes of Health. Sanders finally held that hearing last week.
Alex Wong/Getty Images
For months, Sen. Bernie Sanders (I-VT) refused to hold a hearing on Dr. Monica Bertagnolli's nomination to lead the National Institutes of Health. Sanders finally held that hearing last week.
Alex Wong/Getty Images
Dr. Monica Bertagnolli is expected to finally get a vote in a Senate committee on her nomination to lead the National Institutes of Health this week. It's been a long time coming — and Sen. Bernie Sanders says he'll vote against her.
"Dr. Monica Bertagnolli is an intelligent and caring person, but has not convinced me that she is prepared to take on the greed and power of the drug companies and health care industry," Sanders (I-Vt.) said in a statement Tuesday afternoon. "I intend to vote NO at her confirmation hearing on Wednesday. I have not asked any member of the Committee to follow my lead. This should be a vote of conscience."
A markup on her nomination is set for Wednesday at 10 a.m. and a vote is expected to follow. She may still win that vote, though it will not be unanimous.
The top spot at NIH has been open since Dec. 2021, when Dr. Francis Collins, the longest serving NIH director, stepped down. President Joe Biden nominated Bertagnolli, who heads the National Cancer Institute, back in the spring of 2023.
The process has been stalled for months because Sanders, who chairs the Health, Education, Labor and Pensions Committee, wanted to get more action and concessions from the Biden administration on high drug prices before he would proceed with Bertagnolli's nomination.
A Senate committee finally held a hearing last week on Oct. 18 and Sanders remained focused on drug prices — an issue over which the NIH has very little control.
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Dr. Monica Bertagnolli testifies during her Senate HELP Committee confirmation hearing on Oct.18. She currently heads the National Cancer Institute.
Kevin Dietsch/Getty Images
Dr. Monica Bertagnolli testifies during her Senate HELP Committee confirmation hearing on Oct.18. She currently heads the National Cancer Institute.
Kevin Dietsch/Getty Images
After introducing Bertagnolli, Sanders quickly pivoted to the high prices Americans pay for prescription drugs.
"Let me say a few words about my concerns," he said, using his opening statement to detail the failures of the country's "broken" health system. "Very relevant to the hearing that we are conducting right now," he said, "we spend, as a nation, the highest prices — we pay the highest prices in the world for prescription drugs, in some cases 10 times more than the people in other nations."
In his statement Tuesday, Sanders called American health care dysfunctional and decried how expensive it is even as life expectancy declines.
The way the hearing began — introducing issues and politics that are not necessarily on point — highlights how much the job of leading the NIH has changed. The agency has a budget of more than $47 billion, making it the largest funder of medical research in the world. But the responsibility of its director has, since the pandemic, taken on new layers of complexity.
It has become "an enormous job of bridging between the world of policy, the world of the public, and the world of science," said Larry Levitt, executive vice president for health policy at KFF. (KFF Health News is an editorially independent program of KFF, the nonpartisan health policy organization.)
"COVID turned the scientific health agencies into political footballs like never before," Levitt said.
The nomination of Bertagnolli, a surgical oncologist, was applauded by much of the medical research community, especially the oncology world. But after she was tapped for the role in May, progress stalled. Dr. Laurence Tabak, a dentist, has been the acting director of NIH in the interim.
The confirmation of Bertagnolli's predecessor, Dr. Francis Collins, a physician and geneticist, took just four weeks in 2009, Sen. Tommy Tuberville (R-Ala.), observed. Bertagnolli's, he told her, has "faced a much different nomination process. Your nomination was held up by Chairman Sanders."
Sanders agreed to hold the hearing only after the Biden administration announced a contract with biotech company Regeneron Pharmaceuticals for a next-generation monoclonal antibody to prevent COVID-19 that required the list price of any resulting drug to be equal to or lower than the price in other major countries.
During the hearing, he returned to the issue, suggesting NIH should seek more such agreements with drugmakers that depend on the agency's research. He asked Bertagnolli if she could "commit to us that you will work to make sure that Americans do not pay higher prices for prescription drugs in this country than people around the world."
She responded noncommittally: "It would be a great honor to be able to work with you to make sure that the American people have access to the care that they need to live long and healthy lives."
As part of his criticism of Sanders, Tuberville also pointed out that the NIH has been without a confirmed director for 21 months. Tuberville, meanwhile, has for months been holding up nominations to military leadership positions over abortion policies.
If she's confirmed, Bertagnolli would lead the NIH at a time of high scrutiny and skepticism of public health agencies. HELP Committee Ranking Member Bill Cassidy (R-La.) told her that part of her duty would be "to rebuild the relationship with Congress and the public, being a leader that represents the interests of all Americans and not just of the scientific community."
To this end, senators asked Bertagnolli about how she would lead the agency's research on maternal health and diabetes, and about how she would address both opioid addiction and mental health crises. She was pressed on how accessible NIH's data would be to the public.
Sen. Roger Marshall (R-Kan.) asked if she thought taxpayers should "fund gender reassignment experiments." She dodged the question, noting that transgender youth are some of the most vulnerable in the country.
Bertagnolli kept a cool tone throughout the hearing as she shared her vision of "making sure that American people have access and availability and can afford the health care that can save lives."
Senators also questioned how well-rounded Bertagnolli's experience is and whether she would favor the NCI over the agency's 26 other institutes and centers. Sen. Susan Collins (R-Maine) asked Bertagnolli if she would be able to find a balance.
She explained that, as an oncologist, she "took care of patients of all ages, all walks of life, all different health states. I am very familiar to working with colleagues in cardiology, in mental health, in opioid use disorder, in kidney disease, to take care of my patients with cancer."
The HELP Committee has scheduled a markup on Bertagnolli's nomination Oct. 25. If her nomination passes the committee, it will then move to a full Senate vote. If confirmed, she will be the first woman to hold the job since 1993.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. | Health Policy |
Drug companies are systematically funding grassroots patient groups that lobby the NHS medicines watchdog to approve the rollout of their drugs, the Observer can reveal.
An investigation by the Observer has found that of 173 drug appraisals conducted by the National Institute for Health and Care Excellence (Nice) since April 2021, 138 involved patient groups that had a financial link to the maker of the drug being assessed, or have since received funding.
Often, the financial interests were not clearly disclosed in Nice transparency documents.
Many of the groups that received the payments went on to make impassioned pleas to England’s medicines watchdog calling for treatments to be approved for diseases and illnesses including cancer, heart disease, migraine and diabetes. Others made submissions appealing Nice decisions when medicines were refused for being too expensive.
In one case, a small heart failure charity that gave evidence to a Nice committee arguing for a drug to be approved received £200,000 from the pharmaceutical company, according to the maker’s spending records.
In another case, a cancer patient group supplied evidence relating to drugs made by 10 companies – from nine of which it had received funding. The payments raise urgent questions for the medicines watchdog about its management of potential widespread conflicts of interest and efforts by companies to forge ties with groups involved in the appraisal process.
Prof Martin McKee, a public health expert and former president of the British Medical Association, said industry funding of patient groups was a “longstanding concern”, adding: “Mechanisms for managing conflicts of interest are not fit for purpose.”
Dr Leeza Osipenko, who worked for Nice from 2012-19 and was its former director of scientific advice, said: “It’s a massive problem. It’s a massive conflict of interest. There needs to be a discussion at a government level to decide what is the solution.”
The Observer investigation discovered that in some cases the amounts received by charities made up a substantial proportion of their income.
The Pumping Marvellous Foundation, a small heart failure charity, was paid £200,000 by a drug maker while taking part in the Nice appraisal for its drug in 2022 and 2023.
When the drug – AstraZeneca’s Forxiga – was refused by Nice on cost grounds, the charity submitted an appeal saying the decision had led to “great disappointment”.
It said it had “always provided the required information” to Nice and was not influenced by the funding. In another case, a company owned by the Migraine Trust charity received £115,000 from Pfizer in “conference sponsorship” while the charity was engaged in a Nice appraisal for the company’s migraine drug Vydura. The charity said it had not declared the 2022 sponsorship as it did not consider it relevant and its subsidiary company was a separate entity.
In other cases, there were questions surrounding whether funding was properly disclosed. During an appraisal of Novartis’s drug Kesimpta in 2021 for the treatment of multiple sclerosis, patient group the Multiple Sclerosis Trust said it had received “£1,600” in conference fees from the company in the previous 12 months.
But the charity’s annual reports suggest the figure was much higher – more than £230,000 from 2018 to 2021. The charity said it always accurately disclosed donations within a 12-month period, but appraisal timings meant it was possible some donations did not need to be declared.
Another charity, the Roy Castle Lung Cancer Foundation, has taken part in 12 Nice appraisals since April 2021 relating to drugs made by 10 companies – from nine of which it has received funding. But it does not appear to have disclosed details of the funding, stating simply that: “Our funding base is a broad mixture including community, retail, corporate, legacies and charitable trusts.”
Steve Goodrich, head of investigations at anti-corruption organisation Transparency International UK, said the payments raised “serious questions as to whose interests” the groups were representing. “Even when this funding is declared, which isn’t always the case, there’s an argument to say transparency is necessary but not sufficient in managing the conflicts of interest that arise. There needs to be a fundamental rethink about the resourcing of patient groups to ensure they don’t just act as puppets for the industry,” he said.Most Nice appraisals only include input from one or two patient groups, meaning those with financial interests were often the only ones providing a patient voice to the expert committee.
Diarmaid McDonald, the lead organiser at Just Treatment, which campaigns for lower drug prices, said the payments raised serious conflict of interest concerns and risked undermining the Nice appraisal process. “There are times when the interests of a drug company and a patient group might overlap, but there are also times when they will diverge. We need proper independent voices that can provide a critical view,” he said.
This weekend, Nice said it was looking into the issues raised. It said its appraisals were “greatly enhanced by the patient voice” and that it had “robust processes” that enabled it to “make recommendations based on careful analysis of all the evidence” in the face of “pressures from across the health ecosystem”.
It added: “We recognise that these payments are made, and our committees are aware that both patient groups and their representative charities give their insights from their own perspective and interests.”
The watchdog - which assesses the cost-effectiveness of treatments to see if they should be available on the NHS - receives evidence from different stakeholders, including drug companies and clinical experts. The role of patient groups is to give a voice to lay people, providing insights to expert committees about living with the medical conditions being discussed, and allowing the groups opportunities to “contribute to developing Nice guidance, advice and quality standards”.
All parties providing evidence are expected to declare interests, including any direct funding from drug makers as well as indirect interests where related third parties might benefit. The declarations are typically only required to cover the 12-month period before their involvement with Nice began, meaning more historic ties are often unclear. They are then expected to update their interests throughout the appraisal process. The Nice policy says it is the group’s responsibility to “identify and declare interests at the earliest opportunity, and to ensure this declaration remains up- to- date”..
The Association of the British Pharmaceutical Industry (ABPI) said drug companies were prohibited from paying patient groups to advocate for their products in Nice appraisals.
Dr Amit Aggarwal, the ABPI’s director of medical affairs, said: “It is wrong to suggest any inappropriate connection between company partnerships with patient groups and the Nice health technology appraisal process. The industry’s strict code of practice demands that any partnership is transparent and companies must respect the independence of patient organisations at all times.”
Patient groups identified in our analysis strongly denied they had been influenced by any funding and said they had complied with Nice rules. The Pumping Marvellous Foundation shared an email showing it told Nice in response to a request in April 2023 it had received funding from AstraZeneca, including for “disease awareness” and advisory board work. When asked whether it had declared the interest earlier - such as when it first submitted evidence to Nice in 2022 – it did not answer.
He added that patient group funding was “a challenge”.
The foundation’s chief executive, Nick Hartshorne-Evans, said the charity had declared its interests properly, would have been involved in the Nice appraisal even if it had not received funding from AstraZeneca and that its core aim was to “advocate for patients to provide a better quality of life”. He added: “Given the lack of any other treatment available, it would have been seriously remiss of the charity not to focus on [the Forxiga] appraisal and push for the treatment adoption by Nice.” Records show AstraZeneca has financial ties to most patient groups involved in Nice appraisals of its drugs. Of 10 groups involved in eight Nice appraisals for its drugs since 2021, nine have received payments from the company. AstraZeneca said: “We do not offer donations or payments to charities in exchange for their participation in the Nice process. All of our payments to patient organisations are listed on our website.”
The Multiple Sclerosis Trust said it “strongly refuted” any suggestion it underreported industry income and always complied with Nice policies. “At all times, we maintain an independent and unbiased voice in the appraisal system,” it added.
Novartis did not respond to a comment request. The Migraine Trust said it acted in “the best interests of the migraine community” and followed all Nice processes.“All relevant financial interests are always declared and the submissions are overseen by medical experts,” it said.
Pfizer said its payments to charities were “in no way related to medicines undergoing the Nice appraisal process”, that it complied with industry code and that its work with patient groups was to help “build understanding of patients’ needs”.
The Roy Castle Lung Cancer Foundation said that “income from pharma” did not influence the charity’s involvement in Nice processes. “We retain an independent voice and our input is based on potential benefits of any new treatment,” it said.Concerns about industry funding of patient groups have been highlighted before.
In May, a study by academics at the London School of Economics found that “almost all funds (90%) from pharmaceutical companies were directed to patient organisations … aligned with companies’ approved drug portfolios and research and development pipelines”. The authors of the study warned that “reliance on industry funding can undermine the credibility of patient groups and align their agendas with their funders. Given the important role played by these groups in Nice, the potential lack of transparency and impartiality warrants further scrutiny of their ties to industry,” they added.
Earlier this year, the Observer revealed how the drug
company behind the Wegovy obesity injections paid millions to experts and groups that in some cases went on to praise the drug in submissions to Nice without always making their links to the company clear. Nice subsequently launched an internal inquiry which found that some of those who advised it on the use of Wegovy in the NHS had not properly declared their interests.
Additional reporting by Nneoma Ekwegh and Skyler King | Health Policy |
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