article_text
stringlengths 294
32.8k
⌀ | topic
stringlengths 3
42
|
|---|---|
Little pigs with big genome edits could be the future of organ donation.
A monkey that received a kidney from a genetically engineered miniature pig lived for more than two years after the transplant, scientists report October 11 in Nature. The team took a molecular red pen to donor pigs’ genomes, editing the animals’ organs to be more of a match for humans. Such an editing strategy could one day make it more likely for people’s bodies to accept organs from different species.
The work, funded by biotechnology company eGenesis, is the latest in a string of efforts seeking to use other species to address global organ shortages. The new study is “promising work and a step in the right direction,” says Parsia Vagefi, a transplant surgeon at UT Southwestern Medical Center in Dallas, who was not involved with the research.
In the United States, the demand for new organs to replace damaged or diseased ones far outpaces supply. As of October 11, nearly 104,000 Americans sit on the national transplant waiting list. Some 89,000 of these people are seeking kidneys. “There just simply aren’t enough kidneys to go around,” said eGenesis president and CEO Mike Curtis in a news conference on October 10. Most people waiting will never get the offer, he says. “They will die on dialysis.”
That’s where cross-species transplantation — giving people organs from other animals — comes in, Curtis said. It’s “the only near-term viable solution to solving this huge shortfall in organ availability.”
But the path forward is studded with scientific stumbling blocks. Pig organs aren’t a molecular match for human bodies, for one. Porcine cells display suspicious-looking sugars that spell “stranger” to our immune systems. This can prompt rejection of a transplanted organ.
If the body sees those sugars, “It’s like, ‘whoa, you’re not supposed to be here,’ and the immune system attacks,” says Jayme Locke, a transplant surgeon at the University of Alabama at Birmingham. Scientists tweak donor animals’ genomes to “make the pig kidney as human as possible so that our body recognizes it and doesn’t immediately attack it,” she says.
Locke and others have already made progress in this field. In 2021, a team at NYU Langone Health tested how well a kidney from a genetically modified pig functioned by attaching it to a brain-dead woman (SN: 10/22/21). In 2022, Locke’s group upped the ante, publishing the first peer-reviewed study on a gene-edited pig kidney transplanted into a brain-dead person.
That year, doctors also transplanted modified pig hearts into two brain-dead people — and even a living man (SN: 7/12/22). The man, 57-year-old David Bennett from Maryland, survived for two months with the transplanted organ (SN: 1/31/22). This September, another patient, Lawrence Faucette, became the second living person to receive a genetically modified pig heart.
In August, Locke’s team reported that pig kidneys transplanted into a brain-dead man can function normally, producing urine over the course of a seven-day study. Her team worked with a different kind of genetically modified pig than the ones Curtis and his colleagues created — one with 10 genomic edits rather than up to 69.
The edits, which strip away some pig aspects and add in human ones, fall into three main categories designed to make the animals’ organs safer for human use. They lop off stranger-danger sugars from pigs’ cells, insert human genes to help prevent organ rejection and knock out potentially harmful retroviruses embedded in the pigs’ genomes. “This is probably the most genetically modified pig that I’ve seen described in the literature,” Locke says.
Curtis’ team mixed and matched edits in different pigs and transplanted their kidneys into monkeys. Because these are pig kidneys genetically tailored for humans, scientists have to dose the monkeys with powerful immunosuppressive drugs, so the animals don’t reject the new organs. But these types of animal studies are important, Locke says, because they can demonstrate long-term organ function, which is difficult to show in people with brain death.
Eight out of 15 monkeys that received pig kidneys lacking the sugars and carrying the human genes survived 176 days or longer, Curtis’ team showed. One monkey lasted much longer, living 758 days after the kidney transplant. Monkeys with pig kidneys missing the human genes didn’t fare nearly as well, surviving a median of 24 days.
“It’s encouraging when you see a pig kidney being able to function for two years,” Vagefi says. “But I think it’s even more encouraging when you see it done consistently.” Like any good study, he says, the work opens a chasm of questions. He wonders, for example, how many more genetic edits pig organs may need to succeed long-term in monkeys regularly.
Even then, there might not be a single kind of pig donor that’s right for every person, Locke points out. She thinks it’s important to have options. Doctors may “need more than one type of genetically edited pig in order to serve all the people in need.” | Medical Innovations |
Michigan marijuana sales hit another record high in June, reaching nearly $261 million.
Adult-use cannabis purchases accounted for the majority of the total, at $254,153,133. Medical marijuana sales were at $6,643,877. This beats the prior record set in March by more than $10 million.
The state is seeing these record-setting sales even as the average cost of marijuana has remained at record lows, with the price of an ounce for adult-use cannabis now hovering around $90. In December 2021, by contrast, the cost of an ounce was about $180. The average ounce for medical marijuana last month was about $100.
While the state’s cannabis market has continued to mature, businesses still face challenges under federal prohibition, including a lack of access to traditional financial services that has created a cash-intensive industry that is uniquely targeted by crime.
The attorney general of Michigan said in March that a string of break-ins at marijuana dispensaries in the state underscore the need for Congress to pass cannabis banking reform.
Meanwhile, former Michigan House Speaker Rick Johnson (R), who went on to chair the state’s Marijuana Licensing Board, caught headlines in April after a federal prosecutor charged him for allegedly taking bribes in exchange for providing privileged information and assistance to select license applicants. He and other defendants reached plea agreements in the case.
Michigan regulators announced last year that they were issuing another round of grants to support research into the therapeutic benefits of marijuana for military veterans, using tax dollars the state generated from adult-use cannabis sales.
This time around, CRA recommended awarding $20 million in grants to two universities as part of the Veteran Marijuana Research (VMR) Grant Program.
Officials also announced last year that the state would be distributing nearly $150 million in marijuana tax revenue, divided between localities, public schools and a transportation fund.
Meanwhile, state officials recently approved changes to the state’s employment policy, making it so applicants for most government jobs will no longer be subject to pre-employment drug testing for marijuana.
—
Marijuana Moment is tracking more than 1,000 cannabis, psychedelics and drug policy bills in state legislatures and Congress this year. Patreon supporters pledging at least $25/month get access to our interactive maps, charts and hearing calendar so they don’t miss any developments.
Learn more about our marijuana bill tracker and become a supporter on Patreon to get access.
—
Michigan isn’t the only state setting cannabis sales records.
Massachusetts marijuana sales reached nearly $152 million in June—a record monthly high since the state’s adult-use market launched in November 2018—state data shows.
Connecticut also saw record high marijuana sales last month, at $24 million for the sixth months since the opening of the state’s recreational industry.
In Maryland, where adult-use cannabis market launched this month, marijuana sales topped $10 million during the opening weekend. | Disease Research |
NEW ORLEANS – Moments after Morris Jeff Community School’s graduation ceremony ended May 31, gunshots pierced the air. The crowd of students, many still in caps and gowns, and family members scattered. Some attendees fell to the ground as the joyful moment turned deadly for members of the Class of 2022.
Augustine Greenwood, 80, a mother to six children and grandmother to 15, died in the shooting. She had just watched her youngest grandson get his diploma. The violence broke out in a gun-free zone on a local university campus. Two more were injured. Police say six guns were seized at the scene.
In a nation where adolescents under 19 were more likely to die from a gun-related injury in 2020 than a car accident, New Orleans ranks among the worst cities for firearm death. Louisiana experiences the second-highest rate of gun-related deaths in the country, according to the Centers for Disease Control and Prevention’s firearm mortality data.
WATCH: Students speak out about the impact gun violence has on their daily lives
When Geraldine Greenwood-Lashley, Greenwood’s daughter, memorialized her mother in a post on Facebook, she also directed a message to those responsible, writing, “You have ruined my son and family’s world.”
Corey Lashley, Jr., a graduate from Morris Jeff High School (c) in New Orleans, poses for pictures with his mother, Geraldine Greenwood-Lashley (r), and his 80-year-old grandmother (l), Augustine Greenwood. The grandmother of 15 was killed following a triple shooting. Photo courtesy of Corey Lashley, Sr.
“The graduating seniors of Morris Jeff were there to share in their collective achievements and bask in the brightness of their futures – only to have their optimism ripped apart by gun violence,” Henderson Lewis Jr., the NOLA Public Schools Superintendent, told the PBS NewsHour in a statement after the shooting. He had spoken at that graduation alongside the mayor. “This has got to stop.”
In New Orleans, gun violence has been a problem for decades as the number of deaths from firearms among children is steadily rising. In 2022, Louisiana has six times the national average of mass shootings per capita, defined as shootings in which four or more people are injured, according to the Gun Violence Archive. New Orleans leads the state with four mass shootings so far this year.
On the same day across town, Tory Morgan, 19, was leaving for Northwestern State University. As the star athlete approached the end of his high school career, he sought opportunities to help him make it out of the city, in part hoping to “escape the city’s gun violence.” While he saw his newly earned diploma and full scholarship to Northwestern as huge accomplishments, he was most happy that he lived to graduate.
“Gun violence is taking over. It’s not if you know anyone who’s been shot, it’s how many,” Morgan said. “Every day, you’re fighting to survive. I definitely feel grateful that I was able to survive. I made it out.” Morgan said.
19-year-old Tory Morgan graduated from Edna Karr High School and quickly left town to escape gun violence. Morgan received a full scholarship to Northwestern State University. He hopes to return to Karr as a mentor. Photo by Tory Morgan / Student
In the last year, two friends and fellow students at Karr High School – Keyron Ross and Caleb Johnson – were killed in separate incidents of gun violence. Police charged a fellow student with Ross’ murder. Prosecutors said Johnson was killed in a triple shooting 21 days before graduation when 20 shots were fired during a gun exchange. A year later, police arrested Johnson’s father for murdering his son’s alleged 21-year-old killer during a drive-by shooting.
Morgan is tired of seeing his friends in coffins.
“I know many students I grew up with and who I went to school with who got killed by gun violence and fell victim to the situation and the crime. I can’t even count them on my hands,” he said. “It’s devastating. It hurts to know they had a future and it’s taken away … It makes you just sit down and say, ‘I got to get out. It could easily be me.’”
Why more children are being killed by gun violence
The youth gun violence epidemic took center stage again following the mass shootings in Tulsa, Buffalo, New York, and Uvalde, Texas, where a gunman shot and killed 19 children and two adults at an elementary school. In a prime-time address on May 24, President Joe Biden highlighted the loss.
“To lose a child is like having a piece of your soul ripped away,” the president said, who repeated his concerns in a second speech days later, calling for gun law reform. He cited a May report from the CDC that listed guns as the No. 1 killer of children and adolescents in 2020. The agency said firearms overtook car accidents and cancer as the leading cause of death for that age group, up to 19 years old.
READ MORE: We asked every senator what action should be taken on guns. Here’s what they said
Several high-profile shootings in New Orleans have made advocates reach their breaking point in the last year. A 3-year old girl was shot and killed inside her home in the French Quarter. A 7-year-old was fatally shot while riding with her mom in a car. A 12-year old boy was shot and left to die on a street.
Members of the grassroots organization, New Orleans Moms Demand Action, march through the streets during a rally against gun violence. Photo by Pleshet Ball/Moms Demand Action
“People want to see something changed. People across the city and nation are seeing this increase and are very afraid of how it may impact them. It’s scary for people,” said Red Devitt, the leader of the New Orleans branch of the Moms Demand Action advocacy organization. “I think families are scared. I think they are considering leaving the area because of the violence. I’d definitely say it’s a breaking point, but it’s not an issue unique to New Orleans.”
The NewsHour made repeated requests to the City of New Orleans, the New Orleans Police Department, and the Orleans Parish District Attorney for gun violence data broken down by age, race, and gender. None could cite the data being used to drive the city’s gun violence reduction plan. Other cities, like Denver and Philadelphia, have publicly mapped out gun violence data in order to study the factors driving youth gun violence.
Between January 2021 and April 2022, 24 children under 18 were killed by a gunshot wounds. As of June 9, nine children and teens from this age group have been killed so far this year, according to figures from the Orleans Parish Coroner’s office compiled by the Metropolitan Crime Commission (MCC), a New-Orleans nonprofit and watchdog group that monitors crime and corruption. A majority of the victims – 20 – were Black males.
Crime scene tape marks the scene of a triple shooting outside of New Orleans High School graduation, where the grandmother of one of the graduates from the Class of 2022 was killed. Photo by Jim Pennison/Photojournalist WVUE-TV
In the New Orleans region, homicide is the top cause of injury deaths for children aged 1-14, according to the New Orleans Health Department. That’s the highest rate for the entire state of Louisiana.
Morgan said the fight to survive means a lot of young people have guns, and they are easy to get.
“It’s super easy. There are so many on the streets. You can see them every day,” he said. “I see young kids having them. They don’t even know how to work it, but they have it. If I guessed, I’d say they are scared and feel like they need it to survive, which is the problem. I don’t blame them. I just wish they had help.”
Data from a 2019 study from the Institute of Women and Ethnic Studies (IWES), a national nonprofit health organization based in New Orleans, showed how the intergenerational trauma caused by youth gun violence runs deep in the city. The survey measured the exposure to violence of roughly 1,500 participants aged 11 to 19. They found that one in five children witnessed a murder, and more than half had someone close to them murdered.
Finding solutions falls on the city’s Office of Gun Violence Prevention, which was created last year by Mayor LaToya Cantrell to decrease gun-related murders and other related crimes in New Orleans. The goal of the program is to reduce those numbers over the next 50 years.
The mayor noted as part of a 2019 report outlining her plan to decrease gun violence that there had been at least 145 murders in New Orleans every year for the previous 50 years, adding that at the time, the city had the seventh highest murder rate of all major U.S. cities.
Members of the community participate in a March For Our Lives demonstration marching in front of Jackson Square in New Orleans. Photo by Marc PoKempner / Photojournalist
The plan includes gathering more data and tracking where crime happens, improving operations at the New Orleans Police Department by solving more cases, and building its own crime lab. It also emphasizes delivering community-based services to help neighborhoods at risk of gun violence.
So far this year, numbers are rising. Shooting incidents are up 92 percent compared to 2019, and homicide is up 150 percent, with 135 people killed as of June 13, according to MCC, which is not affiliated with the city’s gun violence prevention office. Last week, there were 12 more homicides.
Efforts of the city’s Office of Gun Violence and Prevention have been in the crosshairs of the New Orleans City Council. Council member JP Morrell threatened that the office could lose funding if it can’t show results. Meanwhile, other members supported the program as a “holistic” effort against crime, as recently reported by NOLA.com.
According to the report, critics accuse the Office of Gun Violence and other programs for at-risk youth of “spending taxpayer money to dubious effect and crowding out funding for worthy non-profits.”
Patrick Young, the director of the New Orleans Office of Gun Violence Prevention, said the annual budget for his office is $216,000, while violence costs the city $25.7 million in medical costs each year, according to 2018 figures.
Patrick Young, director of the Office of Gun Violence Prevention speaks at a community gathering as part of his office’s gun violence prevention work to decrease crime and provide resources. Photo by Patrick Young/Office of Gun Violence.
“It’s a lot of work. It’s a totally devastated landscape that we need everybody in on. It’s just like after Katrina,” Young said. “We need that same kind of energy to come back and impact the lives of these kids. We need as many people to get in front of those kids to help them understand that they can deal with their feelings without violence.” Young, who was formerly incarcerated and lost a brother to gun violence, said he can relate.
Despite the urgency, Young said there is a lack of a central database to map the violence plaguing young people.
Young said a new partnership with Tulane University’s Violence Prevention Institute will create a CDC-funded research hub for youth violence prevention. A report is expected early next year, which Young hopes will provide some insight as to what is driving the surge as well as potential solutions.
“We haven’t tapped into the why. There hasn’t been any report produced to say what works. We know the murder rate fluctuates, but we never know why,” he said.
Young said the shooting at the Morris Jeff graduation was a harbinger of another long, hot, and violent summer in the Big Easy. On a single day last week, a 16-year-old boy was killed, and a 17-year-old girl was injured by gunfire.
Following every shooting in New Orleans, members of the Office of Gun Violence respond with resources and place signs promoting a violence-free city. Photo by Patrick Young/Office of Gun Violence.
“Every kid is at risk,” Young said. “If we can’t learn how to teach them how to control emotions, then we’ll see what we saw at graduation. This summer, we will see a spike like no other,” predicted Young. “We need to look at violence as a public health issue and look at it the same way as a virus … Violence spreads the same way, and on social media; it mutates.”
But, Young said “unity is the key” to breaking the cycle of violence that keeps taking young lives.
“It feels like we are on an island, like we are by ourselves. We need a unified effort to really work together. We can’t have peace if we’re in pieces.”
Focusing on change
Educators at Edna Karr High School, which is run by Inspire NOLA, a charter school management network, have seen trauma from gun violence permeate schools. From the classroom to the lunchroom to the football field, students are constantly reminded of the epidemic that surrounds them. As a result, the school relies on a mentor program that involves everyone, even coaches.
“Coaches aren’t just coaches. We teach kids to survive. Coaches are teachers. Coaches are mentors. We have to go beyond the classroom, not only to teach our children but to reach them,” said Brice Brown, who has been a coach at Karr for 17 seasons and has been to nearly a dozen student funerals.
“We have to know more about them emotionally and socially than we do academically. Our key focus is to not only let them believe what they can do, but to erase the notion of what they can’t do,” he said.
Brown, known for immersing himself in his students’ lives, recalls delivering food to a player in the middle of the night, not just because he lived in poverty and was hungry, but to keep him safely indoors.
Students in the Class of 2022 at Abramson Sci Academy attend graduation ceremonies in New Orleans. One student decorates her cap with the words “It’s Just the Beginning.” Photo by New Orleans Public Schools.
“All we have to do is choose to help and choose to listen. It’s a powerful thing. They have to know you believe in them.”
Inspire NOLA CEO Jamar McNeely, who oversees 5,700 students and eight schools, estimates he’s been to nearly 60 funerals in the last two decades. Two of them were in the last year. Each time, “it definitely rips through our whole community,” he said.
“I can remember the first loss just like it was yesterday. Seeing that student in a casket never goes away,” McNeely said. “The number keeps rising every single year. What’s even more hurtful is when I see our youth in pain. I see our youth in a state of loss. Our school community, in many aspects, is not the same for the entire year.”
In 2019, Karr had a graduation rate of 94.5 percent, according to state data. Mcneely said this year the rate was 99 percent. McNeely and Brown like to also focus on the thousands, like Morgan, who have graduated.
“Our students deserve grace and love. I believe in our students wholeheartedly,” McKneely said. “Yes, we have some stories of tragedy, but we also have a lot of stories of success. They need to see how those successful kids come back. Then, they will want to see themselves come back and tell their story to the next group of kids.”
19 Year old Tory Morgan poses for pictures on signing day after getting a full scholarship to Northwestern State University. The middle linebacker was an all-state and all-district MVP while playing for the Edna Karr Cougars. Photo by Tory Morgan/Student
Tory Morgan knows he’ll soon return to New Orleans to tell his story to help lift the next generation. In fact, he’s already a mentor to a younger ballplayer.
“I know, It could have easily been me.… I want to help the next person; It’s why I’m happy I’m able to leave and go to college. There’s a kid who’s already watching me. If he sees that I made it out, maybe he’s going to follow me,” he said. “Hopefully, I can reach them and show them there is a different way to go.” | Epidemics & Outbreaks |
WHO asks China for more information about rise in illnesses and pneumonia clusters
The World Health Organization says it has made an official request to China for information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children
GENEVA -- The World Health Organization says it has made an official request to China for information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children.
The U.N. health agency cited unspecified media reports and a global infectious disease monitoring service as reporting clusters of undiagnosed pneumonia in children in northern China. In a statement late Wednesday, WHO said it was unclear whether those were linked to a rise in respiratory infections reported by Chinese authorities.
Outside scientists said the situation warranted close monitoring, but were not convinced that the recent spike in respiratory illnesses in China signaled the start of a new global outbreak.
The emergence of new diseases, particularly new flu strains or other viruses capable of triggering pandemics, typically starts with undiagnosed clusters of respiratory illness. Both SARS and COVID-19 were first reported as unusual types of pneumonia.
WHO noted that authorities at China’s National Health Commission on Nov. 13 reported an increase in respiratory diseases, which they said was due to the lifting of COVID-19 lockdown restrictions. Other countries also saw a jump in respiratory diseases such as respiratory syncytial virus, or RSV, when pandemic restrictions ended.
WHO said media reports about a week later reported clusters of undiagnosed pneumonia in children in northern China.
“It is unclear if these are associated with the overall increase in respiratory infections previously reported by Chinese authorities, or separate events,” WHO said, adding that it had requested more details from China about currently circulating viruses and any increased burden on hospitals, via an international legal mechanism.
Dr. David Heymann of the London School of Hygiene and Tropical Medicine said there was a likely background of seasonal respiratory infections.
“The challenge is to discern the outbreaks and determine the cause,” Heymann said in a statement, adding that genetic sequencing and isolating cases would be critical. He led WHO’s response to the 2002-2003 SARS outbreak.
Francois Balloux of University College London said the current wave of disease in China was likely due to respiratory illnesses like flu, RSV or a bacterial infection.
He said China was probably experiencing a significant wave of childhood infections since this was the first winter since lockdown restrictions were lifted, which likely reduced children's immunity to common bugs.
“Unless new evidence emerges, there is no reason to suspect the emergence of a novel pathogen,” Balloux said.
WHO said that northern China has reported a jump in influenza-like illnesses since mid-October compared to the previous three years. It is rare for the U.N. health agency to publicly ask for more detailed information from countries, as such requests are typically made internally.
After SARS broke out in southern China in 2002, Beijing officials told doctors to hide patients, with some being driven around in ambulances while WHO scientists were visiting the country. That prompted WHO to threaten to close its office in China.
Nearly two decades later, China stalled on sharing critical details about the coronavirus with the U.N. health agency after the new virus emerged in late 2019. WHO publicly applauded China's commitment to stopping the virus — weeks before it started causing explosive epidemics worldwide.
“While WHO seeks this additional information, we recommend that people in China follow measures to reduce the risk of respiratory illness,” the agency said, advising people to get vaccinated, isolate if they are feeling ill, wear masks if necessary and get medical care as needed.
___
Cheng reported from London. | Epidemics & Outbreaks |
Twelve years ago, I’d returned home from my job teaching science at a secondary school in Darlington with a bad headache. By the time my husband, Paul, got back from work and found me flat on the sofa, I was in debilitating pain. He tried to convince me to go to the hospital. I put it off until the morning, but by then I couldn’t move an inch without my head and spine screaming in agony.
During my first week at the hospital, where paracetamol and morphine did nothing to touch the pain, I discovered that lying flat on my back was the only way I found any relief. I was still marking my students’ work. They had their GCSEs coming up and I didn’t want to let them down.
The doctors didn’t know what was wrong with me, so I was transferred to another hospital in Middlesbrough. An MRI and lumbar puncture spotted some subdural effusions – little bubbles at the very top of my brain. This indicated a spinal fluid leak, though they couldn’t figure out where it was.
The diagnosis was spontaneous intracranial hypotension. Also known as a CSF leak, it is more usually seen in women who have had an epidural while giving birth, but in those cases doctors know where the hole in the spine was made and where to direct treatment. It’s usually treated with a blood patch: they take blood from elsewhere in your body and reinject it into the spinal membrane. But with me, they struggled to see where to place it.
The blood patch did give me relief, and I was sent home. Three days later, the pain came back, along with double vision, eye pain, pressure in my head, tinnitus and other hearing problems. Lying down was the only thing that helped. Because of my low spinal fluid pressure, my brain is not supported and sinks into my skull when I stand or sit up, causing these symptoms. Since then, I’ve spent most of my time on the sofa.
I’m in least pain in the mornings, having been lying flat all night. I dress on my bed, with clothes that are easy to pull on. Lots of layers are important, as you get cold more easily when you’re not moving around.
I try to go swimming, with the help of my husband or my carer, Emmie. We also have an allotment; I go there in padded ski clothing so I can lie down with my flowers and plants.
At home, I’ll cuddle up with my house rabbit, Truffle, or teach her new tricks. Reading can be hard, so I prefer podcasts or audiobooks. Some days I have to go back to bed to keep warm.
My life is incredibly different to how it was before. In my 20s, I studied biosciences at Birmingham University. I performed in the university circus society; my speciality was fire poi, a form of fire-spinning which is based on a traditional Māori dance.
After graduation, I volunteered at an orphanage in Morocco, then did my teaching qualification. Paul and I got married, and I went into teaching science. I loved it. In our free time, we went camping, cycling, and bought a stunt kite to take to the beach. Life was adventurous; we were happy.
Since I was first discharged in 2010, various doctors have tried to find a fix; they put a pressure-monitoring system temporarily inside my skull, and then stents into my brain. These helped reduce some of my symptoms, but did not solve the problem.
The pandemic slowed things down, but last year I found a doctor who was willing to give blood patches another try. I had a few weeks where I was able to sit up a bit more, even play my piano; but then the pain came back. Every time an attempt fails, it’s devastating.
Paul has been my rock, a tremendous emotional support. His work in the mental health sector has given him valuable skills and empathy. It’s hard to dream about a future where I’m cured, but I’d love to teach again, and go to Iceland and Uzbekistan. I found a Facebook group of people with CFS leaks; it’s a very positive place where people share their experiences, triumphs and disappointments.
For now, I like to focus on what I can do. I’m fundraising for a recumbent tricycle that will allow me to pedal while lying semi-flat and give me much more independence. This isn’t the life Paul and I dreamed of, and I do feel like a burden sometimes, but I know we have more fun when I let him help me.
As told to Grace Holliday | Disease Research |
A lethal parasite’s secret weapon: infecting non-immune cells
Finding defies textbook understanding of leishmaniasis infection
The organisms that cause visceral leishmaniasis, a potentially deadly version of the parasitic disease that most often affects the skin to cause disfiguring disease, appear to have a secret weapon, new research suggests: They can infect non-immune cells and persist in those uncommon environments.
Researchers found the Leishmania donovani parasites in blood-related stem cells in the bone marrow of chronically infected mice – precursor cells that can regenerate all types of cells in the blood-forming system. The finding may help explain why some people who develop visceral leishmaniasis, which is fatal if left untreated, often also have blood disorders such as anemia.
Identifying these cells and other unexpected locations in which these parasites live improves scientists’ understanding of the disease and may lead to new treatment options, said senior study author Abhay Satoskar, professor of pathology in The Ohio State University College of Medicine.
“Treating a patient with leishmania drugs never eliminates every parasite from the body – they persist for the rest of a patient’s life,” Satoskar said. “Perhaps these uncommon cells are the cells responsible for harboring these parasites in low numbers. Some drugs may not reach these cells properly or may not be effective with those parasites, and maybe the parasites in these kinds of cells are different compared to parasites in immune cells because they can adapt. It would be important to eliminate these hidden parasites if we want to stop the transmission of the disease.
“It changes the way we think about this parasite: If uncommon cells are infected, what is the cells’ role? What are the parasites doing there? How did they evade the drug treatment? Are they different from parasites in other cells, or the same? There are lots of questions.”
The research was published recently in the journal Cell Reports.
Cutaneous leishmaniasis is a disfiguring skin disease caused by Leishmania major parasites that affects up to 1.2 million people annually in the tropics, while L. donovani parasites cause the less common visceral leishmaniasis that attacks internal organs, affecting an estimated 100,000 people per year. Scientists have suspected L. donovani may stray beyond their immune cell hosts because they linger in the body, but those suspicions have been difficult to confirm with most conventional technologies because the number of infected cells is low.
Satoskar and colleagues used single-cell RNA sequencing in their search for parasites in spleen and bone marrow cells of chronically infected mice. The technique allowed the team to identify individual cell types based on the thousands of genes expressed by cells that function as a signature of each cell type. Simultaneously, the researchers identified which types of cells were – and were not – infected by L. donovani parasites based on the presence or lack of genes known to be expressed by these organisms.
In the spleen, most of the infected cells detected were frontline immune cells – macrophages and monocytes – known as phagocytes whose job is to swallow up invading organisms.
“Textbooks say Leishmania are parasites of immune cells, mainly phagocytes, that hijack those cells and live there. That is what we’ve learned for many years,” said Satoksar, also a professor of microbiology at Ohio State. “Though that was the dogma, it appears during chronic infection that they’re also infecting other cell types.”
The study showed that these infectious organisms weren’t restricted to only phagocytic cells in either organ – in bone marrow, the blood-related (hematopoietic) stem cells were the main parasitized cells, a surprising finding that was verified through a separate single-cell analysis. The fact their outer surfaces feature some of the same receptors as typical immune cell targets hints at why and how they harbor the parasites, Satoskar said.
Other types of cells in both organs whose gene expression signature suggested they contained L. donovani parasites included white blood cells that assist the immune system – but don’t engulf infectious organisms – and cells responsible for the production of platelets.
“Finding Leishmania genes linked to other cell signatures gives us clues of which cells to look for next in follow-up protocols,” Satoskar said.
This work has potential for rapid translation to human tissue testing in some tropical regions, where taking needle aspiration spleen and bone marrow samples is a routine procedure for people at risk for leishmaniasis. Such samples could be used to help determine if non-immune cells are occupied by parasites in humans as well.
“These are organs where these parasites persist for many, many years after an infection has cleared and a person who becomes immune suppressed can develop disease again,” Satoskar said. “With our animal data and what we find in human samples, we hope to understand the pathways that are assisting parasites to survive and use that knowledge to develop new therapies targeting those pathways.”
This work was funded by the Global Health Innovative Technology Fund and the National Institute of Allergy and Infectious Diseases.
Co-authors include Konstantinos Karagiannis, Sreenivas Gannavaram, Thalia Pacheco-Fernandez, Parna Bhattacharya and Hira Nakhasi of the Food and Drug Administration and Chaitenya Verma of Ohio State. | Disease Research |
How cord-like aggregates of bacteria lead to tuberculosis infections
The ability of Mycobacterium tuberculosis (MTB), a serious respiratory infection, to form snake-like cords was first noted nearly 80 years ago. In a study published October 20 in the journal Cell, investigators report the biophysical mechanisms by which these cords form and demonstrate how several generations of dividing bacteria hang together to create these structures that enable resistance to antibiotics.
"Our work clearly showed that cord formation is important for infection and why this highly ordered architecture might be important for pathogenesis," says senior author Vivek Thacker, who led the work at the Global Health Institute at École Polytechnique Fédérale de Lausannen (EPFL) in Switzerland and is now based at the Department of Infectious Diseases at Heidelberg University in Germany.
The study used a unique combination of technologies to address the role of MTB cord formation. One was a lung-on-chip model, which allowed the researchers to get a direct look at "first contact" between MTB and host cells at the air-liquid interface in the lungs. This revealed that cord formation is prominent in early infection.
The researchers also used a mouse model that develops pathologies mimicking human tuberculosis, allowing them to obtain tissue that could be studied using confocal imaging and confirming that cording also occurs early in infection in vivo.
The work yielded several new findings about how these cords interact with and compress the cell nucleus, how this compression affects the immune system and connections between host cells and epithelial cells, and how cord formation affects the alveoli in the lungs. The study also revealed how these cords retain their structural integrity and how they increase tolerance to antibiotic therapy.
"There is an increasing understanding that these mechanical forces influence cellular behavior and responses, but this aspect has been overlooked since traditional cell culture models do not recapitulate the mechanical environment of a tissue," says Melanie Hannebelle, formerly at EPFL's Global Health Institute and now at Stanford University.
"Understanding how forces at the cellular and tissue level or crowding at the molecular level affects cell and tissue function is therefore important to develop a complete picture of how biosystems work."
"By thinking of MTB in infection as aggregates and not single bacteria, we can imagine new interactions with host proteins for known effectors of MTB pathogenesis and a new paradigm in pathogenesis where forces from bacterial architectures affect host function," says Thacker.
Future research will focus on understanding whether cord formation enables new functionality to known effectors of MTB pathogenesis, many of which are located on the MTB cell wall. In addition, it will look at the consequence of tight-packing on the bacteria within the clump and how this may lead to a protective effect against antibiotics.
"Antibiotic therapy is the mainstay of treatment for tuberculosis infections, but therapeutic regimens are long and complicated, with an increasing threat of drug resistance," says Richa Mishra, the other first author who is currently at EPFL's Global Health Institute. "There is a recognized need for host-directed therapies or therapies that inhibit specific virulence mechanisms that can shorten and improve antibiotic therapy."
Journal information: Cell
Provided by Cell Press | Disease Research |
CNN — With children back in school and daycare after the holidays, weary parents fear what illness awaits them next during this brutal respiratory virus season. Since October, RSV, a respiratory virus which often is most severe in young children and older adults, hit early and cases started rising quickly. Cases of influenza started rising soon after, all while Covid-19 continued to spread, with new variants surfacing. The CDC estimates: At least 24 million illnesses and 16,000 deaths have occurred due to the flu this season; About 15% of the US population lives in a county with a “high” community level of Covid-19; There were about 14 RSV hospitalizations for every 100,000 children under 5 in the latest week of complete data – about eight times higher than the overall hospitalization rate. CNN spoke to parents across the country about the challenges this flu season. They described canceling Christmas, missing trips home to see family and pulling their children out of daycare to keep them safe from illness. Here are some of their stories, as told in their own words. Their responses have been edited for length and clarity. Michaela Riley from Issaquah, Washington I am a single mom living in the suburbs of Seattle. I work for one of the major corporations here. On the outside, I look successful. I have senior in my title, I consistently get promotions and recognition. On the inside, I am breaking from stress related to illness, never getting a real vacation and now the inability to pay for my basic needs. I had to work through the holidays, and I had my kids. My parents were going to watch them. Then they got norovirus, which also canceled Christmas. Then my daughter’s father got some horrible flu, so my backup plan for Christmas got canceled. We still hadn’t celebrated Christmas until January 7 because everyone was healing. I have 4-year-old and 11-year-old daughters. Basically, all November one of us was sick. My kids got RSV and were so sick for 14 days. After that, I got it. I had no vacation time, so I had to work from home with them. It was a very long, trying time. As a single parent, I’ve always been focused on keeping all the balls in the air. But now it is so much harder that what I’m actually doing is making decisions on which ball to drop, just to keep myself going. I have used every single vacation day on either my children being sick, me being sick or me having to take one mental health day because I was totally overwhelmed since the beginning of quarantine. I was supposed to go camping last year with the family. I got Covid for the fourth time and had to cancel. I’m going a little bonkers. The group I work with has been so supportive of me and understanding of my situation. They honestly helped me during the worst times. I have this hashtag for 2023: #BeFree23. Instead of focusing on the struggle, I focus on what’s working in my life. I feel better about 2023. I don’t think anything’s going to change, but changing my mindset is the one thing I have control over. Jason Hecht from Ann Arbor, Michigan I am a doctor who works in critical care with a wife who works in primary care. Not only are we struggling on the health care worker side with the massive demands of this season but also struggling far more at home. The last month or two have probably been the most mentally and emotionally taxing I’ve ever had in my life. We have a 2-year-old and a 3-month-old. It was our youngest who was sick about a month ago and ended up in the ICU on the ventilator with RSV. At the time, we had a healthy, thriving 2-month-old without an issue in the world. To see him so quickly knocked down and be to the point of almost dying in the intensive care unit was very sobering for my wife and I. Seeing your baby that sick – that part alone has been very emotionally draining. I was all too aware of how severe his illness was. It was difficult to play the role of father, husband and caretaker because the pull was so strong to go into health care provider mode. We had to completely upend our life, pull both kids out of daycare. We’re still struggling to find a reliable source of child care that’s going to be safe for both of them, including our now vulnerable son. We’re still paying for both kids’ daycare spots, even though they aren’t going, because daycare waitlists are so long. As parents and health care workers, we are not coping well. We’ve used six or seven weeks of PTO total so far since this happened in November. This was difficult, too, with my wife coming off maternity leave. Her maternity leave has been mostly unpaid, so that was already three months we were going without her paycheck. I don’t have any paternity leave. I am very passionate about what I do, and I love being able to help people when they’re at their worst in the ICU. It’s been difficult to have to put all that aside to prioritize only being a parent right now. Adriana from Warwick, Rhode Island (She asked that her last name not be used) The only reason I waited only two hours in the ER is because my son stopped breathing. Everyone rushed to take care of him. His oxygen levels were at 73. My youngest caught RSV at 7 weeks old. My soul left my body when I was in the hospital. I saw there was a respiratory therapist, a pediatrician and two nurses, that they lay down my baby and they started suctioning all the mucus because he was so stuffy, he couldn’t breathe. They put him on oxygen. I couldn’t believe how lucky we were that he responded to the treatment as fast as he did. Now, I always carry a little oximeter with me. If he gets stuffy or anything like that, I put that on his finger. That’s part of my diaper bag. Between my son being hospitalized for one night and the two kids’ deductibles and co-payments, we are $3,000 in debt, just from September until today. He was given just two doses of Tylenol at the hospital and that was almost $300. Every time I call the pediatrician’s office, they pretty much triage us over the phone to see if the child is sick enough to grant a visit because of how slammed they are. I have been constantly redialing for several minutes just to get through. When you go into the office, you can see they’re all very tired. I think that anything that has to do with kids lately in the country is being overlooked. There’s still the formula shortage. A lot of parents like me, we’re still struggling to find the right formula. I drive all around Rhode Island to find it, and I’m lucky if I can get two cans. My baby is allergic to cow milk protein, so it’s not like I can just get him any formula. We usually fly back home for the holidays – I’m from Puerto Rico. But this year we just stayed home. It was a bummer for my oldest because he’s used to spending the holidays with the grandparents. Mahbubur Rahman from Bonney Lake, Washington In the last three months, we got five colds, four ear infections, visited urgent care 10 times and the emergency room four times, once while my kid was sick with RSV. In the last two years, my child had a cold only once. This is our first child. He’s a Covid child – he’s not exposed to anywhere because we stayed at home for the last two years. When we started sending him to preschool then this started happening, all things are coming together: face the fear of Covid, viruses like the flu and then, RSV. My child had a febrile seizure. His temperature cannot go past 102 and we need to continuously use Tylenol and ibuprofen just to control it. This is happening like every other week. We prepared our car with emergency things for if we need to stay at the hospital. We always pack our bag and put it in our car – like it still is there. I am working from home and my wife is not working. Still, we feel like we are exhausted. In the last two months, I think I did like 50% of the work that I usually do. When my son and wife had RSV, my manager actually just told me to manage time whenever I can work, and it does not need to be 9 to 5. For the holidays, we had a plan to go back our country, Bangladesh, but we had to cancel the trip. We did not visit our home the last three years. I did in 2019 before Covid and never went back because my wife was pregnant and then my child was born. I hope that this will go away, and everything will be better this year. But the fear and the emotions, I think will not go away pretty soon. Stephanie Archinas-Murphin from Lakewood, California My 3-year-old daughter started preschool in September and sure enough she got three viruses – RSV, rhinovirus and pneumonia – all at the same time. She spent four days at the hospital, and it was hell watching her going through it. It’s very heartbreaking to just have her come out and experience the world. And now all these things are happening with her getting sick. We want to have a different experience for her. We pretty much got everything. My older daughter got the flu, so did my husband and myself. We’ve been on this never-ending journey since October. When my youngest was ill, she had to be out for three weeks. My husband was out for two weeks just to be able to take care of her. But when we got hit by the flu after Thanksgiving, my husband didn’t have any time off left. I have a private practice and don’t get PTO, but I had to take the brunt and cancel my clients. That was a dent in our income because I didn’t have any pay. Thankfully, I have some savings, so that helped a lot. When I was low on Motrin and my daughter Morgan had the flu, I happened to post it on Instagram. My relative asked if I want some and even dropped off Motrin for me and drove from almost 40 miles away. It was so heartwarming to know that there are people out there who are looking out for me. I’m all about taking it one day at a time. I don’t want to overwhelm myself. I’m not going to stop planning or going out, but I’m being mindful that things may change. | Epidemics & Outbreaks |
The vaccine campaign against Covid-19 has just been brought forward by a month in the face of changes in the disease’s behaviour. The decision was made as the UK heads into autumn and has raised concerns that the nation faces a new wave of a disease that triggered a national lockdown three years ago. Here we look at the issues involved and scientists’ responses to the threats that lie ahead.
1 Are cases on the rise?
Scientists say that the daily number of new positive tests and the proportion of tests coming back positive have been increasing since the end of June. In addition to waning immunity to Covid-19, poor summer weather and the screening of blockbuster films such as Barbie and Oppenheimer may have caused increased indoor mixing, setting off rises in infections.
2 Will it get worse as winter approaches?
As weather worsens and days get shorter, that social mixing will intensify and numbers of cases are likely to continue to rise, although scientists also point out that current levels are still very low compared with case numbers last year. Nor has Covid-19 become a seasonal disease as expected. “It was thought that Covid-19 would end up being a seasonal illness like flu but this has not yet happened,” added Professor Adam Finn, of Bristol University. “The virus is still evolving quickly and new waves are appearing throughout the year.”
3 What’s happening in hospitals?
New hospital admissions and numbers of beds occupied by Covid patients have also been rising, but again doctors stress they are increasing slowly from a very low baseline.
4 How dangerous is the latest variant?
The new variant, BA.2.86, is characterised by a large number of mutations, many of which might be expected to help the virus evade existing immune responses. “However, our genomic surveillance suggests that BA.2.86 is still at low prevalence, and although this strain has been identified in a number of different countries, it is not yet clear whether it is replacing existing strains in any of these settings,” said Professor John Edmunds, of the London School of Hygiene & Tropical Medicine.
5 How do I get a test these days?
Covid tests are no longer available free of charge. Lateral flow tests can be purchased for a couple of pounds from pharmacies, while PCR tests – which give a more definitive indication of a person’s infection status – cost about £50.
6 Can I get a vaccine?
From 11 September, the vaccine will be offered to residents in care homes; all adults aged 65 years and over; people in clinical risk groups; and frontline health and social care workers. Those outside these groups will not be given a jab and – unlike those seeking immunisation against flu – will not be able to buy one. The government has said recently that in future it will not oppose the sale of Covid vaccines to those who want to buy one. However, manufacturers have yet to offer their products for sale in the UK.
7 Has the Covid-19 vaccine been tweaked?
An updated version of the vaccine that targets two coronavirus variants has been approved for adult booster doses by the Medicines and Healthcare products Regulatory Agency. This will be available to those getting the vaccine from 11 September and targets the original virus strain that appeared in 2020 as well one of the more recent Omicron variants. A new vaccine specifically tailored to target another Omicron variant will become available by the end of the year.
8 Why don’t they create a combined Covid-flu vaccine?
Scientists are working on creating such a joint vaccine. In the meantime, doctors have urged patients to try to arrange to have the two separate vaccines at the same time. “It is easier for patients to have both vaccines at the same time at only one visit: one in each arm,” said epidemiologist Professor Keith Neal at Nottingham University. In the longer term, scientists anticipate that a single vaccine will eventually be developed to protect against Covid and flu and also RSV (respiratory syncytial virus), which also causes illness in winter.
9 Do we know enough about how widespread Covid is?
It is not clear how prevalent Covid has become in the UK. Detailed tracking of the disease has been cut back. “In a sense that is a pity but, on the other hand, we need to be clear about our priorities,” added Finn. “The disease is not the threat it was three years ago and we need to put our resources into the really pressing medical problems that we are facing.”
10 What’s the situation like elsewhere in the world?
The global picture of Covid’s spread is extremely mixed. In developing nations, the disease spread through populations who were not provided with vaccines. By contrast, in countries such as the US, the vaccine take-up rate has been striking and there continues to be strong pressure for all ages to be immunised, including children who rarely suffer ill effects from Covid infections. Uptake rates remain low among young people, however. | Vaccine Development |
Scarlett Rose, now 30, suffered years of excruciating pain during sexAfter years of misdiagnosis she was told she had a transverse vaginal septumFigures suggest that up to 72,000 women globally have the condition Published: 10:26 EST, 5 January 2023 | Updated: 10:28 EST, 5 January 2023 A woman born with two vaginas has told how she was clueless about her bizarre anatomy until she was 21.Scarlett Rose, now 30, suffered years of excruciating pain during sex that left her feeling 'like an alien' because 'I didn't know what was wrong with me'.Mrs Rose, who lives in Queensland, Australia, assumed it was because she 'wasn't ready' or that it was 'supposed to hurt'. Medics even told her that the pain she felt was 'in her head'. Scarlett Rose, now 30, suffered years of excruciating pain during sex that left her feeling 'like an alien'It was only when the she became pregnant that doctors discovered the mother-of-one's vagina was split in two.Discussing her ordeal, she said: 'When I found out I had two vaginas I was relieved because it took me years to figure out what was wrong. What is a vaginal septum? A vaginal septum is when the female reproductive system doesn’t fully develop, leaving a dividing wall of tissue inside the vagina.There are two different types of the condition - longitudinal vaginal septum (LVS) which runs vertically and transverse vaginal septum (TVS) which runs horizontally.Many girls don’t realise they have a vaginal septum until they reach puberty or when they become sexually active and feel pain during sex.Some women with a vaginal septum never have any symptoms.Medics aren’t sure what causes the condition but they know it happens as the person is developing as a fetus in the womb.Figures suggest around one in 72,000 women have a transverse vaginal septum'Now, sex isn't painful and I can lead a normal life.'Mrs Rose, a councillor, added: 'I also want other women to know they are not alone in this.'Figures suggest up to 72,000 women globally have a transverse vaginal septum — when a wall of tissue separates the vagina into two. Her tissue ended two centimetres before the vaginal opening, making it difficult to see and hard for any doctors to diagnose.There are two different types of the condition — longitudinal vaginal septum (LVS) which runs vertically and transverse vaginal septum (TVS) which runs horizontally.Mrs Rose, who started having sex at 18, said: 'The first time that I tried to do anything I thought I wasn't ready or that it was supposed to hurt.'While she sought help at the time, doctors and gynaecologists were baffled by the cause of her agony.Over the course of three years she endured laparoscopic surgery, smears and ultrasounds, as well as treatment for thrush, bacterial vaginosis and vaginismus — when the vaginal muscles tighten during penetration.Discussing her quest to find answers. she said: 'It was really hard. 'I developed severe anxiety because of it. I was told that it was in my head.'I knew that what I was experiencing physical pain and when you are told there is no issue or that people don't believe you it's very difficult. I was so embarrassed.'Mrs Rose added: 'Once I met my husband (Jamie) he told me my pain wasn't normal and I realised there was a problem.' It was only when she became pregnant in 2014 with her son Hunter, now eight, that doctors discovered Mrs Rose's vagina was split in two. Pictured with husband Jamie and son Hunter Despite the strain her condition put on her relationship with her field service technician husband, the pair (pictured together) got married and started trying for a babyShe struggled to find any answers to her questions about her pain online, and no-one she knew had experienced anything similar.Mrs Rose added: 'Even when we talked to friends about it, men would tell me I wasn't good enough and that I needed to figure my problems out as a lack of sex wasn't fair on my husband.'Having sex was incredibly painful. Intercourse isn't just for pleasure it's a way to bond in relationships. At 21-weeks pregnant Mrs Rose was rushed to hospital after she was found to have a weak cervix which could induce premature labour. Pictured with her husband after giving birth'My husband was so supportive and understanding and made sure that I was okay.'Despite the strain her condition put on their relationship the pair still got married and tried for a baby, which Mrs Rose described as 'incredibly painful'. She added: 'Doctors told me that delivering a baby may help with the pain as they assumed my pelvic floor was too tight and having a baby can loosen it.' Mrs Rose and her field service technician husband became pregnant in 2014 with her son Hunter, now eight.However, at 21-weeks she was rushed to hospital for a surgery as she was found to have a weak cervix which could induce premature labour. During the surgery, doctors discovered her vagina was split in two and removed the septum, creating one vagina.She was told that if they hadn't discovered the tissue she could have hemorrhaged during birth, which could have killed her and her son. 'After I gave birth I had to have a smear test at six weeks post-partum. I was terrified because they were usually incredibly painful but after the surgery it was completely fine', she said. 'I wanted to raise awareness because then you can go to appointments with an idea of what is going on and you're more likely to get help and support.'I want people to see my story and know about it so they can advocate for themselves.' Advertisement | Women’s Health |
SACRAMENTO, Calif. -- California Gov. Gavin Newsom has vetoed a bill aimed at decriminalizing the possession and personal use of several hallucinogens, including psychedelic mushrooms.
The legislation vetoed Saturday would 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.
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.”
The legislation, which would have taken effect in 2025, would have required the California Health and Human Services Agency to study and to make recommendations to lawmakers on the therapeutic use of psychedelic substances.
Even if California made the bill a law, the drugs would still be illegal under federal law.
In recent years, psychedelics have emerged as an alternative approach to treating a variety of mental illnesses, 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 worried the legislation would have made it easier for children and young people to access the drugs.
The California Coalition for Psychedelic Safety and Education, which opposed the measure, said more safeguards are necessary before decriminalization occurs.
“We’re grateful that Governor Newsom listened to some of the top medical experts, psychedelic researchers and psychiatrists in the country who all warned that legalization without guardrails was at best premature for both personal and therapeutic use,” the coalition said in a statement Saturday. “Any move toward decriminalization will require appropriate public education campaigns, safety protocols and emergency response procedures to help keep Californians safe.”
State Sen. Scott Wiener, who authored the bill, called the veto a missed opportunity for California to follow the science and lead the nation.
“This is a setback for the huge number of Californians — including combat veterans and first responders — who are safely using and benefiting from these non-addictive substances and who will now continue to be classified as criminals under California law,” Wiener said in a statement Saturday. “The evidence is beyond dispute that criminalizing access to these substances only serves to make people less safe and reduce access to help.”
He said he would introduce new legislation in the future. Wiener unsuccessfully attempted to pass a broader piece of legislation last year that would have also decriminalized the use and possession of LSD and MDMA, commonly known as ecstasy.
Lawmakers can override a governor’s veto with a two-thirds vote, but they have not tried in decades.
In 2020, Oregon voters approved decriminalizing small amounts of psychedelics, and separately were the first to approve the supervised use of psilocybin in a therapeutic setting. Two years later, Colorado voters also passed a ballot measure to decriminalize psychedelic mushrooms and to create state-regulated centers where participants can experience the drug under supervision.
In California, cities including Oakland, San Francisco, Santa Cruz and Berkeley have decriminalized natural psychedelics that come from plants and fungi.
Despite Newsom’s veto, California voters might have a chance to weigh in on the issue next year. Advocates are attempting to place two initiatives to expand psychedelic use on the November 2024 ballot. One would legalize the use and sale of mushrooms for people 21 and older, and the other would ask voters to approve borrowing $5 billion to establish a state agency tasked with researching psychedelic therapies. | Mental Health Treatments |
California lawmakers approved a bill decriminalizing the possession and personal use of numerous psychedelics, including "magic mushrooms," on Thursday.
Senate Bill 58, which passed by a 43-15 vote in the state Assembly on Wednesday and a 21-14 vote in the Senate on Thursday, now heads to Gov. Gavin Newsom who will decide the fate of the measure.
If signed into law, the bill would remove the criminal penalties for the possession and use of psilocybin and psilocin, the active ingredients in psychedelic mushrooms, mescaline (excluding peyote) and dimethyltryptamine, or DMT.
The bill does penalize possession of the psychedelics on school grounds, or possession by, or transferring to, people under 21 years of age.
The pro-psychedelic measure would also require the California Health and Human Services Agency to study the therapeutic use of psychedelics and submit a report to the Legislature with recommendations, the bill says.
California Assembly Republican Leader James Gallagher strongly opposed the bill by arguing that legalizing psychedelics will worsen the crime and homelessness ravaging the Golden State.
"Crime and homelessness are out of control in California. If Democrats don’t think this will make things worse, they’re hallucinating - no mushrooms needed," Gallagher said in a statement to Fox News Digital.
Democrat State Assemblyman Scott Wiener, who introduced the bill, argued that veterans and first responders struggling with PTSD, depression, and addiction "deserve access to these promising plant medicines."
Wiener argued that psychedelics are not addictive and that the U.S. needs to stop criminalizing people who use them.
"We know these substances are not addictive, and they show tremendous promise in treating many of the most intractable conditions driving our nation’s mental health crisis," Wiener said in a news release. "It’s time to stop criminalizing people who use psychedelics for healing or personal well-being."
Newsom has until Oct. 14 to approve or veto the bill. If signed, the bill would go into effect on Jan. 1, 2025. | Mental Health Treatments |
NHS whistleblowers need stronger legal protection to prevent hospitals using unfair disciplinary procedures to force out doctors who flag problems, the British Medical Association has said.
Doctors are being “actively vilified” for speaking out, which has resulted in threats to patient safety, including unnecessary deaths, according to the council chair of the doctors’ union, Phil Banfield.
Despite a series of scandals in recent years, it is becoming more common for hospitals to use legal tactics and “phoney investigations” to undermine or force out whistleblowers rather than address their concerns, he warned.
Banfield said: “Someone who raises concerns is automatically labelled a troublemaker. We have an NHS that operates in a culture of fear and blame. That has to stop because we should be welcoming concerns, we should be investigating when things are not right.
“Whistleblowers are pilloried because some NHS organisations believe the reputational hit is more dangerous than unsafe care,” he added. “Whereas the safety culture in aviation took off after some high-profile airplane crashes in the 70s, the difference is that the aviation industry embraced the need to put things right and understand the systems that led to the disaster – the NHS has not invested in solving the system, it’s been bogged down in blaming the individual instead of the mistake.”
Whistleblowers could be afforded greater protection through changes to the law as well as through cultural change in hospitals, including putting an end to many hospitals’ hierarchical “command and control” management style, which prevent more junior staff from airing concerns, he said.
Banfield cited examples, including Mid Staffordshire NHS hospital trust in 2013, where a report into patient deaths resulting from poor care identified the abuse of whistleblowers as a key failing, and more recently Royal Sussex County hospital, where police are investigating about 40 deaths following allegations of medical negligence made by two consultant surgeons who lost their jobs after raising concerns.
He also highlighted the case of Dr Martyn Pitman, who was sacked by Hampshire hospitals NHS foundation trust after raising concerns about unsafe staffing levels in the maternity unit in which he worked as a consultant obstetrician.
Speaking to the Guardian, Pitman estimated that his trust had spent “well into six figures if not higher” in taxpayer money to oust him, rather than address failings which were since confirmed in a warning by the Care Quality Commission that improvements were needed in 2022. The hospital was also put into special measures last month.
Pitman said his experience was “incredibly disruptive psychologically and took me to some incredibly dark places I wish I’d never got to”. He worried that his treatment will deter colleagues from following his path, saying: “Why would you whistleblow? That has potentially direct negative consequences for provision of safe patient care.”
Pitman found himself cast as the offender, and during a drawn-out two-year process his confidence was shattered and he was invasively monitored, culminating in a decision that his relationship with his managers had reached an “irretrievably poor level”. This provided justification for the use of the legal mechanism “some other substantial reason” (SOSR),which enables organisations to fire employees not on the basis of conduct or capability.
“They weren’t prepared to change so they would take out the messenger,” he said.
Minh Alexander, a former NHS whistleblower who campaigns for stronger legislative and regulatory protections and regularly speaks to whistleblowers, agreed that this was a common approach.
Responses to freedom of information requests that Alexander made in 2019 revealed that between April 2010 and September 2018, the NHS sacked 10,604 members of staff under the SOSR mechanism. These were commonly justified by a breakdown in relationships, similar to Pitman’s case, she said.
She said the current law requires whistleblowers who claim they have lost their jobs due to their disclosures to meet a series of legal tests, which invite the employer to attack whistleblowers, for instance by casting aspersions on whether they genuinely acted in the public interest. “If any [test goes] wrong, your case fails entirely,” she said.
A spokesperson for Hampshire hospitals trust said: “Dismissal is always a last resort and since Hampshire hospitals was formed 11 years ago, no member of staff has ever been dismissed for whistleblowing or raising concerns over patient safety; and they never will be. Mr Pitman has not been actively working at the hospital for two years and questions surrounding his dismissal will be resolved at an employment tribunal later this year.
“Patient safety remains our top priority, and our maternity teams work exceptionally hard together to provide the best care to our patients.”
A Department of Health and Social Care spokesperson said: “Whistleblowers are protected by law and those acting in the public interest and seeking to maintain public safety should never be prevented from doing so.” | Health Policy |
- Eli Lilly will acquire Versanis, a privately held obesity drug maker, for up to $1.93 billion to expand its weight loss treatment portfolio.
- The deal is Eli Lilly's latest attempt to capitalize on the weight loss industry gold rush, which began last year after Novo Nordisk's blockbuster injections Wegovy and Ozempic boomed in popularity.
- Oakland, California-based Versanis has once drug candidate called bimagreumab, which binds directly to certain cells in the body to reduce fat mass.
Eli Lilly agreed to pay Versanis shareholders in cash, which will consist of an upfront payment and potentially subsequent payments if Versanis achieves certain "development and sales milestones."
related investing news
The Oakland, California-based Versanis, which was founded in 2021 by biotech investment firm Aditum Bio, has one experimental drug for obesity and potentially other conditions.
An estimated 40% of U.S. adults are obese. Analysts project that the global weight loss drug market could be worth $100 billion by around 2030.
Versanis's drug, bimagreumab, binds directly to certain cells in the body to reduce fat mass.
The company is studying bimagreumab in a phase two trial in adults who are overweight or obese, and in another trial that compares the treatment with Novo Nordisk's Wegovy and Ozempic.
Bimagreumab works differently from Novo Nordisk's drugs and similar treatments from Indianapolis-based Eli Lilly. Those drugs, known as GLP-1 agonists, mimic hormones produced in the gut called incretins to suppress a person's appetite.
But Versanis said combining bimagreumab with those incretin-based therapies could potentially lead to better outcomes for people living with obesity and cardiometabolic conditions, which includes diabetes, kidney disease and disorders affecting the heart.
Eli Lilly is working on several obesity treatments.
The company's once-weekly experimental injection, retatrutide, helped overweight or obese patients lose up to 24% of their weight after 48 weeks.
That surpasses the weight reduction caused by other obesity drugs.
Eli Lilly's experimental obesity pill, orforglipron, also helpd overweight or obese patients lose up to 14.7% of their body weight after 36 weeks.
The company is also pushing to approve its type 2 diabetes treatment, Mounjaro, for obesity. | Drug Discoveries |
Norovirus appears to be at a seasonal high, according to data from the Centers for Disease Control and Prevention.
The rate of norovirus tests coming back positive, averaged over three weeks, exceeded 15% at the end of last week. That’s the highest recorded since late March 2022.
Norovirus is sometimes referred to as the stomach flu, but it is not related to the influenza virus. Rather, it is a highly contagious virus that typically causes gastrointestinal symptoms like diarrhea, vomiting, nausea and stomach pain. Mild fever and aches are possible, too.
Just a few virus particles are enough to make someone sick, and they spread easily via hands, surfaces, food and water. An infected person can transmit the virus for days after they’re feeling better, potentially even up to two weeks, according to the CDC.
Regionally, the Midwest had the highest average test positivity rate for norovirus as of Saturday, at over 19% — higher than any other week in the last year.
The CDC did not immediately respond to a request for additional information about current norovirus rates.
The agency tracks norovirus outbreaks via a network of 14 state health departments. Although the network’s data lags, its most recent tally suggests state health departments reported 25 outbreaks as of the first week of January, the most since May. Between August and early January, a total of 225 norovirus outbreaks were reported to the CDC, compared to 172 during the same period last season.
Norovirus is the leading cause of foodborne illness in the country. Food can get contaminated if fruits or vegetables are grown or washed with contaminated water. Oysters, too, pose a norovirus risk if they are harvested from contaminated water. In December, a multistate outbreak was linked to raw oysters from Texas, with nearly 300 norovirus cases reported.
Most norovirus outbreaks in the U.S. happen between November and April. On average, the country sees around 20 million cases per year, with nearly 110,000 hospitalizations and 900 deaths, mostly among those who are 65 and older.
There is no treatment for norovirus, but the CDC recommends drinking lots of fluids to prevent dehydration. The illness typically resolves within a few days.
In England, norovirus rates this year are exceptionally high, according to the UK Health Security Agency. As of the end of January, lab reports of norovirus were 66% higher than the average over the five seasons before the Covid pandemic. The agency primarily attributes the increase to higher reporting among people 65 and older. | Epidemics & Outbreaks |
A crippling lack of ambulances has seen hundreds of desperately ill patients rushed to hospital by TAXI at a cost of £129,000.
One scandal-hit service ferried 27 critical condition patients by cab. Each was on a category 1 call – needing life-saving intervention or resuscitation.
A further 281 taxi rides were used for category 2 patients – with conditions such as heart attacks, strokes, sepsis or burns.
The cases, from last April to November, were in the East of England – the country’s worst-performing ambulance service.
Paramedic Glenn Carrington, Unison’s regional chair, said: “These are patients who without medical help will die and they are being thrown in the back of a taxi.
“It is like something out of a dystopian movie, but that is how bad things have got. There’s no slack in the system. It is broken.”
A Freedom of Information request revealed the £129,100 bill is a massive rise on the £35,180 spent during 2021-22.
Peterborough-based Glenn, 58, said taxis were used because 999 crews were stuck in queues at overcrowded A&E departments.
He added: “A clinician will ring a patient and say: ‘Can you get into a taxi? And they will say: ‘Yes, I’m having a heart attack, but I can climb into a taxi’. They go to A&E, the driver drops them, puts them in a wheelchair and hopefully a nurse will come.
“But what happens if they deteriorate in a taxi? We do this job because we care. We help people. And when we can’t do that there’s nothing more soul destroying and that’s why people are leaving.”
The target ambulance response time for category 1 calls is seven minutes.
Labour’s Shadow Health Secretary Wes Streeting blamed the taxi scandal on years of Tory failure. He said: “What does it say about the state of our NHS under the Conservatives?”
Unison’s head of health Sara Gorton added: “The Government has to deal with the NHS staffing emergency. That means improving wages to stop people leaving for better paid, less stressful work.”
But most strike action planned for this week has been suspended after the Government agreed to pay talks.
Ambulance staff numbers in England are down from 20,532 to 18,536 in five years.
Glenn says some burnt-out colleagues even quit to become Tesco shelf stackers.
The East of England Ambulance Service said: “A decision to use a taxi is made once deemed safe and appropriate by a clinician and consent is gained by the patient – including, on some occasions, after an assessment by a paramedic on scene. An ambulance is always sent if there is any question about the suitability of a taxi.”
Cost of Living
Our Cost of Living team of experts are here to help YOU through a very difficult year.
They'll be bringing you the latest money news stories and also providing specialist advice.
Whether it's rocketing energy bills, the cost of the weekly shop or increased taxes, our team will be with you all the way.
Every Thursday at 1pm they will take part in a Facebook Live event to answer your questions and offer their advice. Visit facebook.com/dailymirror/live to watch. You can read more about our team of experts here.
If you have a question - or want to share your story - please get in touch by emailing [email protected].
A Care Quality Commission report last year found some patients were forced to wait more than 12 hours for an ambulance.
The service, covering Cambridgeshire, Essex, East Anglia, Bedfordshire and Hertfordshire, has been in “special measures” since October 2020.
In 2019 an independent investigation was launched after the suspected suicides of three male staff in 11 days. A report criticised working culture and said bosses needed to help staff with mental health. | Health Policy |
- There has been a surge in respiratory illnesses in children in China, according to news reports.
- But this pneumonia outbreak appears to be the result of known illnesses.
- The surge in respiratory illness may be a result of China lifting COVID restrictions earlier this year.
A recent surge in respiratory illnesses — primarily in children — in China has drawn attention from the
In mid-November, China’s National Health Commission announced a significant rise in influenza, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Mycoplasma pneumonia (a bacteria that causes pneumonia), and respiratory syncytial virus (RSV).
The country’s health authorities attributed the surge to an easing of China’s long, stringent COVID-19 restrictions and the normal cycle of cold and flu season.
But given similar headlines that started appearing in late 2019, before the pandemic became global the following spring, the news has raised alarm.
Many experts suggest that this is a normal response to the lifting of COVID restrictions, which can create a scenario where the general population’s immunity becomes more vulnerable to other common respiratory infections.
Dr. William Schaffner, a professor of preventive medicine specializing in health policy and infectious diseases at the Vanderbilt University School of Medicine, told Healthline that while the headlines may seem familiar, there’s no immediate cause for alarm.
“Initially, everyone was wondering whether they had seen this movie before, right? But the World Health Organization has had a virtual meeting with the Chinese scientists and infectious disease folks and I think left that meeting reassured that first of all, there is no new novel, strange virus, such as COVID,” Schaffner said.
“What the Chinese authorities have said is that consequent to their opening things up and coming out of lockdown, they are having an experience which was similar to the experience that we in the United States and the Western world had last year. Their lockdown lasted longer.”
Schaffner pointed out that respiratory disease in the U.S. also rose as people stopped social distancing after the peak of the COVID-19 pandemic.
“We had early and very brisk influenza, and similarly RSV infections, and we had COVID also increasing,” he said.
The concept of “immunity debt” — in which social distancing, masks, and lockdowns weaken a population’s resistance to other pathogens — is a common theory behind China’s surge.
“The term ‘immunity debt’ or ‘immunity gap’ has been employed to describe this phenomenon, but this really just means that we are more susceptible to viruses we have not seen for a few years because we don’t have any immunity to them,” Dr. Monica Gandhi, MPH, a professor and director of University of California San Francisco’s Bay Area Center for AIDS Research, told Healthline.
“We saw a severe influenza season in Australia during our summer of 2022 (their winter), which was mirrored by our severe influenza and RSV season last winter in the Northern Hemisphere (especially among children).”
A
In the short term, it appears unlikely that these respiratory illnesses could develop into a novel virus that becomes a global pandemic.
The combination of China’s extended lockdown, the expected “immunity debt” that resulted, and the country’s size are all factors that have to be considered as a reason for the current outbreak.
Additionally experts pointed out that most cases have only been reported in northern China, so we can expect to see more reported surges of these illnesses as people travel throughout the country.
“China is a big country. So this phenomenon may occur repeatedly in different parts of the country; the whole country is not experiencing this simultaneously,” Schaffner said. “As far as we know, this is happening mostly in northern China, is my understanding. So we may get a repeat of this in other parts of China as the weeks go by.”
The number of pneumonia cases in children are certainly alarming, but context has to be considered, Gandhi said.
“It is biologically plausible, given the almost three years of lockdown and avoidance of other pathogens in the country, that the immunity debt in China would be worse than in other countries, leading to this wave of pneumonias,” Dr. Gandhi said.
Schaffner acknowledged that respiratory infections can easily be exchanged between different populations through travel but cautioned that there’s not any indication of accelerated risk.
“Any virus — influenza, for example — can be carried by travelers from one place to another. But at the moment, the Northern Hemisphere, we in the United States, for example, are seeing a somewhat early increase in our own influenza, so we don’t need external importations,” he said.
“We’ve got plenty already. And our season is starting to take off.”
China’s surge in respiratory illnesses, especially pneumonia among children, is most likely a result of the country’s extended COVID-19 lockdown, which was longer than any other country in the world.
“Immunity debt,” the phenomenon in which a population’s susceptibility to certain pathogens and viruses increases from measures like social distancing, masking, and lockdowns, is the most viable explanation for the surge in these illnesses.
There’s little reason for other countries to worry that this points to another global pandemic, experts say. | Epidemics & Outbreaks |
Cannabis Opponents Spread Misinformation In Slovenia
Earlier this month cannabis opponents in Slovenia provided an open letter to European Commissioner for Home Affairs Ylva Johansson. The cannabis opponents also issued a press release, which is common for anti-cannabis propaganda efforts. The letter was sent by Preventivna Platforma, which describes itself as ‘a network of NGOs that work in the field of prevention.’ The entity’s professed overall goal is ‘quality in prevention’ and they tout in their publications that their efforts ‘receive financial assistance from Slovenia’s Ministry of Health.’
Preventivna Platforma’s letter was geared towards encouraging Commissioner Johansson to join them in opposing adult-use legalization in Germany. To someone that is not familiar with prohibitionist talking points, the letter may seem scary. However, as any long-time cannabis advocate will quickly point out, the letter is riddled with half-truths, lack of context, and in some cases, claims that are not supported by evidence and reality.
“As non-governmental organizations that work in the field of prevention, treatment, rehabilitation and recovery from drug use and addiction, we strongly oppose the legalization of cannabis. We are convinced that it will increase cannabis use and harm in Germany, and will also undermine the efforts of other EU member states in the field of preventing drug use and related harm.” the letter stated (translated from Slovenian to English.
As is often the case with anti-cannabis propaganda, the letter from Preventivna Platforma makes general claims that are easily refuted with peer-reviewed studies, logical reasoning, and government data from legal jurisdictions. For many years, opponents could make such claims and never be challenged because, after all, there were no legal jurisdictions to point to. That is obviously no longer the case.
We now know what happens when jurisdictions legalize cannabis for adult use; that the sky does not fall, and that the success of legalization in legal jurisdictions is likely why Preventivna Platforma relied so heavily on technical legal arguments in their letter rather than making a case that cannabis prohibition is better public policy than modernized regulation.
“Plans to legalize cannabis in Germany run counter to international drug control conventions, which have been ratified by all EU member states, among others. The International Narcotics Control Board (INCB) has repeatedly criticized similar policies in the United States, Canada and Uruguay.” Preventivna Platforma stated in its letter.
“By legalizing cannabis, Germany would also violate the sixth chapter of the Schengen Agreement, which stipulates that EU member states must respect the UN conventions on the control of illegal drugs and take the necessary measures to prevent illegal traffic in them. In addition, the German plans conflict with the EU Council Framework Decision 2004/757/RIF, which states that EU member states must ensure that the production, acquisition, sale, distribution, marketing, transportation and importation of illicit drugs, including cannabis, a felony.” the letter goes on to say.
Preventivna Platforma states in its letter that, “the German government wants to open up a legal, commercial market for cannabis, something that has not yet happened in any EU member state.” Obviously, there are two countries that have already legalized a cannabis commercial market at a national level, albeit not in Europe, and Preventivna Platforma omitting that fact seems to be purposeful. Cannabis opponents will always try to deflect and distract from legalization succeeding in other places.
A classic cannabis prohibitionist talking point that was incorporated by Preventivna Platforma in its letter ironically makes a strong argument for widespread legalization, which is the only true way to prevent diversion from regulated markets to unregulated markets.
“Undoubtedly, the legalization of cannabis in Germany would have a significant impact at least on neighboring countries. In a single market with open borders, it would be difficult to ensure that hemp grown legally in Germany does not divert to more profitable markets in other countries. Indeed, experience from the United States of America confirms that there is a high risk of diversion of cannabis from legal to illegal markets in other areas where its sale is not allowed.” the open letter states.
The letter goes on to cherry-pick certain information while ignoring other available information that either directly refutes their claims or puts it into proper context.
“After a decade, the legalization of cannabis in the countries where it has been legalized so far is still relatively in its infancy, but the first findings worry us. Data from the US show that cannabis consumption has increased, particularly more intensive use. Canadian data is scarcer, but official statistics show that both regular and frequent cannabis users have increased in the years since legalization.” Preventivna Platforma stated.
For starters, adults consuming more cannabis is not automatically a bad thing, and studies are showing that cannabis is often used as a substitute for more harmful substances, which is clearly a great thing. There seems to never be controls in the collection process of government usage data to calculate for long-time cannabis consumers finally admitting to government data collectors that they consume cannabis.
Government data collectors will record those people as being ‘new users’ when that is not actually the case. Speaking from firsthand experience, there was no way that I was ever going to tell the government that I consumed a product that was prohibited, and it’s logical to assume that I am far from alone in changing my answer after my jurisdiction’s (Oregon) cannabis policies were modernized. People need to keep that in mind when there are ‘rising consumption rates’ reported post-legalization.
Furthermore, and the propaganda letter tries to make it seem as if the two are connected, while adult use may be increasing in legal jurisdictions, the same is not true for kids and young people. It’s a ‘three card monte’ maneuver that prohibitions use because they assume that most people won’t unpack their talking points and that people will assume that if consumption rates are going up, then clearly that extends to young people. But as we know from data out of Canada, which is not ‘scarcer’ despite what prohibitionists claim, as well as data out of the United States, a spike in youth consumption post-legalization has yet to materialize.
Per government data from the Oregon Health Authority, not only was there no spike in youth consumption following the launch of legal adult-use sales and outright possession legalization in 2015; youth consumption rates actually went down from 2012 to 2018 in Oregon. A broader study conducted by researchers at Michigan State University, which involved consumption survey data from over 800,000 respondents in states where cannabis sales were permitted, also found no spike in youth cannabis usage rates.
A study in 2021 conducted by researchers in Canada found ‘no significant differences’ in cannabis consumption rates before and after cannabis legalization in Canada. As of May 2022, data out of Uruguay also demonstrated no sustained changes in youth consumption rates post-legalization.
Another popular prohibitionist talking point that does not provide nearly enough context is that ‘the unregulated cannabis market still exists in Canada and the United States.’
“One of the main goals of legalization was to eliminate the illegal cannabis market. However, there is still a thriving illegal market in all jurisdictions, supplying both the local market and markets in neighboring countries.” Preventivna Platforma stated.
Make no mistake about it, the unregulated cannabis market will always exist, just as the unregulated tobacco and alcohol markets will always exist, and the market for fake apparel and bootlegged entertainment media will always exist. Just because an unregulated market exists to some small degree does not in any way justify prohibition and the economic and social costs that go with it. The goal is to mitigate the unregulated market as much as reasonably possible for various reasons, not the least of which are improving public health outcomes via boosting regulated product availability, and taking money out of the hands of organized crime.
One talking point that is seemingly always included in anti-cannabis propaganda is the ‘terror on the roadways’ talking point.
“The increase in use is accompanied, among other things, by an increase in the number of traffic accidents and accompanying deaths related to cannabis, an increase in the number of visits to emergency centers and hospitalizations…” the letter stated.
However, a study from this month out of Canada found that, per the researchers, “[N]either the CCA [Canadian Cannabis Act] nor the NCS [number of cannabis stores per capita] is associated with concomitant changes in (traffic safety) outcomes. … During the first year of the CRUL’s [cannabis recreational use laws] implementation in Toronto, no significant changes in crashes, number of road victims and KSI [all road users killed or severely injured] were observed.”
The Preventivna Platforma letter goes on to indicate that there is still a lot that is “unknown” when it comes to legalization and that the “consequences” of cannabis hyperemesis syndrome (CHS), which is an extremely rare condition, were “not known until a few years ago.” That claim was made despite the condition being mentioned in a study nearly twenty years ago.
Also, a study from this month out of the legal state of Massachusetts in the U.S. found that CHS only represented .1% of all hospitalizations in 2021. It’s a serious thing that sufferers need to be mindful of, however, it’s far from being an epidemic and the most common treatment for CHS is a warm shower and refraining from consuming cannabis. Furthermore, it’s entirely possible that the current rates for CHS in legal jurisdictions were always what is being reported now, but that people were too afraid to seek out medical advice pre-legalization due to fear of prosecution.
One citation that stood out to me in the letter was applied to the claim that THC vaping is responsible for “an epidemic of serious lung disease.” However, upon further examination, the citation is from the United States Centers for Disease Control’s (CDC) tobacco overview page. The CDC points out on that page that it is not regulated products that are responsible for suspected lung issues, but rather, the unregulated market, and it is classified as an “outbreak” and not an “epidemic.”
“National and state data from patient reports and product sample testing show tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online dealers, are linked to most EVALI cases and play a major role in the outbreak.” the CDC states on the page that is cited in the Slovenian anti-cannabis propaganda letter.
“Vitamin E acetate is strongly linked to the EVALI outbreak. Vitamin E acetate has been found in product samples tested by FDA and state laboratories and in patient lung fluid samples tested by CDC from geographically diverse states. Vitamin E acetate has not been found in the lung fluid of people that do not have EVALI.” the page goes on to say, which directly refutes the claim in the propaganda letter that THC from regulated products is the culprit for issues.
Again, the cannabis prohibitionists responsible for the recent letter make no genuine effort to argue that cannabis prohibition is an effective policy. Rather, they offer up half-truths, lack of context, and in some cases outright inaccurate information. Much like cannabis prohibitionists found elsewhere in the world, such as Kevin Sabet, they do anything they can to slow down the modernization of cannabis policies because, presumably, they know that the status quo is on their side, and they don’t have to move any needles.
All cannabis opponents must do is muck up the process and try to confuse as many people as possible, and they know it. They presumably believe that doing so will prevent meaningful reform from occurring, and that comes at the expense of having a rational conversation about cannabis policy in Slovenia, Europe, and anywhere else where these types of cannabis propaganda spreaders operate. Hopefully the citizens of Slovenia and European Commissioner for Home Affairs Ylva Johansson will see through the propaganda, and support Slovenia modernizing its cannabis policies for the sake of improved public health outcomes, as well as for the increased economic opportunities that sensible cannabis policies create. | Drug Discoveries |
The expiration of federal COVID-19 emergency declarations on Thursday brings a slew of changes with potential effects on public health policy, food security, immigration and other areas of life.
But many changes might not be that noticeable. Much of what constitutes a public health emergency takes the form of bureaucratic changes within government, noted John’s Hopkins University infectious disease specialist Dr. Amesh Adalja.
“For the average person on the street, May 10 is not going to be very much different than May 11,” Adalja, an adjunct professor at Johns Hopkins Bloomberg School of Public Health, told the Daily News.
Here is a breakdown of the major programs and policies that will change or go away.
Public health
In terms of federal public health policy, changes to our daily lives will depend in part on insurance coverage.
Testing
Insurance companies will no longer be mandated to provide free at-home COVID tests, though they might do so anyway. And free testing might not be available on every street corner.
“For Americans who have adequate health insurance, I think there probably won’t be much of an impact,” said Dr. Peter Hotez, co-director of Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine, via the AAAS. “You’ll still have availability of diagnostic testing and diagnostic kits, as well as vaccines. I think the big greater unknown is what about the uninsured — or those who are underinsured.”
When it comes to keeping track of the disease itself, data collection methods will change. The U.S. Centers for Disease Control and Prevention (CDC) will stop collecting hyper-local data on COVID infections within communities, though it will continue to monitor overall rates of hospitalization and death. COVID infection prevalence will be monitored on a broad-brush scale via wastewater analysis.
Deaths will be monitored the same way flu death rates are. Laboratories will no longer be required to report COVID test results. Paxlovid will be available gratis “while supplies last,” the CDC said last week.
Vaccine mandates
Vaccines and related mandates are governed by a hodgepodge of agencies, each with their own requirements and criteria. Many have been lifted already, especially in the private sector.
The end of the emergency does not affect the U.S. Federal Drug Administration (FDA) emergency authorization of vaccines, but it does officially lift the mandate for federal workers, federal contractors and foreign air travelers to the U.S. to be immunized. The elimination of mandates for Head Start educators, health care workers, and noncitizens crossing into the U.S. by land are not far behind.
“While I believe that these vaccine mandates had a tremendous beneficial impact, we are now at a point where we think that it makes a lot of sense to pull these requirements down,” White House COVID-19 coordinator Dr. Ashish Jha told The Associated Press last week.
Vaccine mandates are still in place for many employees at the National Institutes of Health, the Indian Health Service and the Department of Veterans Affairs, and those are being reviewed by the individual agencies.
Vaccine and treatment costs
Breaking News
This is where patients could get pinched, as government funding gives way to the commercial market, Politico noted. Medicaid recipients will be able to get free treatment until Sept. 30, 2024, and seniors will still be eligible for vaccines under Medicare Part B. When it comes to vaccines for everyone else, the COVID shot falls under Affordable Care Act coverage requirements for preventative services. But there might still be some out-of-pocket costs.
Food security
The impact on food assistance programs “will be minimal” for most participants, the U.S. Department of Agriculture’s Food and Nutrition Service (FNS) says on its website. “But in some programs, it will trigger changes that impact low-income individuals and families.”
As of Thursday, homeless young adults aged 19-24 will no longer be eligible for emergency shelter under the Child and Adult Care Food Program (CACFP), the FNS said. Children who received the equivalent of school lunch funds while home-schooling during the pandemic will continue to be eligible through the end of the summer, the FNS said, but benefits for younger kids who were closed out of day care facilities during lockdown will end Thursday.
Other EBT changes will be eased in. “Able-bodied adults” with no dependents who receive benefits from the Supplemental Nutrition Assistance Program (SNAP) will have to once again meet the work requirement as of July 1. If they don’t get work by Oct. 1, they could lose those benefits.
Immigration
Thursday also marks the end of Title 42, shorthand for a section of a 1944 public health law limiting migration if warranted to protect public health. The CDC invoked it in March 2020 for asylum seekers, ostensibly as a way to reduce the spread of COVID-19. Championed by the Trump administration, the order allowed Customs and Border Protection to boot migrants, including people seeking asylum, on grounds that the places they would be held in are not designed for social distancing or quarantine.
The CDC tried to suspend the rule last year after vaccines and treatments became widely available, but the U.S. Supreme Court upheld it. The Biden administration is preparing for an influx at the southern border, and Republicans have been pushing for new restrictions, including more border walls.
With News Wire Services | Health Policy |
Meta Platforms, the parent company of Facebook and Instagram, is facing eight new lawsuits after lawyers with the Beasley Allen Law Firm filed a series of complaints this week accusing the company of exploiting young people for profit. The complaints also accuse Meta of employing additive psychological tactics to get people to use their platforms more frequently and failing to protect young and at-risk users, according to a press release from Beasley Allen. "The defendants knew that their products and related services were dangerous to young and impressionable children and teens, yet they completely disregarded their own information," Beasley Allen attorney and Mass Torts Section Head Andy Birchfield said in a Wednesday statement. "They implemented sophisticated algorithms designed to encourage frequent access to the platforms and prolonged exposure to harmful content." Eight new lawsuits filed against Meta Platforms, the parent company of Facebook and Instagram, accuse the company of exploiting young users for profit. (Ute Grabowsky/Photothek / Getty Images) The lawsuits filed in Colorado, Delaware, Florida, Georgia, Illinois, Missouri, Tennessee and Texas claim that users' prolonged exposure to Meta and its platforms has led to actual or attempted suicides, self-harm, eating disorders, anxiety, depression and reduced ability to sleep, among other mental health conditions. OREGON MOM SUES SNAP, META OVER 15-YEAR-OLD DAUGHTER'S DECLINING MENTAL HEALTH: ‘DELIBERATE ADDICTIVE DESIGN’ Beasley Allen referenced an Oct. 5, 2021 Senate hearing that included testimony from Facebook whistleblower Frances Haugen, who accused Meta of prioritizing profit over attempts to stop public harm."Social media use among young people should be viewed as a major contributor to the mental health crisis we face in the country," Birchfield said. "These applications could have been designed to minimize any potential harm, but instead, a decision was made to aggressively addict adolescents in the name of corporate profits. It’s time for this company to acknowledge the growing concerns around the impact of social media on the mental health and well-being of this most vulnerable portion of our society and alter the algorithms and business objectives that have caused so much damage."LAWSUIT ACCUSES SNAPCHAT OF ‘DEFECTIVE DESIGN’ AND ‘NEGLIGENCE’ AFTER CT GIRL, 11, DIES OF SUICIDEPrior to the October 2021, hearing, Instagram acknowledged that its app can be harmful for young users after The Wall Street Journal released internal documents summarizing findings by researchers tapped by the tech giant to examine the app's impact on young users' mental health over the past three years. The study found that 32% of teen girls who "felt bad about their bodies" said Instagram made the issue worse, according to WSJ. Facebook whistleblower Frances Haugen testified in 2021 that Meta prioritizes profit over attempts to stop public harm. (Robert Fortunato/CBS News/60 Minutes / AP Newsroom)Karina Newton, Instagram's head of public policy, said in a September 2021 blog post that the platform stands by the research, which demonstrates the company's "commitment to understanding complex and difficult issues young people may struggle with, and informs all the work" Instagram does "to help those experiencing these issues.""We’re proud that our app can give voice to those who have been marginalized, that it can help friends and families stay connected from all corners of the world, that it can prompt societal change; but we also know it can be a place where people have negative experiences, as the Journal called out today," Newton said in the blog post.INSTAGRAM ACKNOWLEDGES THAT APP CAN HARM TEENS' SELF-ESTEEM IN RESPONSE TO REPORTInstagram's head of public policy added that the company is taking steps to combat issues such as bullying, self-harm, suicide and eating disorders as they relate to users. The app has created features so that users can "protect themselves from bullying" and gives users the option to hide the number of "likes" on their posts. More than 40% of Instagram's users are under 22 years old, and about 22 million teens use the app every day, WSJ reported, citing Facebook's documents. A 2018 Pew Research survey that Newton cited in her Tuesday blog post found that 81% of teens ages 13 to 17 found that social media in general makes them feel more connected while 26% said it makes them feel insecure. In September 2021, Instagram acknowledged that its app can be harmful for young users. (AP Photo/Jenny Kane / AP Images)Four in 10 teens said they only post on social media so that they look good to other people, and more than half of teens surveyed said they have "unfriended" or "unfollowed" other users due to bullying.GET FOX BUSINESS ON THE GO BY CLICKING HEREThe lawsuits from Beasley Allen are one of many filed against Meta in over the past year accusing the tech company and its platforms of facilitating harm against young users. The various complaints point to a burgeoning mental health crisis among U.S. youth that appears to correlate with the rise of technology and social media.U.S. Surgeon General Dr. Vivek Murthy issued a new Surgeon General’s Advisory in December 2021 warning of a growing youth mental health crisis amid the coronavirus pandemic as many young people spent time away from physical school and activities and more time online. Early estimates for 2020 show more than 6,600 suicide deaths among U.S. youth, ages 10 to 24, according to the Centers for Disease Control and Prevention (CDC).CLICK HERE TO READ MORE ON FOX BUSINESSEmergency room visits for suicide attempts among adolescent girls, in particular, rose by 51% during the pandemic, and emergency room visits among adolescent boys increased by 4% during the same time period, CDC data shows. Even prior to COVID-19, one in every five U.S. children between the ages of 3 and 17 experienced mental, emotional, developmental or behavioral disorders, a CDC report shows.The National Suicide Prevention Lifeline can be reached by calling 800-273-8255.For those who don’t want to speak to a counselor, there’s also a national Crisis Text Line available 24/7 by texting "home" to 741741. | Mental Health Treatments |
You stand up quickly from the couch, and for a few seconds, you struggle to see and maintain your balance as your surroundings suddenly plunge into darkness.
This common-yet-unnerving experience raises a question: Why do you sometimes get dizzy when you stand up, and why can your vision go dark?
It turns out that this reaction — known as postural or orthostatic hypotension — is caused by a rapid change in body positioning, and it's usually nothing to worry about. But if it happens frequently or lasts a long time when it occurs, that could be a sign of a chronic health condition, an expert told Live Science.
Visual changes, lightheadedness and dizziness that occur in the seconds after you stand up happen due to a sudden, temporary drop in blood pressure, Dr. Stephen Juraschek, an associate professor of medicine at Beth Israel Deaconess Medical Center of Harvard Medical School, told Live Science by email.
Related: What is normal blood pressure?
For a moment, the brain is not supplied with enough blood and oxygen, he said. And the oxygen supply for the light-sensing tissue of the retina also falls. Since the retina requires a lot of oxygen to function properly, even a small dip in its supply can lead to vision problems.
The process of maintaining stable blood pressure after standing up is controlled by the autonomic nervous system, a set of nerves that regulates involuntary bodily functions, such as heart rate, breathing and digestion, Juraschek said. "When people stand up, about 300-800cc [cubic centimeters] of blood gets pulled in the legs, leading to a temporary drop in blood pressure," he said; that's about 0.3 to 0.8 quarts of blood suddenly flowing into the legs.
This drop in blood pressure is detected by pressure-sensitive receptors in the arteries that supply blood to the brain and in the right atrium of the heart, which blood flows into after delivering oxygen to the body. These activated receptors then trigger a body-wide response that stabilizes the person's blood pressure — blood vessels constrict, the muscles of the legs and abdomen contract and heart rate increases, Juraschek said.
This does not usually cause noticeable effects. But in people who are dehydrated or experiencing an illness, like the flu, the drop in blood pressure may be more dramatic and might take longer to stabilize, Juraschek explained. People can also be prone to this dizziness if they take medications to reduce blood pressure, such as beta-blockers, he said.
Related: How much blood is in the human body?
And some people can be prone to the symptoms when getting out of bed in the morning, since their blood pressure is typically low at that time, and also when they're drinking alcohol or sweating a lot, according to Houston Methodist.
These short bouts of dizziness differ from chronic orthostatic hypotension, in which some individuals experience long-lasting or frequent loss of vision and balance after standing. This condition can interfere with their daily lives and cause falls, fainting and car accidents, and it's a risk factor for cardiovascular problems and kidney disease, Juraschek said.
"Postural hypotension may be particularly concerning if it persists beyond 3 minutes of standing," he noted.
Depending on what causes the condition, orthostatic hypotension can be either primary or secondary, according to the National Institute of Neurological Disorders and Stroke. Primary orthostatic hypotension is rare and caused by impairments to the autonomic nervous system, such as those caused by nerve damage.
Secondary postural hypotension, in which symptoms are caused by other medical conditions, is more common. This can be related to low heart rate (bradycardia), low blood sugar (hypoglycemia) and thyroid conditions, for instance, the Mayo Clinic states. Aging can also leave the pressure sensors in the neck and heart less reactive and the heart less able to quickly adjust its speed, leaving people ages 65 and older more prone to these dizzy spells.
This article is for informational purposes only and is not meant to offer medical advice.
Live Science newsletter
Stay up to date on the latest science news by signing up for our Essentials newsletter.
Anna Gora is a health writer at Live Science, having previously worked across Coach, Fit&Well, T3, TechRadar and Tom's Guide. She is a certified personal trainer, nutritionist and health coach with nearly 10 years of professional experience. Anna holds a Bachelor's degree in Nutrition from the Warsaw University of Life Sciences, a Master’s degree in Nutrition, Physical Activity & Public Health from the University of Bristol, as well as various health coaching certificates. She is passionate about empowering people to live a healthy lifestyle and promoting the benefits of a plant-based diet. | Disease Research |
At first, Rich was just a friend from the dog park.
âHe had a couple of dogs and I had a dog and we were in a group one day,â says Dale Tunnell, a research psychologist in Sun City West, AZ. âWe sat down and talked and found we had shared experiences in the military: I was in the Army and Rich is a former Marine. We became close. Weâre closer than most brothers are.â
When they met, Rich was overweight and had back problems. Heâd had a heart bypass years earlier that inspired him to quit smoking.
Later, when Rich was diagnosed with peripheral artery disease (PAD), he was hopeful that it could be treated.
âHe was cheerful and pragmatic about the things he couldnât control,â Tunnell says. âHe knew PAD was the result of how he lived, but probably wouldnât go back and change anything.â
Only a small number of people with PAD need to have an amputation. But multiple doctors and treatments couldnât prevent Rich from eventually losing a leg below the knee. Tunnel says his buddy became âmorose.â
Richâs wife is his primary caregiver. Tunnell also worked hard to bolster Richâs spirits. âRich is very blustery. Heâs not pompous but very gregarious and vocal,â he says. âIâll bring him chai tea and weâll talk about our experiences and politics and anything he wants to talk about. The only guy heâll listen to is me.â
Then one day, Richâs wife asked Tunnell to drive her husband to an appointment. Thatâs when Tunnell turned into his friendâs advocate. Throughout the process, Tunnell has seen firsthand how hard PAD can be on both the person and their caregiver.
âTo the patient, PAD can feel like a never-ending deal and probably the last thing thatâs going to happen to them before they die -- and it may be,â he says. âThe caregiver is going to hurt as much as the patient. Theyâre going to curse themselves for not being able to do more. Itâs the nature of the beast. If you care, thereâs always the feeling of despair: I wish there was more I could do.â
Advice for Caregivers
Patience, with yourself and your loved one, is the most important part of caring for someone with PAD.
âYouâre dealing with someone who has a whole range of habits they need to modify,â says Danielle Mondesir, a nurse practitioner with Modern Vascular, an outpatient medical clinic in Houston. âA lot of patients are depressed because they canât do things they enjoy anymore. Theyâre anxious because they know PAD can end in amputation, though thatâs not the case with everyone.â
Those with PAD arenât the only ones who feel frustrated. Many spouses, partners, and loved ones feel angry because they saw this coming.
âTheyâve pushed their loved ones to stop smoking or watch their sugar. They say, âI told them to stop. I told them this would be an issue,ââ Mondesir says. âThey want the best for their loved one but couldnât get through to them. Sometimes it takes more than PAD to make them stop.â
Itâs normal to feel helpless watching your loved one deal with the physical and emotional aspects of PAD, but there are ways you can make progress.
âThis is a chronic disease, and it takes effort not just by the patient but the caregiver to get the best outcomes,â Mondesir says. âPatients donât do as well if the caregiver just brings them to appointments and isnât as involved. The more you learn about PAD, the more youâll understand what it takes to be there for your loved one.â | Disease Research |
Australian researchers have developed a way of highlighting changes in the brain that mark the progression of Parkinson’s disease years before physical symptoms show.
Researchers at the Florey Institute and Austin Health in Melbourne have shown it is possible to detect signs of Parkinson’s disease, a debilitating neurodegenerative condition, by injecting patients with a synthetic compound, known as 18F-AV-133, designed to bind to a protein in the brain known as VMAT2.
There is significant evidence that deficiency of VMAT2, an essential protein for neurotransmitter regulation, is linked to Parkinson’s disease.
The F-AV-133 compound becomes concentrated in areas of the brain where VMAT2 is active, with researchers then able to conduct a PET scan to capture images that show the strength and areas of VMAT2 activity in the brain, creating an imaging biomarker.
The researchers studied 26 patients with Parkinson’s disease, a control group of 12 people, and 11 people with Rapid Eye Movement (REM) sleep behaviour disorder, which is a significant indicator of Parkinson’s disease. Each person undertook two PET scans two years apart.
The were no significant changes in clinical symptoms in any of the participants according to currently available assessments for Parkinson’s disease, which involve asking people questions about their symptoms.
By contrast, the PET scans showed significant neuronal loss in three key regions of the brain in individuals with Parkinson’s disease, and in one key area of the brain in those with REM disorder, suggesting F-AV-133 is a more sensitive means of monitoring neurodegeneration.
The findings were published in the international journal Neurology on Thursday.
The study’s lead researcher, Prof Kevin Barnham, said Parkinson’s disease is often thought of as an illness of old age, when in fact it starts in midlife and can go undetected for decades.
“Parkinson’s disease is very hard to diagnose until symptoms are obvious, by which time, up to 85% of the brain’s neurons that control motor coordination have been destroyed,” he said.
“At that point, many treatments are likely to be ineffective. Our long-term goal is to find a way to detect the disease much earlier and treat people before the damage is done.”
He said further mathematical modelling conducted on the study data had found the imaging biomarker may be able to detect Parkinson’s disease up to 30 years before symptoms appear.
Degeneration happens in the brains of people with Parkinson’s before clinical diagnosis.
This is because there needs to be comprehensive loss of nerve cells that produce a chemical called dopamine before physical symptoms show, said Assoc Prof Lyndsey Collins-Praino, a neurodegenerative diseases expert and senior lecturer in medicine with the University of Adelaide.
“So in recent years, there’s been a big push in the field to try to identify what are called the prodromal symptoms of Parkinson’s, which are early warning signs and include things like reduction in the sense of smell, constipation, anxiety, and REM sleep behaviour disorder which is the most predictive indicator,” she said.
She said the Parkinson’s field lags behind Alzheimer’s, which has much more extensively incorporated the use of biomarkers in research and testing. This is despite Parkinson’s being the fastest-growing neurological disease.
“In Parkinson’s, diagnosis is almost entirely based on subjective clinical judgment and to move forward, the field really does need to incorporate biomarkers,” Collins-Praino said.
Information for people living with Parkinson’s can be found at Fight Parkinson’s, or by phoning 03 8809 0400 | Disease Research |
Creating an environment in which individuals and marginalised groups were shamed during the Covid pandemic was a “cynical” tactic to steer attention away from the UK government’s errors, an academic study has concluded.
The research by medical humanities scholars at the University of Exeter said people from ethnic minority groups, those with medical conditions such as obesity and health professionals all suffered shame and stigma.
They argue that by putting the onus on citizens to use their common sense and encouraging people to report rule-breakers rather than formulating cohesive public health policies the perfect conditions for shame to pervade were created.
“There has been a wilful political decision to create shame or to allow it to spread, as a means of shifting focus away from bad governance,” said Luna Dolezal, associate professor in philosophy and medical humanities and one of three co-authors of the research.
“The uncomfortable conclusion that we draw is that shame has come to define significant elements of the pandemic, and rather than this emotion being experienced by everyone equally, it’s been directed at some of the most marginalised and vulnerable members of society.”
Dolezal said by singling out communities – and often ones without much power – a “government-sanctioned blame culture” was created. “This was at a time when we needed cohesion, not division,” she said.
Dolezal added that there was a long tradition of “curtain-twitching” in England. “That intensified during the lockdowns.” She said she thought the trend had abated. “But it could easily be reignited.”
The book, Covid-19 and Shame: Political Emotions and Public Health in the UK, is being published by Bloomsbury on 9 February.
It maps out how and why shame was experienced in England, from the first tweet to mention the term Covidiot (26 February 2020) to the online shaming of Columbia Road flower market the following month when – legally – people continued to visit.
It recalls the first “local lockdown” in Leicestershire, which led to one resident describing feeling like a “Leicester leper” and in a chapter called “Coughing while Asian” discusses the “outpouring of racist hatred and abuse at individuals assumed to be Chinese” and the myth of a healthy western country “under siege from foreign diseases”.
The book highlights the case of a mother who was “named and shamed” on social media for not clapping for carers. “I was mortified,” the woman said. “The post said … I showed the street up and if I can’t spend a minute showing my appreciation I don’t deserve to use the NHS.”
The phenomenon of care workers being spat at and verbally abused, accused of being “killers” and “carriers of death” and nurses being told to hide their ID cards and disguise their uniforms on their way to and from work for fear of attack is studied.
Another group that was shamed, according to the researchers, were overweight people, who were depicted as more likely to become seriously ill and thus became “a selfish burden on straining health systems”.
The study highlighted one particular campaign that used shame. In January 2021 the UK government launched its “Can you look them in the eyes?” campaign aimed at citizens bending the rules and featuring Covid patients in oxygen masks and casting a “shaming gaze” towards the camera.
In a chapter called “Good solid British common sense” the authors argued the UK government’s emphasis on common sense held members of the public accountable for the pandemic in ways that encouraged “deeply damaging patterns of judgment, shame and surveillance”.
Fred Cooper, another of the authors and an expert on shame and loneliness, said: “Unable to provide an intrinsically useful or agreed-upon code for effective public health or good pandemic citizenship, appeals to common sense served a cynical political purpose. They eroded trust in scientific expertise, flattered people who like to think that they have it, and created a shamed group.”
The research asserts: “Our uncomfortable conclusion is that shame has played a part in the pandemic which, rather than being detrimental to everyone, has been useful to some at the direct expense of the most marginalised and vulnerable.”
The book is based on research gathered through two projects: Scenes of Shame and Stigma in Covid-19, funded by the UKRI Arts and Humanities Research Council and Shame and Medicine, funded by the Wellcome Trust. | Epidemics & Outbreaks |
That is why we have seen A&E waiting times in England the best in two years.
Rishi Sunak told Prime Minister’s questions on 19 July that A&E waiting times in England were the “best in two years”.
There are lots of different performance figures for accident and emergency departments in England, so it is not clear exactly what data Mr Sunak was referring to, and Downing Street has not responded to our request for comment.
But health experts have told Full Fact that Mr Sunak’s claim is “difficult to square” with the published data. This data shows that while there have been improvements in performance in recent months, June 2023 was not the best month in the last 24.
Ministers must provide evidence for what they say, and ensure that any statistics and data they rely on to back up their claims are provided publicly in accordance with the Code of Practice for Statistics or relevant guidance. The OSR also recommends that when data is quoted publicly it should be “published in an accessible form”.
Honesty in public debate matters
You can help us take action – and get our regular free email
I’m in
The A&E waiting times target
NHS England has a target to admit, transfer, or discharge 95% of accident and emergency visits within four hours of arrival. This standard has not been met since 2015.
The most recent NHS England data when Mr Sunak made his claim, shows that 73.3% of patients attending A&E across England were seen within four hours in June, which was up from 72.1% in the same month the previous year, but lower than in April or May 2023. Performance on this measure was also higher throughout 2021.
This suggests that there has been an improvement in recent months from a record low of 65% in December last year, but that levels have returned to where they were around the first half of 2022.
This data counts individual attendances to A&E, so if a patient goes more than once within a month for unplanned follow up or a different condition then they will be recorded in the data each time.
The number of A&E patients waiting for a hospital bed
The number of patients waiting more than four or 12 hours for a hospital bed after the decision to admit them is another metric often scrutinised in the media.
The latest data shows that the number of people waiting more than four hours has certainly improved recently, but it was still higher in June 2023, at 113,834, than it was in September 2021 or earlier.
The data on patients waiting more than 12 hours shows a similar story, with clear improvement after December 2022, but with numbers in June 2023 still higher than they were before June 2022.
Time of arrival data
Earlier this year, NHS England began regularly publishing monthly data showing the number of patients waiting more than 12 hours in A&E from their time of arrival (rather than from a decision to admit them). Previously it only released data on the number of people spending more than 12 hours in A&E from arrival annually. This new data shows that in June 2023, 108,225 people spent more than 12 hours in an emergency department from arrival to departure—meaning they were either admitted to hospital, transferred or discharged.
This is down from a peak of 147,405 in March this year. This data only goes back to February, but the Royal College of Emergency Medicine (RCEM) has also published data it collected through Freedom of Information requests, dating back to January 2018.
This FOI data shows that the number of patients waiting 12 hours or longer in A&E from their time of arrival was still higher in June this year than it had been in February 2022 or earlier.
This again suggests that while there have been improvements in recent months, the number of patients waiting more than 12 hours from arriving in A&E is not the best it has been in the past two years.
Are A&E waits the best in two years?
The data we have doesn’t seem to back this up, although it’s possible Mr Sunak had some other measurement in mind.
The published NHS data does show that there have been improvements in recent months across the four-hour target, four and 12 hour waits from decisions to admit to admission and 12 hour waits from arriving in A&E.
But none of the data suggests waiting times are the best they’ve been for 24 months, and the 12-month averages have all got worse since June 2021.
Nuffield Trust fellow Jessica Morris told us: “It is difficult to tell what the Prime Minister meant by saying A&E waiting times were the best for two years, as June’s figures on the headline four hour performance indicator are worse than those for April and May.
“This claim could reflect that June, and the past three months, were better than the same time last year, though worse than in 2021.”
Tim Gardner, assistant director of policy at the Health Foundation, agreed about the trend in the four hour A&E waiting time figures, and added: “Last month [was not] even the best for the four hour standard in the last two years—performance exceeded 73.3% in nine of the last 24 months (July 2021-January 2022 and April-May 2023), leaving June 2023 as only the tenth best month in the last two years.
“[...]The prime minister’s claim that A&E waiting times in England are the best in two years is difficult to square with the data currently in the public domain.
“If the government is relying on unpublished data—or measuring its success against an alternative target—it needs to be transparent about how it has reached that conclusion.”
Full disclosure: The Health Foundation has funded Full Fact's health fact checking since January 2023. We disclose all funding we receive over £5,000 and you can see these figures here. (The page is updated annually.) Full Fact has full editorial independence in determining topics to review for fact checking and the conclusions of our analysis.
Image courtesy of UK Parliament/Jessica Taylor | Health Policy |
FIRST ON FOX: The White House is honoring law enforcement at the front lines of the battle to keep illicit fentanyl and other illegal drugs out of American communities — as the Biden administration says its sweeping drug control strategy is getting results in the fight against the opioid crisis.
The White House Office of National Drug Control Policy (ONDCP) Director Dr. Rahul Gupta is recognizing law enforcement groups who have shown themselves to be the "best of the best."
The ONDCP U.S. Interdiction Committee Awards recognize the efforts and achievements of law enforcement agencies and individuals, and the awards show the broad scope of the fight against stopping drug trafficking.
"The awards highlight the best of the best out of almost 100 applications that our nation has to offer in terms of investigations, as well as going after in every way possible the bad guys to disrupt and dismantle the drug trafficking organizations, which are really criminal networks," Gupta said in an interview ahead of the awards with Fox News Digital.
The U.S. has been locked in an opioid crisis for years, with deaths from fentanyl overdoses spiking into the tens of thousands in recent years. The drug is primarily created in Mexico using Chinese precursors and then trafficked across the U.S. southern land border. The U.S. has called for an international coalition to tackle the crisis.
However, the threat is evolving, as highlighted in the efforts recognized at the White House. One of the investigations highlighted was a probe by the Department of Homeland Security, FBI, Postal Service and the Palm Beach County Sheriff’s Office targeting a dark web vendor that was trafficking fentanyl, heroin, MDMA and cocaine. The vendor had been linked to at least one death in Utah. The investigation shut down the vendor and arrested those associated with it.
Gupta said the case shows how the threat is "constantly changing."
"The drug traffickers and produce will continue to evolve because they'll be responsive to our actions. Now, what has happened in the past administrations often is we are. Exclusively reactionary. And what we're doing different in this administration is both looking at the task at hand today, as well as preparing for the future actions that will happen as a result of reactionary forces of the cartels," he said.
The awards will also highlight the Drug Enforcement Administration’s Operation Titan Fall — which took down a violent drug trafficking organization in Florida and seized firearms and over 100 kilograms of cocaine, fentanyl and heroin.
Gupta noted a Nov. 17, 2022 operation, in which Customs and Border Protection’s Air and Marine Operations chased two ships to Puerto Rico, believing them to be smuggling cocaine. They were fired upon, leading to one agent — Michael Maceda — being killed and two others injured. However, the boats were stopped, the suspects arrested and over 2,800 pounds of cocaine seized. A moment of silence was held at the ceremony on Thursday to honor Maceda's sacrifice.
"So his ultimate sacrifice in defense of our nation is what we're celebrating today. We're also celebrating not just the great work, investigatory and hard work that our women and men do in uniform every single day. But we're thankful to people who have paid this sacrifice with their life, the ultimate sacrifice in their work," Gupta told Fox.
Meanwhile, Operation Chain Break — launched by Immigration and Customs Enforcement and Homeland Security Investigations — targeted Chinese pill press manufacturers and Mexican cartels that used it. The DEA will also be honored for its investigation into the Revolutionary Armed Forces of Colombia, which led to dozens of arrests and the seizure of thousands of pounds of cocaine.
The awards are tied to the Biden administration’s National Drug Control Strategy, which has looked to simultaneously address addiction and aid in treatment for those addicted, while also tackling the criminal organizations behind the multibillion-dollar effort to get Americans hooked on poison.
Gupta said there were two drivers of the strategy, "One, untreated addiction, which is creating the addiction infrastructure there needs to be to help Americans get the help when and where they need it. Two, Drug trafficking and its profits that push the trade of this. So we're both getting people the help they need when and where, as well as going after the drug traffickers, producers and their profits."
Gupta said there are signs of success. He pointed to 34,000 pounds of fentanyl seized and $22 billion denied to drug producers and traffickers, and more law enforcement operations accompanying the expansion of treatments and availability of drugs like Narcan. He also pointed to the use of non-intrusive inspection tech at ports of entry — including in Nogales, Arizona, which led to a 445% increase in seizures and about 38 million pills seized.
Additionally, the White House has highlighted that the spike in overdose deaths since 2018 has flattened in 2022 and 2023. Gupta doubled down on President Biden’s calls for additional funding from Congress to fight the crisis, calling it now an "inflection point."
"We need to double down on our efforts that are working, clearly, and that that that includes making sure that we're implementing all these policies and getting the Congress to provide the funding that the president has requested for the drug control budget, which is $46.1 billion and is historic and unprecedented because there's no more important things to do than to save American lives," Gupta said. | Drug Discoveries |
Lynne Sladky/AP
toggle caption
A sign for monkeypox vaccinations is shown at a vaccination site in Miami Beach, Fla.
Lynne Sladky/AP
A sign for monkeypox vaccinations is shown at a vaccination site in Miami Beach, Fla.
Lynne Sladky/AP
When the JYNNEOS vaccine for mpox rolled out last summer, health officials believed it would work. It was an educated guess, at the height of a public health emergency, based mostly on data from animal studies.
Now, after 1.2 million doses have been given in the U.S., the Centers for Disease Control and Prevention has real-world evidence that the mpox vaccines are working to prevent disease.
Three new studies show that two doses of the JYNNEOS vaccine are somewhere between 66% and 86% effective at preventing mpox among people at risk. The research was published on Thursday in the New England Journal of Medicine and the CDC's Morbidity and Mortality Weekly,
"Two doses of vaccine offer the best protection against mpox disease," says Leora Feldstein, an epidemiologist at the CDC. "We really recommend staying up to date on vaccination going into the summer and into pride season."
The new data come as health officials are working to stave off a possible summer wave of mpox.
The CDC's concern about a resurgence of mpox is based on a recent cluster of cases found in Chicago. In the past month, 21 people there were diagnosed with mpox, according to Dr. Demetre Daskalakis, deputy director for the White House National Monkeypox Response, who spoke at a press briefing on Thursday.
The cluster of cases breaks a three-month streak where almost no cases were found in Chicago. Daily cases remain low across the U.S. Many of the people who caught mpox in Chicago had been fully vaccinated; none were hospitalized.
"Even if it doesn't prevent infection...vaccination makes getting and spreading impacts less likely, and may decrease the chances of severe illness, hospitalization and death," says Daskalakis.
Mpox is a disease that causes rashes and lesions and is primarily spreading through sexual contact. Most of the cases in the U.S. have been detected in gay, bisexual and other men who have sex with men, with multiple partners.
The CDC estimates about 1.7 million people are at high risk of contracting mpox, but, so far, only a quarter are fully vaccinated – meaning they've received two doses of the JYNNEOS vaccine.
"If you didn't get your first dose, get it. And if you didn't get your second dose, get that. Seek healthcare and get tested if you have a rash, even if you've been previously vaccinated or had mpox in the past," Daskalakis says. "We need to be ready to use all the tools in the prevention toolkit – that includes vaccines, testing and importantly, education – so that people can make informed decisions about their sex lives to halt the spread."
Daskalakis says they're working with local health authorities and organizers to provide vaccines and good health information at upcoming Pride events. The CDC has also created a database of health centers offering free mpox vaccines.
While the U.S. ended the public health emergency for mpox in January, the CDC says these recent cases show that the outbreak is not over, and that the disease continues to circulate. | Vaccine Development |
Nearly a quarter of a million people who signed up to be a blood donor in 2022 are yet to make a donation.
Exclusive figures given to BBC 5Live from NHS Blood and Transplant show only about 91,000 people out of 325,000 who registered have had an appointment.
The NHS said existing donors were prioritised in 2022 due to low blood stocks, meaning fewer appointments for first time donors.
I've been speaking to people at the UK's largest blood processing centre near Bristol about why it is so important for people to book their appointments now.
Phil Brown received "multiple" blood transfusions to treat his leukaemia and has worked at the NHS Blood and Transplant Centre for 35 years.
"Twenty years ago I had leukaemia, and I suppose leukaemia and bone marrow cancer, and I received numerous red cell and platelet transfusions during my treatment," he said.
"It's one of the strong motivating factors for me [to work at the centre], making sure all the products are processed correctly and that they're safe and therapeutically effective. It's very important."
Mark Chambers, assistant director at the Filton facility, said: "The situation is challenging in the sense of trying to get more donors.
"We're now at about six-and-a-half days but we know we have a lot of donors who have registered to try and get through the door."
He said the two types that are needed the most currently are O negative and RO.
"We need O negative because that's a universal blood type and can go to all patients," he said.
"For sickle cell we need donors who are RO and that is usually found in donors with black heritage."
In a statement the NHS said the service faced a challenging year in 2022 with low blood stocks.
"Existing donors are prioritised at these times as their blood type is known and they are more likely to complete a successful donation, which means appointments for first time donors are reduced," it said.
Blood stocks have "stabilised" since then, the statement added, and there are now more slots available for new donors and people who registered are being urged to book now.
David Rose, director of donor experience at NHS Blood and Transplant, said: "We always need new people to join our amazing community of lifesaving blood donors and help meet the needs of patients right now and in the future.
"If you are one of the 235,000 people who registered last year but are yet to attend an appointment, or you're thinking about signing up to donate, please make 2023 the year you save lives."
Follow BBC West on Facebook, Twitter and Instagram. Send your story ideas to: [email protected] | Global Health |
A wearable robot that assists people with walking
In recent years, roboticists have introduced increasingly advanced systems, which could open exciting new possibilities for surgery, rehabilitation, and health care assistance. These robotic systems are already helping to improve the quality of life of many people with disabilities, as well as patients who suffered physical trauma or underwent medical procedures.
Researchers at Chung-Ang University in South Korea recently introduced a new wearable robot designed to specifically assist humans who have difficulties walking due to aging, muscle weakness, surgeries or specific medical conditions. This robot, presented in a paper published in Science Robotics, was found to improve balance, while also reducing the energy spent while walking (i.e., the so-called metabolic cost).
"Our recent paper was primarily inspired by the recognition that most wearable robots for gait assistance have focused solely on movements in the sagittal plane," Giuk Lee, one of the researchers who carried out the study, told Tech Xplore. "However, walking is inherently a three-dimensional activity, and movements in other planes are just as crucial."
In contrast with other robotic systems for hip abduction assistance proposed in the past, the robot created by Lee and his colleagues focuses on the frontal plane. This is the frontal part of the human body, known to support movements and lateral stability while walking.
"Traditionally, research on walking motion has considered forward movement and lateral balance as separate functions," Myunghee Kim, co-author of the paper, said. "Only recently has the fore-aft direction's assistance been acknowledged for its contribution to lateral stability. Yet, the reverse—the influence of lateral assistance on fore-aft walking efficiency—remains insufficiently explored."
The key assumption behind the researchers' study is that the metabolic cost of walking could be reduced using wearable robots that mimic the natural hip abduction moment. This is the movement of the leg away from the body's midline, which supports walking and many other actions humans perform every day.
"The wearable robot for hip abduction assistance that we've developed operates on the principle that walking efficiency can be improved by supporting lateral body movements," Lee said. "As we walk forward, our body's center of mass naturally shifts side to side to maintain balance—a process known as recovery. During this recovery phase, the hip abduction muscles are engaged. Our device assists these muscles, making it easier for the wearer to recover their center of mass with less effort."
Lee and his colleagues evaluated their robot's performance in both simulations and real-world experiments. The results of these tests were highly promising, showing that the robot reduced the metabolic cost of walking by 11.6% compared to normal, unassisted walking, while also improving balance and stability.
"Our study demonstrates that enhancing gait efficiency doesn't require the wearable robot to focus only on the sagittal plane," Lee said. "Since walking is a three-dimensional motion, it's essential to consider movements across various planes."
Essentially, the hip abduction assistance robot developed by Lee and his colleagues influences the movements of the hips and legs known to support walking. Its unique design allows it to effectively 'replace' part of the efforts that humans would normally place when walking.
"Our study demonstrates a substantial role for lateral assistance in enhancing walking efficiency by facilitating a more effective transfer of the body's center of mass from one foot to the other," Kim added. "This insight is especially encouraging for individuals with reduced muscle strength, offering a new direction for support mechanisms. Moving forward, it will be important to explore how lateral assistance could help those with limited mobility, potentially transforming rehabilitation and support strategies."
In the future, the robotic system developed by this team of researchers could be improved further and eventually commercialized, supporting both rehabilitation and everyday use. The robot could prove useful for older adults, patients who underwent leg or hip surgeries, and other people who experience difficulties walking.
"For future research, we plan to delve deeper into how hip abduction affects walking balance," Lee added. "We've observed that hip abduction not only improves gait efficiency but may also influence balance. We aim to explore the potential of wearable robots in enhancing walking balance."
More information: Juneil Park et al, Effect of hip abduction assistance on metabolic cost and balance during human walking. Science Robotics (2023). DOI: 10.1126/scirobotics.ade0876.
© 2023 Science X Network | Medical Innovations |
But it can turn serious in the vulnerable, such as infants, older children with weakened immune systems and the elderly and is a leading cause of lung infections such as pneumonia and bronchiolitis, which can require ventilation.
There has been a 473 per cent surge in RSV hospitalisations in the week ending 16 November compared to the same period in October, according to the UK Health Security Agency (UKHSA).
During the past two winters, cases have been higher than usual because Covid measures in previous years suppressed occurrences – meaning youngsters have now had much lower immunity.
About three in 100 babies with RSV will need hospital treatment, according to the charity Asthma + Lung UK. The virus results in 20 to 30 infant deaths per year in the UK, according to the Department of Health and Social Care.
Experts warn parents to look out for symptoms such as difficulty breathing and feeding, noisy breathing, a dry raspy cough and a high temperature.
Lydia Johnson had not realised how serious RSV could be until her six-week old baby, Leo, nearly died in hospital in May this year. He was born at full term and with no obvious vulnerabilities.
At one point, the nurses prepared the mother-of-three for the worst and asked her if she wanted to call a priest.
The now eight-month-old has been in and out of hospital and doctors say he has been left with lung damage.
“I’m keen to raise awareness because Leo deteriorated so rapidly,” she told i.
‘I had no idea that RSV could be so dangerous’
Lydia, 29, from Telford, Shropshire, was breastfeeding Leo at home when she noticed his breathing had become laboured. “He was sucking in at his ribs, as though he was really short of breath,” she said.
Within 10 minutes, he had gone blue and floppy and she rushed him to hospital. By the time she got to A&E, he was completely unresponsive. “It’s just a five-minute drive to the hospital, he went downhill so quick,” she recalled.
After being put on oxygen, baby Leo was discharged two days later. But later that day he started struggling to breathe again.
Before they reached the children’s ward, Leo had stopped breathing completely and was unresponsive. Lydia watched on in shock as the skin on his legs went mottled and the doctors put him on an oxygen machine. He was also fitted with a feeding tube.
An X-ray showed Leo’s lungs were congested and he was taken to the high dependency unit in a critical condition. The next day he crashed again.
“I felt so helpless,” said Lydia. “At around 6am, he made this strange gasping sound and stopped breathing again and the nurse pulled the emergency cord. All I could see were tiny, pale grey legs sticking out from under the doctors’ and nurses’ arms as they tried desperately to save him. I ran down the corridor hysterical. I couldn’t watch.”
A nurse gave Lydia and her husband Clayton a stark warning. “She said he was the sickest baby they had in there. She asked if he was baptised and if we wanted a priest.”
It was touch and go for a few days but, thankfully, the antibiotics worked and Leo pulled through. However, the youngster has been hospitalised a total of eight times since.
Lydia says she’s very anxious about him picking up infections from nursery and her other children, Sofia, four, and Alyssia, nearly two.
“We don’t know what the future holds for Leo, but I’m just so glad I trusted my instincts and took him to hospital straight away ,” said Lydia. “I had no idea that RSV could be so dangerous or cause lasting damage.”
Calls for jab rollout
Last June, the Joint Committee on Vaccination and Immunisation, which advises government on vaccine policy, called for a new winter vaccine rollout to tackle RSV. It said ministers should consider a seasonal or year-round invitation for the jab for pregnant women and babies as well as over-75s. But, in September, the Government delayed the rollout.
It was announced on Thursday that Pfizer’s Abrysvo jab has been given the green light by the Medicines and Healthcare products Regulatory Agency for British pregnant women for the first time.
The jab is the second RSV vaccine to be approved in the UK – after GSK’s Arexvy in July.
Experts say the shot will protect infants from complications from birth through to six months of age through maternal immunisation.
Asthma + Lung UK say the vaccines should be delivered as soon as possible, to help vulnerable groups and protect the NHS from becoming overwhelmed each winter.
The charity’s head of health advice, Emma Rubach, said: “Like most other colds and viruses, RSV starts with a blocked or runny nose and can progress to cause a cough, fever and sometimes breathing difficulties. For most children, it will clear in a few days and they can be looked after at home.
“However, some children do develop more severe symptoms and bronchiolitis. Warning signs to look out for in your children include if they are finding it difficult to feed or eat, they are breathing more quickly, they have a high temperature, they have noisy breathing (wheezing) or seem very tired.
“If they are showing any of these signs, seek urgent medical help. And call 999 for urgent help if your child is struggling to breathe, there are pauses when you child breathes, your child’s skin, tongue or lips are blue or your child is very floppy.”
A spokesperson for the DHSC said: “The NHS already offers monoclonal antibodies, which provide protection against RSV to infants at very high risk.
“We are developing options for delivering wider infant and adult RSV programmes, in collaboration with the UK Health Security Agency, NHS England and manufacturers. We will update in due course.”
For more information and advice on RSV and bronchiolitis visit here or or call the Asthma + Lung UK helpline on
0300 222 5800. | Vaccine Development |
KAMPALA – It was a typical day for Dr Hadson Kunsa, an intern at Uganda’s Mubende Regional Referral Hospital, 90 miles from the capital, Kampala. A patient came in with severe abdominal pain and tests found he had a perforated stomach. He was rushed to surgery, but it was too late. Several of his organs had shut down and no amount of resuscitation could help.
At the time, Kunsa and colleagues did not know they had just been exposed to Ebola – a rare, infectious virus that has been known to have a fatality rate of up to 90 percent.
Looking back, the signs had been there. This was mid-September 2022, and a handful of other patients that week had died suddenly with similar symptoms. “One died on arrival at our hospital,” Dr Emmanuel Batiibwe, Mubende’s hospital director, told VICE World News.
But still, nobody could work out what was going on. Investigations into these mysterious deaths led the hospital staff to Madudu’s surrounding villages. “We found that nine deaths had already occurred, and the locals were also suspicious that something was wrong,” Batiibwe added.
Many families in these villages had allegedly been seeking treatment from traditional healers, so it was hard to gauge the full extent of whatever this outbreak was. “Seeing people falling very sick at once and then dying one after another was strange,” Silvest Lwambuka, a community leader in Kassanda, one of the worst-hit districts, told VICE World News. “Instead of going to the hospital, many went to traditional healers to chase these evil spirits away.” Some of these treatments included drinking a concoction of local herbs and chanting specific, spiritual words. Going to hospital, Lwambuka added, was their last option.
Eventually, when a 24-year-old man with a bleeding nose arrived at Mubende hospital, a sample was instantly taken for testing and returned on the 19th of September. It was Ebola, the Sudan Variant, a strain that’s especially feared because it has neither a vaccine nor specific treatment.
Days later, Kunsa and several colleagues started experiencing ferocious bouts of fever, a drastic loss of appetite, overpowering body aches and intense diarrhoea. “I remember thinking of running away, anywhere, to avoid my reality,” Kunsa said as he came to terms with both what this could mean for his personal health and also his professional responsibilities in the coming days.
Five staff members died within days – four health workers and a hospital driver. Two other health workers in nearby smaller community clinics also died. Morbid fear and confusion gripped the hospital staff, along with grief.
“We hurt,” Batiibwe told VICE World News, his voice just a whisper.
As word of the positive Ebola tests spread, governments and the media around the world started to paint a grim picture of Uganda’s ability to contain the outbreak, especially when cases spread beyond Mubende. The Telegraph would later report a leaked assessment that claimed 500 people would die by April, 2023. Memories of 2013-16, when a major outbreak across Liberia, Guinea and Sierra Leone killed more than 11,000 people were still fresh, with any new cases in the interim period sparking anxious updates on news wires. Yonas Tegen, the WHO Country Representative described these reports as dramatic. The country’s tourism sector started to take a hit as visitors cancelled their trips to Uganda.
On the 11th of October, the US urged its citizens to reconsider travel to Uganda, and introduced special screening for passengers who had visited or transited through the country. “We anticipated that it would take 1-2 years to manage the outbreak, especially as Ebola cases presented in a complex urban setting such as Kampala,” Anne Robins, the United Nations Children’s Fund (UNICEF) Chief of Child Survival and Development, told VICE World News.
Yoweri Museveni, Uganda's 78-year-old president – a military strongman ruler who has been in power since 1986 – instructed senior army medical personnel to lead the fight against the disease.
“The government mobilised its resources,” Lt. Col. Dr. Kyobe Henry Bbosa, who was appointed to run the government’s response, told VICE World News. “It was a combination of skills coming together to get work done.”
He said his core team of 20, which he called “the engine of the operation,” partnered with around 3,500 health experts from across the country. But the first two weeks of the operation did not go well.
The normally busy Mubende-Kampala highway seemed deserted. The bustling Mubende market was just as mirthless; a few women could be seen hawking produce, but unsure whether the customers were comfortable with them moving close. In the worst-hit villages in Madudu, the roads are just as empty as the highway, save for the occasional farmer.
It took around 10 days for the government to establish a working relationship with local communities, where many people were still relying on local healers they knew and trusted. As a result, identifying and extracting suspected cases from their communities was a challenge. A task force was created to track and engage with suspected cases, while a series of risk analyses were carried out to identify the most at-risk areas and determine the worst-case scenarios.
Yet cases just kept rising and the Mubende Regional Referral Hospital – one of the biggest in central Uganda, with approximately 200 beds – was becoming overwhelmed with new cases. “In the first week alone, we had almost 49 admissions,” Batiibwe said. “In a few days, three people had already died. It was tough.”
Treatments that had worked against other Ebola variants were much less effective. On the 15th of October, nearly a month after the first confirmed case, and after an estimated 19 people had died from Ebola, President Museveni announced a lockdown for the roughly one million people who lived in the worst affected districts of Mubende and Kassanda.
Unfortunately, a pre-symptomatic Ebola case had travelled out of Mubende to Kampala and exposed up to 17 people to the virus, including six school children. Overall the number of new infections had dropped, but the presence of Ebola in Uganda’s densely populated capital signalled a new phase of the crisis.
Across Kampala, talk was of a potential lockdown, but while some people started wearing masks and crowded malls asked visitors to sanitise their hands before entering, most of the capital continued as normal.
Schools were eventually closed and some health experts lobbied for a wider lockdown, but authorities quickly ruled out the idea. “The entire public was tired of epidemics; many people refused to believe there was another one barely a year later," Dr. Richard Kabanda, the acting Commissioner of Health Services, told VICE World News.
The health ministry chose instead to launch a campaign to educate the public on the virus. Authorities believe the education programme proved the most successful aspect of the response. Thousands of flyers with messages from health officials were quickly circulated, encouraging people to seek help. “Your chances of survival and recovery are much higher if you seek early treatment and care from qualified health workers,” one read.
Posters with illustrations showing symptoms of Ebola with captions translated into multiple local languages helped the messages reach all ethnic groups. These were circulated in busy spots, such as markets, published in local newspapers and in TV ads. Toll-free numbers were shared, and the telecom companies played Ebola-awareness messages as people waited for their call to be picked up.
Authorities used a network of hundreds of Village Health Trainers (VHTs), who are the Health Ministry’s first point of community contact, known to help disseminate immunisation calls and family planning advice. Armed with portable megaphones, these individuals, trusted and loved in their local communities, moved from door to door, raising awareness.
"As we moved, we would also collect any information about who was not feeling well, and if the symptoms were similar to Ebola, we forwarded the details,” Anna Nalubega, a VHT in Kassanda, said.
“We gave people our numbers to call at any time, and we notified the district Ebola teams when they did,” Fedris Nambooze, also a VHT, added. Many VHTs had also been deployed during the COVID-19 outbreak, and we’re now doing the painstaking work of educating a populace on a unique virus all over again.
By mid-October, the biggest threat to the fight against Ebola was the myth in rural communities that the virus was spread by witchcraft. Bbosa’s Ebola taskforce successfully worked to educate traditional healers on the symptoms and dangers of the disease. They all agreed they would not treat anyone with Ebola symptoms but instead refer them to a hospital.
“We watched each other to make sure no one was putting themselves or the community at risk,” Mpuga Teribirye, the Uganda national inspector and chairperson of traditional healers in Mubende district, told VICE World News.
Despite the focus on education and prevention, the government widely failed to acknowledge the challenges communities faced by putting them into strict lockdowns, such as limited access to food and basic household items. “Should I stay in the house and watch my children die of hunger?” Gladys Kakulu, a casual labourer and mother of four in the Mubende district, said.
Communities blamed the government and called out their elected officials, who voiced these concerns. “I appreciate the need to keep our people safe, but what should they eat in the meantime?” the Mubende Woman Member of Parliament, Hope Nakazibwe Grania. told VICE World News. “Most of these people live from hand-to-mouth; but now they can’t go out to work to put food on the table.”
However, the growing number of known Ebola-related deaths continued to take precedence. By the 30th of October, at least 53 people had died and about 136 had been infected by the virus. Benedicto Mweba, 11, from Kassanda district recalls answering more questions about his battle with Ebola than he could fathom. "I was so weak,” he told VICE World News over the phone. “I couldn't stand; even sitting was a problem. Sometimes I would be awake but hear doctors calling my name from far, and yet they were near me.”
Mweba tested positive for Ebola after his brother died from the virus; doctors found that he also had malaria. Before he died, his brother had been sick for a week, but they had assumed it was malaria, too. It wasn’t until Mweba tested positive that they realised he could have died from Ebola.
UNICEF's Robins confirms that several child Ebola and malaria cases – a common disease in Uganda – manifested simultaneously, with a near 60 percent fatality rate. UNICEF quickly started providing preventive medicine for malaria in the Ebola-affected districts and helped get faster referrals and more suitable treatment for child patients.
“There was a family that lost a mother, a baby, and then the remaining 7-year-old was left for treatment in the Ebola Treatment Unit to die alone,” Robins added. “He died after 19 days and his suffering, both physically and emotionally, was heartbreaking for all.”
UNICEF set up a child-friendly treatment centre in the lockdown districts that included a play area, and by extension, they also distributed picture-filled posters with messages about Ebola targeting children in and out of school.
According to Dr Scott Murcko, a doctor with Doctors Without Borders, the treatment centres were a challenging place to work. “Some days you had three critical patients in the Intensive Care Unit fighting for their lives, and those were tough days,” he said.
Murcko said they did everything possible to keep people in good spirits, including once dancing for a patient in intensive care. “His morale was low, we needed him to feel hopeful again, so we danced for him,” he said. “Later, when he was discharged, we danced again to celebrate and give him more hope.”
This period also marked an important turn in the fight against the crisis, as hospitals started to note fewer transmissions and more recoveries.
“As soon as the minister and her team arrived and partner organisations like WHO, CDC, MSF, Baylor, Infectious Diseases Institute and others joined, I started to see results,” Batiibwe. “The workforce was bigger and it had health workers who had previously managed Ebola.”
Though chaotic, Batiibwe remembers how the first two weeks helped them build systems and that would eventually lead to less panic. “Even when more patients came, we knew what to do, and the teams in the field were making sure the suspected cases got to us on time,” he said. “We went from having patients arriving to die in hospital in September to mid-October, to having no deaths later in November.”
On the 12th of November, WHO’s Tegen told media that only five cases had tested positive for Ebola that week and that the previous three weeks had seen a sharp drop in the number of cases.
In Kampala, where a large treatment centre had been set up, Bbosa said that there weren’t any patients. “By mid-November, there were 300 unused beds at the National Referral Hospital alone in anticipation of a rise in patients, but there wasn’t any new case,” he told VICE World News.
On the 11th of January, Uganda and the WHO announced the outbreak was over after no new cases had been detected since late November. Ultimately, the WHO reported 142 confirmed Ebola infections, 55 deaths and 87 recoveries; CDC reported an additional 22 probable deaths from undiagnosed cases and over 4000 contacts traced. The final numbers are a long way from the initial estimates of over 500 deaths that were predicted at the outset of the outbreak.
The programmes have since shifted to the discharged patients who, the team on the ground recognised, still needed support. Alongside aid organisations such as USAID, the health ministry has since established Ebola survivor programmes.
"There are clinical issues that remain once you are discharged," Dr Sarah Page, the USAID Global Health Security Agenda Advisor, explained. "For many survivors, they experience headaches, joint pain, and sometimes you can have the virus persisting in breast milk and semen.”
Uganda’s survivor clinics continue to do rigorous 72-hour mobile testing of breastfeeding mothers and support infants who have been weaned. Not to mention the emotional support programmes monitoring survivors’ mental health.
Today, while the survivor monitoring continues, finding patient zero is high on the agenda. Dr Amy Boore, CDC Director of Global Health Protection, said that the world hopes Uganda will be the first country to deliver this critical news that has eluded every Ebola outbreak. Many studies are going on for now, with suspicion being placed on an animal reservoir. "We don't know which one, but Uganda's Ministry of Health is leaning in hard with the Wildlife Authority as well to up the game with ecologic studies," she says. "They are pretty determined this time around to answer that question, and if they do, they will be answering it for the world."
She commends the country for quickly differentiating between the Ebola variants. “Uganda is one of the very few places on this planet that could have identified the Sudan species,” she adds.
Emmanuel Ainebyoona, the Health Ministry’s Spokesperson, added: “Uganda has been a good example within the African continent to the extent that some other countries have had their samples tested here. The whole response lasted less than four months, contrary to the doom the articles in some foreign media had predicted.”
The UN has been equally complimentary. “I congratulate the government, health care workers, and the people of Uganda, for your leadership and dedication, which have enabled this Ebola outbreak to be contained in less than four months,” the Director General of the WHO, Tedros Adhanom Ghebreyesus, said in a video message last month. “Even in the absence of approved vaccines and therapeutics for this specific Ebola, Uganda was able to use proven public health tools to contain the outbreak.”
“We commend the Ugandan government in leading efforts to put a swift end to the spread of the Sudan ebolavirus which spurred the outbreak, the US government said in a statement. “A major accomplishment in such a short time.”
In the end, Boore gives most of the credit to the people of Uganda. “Everything that Ugandans do, they do with absolute effort; people do not reserve energy till the end,” she told VICE World News. “The story of Uganda and Ebola from 2000 until now is inspirational.” | Epidemics & Outbreaks |
Following Tina Turner’s death on May 24 at age 83, it was reported that the legendary singer had died of natural causes.
The "Queen of Rock ‘n’ Roll" had struggled with several health issues, however, including long-term kidney disease.
As recently as March 9, on World Kidney Day, Turner announced her support of an international campaign for kidney health via Instagram.
Turner shared in the post how her failure to seek treatment had harmed her health and endangered her life.
"My kidneys are victims of my not realizing that my high blood pressure should have been treated with conventional medicine," the singer wrote on Instagram.
"I have put myself in great danger by refusing to face the reality that I need daily, lifelong therapy with medication. For far too long, I believed that my body was an untouchable and indestructible bastion."
Turner’s battle with kidney issues began in 1978, when she was diagnosed with hypertension.
Not realizing the danger that her high blood pressure posed, she never made much of an effort to control it, as she wrote in a story posted on ShowYourKidneysLove.com, a kidney awareness website.
"In 1985, a doctor gave me a prescription for pills, of which I was supposed to take one a day, and that was it," she wrote. "I didn’t give it any more thought."
"I have put myself in great danger by refusing to face the reality that I need daily, lifelong therapy with medication."
It wasn’t until 2009, when the "poorly controlled hypertension" caused the singer to suffer a stroke, that Turner started to understand the function and purpose of the kidneys.
"This is when I first learned that my kidneys didn’t work that well anymore," Turner wrote. "They had already lost 35% of their function."
The singer continued taking blood pressure medication, but she believed it only made her feel worse.
"With time, I developed a fatal dislike of these pills," she wrote. "I remembered relishing life before I started taking them and wished I could be as clear-headed and energetic as I used to be."
Eventually, Turner gave up the conventional medication in favor of homeopathic medicine — a decision that ultimately put her life in danger.
"I had not known that uncontrolled hypertension would worsen my renal disease and that I would kill my kidneys by giving up on controlling my blood pressure," Turner wrote in the online story. "I never would have replaced my medication (with) the homeopathic alternatives if I had an idea how much was at stake for me."
"Thanks to my naivety, I had ended up at the point where it was about life or death," she wrote.
By this time, Turner was suffering from signs of late-stage kidney disease, including fatigue, nausea and irritability.
"The doctors made it very clear that the consequences of my decision were irreversible," the singer wrote. "My kidney function had reached its all-time low."
"I realized that the struggle for healing is always also a struggle for accurate information."
Turner’s only option was to start dialysis, which is a treatment that removes excess fluid and waste from the blood when the kidneys cannot function properly.
"I realized that the struggle for healing is always also a struggle for accurate information," the singer wrote. "For example, I had not been aware that chronic kidney failure is called a ‘silent killer’ because symptoms do not become noticeable until 80% of renal tissue is lost."
In 2017, Turner received a life-saving kidney transplant from her husband, Erwin Bach, who she’d married in 2013 after they’d been together for 27 years — but the months after the surgery were riddled with challenges.
"From time to time, my body tried to reject the donor kidney, as it frequently happens after a transplantation," the singer explained. "Every so often, this required more hospital admissions."
"The doctors made it very clear that the consequences of my decision were irreversible."
Turner continued to suffer from nausea, dizziness and memory loss.
"I am on multiple prescriptions and take great care to follow my doctors’ orders meticulously, for I know that I can trust them and their therapies," she wrote.
Just two months after the Instagram post announcing her support of kidney health awareness and sharing her own story, Turner died in her Switzerland home.
What to know about kidney disease
Healthy kidneys have three key jobs, per the National Kidney Foundation (NKF). They remove waste products and excess fluid from the body, help to control blood pressure and play a role in producing red blood cells.
Kidney failure, also known as renal failure, occurs when 85-90% of the organs’ function is gone and they can no longer work on their own. This causes extra fluid and toxic waste to build up in the body, which can cause life-threatening conditions.
The two primary causes are high blood pressure, as was the case for Turner, and diabetes. Certain diseases, injuries and inherited disorders can also result in kidney damage.
In most cases, people don’t experience symptoms until they are already in renal failure.
Those include loss of appetite, fatigue, sleep problems, anemia, weakness, unexplained weight loss, itching, muscle cramps and swelling of the feet or ankles.
People in renal failure require continuous treatment to stay alive.
The two options for treatment are dialysis and a kidney transplant.
"The dialysis treatments or transplanted kidneys will take over some of the work of your damaged kidneys and remove wastes and extra fluid from your body," NKF states on its website. "This will make many of your symptoms better."
Other treatments may include medications, dietary restrictions, regular exercise and restriction of salt intake.
More than one in seven, or 15% of U.S. adults, have chronic kidney disease, according to the Centers for Disease Control and Prevention (CDC).
As many as nine in 10 adults with chronic kidney disease are not aware that they have it.
People 65 years of age and older are at higher risk of the disease, making up 38% of the cases, compared to 12% of those aged 45 to 64 and just 6% of those aged 18 to 44. | Disease Research |
WASHINGTON -- President Joe Biden announced Tuesday that the manufacturers of all of the first 10 prescription drugs selected for Medicare's first price negotiations have agreed to participate, clearing the way for talks that could lower their costs in coming years and give him a potential political win heading into next year's election.
The drugs include the blood thinner Eliquis, which the White House said was used by more than 3.7 million Medicare enrollees from June of last year through this past May and had an average out-of-pocket cost of $608 per enrollee for 2022. Also included is diabetes treatment Jardiance, which was used by nearly 1.6 million Medicare enrollees and had a 2022 out-of-pocket cost per enrollee of $490.
In all last year, 9 million seniors and other Medicare beneficiaries paid more than $3.4 billion on these 10 drugs alone, the White House said.
“For decades, drug companies in America made record profits while big pharma worked to block Medicare from being able to negotiate lower drug prices for seniors. In fact, Americans now pay two to three times more than people in other countries for the exact same prescription drug made by the exact same company,” Biden said in an online video from the Oval Office. "So, my administration finally took a step to change that."
How much prices could fall is not yet known. Prices negotiated for the first set of drugs participating won't go into effect until 2026.
Still, promises to lower prescription drug costs are a key part of Biden’s reelection pitch to voters — even as the Democratic president has so far struggled to convince the public that his administration’s policies have lowered health care expenses and cut other everyday costs. In announcing that price negotiations will go forward, Biden noted that the program was created under the Inflation Reduction Act, which Congress passed last year without any Republican support, and that major pharmaceutical companies have continued to work to stop Medicare from haggling over drug pricing.
The Centers for Medicare and Medicaid Services announced in August the first 10 drugs selected for the negotiation process and said manufacturers had until Monday to agree to participate and submit manufacturer-specific data.
But even with Tuesday's announcement, the process could still be complicated by lawsuits from drugmakers and sharp criticism from Republicans. Biden noted that the drug manufacturers' agreeing to participate followed a court decision allowing Medicare price negotiation plans to move forward.
“For many Americans, the cost of one drug is the difference between life and death, dignity and dependence, hope and fear,” Biden said in the video, "And that's why we'll continue to fight to lower health care costs and we will not stop until we finish the job.” | Health Policy |
This gene-editing therapy could cure sickle cell disease, and it’s close to FDA approval
A breakthrough treatment for sickle cell patients could soon become the first gene-editing treatment to be approved by the Food and Drug Administration (FDA).
Sickle cell disease (SCD) is an inherited blood disorder that affects roughly 100,000 Americans, most of whom are Black. The disease causes red blood cells to become sickle or c-shaped, clumping together and clogging blood vessels, causing pain and other complications.
There is only one approved treatment that can cure sickle cell disease: a bone marrow transplant in which a healthy donor offers stem cells that create red blood cells in the sick patient. In the vast majority of cases, the best donor is the patient’s fully related sibling, but even then, a sibling only has a 1 in 4 chance of being a match.
“Only about 18 percent, or less than 1 in 5 individuals, will have a suitable match. And the best match possible is a sibling who happens to have the same tissue type that they do, but only about less than 20 percent of sickle cell patients will have a sibling with an appropriate match,” said Alexis Thompson, chief of the Division of Hematology at Children’s Hospital of Philadelphia.
As a result, doctors and regulators are highly interested in a new treatment known as exagamglogene autotemcel (exa-cel), which was developed through a partnership between Vertex Pharmaceuticals and CRISPR Therapeutics.
This treatment takes a patient’s stem cells and edits them to produce more fetal hemoglobin, an abundance of which has been observed to cause red blood cells to not “sickle.”
“Gene therapy really becomes a really important option because the patient is their own donor,” said Thompson.
The idea of altering a person’s genes to potentially cure a disease sounds like science fiction, but gene therapy has been used more and more in medicine in recent years. More than 30 FDA-approved gene therapies are used to treat illnesses like cancers, hemophilia and certain degenerative disorders.
The FDA approved a gene therapy for thalassemia, an inherited illness similar to SCD, last year. Exa-cel is also indicated for this disease.
According to physicians, even with the addition of next-generation technology, the use of exa-cel is not too far off from what SCD transplant recipients already experience.
“Though they’re doing something novel in the space of fixing the problem in the cell, you’re still giving a transplant because you need to get those cells back in the body,” said Titilope Fasipe, co-director of the Texas Children’s Hospital sickle cell program.
“If you know anything about transplant, it’s not an easy therapy. It’s a therapy that requires intense medications and monitoring in the hospital. And then intense monitoring even after the transplant, but the goal is to cure the disease,” Fasipe added.
Before a patient can receive new bone marrow, they must first undergo chemotherapy to kill off the faulty cells. The same is done for patients undergoing exa-cel gene therapy.
Those who have undergone the gene therapy say the process was life-changing for them.
Victoria Gray, the first sickle cell patient to undergo exa-cel, told the FDA’s advisory committee on cellular, tissue, and gene therapies that the treatment freed her from constant hospital visits due to SCD-related pain events.
“Before this treatment, my entire childhood and adult life was plagued with severe pain, fatigue, numerous hospital stays and the fear of dying,” Gray said.
“After receiving this treatment, I no longer have pain and I no longer have to take opioids. I no longer have hospital stays or receive blood transfusions,” she said. “I get to participate with my kids and join them in their activities, when they play sports, cheer them on at their dance events and just be here and just to play with them, knowing that I no longer have to leave them to go to the hospital.”
There are still concerns, though, particularly regarding the use of CRISPR technology and the potential for off-target editing or unintentional genetic alterations.
Daniel Bauer, associate professor of pediatrics at Harvard Medical School and director of the gene therapy program at Boston Children’s Hospital, addressed these concerns to the FDA gene therapy committee last week.
Speaking on the potential hazards of off-target gene editing, Bauer said, “My guess is it’s a relatively small risk in the scheme of this risk-benefit, but it’s new and unknown but easily measurable.”
When asked if the risk could be “catastrophic,” Bauer acknowledged that given the millions of cells that are used in the process, there’s always a risk that one cell could mutate and cause leukemia.
“Has it been shown that an off-target effect of gene editing causes leukemia? No. Theoretically, could it? Yes,” said Bauer.
This concern has followed CRISPR throughout its history. According to Thompson, some off-target edits can be inconsequential, having no major effect whatsoever, but the possibility of inducing a malignancy is ever-present.
“There has been extraordinary effort put by not just by the sponsor but by people across the field to look for ways to mitigate or to reduce, or what some people call to de-risk CRISPR casts,” said Thompson.
Following the presentations from researchers last week, some of the FDA committee members concluded the potential benefits offered by exa-cel outweighed the risks, though others said they felt further study was warranted.
But as is the case with new medical advancements, not all those who can benefit will get to take part. According to the Sickle Cell Disease Association of America, the cost of exa-cel is estimated to be upwards of $2 million.
“My double-edged sword about all of this, about gene therapy, is that access is still going to be the biggest barrier,” Fasipe said. “I can stand outside on the street tomorrow and say, ‘Hey, I have a great treatment for sickle cell,’ and I will tell you I will not reach everybody with sickle cell disease. And that’s because the majority of people, especially adults with sickle cell disease, do not have access to comprehensive care by an expert who manages sickle cell disease.”
This advancement, however, still provides a degree of hope for the future of treating SCD and providing more people with a chance at living without the pain brought on by the disease.
Recalling a clinic visit with a few 3-year-old patients of hers, Fasipe said being able to talk about a better future for them gave her joy.
“I’m already happy on their behalf and what I tell families of children that young is that because the future is now, their child will get some version of a better tomorrow for sickle cell disease,” said Fasipe.
“If we fast forward in five years, I’m sure the technology will continue to advance, more options will be available. So, for a child in today’s world with sickle cell disease, living in the United States, there’s a lot of hope that even if they don’t get gene therapy in 2024, there is a more of a reality for them to get it sometime in their new future when they’re still a child.”
A decision on the approval of exa-cel is expected by Dec. 8.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Disease Research |
Like many people, you may not know how much a prescription costs until you get to the pharmacy. When you pick it up, you might be shocked by the high price.
Your doctor may prescribe a medication without knowing the out-of-pocket cost or whether your insurance will cover it. That's why it's smart to talk to your doctor if you think your medicine is too expensive.Â
âHigh prescription costs may not be on your doctorâs mind while prescribing certain medications,â says Kyle Manera, an executive with Co-Immunity, a patient organization in Wichita, KS, for people with chronic illnesses. Unless you bring it up, he says, you may end up with a prescription that costs more than you expect.
How Your Doctor Can Save You Money
In a recent survey, about 67% of people who talked to their doctors about prescription costs said they were able to find a less expensive drug.
âDoctors can help by prescribing generic versions of medications, 90-day supplies, or larger dosages that can be split into the correct dose,â Manera says. âThey may also be aware of different pharmaceutical programs that are there to help lower the cost of your prescriptions.â
Here are some ways your doctor can help lower your costs.
Prescribe a generic. Ask your doctor to prescribe a generic form of medication, if one is available for the drug you need. Generics have the same active ingredients as brand-name medications. And like brand-name medications, theyâre regulated by the FDA.
Using a generic form of medication can save a lot of money. It may cost up to 85% less than a brand-name version of the same drug.
Change your dosage. The cost of certain pills may be the same no matter the dosage. Ask your doctor if itâs OK to pay for a higher dose, then split the pills in half. For example, if your doctor recommends 25 milligrams per day, ask if they can prescribe 50 milligrams and you take half a pill a day. Many pills are even designed with a notch that helps you split them evenly.
This isnât always a good idea for all prescriptions, Manera says. Some drugs, such as those with time-release formulas, don't work the same when you split pills. Always clear this with your doctor first.
Change your medication. Ask your doctor if thereâs a similar, less expensive drug available that does the same thing as the more expensive one. Different medications that treat the same condition may have very different costs.
You might be able to do without some medication. In a 2017 survey, 70% of people who talked to their doctors about prescription costs were able to forgo at least one of their medications. But never stop taking a drug you're prescribed without talking to your doctor first.
Ask for a 90-day supply. One of the best ways to save money is to order a 90-day supply of your medication. You often pay less per dose when you buy a larger amount. This tactic may work well for a drug you take on a long-term basis.
âPurchasing a 90-day supply may be a little more up front, but over 3 months, it can save you a lot of money,â Manera says.
You can try a mail-order pharmacy that delivers a 90-day supply directly to your home. Some retail pharmacies also offer the option of a 90-day-supply.
Making fewer visits to the pharmacy can also save you time.
Use coupons. Ask your doctor if they have coupons available. Doctors often receive coupons from drugmakers. They may be for name-brand prescription medications or over-the-counter drugs.
Â
How to Talk to Your Doctor About Prescription Costs
A recent survey suggests that most doctors donât talk about prescription costs with their patients. If you donât usually talk about medication costs with your doctor, you may need to start the conversation.
You could feel awkward or embarrassed at first. If your appointments are rushed, you may feel like thereâs not enough time. But talking about your concerns, especially if youâre struggling with prescription costs, helps them understand your needs and give you better care.
âMedical providers are there to help you, not to judge,â Manera says. Having more affordable medications can help you stay on track and keep you healthy.
Before your visit, make a plan to bring up the topic of drug costs.
âBring an agenda or list of concerns to your appointment to ensure that you talk about everything youâre worried about, including prescription costs,â Manera says.
Ask your doctor to review your current prescriptions and see if there are ways you can save money. Let them know if any of your medications aren't covered by your insurance plan, or if your copay is unaffordable.
Ask questions like:
- Do you know the cost of this medication?
- Do I need to keep taking the medication Iâm currently taking?
- Do I need the new medication youâre prescribing?
- Is there a less expensive drug that may work just as well?
- Is there a generic version of this medication?
- Do you have coupons for this medication?
- Can you prescribe a medication that has a coupon and will work just as well?
- Do you have any samples of this medication?
- Can I get a higher dose of this medication, then cut it in half?
- Can you prescribe a 90-supply?
By helping you save money, your doctor can help you stay healthy.
Show Sources
Photo Credit: Tetra Image/Getty Images
SOURCES:
Ryan Kaufman, Kaufman's Insurance Solutions.
Kyle Manera, Co-Immunity Foundation.
Consumer Reports: âAs Drug Prices Increase, Quality of Life Goes Down,â âDoctors and Rx Prices: Ending the Silence,â âLower Your Drug Costs with These Six Hacks.â
University of Michigan National Poll on Healthy Aging: âDoctors and Pharmacists: An Underused Resource to Manage Drug Costs for Older Adults.â
Vermont Education Health Initiative (VEHI): âLetâs Talk about Rx Costs.â
FDA: "Generic Drug Facts." | Drug Discoveries |
Under-18s are coming from England to Wales for Botox as there is no law preventing it, campaigners have said.
Cosmetic Botox and lip fillers for under-18s were banned in England in 2021, but no such law exists in Wales.
Save Face, a group that has a register of qualified practitioners in the UK, said it had reports of under-18s coming to Wales to get round the law.
The Welsh government said it was aware of the regulatory gap with England and would do further work in the area.
Ruby David, 18, from Bridgend, wants lip fillers and said it was down to pressure from things such as social media.
It was only concern from her parents that stopped her from having them so far.
Despite this, she wants to see the law introduced in Wales to protect young people from "making mistakes". She told Wales Live: "Two or three years ago I probably wouldn't have cared as much as I do now. When I was 15 or 16, I was like 'oh whatever it doesn't matter - you only live once'.
"The older you are, the more you think about things. You think about the outcome, or what could happen."
Ashton Collins, director of Save Face, said treatments were becoming increasingly popular and there was a "crisis waiting to happen with young people".
Mrs Collins, who worked with MP Laura Trott to bring in the law in England, said she thought it would be a "no brainer" for Wales to follow suit.Â
She believes the risks involved in the procedures mean an age limit would avoid children having to deal with complications.Â
Since England's law change, she also said the organisation had taken calls about under-18s who had "literally just crossed the border and come to Wales and had these treatments done".
She added: "People only report to us when something goes wrong, so what we're seeing is literally the tip of the iceberg."
Age checks on lip fillers and Botox?
Save Face said it was told by one mother from Hereford that her 18-year-old daughter was among those who had travelled to Wales for treatment. Another from Bristol told the organisation her 16-year-old had lip fillers across the border.
She told Save Face: "She wasn't asked her age. I called the practitioner to complain but she just hung up on me."
BBC Wales Live called and messaged 10 clinics across Wales to see if they would book in a 17-year-old.
None asked for an age before offering an appointment, but were then told the patient was 17.
Seven declined the booking, two said they were unsure and would call back and one said, if a parent came along, they would carry out the treatment.Pharmacist prescriber Sophie Riddell works at clinics in south Wales and said under-18s contacted her for treatment but she would not book anyone under 21.
Now she said she felt "powerless" to stop teenagers going elsewhere and although she had not been contacted by any under-18s from England, she was "aware of it happening through conversations with younger patients".
"I feel like the Welsh government aren't really doing enough to aid patients' safety in this industry," she said
The Welsh government said Botox was a prescription-only medicine and the qualified prescriber was "responsible for ensuring the product is given safely and in accordance with accepted professional standards and in the patient's best interests".
It added: "We are aware that there is a regulatory gap in Wales in relation to these types of procedures and will be doing further work in this important area." | Medical Innovations |
Why our bodies fight flu better than cancer
Published: 6 November 2023
UofG Scientists at the Cancer Research UK Scotland Institute have discovered why the immune system is better at fighting flu than fighting cancer
UofG Scientists at the Cancer Research UK Scotland Institute have discovered why the immune system is better at fighting flu than fighting cancer.
It was already understood that the human body does not always recognise the major threat cancer presents - but the reasons why have been less clear.
Now, the team of researchers in Glasgow has been able to identify the part of the immune system which often prevents it recognising cancer as a threat but which allows it to perceive the danger posed by flu. It is hoped the discovery, published in Science Immunology, could lead to new treatments which boost the immune response so it fully activates and tackles cancer with greater strength.
Each year around 34,100 people are diagnosed with cancer in Scotland. With around 16,300 Scots sadly losing their lives to the disease annually, finding new ways to tackle it is vital.
The Cancer Research UK team used a flu virus and a type of skin cancer that had spread to the lungs to examine how the immune system in mice reacted to both.
They found that while the immune system reacted vigorously to the flu virus, it did not fully activate against the cancer.
They specifically looked at cells in the immune system of mice - called dendritic cells - which also exist in humans. There are two types of dendritic cells, one which exists in the cells which become tumorous and those which live in the lymph nodes (a key part of the immune system).
Once the cancer begins, the dendritic cells in the cancer move towards the lymph nodes, but once there, they do not give out the same level of danger alert to the dendritic cells in the lymph nodes as they do when the flu virus is present.
This means the immune system sees the level of threat from the cancer as the same as a minor injury, such as a small cut, and only activates in a low level way.
Lead researcher, Dr Ed Roberts of the Cancer Research UK Scotland Institute and the University of Glasgow, said: “We looked at cancer which had spread to the lungs as it affects the same organs which are affected by flu for the best comparison. We wanted to see how the immune system coped with the different threats and we saw that the alarm system didn’t activate as strongly as it did for the flu.
“Knowing that the emergency signals get stopped in the part of the process which the dendritic cells are responsible for, could allow new immunotherapies to be created which boost the immune system so it does attack the cancer, or activate the alert system itself.
“This could allow cancers to be caught at an early stage and tackled by a patient’s own immune system rather than harsh treatments which are necessary at a later stage when the cancer has grown and potentially spread to other parts of the body.”
Although the research examined skin cancer that had spread to the lungs, how the immune system reacts to the cancer was the focus and therefore the results could be applicable to a variety of cancer types.
Dr Catherine Elliot, Director of Research at Cancer Research UK, said: “The immune system is a growing focus of cancer research and this exciting research could help us find ways to help our own bodies fight cancer more vigorously.
“This discovery could help us tackle cancer in its early stages and prevent it developing, spreading and even starting in the first place.
“Further research in this area will be needed but immunology studies such as this could be key to how we treat cancer in the future.”
The next step for the research will be to further examine how the immune system communicates, how it receives signals alerting it to threats and how it understands how significant the threat is.
Further studies will also demonstrate whether the exposure of the immune system to the threat is a factor in how much, or how little, it reacts.
The paper, “Co-transfer of antigen and contextual information harmonises peripheral and lymph node cDC activation,” is published in Science Immunology.
Enquiries: [email protected] or [email protected] / 0141 330 6557 or 0141 330 4831
First published: 6 November 2023 | Disease Research |
Exercise -- No pain, no gain, right? Not when you live with migraine. For you, exercise can be a double-edged sword. Some physical activity can trigger symptoms. But sweating it out on a regular basis could help you get migraines less often. You just have to know how to do it.
When Exercise Helps
In a study of more than 4,500 people with migraine, those who managed to get at least 2 1/2 hours of moderate to vigorous exercise every week got fewer migraines than those who moved little or not at all. People got benefits from brisk walking, biking, jogging, and even heavy cleaning -- if thatâs what you're into.
Whatâs more, your sweat sessions release endorphins and other chemicals that directly affect pain. But much of their benefit may be indirect.
âWhile stress is the number one trigger for migraines, sleep issues are a close second,â says Julia Jones, MD, a neurologist at Houston Methodist Hospital. âCardio helps you sleep better and cuts stress, so, in most migraine patients, exercise helps.â
Physical activity can also help you lose or maintain your weight, and studies show that keeping a healthy weight reduces attacks.
When Exercise Hurts
So whatâs the downside of a workout?Â
A number of things that happen at the gym or while you work out possibly could set off an attack.Â
âOverexertion, bright lights, heat, dehydration, or a strenuous workout might tip a patient into a migraine," Jones says.
Active overhead lifting and pushups may not be a good idea for people who get migraines, says Stephen Corvini, PT, DPT, a physical therapist at Montefiore Medical Center in New York City. High-intensity or strenuous upper-body activities might be a trigger, he says, because they might raise your blood pressure too high.
Rather than pushups, try planks or chest presses with dumbbells.
Find the Sweet Spot
It may take a little trial and error, says Jessica Schwartz, a spokesperson for the American Physical Therapy Association, but you can find that sweet spot for working out with migraine. Try these tips.
Start out slow. If you get migraines, "light to moderate exercise is usually very safe,â Corvin says.
Trade high-intensity activities for lower intensity options. That could be brisk walking, swimming or biking on a flat surface. Limit interval and CrossFit training to no more than once a week, Corvini adds.
Donât get your heart rate too high if youâre exercise-sensitive. If youâre especially sensitive to exercise, you may need to keep your heart rate under 60% of its max, Schwartz suggests. How can you tell? Use this formula: (220 - your age) x .60 = 60% of your max heart rate. So, if you are 45, you want to shoot for no more than 105 beats per minute when you work out. You can check your pulse with your fingers or use a heart monitor while you sweat. If your heart rate gets too high, tone the workout down.
Avoid triggers when you work out. If light sets you off, get it done in the early morning or late afternoon and wear sunglasses. Avoid gyms with those blinding overhead lights. If lack of sleep is an issue, make sure you work out after a good nightâs rest.
Normalize your routine. âEat, sleep, and exercise at the same times each day,â Jones advises. This helps maintain your bodyâs natural equilibrium, which can help fend off migraines.
Fuel your body. Stay hydrated and eat protein about an hour and a half before you hit the gym, pool, or pavement to keep your blood sugar stable.
Talk to your doctor. Before you start an exercise routine, talk with your doctor. Make sure your symptoms really are migraine and not another health condition. | Stress and Wellness |
Recent research has found that young individuals with autism not only experience heightened daily stress but also tend to employ less effective emotional regulation strategies compared to their non-autistic peers. This study, published in the journal Autism, provides a deeper understanding of the daily emotional landscape faced by those with autism.
Earlier studies have consistently shown that individuals with autism often report higher levels of stress and are more likely to encounter adverse experiences, such as bullying, compared to non-autistic individuals. These increased levels of stress can contribute to a range of mental health issues, including anxiety and mood disorders. Recognizing these challenges, researchers aimed to delve deeper into how autistic adolescents and young adults react to daily stressors, particularly focusing on their emotional responses and coping strategies.
“Autistic individuals are shown to have increased likelihood of developing mental health difficulties during the lifespan, so possible risk and protective factors are important to identify,” said study author Laura Ilen, a PhD student in clinical psychology at the University of Geneva.
“Increased affective reactivity to daily-life stress has been shown to be a vulnerability factor for negative evolution in several clinical populations, which is why we were interested in investigating the topic in adolescents and young adults with autism too. Moreover, to better understand the role of emotion regulation and how clinical interventions could be targeted, one of the study’s interests was to investigate the link between cognitive emotion regulation and affective responses to daily-life stress.”
The study involved a meticulous and detailed methodology to gather accurate data. A total of 94 participants were involved, comprising 39 autistic individuals aged between 12 and 29 years and 55 non-autistic individuals aged between 12 and 26 years. The autistic participants were recruited through clinical centers and family associations in Switzerland and France, ensuring a diverse and representative sample. On the other hand, the non-autistic participants were sourced from the local community in Geneva and from an ongoing study of typically developing individuals.
To measure stress and emotional responses, the study used a technique called Ecological Momentary Assessment (EMA). This involved participants receiving notifications on their smartphones eight times a day for six consecutive days to complete questionnaires about their current feelings and the stressfulness of their activities. This method provided real-time data on the participants’ emotional states in their natural environments, offering a more nuanced understanding of their daily experiences.
The results showed that autistic participants reported higher levels of negative emotions, such as sadness and anxiety, in their day-to-day lives. They also experienced significantly higher levels of stress related to social interactions and daily activities, although there was no significant difference in stress related to specific events. Interestingly, the study revealed that autistic individuals found social events less pleasant than non-social events, suggesting a heightened sensitivity to social stressors.
A particularly notable finding was the increased reactivity of autistic participants to stress related to daily activities. This suggests that routine tasks and obligations may be more emotionally taxing for individuals with autism. Additionally, autistic females exhibited higher stress reactivity to these daily activities and events than autistic males, pointing to possible gender differences in stress responses within the autistic population.
The researchers also explored cognitive emotion regulation – the strategies individuals use to manage and respond to their emotions. Cognitive emotion regulation strategies are mental techniques that people use to manage and influence their emotional responses to situations.
It was found that autistic participants used less adaptive strategies, like positive refocusing and planning, and more non-adaptive strategies, such as rumination and self-blame. This pattern could contribute to the higher levels of stress and negative emotions observed in this group.
“We showed that autistic adolescents and young adults report increased perceived stress in the flow of their daily lives compared to their non-autistic peers, which highlights the importance of reducing stressors in the context of daily life, for example through environmental adjustments,” Ilen told PsyPost. “Autistic participants also reported more difficulties in regulating their emotions (e.g., more frequent use of rumination).”
“These emotion regulation difficulties increased negative emotions in relation to daily stressors and might contribute to the severity of mental health symptoms. Therefore, our results suggest that to prevent stress-related negative emotions and mental health symptoms in young people with autism, clinical interventions could focus on stress management skills and strategies that youth use to manage their emotions when faced with daily stressors.”
Positive refocusing involves shifting one’s focus away from a negative or stressful situation and directing attention towards positive aspects or experiences, while planning as a cognitive emotion regulation strategy involves thinking about how to cope with a stressor or challenge in a constructive way. On the other hand, rumination is a maladaptive cognitive emotion regulation strategy that involves repeatedly thinking about distressing situations, feelings, or thoughts, while self-blame involves attributing personal responsibility, often unfairly or irrationally, for negative events or outcomes.
For participants without autism, the use of adaptive emotion regulation strategies was found to weaken the link between event-related stress and negative emotions. However, this moderating effect of adaptive emotion regulation strategies was not observed in participants with autism.
“We showed that the use of ‘non-adaptive’ emotion regulation strategies increased autistic participants’ negative emotions in relation to daily stressors, as expected,” Ilen explained. “In contrast, more frequent use of ‘adaptive’ emotion regulation was not associated with affective reactivity to stress and was therefore not a protective factor against negative emotions when faced with stress, as might have been expected. This could possibly be explained by the fact that we only investigated cognitive emotion regulation, and not other types of strategies that youth with autism might use.”
While the study offers valuable insights, it’s important to approach these findings with some considerations in mind. One limitation of the study is its reliance on subjective self-reports, which can vary significantly from person to person. Also, the study’s participants were verbally fluent and mostly had average or above-average intellectual functioning, which means the results may not apply to all individuals on the autism spectrum. Moreover, the study’s cross-sectional design means that it can highlight correlations but cannot conclusively prove cause-and-effect relationships.
“As the study design was cross-sectional, we could not make any causal interpretations about the association between affective reactivity to stress and mental health symptoms,” Ilen said. “Future longitudinal studies are needed to determine whether increased stress reactivity can predict later mental health difficulties in autistic youth and adults.”
The study, “Cognitive emotion regulation difficulties increase affective reactivity to daily-life stress in autistic adolescents and young adults“, was authored by Laura Ilen, Clémence Feller, and Maude Schneider. | Mental Health Treatments |
A one-to-one-video call service that was brought in during lockdown to support people with eating disorders is being stopped. One person has said the service saved her partner's life, while a 19-year-old has said she is now worried for the future.
Funded through the Avon and Wiltshire Mental Health Partnership (AWP), the trust said that it was only ever meant to be temporary and they are bringing in new services which will provide improved care.
Tia is sat in the kitchen with a laptop set up in front of her.
She is on a daily call with her nurse who is counting her down from five to one.
At one, Tia pulls back the lid on a rice pudding.
The nurse reassures 19-year-old Tia, from Yate, and encourages her to eat.
Tia has been receiving these calls for around a year, but at the end of March, the Eating Disorder Home Care (EDHC) service is due to stop.
Warning: This article contains an image some readers might find upsetting
Three years ago, Tia was studying at school and playing rugby, but she said she was bullied for being "bigger" and had body image issues.
When lockdown came in March 2020 she decided she wanted to come out of it "brand new".
She lost a lot of weight and people complimented her on her new look, but before long it "spiralled out of control," she said.
Tia's brain and body were massively undernourished. She was cold all the time, losing her hair, bruising easily and could not sleep properly.
In 18 months she said she lost half her body weight.
Tia was in and out of hospital "so many times I lost count" and there were serious concerns about her heart, which had shrunk in size.
Tia spent days hooked up to hospital machines. "They were really dark days - we were told she was dying," mum Jo said.
Jo was contacted about the EDHC service, which she was keen to take up, and Tia was sent home under their care.
"I am so thankful that they came to my mum and asked my mum, because I know I may not have taken it up... it has changed my whole life," Tia said.
"They have got me through so many hard moments... and have been there every step of the way."
Video calls would take place up to six times a day, during which a specialist would guide patients through eating snacks and meals.
Without them, Tia said she just would not eat.
"I just can't do it by myself. I really struggle and that is something me and my therapist are still working on," she said.
Tia's family said the service has kept her out of hospital - with the nearest available inpatient space being in Manchester. It also allows her to be supported at work and while on holiday.
Jo added: "I genuinely don't know what we would have done without them.
"The opportunity for her to be able to stay at home, us stay as a family... was everything really.
"There were so many days that we would have ended up at A&E because we were exasperated.
"We couldn't do it by ourselves. It has given us our life back."
Now EDHC is ending, Jo said she is worried about what the future may look like.
"I'm really worried that there doesn't seem to be a plan in place," she said.
"We've not had a conversation at all and it is only next month."
The service was set up in the winter of 2021 and had 43 referrals, although only about half stuck with the programme.
Currently, it has about nine people using the service ahead of its closure in March.
AWP said the temporary service was brought into Bristol, North Somerset and South Gloucestershire (BNSSG) at a specific time, to deal with specific problems - including a shortage of staff, a lack of inpatient beds and the fact lockdown meant they were unable to visit patients in person.
It added that while it is pleased the calls have been helpful to some, it also risks creating dependency rather than treating the causes of the eating disorder.
AWP said it has now increased its eating disorder team staff from 10 to 40 and brought down its waiting list from 400 people in July last year, to just over 100, allowing it to now provide better, evidence-based, support.
But now on her way to recovery, Tia said she is worried for anyone else that has recently been diagnosed.
"EDHC has been vital to my recovery. They are the people I trust the most and they believe in me," she said.
"When things do get hard, I'm not going to have them there. It's just a bit daunting and I don't think it has really sunk in yet.
"I'm also upset that some people aren't going to get the same opportunity as me to recover in their safe place, at home.
"The fact that so many other young people and adults that can't do it themselves are going to have to in the future [is upsetting]."
Sally Monkhouse, 74, said she is "devastated" the service is ending.
Her partner has had anorexia for more than 60 years and has also been receiving support through the EDHC.
She said the loss of the service is going to have a big impact on both her partner and herself.
"My partner has given me permission to say they wouldn't be alive today if it wasn't for this wonderful, wonderful service," said Ms Monkhouse, who lives in Chew Valley.
"What is so special about it is people can go on living their lives whilst they're being healed, they're living in their homes, they are being treated in their homes, they can continue education, parents can continue parenting their children safely, people can earn a living while they are doing it.
"I think it is a transferable model, it could go into all sorts of areas of mental health and I think this is a real missed opportunity and I really hope that they look at it again."
'Richer programme'
AWP said EDHC was brought in whilst wider improvements to the eating disorders services were being developed, including a new early intervention programme.
It is now seeing all urgent patients within two weeks, with everyone referred assessed within four weeks.
This has allowed it to provide more tailored support for individuals, significantly reducing the need for EDHC, it said.
A spokesperson added: "We really don't want people to be on intensive meal support for any length of time.
"It was only meant to be brief intervention and what will now be in place is actually a much richer programme that is addressing the underlying factors which is what meal support in itself can not do."
Support offered will include psychological therapy, occupational therapy, dietetic appointments and a level of meal support which will help people work towards independence and recovery. | Mental Health Treatments |
Dozens of young autistic people have died after serious failings in their care despite repeated warnings from coroners, BBC News has found.
Our investigation found issues that were flagged a decade ago are still being warned about now.
The government says £4.2m is being invested to improve services.
Two bereaved mothers told us lessons had not been learned by their local health authority after the deaths of their teenage sons, two years apart.
The coroner who oversaw both cases, noted a repeated failure in care.
After the first death, the coroner criticised NHS Kent and Medway for "inadequate support" and said a similar incident may happen if this continued.
Two years later, the second autistic teenager died under the care of the same authority.
The same coroner found that had the 15-year-old received the recommended level of care, he might have got the therapy he needed.
In the first piece of research of its kind, the BBC combed through more than 4,000 Prevention of Future Death (PFD) notices delivered in England and Wales over the past 10 years.
Coroners are legally required to issue such warnings at inquests, if they believe there is a risk future deaths will occur unless action is taken by the authorities responsible. But there is currently no legal duty for them to act.
The lack of oversight means that it is very difficult to see if action was taken and if it had any impact. The majority of the authorities' responses to the PFDs have no clear timelines.
The BBC identified 51 cases where PFDs described serious failings in the care of autistic people, and health and social care bodies were urged to take action to prevent future deaths.
The majority of those who died were under 30, and nearly a third were children.
Former Justice Secretary Sir Robert Buckland described the BBC's findings as "deeply disturbing", and called for the government to investigate urgently.
Life expectancy for autistic people is - on average - 16 years less than for the general population. There is no clear reason for this - people do not die of autism, it is a neurological condition that affects how people interact with others, learn, and behave.
The causes of death in the inquests varied, but nearly half were categorised by coroners as relating to mental health or suicide.
Our research identified five key concerns repeatedly flagged by coroners over the past decade:
- A lack of trained staff with an understanding of autism
- Failure to treat autism and mental health problems as two separate conditions
- Shortage of specialised accommodation
- Lack of a health professional to co-ordinate the young person's care - as recommended in NICE guidelines
- Late diagnosis of autism
The charity Autistica says our research helps explain the avoidable reasons why many autistic people are dying young.
Sir Robert, who heads the all-party parliamentary group on autism, says there is clearly a "mounting concern".
"Lessons are not being learned. Fifty-one [deaths] is a lot. It suggests a systemic problem."
The two mothers, whose autistic sons died as teenagers, say they are "tormented" by the lack of accountability.
The deaths of Sammy Alban Stanley, 13, and Stefan Kluibenschadl, 15, each resulted in a PFD being issued. The boys had gone to the same school and died in the same hospital.
It was while Stefan was in intensive care - two years after Sammy's death - that Emma Kluibenschadl got in touch with Patricia Alban Stanley.
To lose a child, they agree, is a life sentence. And to know there was a chance that the deaths could have been prevented is "torment", says Ms Alban Stanley.
Sammy fell from a cliff near his home in Ramsgate, in April 2020. Witnesses reported his last words were: "I'm autistic."
"He meant 'Please help me'," his mother says.
As well as being autistic, Sammy had Prader Willi Syndrome (PWS), a rare neurological condition, which left him unable to regulate his emotions.
"It would be impossible to stop him at times," says Ms Alban Stanley. "He had no concept of danger. He would try to jump out of moving cars, or on one occasion he put needles up his nose."
Ms Alban Stanley - who has three other children and no partner - says she "begged the council for more support" and was "struggling to cope". Her safety net was the police, she says. She called them at least 29 times.
Their GP, senior social workers and the police also made many referrals calling for more support. "But it made no difference," says Ms Alban Stanley.
After six years, she was finally granted two hours of after-school care in January 2020. But it wasn't enough - Sammy died just three months later.
Without extra help, his mother couldn't stop him from leaving the house. Blind to the danger the nearby cliff posed, he fell. He died four days later in intensive care, in his mother's arms.
In her Prevention of Future Death notice to NHS Kent and Medway, coroner Catherine Wood said Sammy fell during an "episode of high risk behaviour" and criticised the local authority and mental health services for "inadequate support".
She also made it clear that it was "predictable that a similar incident may arise⦠if children with complex neurodevelopmental needs are excluded from accessing the care and treatment they require to keep them safe".
Kent and Medway responded to the coroner's PFD saying it was investing in services for children and young people with neurodevelopmental needs - and would make sure care was "co-ordinated rapidly around the child and family".
A few miles away, in Margate, Emma Kluibenschadl and her family were battling with the same health officials. Nearly two years later, the coroner's stark prediction would come true.
Ms Kluibenschadl's son Stefan was struggling with his mental health. He had been bullied for being autistic and spent many years watching his family try to get the help he desperately needed.
She believes this had a profound effect on her son, who felt nobody cared.
The family have battled with support services since he was diagnosed at the age of six. Stefan really began to struggle with his mental health six months before he died.
Despite their GP making referrals, the family's pleas for help were rejected by NHS Kent and Medway.
Just over a month after their final application for autism-specific counselling was turned down, Stefan was found hanging. He died four days later in intensive care.
"Stefan didn't get any care - never mind co-ordinated care," says Mrs Kluibenschadl. She thinks if they had received support they wouldn't be in this position now.
"Our lives have been destroyed."
Coroner Catherine Wood - who also oversaw Sammy Alban Stanley's inquest - said Stefan had died as a consequence of his own actions but she could not be sure of his intention.
She addressed her concerns to NHS Kent and Medway again - highlighting that the trust had not been following NICE guidelines, which state that every autistic child should have access to a designated key worker.
With such a health professional overseeing his care, Ms Wood said Stefan might have received the therapy he needed.
Sammy's and Stefan's stories are stark examples of a national problem.
Kent and Medway is one of 11 local health and social care authorities to be sent multiple PFD notices in the past 10 years. Twenty-one national authorities also received warnings.
Reports about "potentially life-saving recommendations for change" should be treated with the utmost seriousness, says Deborah Coles from the charity Inquest.
"The current system is simply not fit for purpose, and that betrays bereaved people. But it also betrays the public interest because it puts all of us at potential risk."
For Sir Robert Buckland, the ramifications are huge. "What is the point of PFDs if there is no accountability?" he says. "Autistic people carry on having to put up with poorer life outcomes."
The Department of Health and Social Care says a national autism training programme is being rolled out.
In a statement to the BBC, the chief nursing officer at NHS Kent and Medway, Allison Cannon, apologised on behalf of the NHS for the "tragic loss" of both Sammy and Stefan.
Many changes had been made, she said, including enhancing its community support and key worker programme to improve services. | Mental Health Treatments |
A war of words played out over the first two years of the pandemic. On one side were commentators and scientists opposed to any form of social restriction as a way of keeping infection rates down. On the other, those who argued the government should be pursuing a “zero Covid” policy to eliminate the disease at all costs. Caught between this tug of war were the majority of scientists and the British public.
Sometime last summer, those debates melted into the background with the promise of a “to be continued…” when the statutory inquiry into Covid eventually starts to publish its findings. But the second season of Lockdown Wars has been thrust on us sooner than expected after the Telegraph obtained more than 100,000 pandemic WhatsApp messages. They were passed on by the journalist Isabel Oakeshott, who was granted access to them by Matt Hancock while she was co-authoring the former health secretary’s pandemic diaries. She has argued that the public interest in releasing the messages justified breaking her non-disclosure agreement.
Oakeshott has described pandemic social restrictions as a “reckless overreaction” and “monumental disaster” and universal vaccine rollout as “one of the most extraordinary cases of mission creep in political history” and has been clear that she chose the Telegraph because of its anti-lockdown editorial stance. So it’s perhaps little surprise the paper is combining news reports of these messages with columns from prominent lockdown sceptics – Nigel Farage and Rachel Johnson among others – claiming they prove they were right all along.
While this risks creating the perception that the Telegraph might be selectively releasing messages to shore up its preferred narrative that social restrictions were a case of ideology trumping evidence, it’s notable that there isn’t – yet – anything that really supports that view. But there are plenty of messages that fit in with what we already know, for instance that some cabinet ministers – most notably Rishi Sunak – strongly opposed restrictions. So far, the Lockdown Files echo a previous investigation by the same paper, but with a crucial difference – it is as if the Telegraph had published its explosive 2009 MP expenses revelations, but packaged them with a set of opinion columns arguing – against the evidence – that this was all a problem of one party only.
But the story demonstrates one thing beyond question – that it was wrong for the government to kick the assessment of its Covid record into the long grass by setting up a statutory inquiry that would take years to report. There are two questions to which we deserve an answer. First: were the decisions taken in the battle with Covid the right ones? And second: how were those decisions taken and who was responsible for any mistakes made? Both are important for learning lessons from the pandemic, but the first can be answered relatively speedily. In fact, there were calls – backed by the Observer – to conduct rapid reviews of what went right and wrong just a few months into the pandemic. Other countries have already published the results of such reviews.
Beyond reinforcing a lot of what we already know about the main characters – such as Hancock is a walking self-destruct button – the Telegraph leaks are really about the second question. The truth is we don’t need a big cache of leaks to understand what the government got right and wrong; there is plenty already out there for a rapid inquiry to draw on. The balance of evidence shows that government-imposed restrictions that reduced people’s social contacts cut infection rates and saved lives. It also suggests that countries that acted more quickly to impose social restrictions did a better job of protecting the economy. Allowing the virus to spread uncontrolled would have incurred substantial economic costs.
These broad headlines disguise important contextual differences. A country such as Peru struggled to enforce its strict lockdown and ended up with a higher death rate than neighbours that had less strict measures. The case of Sweden – the darling of anti-lockdowners – is nuanced. Sweden only really deviated from similar countries in the stringency of its social restrictions in the first Covid wave and even then it imposed some measures. Its Covid mortality rates were significantly worse than its Nordic neighbours and while the Swedish Covid commission concluded that its government was right to focus on requests rather than mandates to avoid social contact – and levels of compliance with these requests were generally very good – it said it should have taken faster and stronger action to slow the spread of Covid in the first wave, such as closing restaurants.
The evidence about impact on lives and the economy isn’t by itself sufficient, however: different social restrictions inflicted different types of cost. The lifelong heartbreak of knowing your beloved parent died alone is different to the impact of not seeing friends for a few weeks. Children missing out on months of school is of a different order to being prevented from enjoying live music.
Why did the government reopen pubs before schools? Why did it do so shamefully little to mitigate the impact of school closures in the first wave? Why did it not learn the basic lesson of the first wave – that acting too late in the case of an exponential virus means not just more deaths but more economic damage – and apply this in the second wave even as it was getting ready to roll out a vaccine that would eventually reduce the need for restrictions? What actions could it have taken to blunt the cruellest impact of the first-wave restrictions? Was it necessary to give the police such draconian powers to enforce regulations when public compliance, apart from in Downing Street, was generally very good?
In trying to shoehorn the WhatsApp leaks into their own ideological narrative, the Telegraph’s anti-lockdowners obscure these important questions. We urgently need a rational assessment of what the government got right and wrong, based not just on scientific evidence but on how the response aligned with the values of citizens, the vast majority of whom still think the government either got the balance right overall on social restrictions, or didn’t go far enough, and who will have their own views on the specific trade-offs involved. The longer we go without it, the more we will see ideologues trying to fill the gap. | Epidemics & Outbreaks |
Oct. 27, 2023 â The virus that causes COVID-19 is adapting again, and the variant of Omicron known as BA.2.86 has a new mutation called JN.1, prompting experts to urge us all to remain calm but vigilant.
The coronavirus is constantly mutating to survive the growing antibody pushback it encounters as our bodies learn how to fight it after vaccinations and infections.
Variant BA.2.86 is a concern because of the extensive array of mutations in its spike protein, David Ho, MD, from Columbia University in New York City, and his team point out in their new lab report published this week in the journal Nature.
The worries are reminders of when the first Omicron appeared, they said.
Even though there is less COVID surveillance happening these days, sequences of BA.2.86 â nicknamed Pirola by some scientists â have already been found in 28 countries around the world since August.
With so little monitoring, experts suspect there are more cases circulating than they've been able to confirm.
With more than 40 new mutations already tallied, the new one called JN.1 has been found in France, Portugal, the United Kingdom, and the U.S., among other nations. New derivatives called JN.2 and JN.3 are also cropping up.
The virus is evolving, says virus tracker Rajendram Rajnarayanan, PhD, from the New York Institute of Technology at Arkansas State University. And, "This is the top dog binding better."
We won't know for a few weeks whether the new variants will be linked to a significant rise in COVID cases or how well immune systems will respond.
"If we had an alert system, I would call this an amber alert," Rajnarayanan said. "It's not an urgent, red alert at this time, but the amber alert is definitely a wake-up call to remind us it's time to pay attention again."
An Amber Alert
In much the same way people already rely on meteorologists to understand Earth's atmosphere and warn of severe events like hurricanes, wildfires, and snowstorms, Rajnarayanan says this is what we are learning to do to help people navigate infectious diseases in their communities.
In the United States, the HV.1 variant, also part of the Omicron group of variants, is currently leading in new COVID infections.
And in the battle between our bodies and the coronavirus, we've already come a long way since the beginning of the pandemic. So many people have some level of immunity from prior infection, vaccines, or both, that scientists monitoring wastewater aren't seeing a rise in infections or COVID-related hospitalizations in the U.S. now.
"But these mutations are popping up fast," Rajnarayanan said. "And it makes sense to monitor them closely. This is also a good time to add more COVID testing and reporting of positive and negative results," he said.
Scientists are already detecting JN.1 in U.S. airports, he said.Â
And if you haven't gotten an updated vaccine yet, it would be a very good idea to go ahead, said Eric Topol, MD, executive vice president of Scripps Research and editor-in-chief of Medscape.
This is especially important for older people or those who are immunocompromised, he said. In the U.S., the vaccines are approved for all age groups 6 months and older. "It will rev up our immune system, including cellular immunity to enhance protection," he said.
And, of course, preventing infections using public health measures will help work against all strains of the coronavirus and other respiratory viruses that are circulating now, including the flu and RSV.
"What I think we're seeing now is a transition of the virus," said Andrew Pekosz, PhD, a virologist with Johns Hopkins University in Baltimore. "My hope is that we are watching this virus become seasonal."
A shift, Pekosz said, that might make it easier for COVID vaccines to be updated annually in much the same way we update flu shots each year to target circulating strains.
Next Steps
This year, people are getting the XBB-targeted COVID shot, and next year's updated vaccine could focus on another variant, like the JN.1 we are seeing rise now, for example.
Topol said the coronavirus will keeping finding new ways to evade our immune response and become more transmissible to continue infecting us again and again. Thatâs why he'd like to see new vaccines protect us from what he calls the "relentless evolution of the virus."
He is calling for nasal vaccines that would block entry to the upper airway, which could stop infections in a way we haven't be able to so far. And a new pan-coronavirus vaccine could target all variants at once, offering more protection. "If we had a vaccine â nasal or even shots â that were completely variant-proof, then we wouldn't have to worry about any of this stuff,â he said. | Epidemics & Outbreaks |
Courtesy NIAID CNN — Public health officials says they have found two cases of gonorrhea that appear to have reduced susceptibility to every kind of antibiotic available to treat them. It’s the first time strains of gonorrhea this resistant to antibiotics have been identified in the United States. Increased sexual activity during the pandemic, coupled with fewer people getting routine health screenings, supercharged the spread of sexually transmitted infections around the world. Those infections, including gonorrhea, are becoming increasingly resistant to antibiotics available to treat them, a problem that is becoming a dire threat to public health. Globally, infections that are resistant to antibiotics kill approximately 700,000 people each year. That number is expected to rise to 10 million deaths per year by 2050 if steps aren’t taken to stop the spread of resistant organisms. Experts say it was never a question of when this highly resistant gonorrhea strain would reach the US, but when. “The concern is that this particular strain has been circulating around the world, so it was only a matter of time before it would hit the US,” says Dr. Jeffrey Klausner, a clinical professor of public health at the University of Southern California’s Keck School of Medicine in Los Angeles. “It’s a reminder that gonorrhea is becoming increasingly resistant, increasingly hard to treat. We don’t have any new antibiotics. We haven’t had new antibiotics to treat gonorrhea for years and we really need a different treatment strategy,” said Klausner, who sits on the CDC workgroup for gonorrhea treatment. Gonorrhea is sexually transmitted, and one of the most commonly diagnosed infections in the US. It is caused by the bacteria Niesseria gonorrhoeae, which can infect the mucous membranes in the genitals, rectum, throat and eyes. People can be infected without having symptoms. Left untreated, the infection can cause pelvic pain and infertility in women and blindness in newborns. In addition to reduced susceptibility to ceftriaxone, the strains of gonorrhea identified in Massachusetts also showed reduced susceptibility to cefixime and azithromycin; the strains were resistant to ciprofloxacin, penicillin and tetracycline, according to a clinical alert sent to physicians by the Massachusetts Department of Public Health. The MDPH says it hasn’t yet found any connection between the two cases. In 2021, the US Centers for Disease Control and Prevention recommended giving a double dose of the antibiotic ceftriaxone in an effort to overcome the bacteria’s building resistance to this antibiotic, and that seems to have worked in these cases, but that antibiotic is the last line of defense against this infection, and experts say a new approach is needed. Klausner is hoping to win FDA approval for a test that would tailor antibiotic treatment to the genetic susceptibilities of the particular strain of gonorrhea that is infecting a person. This is called resistance-guided treatment, and Klausner says it works for HIV, TB and some other hospital acquired infections, but it’s never really been tried for gonorrhea. This strain of gonorrhea has been previously seen in Asia-Pacific countries and in the United Kingdom, but not in the US. A genetic marker common to these two Massachusetts residents was also previously seen in a case in Nevada, though that strain retained sensitivity to at least one class of antibiotics. The first symptoms of gonorrhea are often painful urination, abdominal or pelvic pain, increased vaginal discharge, or bleeding between periods, but many infections are asymptomatic, according to the CDC, making routine screenings important for catching the infection. | Disease Research |
WASHINGTON -- Federal officials on Tuesday called for more testing and research on xylazine, the powerful animal sedative that’s spreading through the nation’s illicit drug supply, but they stopped short of recommending new restrictions on the veterinary medication.
A six-point plan from the White House's drug control office aims to scale up testing, treatment and efforts to intercept illegal shipments of xylazine, which is being mixed into fentanyl and other illicit opioids.
The White House declared xylazine-laced fentanyl an “emerging threat” in April and called for a national strategy to combat its use. Xylazine, sometimes known as tranq, can cause breathing and heart rates to fall to dangerous levels when used in humans. When injected it can cause large open sores and infections, sometimes leading to amputation.
In the report released Tuesday, drug czar Dr. Rahul Gupta said administration officials will “explore” making xylazine a scheduled drug, subject to regulatory restrictions similar to opioids and amphetamines.
While some states have already scheduled the drug, those efforts have faced pushback from veterinarians, farmers and others who regularly work with it. Federal scheduling limits how drugs can be prescribed, dispensed and stored. Several bills in Congress aim to tighten use of xylazine without limiting its legitimate use in sedating horses, sheep and other animals.
The bulk of the White House’s plan focuses on improving how use of the drug is tracked and treated by health professionals.
“We need more testing to get a national picture of the threat,” Gupta told reporters.
Current testing for xylazine is a patchwork of different approaches, with some medical examiners and health departments regularly detecting the drug in deceased overdose victims and collected drug paraphernalia. Recent federal figures suggest use has mushroomed in recent years. But a standardized testing approach is needed to understand the trajectory and scope of the drug’s spread.
The plan also calls for the development of rapid tests for use by hospital staff and community workers who treat patients experiencing overdoses. Developing medical billing codes for the treatment of xylazine-impacted patients is another step needed to complete the data picture, officials said.
Other key goals include:
— Developing and educating health professionals on best practices and medications to treat xylazine withdrawal and addiction. That includes treating the skin wounds associated with xylazine.
— Identifying and disrupting illegal imports of xylazine from overseas, including from China and Mexico.
— Researching new drug options to quickly reverse the effects of xylazine, which can cause users to black out. Because it is not an opioid, xylazine does not respond to the standard opioid-reversal drug, naloxone.
If successful, federal officials hope the strategy will reduce xylazine-related overdose deaths by 15% by 2025.
The plan does not include new federal funding, which senior administration officials said depends on Congress. They noted that President Joe Biden’s most recent drug control budget called for $46 billion to expand addiction treatment and disrupt illegal drug supplies.
The government's xylazine plan will be distributed to federal agencies, including the Food and Drug Administration and the Drug Enforcement Administration, which will be tasked with helping implement it.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content. | Drug Discoveries |
Seven British patients who travelled to Turkey for weight loss surgery died after operations there, a BBC investigation into the trend has found.
Others have returned home with serious health issues after having had gastric sleeve operations, during which more than 70% of the stomach is removed.
The operations, used to treat morbid obesity, are carried out in the UK.
But, because it can take years to get one through the NHS, some people are looking abroad for treatment.
Social media advertising has helped fuel interest in travelling overseas for weight loss surgery in recent years.
Katie (not her real name) from Belfast first considered travelling to Turkey after seeing an advert online.
Like many others, she had watched "before and after" weight loss videos on social media - the TikTok hashtag #gastric sleeve has had 292 million views in the UK in the past three years.
Katie flew out for surgery in October 2021. Soon after the procedure, she says she was in agony, but the Turkish clinic told her it was just trapped gas.
After flying home and "squealing" in pain, she was rushed to hospital with sepsis and pneumonia days later.
Katie spent almost a year in and out of hospital, contracting sepsis on six separate occasions. NHS doctors were forced to remove her entire stomach.
She says the procedure has left her constantly tired and unable to continue in her job as a support worker for the elderly.
"It's the worst mistake I've ever made," she says. "It's ruined my life."
Katie says her treatment and care were "nothing like" the promotional material she saw online.
Presenter Alex Hollywell-Rolfe investigates if it's safe to travel abroad for life-changing weight loss surgery.
Watch the programme on BBC iPlayer (UK only) or on BBC Three at 21:00 on Tuesday 21 March.
The BBC has spent months investigating the trend.
British doctors say that they're treating an increasing number of patients who have travelled to Turkey and returned with serious complications.
About once a week, a "very unwell" patient arrives at Newcastle Airport from Turkey and is taken straight to hospital, according to Dr Sean Woodcock, a consultant at Northumbria Healthcare NHS Foundation Trust.
Dr Ahmed Ahmed, a leading surgeon and member of council at the British Obesity and Metabolic Surgery Society, says he's treated patients returning from Turkey who have had an entirely different operation to the one they understood they had paid for.
There are no records of the number of people who have travelled to Turkey for this kind of treatment.
But the BBC has learned that seven Britons have died after having weight loss surgery there since 2019.
One of those was 25-year-old Joe Thornley. The first his parents knew of his death was when the police visited their home.
Officers passed on a phone number for the Turkish clinic - which Mick, Joe's father, rang.
"The doctor just turned around and says: 'Oh he had low blood pressure, he had a heart attack.'"
After Joe's body was returned to the UK, a post-mortem examination revealed that he had actually died of internal bleeding at the site of his surgery.
"We tried to ring the doctor back and he just wouldn't answer the phone, refused emails, everything," says Mick.
Joe's friends say he told them he had been feeling unhappy after trying everything he could to lose weight. His mother says his death was "a nightmare".
Treatment can be booked at some clinics in just a matter of minutes by messaging over WhatsApp. The cost can be as little as around £2,000 ($2455) - a fraction of the £10,000 ($12,274) charged by some private providers in the UK.
The BBC has also been told that some people are being accepted for surgery who do not have a medical need for it.
In the UK, weight loss surgery is usually only offered to someone with a Body Mass Index (BMI) of 40 or over. A person's BMI is calculated using a formula which involves dividing their weight by their height - a healthy BMI is considered to be between 20 and 25.
We contacted 27 Turkish clinics to see if they would accept someone for treatment who was considered to have a normal Body Mass Index (BMI) - this is considered to be between 20 and 25.
Six of the clinics we approached were happy to accept someone with a BMI of 24.5 for extreme weight loss surgery.
Separately, the BBC also found that some clinics who refused the treatment actually then encouraged patients to put on weight, to enable them to be accepted for surgery.
One said: "You need to gain 6.7kg to have sleeve surgery. I think you can easily eat some food and then lose weight easily." Another asked: "How soon can you gain weight?"
Dr Ahmed says the practices are "reckless" and "unethical".
"It's appalling - I've never come across a situation where somebody's being told to eat more to put their weight up. They should not be offering any kind of surgery at a normal BMI."
The government says it is trialling new treatments for obesity and recommends that those travelling to Turkey consider risks and after-care needs.
Dr Ahmed says the failure to provide this surgery has left the NHS with the twin costs of handling health complications caused by obesity and expensive after-care following botched surgery.
The BBC has learned that the number of weight loss surgeries performed in England has fallen by a third from 6,818 procedures three years ago, to just 4,409 in 2022.
But Dr Ahmed suspects that weight-loss tourism will continue while the long NHS waiting lists remain:
"If you have to wait so long for a treatment to make you healthy, who's going to do that? If you can afford it, you're going to find other ways."
For details of organisations in the UK, which offer advice and support with body image and mental health, go online to bbc.co.uk/actionline
Have you travelled abroad for surgery? Share your experiences by emailing [email protected].
Please include a contact number if you are willing to speak to a BBC journalist. You can also get in touch in the following ways: | Weightlifting & Bodybuilding |
Ministers are reportedly poised to ban single-use vapes, after a series of calls from councils, leading paediatricians and public waste campaigners to make selling the disposable devices illegal on health and environmental grounds.
The move could come next week after the government concluded the products are overwhelmingly aimed at children, who then become addicted. It is due to be revealed in a consultation issued by the Department of Health and Social Care next week, though timings could alter, according to the Daily Telegraph.
Last week, the Guardian revealed that 5 million single-use vapes are being thrown away in the UK every week, a fourfold increase on 2022. Research by the not-for-profit organisation Material Focus said this amounted to eight vapes a second being discarded, with the lithium in the products enough to create 5,000 electric car batteries a year.
Child respiratory doctors criticised the government last year for failing to heed warnings about the risks of allowing e-cigarettes to be sold in child-friendly packaging containing the names of popular sweet treats – including banana milkshake and jelly babies, both of which contain 2% nicotine, the highest concentration allowed in the UK.
At the time, Prof Andrew Bush, a consultant paediatric chest physician at Royal Brompton and Harefield hospitals, said: “I am concerned that we are sleepwalking into a public health catastrophe with a generation of children hooked on nicotine.”
Scott Butler, the executive director at Material Focus, said last Friday that the “problem with single-use vapes has gotten further out of control” over the past year. “Single-use vapes are a strong contender for being the most environmentally wasteful, damaging and dangerous consumer product ever made,” he said.
In July, MPs urged the government to introduce restrictions on the packaging and marketing of disposable vapes to tackle the alarming trend of children using these addictive products.
Britain is lagging behind the rest of the world in addressing the issue. Australia has banned all vaping without a prescription, Germany prohibited flavoured e-cigarettes and New Zealand outlawed most disposable vapes and put curbs on marketing to children. Earlier this month, France also announced it is planning to ban all disposable e-cigarettes.
The government is understood to have stopped short of a ban on all vaping without a prescription because it sees vaping as a good alternative for adults who smoke.
Prof Sir Chris Whitty, England’s chief medical officer, has said in the past: “If you smoke, vaping is much safer; if you don’t smoke, don’t vape, and marketing to children is utterly unacceptable.”
A DHSC spokesperson said: “We are concerned about the rise in youth vaping and the environmental impacts of disposable vapes.
“That is why we launched a call for evidence to identify opportunities to reduce the number of children accessing and using vaping products – and explore where the government can go further.
“We will set out our response in due course.” | Health Policy |
A New Zealand government whistleblower has come forward with explosive official data that shows more than 20% of the nation’s citizens have now died after receiving their Covid mRNA shots.
Like many other countries around the world, New Zealand has suffered an unprecedented spike in excess deaths over the past two years.
Due to strict mandates and heavy government pressure during the Covid pandemic, the vast majority of the New Zealand population is fully vaccinated.
Official data shows that 95.8% of the eligible New Zealand population aged 12 and over have received one dose of the Covid mRNA shots.
While a staggering 94.7% of the eligible New Zealand population aged 12 and over are considered to be fully vaccinated.
A New Zealand government database administrator, who helped to catalog official data on vaccine recipients, has come forward with explosive information.
The whistleblower has exposed official government data that shows the nation’s spike in excess deaths is associated with the Covid injection campaign.
According to the statistician whistleblower, who called himself “Winston Smith,” vast numbers of vaxxed New Zealanders are now dead.
Smith worked on a program logging vaccine compensation for providers.
Due to his unique access, Smith was able to pinpoint how deaths began occurring shortly after the vaccine rollout.
The IT specialist made the revelations in a recent interview with researcher investigative journalist Liz Gunn.
During the interview, Smith discussed how he made the correlation between shots administered and subsequent deaths.
“When I was looking at the data, which is part of my job, I noticed some discrepancies with the dates of death, people getting people dying within a week of being vaccinated,” the whistleblower told Gunn.
“And this is Pfizer’s batch number one.
“We’ve had 711 from batch number one vaccinated 152 of those died which makes a 21 percentage death rate, mortality rate,” Gunn said looking at the data, which Smith confirmed was correct.
“These are real people,” Smith added.
“These are real numbers.
“This is government data.
“So the top V1 has vaccinated 246 people and 60 of them are now no longer with us.”
“That is nearly 25%,” Gunn noted.
“1 in 4, nearly 1 in 4 that that person is vaccinated is now dead,” Smith confirmed.
Smith said while some batches of AstraZeneca and Moderna Covid shots were administered, those injections were “only few and far between.”
“Mostly it’s Pfizer, mostly it’s Pfizer in New Zealand,” Smith confirmed.
New Zealand Data Concerning Deaths Associated With Vaccine
M.O.A.R
Summary
Winston Smith (alias), a statistician and data administrator for the Ministry of Health in New Zealand, has come forward with a wealth of government data that he believes shows the dangers of the… pic.twitter.com/FOSQyO6Hwu
— Dr. My Le Trinh -unlawful indefinte suspension8:32 (@myletrinh123) November 30, 2023
Here are some of the key excerpts from Smith’s comments during the interview:
“I was involved with building a project, helped with implementing a vaccine payment system for our providers.
“It’s called a pay per dose system.
“So that means that every time someone gets vaccinated, they get a payment for it as a provider.
“And I helped build it, I implemented it.
“And when I was looking at the data, which is part of my job, I noticed some discrepancies with the dates of death, people getting people dying within a week of being vaccinated.
“The chances of that occurring naturally by chance is almost impossible.”
“Well, as soon as the system went live, we noticed that people were dying almost straight away after being injected.
“So that sort of prompted my curiosity a bit, and so I dug a little deeper.
“And I am a scientist by nature. I love science. It’s my all time favorite.
“I’ve got a master’s degree in science.”
“Because it’s a payment system and I’m the database administrator for it. I’m the only one.
“Because New Zealand is a small country, you can get away with one database administrator to do this.
“So I’m in a unique position in the world.
“And because New Zealand is a tier one country with really good in I.T., I was able to manage and build the system and be the only database administrator needed to look after it.
“In other countries like America or Britain, you’d need a whole team of people.
“So it would be very difficult for one person to get access to all of this information.
“But in New Zealand, because of its size and because it’s got really good I.T, I happen to be the one.”
Commenting on Smith’s bombshell, infamous tech entrepreneur Kim Dotcom demanded that “This must be investigated.
“If this data of mass vaccine casualties is real there must be accountability,” he added.
Smith’s alarming claims have not been disputed by the New Zealand government as of writing.
During the Covid pandemic, former New Zealand Prime Minister Jacinda Ardern implemented vaccine mandates for hospitality workers and linked vaccine rates to lockdowns.
Ardern resigned earlier this year.
Prime Minister of New Zealand Jacinda Ardern offers her tearful resignation. She implemented arguably the strictest vaccine mandates and lockdowns in the world. In 2021, Ardern locked down the whole country over a single Covid case. pic.twitter.com/RDgNztTgtX
— The First (@TheFirstonTV) January 19, 2023 | Epidemics & Outbreaks |
Vulnerable people in the UK are to be offered another Covid booster jab this spring, public health bodies have said, as the virus continues to circulate at high levels.
According to the latest data from Office for National Statistics, about one in 45 people in England, Scotland and Wales had Covid in the week ending 21 February, with the figure at one in 90 for Northern Ireland. In England, infection levels are rising, including in people aged 70 and over.
Now the UK’s Joint Committee on Vaccination and Immunisation (JCVI) has announced plans for a spring booster campaign, with Covid jabs set to be offered to people aged five years and over who are immunosuppressed as well as adults 75 years and over, and older adults living in care homes.
Dr Mary Ramsay, head of immunisation at the UK Health Security Agency (UKHSA), urged those offered the jab to accept it.
“Covid-19 is still circulating widely, and we have recently seen increases in older people being hospitalised,” she said.
“It is important those at highest risk of severe illness do not become complacent and I would encourage everyone who is eligible to come forward once the booster programme starts.”
The announcement comes a month after the NHS ended the offer of a Covid booster jab to healthy people aged 16 to 49. While initial Covid vaccinations are still available for this group, the JCVI has advised that they too, should be withdrawn in 2023 in favour of a more targeted approach.
The UKHSA said that there will be four vaccines available for use in the spring booster campaign including the Pfizer/BioNTech bivalent jab and the Moderna bivalent, both of which are mRNA vaccines that target two different coronavirus variants, as well as the protein-based Sanofi/GSK vaccine that targets the Beta variant, and the Novavax jab – a protein-based vaccine that targets the original 2020 strain of Covid. The agency said the latter is only to be used when alternative jabs are not considered clinically suitable.
UKHSA said children under 12 years of age who are eligible for a spring booster will be offered a Pfizer/BioNTech vaccine.
Prof Wei Shen Lim, chair of the JCVI’s Covid-19 Committee, said: “The spring booster programme provides an opportunity for those who are at highest risk of severe illness to keep their immunity topped up.
“This year’s spring programme will bridge the gap to the planned booster programme in the autumn, enabling those who are most vulnerable to be well protected throughout the summer,” he said. | Vaccine Development |
An influencer has revealed he has been trolled by people who say his new teeth look like a piano after he had implants in Turkey - but said he loves his new look despite the abuse.Jordan Declan Field, from Ipswich, shared his dental journey on TikTok, which included two trips to Turkey and a treatment in the UK.The online influencer excitedly showed off his new pearly whites, letting haters know that he's happy with his results no matter what they say.After one person compared his new gnashers to a piano, he laughed off the comment and said it was in the 'top three' responses he had received commenting on his cosmetic procedure. Jordan began his journey in November 2021, when he travelled to Turkey, which offers cosmetic dental procedures at cheaper prices, for a consultation. There, he underwent the first stage of treatment which included getting temporary plastic veneers, and undergoing four teeth extractions - as well as the removal of three wisdom teeth.Jordan's teeth were filed down and he also had implants. Jordan Declan Field (pictured before he got his teeth done), from Ipswich, shared his dental journey on social media, which included two trips to Turkey and a treatment in the UKHe travelled back to the UK absolutely over the moon with his new smile, which featured a decorated new set of teeth, with some work to be done in six to twelve months.In April, Jordan got root canal treatments at a dental clinic in Worthing, West Sussex - and was all set for his second trip abroad. Last spring, online influencer excitedly showed off his new pearly whites, letting haters know that he's happy with his results no matter what they sayBy May 2022 everything was wrapped up and Jordan let his followers know how pleased he was with the results.In a TikTok video two weeks after his completed treatment, the influencer explained that he had 'no problems, no sensitivity' and 'no pain'.His only qualm was with the antibiotics he was given - which 'upset his insides a little bit' - but other than that, the experience was 'absolutely fab'.Jordan also hit out at commenters which told him his teeth were too big, explaining that they were the same size as his old ones. Jordan began his journey in November 2021 (pictured left), when he ventured to the nation - famed for more affordable dentistry - for a consult and treatment plan. By May 2022 (pictured right) - everything was wrapped up - and Jordan let his followers know how pleased he was with the resultsThe influencer explained they may, for some people, seem larger because they're now white and populate his whole mouth; but he's happy with them.In one clip, a commenter said: 'It's giving horse'. 'They look ridiculous,' one user wrote. 'I have an oak tree you can knaw down.''Well that's a really kind comment,' Jordan replied sarcastically. 'And I actually might take you up on that offer 'cause that's really nice.' In November 2021, Jordan (pictured) underwent the first stage of treatment which included getting temporary plastic veneers, and undergoing four teeth extractions - as well as three wisdom onesHe added: 'If I'm that ridiculous why are you following? Why are you doing that?' 'Well looks awful,' another added. 'Sorry to say but looks cheap and plasticky.' Jordan dryly responded: 'Thank you ever so much for your feedback. I will take that on board. And...yeah, I'll just pull all my teeth out now.Another mean comment in a video read: 'It's giving piano.' Jordan's positive experience comes amid horror stories of Britons suffering permanent damage to their teeth after travelling to Turkey for treatment. A trend known as 'Turkey teeth' that involves travelling abroad to get drastic cut-price treatment is leaving thousands facing painful complications.The cosmetic fad, made popular by stars like Katie Price and Love Island's Jack Fincham, involves filing down teeth to pegs then replacing them with crowns or veneers.The procedure, which leaves patients with a Hollywood smile, is being fuelled on social media under the hashtag #Turkeyteeth which has been viewed more than 322 million times on TikTok.In July, a BBC documentary looked at the fallout, asking whether the risks really outweigh the savings on having cheaper treatment, with UK dentists warning the complications can leave patients with huge medical bills to fix shoddy work.A number of dentists surveyed on behalf of the BBC said some of the remedial work was provided by the NHS.Meanwhile one private clinic urged patients to be certain they know what they are getting after being contacted by clients who had been sold veneers but given the much more aggressive option of crowns.The Harley Street Smile Clinic in London said they had been inundated by young people suffering from severe infections, intense long lasting pain, infected gums or rotting teeth due to the procedure.In one case, Tiktok user Lisa Martyn revealed how her experience turned into a nightmare after she travelled to Turkey for the cosmetic treatment and paid 3,500 Euros (£2,960) for what she thought was veneers but was actually a set of crowns.She told the BBC: 'I was duped into the dream of having a full set of perfect teeth that I was never going to have any issues with but I was grossly misled about what I was having done - they were sold to me as veneers not a full set of crowns. This graphic shows how a tooth is shaved down slightly to make room for a thin veneer'No one sat down and told me the risks or if there were any other options. I thought that once they put the new teeth into my mouth that would be it - there would never be any more problems.'But not only have I been in crippling pain every day since, but it has also cost me thousands. It's the biggest mistake of my life.'Lisa flew to Turkey in 2021 under the belief she would be fitted with 26 veneers in a bid to get the 'Hollywood smile' for her son's wedding but was actually fitted with crowns - a far more invasive procedure.But months after her treatment, the 48-year-old was left in horrific pain after developing an abscess which nearly paralysed half her face and is suffering from nerve sensitivity.The treatment has proven popular with social media influencers and TV stars including model Katie price.Love Island's Jack Fincham was one of the first to share his Turkey Teeth story after getting the treatment before appearing on the ITV reality show in 2018. Pictured: Before and afterIn August 2020, she shared a video which showed that her natural teeth had been shaved down to points which she said made her look like a James Bond villain before she had new veneers fitted while in Turkey.The treatment was carried out after her original veneers fell out. However, in October that year, she had to go back to Turkey again after some of her new veneers fell out.A spokesman for the star told the Sun at the time she had to return to Turkey to get the work fixed.Love Island star Jack Fincham also received treatment in Turkey before appearing on the ITV reality show. Crowns and veneers: What's the difference? Veneers and crowns are both dental treatments that can improve the look and function of your teeth.The most significant difference between the two is that a veneer only covers part of the tooth while a crown covers the entire tooth.A veneer is a very thin layer of porcelain, but can be made from other materials, and is usually chosen more for cosmetic purposes.They are bonded to the front of existing teeth with colouring to existing teeth matched by the dentist.A crown is roughly twice as thick and covers the whole tooth in a far more invasive procedure than veneers because most of the tooth is removed to make room. It can be made from porcelain, porcelain fused to a metal alloy or an all-metal alloy.While crowns are also chosen for cosmetic purposes, they also offer a solution for those with conditions including broken, decayed or crooked teeth. After the Love Island winner discussed his Turkey Teeth in 2018, Google searches for the term sky-rocketed.Mr Fincham travelled to the Turkish city of Antalya years ago, saying in a Love Island promotion video 'I absolutely love my pearly whites.'I went all the way to Turkey to get these. I come back with a winning smile and a nice little holiday.' But in the BBC Three documentary 'Turkey Teeth: Bargain Smiles or Big Mistake,' he admitted he would 'do it differently' and showed off how his teeth had been filed down for his veneers.He said that he receives lots of messages from people asking about the work he had done, and told the BBC that he now tells them about his own experience.Speaking to the documentary's host Dr Trishala Lakhani, a dentist as well as Miss Universe GB, he said: 'I flew out there in the winter time, not the holiday season, and pretty much everyone on the flight was going to get some sort of procedure done.'He got the work done despite knowing about the risks that come with veneers - such as a higher risk of requiring root canal work done or his teeth being removed.'They mentioned all this stuff and it didn't put me off. It was for cosmetic purposes, so I was probably being a bit vain,' he admitted.On the procedure itself, he said it 'can be quite uncomfortable'. 'You have loads of injections to numb your mouth. It's not an easy procedure. You have to do your research.' He added: 'Honestly, I love my teeth, but going back, if someone said, 'Would you have the composites or just get crowns done?' I'd get that.' A survey carried out for the BBC found that hundreds of dentists in the UK had treated patients suffering from complications after getting work done abroad.Dr MJ Rowland-Warmann, director of a dental clinic in Liverpool, told the broadcaster: 'If I did 20 crowns on a 21-year-old for the purposes of improving the colour, I would have my licence revoked, I would be struck off.'She said her clinic receives one to three calls a day from people with issues with their teeth after going abroad but that her clinic cannot treat them.'Some can't floss because their crowns are stuck together or they're in pain because they have bleeding gums.'But it's easier for us not to take that patient. At the point when you inherit that patient and do any work, that's when the problems really start and that's when the UK dentist becomes liable. A risk we cannot take.'This leaves patients in very vulnerable positions trying to scrabble around for help and it becomes very costly trying to fix the damage.'Dr Maurice Johanne, Principle Dentist at Harley Street Smile Clinic, urged people to be careful about what treatment they were getting.He said: 'I can't stress enough that people need to be 100 per cent clear about exactly what they are signing up for when they go abroad for cosmetic dental treatment.'Although patients are under the impression they are having veneers, in reality they are having crowns placed, which means much more aggressive tooth reduction.'London-based dental clinic said that it has been 'inundated' with young people seeking to have their botched survey rectified.Not everyone who receives treatment abroad suffers complications. The BBC spoke to Tilly Entwhistle from Manchester who said she was thrilled with her work after being compared to Bugs Bunny as a child.However, she said since visiting a dentist back in the UK, she was told they would not touch her teeth as they did not want to take responsibility for any issues with the work done in Turkey. | Medical Innovations |
People with heart failure who increase their daily step count saw improvements in their health in just 12 weeks, according to a peer-reviewed study published last week.
The research suggests that physical data from wearable devices, such as FitBits and step counters, can be clinically significant.
Consumer wearable devices to track health status and progress are commonly used and part of a growing trend of mobile health technology. However, how to interpret data from wearable devices is at times unclear.
“Our research showed increased step counts were significantly associated with improvements in health status, suggesting that increases in step count over time as assessed by a wearable device may be clinically meaningful,” said Dr. Jessica Golbus, first author of the paper published in JACC: Heart Failure.
Golbus’s team at the University of Michigan in Ann Arbor, sought to determine the relationship between daily activity and patient outcomes for people with heart failure. Researchers used data from a randomized controlled trial that provided 425 participants with a Fitbit and asked them to complete questionnaires through a smartphone application.
The questions measured physical symptoms, quality of life, and social limitation, scored on a scale of zero to 100 with higher scores indicating better health. Changes in scores of five points or more are considered “clinically significant” and have previously been shown to be associated with heart failure outcomes.
TECH TO THE RESCUE: Apple Watch Saves Woman from Pulmonary Embolism While She Slept
After two weeks, the mean physical limitation score was 55.7 and the total symptom score was 62.7. Physical limitation scores increased by four points on average through 12 weeks and total symptom scores increased by 2.5 points.
Higher daily step counts equated with increased scores for both physical limitation and total symptom scores. People with total symptom scores of zero-24 averaged 2,473 steps per day and those with scores of 75-100 averaged 5,351 steps per day.
When comparing results to differing step counts, people who walked 1,000 steps per day had total symptom scores that were 3.11 points lower than people who walked 2,000 steps per day. And people who walked 3,000 steps per day had total symptom scores that were 2.89 points higher than those who walked 2,000 steps per day.
However, little association was seen once step counts reached higher than 5,000 steps per day.
Changes in step count over time were also significantly associated with changing scores, suggesting that step count data from a wearable device may be leveraged to inform clinical care.
The study found participants whose step counts increased by 2,000 steps per day saw a 5.2-point increase in their total symptom scores and a 5.33-point increase in their physical limitation scores when compared to participants with no change in step count.
People who saw a decline in their step count had numerical declines in their physical limitation score that were not statistically significant, when compared to participants with no change in step count.
“What does this mean at the end of the day? If providers see improvements in step counts, then that is a good thing, however, seeing a decrease in step counts does not necessarily mean the converse.”
WALK This Encouragement to Pals With Heart Issues on Social Media… | Disease Research |
She doesn’t sleep, she hibernates.
A UK woman has dubbed herself a “real-life Sleeping Beauty” due to her unusual condition, which causes her to sleep up to 22 hours a day.
“I can’t be woken up once I’m asleep,” Joanna Cox, 38, told SWNS of her unusual condition. “I wake up not knowing what day it is or how long I’ve been asleep for.”
She added, “It’s honestly ruining my life — I’m like a real-life Sleeping Beauty,”
The Castleford resident suffers from idiopathic hypersomnia, a rare sleep disorder that causes the sufferer “to be very sleepy during the day even after a full night of good sleep,” according to the Mayo Clinic.
“It also often causes difficulty waking up after you’ve been asleep,” they write. “If you take a nap, you generally don’t feel refreshed and you may wake up confused and disoriented.”
Due to her condition, Cox says she never “feels rested” despite sleeping between 18 and 22 hours per day. “It’s really upsetting when people just say I’m ‘lazy’ or need to set more alarms,” she said.
The human hibernator first noticed something was awry in 2017 after she felt preternaturally tired at all times and couldn’t get through the day without a nap. “It started out of nowhere — nothing triggered it, I just felt really tired,” lamented the Brit, who owned a cleaning company at the time.
Cox eventually found herself falling asleep in unusual places, such as behind the wheel, which resulted in her giving up driving altogether.
The big sleeper even recalled a time when she dozed off during a night out. “Before I was diagnosed, I fell asleep in a booth in a club on a night out,” the mother of two lamented. “The bouncer thought I was just drunk and kicked me out — it was so embarrassing.”
Hoping to get to the bottom of her fatigue, the consummate slumberer reported to the doctor, who misdiagnosed her with depression. However, medics quickly ruled that out as Cox didn’t exhibit any other symptoms besides tiredness.
This kicked off a years-long saga of fruitless doctor’s visits with medics incorrectly claiming she had everything from infections to cancer.
Finally, in October 2021, doctors referred Cox to a sleep clinic at Pontefract Hospital in Yorkshire, where doctors revealed that she had idiopathic hypersomnia.
Unfortunately, the cause of the condition is yet unknown, meaning there is no existing cure. Not to mention that she’s tried dozens of so-called treatments but to no avail.
By that point, Cox’s over-dozes had snowballed to the point that she struggled to stay awake for more than a few hours each day. “One day recently, I was awake for 12 hours and that was the longest I’ve been awake in nearly six years,” she said. “The shortest is usually just a few minutes, enough time to wake up, have a drink and then fall back to sleep again.”
Her condition got so bad that Cox had to quit her job in 2019 due to her inability to stay awake. The perennially fatigued gal also frequently misses flights, including one trip to Spain that she had planned with her daughters Caitlin, 20, and Isabelle, 18.
“I can’t work, I can’t drive, and I can never make any plans because I don’t know if I’ll be awake,” said Cox.
Cox’s hypersomnia is more than just a major inconvenience. The real-life Rip Van Winkle recalled one time when she ended up in hospital with low blood sugar after embarking on a four-day slumber bender without any food breaks.
It’s a horrible Catch-22 as fighting to stay awake results in “vivid hallucinations.” Cox said one of her more horrific visions involves “hundreds of spiders” crawling all over her bed.
Interestingly the only time the over-dozer is awake is in the early morning around 2 a.m., which is when she walks her cockapoos, Autumn and Bobby.
Cox, who lives alone, said she wouldn’t be able to survive the nap-ocalypse without her daughters’ support.
“Isabelle has seen me at my worst and basically had to step up and be mum – waking me up as best she can to make me eat or help me to the loo,” she said. “I’ve had carers in the past, but no one really knows how to look after me because it’s such an unusual condition.”
She added, “I can wash and feed myself but it’s just getting me to wake up which is impossible.”
In addition, the hypersomnia has put to bed any notions of a love life for Cox, who says she’s been single for seven years. “I don’t entertain the thought of having a partner ever again — it doesn’t even cross my mind,” she said. “I can’t imagine being with anyone with this condition.”
Ultimately, Cox says she wants her life to return back to normal. “I’m really hoping that sharing my story will help me reach out to others with the condition, and hopefully, find a doctor who can help.” | Disease Research |
Earlier this year, researchers raised eyebrows when Australia's traditionally conservative medicines regulator approved the use of psychedelics to assist therapy sessions.
The decision will see psilocybin, found in magic mushrooms, used for treatment-resistant depression. It will also allow MDMA, known as ecstasy in tablet form, for post-traumatic stress disorder (PTSD).
The changes come into effect on Saturday, making Australia the first country to classify psychedelics as medicines at a national level.
While initial access to the drugs will be limited and costly, many experts and patients are hailing it as a landmark moment.
But major health organisations have also urged caution.
'Shining again'
Marjane Beaugeois was diagnosed with severe depression in 2017. "Within two months, I lost my mother, grandmother, beloved pet dog and my romantic relationship," she recalls.
She couldn't eat, shower, or leave her house in Melbourne - but says prescription antidepressants left her "zombie-like, unable to cry, self-soothe or feel better".
"I'd still go to bed praying not to wake up," the 49-year-old says.
When her research for alternative therapies led her to a psilocybin clinic in Amsterdam, she was hesitant.
"I have no history of drug or alcohol use. As an addiction counsellor, I was always very against it," she says.
But she was also desperate to escape her treatment-resistant depression, so in 2018, she booked herself in.
The psilocybin was taken in a tea. "Colours became more vivid. I felt powerfully reconnected to the world; warm and fuzzy. I'm getting emotional just talking about it⦠it was a massive, beautiful experience of unconditional love."
Three sessions later, she felt healed. "I could smile, feel joy, go about my daily routine with clarity," she says. "When I got home, friends said they saw my eyes shining again."
When Glen Boyes suggested microdosing psychedelics to treat his crippling depression, his therapist was sceptical.
"He explained it wasn't something he does, but he couldn't stop me, and would do brain scans to track my progress," he says.
The 33-year-old veteran says he began experiencing "lingering PTSD" from his time in the army, during Covid-19 lockdowns in Sydney.
But after 10 weeks of microdosing and therapy sessions, red areas on his initial brain scans showing blockages had cleared. "My brain fog evaporated. I could think clearly again."
Due to no other country rescheduling these substances for clinical use on a national level, the cohort who've experienced psychedelic therapy is small.
Professor David Nutt, Head of Neuropsychopharmacology at the UK's Imperial College, congratulated Australia on "leading the world in this vital treatment innovation".
Psychedelic researcher and psychiatrist Dr Ben Sessa described the approval as pioneering. "This is where the global psychedelic spotlight now shines," he told the BBC.
Dr Sessa has resigned from his job running the UK's primary psychedelic clinical organisation and will spend the next 18 months travelling to Australia to deliver a bespoke psychedelic prescribing training programme.
Other countries have explored psychedelics for compassionate use, including Switzerland, Canada, and Israel - where regulators have made similar decisions, although not nationally like in Australia. Psychedelic clinics also operate legally in countries including Jamaica and Costa Rica.
But how Australia rolls out clinical prescriptions for both drugs, and at what price tag, will be closely watched.
First developed as an appetite suppressant in 1912, ecstasy was used in therapy sessions in the US until the mid-1970s when it was outlawed. It entered Australia in the 1980s as a party drug due to its reported effects of increased energy, empathy, and pleasure, and was criminalised in 1987.
In the 2000s though, research slowly started up again - with recent trials finding that both MDMA and psilocybin can quickly improve symptoms of severe depression, though little is known about how they do this.
Mind Medicine Australia (MMA), a charity which lobbied for psychedelic treatments, is helping to train health professionals tasked with procuring and prescribing the drugs.
To become an authorised prescriber, psychiatrists must apply to an ethics committee and to Australia's drugs regulator the Therapeutic Goods Administration (TGA). They'll then need to source and supply both MDMA and psilocybin.
Once all expenses are factored in - including the drugs themselves, supervision from multidisciplinary teams, psychiatrist sessions and hiring a private clinic - costs could spiral to A$30,000 (£15,700, $20,000) per treatment, according to one psychedelics expert.
Due to the prohibitive price tag, Dr Stephen Bright, senior lecturer at Edith Cowan University, says he doubts these treatments "will be very widely available at all" for the first 12-18 months.
Philanthropist Peter Hunt, chair of MMA, disputes those estimates, telling the BBC patients should expect to pay between A$10,000 for two psilocybin assisted therapy sessions, and A$15,000 for three MDMA assisted sessions. "We costed the treatments with a mental health clinic," he said.
But with no planned government subsidies, the five-figure treatments are expected to remain unaffordable for most patients.
'Not a miracle cure'
Australia's major medical and mental health bodies are among the loudest voices pushing back against psychedelic treatments.
"There's been considerable caution from the scientific and medical community," said Kristen Morely, a professor of addiction medicine at the University of Sydney.
According to MMA, the "weight of submissions from thousands of Australians whose current mental health treatments just aren't working" helped get the TGA approval over the line.
But the Australian Medical Association (AMA) and the Royal Australian and New Zealand College of Psychiatrists (RANZCP) have expressed serious concerns.
Both groups have called for larger-scale studies and better research into psychedelic treatments, warning of unknown risks, long-term side effects and "potentially very limited benefits" from their use in therapy.
"Psychedelic-assisted therapy may offer hope to a small number of people where other treatments have been attempted without success. But it's not a miracle cure," warned Professor Richard Harvey, who chairs the RANZCP's Psychedelic-Assisted Therapy Steering Group, warned.
He urged a "cautious, considered and informed" approach, due to the "potential for psychedelic substances to cause fear, panic and re-traumatisation".
"Vulnerable people can understandably feel distressed if their experience doesn't match their expectations of this therapy," he said.
It's also unclear, he argued, whether the results from psychedelic treatments stemmed more from the substances themselves, or the psychotherapy.
"Put simply, psychedelic-assisted therapy is in its infancy. There is more we need to know." | Mental Health Treatments |
- The CDC says the fungus candida auris has spread at an "alarming rate" in the U.S.
- Candida auris was initially limited to New York City and Chicago, but has since been detected in more than half of U.S. states and has become in endemic in some areas.
- The fungus was first identified in Asia in 2009, and the first U.S. case dates back to 2013.
- A growing number of samples are resistant to drugs used to treat fungal infections.
A fungus that is often resistant to drugs has spread at an "alarming rate" through health-care facilities in the U.S., according to the Centers for Disease Control and Prevention.
Candida auris is an emerging fungus that is serious and potentially fatal for hospitalized patients, particularly those with multiple medical problems.
The fungus was first identified in Asia in 2009, and the first U.S. case dates back to 2013. Candida auris was initially limited to New York City and Chicago, but has since been detected in more than half of U.S. states and has become in endemic in some areas, according to a CDC report published in the Annals of Internal Medicine on Monday.
From 2019 to 2021, 17 states detected their first-ever cases of the fungus. California, the Mid-Atlantic region, the Midwest, Texas and Florida had growing transmission during that time, according to the CDC.
Infections have increased by about 200%, from about 500 infections in 2019 to more than 1,400 in 2021. The fungus has spread most in long-term care hospitals for people who have serious medical conditions and need ongoing treatment, according to the CDC.
Symptoms can vary greatly depending on the type of infection, but fever and chills are the most common. People with weak immune systems, who have diabetes, who receive a lot of antibiotics or who are are on breathing tubes, feeding tubes and catheters are more likely to be affected.
A 2021 CDC report found that mortality in two outbreaks of the fungus that was resistant to echinocandins was 30% over 30 days. The cases studied in the outbreaks were primarily severely ill patients at long-term care facilities, so the exact contribution of Candida auris to the deaths was unclear. The outbreaks took place in Washington D.C. and Texas.
Join CNBC's Healthy Returns on March 29th, where we'll convene a virtual gathering of CEOs, scientists, investors and innovators in the health care space to reflect on the progress made today to reinvent the future of medicine. Plus, we'll have an exclusive rundown of the best investment opportunities in biopharma, health-tech and managed care. Learn more and register today: http://bit.ly/3DUNbRo
Candida auris is often resistant to medication used to treat fungal infections. In 2020, 86% of samples were resistant to a class of antifungal drugs called azoles and 26% were resistant to amphotericin B, according to the CDC.
Just over 1% of samples tested in 2020 were strains resistant to the main drug class used to treat such infections, called echinocandins, up from 0.4% in 2018. The CDC said that although resistance to echinocandins is still uncommon, the number of such cases tripled in 2021 compared to the previous two years.
"Even this subtle increase is concerning because echinocandins are the first-line therapy for invasive Candida infections and most Cauris infections," the CDC said in its report.
The CDC attributed the rapid spread of the fungus to a decline in infection control during the pandemic due to strain on the health-care system, from staff and equipment shortages to a surge in patient burden and increased antimicrobial use.
"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," said CDC epidemiologist Dr. Meghan Lyman, the lead author on the report. | Epidemics & Outbreaks |
A new study from researchers at UBC’s Faculty of Medicine reveals a direct link between high insulin levels, common among patients with obesity and type 2 diabetes, and pancreatic cancer.
The study, published in Cell Metabolism, provides the first detailed explanation of why people with obesity and type 2 diabetes are at an increased risk of pancreatic cancer. The research demonstrates that excessive insulin levels overstimulate pancreatic acinar cells, which produce digestive juices. This overstimulation leads to inflammation that converts these cells into precancerous cells.
“Alongside the rapid increase in both obesity and type 2 diabetes, we’re seeing an alarming rise in pancreatic cancer rates,” said co-senior author Dr. James Johnson, a professor in the department of cellular and physiological sciences and interim director of the Life Sciences Institute at UBC. “These findings help us understand how this is happening, and highlights the importance of keeping insulin levels within a healthy range, which can be accomplished with diet, exercise and in some cases medications.”
The study focused on pancreatic ductal adenocarcinoma (PDAC), the most prevalent pancreatic cancer, and one that is highly aggressive with a 5-year survival rate of less than 10 per cent. The incidence of pancreatic cancer is on the rise, and by 2030, PDAC is expected to become the second leading cause of cancer-related deaths.
While obesity and type 2 diabetes had previously been established as risk factors for pancreatic cancer, the exact mechanisms by which this occurred remained unclear. This new study sheds light on the role of insulin and its receptors in this process.
“We found that hyperinsulinemia directly contributes to pancreatic cancer initiation through insulin receptors in acinar cells,” said Dr. Anni Zhang, the study’s first author who recently graduated with their PhD from UBC. “The mechanism involves increased production of digestive enzymes, leading to heightened pancreatic inflammation.”
“We hope this work will change clinical practice and help advance lifestyle interventions that can lower the risk of pancreatic cancer in the general population.”
Dr. Janel Kopp
While insulin is widely recognized for its role in regulating blood sugar levels, the study underscores its importance in pancreatic acinar cells. The findings show that insulin supports the physiological function of these cells in producing digestive enzymes that break down fat-rich foods, but at high-levels, its increased action can inadvertently foster pancreatic inflammation and the development of precancerous cells.
The findings may pave the way for new cancer prevention strategies and even therapeutic approaches that target insulin receptors in acinar cells.
“We hope this work will change clinical practice and help advance lifestyle interventions that can lower the risk of pancreatic cancer in the general population,” said co-senior author Dr. Janel Kopp, assistant professor in the department of cellular and physiological sciences at UBC. “This research could also pave the way for targeted therapies that modulate insulin receptors to prevent or slow the progression of pancreatic cancer.”
In collaboration with researchers at BC Cancer and the Pancreas Centre BC, the team has initiated a clinical trial to help patients diagnosed with PDAC control their blood sugar and circulating insulin levels with the help of an endocrinologist.
The researchers say the findings may have implications for other cancers associated with obesity and type 2 diabetes, where elevated insulin levels may also play a contributing role in disease initiation.
“Colleagues in Toronto have shown similar connections between insulin and breast cancer,” said Dr. Johnson. “In the future, we hope to determine whether and how excess insulin might contribute to other types of obesity- and diabetes-driven cancers.” | Disease Research |
You may be among the 45% of adults who snore at least occasionally or you likely know someone who does. They may be the brunt of jokes ("Uncle Joe snores so loudly he rattles the windows!"), but snoring is serious business.
For one, a snoring person often keeps their partner from a good night's sleep, which can be stressful. "Snoring can create real problems in a marriage," says Daniel P. Slaughter, MD, an otolaryngologist and snoring expert at Capital Otolaryngology in Austin, Texas.
Not only is snoring a nuisance, but 75% of people who snore have obstructive sleep apnea (when breathing is disrupted during sleep for short periods), which raises the risk of developing heart disease, Slaughter says.
Use caution before you self-treat with over-the-counter sprays and pills until you've checked with your doctor, says Sudhansu Chokroverty, MD, FRCP, FACP, program director for Clinical Neurophysiology and Sleep Medicine at JFK Medical Center in Edison, N.J. "Many stop-snoring aids are marketed without scientific studies to support their claims," says Chokroverty, who is also a neuroscience professor at Seton Hall University's School of Health and Medical Sciences.
Instead, try these natural solutions and lifestyle changes, which may help you stop snoring.
1. Change Your Sleep Position.
Lying on your back makes the base of your tongue and soft palate collapse to the back wall of your throat, causing a vibrating sound during sleep. Sleeping on your side may help prevent this.
"A body pillow (a full-length pillow that supports your entire body) provides an easy fix," Slaughter says. "It enables you to maintain sleeping on your side and can make a dramatic difference."
Taping tennis balls to the back of your pajamas can also stop you from sleeping on your back, Chokroverty says. "Or you can recline the bed with the head up and extended, which opens up nasal airway passages and may help prevent snoring. This may cause neck pain, however."
If snoring continues regardless of the sleep position, obstructive sleep apnea may be a cause. "See a doctor in this case," Chokroverty says.
2. Lose Weight.
Weight loss helps some people but not everyone. "Thin people snore, too," Slaughter says.
If you've gained weight and started snoring and did not snore before you gained weight, weight loss may help. "If you gain weight around your neck, it squeezes the internal diameter of the throat, making it more likely to collapse during sleep, triggering snoring," Slaughter says.
3. Avoid Alcohol.
Alcohol and sedatives reduce the resting tone of the muscles in the back of your throat, making it more likely you'll snore. "Drinking alcohol four to five hours before sleeping makes snoring worse," Chokroverty says. "People who don't normally snore will snore after drinking alcohol."
4. Practice Good Sleep Hygiene.
Bad sleep habits (also known as poor sleep "hygiene") can have an effect similar to that of drinking alcohol, Slaughter says. Working long hours without enough sleep, for example, means when you finally hit the sack you're overtired. "You sleep hard and deep, and the muscles become floppier, which creates snoring," Slaughter says.
5. Open Nasal Passages.
If snoring starts in your nose, keeping nasal passages open may help. It allows air to move through slower, Slaughter says. "Imagine a narrow garden hose with water running through. The narrower the hose, the faster the water rushes through."
Your nasal passages work similarly. If your nose is clogged or narrowed due to a cold or other blockage, the fast-moving air is more likely to produce snoring.
A hot shower before you go to bed can help open nasal passages, Slaughter says. Keep a bottle of saltwater rinse in the shower. "Rinse your nose out with it while you're showering to help open up passages," Slaughter says.
You could also use a neti pot to rinse out your nasal passages with a salt-water solution.
Nasal strips may also work to lift nasal passages and open them up -- if the problem exists in your nose and not within the soft palate.
6. Change Your Pillows.
Allergens in your bedroom and in your pillow may contribute to snoring. When did you last dust the overhead ceiling fan? Replace your pillows?
Dust mites accumulate in pillows and can cause allergic reactions that can lead to snoring. Allowing pets to sleep on the bed causes you to breathe in animal dander, another common irritant.
"If you feel fine during the day but obstructed at night, these things may be contributing to your snoring," Slaughter says.
Put your pillows in the air fluff cycle once every couple weeks and replace them every six months to keep dust mites and allergens to a minimum. And keep pets out of the bedroom.
Beware before spending money on special pillows designed to prevent snoring, Chokroverty says. "They may work if it props up your head, which fixes nasal issues, but can cause neck pain."
7. Stay Well Hydrated.
Drink plenty of fluids. "Secretions in your nose and soft palate become stickier when you're dehydrated," Slaughter says. "This can create more snoring." According to the Institute of Medicine, healthy women should have about 11 cups of total water (from all drinks and food) a day; men need about 16 cups.
Overall, get enough sleep, sleep on your side, avoid alcohol before bedtime and take a hot shower if nasal passages are clogged, Slaughter says. "These simple practices can make a huge difference in reducing snoring." | Stress and Wellness |
By Rabia Malik, MD, as told to Kara Mayer Robinson
Myasthenia gravis (MG) is sometimes referred to as the âsnowflake diseaseâ because no two people with MG are ever alike.
This is also true for treatment response. Like other autoimmune diseases, thereâs no cure for myasthenia gravis. The goal of treatment is to have more days where you feel like yourself instead of a person with MG.
A Variety of Treatments
Your doctor may consider different types of treatment. They may have varying results.
For mild disease, acetylcholinesterase inhibitors like pyridostigmine may give you some relief.
If your symptoms are more severe, your doctor may try medications that suppress or modulate your immune system. But results often vary.
They may start with corticosteroids like prednisone. These are also known as steroids. If you need a high dosage of steroids or if your body doesnât tolerate them, your doctor may try steroid-sparing agents, like mycophenolate and azathioprine, which are also known as immunosuppressants.
There are some other newer treatments available now as well. Monoclonal antibodies are intravenous medications that target a specific part of the immune system called the complement system. Theyâre usually used for people who either donât respond to traditional treatments or have serious side effects from them. Rituximab (Rituxan) is helpful for some people with MG, particularly those with MuSK antibodies. Two others are Eculizumab (Soliris) and the one most recently approved by the FDA, ravulizumab (Ultomiris).
Efgartigimod (Vyvygart) is a new class of medication. It reduces levels of abnormal antibodies that block the signal transmission between nerves and muscle cells, which is what creates the weakness in patients with MG.
Or your doctor may recommend IV medication or thymus gland removal surgery.
What to Expect
With intravenous immunoglobulin, or IVIG, and plasma exchange, or PLEX, you may see improvement within days. With oral medications like steroids, it may take up to 2 weeks. For steroid-sparing agents, it may be several months or even up to a year.
MG medications work best if you take them consistently, without abrupt changes, so staying on track with your medication is key.
When you start taking medication, you may need to follow up closely with your doctor and complete bloodwork to make sure your body is tolerating them well.
Before you start any medication, ask your doctor about common side effects. Find out if your medication needs to be taken with food or an empty stomach.
Striking a Balance
Treating MG is about striking a fine balance between suppressing the disease and minimizing side effects. Your doctor may try different strategies to reduce side effects and improve tolerance.
For most new medications, they may start at a low dose and increase it gradually as needed.
Changing the dosage sometimes helps. For example, if you take pyridostigmine and have diarrhea, abdominal cramping, or muscle cramping, it may help to switch to a lower dosage.
If you take steroids, your doctor may recommend taking them in the morning on a full stomach to reduce stomach irritability and insomnia. Calcium and a vitamin D supplement may reduce steroidsâ impact on bone density. Limiting your sugar and salt intake may help with weight gain, fluid retention, and a spike in blood sugars and blood pressure.
When Treatment Doesnât Work
Most people with MG respond very well to medications and start noting significant improvement in symptoms. However, about 10% to 15% of people may have very resistant disease.
There are several factors that determine how you respond to treatment, including the subtype of MG and the presence or absence of thymus gland malignancy or thymoma. But there are still a number of unknown elements, which makes it difficult to predict how youâll respond to treatment.
It's also important to note that even though MG is characterized by fluctuations, some people develop fixed weakness, which may not respond to treatment.
Managing Triggers
Since MG is a relapsing and remitting disease, itâs helpful to identify your triggers.
Common triggers include:
- Stopping your MG medication suddenly
- Illness
- Recent surgery
- Sleep deprivation
- Stress
Reading and watching a screen for a prolonged period without breaks may bring on symptoms. Itâs typical for most people with MG to experience more symptoms in the late afternoon or evenings.
Itâs also important to note that certain medications, including antibiotics, and supplements, like magnesium, can aggravate MG.
Try keeping a symptom diary to track your symptoms. Note the frequency. For example, if you have double vision, is it weekly, daily, or constant? A symptom diary can help your doctor understand your response to treatment and how to modify your regimen.
Taking Care of Yourself
Medication compliance and close follow-up with your neurologist are important to get the most from your treatment and prevent MG from progressing.
Sleep Well. Try to regulate your sleep-wake cycle as much as possible. Have a consistent bedtime. Reduce stimulation in the evenings. Donât keep your TV on in bedroom. Taking a nap during the day may combat fatigue, but try to regulate the time and duration of naps.
Eat Well. Eat a clean and simple diet. Limit processed foods. Eat more fresh fruits, vegetables, and lean proteins.
Get Moving. Start an exercise program with help from your doctor. In addition to cardiovascular benefits, exercise may help with stress reduction and muscle strength. Try exercising at a time of day when you feel your best.
Get Vaccinated. Talk to your doctor about vaccines to prevent infections. The majority of vaccines, including flu, shingles, and COVID-19, are considered safe and effective for those with MG.
Build a Good Relationship With Your Doctor
A good patient-doctor relationship is key to success. Your doctor can help you achieve the goal of having more days where you feel like yourself.
Try these tips to improve your relationship with your doctor:
- Be organized. Make a list of your symptoms and your questions before your visit. At the end of your visit, ask for instructions in writing.
- Follow up. Make sure you understand when you need follow-up visits. Find out how to best get in touch with your doctor and support staff. For example, do they prefer phone calls or an online scheduling system?
Remember, open communication with your doctor is essential.
Show Sources
Photo Credit:Â jcphoto / Getty Images
SOURCES:
Rabia Malik, MD, neurologist, Rush University Medical Center, Chicago.
Neurology: âComparison of IVIG and PLEX in patients with myasthenia gravis.â
Therapeutic Advances in Neurological Disorders: âWhen myasthenia gravis is deemed refractory: clinical signposts and treatment strategies.â
Cleveland Clinic: âCorticosteroids.â
Mayo Clinic: âMyasthenia Gravis.â
BioDrugs: âMonoclonal Antibody-Based Therapies for Myasthenia Gravis.â
FDA: âFDA Approves New Treatment for Myasthenia Gravis.â | Disease Research |
Drinking Kombucha May Reduce Blood Sugar Levels in People with Type 2 Diabetes
Small Pilot Study Suggests Larger Trials Warranted to Confirm Potential Benefit of Fermented Tea.
Media Contact
Karen Teber, [email protected]
WASHINGTON (August 1, 2023) — People with Type 2 diabetes who drank the fermented tea drink kombucha for four weeks had lower fasting blood glucose levels compared to when they consumed a similar-tasting placebo beverage, according to results from a clinical trial conducted by researchers at Georgetown University’s School of Health, the University of Nebraska-Lincoln and MedStar Health. This finding, from a pilot 12-person feasibility trial, points to the potential for a dietary intervention that could help lower blood sugar levels in people with diabetes and also establishes the basis for a larger trial to confirm and expand upon these results.
This finding was reported in Frontiers in Nutrition on August 1, 2023.
Kombucha is a tea fermented with bacteria and yeasts. It was consumed as early as 200 B.C. in China, but did not become popular in the U.S. until the 1990s. Its popularity has been bolstered by anecdotal claims of improved immunity and energy and reductions in food cravings and inflammation, but proof of these benefits has been limited.
“Some laboratory and rodent studies of kombucha have shown promise, and one small study in people without diabetes showed kombucha lowered blood sugar, but to our knowledge this is the first clinical trial examining effects of kombucha in people with diabetes,” says study author Dan Merenstein, MD, professor of human science in Georgetown’s School of Health and professor of family medicine at Georgetown University School of Medicine. “A lot more research needs to be done, but this is very promising.”
Merenstein continued, “A strength of our trial was that we didn’t tell people what to eat because we used a crossover design that limited the effects of any variability in a person’s diet.”
The crossover design had one group of people drinking about 8 ounces of kombucha or placebo beverage daily for four weeks. Then, after a two-month period to “wash out” the biological effects of the beverages, the kombucha and placebo were swapped between groups with another four weeks of drinking the beverages. Neither group was told which drink they were receiving at the time.
Kombucha appeared to lower average fasting blood glucose levels after four weeks from 164 to 116 milligrams per deciliter while the difference after four weeks with the placebo was not statistically significant. Guidelines from the American Diabetes Association recommended blood sugar levels before meals should be between 70 to 130 milligrams per deciliter.
The researchers also looked at the makeup of fermenting microorganisms in kombucha to determine which ingredients might be the most active. They found that the beverage was mainly comprised of lactic acid bacteria, acetic acid bacteria, and a form of yeast called Dekkera, with each microbe present in about equal measure; the finding was confirmed with RNA gene sequencing.
The kombucha used in this study was produced by Craft Kombucha, a commercial manufacturer in the Washington, DC, area. It has been rebranded as Brindle Boxer Kombucha.
“Different studies of different brands of kombucha by different manufacturers reveal slightly different microbial mixtures and abundances,” says Robert Hutkins, PhD, University of Nebraska-Lincoln and the study’s senior author. “However, the major bacteria and yeasts are highly reproducible and likely to be functionally similar between brands and batches, which was reassuring for our trial.”
“An estimated 96 million Americans have pre-diabetes — and diabetes itself is the eighth leading cause of death in the U.S. as well as being a major risk factor for heart disease, stroke and kidney failure,” says Chagai Mendelson, MD, lead author who was working in Merenstein’s lab at Georgetown while completing his residency at MedStar Health. “We were able to provide preliminary evidence that a common drink could have an effect on diabetes. We hope that a much larger trial, using the lessons we learned in this trial, could be undertaken to give a more definitive answer to the effectiveness of kombucha in reducing blood glucose levels, and hence prevent or help treat Type 2 diabetes.”
Additional study authors at Georgetown University are Sabrina Sparkes, a student in the School of Health, Varun Sharma and Sameer Desale. In addition to Hutkins, Chloe Christensen, Jennifer M. Auchtung, Car Reen Kok and Heather E. Hallen-Adams are at the University of Nebraska-Lincoln.
The authors wish to express their gratitude to Tanya Maynigo, founder of Craft Kombucha for providing the kombucha and placebo kombucha for this study. She teaches kombucha classes in Washington, DC, and this year is launching a new brand of her favorite drink called Brindle Boxer Kombucha.
The study received no external funding. Hutkins is a co-founder of Synbiotic Health. Auchtung has a financial interest in Synbiotic Health. Merenstein is president of the International Scientific Association for Probiotics and Prebiotics board, a non-paid position. All other authors have no competing interests to declare. All kombucha and placebo drinks were donated by Craft Kombucha. Craft Kombucha did not have any access to data reported in this study. No author has any financial ties with Craft Kombucha
Top Image: Craft Kombucha | Nutrition Research |
An experimental asthma management app for Apple Watch shows promising results -- especially for low-income individuals -- but faces numerous challenges to wider adoption.
In a collaborative effort, Apple and Anthem -- now Elevance Health -- embarked on a large-scale digital asthma study announced during an Apple keynote in September 2020. The study aimed to utilize Apple's devices and an accompanying app to address the pervasive issue of asthma. While Apple has often claimed its devices can contribute to healthier living, concrete evidence has been limited.
In partnership with Anthem, the study tracked 900 asthma patients in Medicaid and commercial plans. Participants received an Apple Watch and sleep-tracking mat to monitor respiratory rate, heart rate, and awakenings for baseline data, reports STAT.
The app helped users reflect on symptoms and triggers and provided tools to respond to flare-ups. Initial data showed a potential reduction in emergency visits among Medicaid users who engaged with the intervention. On average, one visit was avoided for every four users who participated in the program.
Bronwyn Harris, a cardiologist involved in designing the product during her time at Apple, expressed optimism about the tool's potential significance in asthma self-management.
However, the app's fate hinges on a more in-depth analysis of study data, including health outcomes and cost savings. Additionally, the question remains whether the study aligns with the strategic priorities of Apple and Elevance.
The study's focus on Medicaid enrollees, a population with a higher likelihood of poor asthma outcomes, adds a crucial dimension to digital health innovation. However, challenges, such as navigating state-by-state bureaucracies and addressing concerns about smartphone affordability, underscore the complexities of targeting lower-income populations.
Despite the early positive indicators, skepticism persists. Some experts question the sustainability of the intervention, noting its complexity and potential difficulty in long-term maintenance. Moreover, the intervention operates independently of other care, potentially missing opportunities to reinforce vital relationships in healthcare.
While the study demonstrated the challenges of obtaining approval from both Apple and Anthem, the real hurdle may be launching the asthma management tool in the broader market.
Apple has been hesitant in the past when it comes to venturing into the healthcare field, and the departure of important figures involved in the study has raised doubts about the future of this tool. While the need for expansion and exploration is recognized, bureaucratic processes and high costs may hinder its wider adoption despite positive outcomes.
The two-year remote study focused on asthma sufferers between the ages of 18 and 64. Participants were required to have a health plan through Anthem or its subsidiaries. Health technology company CareEvolution collected and analyzed resulting data from the study.
An experimental asthma management app for Apple Watch shows promising results -- especially for low-income individuals -- but faces numerous challenges to wider adoption. | Medical Innovations |
Cipla To Acquire South Africa's Actor Pharma For $48.6 Million
Actor Pharma is the fifth largest privately owned, over-the-counter player in the South African private market.
Cipla Ltd.'s wholly-owned South African subsidiary—Cipla Medpro South Africa (Pty) Ltd.—entered into a binding term sheet to acquire a 100% stake in Actor Holdings (Pty) Ltd., a privately owned pharmaceutical company specialising in consumer health and generic medicine.
The consideration has been fixed at ZAR 900 million (approx. $48.6 million or around Rs 400 crore) in cash for 920 equity shares representing a 100% equity stake, according to the exchange filing dated Sept. 4.
This was a strategic acquisition for Cipla South Africa to unlock future growth opportunities and leverage cost synergies in the South African market, Cipla said in the filing.
The acquiree company—Actor Pharma—was founded in 2009 and is currently the fifth largest privately owned over-the-counter player in the South African private market. It specialises in OTC and generic medicine with established consumer brands and identified niche prescription markets in women’s health, nasal, cough and cold, and baby and child, the filing said.
The proposed acquisition is subject to the signing of the share purchase agreement, which is expected within 14 days from the date of the binding term sheet.
The transaction is expected to be completed within a maximum period of four months from the date of signing the share purchase agreement.
It will also require approval from the South African Competition Commission.
Umang Vohra, global managing director and chief executive officer at Cipla, said, "This is in line with our strategy of strengthening our OTC and wellness portfolio."
According to Paul Miller, chief executive officer of Cipla South Africa, "This is a unique opportunity that helps to build Cipla’s OTC portfolio, providing the business with a more balanced revenue contribution between the prescription and over-the-counter businesses and continue to provide additional quality medicines for consumers."
Actor Pharma's revenue for the last three years—FY23, FY22, and FY21—stood at ZAR 233.6 million ($2.6 million or around Rs 100 crore), ZAR 199.3 million ($10.8 million or around Rs 90 crore), and ZAR 154.4 million ($8.3 million or around Rs 70 crore), respectively.
Shares of Cipla closed 0.49% lower at Rs 1,238.90 apiece, as compared with a 0.37% rise in the benchmark Sensex. | Drug Discoveries |
Drugs used to treat serious bacterial infections in children and newborns may be losing their effectiveness in many countries due to "alarmingly high" rates of antimicrobial resistance (AMR), a new study finds.
The new analysis investigated bacterial samples from 11 countries in Southeast Asia and the Pacific, including China and India. It revealed that many antibiotics recommended by the World Health Organization (WHO) to treat life-threatening bacterial infections in children are less than 50% effective against the microbes that most commonly cause these illnesses. The dangerous infections include the lung infection pneumonia, the whole-body immune reaction sepsis and the nervous-system infection meningitis.
While AMR is a global threat, the new findings, published Tuesday (Oct. 31) in the journal The Lancet Regional Health - Southeast Asia, are particularly concerning for many low- and middle-income countries in the Asia-Pacific where health care resources and access to new drugs are limited, the study authors said.
"Antibiotic resistance is rising more rapidly than we realize," lead study author Dr. Phoebe Williams, an infectious disease specialist at the University of Sydney, said in a statement. "We urgently need new solutions to stop invasive multidrug-resistant infections and the needless deaths of thousands of children each year," she said.
The rise of AMR is one of the biggest public health threats facing humanity, particularly among high-risk groups, such as children and babies. Young children face a higher risk of bacterial meningitis than other age groups, for instance. Globally, between 140,000 and 214,000 newborns are estimated to die every year as a result of microbes that are resistant to antibiotics.
In the new study, the authors used statistical models to predict the rates of AMR in the 11 countries based on data from 86 published papers, which collectively included more than 6,600 samples of bacteria. They found that one particular antibiotic, ceftriaxone, is likely to only be able to treat 29% of cases of sepsis and meningitis in newborns in the studied countries. Similarly, another antibiotic, gentamicin, is only likely to treat 39% and 21% of sepsis and meningitis cases in children, respectively.
The researchers predicted that carbapenems were likely the most effective antibiotics overall; for instance, they were predicted to treat 81% of cases of sepsis or meningitis in newborns. However, these antibiotics are considered a "last-resort" treatment for many drug-resistant infections, because they target an extremely wide variety of bacteria.
Although they can be very effective, the use of these drugs needs to be carefully weighed up against the potential risk of propagating carbapenem-resistant bacteria, the authors wrote. Carbapenem-resistant strains of deadly Acinetobacter baumannii, for example, are a significant threat in hospitals.
"We need to update the guidelines, but one of the biggest problems is we're just not getting new drugs licensed for use in children and babies so there isn't really much new to recommend," Williams said. Of the 14 new antibiotics that have been licensed since 2000, only four have been licensed for use in babies because "drug companies are reluctant to do research on babies and children," she told The Guardian.
In light of these findings, the authors wrote in the paper that new drugs to treat these common infectious diseases in children are "urgently needed" and that children and newborns should be prioritized in future clinical trials.
Ever wonder why some people build muscle more easily than others or why freckles come out in the sun? Send us your questions about how the human body works to [email protected] with the subject line "Health Desk Q," and you may see your question answered on the website!
Live Science newsletter
Stay up to date on the latest science news by signing up for our Essentials newsletter.
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]) | Disease Research |
UK experts recommend chickenpox shot for kids for the first time, decades after other countries
An expert scientific committee advising the British government recommended for the first time Tuesday that children should be immunized with the chickenpox vaccine — decades after the shots were made widely available in other countries, including the U...
LONDON -- An expert scientific committee advising the British government recommended for the first time Tuesday that children should be immunized with the chickenpox vaccine — decades after the shots were made widely available in other countries, including the U.S., Canada and Australia.
In Britain, those who want to be immunized against the disease have to pay about £150 (US $184).
In a statement, Britain's Joint Committee on Vaccination and Immunisation said that children between 1 year and 18 months should be offered two doses of the vaccine, in a shot that also combines protection against measles, mumps and rubella.
“For some babies, young children and even adults, chickenpox or its complications can be very serious, resulting in hospitalization and even death,” said Andrew Pollard, chair of the expert vaccine group in a statement.
Pollard said that “decades of evidence” of the vaccine's effectiveness from other countries demonstrate the vaccine's safety; the U.S. was the first country to introduce an immunization program against chickenpox in 1995.
The U.S. Centers for Disease Control and Prevention describes chickenpox cases in the country as “rare,” estimating there are fewer than 150,000 cases and 30 deaths every year.
British experts have previously estimated there are more than 650,000 cases of chickenpox in England and Wales.
Chickenpox is a highly infectious disease that mostly affects children and can cause an itchy rash, blisters and fever. Symptoms usually last about a week, but in rare cases, the virus can lead to pneumonia, encephalitis and even death. Two doses of the vaccine offer more than 90% protection against the disease.
The chickenpox vaccine recommendation will next be considered by the government.
Britain's National Health Service has long said that introducing the chickenpox vaccine might leave some adults vulnerable to shingles, if unvaccinated children catch the virus as adults, which can be more severe than chickenpox.
Experts noted, however, that Britain's government offers the shingles vaccine to adults at risk of the disease.
Dr. Gayatri Amirthalingam, deputy director of public health programs at Britain's Health Security Agency, said the new chickenpox vaccine recommendations would “help make chickenpox a problem of the past.” | Vaccine Development |
A Vancouver woman who went to hospital seeking help for suicidal thoughts says she was further distressed by a clinician who unexpectedly suggested medical assistance in dying.
Kathrin Mentler, 37, lives with chronic depression and suicidality, both of which she says were exacerbated by a traumatic event early this year. Feeling particularly vulnerable in June, she went to Vancouver General Hospital looking for psychiatric help in dealing with feelings of hopelessness she feared she couldn’t shake.
Instead, Ms. Mentler says a clinician told her there would be long waits to see a psychiatrist and that the health care system is “broken.” That was followed by a jarring question: “Have you considered MAID?”
“I very specifically went there that day because I didn’t want to get into a situation where I would think about taking an overdose of medication,” Ms. Mentler, a first-year counselling student, told The Globe and Mail in an interview.
“The more I think about it, I think it brings up more and more ethical and moral questions around it.”
Vancouver Coastal Health, which operates the hospital, confirmed that the discussion took place but said the topic of MAID was brought up to gauge Ms. Mentler’s risk of suicidality.
MAID is not currently legal for mental illness alone. Canada legalized assisted dying in 2016 for patients with “reasonably forseeable” deaths and expanded eligibility in 2021 to those with incurable conditions who were suffering intolerably. The legislation was set to expand again in March to allow MAID for those with mental illness as a sole condition, but the federal government sought a one-year pause to allow for further study.
The issue has divided doctors, researchers and mental health advocates who have taken sides in a contentious debate that is ultimately about patient autonomy versus patient protection.
Publicized cases have fuelled criticisms that the life-ending procedure is being offered in lieu of sufficient mental health and social supports. In April, 2022, CTV News reported that a 51-year-old Ontario woman with severe sensitivities to chemicals chose MAID after failing to find affordable housing free of cigarette smoke and chemical cleaners. And last August, Global News reported that a Canadian Forces veteran seeking treatment for post-traumatic stress disorder and a traumatic brain injury was unexpectedly offered MAID by a Veterans Affairs Canada employee.
Cases like Ms. Mentler’s raise questions about just how clinicians, first responders and others should be responding to those in suicidal crisis.
When Ms. Mentler presented to Vancouver General Hospital’s Access and Assessment Centre in June, she wanted psychiatric help and was prepared to stay overnight if needed. The centre offers mental health and substance use services, including crisis intervention, according to a web page about its services.
After filling out an intake form, she was taken to a smaller room where she shared her feelings and mental health history with a clinician. Day-to-day life was feeling overwhelming and she worried about her persistent feelings of depression, she recalled telling the clinician.
“She was like, ‘I can call the on-call psychiatrist, but there are no beds; there’s no availability,’ ” Ms. Mentler said. “She said to me: ‘The system is broken.’ ”
But it was the clinician’s next comments Ms. Mentler found particularly distressing.
“She said, ‘Have you ever considered MAID?’ ” Ms. Mentler said, adding that she was so bewildered by the question that she didn’t initially understand what the clinician meant. “I thought, like a maid that cleans a room?”
Ms. Mentler had not considered MAID before, but told the clinician of her past attempts to end her life by overdosing on medication. She said the clinician replied that such a method could result in brain damage and other harms, and that MAID would be a more “comfortable” process during which she would be given sedating benzodiazepines among other drugs.
The counselling student says she left the centre soon after, not wanting to think about the encounter. The next day, she says she awoke wanting to scream and cry, and posted about the exchange on a private social media account to a group of friends who echoed how troubling they found it to be.
Contacted by The Globe and Mail, Vancouver Coastal Health said MAID was brought up not as a suggestion, but as a tool to assess Ms. Mentler’s risk of self-harm.
“During patient assessments of this nature, difficult questions are often asked by clinicians to determine the appropriate care and risk to the patient,” said the health authority in a statement provided by public affairs leader Jeremy Deutsch.
“Staff are to explore all available care options for the patient and a clinical evaluation with a client who presents with suicidality may include questions about whether they have considered MAID as part of their contemplations. We understand this conversation could be upsetting for some, and share our deepest apologies for any distress caused by this incident.”
The statement said the health authority abides by current federal legislation that states MAID is only provided to legally eligible patients.
Ms. Mentler is unconvinced.
“Gauging suicide [risk] should not include offering options to die, which is what it felt like,” she said. “I also think it’s worth considering that, as of right now, MAID for mental health is not legal yet, so giving someone the specifics of the process seems wrong. How can this be standard procedure for suicide crisis intervention?”
She has since accessed supports from Vancouver Coastal Health’s Suicide Attempt Follow-up Education and Research (SAFER) program and is expected to see a psychiatrist when one is available in the fall.
Jonny Morris, chief executive of the Canadian Mental Health Association’s B.C. division (CMHA BC), said the province, like many other jurisdictions, lacks a “systematic, accepted response” for how people should approach those in suicidal crisis. This has resulted in a wide range of responses, from helpful to harmful.
“All too often, the quality of the interaction around suicide risk – the planning, the treatment – it’s often very reliant on the individual treating clinician,” he said.
“Police are often the default … If you enter into an ER, you may experience a very compassionate response, someone sitting with you to understand. You may also experience someone who doesn’t know what to do, even though you’re presenting as suicidal, and you may not even be asked about it.”
Under the Columbia-Suicide Severity Rating Scale, a widely recognized instrument for assessing suicide risk, health care providers are given a number of prompts to inquire about suicidal ideation and behaviour. They include questions about specific plans and intent, intensity of ideation, attempts and lethality.
Mr. Morris said raising MAID as a suicide risk assessment tool “doesn’t align with my understanding of what a comprehensive risk assessment would typically look like,” and said he is worried by the idea of MAID and mental illness being discussed in the same conversation.
B.C.’s Ministry of Health said it was not able to provide comment on Ms. Mentler’s specific case, but noted the Criminal Code requires that to receive MAID, a patient must make a voluntary request for the procedure that, “in particular, was not made as a result of external pressure.”
It added that all such deaths in the province “are reviewed by the Ministry of Health’s MAID Oversight Unit for compliance with the eligibility criteria and safeguards in the Criminal Code, as well as provincial safeguards and regulatory college practice standards for MAiD,” according to a statement provided by communications manager Amy Crofts.
CMHA BC is now leading an initiative to develop a provincial framework for suicide care based on international best practices, local clinical expertise and the perspectives of those with lived experience.
The guidelines, which will focus on care-provider training, standardized intake screening, management strategies and follow-up care, are expected in coming weeks. They will not be mandated, but will be delivered in partnership with health authorities.
The province has invested $2-million to support the creation of the guidelines, as well as training.
Mr. Morris said suicide deaths among people in the care of the health system are preventable, and so the health system must do what it can to meet that need.
“The health system needs to have the imagination, and the creativity, and the care and the compassion, to do what it can to help people experience conditions that are worth living in,” he said.
If you are having thoughts of suicide, call Crisis Service Canada at 1-833-456-4566 or visit crisisservicescanada.ca. Young people can also call Kids Help Phone at 1-800-668-6868, text 686868, or visit kidshelpphone.ca. If it is an emergency, call 911. | Mental Health Treatments |
Plagues, poisons and magical thinking: How COVID lab leak hysteria could be straight from the Middle Ages
The COVID "lab leak" story clearly isn't going away soon. The theory that the pandemic began with an accidental release of the virus from a lab in Wuhan recurs like clockwork—most recently in a report from Senate Republicans in the US this week.
Earlier this year, the US Department of Energy and FBI endorsed the same theory. It's a very modern story—but as medievalists, we can tell you we've been here before, and we should be wary of simple narratives of blame.
The lab leak theory remains a legitimate hypothesis to investigate. Yet much of the discussion surrounding it shows evidence of the "contagion effect" of magical thinking—the belief that a visible effect is somehow contaminated by a hidden essence linked to its origin.
The anxieties still whirling in conservative media echo the escalating accusations of well-poisoning in medieval Europe. These exploded into mass violence in the mid-14th century, and survive in later legends about witches' ability to concoct poisonous agents.
In an age of antibiotics and scientific explanations, we like to consider ourselves more advanced than our forebears. But our research into the early history of conspiracy theories and xenophobia tells a more complicated story about how magical thinking continues to shape our response to disasters like the pandemic.
Poisonous powders and plagues
Fears of contagion often derive from anxieties about unknown or poorly understood aspects of disease. Who among us never felt compelled to disinfect our groceries or mail during the early months of the pandemic?
Our current research, "The First Era of Fake News: Witch-Hunting, Antisemitism and Islamophobia," examines how myths that emerged during the Middle Ages are still being used to justify modern atrocities. It shows how the contagion effect also leads to scapegoating and faulty attributions of blame. The threat of disease is layered onto suspicious "others"—such as Jews during the Middle Ages, or Chinese labs today.
When Jews were accused of poisoning wells to cause outbreaks of plague in 1348–49, the "contagion" associated with them was both literal and metaphorical. Jews were accused of concocting poisonous powders from spiders, toads and human remains—the ingredients form a running list of items invoking disgust and fear of infection.
But Jews were also considered suspicious simply because they were Jews—exotic religious outsiders who might have connections with coreligionists in other cities, or who might travel far from home. Jews were feared to contaminate Christian communities by their very presence, and medieval preachers weren't shy about saying so.
We can call this kind of contagion "magical"—fear that simple contact with a mistrusted outsider somehow makes us vulnerable to influences or activities we do not understand. We should take heed: in the case of well-poisoning accusations, those fears led to the wholesale slaughter of Jewish communities in Central Europe.
Individual Jews were tortured into elaborate confessions of guilt, then murdered along with their communities. They were blamed for the plague's spread and devastation. The contagion effect easily convinced medieval Christians that a terrible disease must originate with people already considered suspicious.
Conspiracy and Christianity
There are similar fears of magical contagion in theories about the lab leak being the pandemic's origin. Blame is a powerful motivator. We continue to be swayed by the idea that some specific agency must be responsible, rather than unpredictable processes of virus mutation.
Even China has embraced this logic, with various suggestions made about the virus emerging somewhere (anywhere) outside its borders. The contagion effect has also been manipulated for political advantage. Donald Trump's early fear mongering about a "China virus" was a convenient distraction from the failures of his own administration in the early days of the pandemic.
Like medieval civic leaders, it was easier for some politicians to assuage the rage and anxiety of people with stories of blame than by acknowledging failures and unknowns.
There are bad as well as good reasons to investigate the lab-leak hypothesis. Using the theory as a way to target and punish enemies is a bad reason. So is the a priori assumption that nefarious intentions lie somewhere behind every major event, a cornerstone of conspiratorial thinking both ancient and modern.
We should be on the alert for this style of thinking. It tends to get people killed. When Jews were accused of poisoning wells in medieval Europe, they were believed by many to be doing so "in order to destroy and eradicate the whole Christian religion."
Viral magical thinking
In some political quarters, the lab-leak theory operates as the thin edge of a similar civilisational struggle, with the Chinese as the villains working in secret on various schemes to dominate or destroy Western democracies.
Such accusations attempt to impose coherence on a profoundly uncertain situation, and suggest a reassuring narrative of clear cause and effect rather than random chance.
China's tight-lipped approach to information-sharing isn't helping to allay suspicions. In the eyes of lab-leak theory advocates, the desire to hide information suggests something more nefarious than a simple desire to avoid blame.
But embracing an argument built on a tissue of circumstantial evidence is also part of the conspiracy theory playbook: magical thinking enters the gray zone of unanswered questions to create elaborate narratives of false reassurance.
Some questions about the origin of COVID-19 may never be answered. For many, that is an unpalatable idea. Yet if we are to intervene in this historical pattern of overreaction, conspiracy theory and blame, we need to be honest about the limits of our knowledge.
Provided by The Conversation | Epidemics & Outbreaks |
WASHINGTON — The main U.S. health agency is formally recommending that the Drug Enforcement Administration ease government restrictions on marijuana, which remains illegal at the federal level despite more than 40 states legalizing its use in some form.
The move comes 11 months after President Joe Biden ordered the Department of Health and Human Services to conduct a review of the drug. The recommendation would move marijuana from what’s known as a Schedule I drug to Schedule III under the Controlled Substances Act.
In the eyes of the DEA, cannabis is in the same category as other Schedule I drugs like heroin and LSD, meaning it’s considered to have a high potential for abuse and no accepted medical use.
A spokesperson for HHS said it has “expeditiously” responded to the directive in providing its recommendation to the DEA on Tuesday.
If the DEA were to reschedule cannabis to Schedule III, it would most notably eliminate an IRS code intended to prevent drug dealers from claiming tax deductions for business expenses.
That alone could save the marijuana industry at least $100 million, and small business owners who spoke to NBC News said the inability to deduct what would otherwise be ordinary business expenses is their single biggest financial burden.
Now that HHS has made its recommendation, all eyes are on the DEA which has the ultimate authority on scheduling substances.
The Biden administration had hoped to announce the rescheduling of the drug sometime in the fall, around the one-year mark following Biden's request for the review, according to five sources familiar with planning. It's not yet clear how long the DEA’s public review process will take.
The DEA did not immediately respond to a request for comment.
Asked about the recommendation during a press briefing Wednesday, White House press secretary Karine Jean-Pierre said the review “is an independent process that is led by HHS and” the Department of Justice, adding that she would not comment on where Biden currently stands on the issue of decriminalizing marijuana at the federal level.
Reaction to the HHS recommendation has been largely positive on Capitol Hill. In a statement, Senate Majority Leader Schumer praised HHS as having done “the right thing” and urged the DEA to “quickly follow through on this important step to greatly reduce the harm caused by draconian marijuana laws.” Schumer, D-N.Y., said “there is much more that needs to be done legislatively to end the federal prohibition on cannabis and roll back the War on Drugs.”
Marijuana legalization advocates see this initial step as significant in and of itself: the federal government is formally recognizing cannabis’ medical contributions for the first time.
The Cannabis Industry Association on Wednesday said that while the recommended reclassification would be historic, more should be done to align federal law with states where marijuana is legal. “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 CEO Aaron Smith in a statement.
Easing federal marijuana restrictions is also a political issue that both parties hope to capitalize on ahead of a major election next year as polls have indicated a majority of Americans support legalization.
Some Republicans, including Florida Reps. Matt Gaetz, Greg Steube and Brian Mast have publicly called on the drug to be rescheduled and urged the Biden administration to prioritize the effort. But on the presidential campaign trail, Florida Gov. Ron DeSantis doubled down this week on his opposition to marijuana decriminalization and legalization, despite voters in his state legalizing medical use of the drug last year. The Florida Supreme Court is now considering whether a cannabis legalization initiative will appear on the ballot in 2024.
Separately, there is an ongoing bipartisan effort in Congress that would make it easier for financial institutions to offer banking services to legal cannabis companies.
Schumer has said that getting the legislation, known as the SAFE Banking Act, across the finish line was a “top priority” when the Senate returns in September. But a looming government shutdown could complicate that effort, even as lawmakers behind the bill have worked to break an impasse over the August recess. | Drug Discoveries |
Iran's Supreme Leader Ayatollah Ali Khamenei has called the wave of suspected poisonings of schoolgirls in recent months an "unforgivable crime".
"If there are any people involved in the matter, and there certainly are... the perpetrators must be given the most severe of punishments," he warned.
More than 1,000 girls at dozens of schools have been affected by unexplained illnesses since November.
Incidents were reported in at least 15 cities and towns on Sunday alone.
Authorities have released very little information about their investigations and announced no arrests, but they have accused Iran's "enemies" of using the suspected poisonings to undermine the clerical establishment.
Some Iranians believe the girls' schools are being targeted by hard-line elements to stop them receiving an education.
Others suggest the authorities may be punishing girls for their leading role in the nationwide anti-government protests that erupted in September.
This horrifying footage shows dozens of Iranian girls gasping for breath at a school.— Parham Ghobadi (@BBCParham) March 5, 2023
Thousands of girl students have been poisoned in Iran in apparent gas attacks since November. The scope and scale is expanding on a daily basis. pic.twitter.com/YvBQLzZFrl
The first known case was reported at a school in the Shia holy city of Qom on 30 November, when 18 schoolgirls fell ill and were taken to hospital.
Since then, a total of 127 schools in 25 of Iran's 31 provinces have been affected, according to a tally by the reformist news outlet Etemad Online.
Students have said they smelled tangerine or rotten fish before falling ill. Many have suffered respiratory problems, nausea, dizziness and fatigue.
In his first public comments on the matter Ayatollah Khamenei called on law enforcement and intelligence agencies to "seriously pursue the issue".
"The poisonings are a grave and unforgivable crime," he declared during a speech at a tree planting event in Tehran, adding that there would be "no pardons" if anyone was identified as a perpetrator and convicted.
Judiciary Chief Gholamhossein Mohseni Ejei meanwhile warned that they could face the charge of "corruption on earth", which is punishable by death.
He also said special courts would be set up in each province to summon "lie-spreaders and disrupters of public opinion in the case of the poisonings".
Their remarks came a day after a series of suspected poisonings was reported in at least 15 cities and towns, with the south-western city of Ahvaz and the central city of Yazd said to have been worst affected.
Opposition activist collective 1500 Tasvir posted footage that it said showed girls at Fatemieh Art School in the western city of Hamadan shouting: "We don't want to die."
In another video, a woman in the northern city of Rasht said security forces had fired tear-gas at concerned mothers protesting outside the local education department.
On Saturday, Interior Minister Ahmad Vahidi said that investigators had gathered "suspicious samples" at affected schools, but provided no details.
Health Minister Bahram Eynollahi meanwhile told a conference last Tuesday that research indicated that "a kind of mild poison caused the intoxication".
1500 Tasvir tweeted on Sunday that it had "received the results of 25 blood tests from poisoned students in different cities" and that the "MCV number in all of them is lower than normal".
The MCV, or "Mean Corpuscular Volume" count, measures the average size of red blood cells, which are responsible for transporting oxygen from the lungs to other parts of the body. | Epidemics & Outbreaks |
Story at a glance
- Chris Meffen was on a train with his family when he was approached by a woman concerned about a spot on his face.
- That woman was Chelsey Straight, a dermatologist, and she suggested he get the spot looked at.
- It turned out to be melanoma and was removed.
AUSTIN (KXAN) — As the summer sun continues to beam down, doctors warn about the dangers of skin cancer. According to the Prevent Cancer Foundation, it’s the most common form of cancer in the country, and yet a majority of adults don’t get checked for it.
It’s a danger that hit close to home for Chris Meffen, after a train ride that might have saved his life.
“It was a big blessing,” Meffen said.
While enjoying time with his family, Meffen said a woman approached him concerned about a spot on his face.
“(She) asked me, ‘Have you ever had that spot on your, on your face checked?’ They said that, you know, I should have a dermatologist look at it,” he said.
That woman was Chelsey Straight, a dermatologist.
“Instantly his wife was like, ‘I’ve been telling you that you need to get this looked at,'” Straight said.
Straight and her husband, doctor Chris Chu, recently opened Pure Dermatology in Austin.
They were on that train ride with their family when they noticed the mark on Meffen’s face.
Meffen scheduled an appointment to get it tested. The results showed it was melanoma, and after a series of procedures, it was removed.
“Forever grateful to Dr. Straight for being on that train ride that day,” Meffen said.
Staying protected
So far this summer, the doctors said there’s been a high UV index in Texas, which makes it especially important to protect your skin.
“If you find yourself sweating a lot, you can try to find, you know, a water resistant sunscreen,” Chu said. “Or just try to wear a lot of hats.”
Straight said its important to reapply at least a 30 SPF broad spectrum sunscreen every two hours. She also recommended doing outdoor activities earlier in the morning or later in the evening.
What to look out for
The doctors said they generally recommend people who have fair skin and get a lot of sun exposure to get checked for skin cancer every year.
“If you have other risk factors, like you’ve got a strong family history of skin cancer, if you have a personal history of skin cancer, then sometimes that bumps up to every six months,” Chu said.
They said if a mole or spot is multiple colors, gets larger or starts to bleed on its own, get it checked.
Straight said there are specific things to observe when looking for melanoma:
- Asymmetrical: If the shape of the mole is asymmetrical
- Borders: If the borders are not smooth
- Colors: If it has multiple colors
- Diameter: If it is large in diameter
- Evolving: If the mole is changing shape, size or color
Chu and Straight said about 30% of melanomas come from pre-existing moles, which is why they recommend checking both old and new marks. Meffen agreed.
“The slightest little thing that you see, right away, make sure to go and get it checked,” Meffen said.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Disease Research |
Are you using — or considering using — marijuana to help with anxiety, pain, muscle spasms, nausea during pregnancy, poor sleep and more? You may be surprised to discover there is little quality evidence on the benefits of marijuana, according to a new analysis of more than 100 clinical trials and meta-analyses.
“After applying very strict quantitative criteria, and accounting for both observational studies and experimental trials, most of the associations between cannabis and health outcomes were supported by very low or low credibility,” said study author Dr. Marco Solmi, associate professor of psychiatry at the University of Ottawa and investigator at Ottawa Hospital Research Institute in Canada.
Much of the most convincing evidence in the study, in fact, pointed to the potential harms of using marijuana, especially for pregnant women, anyone with a mental health disorder and the adolescents and young adults who currently make up the majority of cannabis users.
“If we pair these findings with the fact that almost 2/3 of those with mental disorders have onset before age 25, it sounds reasonable to state that cannabis should be avoided in younger strata of the population,” he said.
The review did find some benefits of cannabis use, particularly with “seizure reduction, chronic pain, and muscle spasms,” said Carol Boyd, founding director of the Center for the Study of Drugs, Alcohol, Smoking & Health at the University of Michigan in Ann Arbor, who was not involved with the study.
However, most studies on seizures, nausea and pain have investigated the impact of carefully made synthetic cannabis or extracts, said clinical pharmacologist Robert Page II, who chaired the medical writing group for the American Heart Association’s 2020 scientific statement on marijuana. Page was also not involved in the study.
Such lab-made cannabis-based drugs have extremely high standards, and may even by regulated by the US Food and Drug Administration, which is not the case with most products members of the public can buy at their local cannabis dispensary, Page said.
“So, from a public health standpoint, I don’t want individuals to read this and say, ‘Oh, I can go down to my dispensary and take care of my pain.’ The answer is no, because the products patients are using in the real world are seldom being evaluated in these studies.”
Where marijuana may harm
Mental health: When it comes to easing the symptoms of anxiety, depression and other mental disorders, the analysis found no benefit. In fact, the opposite is actually true, Solmi said.
Mental health can be dramatically impacted by cannabis, the review found. Using the drug raised the risk of an onset of a psychotic or mental health disorder and using it after the onset of a mental condition worsened clinical outcomes, the study found.
“For instance, in people with psychosis, cannabis increases the risk of relapse, and worsens cognition,” Solmi explained.
Psychosis, often defined as emotional upset so severe that a person loses contact with reality, can occur in people with schizophrenia, bipolar disorder or severe depression. It can also be triggered by “sleep deprivation, certain prescription medications, and the misuse of alcohol or drugs,” according to the National Institute of Mental Health.
Pregnancy: Pregnant women too often turn to cannabis to ease their nausea, especially during the first trimester, studies have found. Yet the review found “convincing” evidence for a link between cannabis use and risk of having a small, low birth weight baby.
“Most of the literature on nausea during pregnancy is on prescription-level cannabis, which is synthetically made and carefully controlled as to dose, quality and levels of THC,” Page said.
Delta-9-tetrahydrocannabinol, or THC, is the part of the cannabis plant that produces a “high” — a key reason marijuana helps with nausea and pain, he added.
“It alters perception, which can affect the experience of pain,” Page said. “I do not recommend pregnant women use cannabis because it is linked to low birth weight, and based on animal data, may have effects on the fetal brain. Cannabis can also be passed to the baby while breastfeeding — why take the risk when there are other, safer choices?”
Adolescence and early adulthood: Altering perception and reality while a brain is still developing, as is the case throughout adolescence and a person’s early 20s, is dangerous for cognition and mental health, the review found.
“Adolescents and young adults in particular should be aware that cannabis can have detrimental effects on their mental health, should receive adequate information on effects of cannabis, should not use cannabis, or should monitor their mental health if they decide to use it,” he added.
Beyond psychiatric symptoms, clinical trials have found convincing evidence between cannabis and negative effects on memory, verbal cognition and visual recall, the study said.
“Cannabis worsens multiple domains of cognition,” Solmi said. “Our work can’t answer whether the effects are permanent or not, and more research should be conducted on that topic.”
Young people should “stop using cannabis if they notice a drop in educational achievements, social connections, mental health or functioning in general,” he added.
Where marijuana can help
Areas in which marijuana has been shown to help include seizures disorders, muscle spasms, chronic pain and sleep — but only for certain people, the study found.
“Cannabidiol (CBD) is beneficial for epilepsy, and cannabis-based medicines can improve spasticity in people with multiple sclerosis, pain in chronic pain conditions, (and) sleep in persons suffering from cancer,” Solmi said.
“Overall, cannabis was effective in improving pain across multiple measures of pain across different populations, he said. However, there is “no evidence cannabis improves sleep in the general population.”
And no one suffering from any of these conditions should self-medicate with cannabis, Solmi stressed.
“Those suffering from epilepsy, multiple sclerosis, or chronic pain, should seek medical advice and not self-treat symptoms with cannabis, given that it can be associated with adverse events, as any substance or medication that is commonly prescribed,” Solmi said.
Still, the review found conclusions with high certainty in either direction — positive or negative — were few and far between, said Cinnamon Bidwell, associate professor of psychology and neuroscience at the University of Colorado Boulder, who was not involved in the research.
“This literature has been strongly limited by regulatory barriers that restrict cannabis research,” she said. “The biggest take home from this summary is a need to provide pathways for researchers to conduct many more rigorous and valid trials on the harms and benefits of forms of cannabis accessible on legal markets.” | Drug Discoveries |
Subscribe to Here’s the Deal, our politics
newsletter for analysis you won’t find anywhere else.
Thank you. Please check your inbox to confirm.
Matthew Perrone, Associated Press
Matthew Perrone, Associated Press
Leave your feedback
WASHINGTON (AP) — U.S. officials have approved the first over-the-counter birth control pill, which will let American women and girls buy contraceptive medication from the same aisle as aspirin and eyedrops.
The Food and Drug Administration said Thursday it cleared Perrigo’s once-a-day Opill to be sold without a prescription, making it the first such medication to be moved out from behind the pharmacy counter. The company won’t start shipping the pill until early next year, and there will be no age restrictions on sales.
WATCH: Iowa Republicans pass ban on most abortions after 6 weeks
Hormone-based pills have long been the most common form of birth control in the U.S., used by tens of millions of women since the 1960s. Until now, all of them required a prescription.
Medical societies and women’s health groups have pushed for wider access, noting that an estimated 45% of the 6 million annual pregnancies in the U.S. are unintended. Teens and girls, women of color and those with low incomes report greater hurdles in getting prescriptions and picking them up.
Some of the challenges can include paying for a doctor’s visit, getting time off from work and finding child care.
“This is really a transformation in access to contraceptive care,” said Kelly Blanchard, president of Ibis Reproductive Health, a non-profit group that supported the approval. “Hopefully this will help people overcome those barriers that exist now.”
Ireland-based Perrigo did not announce a price. Over-the-counter medicines are generally much cheaper than prescriptions, but they aren’t covered by insurance.
Many common medications have made the switch to non-prescription status in recent decades, including drugs for pain, heartburn and allergies.
Perrigo submitted years of research to FDA to show that women could understand and follow instructions for using the pill. Thursday’s approval came despite some concerns by FDA scientists about the company’s results, including whether women with certain underlying medical conditions would understand they shouldn’t take the drug.
FDA’s action only applies to Opill. It’s in an older class of contraceptives, sometimes called minipills, that contain a single synthetic hormone and generally carry fewer side effects than more popular combination hormone pills.
But women’s health advocates hope the decision will pave the way for more over-the-counter birth control options and, eventually, for abortion pills to do the same.
That said, FDA’s decision has no relation to the ongoing court battles over the abortion pill mifepristone. The studies in Perrigo’s FDA application began years before the Supreme Court’s reversal of Roe v. Wade, which has upended abortion access across the U.S.
With some states curtailing women’s reproductive rights, the FDA has faced pressure from Democratic politicians, health advocates and medical professionals to ease access to birth control. The American Medical Association and the leading professional society for obstetricians and gynecologists backed Opill’s application for over-the-counter status.
An outside panel of FDA advisers unanimously voted in favor of the switch at a hearing in May where dozens of public speakers called for Opill’s approval.
Dyvia Huitron was among those who presented, explaining how she has been unable to get prescription birth control more than three years after becoming sexually active. The 19-year-old University of Alabama student said she still isn’t comfortable getting a prescription because the school’s health system reports medical exams and medications to parents.
“My parents did not let me go on the pill,” Huitron said in a recent interview. “There was just a lot of cultural stigma around being sexually active before you’re married.”
While she uses other forms of contraception, “I would have much preferred to have birth control and use these additional methods to ensure that I was being as safe as possible.”
Huitron spoke on behalf of Advocates for Youth, one of the dozens of groups that have pushed to make prescription contraceptives more accessible.
The groups helped fund some of the studies submitted for Opill and they encouraged HRA Pharma, later acquired by Perrigo, to file its application with the FDA.
Advocates were particularly interested in Opill because it raised fewer safety concerns. The pill was first approved in the U.S. five decades ago but hasn’t been marketed here since 2005.
“It’s been around a long time and we have a large amount of data supporting that this pill is safe and effective for over-the-counter use,” said Blanchard, of Ibsis Reproductive Health.
Newer birth control pills typically combine two hormones, estrogen and progestin, which can help make periods lighter and more regular. But their use carries a heightened risk of blood clots and they shouldn’t be used by women at risk for heart problems, such as those who smoke and are over 35.
Opill has only progestin, which prevents pregnancy by blocking sperm from reaching the cervix. It must be taken around the same time daily to be most effective.
In its internal review published in May, the FDA noted that some women in Perrigo’s study had trouble understanding the drug’s labeling information. In particular, the instructions warn that women with a history of breast cancer should not take the pill because it could spur tumor growth. And women who have unusual vaginal bleeding are instructed to talk to a doctor first, because it could indicate a medical problem.
Perrigo executives said the company will spend the rest of the year manufacturing the pill and its packaging so it can be available in stores nationwide and online by early next year.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Support Provided By:
Learn more | Drug Discoveries |
The White House has welcomed the outline of a bipartisan Senate agreement to rein in gun violence.
Watch the briefing in the player above.
Although waiting for the bill’s text, White House press secretary Karine Jean-Pierre acknowledged “the president is pleased to see this is a step forward,” adding President Joe Biden “wants to see this on his desk as quickly as possible.”
While the framework has has no game-changing steps banning the deadliest firearms. It does propose measured provisions making it harder for some young gun buyers, or people considered threatening, to have weapons.
And there are meaningful efforts to address mental health and school safety concerns.
It all reflects election-year pressure to act both parties feel after mass shootings in May killed 10 people in Buffalo, New York, and 21 more in Uvalde, Texas.
While not announcing details of a presidential trip to the Middle East, Jean-Pierre did confirmed that the White House was planning travel to Israel and Saudi Arabia.
WATCH: Analyzing the Jan. 6 hearings and a potential agreement on gun reform
Biden is leaning towards making a visit to Saudi Arabia — a trip that would likely bring him face-to-face with the Saudi crown prince he once shunned as a killer.
The White House is weighing a visit that would also include a meeting of the leaders of the Gulf Cooperation Council countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates) as well as Egypt, Iraq and Jordan, according to a person familiar with White House planning, who spoke on the condition of anonymity to discuss the yet-to-be finalized plans.
It comes as overriding U.S. strategic interests in oil and security have pushed the administration to rethink the arms-length stance that Biden pledged to take with the Saudis as a candidate for the White House.
Any meeting between Biden and de facto Saudi ruler Prince Mohammed bin Salman during a Biden visit to the Middle East could offer hope of some relief for U.S. gasoline consumers, who are wincing as a squeaky-tight global oil supply drives up prices. Biden would be expected to meet with Prince Mohammed if the Saudi visit happens, according to the person familiar with the deliberations.
Jean-Pierre also urged the United Kingdom and European Union to return to talks as Britain’s government proposes new legislation that would unilaterally rewrite post-Brexit trade rules for Northern Ireland, despite opposition from some U.K. lawmakers and EU officials who say the move violates international law.
The proposed bill seeks to remove customs checks on some goods entering Northern Ireland from the rest of the U.K. That will override parts of the trade treaty that Prime Minister Boris Johnson signed with the European Union less than two years ago. | Mental Health Treatments |
- Oops!Something went wrong.Please try again later.
Toby Keith's health has been making headlines since he first shared that he'd been diagnosed with stomach cancer in June 2022. Fans have eagerly awaited updates on how the country star is doing and what his prognosis is.
Keith has shared some details publicly about his cancer treatment and has seemed to keep his spirits high over the past two years of being treated for the disease. He even performed for the first time since his diagnosis at People’s Choice Country Awards on Sept. 28.
Since then, he also sold out three night of shows taking place in Las Vegas in December 2023.
The "Red Solo Cup" crooner has made it clear since revealing his news that he intends to perform again with his band soon. Here's what else we know about Toby Keith's health and illness.
What illness does Toby Keith have?
Keith revealed that he was diagnosed with stomach cancer in the fall of 2021.
"Last fall I was diagnosed with stomach cancer,” Keith posted in June 2022 when he finally made his diagnosis public. “I’ve spent the last 6 months receiving chemo, radiation and surgery. So far, so good. I need time to breathe, recover, and relax.”
“I am looking forward to spending this time with my family. But I will see the fans sooner than later. I can’t wait.”
Stomach cancer, also known as gastric cancer, occurs when cancer cells develop in any part of the stomach, but in the U.S. it most often starts where the esophagus connects to the stomach, according to Mayo Clinic.
There are several different types of stomach cancer based on where the cancer cells form and from what kind of cells. The most common type, according to the National Cancer Institute, is adenocarcinoma of the stomach, which starts in the mucus-producing cells in the inner-most stomach lining. Most are being in the upper part of the stomach close to the esophagus.
Stomach cancer is the fifth most common type of cancer worldwide and affects men and people of color more than women or whites. Your risk of stomach cancer can increase due to genetics, certain medical conditions, diet low in fruits and vegetables and high in processed foods, tobacco use and your environment.
Common symptoms of stomach cancer include trouble swallowing, pain in your abdomen, feeling bloated or full after having small amounts of food, not feeling hungry, nausea, heartburn, indigestion, vomiting, losing weight, fatigue and black stools.
How is Toby Keith doing?
Keith is doing well enough to be able to perform for a full crowd in December 2023. He announced on Nov. 3 that all three of his shows at Las Vegas' Dolby Live venue are sold out.
The most recent time Toby Keith shared how he was doing, he said "I feel pretty good," while at the inaugural People’s Choice Country Awards at the Grand Ole Opry in Nashville on Sept. 28.
“It’s a little bit of a roller coaster," he continued to E! News. "You get good days and, you know, you’re up and down, up and down. It’s always zero to 60 and 60 to zero, but I feel good today.”
He attended the event with wife Tricia Lucus and was strong enough to perform “Don’t Let the Old Man In” from Clint Eastwood’s movie “The Mule.” He said he chose the song because of his cancer.
"I’ve been going through my cancer fight for the last couple of years, and it’s really inspiring for a lot of people,” he said during NBC’s pre-show event. “And coming back on TV for the first time and performing live in front of a live audience, I thought it was fitting.”
Keith shared back in June 2023 that his cancer was moving in a "real positive trend" because his tumor had shrunk and that he hoped to be performing again soon.
The country star first revealed that he'd been diagnosed with cancer in June 2022, about six months after he'd started treatment. He first received his diagnosis in the fall of 2021.
Since then, he's opened up about being treated for stomach cancer a few different times, noting that the condition can be "debilitating" and that he was trying to get back into "fighting shape" with the hope of performing again.
What is Toby Keith's prognosis?
When Keith first shared his diagnosis publicly, he did not provide a specific prognosis or stage of his cancer but did explain that his treatment would require chemotherapy, radiation and surgery for at least six months.
The American Cancer Society explains that for some early stage stomach cancers, radiation and chemotherapy can be used before surgery "to try to shrink the cancer and make it easier to remove." Radiation and chemotherapy can also be used after surgery to kill any cancer cells that remained after the surgery.
When caught in an early stage, most stomach cancers are curable. However, most stomach cancers are actually found in later stages, making them harder to treat, Mayo Clinic notes.
In June 2023, he told The Oklahoman that his treatments have been working, saying that his tumor had shrunk by one-third and his blood scans indicated his health was moving in the right direction.
“I’m about another eight weeks from my last scan," he said. "So I expect next time I look for that tumor to be even less — and I’ve only got one that’s shown up. Basically, everything is in a real positive trend.”
In a December 2022 interview with “CMT Hot 20 Countdown,” he said he felt optimistic about his prognosis. “It’s pretty debilitating to have to go through all that, but as long as everything stays hunky-dory, then we’ll look at something good in the future,” he said.
Will Toby Keith tour in 2023?
The country singer will perform in Las Vegas for three nights in late 2023 — Dec. 10, 11 and 14. He announced on Instagram on Nov. 3 that all three nights had sold out already. According to his website, he does not having any other upcoming performance dates besides the three nights in Las Vegas in December 2023.
How old is Toby Keith?
Keith is currently 62 years old.
When he was diagnosed with stomach cancer in fall 2021, he was about 60 years old.
Does Toby Keith have kids?
Yes, Keith has three children with wife Tricia Lucus. The oldest is daughter Shelley Covel Rowland, 43; followed by singer-songwriter and daughter Krystal Keith, 38; and son Stelen Keith Covel, 26.
This article was originally published on TODAY.com | Disease Research |
In a bold move to address longstanding concerns about drug policy in the UK, the UK Pirate Party is advocating for the decriminalization of drug possession. This proposal comes in the wake of a leaked 27-page report, which reveals that official drug advisers recommended such a move back in 2016. Despite attempts to keep this report confidential, it has sparked a vital conversation about the country's approach to drug use.
The leaked report, sent to the then home secretary, outlined several compelling arguments in favor of decriminalization. It emphasized the lack of consistent international evidence that criminalization effectively reduces drug use and highlighted that the UK was not obligated to criminalize drug use under its treaty obligations. Furthermore, the report noted that criminalization had detrimental effects on individuals' educational and employment prospects.
This revelation has put the spotlight on the UK government's approach to drug policy, which has faced growing criticism in recent years. Scotland, in particular, has pointed out that this approach has led to greater harm to those who use drugs. The UK government's recent announcement of plans to imprison individuals for possessing laughing gas has further intensified the debate.
Experts in the field, including Professor David Nutt, argue that this suppression of recommendations reflects a reluctance to embrace evidence-based drug policies. The report itself aimed to align the 1971 Misuse of Drugs Act with the 2016 Psychoactive Substances Act, which generally does not criminalize possession. It also cited the success of Portugal in decriminalizing drugs and the stable drug use rates in countries that have decriminalized possession.
Steve Rolles of Transform Drug Policy Foundation stressed that transparency in this matter could have accelerated much-needed reforms, reducing the negative impacts of the UK's current drug laws.
The former Prime Minister of New Zealand, Helen Clark, who chairs the Global Commission on Drug Policy, commended the leaked advice and called on the UK government to consider and act on it.
However, the government's response has been steadfast in maintaining its tough stance on drugs. The Home Office has emphasized the dangers of illegal drug use and affirmed its commitment to tackling drug supply and supporting treatment and recovery programs.
While the prime minister and other political figures have rejected the idea of drug decriminalization, the UK Pirate Party is taking a different stance. They believe it's time to prioritize a harm reduction approach and a fresh perspective on drug policy to better serve individuals and communities.
In contrast to the government's stance, the UK Pirate Party sees decriminalization as a way to address the ongoing drug crisis, reduce harm, and offer support to those in need. Their push for a new approach to drug policy seeks to align the UK with evidence-based practices that have proven successful in other countries.
As the debate continues, it remains to be seen whether the UK will consider the evidence put forth by its own drug advisers and follow the lead of nations that have adopted more progressive drug policies. The conversation initiated by the UK Pirate Party's advocacy for drug decriminalization is a critical step toward reevaluating and reshaping the nation's approach to drug use and its consequences. | Health Policy |
A breakthrough technique developed by University of Oxford researchers could one day provide tailored repairs for those who suffer brain injuries. The researchers demonstrated for the first time that neural cells can be 3D printed to mimic the architecture of the cerebral cortex. These results have been published today in the journal Nature Communications.
This advance marks a significant step towards the fabrication of materials with the full structure and function of natural brain tissues. The work will provide a unique opportunity to explore the workings of the human cortex and, in the long term, it will offer hope to individuals who sustain brain injuries.
Lead author Dr Yongcheng Jin (Department of Chemistry, University of Oxford)
Brain injuries, including those caused by trauma, stroke and surgery for brain tumours, typically result in significant damage to the cerebral cortex (the outer layer of the human brain), leading to difficulties in cognition, movement and communication. For example, each year, around 70 million people globally suffer from traumatic brain injury (TBI), with 5 million of these cases being severe or fatal. Currently, there are no effective treatments for severe brain injuries, leading to serious impacts on quality of life.
Tissue regenerative therapies, especially those in which patients are given implants derived from their own stem cells, could be a promising route to treat brain injuries in the future. Up to now, however, there has been no method to ensure that implanted stem cells mimic the architecture of the brain.
In this new study, the University of Oxford researchers fabricated a two-layered brain tissue by 3D printing human neural stem cells. When implanted into mouse brain slices, the cells showed convincing structural and functional integration with the host tissue.
The cortical structure was made from human induced pluripotent stem cells (hiPSCs), which have the potential to produce the cell types found in most human tissues. A key advantage of using hiPSCs for tissue repair is that they can be easily derived from cells harvested from patients themselves, and therefore would not trigger an immune response.
The hiPSCs were differentiated into neural progenitor cells for two different layers of the cerebral cortex, by using specific combinations of growth factors and chemicals. The cells were then suspended in solution to generate two ‘bioinks’, which were then printed to produce a two-layered structure. In culture, the printed tissues maintained their layered cellular architecture for weeks, as indicated by the expression of layer-specific biomarkers.
When the printed tissues were implanted into mouse brain slices, they showed strong integration, as demonstrated by the projection of neural processes and the migration of neurons across the implant-host boundary. The implanted cells also showed signalling activity, which correlated with that of the host cells. This indicates that the human and mouse cells were communicating with each other, demonstrating functional as well as structural integration.
The new advance builds on the team’s decade-long track record in inventing and patenting 3D printing technologies for synthetic tissues and cultured cells.
Senior author Dr Linna Zhou (Department of Chemistry, University of Oxford) said: ‘Our droplet printing technique provides a means to engineer living 3D tissues with desired architectures, which brings us closer to the creation of personalized implantation treatments for brain injury.’
Senior author Associate Professor Francis Szele (Department of Physiology, Anatomy and Genetics, University of Oxford) added: ‘The use of living brain slices creates a powerful platform for interrogating the utility of 3D printing in brain repair. It is a natural bridge between studying 3D printed cortical column development in vitro and their integration into brains in animal models of injury.’
Senior author Professor Zoltán Molnár (Department of Physiology, Anatomy and Genetics, University of Oxford) said: ‘Human brain development is a delicate and elaborate process with a complex choreography. It would be naïve to think that we can recreate the entire cellular progression in the laboratory. Nonetheless, our 3D printing project demonstrates substantial progress in controlling the fates and arrangements of human iPSCs to form the basic functional units of the cerebral cortex.'
Senior author Professor Hagan Bayley (Department of Chemistry, University of Oxford) said: ‘This futuristic endeavour could only have been achieved by the highly multidisciplinary interactions encouraged by Oxford's Martin School, involving both Oxford's Department of Chemistry and the Department of Physiology, Anatomy and Genetics.’
The study ‘Integration of 3D-Printed Cerebral Cortical Tissue into an ex vivo Lesioned Brain Slice’ has been published in Nature Communications. | Medical Innovations |
New research suggests sleepiness during virtual meetings is caused by mental underload and boredom. Earlier studies suggested that fatigue from virtual meetings stems from mental overload, but new research from Aalto University shows that sleepiness during virtual meetings might actually be a result of mental underload and boredom.
'I expected to find that people get stressed in remote meetings. But the result was the opposite -- especially those who were not engaged in their work quickly became drowsy during remote meetings,' says Assistant Professor Niina Nurmi, who led the study.
The researchers measured heart rate variability during virtual meetings and face-to-face meetings, examining different types of fatigue experiences among 44 knowledge workers across nearly 400 meetings. The team at Aalto collaborated with researchers at the Finnish Institute of Occupational Health, where stress and recovery are studied using heart rate monitors. The paper was published in the Journal of Occupational Health Psychology.
'We combined physiological methods with ethnographic research. We shadowed each subject for two workdays, recording all events with time stamps, to find out the sources of human physiological responses,' Nurmi says.
The study also included a questionnaire to identify people's general attitude and work engagement.
'The format of a meeting had little effect on people who were highly engaged and enthusiastic about their work. They were able to stay active even during virtual meetings. On the other hand, workers whose work engagement was low and who were not very enthusiastic about their work found virtual meetings very tiring.'
It's easier to maintain focus in face-to-face meetings than virtual ones, as the latter have limited cognitive cues and sensory input. 'Especially when cameras are off, the participant is left under-stimulated and may start to compensate by multitasking,' Nurmi explains.
Although an appropriate level of stimulation is generally beneficial for the brain, multitasking during virtual meetings is problematic. Only highly automated tasks, such as walking, can be properly carried out during a virtual meeting.
'Walking and other automated activities can boost your energy levels and help you to concentrate on the meeting. But if you're trying to focus on two things that require cognitive attention simultaneously, you can't hear if something important is happening in the meeting. Alternatively, you have to constantly switch between tasks. It's really taxing for the brain,' Nurmi says.
Story Source:
Journal Reference:
Cite This Page: | Stress and Wellness |
These Shopping Carts Can Tell If You Have a Heart Condition🛒
A Healthcare |Fraud of Nearly $2 Billion 💰
Fentanyl Killing 1,000+ People in Wisconsin Each Year ☠
Malaria Spreading in Texas and Florida🦟
“Physical fitness is the first requisite of happiness.” – Joseph Pilates
Shopping Carts Saves Life’s🛒
1/Innovative Method for AFib Screening
A recent UK study conducted by researchers at Liverpool John Moores University explored the use of sensors integrated into shopping cart handles to detect atrial fibrillation (AFib), a common heart condition that often goes undiagnosed. The study involved 2,155 adults who used the specially equipped shopping carts, and the sensors would light up green if AFib was not detected and red if it was. While the accuracy of the system needs improvement, the researchers identified 39 previously undiagnosed AFib cases, potentially reducing the risk of strokes for these individuals.
2/AFib and the Importance of Early Detection
AFib, a condition where the heart’s upper chambers beat irregularly, affects an estimated 40 million people worldwide. It significantly increases the risk of strokes, but many individuals with AFib are asymptomatic, making it challenging to diagnose. Currently, doctors do not typically screen asymptomatic individuals for the disorder. As a result, approximately 15% of AFib cases remain undiagnosed. The study aimed to address this issue by integrating ECG sensors into shopping cart handles as a convenient and accessible screening method.
3/Future Implications and Challenges
While the AFib screening system using shopping cart handles shows promise, further refinement is necessary to improve its accuracy. In the study, only 26% of those flagged as having AFib received a positive diagnosis from the cardiologist. The researchers acknowledge the need for adjustments, such as implementing designated grip spots on the handle, to enhance accuracy. Despite the challenges, the study highlights the potential of integrating screening methods into daily routines to increase AFib diagnoses and reduce the risk of strokes in the population. Further research in larger studies will be crucial to refine and validate this innovative screening approach.
Fraud of Nearly $2 Billion💰
1/Telemedicine Fraud Scheme Unearthed
The US Department of Justice (DoJ) has exposed one of the largest healthcare fraud schemes ever prosecuted, operated by executives at DMERx. They used mass telemarketing to sell unnecessary medical equipment and prescriptions, amounting to over $1.9 billion in fraudulent orders. The DoJ filed charges against 78 individuals exploiting care programs, seizing millions in assets.
2/Alarming Statistics and Individual Cases
The DoJ uncovered $2 billion in fraudulent Medicare claims, $370 million in fraudulent prescription drug claims, and $150 million in false billings for opioids and lab testing fraud. A physician signed off on 2,800 fraudulent orthotic brace orders in under 40 seconds, and assets worth $10.3 million were seized. Since 2007, over 5,000 defendants have collectively billed over $24 billion, and a defendant was sentenced to 15 years for distributing $230 million in diverted medications.
“They die so quickly”💊
Wisconsin Watch, a nonprofit and nonpartisan newsroom, sheds light on the growing crisis of fentanyl-related deaths in Wisconsin. Fentanyl, a highly potent synthetic opioid, has been responsible for a significant increase in overdoses and poisonings. In 2021, the Wisconsin Department of Health Services reported that synthetic opioids, particularly fentanyl, caused 91% of opioid-related deaths in the state. This alarming trend has prompted the state to allocate $18 million in funding for drug abuse treatment and prevention, specifically targeting fentanyl.
2/Educating about Fentanyl
Following the tragic death of their son, Logan, to a fentanyl-laced pain medication, Rick and Erin Rachwal established the Love, Logan Foundation. The foundation aims to raise awareness about the dangers of fentanyl and reduce the stigma surrounding substance use. The Rachwal family has noticed the widespread availability of fentanyl, particularly in pill form, which poses a significant risk to young individuals who may unknowingly ingest the deadly substance. Logan’s story serves as a reminder of the importance of education and prevention efforts to combat the fentanyl crisis in Wisconsin.
First US-based Cases In Two Decades🦟
1/CDC Warns of Locally Acquired Malaria Cases
The Centers for Disease Control and Prevention (CDC) has issued a health alert urging doctors to be vigilant for cases of malaria in Texas and Florida. This warning comes after five individuals, who had not traveled outside the country, contracted locally acquired malaria infections. The CDC expressed concern that increased international travel during the summer months could lead to a rise in imported cases. These recent cases mark the first instances of locally acquired malaria in the US since 2003.
2/The Threat of Malaria Reemergence in the US
While the CDC considers the overall risk of locally acquired malaria in the US to be “extremely low,” these recent cases serve as a reminder of the potential for re-emergence. Prior to the COVID-19 pandemic, the US typically saw around 2,000 imported malaria cases annually. The recent cases in Florida and Texas, caused by the P. vivax parasite, demonstrate the need for continued vigilance due to factors such as global travel and climate change, which can increase opportunities for malaria transmission. Malaria, a deadly disease affecting millions worldwide, had been eliminated from the US in 1951 through various interventions, including improved sanitation, medical care, and mosquito control measures.
Disclaimer: This health newsletter is for educational purposes only and should not be used as a substitute for professional medical advice. The views expressed in the newsletter are those of the authors and not necessarily of the publisher or editor. Any information presented should be carefully evaluated and discussed with a healthcare provider before making any changes to medical or lifestyle choices.
Copyright (C) 2023 Nourish Note. All rights reserved. | Medical Innovations |
A hearty breakfast instead of a midnight snack could lead to better sleep when traveling
From the Journal: Chaos
WASHINGTON, Sept. 5, 2023 — Traveling to faraway places is a great way to seek out new experiences, but jet lag can be an unpleasant side effect. Adjusting to a new time zone is often accompanied by fatigue, difficulty sleeping, and a host of other problems that can turn an otherwise exciting adventure into a miserable trip.
Jet lag is caused by a difference between the circadian system — the body’s internal clock — and the surrounding environment. Around the turn of the century, scientists began to recognize that the body has multiple internal clocks, calibrated in different ways, and that jet lag-like symptoms can result when these clocks drift out of sync with each other. This can happen in several ways and grows more prevalent with age.
In Chaos, from AIP Publishing, a team of scientists from Northwestern University and the Santa Fe Institute developed a theoretical model to study the interactions between multiple internal clocks under the effects of aging and disruptions like jet lag.
Modern research has shown that circadian clocks are present in almost every cell and tissue in the body. Each relies on its own set of cues to calibrate; the brain’s clock depends on sunlight, for instance, while the peripheral organs calibrate at mealtime.
“Conflicting signals, such as warm weather during a short photoperiod or nighttime eating — eating when your brain is about to rest — can confuse internal clocks and cause desynchrony,” said author Yitong Huang.
At this point, little is known about how the body’s various internal clocks affect each other. The added complexity of accounting for multiple clocks means researchers tend to use simplified models.
“Most studies primarily focus on one particular time cue or a single clock,” said Huang. “Important gaps remain in our understanding of the synchronization of multiple clocks under conflicting time cues.”
Huang and her colleagues took a different approach, building a mathematical framework that accounts for this complex interplay between systems. Their model features two populations of coupled oscillators that mimic the natural rhythms of circadian cycles. Each oscillator influences the others while simultaneously adjusting based on unique external cues.
Using this model, the team was able to explore how such a coupled system could be disrupted and what makes the effect worse. They found that common symptoms of aging, such as weaker signals between circadian clocks and a lower sensitivity to light, result in a system that is more vulnerable to disruptions and slower to recover.
They also landed on a new method to speed up recovery from jet lag and similar disruptions. According to their results, the way to better sleep is through the stomach.
“Having a larger meal in the early morning of the new time zone can help overcome jet lag,” says Huang. “Constantly shifting meal schedules or having a meal at night is discouraged, as it can lead to misalignment between internal clocks.”
The authors plan to investigate the other side of the equation and identify the factors that result in more resilient internal clocks. Such discoveries could result in recommendations to prevent jet lag in the first place, or to keep the circadian system healthy into old age.
For more information:
Wendy Beatty
[email protected]
301-209-3090
Article Title
Authors
Yitong Huang, Yuanzhao Zhang, Rosemary Braun
Author Affiliations
Northwestern University, Santa Fe Institute | Stress and Wellness |
Subscribe to Here’s the Deal, our politics
newsletter for analysis you won’t find anywhere else.
Thank you. Please check your inbox to confirm.
Leave your feedback
After nine months of difficulty finding and filling prescriptions for Adderall, ADHD patients are now facing shortages of other medications, leaving millions who rely on the drugs with uncertainty, frustration and bureaucratic hassles.
In addition to Adderall, variations of methylphenidate, commonly known under brand names Ritalin or Concerta, are affected. According to a watchlist from the American Society of Health-System Pharmacists, some extended-release doses of methylphenidate have been in short supply since May.
WATCH: Adderall shortage raises questions about widespread dependency on the drug
While Adderall has been consistently hard to get, these other ADHD drugs that patients have turned to as alternatives have only been “intermittently available” themselves, said Dr. Michael Ganio, ASHP’s senior director of pharmacy practice and quality. For many people, the latest inconsistency in supply is nearly as vexing as the original shortage.
“These are really frustrating shortages because you can only get a 30-day supply at a time,” Ganio said. “Patients need a new prescription every 30 days. You can’t get a 90-day supply. You can’t even pay cash for a longer supply if you want to.”
More than 6 million children have been diagnosed with attention-deficit/hyperactivity disorder, according to 2016 data from the Centers for Disease Control and Prevention, and 60 percent were being treated with medication. About 4.4 percent of adults in the U.S. have been diagnosed with ADHD, with about 4.1 percent of them being treated with medication. That’s millions who use medication to help them concentrate or manage their schoolwork, employment and relationships.
Exact figures for how many people have ADHD is the subject of debate. Since 2015, more adults have been receiving pharmaceutical treatment for the disorder, according to Shire PLC, the former maker of popular medication Vyvanse. That year, the company’s analysis found that 53 percent of the 63 million prescriptions written for ADHD medications were for adults.
But while increasing demand is one reason for the shortage, it is not the only cause.
Manufacturers are required to notify the FDA of a shortage, but not the cause of the interruption. As with any drug shortages in the country, the reasons can vary, from manufacturing problems to more patients using the medication.
The Adderall shortage last year created a “perfect storm” of contributing factors that threw entrenched supply-and-demand patterns out of whack, multiple doctors who treat ADHD told the PBS NewsHour.
During the COVID-19 pandemic, patients turned to telehealth to get ADHD medications, and Adderall prescriptions jumped.
Compared with previous years, which saw small increases in the number of people receiving prescriptions for the stimulants, the percentage of girls and women aged 15 to 44 and men aged 25 to 44 who received prescriptions increased by more than 10 percent from 2020 to 2021, according to the CDC.
The agency noted several caveats, including that people who are prescribed stimulants may use them to treat a condition other than ADHD. Adderall, for example, is also used to treat narcolepsy.
The rise in prescriptions likely is not only due to changes in policies that loosened in-person visit requirements; the pandemic also led more people to seek treatment for mental health challenges, including ADHD.
“I certainly have heard people say that they had more access to care — could get it online — and [had] time for it during the pandemic. They weren’t commuting as much,” said Dr. Craig Surman, an associate professor of psychiatry at Harvard Medical School.
During those months, Surman said, he heard “diverging stories” from patients about their need to treat ADHD. With more people working from home, some realized they needed the structure of the office to keep their ADHD in check, while others found that their homes were less distracting than their offices had been.
“There is an interplay between structure, accountability and ADHD impact,” Surman said. “But it could go either way – better or worse, depending on the particular person and the kind of accountability they had.”
READ MORE: Could being born in August make an ADHD diagnosis more likely?
With greater health care accessibility, the change in demand – and manufacturers not being able to keep up with that demand – led to some shortages.
Dr. Meghan Schott, who treats children with ADHD in Washington, D.C., said the Adderall shortage resulted in doctors prescribing alternatives.
“A lot of our kids in our outpatient work are waiting days, weeks to get it to come in, even on the other variants, because [pharmacies are] not stocking it appropriately or because no one’s really prescribing Adderall anymore,” Schott said. “It’s been a hot mess.”
Then another layer: Patients, unable to find their medication in stock, started seeking out ADHD drugs at multiple stores, calling individual locations to inquire about stock. Even if they were able to find their medication, these prescriptions are not transferable between pharmacies and need to be re-issued by doctors.
To those challenging dynamics, add the nuances and limitations of insurance coverage: Brand name prescriptions are not always covered if generics are out of supply, Ganio noted.
“It’s a monthly challenge for the pharmacists and the pharmacy technicians because they’re constantly fielding phone calls and looking for a product,” Ganio said. And that searching by patients also adds to the ongoing supply confusion.
“When people are hunting pharmacy to pharmacy to pharmacy, there’s shifting demand that used to be more static,” Surman said.
Satisfying demand and solving shortages of ADHD medications is not as simple as making more medication.
ADHD medications are tightly controlled by regulations because they contain ingredients that are Schedule II controlled substances that, according to the Department of Justice, “have a high potential for abuse which may lead to severe psychological or physical dependence.” Adderall, for example, contains amphetamine, a controlled substance regulated under federal law.
While pharmacists, manufacturers, FDA and the Drug Enforcement Administration do work to anticipate shortages, getting it right ahead of time is not easy. Makers of these drugs must first get approval for a quota from the DEA on a quarterly basis, Ganio said. Pharmacists must request stock from wholesalers who may not completely fill orders.
Some members of Congress have taken note of the Adderall shortage and have called for action by the DEA and FDA. In December and February, Rep. Abigail Spanberger, D-Va., sent letters to the federal agencies asking them for their plans to alleviate shortages. In June, Sen. Ron Wyden, D-Ore., said his constituents, particularly those in rural areas, were facing shortages and that the DEA and FDA had said manufacturers had not requested any increase in production – something manufacturers have denied. Wyden said more transparency was needed and called on federal agencies to make more medication available.
“I believe the DEA and FDA have the responsibility to reach out to the manufacturers of these essential medications that are now difficult to access. These manufacturers need clear guidance on how to navigate this very complicated bureaucratic process,” Wyden said.
In the meantime, it’s “a time-consuming process to get any sort of production quarter increase,” Ganio said. “So the manufacturers cannot just turn on a switch and make more.”
And yet, for patients, the personal stakes are high. Allowing ADHD to go untreated can have long-term, serious effects, including death.
“I would consider ADHD [medication] life-sustaining, on average, across the population of people with ADHD, because you see higher morbidity, mortality and earlier mortality,” Surman said. “People die earlier on average and [have] higher rates of accidents.”
In the adult world, medication “will stop you from getting in car accidents.”
For children, untreated ADHD can manifest as hyperactivity and result in behavioral challenges in the classroom and school discipline, such as suspensions or expulsion, as well as academic underperformance that can affect the rest of their lives.
Medication “actually allows them to function throughout the day and allows them to not get in trouble,” Schott said.
“We don’t think of it as things that you need. But for kids that are struggling with ADHD, it is something they need,” he added.
Support Provided By:
Learn more | Drug Discoveries |
Freedom Day remembered
How the doomsayers got it wrong
It is two years to the day since the government lifted all COVID-19 restrictions. Not everybody was pleased.
In a letter to the Lancet, a group of self-proclaimed experts condemned “Freedom Day” (as it was dubbed by the press) as “unethical and illogical”. The signatories, which included the perennial Zero Covid advocates Stephen Reichter, Susan Mitchie, Martin McKee and Gabriel Scally, wrote: “We believe the government is embarking on a dangerous and unethical experiment”. In the British Medical Journal, many of the same academics called the lifting of restrictions “a terrible mistake” and described the new focus on personal responsibility as “an abdication of the government’s fundamental duty to protect public health”.
“I can’t think of any realistic good scenario to come out of this strategy,” said Julian Tang, a clinical virologist at the University of Leicester. “I think it’s really a degree of how bad it’s going to be.” “Allowing infections to run amok in the country is a dangerous mistake”, said Stephen Griffin of Leeds University, while his Independent Sage colleague Christina Pagel said: “It feels really surreal (and not in a good way) to be living in a country that is actively trying to infect young adults and children with Covid.” Robert West, a nicotine addiction expert married to Susan Mitchie, said that telling people to behave responsibly was “like putting someone out on the road without having taught them to drive.”
In the Guardian, Polly Toynbee called it “calamitous health policy misjudgment.” In the same newspaper, Dr Rachel Clarke said that she was “disgusted” by “the government’s decision to pour petrol on Covid numbers.”
Labour leader Keir Starmer called it “a reckless free for all”
Labour leader Keir Starmer called it “a reckless free for all” and said that the government “urgently needs to change course [and] drop plans to lift all restrictions”. Liberal Democrat leader Ed Davey said Boris Johnson had “got it wrong” with his “gamble” and called for mask-wearing to remain mandatory. A report from the Tony Blair Institute for Global Change predicted that the number of people forced to isolate could soon hit ten million and proposed a hierarchical three-tier system for the unjabbed, single-jabbed and double-jabbed, with the latter no longer forced to self-isolate.
The rest of Europe, bar Sweden, continued to labour under a range of restrictions and looked on in horror at Britain’s experiment with normality. In Australia, the former secretary health department Stephen Duckett said: “There is no reputable public health adviser of any kind who would recommend opening up at a time when the virus is spreading rapidly.” In the Financial Times, a columnist reported that “other countries look upon the UK with bemusement”. “I don’t need untapped freedom, festivals and frenzy”, she added. “I just want a foreign holiday.” Another FT columnist quipped that Freedom Day should really be called “Surrender Day”, adding that “England waves a white flag to the virus and embarks on a strategy of mass infection.” Dr Mike Ryan, the executive director of the World Health Organisation’s health emergencies programme called it “moral emptiness and epidemiological stupidity”. Irish Times readers living in England told the newspaper that the lifting of restrictions was “ludicrous” and “scary”. “It is extraordinarily hard to live under Boris Johnson’s government,” wrote one woman who intended to use “stronger masks” from now on, “their lack of care for others is overwhelming.”
Many critics argued that what appeared to be freedom was anything but. Journalist Carole Cadwalladr, who helped form Independent Sage, tweeted: “It’s not ‘Freedom Day’. It’s #UnFreedomDay. It’s the triumph of unreason & untruth & unscience.” On the academic website The Conversation, a lecturer in Political Communications at Nottingham Trent University argued that the whole idea of “Freedom Day’ was propaganda. “Concepts like ‘freedom’ and ‘liberty’ have been invoked by propagandists since the 16th-century Protestant Reformation and subsequent Enlightenment period”, he sagely observed.
On his LBC show, James O’Brien nearly had an aneurysm as he tried to work out the difference between advice and compulsion:
Why are you calling it Freedom Day if you’re telling me I can still catch it, I can still pass it on even if, as I am, I’m fully vaccinated? And you’re telling me I should still protect myself and others by following the advice that you’ve just freed me from having to follow? Are you still with me at the back? Are you free or are you not free? Are you free to follow? Are you free to not follow? What?!
With no sign of Boris Johnson backing down, the projections of epidemiological modellers would finally be put to the test. On the Today programme, Prof John Edmonds from the London School of Hygiene & Tropical Medicine predicted that there would be a “higher level of incidence for a protracted period right through the summer and probably through much of the autumn”. His fellow modeller Neil Ferguson said that it was “almost inevitable” that the number of daily cases, then running at 50,000, would hit 100,000 after all restrictions were lifted. “The real question is do we get to double that — or even higher,” he said. With hospital admissions for COVID-19 running at 4,000 a day, former health secretary Jeremy Hunt said “we are heading for about 10,000 Covid hospital patients by the end of August”.
None of this happened, of course. As any armchair epidemiologist who had seen the schedule of the European football championships could have predicted, the number of new infections had peaked more than a week earlier. In England that summer, the number of daily recorded cases remained below 60,000 and soon fell to less than half of that. The number of daily Covid-related hospital admissions barely exceeded 5,000, of which a growing number were not primarily due to Covid.
Boris Johnson and Rishi Sunak spent the day self-isolating after coming into contact with health secretary Sajid Javid who had come down with the virus two days earlier. In Trafalgar Square, anti-lockdown campaigners held an eccentric protest against lockdowns.
The people who been so hysterically and completely wrong dusted themselves down and prepared to do it all again when the Omicron variant emerged in the winter. None of them ever apologised.
Enjoying The Critic online? It's even better in print
Try five issues of Britain’s newest magazine for £10Subscribe | Epidemics & Outbreaks |
WASHINGTON - U.S. Secretary of State Antony Blinken called Friday on dozens of countries to work together to combat synthetic drugs, but China — facing blame in Washington over an addiction epidemic — denounced the effort.
Inaugurating a new U.S.-led "coalition" on the scourge, Blinken told ministers from more than 80 countries that the United States — where nearly 110,000 Americans died last year from drug overdoses, mostly from fentanyl and other synthetic opioids — was "a canary in the coal mine."
"Having saturated the United States market, transnational criminal enterprises are turning elsewhere to expand their profits," Blinken said.
"If we don't act together with fierce urgency, more cities around the world will bear the catastrophic costs" witnessed in the United States, he said.
Americans' addictions began soaring in the 1990s as painkillers were aggressively marketed by profit-seeking pharmaceutical companies, with a disproportionate effect on veterans from U.S. wars in Iraq and Afghanistan.
As the drugs' addictiveness became increasingly clear, the United States pressured China, the chief source of fentanyl, to ban exports, which it did in 2019.
But China is still a major producer of precursor chemicals, which are then shipped to Mexico and Central America where cartels produce fentanyl for smuggling into the United States.
With China increasingly seen as hostile in the United States, lawmakers facing addicted constituents have again put blame on Beijing.
Some Republicans have called for military action against cartels in Mexico.
China refused an invitation to participate in the coalition, saying it believed in international cooperation against drugs but that the United States has sent the wrong message by imposing sanctions on Chinese companies over fentanyl.
China "firmly opposes smearing and attacking other countries or imposing unilateral sanctions on other countries in the name of counternarcotics," Foreign Ministry spokesperson Weng Wenbin said in Beijing.
Global coordination
Todd Robinson, the U.S. assistant secretary of state for international narcotics and law enforcement, said the United States would welcome China's participation in future meetings and hoped that other countries would reach out to Beijing.
"Part of the reason we're trying to bring this coalition together is to engage other countries in their efforts against these supply chains, and part of their responsibility is going to be engaging with the PRC," he said, referring to the People's Republic of China.
Blinken implicitly acknowledged that action by China alone would not end the epidemic.
"When one government aggressively restricts a precursor chemical, traffickers simply buy it elsewhere," he said.
South Korean Foreign Minister Park Jin said that COVID-19 showed the need for global coordination on emerging epidemics, including drugs.
"We once prided ourselves as a drug-free country. Yet today we are witnessing a significant increase in drug consumption, especially among our youth," Park said.
Blinken said the coalition would also look at best practices domestically in treating addiction.
Members of the coalition will meet in person in September on the sidelines of the U.N. General Assembly, Blinken said.
The new grouping will also address other synthetic drugs including captagon, the amphetamine-like stimulant that has seen a surge of use in Arab countries including Saudi Arabia, which was participating in Friday's meeting.
An AFP investigation in November found that Syria has developed a $10 billion industry in captagon, dwarfing all other industries in the war-ravaged country and funding President Bashar al-Assad and many of his enemies. | Drug Discoveries |
- A tick expert from Connecticut predicts "an above average year for tick activity" because of this year's mild winter.
- Lyme disease is common in the Northeast and Midwest, and is the most common tick-borne infection in the United States.
- Tick season in the United States generally stretches from April to October. The insects are mostly dormant during the winter months.
After a mild winter in the U.S., will there be an uptick in ticks this year?
Researchers say it is hard to predict how the tick season will play out. This year’s mild winter and early snow melt, though, could mean more ticks earlier than usual and a wider spread of Lyme disease and other tick-borne diseases, scientists said.
In Connecticut, ticks are showing up in greater numbers this year, according to Goudarz Molaei, a tick expert for the state. So far, more than 700 ticks have been sent in for a testing program that normally would have gotten 200 to 300 by now. The state typically sees a lot of Lyme disease, which got its name from a Connecticut town.
"It’s going to be an above average year for tick activity and abundance," Molaei said.
What Diseases Do Ticks Spread?
Infected ticks spread bacteria, viruses and parasites that make people sick. Lyme disease is the most common tick-borne infection in the U.S., mostly in the Northeast and Midwest. An estimated 476,000 Americans are diagnosed with Lyme disease each year, according to the Centers for Disease Control and Prevention. Black-legged ticks, also called deer ticks, can carry more than Lyme-causing bacteria. They can also spread babesiosis, anaplasmosis and Powassan virus disease. The lone star tick, mainly located in southern, eastern and midwestern states, can carry ehrlichiosis and Heartland virus disease. American dog ticks can spread Rocky Mountain spotted fever. Ticks pick up disease-causing germs by biting infected wildlife, usually rodents.
When is Tick Season?
It varies by region, but tick season generally stretches from April to October. Ticks are mostly dormant during the cold winter months, and emerge as temperatures rise, but can be active on warm winter days, too. Memorial Day is often considered the start of the season but that’s largely because that’s when people in cold-weather states start spending more time outdoors, said Sam Telford of Tufts University’s school of veterinary medicine in North Grafton, Massachusetts. Lyme disease cases typically peak in June, July and August. April and May are typically lighter months, but not always.
Tiny ticks at the nymph stage — about the size of poppy seed — could be active early this year, said Dr. Bobbi Pritt, who studies tick-borne diseases at the Mayo Clinic in Rochester, Minnesota. "When we have mild winters, we do anticipate that the ticks are going to be out earlier, and biting humans," Pritt said.
What Makes for a Bad Season?
Government disease trackers say predicting how tick-borne diseases will trend is complicated. The number of ticks can vary from region to region, and diagnoses can be affected by how well different doctors test and report cases. The changing climate has both positive and negative implications for ticks, as warm, wet weather is beneficial to them, but especially hot weather is not, Telford said. Tiny ticks could indeed be active early, but a dry, hot summer could also kill ticks, he said. The best approach is to assume ticks will be very active. "Every year should be considered a bad tick year," he said.
How Can People Protect Against Ticks?
Thankfully, there are numerous ways to prevent tick bites. The CDC recommends treating clothing with products containing 0.5% permethrin. It’s also important to be especially cautious in areas where ticks live, such as grassy and wooded areas. Using repellents and doing thorough checks afterward is also key, the CDC says. Limiting exposed skin also helps avoid bites.
The disease can cause a fever, chills, fatigue and muscle and joint pain. It is treated with antibiotics, and most people recover. Left untreated, it can worsen, causing symptoms such as heart problems and debilitating pain. There is no Lyme vaccine on the market in the U.S. for people but one is being tested. | Epidemics & Outbreaks |
Improving nanotherapeutic vaccine delivery
Northwestern Medicine scientists have developed a more effective way of creating nanotherapeutic vaccines and medicines, according to a new study published in ACS Nano.
"Over the last decade, spherical nucleic acid, or SNA, technology has emerged as a broad therapeutic platform for a wide variety of diseases, including cancer and other illnesses," said Chad Mirkin, Ph.D., professor of Medicine in the Division of Hematology and Oncology, the George B. Rathmann Professor of Chemistry at Northwestern's Weinberg College of Arts and Sciences, and director of the International Institute for Nanotechnology, who was the lead author of the study.
In the Mirkin laboratory, investigators have harnessed this SNA technology in their work to design precision nanomedicines for use in gene regulation and in cancer immunotherapy with limited unwanted side effects through a systematic development process known as rational vaccinology.
"In the development of vaccines, historically, very little attention has been paid to vaccine structure," said Mirkin, who is also a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. "All of the emphasis has been on the components. The premise of rational vaccinology is that, while components are critical, structure is equally important. How you present vaccine components within a modular nanoscale architecture can have a dramatic impact on vaccine efficacy, whether it's treating infectious disease or cancer."
In the study, investigators first tested the effects of using different chemical anchoring groups to attach the oligonucleotides—short strands of DNA or RNA—to the surface of the liposomes to prepare SNAs. They found that when increasingly hydrophobic dodecane-based anchoring groups were used, the stability of the nanostructure was significantly improved. When introduced to bone marrow-derived dendritic cells from mice, these more stable SNA constructs exhibited improved cellular uptake compared to the other versions of SNAs that were prepared using other types of anchoring groups, with different chemistries.
"We discovered a way to anchor the oligonucleotides to the surface of the particle that changes the overall stability of the SNA construct, which is critical," said Jasper Dittmar, a Ph.D. student in the Mirkin laboratory and a co-author of the study. "The beauty of the SNA architecture is that it's recognized by almost all cell types, immune cells included, and rapidly internalized. You get the vaccine to enter the cells that matter at the stoichiometry you'd like, with the desired number of antigens and adjuvant molecules."
Scientists in the Mirkin lab then loaded the SNA vaccine with OVA1 (a model peptide derived from egg protein often used in vaccine development) and administered that to mice with lymphoma. The OVA1 SNA-treated mice not only had a greater number of polyfunctional T-cells (which are considered potent against chronic infections and tumors), they also showed a 21-fold reduction in tumor volumes compared to saline-treated mice, according to the study.
To assess the inflammatory side effects of the vaccine, investigators then studied the SNA to see if it activated excessive immune responses in mice. Mice given the treatment did not produce a cytokine storm, a sometimes-fatal side effect of immunotherapies.
Because cytokine storms are associated with severe cases of COVID-19, Mirkin and his research team also created an SNA vaccine where the OVA1 peptide was swapped out for a peptide from the virus that causes COVID-19 (CoV peptide) and administered it to human cells and ultimately mice. The investigators found that the vaccine enhanced antigen-specific, anti-COVID immune responses with minimal adverse side effects.
"Taken together, the results of this study lay a foundation for a new way of developing and delivering vaccines and other precision treatments, regardless of the target disease," said Michael Evangelopoulos, a Ph.D. student in the Mirkin lab and a co-author of the study.
The findings also highlight the importance of vaccine construction, Mirkin said.
"Structure matters," Mirkin said. "In a field where we've spent very little time focused on the structure of vaccines, we have may have been missing the forest for the trees. It's a combined understanding of the components and the structural presentation that leads to an efficacious medicine or not."
Moving forward, the Mirkin group will continue to devise different configurations of SNA vaccines to assess which are the most effective, he said.
"We are spending a lot of time using the SNA platform to figure out the structures that are the most efficacious, and then trying to figure out why that is, what works and then also why it works," Mirkin said. "We think that by doing that, we'll be able to create a whole new generation of medicines based upon this concept of rational vaccinology."
More information: Jasper W. Dittmar et al, Tuning DNA Dissociation from Spherical Nucleic Acids for Enhanced Immunostimulation, ACS Nano (2023). DOI: 10.1021/acsnano.3c04333
Journal information: ACS Nano
Provided by Northwestern University | Vaccine Development |
Benefit claimants who fail to find work for more than 18 months will have to undertake work experience placements, under rules planned for late next year.
If they refuse they will lose access to their benefits for a period, the government says.
It is part of new plans to get people back to work, which will also see an extra £2.5bn spent on career support.
Meanwhile, Labour pledged to invest an extra £1.1bn to cut NHS waiting lists to help get people back to work.
According to the Treasury, the number of people not seeking work has risen sharply since the pandemic, hurting the economy.
It said there were 300,000 people who had been registered as unemployed for over a year in the three months to July.
Meanwhile, the number "inactive" due to long-term sickness or disability had risen by almost half a million since the pandemic to a record 2.6 million.
Chancellor Jeremy Hunt said that many of these people wanted to work and that "with almost a million vacancies in the jobs market the opportunities are there".
"These changes mean there's help and support for everyone [to find work] - but for those who refuse it, there are consequences too," he added.
"Anyone choosing to coast on the hard work of taxpayers will lose their benefits."
Under its Back to Work plan - which is part of next week's Autumn Statement - the government says it will expand and reform existing career help schemes for people with disabilities, health conditions or the long-term unemployed, as well as launch new ones.
It will also put additional staff in job centres to help claimants struggling to find work.
However, it said there would be stricter sanctions for "people who should be looking for work but are not".
Under a plan that would need parliamentary approval, those solely eligible for the standard Universal Credit allowance who refuse to engage with job centre staff or accept work offered to them after six months will have their claims closed.
That means they will have to go through the application process again if they want to keep receiving benefits and lose access to extras such as free prescriptions and legal aid during that time.
Under the current sanctions regime, such claimants only have a deduction applied to their benefits until they re-comply with their requirement to meet with a work coach and establish a personalised job-seeking plan.
Ministers said the new rules would not apply to additional payments for child, housing or disability support.
From late 2024 mandatory work placement trials will also be rolled out for people unemployed longer than 18 months, and benefits will be removed from those who refuse to take part.
Digital tools will also be used to "track" attendance at job fairs and interviews under the tougher sanctions regime.
The Secretary of State for Work and Pensions, Mel Stride, said: "Our message is clear: if you are fit, if you refuse to work, if you are taking taxpayers for a ride - we will take your benefits away."
Separately, Labour has unveiled its own back to work plan with a focus on cutting NHS waiting lists. Since January waiting lists have risen by 500,000 to a record 7.8 million, it says.
The party has pledged:
- To provide an extra two million operations, scans and appointments a year by paying staff extra to run evening and weekend clinics. The plans will cost £1.1bn and be paid for by abolishing the non-dom tax status.
- Recruit 8,500 more mental health professionals and introduce changes to incapacity benefits to encourage disabled people and people with health conditions to try work without fear of losing their income or having to be reassessed if the job does not work out.
- Introduce a new statutory duty that would require job centres to work in partnership with organisations including the NHS to tackle the root causes of worklessness.
Labour's shadow chancellor Rachel Reeves told the BBC: "Labour have committed to getting rid of the non-dom status. If you make your home in Britain you should pay your taxes here and under Labour you will.
"We will put that money into creating every year an additional two million appointments, scans and operations in our National Health Service so that we can get those waiting lists down, get people the treatment they need, and get them in many cases back into work." | Health Policy |
Many lung cancer patients now have access to a potentially life-saving medication.
Osimertinib, sold under the brand name Tagrisso, is available to patients with Stage 1B-3A lung cancer who have a certain genetic mutation and have had surgery to remove cancerous tumors.
Among those patients, Tagrisso was shown to reduce the five-year risk of recurrent cancer by up to 73% and the risk of death by up to 51%, according to research published in The New England Journal of Medicine over the summer.
"In the world of oncology, that is earth-shattering," Dr. Faiz Y. Bhora, chief of thoracic surgery and central region chair of surgery at Hackensack Meridian Health in New Jersey, told Fox News Digital.
"In the past, medical oncologists were happy with 5% or 10% — and now we're talking about in excess of 50% improvement in survival."
Bhora, who has prescribed the medication to several of his lung cancer patients, spoke about the "groundbreaking" results he's seen in his own practice.
"We're truly in the era of personalized medicine," Bhora also told Fox News Digital. "We now have a lot of targeted therapies that work well for patients who have mutations in their tumors."
For this particular medication, patients who have a genetic mutation called EGFRm — and who have already had surgery — are viable candidates for Tagrisso.
"The pill helps prevent recurrence once the tumor is removed with surgery for those with the genetic marker," he said.
Patients with stage 4 lung cancer are also eligible for the pill if they have the EGFR mutation, even without having had surgery, the doctor noted.
To determine if a patient has the mutation, a tissue sample is extracted from the tumor and tested. Results are typically obtained within 10 to 14 days.
A blood test is also available, Bhora said, with those results available within five to 21 days.
"We used to think of lung cancer as just a smoker's illness. Now, we know that over 30% of individuals who develop lung cancer have never smoked."
"I would say about 25% of patients with lung cancer end up having an ETFR mutation," the doctor estimated.
Around 238,000 new cases of lung cancer are expected in 2023, according to the American Cancer Society (ACS), along with some 127,000 deaths.
"We used to think of lung cancer as just a smoker's illness," Bhora said. "Now, we know that over 30% of individuals who develop lung cancer have never smoked, and a lot of them are women."
Looking ahead, he hopes to be able to prescribe the pill soon to patients upfront, before any other procedures or therapies, with the goal of shrinking tumors prior to surgery.
A patient’s story
Kim Mosko, 67, was diagnosed with stage 2A lung cancer in February 2023.
The mother of two had robotic surgery at Hackensack Meridian just a couple of weeks later.
"The lobectomy was performed by robotic surgery and was an incredible experience," she told Fox News Digital. "I owe all the doctors I see and consulted with a debt I can never repay."
Next, she had four rounds of chemotherapy, which she completed at the end of June 2023.
"I absolutely believe that this medication is going to make sure the lung cancer will not return. I am planning on living for many more years."
When Mosko’s doctors determined in July that she has the genetic mutation, they recommended that she take Tagrisso.
"I needed no persuasion at all," she told Fox News Digital. "I will do whatever is necessary to treat this cancer and lengthen my lifespan."
Mosko has now been taking Tagrisso for 3½ months, with plans to continue taking it daily for three years.
Her insurance covers the cost of the medication.
"Overall, my experience has been positive, and I am grateful that this medication is available," she said.
She has experienced some side effects, such as a skin rash, diarrhea and fatigue, "all of which are manageable," Mosko said.
"I don’t need to have hope," she added. "I absolutely believe that this medication is going to make sure the lung cancer will not return. I am planning on living for many more years."
Where to start
For lung cancer patients interested in Tagrisso, Bhora recommends seeing an experienced team of physicians to get tested for the genetic mutation.
At Hackensack, Bhora said, "we consider every patient a candidate for a cure."
With the advent of personalized therapies, he believes there is hope on the horizon for many lung cancer patients.
"This is a very optimistic time for patients who used to have what was universally considered a fatal disease," Bhora said.
"We are now in an era where in a vast majority of cases, we can either turn it into a chronic disease or aim for a complete cure."
"We are now in an era where in a vast majority of cases, we can either turn it into a chronic disease or aim for a complete cure."
Safety information
AstraZeneca, the maker of Tagrisso, indicates on its website that some side effects have been reported.
The most common of those include low white blood cell counts; low platelet counts; diarrhea; low red blood cell counts (anemia); rash; muscle, bone, or joint pain; mouth sores, fatigue, cough, dry skin; and changes in the fingernails, including redness, tenderness, pain, inflammation, brittleness, separation from the nailbed and shedding of the nail.
Although rare, some potentially serious side effects may affect the lungs, heart, eyes, skin, and blood and bone marrow.
Patients who experience bothersome or long-lasting side effects should consult with their health care provider, AstraZeneca states.
They can also report any side effects to the U.S. Food & Drug Administration (FDA) by calling 1-800-FDA-1088. | Drug Discoveries |
House Republicans this week released messages sent by scientists during the coronavirus pandemic that show the decision to downplay the "lab leak" origin theory was made for political reasons.
The Republican-led House Select Subcommittee on the Coronavirus Pandemic released a report on Tuesday outlining what it says are examples showing that top scientists rejected the theory that the coronavirus came from a lab in China because they were worried about the political impact of that assessment. GOP lawmakers charge those messages were sent in concert with Dr. Anthony Fauci’s National Institutes of Health.
"Given the s--- show that would happen if anyone serious accused the Chinese of even accidental release, my feeling is we should say that given there is no evidence of a specifically engineered virus, we cannot possibly distinguish between natural evolution and escape so we are content with ascribing it to natural process," Dr. Andrew Rambaut wrote in a Slack message to Dr. Kristian Andersen, Dr. Edward Holmes and Dr. Robert Garry, according to the report.
Rambaut, along with Andersen, Holmes and Garry, authored "The Proximal Origin of SARS-CoV-2" on the website Virological in February 2020. That report said the lab leak theory was not "plausible," and subcommittee members say the paper was written at the behest of Fauci to "downplay the lab leak hypothesis and call those who believe it may be true conspiracy theorists."
Andersen responded to Rambaut by saying, "Yup, I totally agree that that’s a very reasonable conclusion. Although I hate when politics is injected into science – but its impossible not to, especially given the circumstances."
The report provides several other comments from scientists, including Dr. Ron Fouchier, who said that furthering the debate about the lab leak theory "would unnecessarily distract top researchers from their active duties and do unnecessary harm to science in general and science in China in particular."
"Since Proximal Origin was published, it has been accessed 5.84 million times," the House report concluded. "Further, it has garnered the third most attention of any paper of a similar age across all journals and the second most attention of any paper of a similar age in Nature Medicine."
"Finally, it has received the fifth most attention of any paper ever tracked. This is one of the single most impactful and influential scientific papers in history, and it expressed conclusions that were not based on sound science nor in fact, but instead on assumptions. The question is why."
The "lab leak theory" suggesting COVID came from a lab at the Wuhan Institute of Virology in Wuhan, China, was widely dismissed as "misinformation" by Democrats, major news outlets, scientists and social media companies in the early stages of the pandemic. Since then, however, it has been deemed the most likely scenario by several agencies within the Biden administration.
FBI Director Chris Wray told Fox News' Bret Baier in March that COVID-19 "most likely" came from a Chinese lab, and Wray repeated that assessment in a House hearing today.
Fauci has insisted that he believes the most likely scenario is that the coronavirus came from nature.
"All of the intelligence groups agree that this was not an engineered virus," Fauci said in April. "And if it’s not an engineered virus, what actually leaked from the lab? If it wasn’t an engineered virus, somebody went out into the field, got infected, came back to the lab and then spread it out to other people. That ain’t a lab leak, strictly speaking. That’s a natural occurrence."
Testifying before the House committee on Tuesday, Andersen rejected the notion that he and his fellow scientists were trying to kill the lab leak theory.
"I think it’s important that we take a step back and focus on what’s possible versus what is probable," Andersen told the committee. "We concluded that the virus very likely emerged as the result of a zoonosis, that is, a spillover from an animal host. This remains the only scientifically supported theory for how the virus emerged. If convincing new evidence were to be discovered, suggesting otherwise, we would, of course, revise our conclusions. This is science."
Anderson and Garry both denied accusations that the Proximal Origin paper was influenced or directed by Fauci or NIH's Dr. Francis Collins.
A press release from the subcommittee said, "Chairman Wenstrup argues that the drafting, coordination, and publication of the infamous Proximal Origin paper was not only antithetical to science, but that it also wrongly downplayed the lab-leak hypothesis."
"Why try to avoid biosafety discussions when people are dying? Science should be clear, even when politics are not," the subcommittee said. | Epidemics & Outbreaks |
We all know that dogs are man's best friends, and now research suggests this could be due to health benefits canines give to our brains.
Scientists in Japan found that owning a dog of any breed – but not a cat – reduces the risk of older people getting dementia by 40 per cent, compared with people without one.
Having a dog increases the likelihood of getting out the house, which leads to more interactions with other humans and in turn exercises the brain, they say.
This has a 'suppressive effect' on the development of the debilitating condition, which affects more than 55 million people worldwide.
Previous research also suggests dog ownership among older adults has a protective effect on frailty disability and death of any cause.
The new study was led by researchers at the Tokyo Metropolitan Institute of Gerontology in Japan, who say it's the first to show that dog ownership protects against dementia.
'Dog owners with an exercise habit and no social isolation had a significantly lower risk of disabling dementia,' they say in their paper.
'Dog care might contribute to the maintenance of physical activity, including having an exercise habit, and social participation even in the face of restrictions to interactions such as those experienced during the Covid-19 pandemic.'
Dementia is an umbrella term for symptoms that occur when there's a decline in brain function, but Alzheimer's is the most common dementia condition.
Many dementia conditions, including Alzheimer's, are associated with an abnormal build-up of proteins in the brain.
But exercise reduces this build-up, while also maintaining adequate blood flow to the brain and stimulating brain cell growth and survival.
Other than getting plenty of physical activity, staying mentally and socially active is another common bit of health advice to stave off dementia.
Mental activity helps to build your 'cognitive reserve' – the brain’s ability to cope and keep working.
For the study, the researchers recruited 11,194 older adults in Japan, aged between 65 and 84 years.
Participants, all physically and cognitively independent at the start of the study, were sent questionnaires to complete about whether they owned a cat or dog.
They were also asked about any types of exercise they engaged in more than once per week, from walking and running, to yoga swimming, cycling and stretching.
About four years later their health was assessed, including the development of any dementia conditions.
For the entire sample, researchers worked out the 'odds ratio', which indicates the risk of developing dementia, for both dog and cat owners.
After adjusting for background factors, the odds ratio was 0.6 for dog owners but much higher – 0.98 – for cat owners and 1 for those who did not own dogs or cats.
As expected, how much the participants exercised also had an effect on their risk of dementia – but this made the all-important difference for dog owners.
Dog owners with a regular exercise habit had an low dementia odds ratio of 0.37 compared with people without dogs who got no exercise.
But dog owners with no exercise habit had a much higher odds ratio of 0.89 compared with people without dogs who got no exercise.
And current dog owners with no social isolation had an odds ratio of 0.41 compared with people without dogs who were socially isolated.
In other words, dog owners with an exercise habit and no social isolation have the lowest risk of disabling dementia.
However, the results show that having a dog doesn't protect against the disease if you get little exercise and are social isolated, the team warn.
'Dog owners without daily lifestyle habits related to dog care, such as no exercise habit and social isolation, did not experience positive effects related to dementia prevention,' they write.
The researchers note that the proportion of dog and cat ownership in Japan is smaller than that in Western countries, such as the US.
'It will thus be important to assess whether the relationships found in Japan are also present in Western and other countries,' they say.
According to the World Health Organisation (WHO), there around 50 million people with dementia globally, and there are nearly 10 million new cases every year.
A 2021 study estimated that global dementia cases will nearly triple to reach more than 152 million by 2050, driven by an ageing population.
The highest increase in dementia prevalence is projected to be in eastern sub-Saharan Africa, North Africa and the Middle East, the University of Washington experts said. | Disease Research |
Her smile is bright, cheery, sometimes goofy and always contagious. But pictures can’t completely capture her upbeat, positive vibe. At 21, Claire Bridges has a mature spirit that amazes those who love her as well as the doctors who had to operate on her heart and remove both legs to save her life.
“She had a will to live, perseverance and a sort of twinkle in her eye — I tell all my patients that’s half the battle,” said Dr. Dean Arnaoutakis, a vascular surgeon at the University of South Florida Health in Tampa who amputated Bridges’ legs after complications from Covid-19.
“Most people would be despondent and feel like life had cheated them,” said Dr. Ismail El-Hamamsy, a professor of cardiovascular surgery at the Icahn School of Medicine at Mount Sinai in New York City, who operated on Bridges’ heart.
“But she told me, ‘I feel like I’m the luckiest person on this planet. I have my whole life ahead of me. I can have kids, a future, so many things to look forward to.’
“There was not once that I looked into her eyes that I didn’t feel her positiveness was true and genuine,” he said. “Claire’s story is one of just incredible resilience and positivity.”
‘My body just literally wouldn’t give up’
In January 2022, Bridges was a 20-year-old model with her own apartment, a gaggle of friends and a part-time job as a bartender in St. Petersburg, Florida. She was a vegan and “exceptionally healthy,” according to her mother, Kimberly Smith.
When she caught Covid-19 that month, no one expected her be hospitalized. She was fully vaccinated and boosted.
But Bridges had been born with a common genetic heart defect: aortic valve stenosis, a mutation of the valve in the heart’s main artery, the aorta. Instead of having three cusps, or flaps, that let oxygen-rich blood flow from the heart into the aorta and to the rest of the body, people with aortic valve stenosis are often born with just two. The condition makes the heart work extremely hard to do its job, often causing breathlessness, dizziness and fatigue.
“I could work out and stuff, but I could never play sports,” she told CNN. “I couldn’t run. I couldn’t overexert myself.”
Her mom added, “We could really tell she began to learn her limits as she got older — she would get out of breath, stop and take a break.”
Whether due to her heart or another unknown reason, Covid-19 hit Bridges hard. Her health quickly spiraled out of control.
“Extreme fatigue, cold sweats — progressively every single day it would get harder to try to eat or drink anything,” she recalled. “Then one day my mom found me unresponsive and rushed me to the hospital. I flatlined three times that night.”
Bridges was put on dialysis, a ventilator and an exterior pump for her failing heart. She slipped into psychosis.
“I was thinking that everyone was trying to kill me, but I was holding on,” she said, adding that she then saw a bright light and her late grandfather.
“He was sitting on a bench, fishing, and he was wearing a baseball cap,” she said. “Then I saw my parents through a window. I don’t know if I actually did or if it was in my delusion, but I thought, ‘I can’t leave them like this.’ And my body just literally wouldn’t give up.”
While Bridges’ spirit battled on, doctors struggled to save her life. Her organs began to shut down, further weakening her frail heart. Blood wasn’t reaching her extremities, and tissues in both legs began to die.
Surgeons tried to save as much of her legs as possible. First, they opened tissue in both legs to reduce swelling, then amputated one ankle. Finally, there was no choice: Both legs had to be removed.
Doctors gathered around her bed to break the news.
“I remember looking up at them and saying, ‘Well, thank you for saving my life. And oh, can I have bionic legs?’ ” Bridges said.
“Everyone was totally shocked that she was taking it so well,” Smith recalled about her daughter. “But my entire family knew that if this tragedy had to happen to any of us, it would be Claire who would handle it the best. Upbeat and positive, that’s Claire.”
Checking off her bucket list
Losing her legs was only part of Bridges’ struggle back to health. “There were so many things that she could have died from while she was in the hospital,” Smith said.
Malnourished, Bridges was put on a feeding tube. She vomited, rupturing part of her small intestine, and “nearly bled out,” Smith said. To save her, doctors had to do an emergency transfusion — a dangerous procedure due to her weak heart.
“She almost died while getting the emergency transfusion because they had to pump the blood in so fast,” Smith said. “Then the next day she bled again, but they caught it in time.”
Bridges developed refeeding syndrome, a condition in which electrolytes, minerals and other vital fluids in a malnourished body are thrown out of balance when food is reintroduced, causing seizures, muscle and heart weakness, and a coma in some cases. Without quick treatment, it can lead to organ failure and death.
In another blow, her hair began to fall out, likely due to the loss of proper nutrition. Her family and friends came to her rescue.
“I knew that the only way to stop me from sobbing every time I pulled chunks of hair out of my head was to just get rid of it all,” Bridges said. “I told my brother Drew I was thinking about shaving my head, and without missing a beat, he immediately looked at me and said, ‘I’ll shave mine with you.’
“Then it snowballed into everyone telling me they would shave their heads, too,” Bridges said with a smile. “It was actually an extremely sweet, fun and freeing time — plus I’ve always wanted to shave my head, so I got to cross it off my bucket list!”
Bridges credits her friends and family — along with members of the community who organized fundraisers or reached out on social media — for her upbeat attitude throughout the ordeal.
“I am very blessed to have such an amazing family and also friends and people in my community that are like family,” she said. “People I didn’t know, people that I haven’t spoken to since elementary school or high school were reaching out to me.
“Yes, I allowed myself to grieve, and there were dark days. But honestly, my friends and my family surrounded me with so much love that I never had a second to really think negatively about my legs or how I look now.”
An unusual heart operation
Bridges’ heart presented another hurdle: Already frail before her prolonged illness, it was now severely damaged. She needed a new valve in her aorta, and soon.
“We always knew Claire would need an open-heart surgery at some point,” her mother said. “Doctors wanted her as old as possible before they replaced the valve because the older you are, the bigger you are, and there’s less chance of needing another operation soon after.”
Her doctors reached out to Mount Sinai’s El-Hamamsy, an expert in a more complicated form of aortic valve replacement called the Ross procedure.
“Anybody who has an anticipated life expectancy of 20 years or more is definitely a potential candidate for the Ross,” El-Hamamsy said, “and it’s a perfect solution for many young people like Claire.”
Unlike more traditional surgeries that replace the malfunctioning aortic valve with a mechanical or cadaver version, the Ross procedure uses the patient’s own pulmonary valve, which is “a mirror image of a normal aortic valve with three cusps,” El-Hamamsy said.
“It’s a living valve, and like any living thing, it’s adaptable,” the surgeon said. “It becomes like a new aortic valve and performs all the very sophisticated functions that a normal aortic valve would do.”
The pulmonary valve is then replaced with a donor from a cadaver, “where it matters a little less because the pressures and the stresses on the pulmonary side are much lower,” he said.
The use of a replacement part from the patient’s own body for the aortic valve also eliminates the need for lifelong use of blood thinners and the ongoing risk of major hemorrhaging or clotting and stroke, El-Hamamsy said. And because the new valve is stronger than the malfunctioning valve it replaces, patients aren’t as likely to need future surgeries.
“Ross is the only replacement operation for the aortic valve that allows patients to have a normal life expectancy,” he said, “and a completely normal quality of life with no restrictions, no modifications to their lifestyle and a very good durability of the operation.”
The Ross procedure is more technically challenging than inserting a tissue valve or a mechanical valve, “some of the simplest operations that we as cardiac surgeons would ever do,” El-Hamamsy said.
Because the operation takes a high level of technical skill, it’s only available in a few surgical facilities at this time.
“It requires dedicated surgeons who want to commit their practice to the Ross procedure and who have the technical skills and expertise to do that,” he added. “Patients need to know they should be undergoing the surgery in a Ross-certified facility.”
‘Claire made that choice’
When El-Hamamsy first met Bridges in a video call last spring, he wasn’t sure he would be able to do the surgery. Only 127 pounds before she got sick, Bridges had lost nearly 70 pounds during her hospitalization.
“She was so emaciated. There was no way I could take her into the operating room the way she was,” El-Hamamsy said. “I never expected that she would recover so quickly and keep her amazingly positive mentality.”
Slowly, over many months, Bridges fought her way back to health. In rehab, she began to learn to walk with prosthetic lower limbs. As she got stronger, she has continued one of her favorite activities — rock climbing.
“At six months, I could hardly recognize her — she had gained weight back, her skin had fully healed over at the amputation sites, and she was a completely different-appearing person to the malnourished and debilitated girl I had met in the hospital,” said Arnaoutakis, the vascular surgeon.
The heart operation was successfully done in December. Today, Bridges is in the middle of cardiac rehabilitation and looking forward to being fitted for prosthetic blades — J-shaped, carbon-fiber lower limbs that will allow her to run on a track for the first time in her life.
She’s also returned to modeling, proud to show the world how well she has survived.
El-Hamamsy isn’t surprised. “I told her from the day I met her on that Zoom, ‘It will be such a privilege to look after you because you’ve inspired me. I’ve never met a young person with this level of maturity and outlook on life.’
“I still think of Claire every once in a while when I bump into difficulty with life or whatever. It’s a reminder that happiness and positivity is a choice. Claire made that choice.” | Medical Innovations |
Hundreds of patients have lost their eyesight or had it irreparably damaged because of NHS backlogs, new research suggests.
NHS England clinicians have filed 551 reports of patients who lost their sight as a result of delayed appointments since 2019, with 219 resulting in “moderate or severe harm”, according to an FoI request by the Association of Optometrists, which believes that hundreds more cases are unreported.
Its chief executive, Adam Sampson, said sight loss was a “health emergency”, and urged ministers to introduce a national eye health strategy to enable high street and community optometrists to ease some of the burden on hospitals.
He said: “There are good treatments available for common age-related eye conditions like macular degeneration but many hospital trusts simply do not have the capacity to deliver services.
“Optometry is ideally placed to take away some of that burden – optometrists are already qualified to provide many of the extended services needed and are available on every high street, so patients can be treated closer to home. It’s incomprehensible and absolutely tragic that patients are waiting, losing their vision, in many parts of the country because of the way eye healthcare is commissioned.”
NHS England figures show that 628,502 people are waiting for ophthalmology appointments, the second largest backlog, equating to one in every 11 patients on an NHS waiting list, while 27,260 have been waiting a year or more.
The chief executive of eye charity, Macular Society, Cathy Yelf, said she received dozens of phone calls each month from worried patients. “People are terrified at the prospect of losing vision. The ones who contact us are the ones who are actively trying to solve the problem. We have no idea how many people sit at home, quietly losing their vision and not making a fuss about it.”
In a survey of UK optometrists, 72% said they have seen a patient in the last six months who had experienced a delay to treatment of 12 months or more, while nearly half (43%) had concerns about patients who could lose sight unnecessarily.
This is the experience of Pam Perceval-Maxwell, 75, who developed wet age-related macular degeneration in 2021 in her only good eye, which requires regular injections. The first two injections happened within a four week period, as required, but since then there have been delays of 12 and eight weeks, causing a rapid decline in her sight and an examination showed vision has been lost.
“I’m terrified I will lose my sight entirely. When your consultant stresses how important it is to have the injections on time but you can’t get an appointment it’s such a worry. I regularly call to see if there is a cancellation but I ask myself how much longer I can I cope with it,” she said.
An additional poll by the Macular Society of 498 members of the public with macular eye conditions requiring treatment in the past two years, revealed that nearly six in 10 (57%) experienced delays, and nearly half (47%) had a loss or decline in vision as a result. Four in 10 feared losing their sight, with 21% struggling with day-to-day tasks.
A Department of Health and Social Care spokesperson said: “No one should have to suffer avoidable sight loss and we are taking action to improve access to services, including appointing a national clinical director for eye care to oversee the recovery and transformation of services so patients receive the care they need.
“We are also investing in the ophthalmology workforce with more training places provided in 2022 – and even more planned for 2023 – alongside improved training for existing staff. We have made strong progress in tackling the Covid backlogs – including those waiting for eye care.” | Health Policy |
NHS doctors are being offered cash bonuses of up to £5,000 to recruit colleagues for jobs at private hospitals, as commercial healthcare providers compete for staff with an overstretched public health service.
US-owned HCA Healthcare, which runs more than 30 facilities in London and Manchester, and claims to be the largest private provider in the world, is spending tens of thousands of pounds recruiting NHS-trained doctors, the Guardian can reveal.
Referral fees vary, depending on skills and seniority. According to marketing material seen by the Guardian and doctors working for HCA who asked not to be named, the company is offering bonuses of £5,000 for intensive care doctors – one of the most in-demand specialisms – £2,500 for general resident doctors, and £1,000 for more junior roles.
The money is offered for staff who go on to work for HCA part- or full-time, meaning they either leave the NHS or reduce the hours they work in the public health service.
At the height of the pandemic, as state-funded hospitals were in danger of becoming overwhelmed, the company emailed recruitment messages to NHS doctors offering golden hellos equivalent to 10% of annual salary.
Other perks for those who want to join the US health company include critical illness cover of up to £10,000 after a year of service, 50% off gym membership and dining out, life insurance and access to private GPs as often as needed.
The company, which is opening a £100m private hospital in Birmingham later this year, is also offering generous sums to those who join. In marketing material from February 2023, circulated on LinkedIn to people looking for work, HCA offered £10,000 welcome bonuses to paediatric nurses joining its Portland hospital in London, where royals including the Duchess of Sussex, and celebrities such as the chef Jamie Oliver’s wife Jools, have given birth.
A spokesperson for HCA UK said: “Along with many others both in the private and public sector, we offer all employees, not just clinical staff, a number of benefits and incentives as standard practice such as bonus schemes, critical illness cover, private healthcare, pension contributions and life insurance as well as provide all our employees with a one-off payment if they help recruit a new member of staff, whether clinical or non-clinical.”
In contracts seen by the Guardian, HCA also has strict rules on where else employed doctors can work in the sector after leaving, stating that a year after quitting they cannot work for a rival. They specifically say “for the avoidance of doubt” this includes Cleveland Clinic – another American-owned health firm – and the London Clinic.
The perks on offer will add to concerns about the creep of privatisation in Britain’s healthcare provision and a drain of talent away from state-funded hospitals. The NHS is in the midst of a jobs crisis, and needs to find 62,000 medical professionals to fill vacancies across the UK, according to a report by MPs.
One senior doctor, speaking anonymously, said: “Generally speaking there is a raid on not just doctors but lots of layers of healthcare workers. There is a poaching of good, talented, NHS resource because the NHS has ceilings where there is no flexibility to incentivise staff. There is a drain by the independent sector of NHS talent at all levels.”
David Rowland, the director of the Centre for Health and the Public Interest, an independent thinktank, said: “There is only one finite pool of medical professionals in the UK, the vast majority of whom are employed directly by the NHS. Recruitment referral fees of this kind are likely to form part of an overall strategy employed by private hospital companies to pull medical professionals away from working in the NHS and towards the private sector.”
He added: “As the for-profit healthcare sector grows, particularly in large cities like London, Manchester and Birmingham, where new facilities are opening we would expect to see more strategies of this kind designed to pull more medical professionals away from the NHS and towards the private sector.”
Private hospitals have increasingly moved into offering intensive care services, when previously they tended to deal with elective procedures – treatment that is scheduled in advance because it does not involve a medical emergency. HCA has high dependency and critical care units in their main hospitals. “No matter how ill you become, when you’re one of our patients, you won’t have to be transferred to another hospital,” the HCA website says.
In a brochure sent to anyone who takes a job, employees are told: “If you know of a dedicated, skilled professional who measures up to the high standards we set for ourselves at HCA, point them in our direction. For every one of your referrals who makes the grade, you’ll receive a bonus of £1,000.”
In an email from 2020, at the height of the pandemic, a HCA recruiter circulated the following email to NHS doctors: “We have competitive salary offers. We are recruiting in the range £60-75k (for full-time 1.0FTE), and at the moment we have a Golden Hello Scheme where you would be eligible for a 10% salary bonus after one-year service for critical care only. As an employee of HCA you would also be able to access our employee benefits package with includes things like free private healthcare, private GP package, private dental package, pension, disability benefit, cycle to work scheme, meals/entertainment card, travel card, technology benefit, subsidised gym memberships etc (there’s quite a lot included).”
The manager says they have flexibility on hours worked but “most prefer to do the full shift”. They added: “There is also a career pathway structure for medical leadership within the company if you considering this career direction.”
At the end of November, a record 7.2 million patients in England were waiting for elective care, non-urgent medical treatment ranging from hip replacements to heart operations on the NHS.
More than half of those on the list had been waiting up to 18 weeks and about 400,000 patients had been waiting more than a year, according to data from NHS England. | Health Policy |
Redispensing cancer drugs reduces both environmental impact and medical costs, according to research from Radboudumc pharmacy published in JAMA Oncology. The annual savings could amount to tens of millions.
Cancer drugs as pills are not always used up by patients. The drugs are mostly expensive and environmentally damaging, both in production and (waste) disposal. In her PhD research, Lisa-Marie Smale of Radboudumc investigated whether these unused drugs can be collected and reissued. Does such an approach ultimately lead to lower environmental impact and costs?
Redispense medication
When redispensing medications, the quality must be guaranteed. Therefore, in this study the medications were packaged separately and fitted with a sensor, which registers whether returned medications were kept within the required temperature. Smale: "If packaging, temperature and expiration date are in order, the returned medications can be redispensed. For two years we investigated this procedure in cooperation with the pharmacies of four Dutch hospitals; Radboudumc, UMC Utrecht, Jeroen Bosch hospital and St Antonius hospital. Over a thousand patients who were taking oral cancer medications at home participated in the study during that period."
Saving tens of millions
The results, published in JAMA Oncology, look promising. The investment in the method, such as packaging with a temperature sensor, amounts up to 37 euros per patient per year. This is offset by savings of 613 euros. Annually, this results in a net saving per patient of 576 euros. Smale: "In the Netherlands, we can save between 20 and 50 million euros annually with this redispensing of medication. Meanwhile, we have further optimized the process, making a net saving of 655 euros per patient possible. In the Netherlands, we have relatively low drug prices. If you look at the U.S., where the price of new drugs is over 300 percent higher, in principle much more money can be saved there."
Large-scale consequence
Of all wasted medicine packaging, two-thirds could be reissued. Project leader Charlotte Bekker of Radboudumc says, "Based on the results, the study will be expanded to 14 hospitals. Again, we are looking at cancer pills. Reissue is only allowed in the context of a scientific study because of European rules. We hope that the approach can eventually be used nationwide, as well as for other drugs."
Sustainability and social impact also benefit
"This approach is cost-effective for expensive drugs”, Smale says, "but ultimately there are other factors you want to consider, such as sustainability or social impact. Think of the environmental impact you can reduce by not destroying drugs but redispensing them; this can also be beneficial for drugs that are in short supply."
Broad interest
The study published in JAMA Oncology is, to our knowledge, the first to examine drug redispensing with guaranteed quality. The topic is attracting strong interest, not only in the medical community but also beyond. Several parties are committed to make further expansion possible. In addition to the participating hospitals, the Dutch Association of Hospital Pharmacists (NVZA) is also closely involved. And it is part of the Green Deal objectives to make healthcare more sustainable. Smale: "We are happy to work with all parties to address and reduce the cost and environmental impact of wasted medicines."
Paper in JAMA Oncology: Cost Savings and Waste Reduction Through Redispensing Unused Oral Anticancer Drugs - Elisabeth M. Smale; Bart J. F. van den Bemt; Eibert R. Heerdink; Ingrid M. E. Desar; Toine C. G. Egberts; Charlotte L. Bekker; for the ROAD Study Group
-
Want to know more about these subjects? Click on the buttons below for more news.
More information
Pieter Lomans
persvoorlichter | Drug Discoveries |
I am a woman in my early 30s. I have a lot of anxiety about sex and relationships, which holds me back from forming the intimate connections I crave. I can appear confident in my day-to-day life but I’m very insecure and sensitive to rejection. I do have close friends but it can take years to build those relationships. What I really miss at the moment is that long-term, intimate relationship that so many of my friends have. I’m even envious of my parents. I am online dating but take long breaks because of the emotional toll: I am distraught when it doesn’t work out, or if I think I have messed it up. The older I get, the more pressure I feel, and the harder it becomes. These feelings are especially extreme relating to sex. It was a problem in my last relationship – I would struggle to feel comfortable even though we knew each other well. It was a big factor in why we broke up. I can feel the impact on my mental health and confidence in other areas of my life. I feel a lot of shame and embarrassment about it, as if people are judging me.The challenges you are facing do not seem exclusively sexual in nature. Perhaps your personality style is one that makes human connection difficult, and maybe you have underlying generalised anxiety, avoidance issues, or phobias around sex, intimacy and even non-sexual intercourse. Low self-esteem and a lack of confidence will certainly contribute greatly to an inability to feel safe enough to enjoy human intimacy and sex. Seek some help for these things, but above all respect who you are. You have high standards for relationships, and there is nothing wrong with expecting a great deal of support from people with whom you become connected – in sexual and non-sexual ways. Unfortunately, the risk of rejection does go hand in hand with seeking the long-term partner you say you want to have, but first take incremental steps to soothe your anxiety and learn how to feel safer in the world generally – which will help you to bear rejection whenever it occurs. Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders. If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to [email protected] (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions. Comments on this piece are premoderated to ensure discussion remains on topics raised by the writer. Please be aware there may be a short delay in comments appearing on the site. | Mental Health Treatments |
Older adults who don’t smoke tobacco but do use marijuana were at higher risk of both heart attack and stroke when hospitalized, while people who use marijuana daily were 34% more likely to develop heart failure, according to two new non-published studies presented Monday at the American Heart Association Scientific Sessions in Philadelphia.
“Observational data are strongly pointing to the fact that … cannabis use at any point in time, be it recreational or medicinal, may lead to the development of cardiovascular disease,” Robert Page II, chair of the volunteer writing group for the 2020 American Heart Association Scientific Statement: Medical Marijuana, Recreational Cannabis, and Cardiovascular Health, said in a statement. He was not involved in either of the new studies.
The AHA recommendations advise people refrain from smoking or vaping any substance, including cannabis products, because of the potential harm to the heart, lungs and blood vessels.
“The latest research about cannabis use indicates that smoking and inhaling cannabis increases concentrations of blood carboxyhemoglobin (carbon monoxide, a poisonous gas), tar (partly burned combustible matter) similar to the effects of inhaling a tobacco cigarette, both of which have been linked to heart muscle disease, chest pain, heart rhythm disturbances, heart attacks and other serious conditions,” said Page, a professor in the department of clinical pharmacy and physical medicine/rehabilitation at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora, Colorado.
“You need to treat this just like you would any other risk factor (for heart disease and stroke), and honestly understand the risks that you were taking,” he said.
A growing problem among older adults
Marijuana use is on the rise among older adults. A 2020 study found the numbers of American seniors over age 65 who now smoke marijuana or use edibles increased two-fold between 2015 and 2018. A 2023 study found past month binge drinking and marijuana use among the over-65 crowd rose by 450% between 2015 and 2019.
Nearly three of every 10 marijuana users develop a dependence on weed called cannabis use disorder. A person is considered dependent on weed when they feel food cravings or a lack of appetite, irritability, restlessness, and mood and sleep difficulties after quitting, according to the National Institute on Drug Abuse.
Marijuana use becomes an addiction when a person is unable to quit using weed even though it interferes with many aspects of life.
Chronic conditions and weed
Older adults often develop a number of chronic conditions by age 65 which appear to make the impact of marijuana worse, according to one of the studies that examined hospital records for adults over 65 with cannabis use disorder who did not smoke tobacco.
“What is unique about our study is that patients who were using tobacco were excluded because cannabis and tobacco are sometimes used together, therefore, we were able to specifically examine cannabis use and cardiovascular outcomes,” said lead study author Dr. Avilash Mondal, a resident physician at Nazareth Hospital in Philadelphia, in a statement. Sorry missed that
Researchers found the 8,535 adults who abused weed had a 20% higher risk of having a major heart or brain event while hospitalized, compared to over 10 million older hospitalized adults who did not use marijuana.
Both abusers and non-users had already been diagnosed with high blood pressure, type 2 diabetes or high cholesterol. The study found that having high blood pressure readings of over 130/80 mm Hg and high cholesterol were key predictors of major adverse heart and brain events in the marijuana users.
“We know acute use can lead to a drop in blood pressure and therefore, particularly when this is vaped or when it is smoked and or combusted. And so therefore, that plays into the … understanding the potential risk for stroke,” Page said. “But what’s interesting is if you look at individuals who’ve used cannabis daily over very long periods of time, it’s actually been associated with an increase in blood pressure which is also a risk factor for numerous other cardiovascular conditions.”
Risk of heart failure rose
A second study presented Monday followed nearly 160,000 adults with a median age of 54 for about four years to see if use of cannabis would impact their risk of developing heart failure. Heart failure doesn’t mean the heart has stopped working, but that the heart isn’t pumping oxygenated blood as well as it should, according to the AHA.
At the end of the study, researchers found people who reported daily marijuana use had a 34% increased risk of developing heart failure, compared to those who reported never using marijuana.
Age, sex at birth and smoking history did not appear to impact the risk. The study researchers did not know if the marijuana was smoked or eaten.
A study published earlier this year also found using marijuana every day can raise a person’s risk of coronary artery disease by one third compared with those who never partake. Coronary artery disease is caused by plaque buildup in the walls of the arteries that supply blood to the heart. Also called atherosclerosis, CAD is the most common type of heart disease, according to the US Centers for Disease Control and Prevention.
“Prior research shows links between marijuana use and cardiovascular disease like coronary artery disease, heart failure and atrial fibrillation, which is known to cause heart failure,” said Dr. Yakubu Bene-Alhasan, a resident physician at Medstar Health in Baltimore, who was lead author of the heart failure study, in a statement
“Our results should encourage more researchers to study the use of marijuana to better understand its health implications, especially on cardiovascular risk,” Bene-Alhasan said.
Sign up for CNN’s Stress, But Less newsletter. Our six-part mindfulness guide will inform and inspire you to reduce stress while learning how to harness it. | Disease Research |
Hacking. Disinformation. Surveillance. CYBER is Motherboard's podcast and reporting on the dark underbelly of the internet.Sen. Elizabeth Warren and a group of other Democratic lawmakers have introduced a bill that would essentially outlaw the sale of location data harvested from smartphones. The bill also presents a range of other powers to the Federal Trade Commission (FTC) and individual victims to push back against the multibillion-dollar location data industry.The move comes after Motherboard reported multiple instances in which companies were selling location data of people who visited abortion clinics, and sometimes making subsets of that data freely available. Such data has taken on a new significance in the wake of the Supreme Court’s looming vote on whether to overturn the protections offered by Roe v. Wade. The bill also follows a wave of reporting from Motherboard and others on various abuses and data sales in the location data industry writ large.“Data brokers profit from the location data of millions of people, posing serious risks to Americans everywhere by selling their most private information,” Warren told Motherboard in a statement. “With this extremist Supreme Court poised to overturn Roe v. Wade and states seeking to criminalize essential health care, it is more crucial than ever for Congress to protect consumers’ sensitive data. The Health and Location Data Protection Act will ban brokers from selling Americans’ location and health data, rein in giant data brokers, and set some long overdue rules of the road for this $200 billion industry.”Do you work in the location data industry? Do you know about any more abuses of location data? We'd love to hear from you. Using a non-work phone or computer, you can contact Joseph Cox securely on Signal on +44 20 8133 5190, Wickr on josephcox, OTR chat on [email protected], or email [email protected] of the bill are senators Ron Wyden, chair of the Senate Finance Committee; Patty Murray, chair of the Senate HELP Committee; Sheldon Whitehouse; and Bernie Sanders, chair of the Senate Budget Committee.The Health and Location Data Protection Act is hugely ambitious in its scope, in that it will rather unambiguously “ban data brokers from selling or transferring location data and health data” barring some limited exceptions, according to a summary sheet of the bill shared with Motherboard by Warren’s staff. Those exceptions include activities that are compliant under HIPAA, the federal law used for protecting healthcare data, and First Amendment speech, the summary adds.The bill itself more specifically says “it shall be unlawful for a data broker to sell, resell, license, trade, transfer, share, or otherwise provide or make available any of the following forms of data, whether declared or inferred, of an individual.” It then lists location and health data.The bill defines location data as “data capable of determining the past or present physical location of an individual or an individual’s device.”Zach Edwards, a privacy researcher who has followed the location and related industries closely, told Motherboard in an email after reviewing the bill that “This legislation would impact location data brokers and big tech companies who make location data for end users available to their partners in unsafe ways.” He added that the phrasing of the bill “makes it clear that organizations who collect location data would have a new responsibility to not expose that location unsafely to their own partners.”The location data industry is a complex web of companies that fulfill different roles and which provide services to a wide range of clients and use cases. This industry includes ordinary apps that collect the data in the first place and may sell their users’ information directly to other firms; companies that create software development kits (SDKs), which are bundles of code that harvest the data and which they then sell the data onwards; data brokers who act simply as middlemen for other parts of the ecosystem; and companies that package the data into their own products and whose clients sometimes include law enforcement, military, and intelligence agencies.Uses for location data vary include real estate companies sourcing it to determine how much foot traffic a plot of land may receive, hedge firms to predict if their investment will pay off, and local governments to work out transportation issues. Motherboard previously reported that the Centers for Disease Control and Prevention (CDC) sourced data on millions of phones to see if Americans followed COVID-19 lockdown orders.Law enforcement and intelligence agencies, including Immigration and Customs Enforcement (ICE), Customs and Border Protection (CBP), the Drug Enforcement Administration (DEA), and the Federal Bureau of Investigation (FBI) have all purchased surveillance products that ultimately rely on the harvesting, transfer, and sale of location data from smartphones. Sen. Wyden has proposed his own legislation, called the Fourth Amendment is Not for Sale Act, that would require agencies to obtain a warrant to get this sort of data. At the moment, agencies can bypass the need for a warrant by purchasing location information from a third party.The industry is also home to startling abuses. Last year a Christian-aligned publication used location data to allegedly out a homosexual priest without his consent.“This legislation would impact location data brokers and big tech companies who make location data for end-users available to their partners in unsafe ways.”Beyond the ban on the sale of location data, the bill includes other mechanisms around enforcement, such as $1 billion in funds for the FTC over the next decade to perform its existing responsibilities and new ones around this law, and powers for the FTC and state attorneys general to sue to enforce the law. Individual people could also sue for damages and injunctions under the bill.Because the bill goes far beyond banning just the sale of location data related to abortion clinics, and instead encompasses the sale of such data in general, it is likely to face fierce opposition from the massive location data industry. X-Mode, a company that Motherboard revealed was harvesting location data from a Muslim prayer app and which had U.S. military contractors among its clients, paid lobbying group Franklin Square Group $30,000 in 2020 (X-Mode has since rebranded as Outlogic, and was acquired by Digital Envoy in 2021). Venntel, a firm that The Wall Street Journal first reported provided location data based products to U.S. law enforcement, paid $160,000 in 2020, $320,000 in 2021, and so far $80,000 in 2022 on lobbying efforts. Venntel paid that money to lobbying firm Alpine Group.Other lawmakers have recently proposed another piece of somewhat related legislation. The My Body My Data Act from congresswoman Sara Jacobs (CA-53) aims to stop the collection and transfer of reproductive health data. It also would give consumers the ability to launch lawsuits against companies that violated the practice, the Washington Post reported earlier this month. As the Post added, the bill is unlikely to become federal law given broad Republican opposition to expanding abortion protections and an evenly split Senate. Jacobs told the Post, “We think this can be a model for states as they are trying to figure out how they can best protect people’s right to abortion.”Edwards, the privacy researcher, added, “This bill from Senator Warren is long overdue, and while it's becoming clearer every day to Americans that their personal lives and decisions are for sale to the highest bidder, it's clear that Senator Warren has a plan to turn the tables on data brokers, and Congress would be wise to pass some version of this important legislation.”Subscribe to our cybersecurity podcast, CYBER. Subscribe to our new Twitch channel.ORIGINAL REPORTING ON EVERYTHING THAT MATTERS IN YOUR INBOX.By signing up, you agree to the Terms of Use and Privacy Policy & to receive electronic communications from Vice Media Group, which may include marketing promotions, advertisements and sponsored content. | Health Policy |
In early studies, Loyal dosed 130 research dogs with its investigational drug. Halioua says the company has shown that it can reduce IGF-1 levels in large dogs to those seen in medium-size dogs. Two dogs had loose stools for a day or two after receiving the injection, but beyond that, Halioua says, no major side effects have been observed.To determine the drug’s effect on lifespan, the company is planning a bigger study that will start in 2024 or 2025, and enroll about 1,000 large and giant breed companion dogs that are at least 7 years old. Each will receive either the experimental drug or a placebo.Halioua says the company aims to have its drug on the market by 2026. But first, Loyal still has to prove to the FDA—which regulates both human and veterinary medicines—that the injection is safe and that the drug can be reliably manufactured. At that point, the FDA can grant conditional approval, a temporary authorization that lasts five years and allows the drug to be sold by prescription. During that time, Loyal will collect effectiveness data and apply for full approval.Loyal is also working on two other drugs: a pill version for large and giant dog breeds, and a pill for older dogs of all breeds.Danika Bannasch, a veterinary geneticist at the University of California, Davis, who specializes in canine genetics, says that IGF-1 is only one factor thought to be associated with dog size and longevity. “As for targeting it, I think it’s a bit premature. We know that smaller breed dogs live longer than larger breed dogs, but we don’t know how much of that is due to the influence of IGF-1,” she says.In a study published last month, Bannasch and her colleagues identified another possible driver of dog longevity, a gene called ERBB4. Studying more than 300 golden retrievers, they compared the DNA from blood samples of dogs that were still alive at 14 years of age to those that died before age 12. They found that dogs with certain variants of the gene survived longer—on average, 13.5 years compared to 11.6 years. Bannasch cautions that the work was conducted in only one breed and that it’s not known whether these variants are associated with longer life in other types of dogs.The ERBB4 gene is the canine version of HER4, a human gene closely related to HER2, which is associated with cancer. Studying the canine gene could have implications for human health. Researchers are also testing new cancer treatments in dogs with the hope that these therapies could help people.Giving an experimental drug to healthy dogs is different from treating sick dogs. Bannasch says Loyal’s drug will need to clear a high safety bar for owners to be comfortable giving it to their pets. She also thinks a drug would need to show more than a few months of life extension before people would want to buy it for their dogs. “As a pet owner, I think anything over a year would be great. I suspect people would be really interested in that,” she says.Linda Rhodes says that humans owe it to dogs to make up for the genetic misfortunes they’ve inherited due to hundreds of years of breeding. “We’ve bred dogs to have problems because we want them to look or act a certain way,” she says. “It’s our responsibility to figure out how we can help.” | Drug Discoveries |
Health Jun 14, 2022 4:44 PM EDT NEW YORK (AP) — A government advisory panel met Tuesday to decide whether to recommend a second brand of COVID-19 vaccine for school-age children and teens.
The Food and Drug Administration’s outside experts will vote on whether Moderna’s vaccine is safe and effective enough to give kids ages 6 to 17. If the panel endorses the shot and the FDA agrees, it would become the second option for those children, joining Pfizer’s vaccine.
The same expert panel will meet Wednesday to consider tot-sized shots from Moderna and Pfizer for the littlest kids, those under 5.
Moderna’s COVID-19 vaccine has long been available for adults in the U.S. and elsewhere and dozens of countries offer it to children, too. In the U.S., children ages 12 to 17 would get two full-strength doses; ages 6 to 11 would get half-sized doses.
The FDA held up Moderna’s teen vaccine for months while it investigated a rare side effect, heart inflammation. That’s mostly a risk for teen boys and young men, and also can occur with the Pfizer vaccine. Moderna got extra scrutiny because its shots are a far higher dose.
In their review, FDA scientists said there were no confirmed cases of the heart inflammation in Moderna’s kid studies. But experts say the studies may have had too few participants for a rare side effect like that to appear.
READ MORE: Moderna says new COVID-19 vaccine protects against omicron
“It’s just not enough people in the clinical trials to detect” the problem if it’s occurring, said Dr. Jesse Goodman of Georgetown University, a former FDA vaccine chief, in a call with reporters earlier this week.
As for other side effects, FDA officials said nothing alarming was reported — mainly sore arms, headache and fatigue.
The FDA analysis concluded that two doses of Moderna are effective in preventing symptomatic COVID-19 illness in teens and younger kids, with the levels of virus-fighting antibodies comparable to those developed in young adults.
Vaccine effectiveness was estimated at 93 percent for the 12-17 group, and 77 percent for the younger group, according to the FDA analysis. However, the research was done when earlier versions of the coronavirus were causing most U.S. infections, and it’s not clear how well they work against more recent variants. It’s also based on a limited number of COVID-19 cases, making the estimates a bit rough.
The FDA review said it was likely a booster shot would be needed, as is now recommended for children vaccinated with Pfizer’s shots, as well as for all adults.
How much demand there will be for Moderna’s shots isn’t clear. Teens became eligible a year ago for Pfizer’s vaccine, which uses the same technology, and only 60 percent have gotten two doses. Shots for younger kids started in November; about 29 percent have been fully vaccinated, according to the Centers for Disease Control and Prevention.
If the FDA authorizes Moderna shots for teens and schoolchildren, the matter moves next to the CDC, which makes recommendations about vaccinations to doctors and the public. A CDC spokesperson said the agency is not expected to take up the question until later this month. Left: The Moderna Covid-19 vaccine awaits administration at a vaccination clinic in Los Angeles, California on December 15, 2021. Photo by FREDERIC J. BROWN/AFP via Getty Images | Vaccine Development |
Naga Munchetty has said she spent decades being failed, gaslit and “never taken seriously” by doctors, despite suffering debilitatingly heavy periods, repeated vomiting and pain so severe that she would lose consciousness.
The BBC presenter, newsreader and journalist told the Commons women and equalities committee on Wednesday that she was “deemed normal” and told to “suck it up” by NHS GPs and doctors during the 35 years she sought help for her symptoms.
Munchetty was finally diagnosed with adenomyosis, a condition where the lining of the womb starts growing into the muscle in its walls, in November last year.
She said she was consistently told by doctors that “everyone goes through this”.
“I was especially told this by male doctors who have never experienced a period but also by female doctors who hadn’t experienced period pain,” said Munchetty.
She said there was a “constant [refrain of]: ‘You’re fine, everyone else is putting up with this, why can’t you?’”
Munchetty’s diagnosis came after she had bled heavily for two weeks and experienced pain so severe she asked her husband to call an ambulance. Only then was she taken seriously, seeing a GP who specialised in women’s reproductive health. That GP advised her to use private healthcare to avoid lengthy NHS waiting lists.
Acknowledging she is “fortunate enough to be able to have private healthcare”, Munchetty said it was the “only time I felt I could sit there and take time and force an issue, force understanding, force explanations from my gynaecologist and not feel bad that I was taking up more than 10 minutes of my GP’s time because there was a queue of people in the waiting room”.
Munchetty and Vicky Pattison, a television and media personality, were giving evidence as part of the committee’s inquiry into the challenges that women face being diagnosed and treated for gynaecological and reproductive conditions.
The committee is also considering any disparities that exist in diagnosis and treatment, and the impact of women’s experiences on their health and lives.
Both women gave detailed evidence of how they struggled to live and work normally over many decades while being repeatedly belittled and failed by medical professionals.
Pattison has only recently been diagnosed with premenstrual dysphoric disorder (PMDD). Now 35, she said she started experiencing extreme symptoms in her late 20s, including “crippling anxiety”, insomnia and fatigue. Doctors in Newcastle and London put her symptoms down to PMS (premenstrual syndrome).
Munchetty and Pattison agreed that the NHS is failing girls and women. They said GPs, specialists and doctors lack the specialism and training required to recognise and treat gynaecological issues that are devastating the lives of women and girls across the UK.
“When I spoke about adenomyosis on my Radio 5 Live programme, GPs got in touch to say they had never head of the condition, never been taught about it and didn’t know how to diagnose it,” said Munchetty.
Pattison said women’s health is “woefully misunderstood” across the NHS. There is, she added, “so much ignorance surrounding it and a lot of stigma as well, which means women are ashamed to talk about it and this horrible culture is perpetuated”.
Munchetty said: “When women do try to speak about it they get labelled as a troublemakers. It’s really hard for women to win but if the medical profession understood more, then we wouldn’t have to fight as hard and feel like such a nuisance.”
The chair of the committee, Caroline Nokes, promised the committee would eventually issue guidance to NHS and schools to tackle what Munchetty ended the session by summarising as the “woeful misunderstood, ignorance, stigma and shame” surrounding women’s health. | Women’s Health |
Just 48 hours after her birth in a Seattle-area hospital in 2021, Layla Babayev was undergoing surgery for a bowel obstruction.
Two weeks later, she had another emergency surgery, and then developed meningitis. Layla spent more than a month in neonatal intensive care in three hospitals as doctors searched for the cause of her illness.
Her parents enrolled her in a clinical trial to check for a genetic condition. Unlike genetic tests focused on a few disease-causing variants that can take months to produce results, the study at Seattle Children’s Hospital would sequence Layla’s entire genome, looking for a broad range of abnormalities — and potentially offer answers in under a week.
The test found Layla had a rare genetic disorder that caused gastrointestinal defects and compromised her immune system. The findings led doctors to isolate her, give her weekly infusions of antibiotics, and contact other hospitals that had treated the same condition, said her father, Dmitry Babayev.
Today, Babayev credits the test, known as rapid whole-genome sequencing, for saving his daughter’s life. “It is why we believe Layla is still with us today,” he said.
Like her disorder, Layla’s experience is rare.
Few hospitalized babies with an undiagnosed illness undergo whole-genome sequencing — a diagnostic tool that allows scientists to quickly identify genetic disorders and guide clinicians’ treatment decisions by analyzing a patient’s complete DNA makeup. That’s largely because many private and public health insurers won’t cover the $4,000-to-$8,000 expense.
But an alliance of genetic testing companies, drugmakers, children’s hospitals, and doctors have lobbied statesto increase coverage under Medicaid — and their efforts have begun to pay off.
Since 2021, eight state Medicaid programs have added rapid whole-genome sequencing to their coverage or will soon cover it, according to GeneDX, a provider of the test. That includes Florida, where the Republican-controlled legislature has resisted expanding Medicaid under the Affordable Care Act.
The test is also under consideration for coverage in Georgia, Massachusetts, New York, and North Carolina, according to the nonprofit Rady Children’s Institute for Genomic Medicine, another major provider of the test.
Medicaid coverage of the test can significantly expand access for infants; the state-federal program that insures low-income families covers more than 40% of children in their first year of life.
“This is an extraordinary, powerful test that can change the trajectory of these children’s diseases and our own understanding,” said Jill Maron, chief of pediatrics at Women & Infants Hospital in Providence, Rhode Island, who has conducted research on the test.
“The only thing interfering with more widespread use is insurance payment,” she said.
Proponents of whole-genome sequencing, which has been commercially available for about six years, say it can help sick infants with potentially rare diseases avoid a months- or years-long odyssey of tests and hospitalizations without a clear diagnosis — and increase survival.
They also point to studies showing rapid whole-genome testing may lower overall health costs by reducing unnecessary hospitalizations, testing, and care.
But the test may have its limits. While it is better at identifying rare disorders than older genetic tests, whole-genome sequencing detects a mutation only about half of the time — whether because the test misses something or the patient does not have a genetic disorder at all.
And the test raises ethical questions because it can also reveal that babies — and their parents — have genes that put them at increased risk for adult-onset conditions such as breast and ovarian cancer.
Even so, some doctors say sequencing offers the best chance to make a diagnosis when more routine testing doesn’t provide an answer. Pankaj Agrawal, chief of neonatology at the University of Miami Miller School of Medicine, said only about 10% of babies who could benefit from whole-genome sequencing are getting it.
“It is super frustrating to have sick babies and with no explanation what is causing their symptoms,” he said.
Even in states that have adopted the test, coverage varies. Florida will add the benefit to Medicaid later this year for patients up to age 20 who are in hospital intensive care units.
Florida state Rep. Adam Anderson, a Republican whose 4-year-old son died in 2019 after being diagnosed with Tay-Sachs disease, a rare genetic disorder, led the push for Medicaid to cover sequencing. The new state Medicaid benefit is named for his son, Andrew.
Anderson said persuading his GOP colleagues was challenging, given they typically oppose any increase in Medicaid spending.
“As soon as they heard the term ‘Medicaid mandate,’ they shut down,” he said. “As a state, we are fiscally conservative, and our Medicaid program is already a huge program as it is, and we want to see Medicaid smaller.”
Anderson said it took doctors more than a year to diagnose his son — an emotionally difficult time for the family as Andrew endured numerous tests and trips to specialists in several states.
“I know what it’s like to not get those answers as doctors try to figure out what is wrong, and without genetic testing it’s almost impossible,” he said.
A Florida House analysis estimated that if 5% of babies in the state’s neonatal intensive care units got the test each year, it would cost the Medicaid program about $3.3 million annually.
Florida’s legislative leaders were persuaded in part by a 2020 study called Project Baby Manatee, in which Nicklaus Children’s Hospital in Miami sequenced the genomes of 50 patients. As a result, 20 patients — about 40% — received a diagnosis, leading to changes in care for 19 of them.
The estimated savings exceeded $3.7 million — a nearly $2.9 million return on investment, after the cost of the tests, according to the final report.
“We have shown that we can justify this as a good investment,” said Parul Jayakar, director of the hospital’s Division of Clinical Genetics and Metabolism, who worked on the study. | Medical Innovations |
Social media companies should be forced to pay a windfall tax to fund mental health services amid a growing crisis in child suicide, experts have said.
Former Children’s Commissioner Anne Longfield and Steve Chalke, the founder of Oasis charity - which oversees more than 50 schools - said they have “never known a generation that is struggling as much with mental health problems” in their 40 years working with children.
They said “there is no doubt that it is fuelled and amplified by the dominance that social media now has in children’s lives”.
The two children’s campaigners are now pleading with Chancellor Jeremy Hunt to commit to a social media levy in the budget next Wednesday.
They want to use it to fund a £1billion package, which they have estimated is needed to boost the quality and effectiveness of mental health care.
Roughly, this would include £500million to extend mental health teams to all schools in England and £250million to improve waiting times and treatment.
It would also allocate £150million to develop community based drop-in mental health centres and £100million to fund sessions in sports, arts, music, drama and other activities for children and young people.
Social media’s impact on children and young people gained huge attention with the tragic case of 14-year-old Molly Russell.
An inquest found the schoolgirl died due to a depressive “act of self-harm” after being "exposed to material that may have influenced her in a negative way”.
Andrew Walker, the coroner, said the "particularly graphic" content she saw "romanticised acts of self-harm", "normalised her condition" and focused on a "limited and irrational view without any counterbalance of normality".
He said it "sought to isolate and discourage discussion" with people who could have helped her, and instead "tended to portray self-harm and suicide as an inevitable consequence of a condition that could not be recovered from".
One in six children and young people in England now have a diagnosable mental health condition, according to official NHS statistics.
Latest figures show that there were 734,000 children referred to the NHS’s child and young people mental health services in 2021-22 - a 47% increase from the previous year and an enormous 84% increase from 2018-19,the last year before Covid.
Average waiting times between a child being referred and starting treatment also jumped up by 25% in the last year.
It went from a 32-day wait in 2020-21 to 40 days in 2021-22, according to analysis published this week by the current Children’s Commissioner Rachel de Souza.
Speaking exclusively to the Mirror, Ms Longfield and Mr Chalke said: “Children attempting to take their own life, and in some cases succeeding, is no longer exceptional in many schools and colleges, particularly since the Covid pandemic.
"Children are falling into crisis, mental health services are overwhelmed, and on current trajectories there won’t be support teams in every school until at least the end of the decade.
“We believe we need emergency support for children’s mental health and that it is only right that social media companies, who are contributing to the problem, help to provide some of the cash to solve it.
“Just as the Government has introduced a windfall tax on energy companies to tackle one emergency, we believe that it should now introduce a levy on social media companies and mobile phone providers to help pay for the children’s mental health emergency.
“The foot-dragging reluctance of the tech giants to take proper responsibility for the impact they have on young minds is palpable.
“It is time they paid their fair share towards funding a children’s mental health system that can help children stay well and which starts to turn around the crisis in young people’s mental health. Ultimately it will even save lives.
“We urge the Chancellor to be bold and to introduce a levy now. Millions of children and parents will thank him for it.”
The Online Safety Bill is expected to return to parliament this summer.
If passed, it will make social media companies legally responsible for keeping children and young people safe online. | Mental Health Treatments |
Having healthy mitochondria, the organelles that produce energy in all our cells, usually portends a long healthy life whether in humans or in C. elegans, a tiny, short-lived nematode worm often used to study the aging process. Researchers at the Buck Institute have identified a new drug-like molecule that keeps mitochondria healthy via mitophagy, a process that removes and recycles damaged mitochondria in multicellular organisms. The compound, dubbed MIC, is a natural compound that extended lifespan in C. elegans, ameliorated pathology in neurodegenerative disease models of C. elegans, and improved mitochondrial function in mouse muscle cells. Results are published in the November 13, 2023, edition of Nature Aging.
The impact of mitochondrial dysfunction in age-related disease
Defective mitophagy is implicated in many age-related diseases. It's tied to neurodegenerative disorders such as Parkinson's and Alzheimer's; it plays a role in cardiovascular diseases including heart failure; it influences metabolic disorders including obesity and type 2 diabetes; it is implicated in muscle wasting and sarcopenia and has a complex relationship with cancer progression. Even though interventions that restore mitophagy and facilitate the elimination of damaged mitochondria hold great promise for addressing these conditions, not one treatment has been approved for human use despite advances in the field.
What's MIC?
MIC (Mitophagy-Inducing Compound) is a coumarin, which are naturally bioactive compounds that have anticoagulant, antibacterial, antifungal, antiviral, anticancer, and antihyperglycemic properties (among others) as well as being an antioxidant with neuroprotective effects. Coumarin is found in many plants and is found in high concentrations in certain types of cinnamon, which is one of the most frequent sources for human exposure to the substance.
A new mechanism of action in mitophagy
The project started in a mouse model of Parkinson's disease where researchers in the laboratory of Julie Andersen, PhD, a senior author of the paper, were looking at known enhancers of mitophagy, including rapamycin. "Co-author Shankar Chinta, PhD, started screening natural compounds in neuronal cells and MIC came up as a major hit," she said. "Rather than taking MIC immediately into a mouse model we wanted to understand its impact on overall aging and identify its mechanism of action, so we took the work into the worm where we found that MIC is in a different class of molecules that enhance the expression of a key protein, TFEB."
In an effort spearheaded by Andersen and research scientist Manish Chamoli, PhD, lead author of the study, researchers found that MIC enhanced the activity of transcription factor TFEB, which is a master regulator of genes involved in autophagy and lysosomal functions. Autophagy is the intracellular recycling process whereby cells clean up damaged proteins; it derives its abilities from the lysosome. Researchers found that MIC robustly increased the lifespan of C. elegans while also preventing mitochondrial dysfunction in mammalian cells.
"This paper helps support the overall notion of TFEB being a key autophagy regulator that extends lifespan, "said Buck professor and Chief Scientific Officer Malene Hansen, PhD, who collaborated on the paper. She added, "Mitophagy is a selective and very significant form of autophagy. The field has recognized TFEB as a player when it comes to quality control in mitochondria. This study provides a possible translational route to induce mitophagy in a TFEB-dependent fashion."
A link to the brain/gut connection
Mechanistically MIC works upstream of TFEB by inhibiting ligand-induced activation of the nuclear hormone receptor DAF-12 (in worms)/FXR (in humans), which in turn induces mitophagy and extends lifespan. FXR is best known for its ability to act in the liver and gut to maintain lipid homeostasis, where it acts to regulate levels of TFEB as part of a feed-fast cycle, but recently TFEB was shown to also be present in brain neurons. This provided Andersen with the clue needed to piece together MIC's potential mechanism of action in the latter. "This study provides another piece of the puzzle when it comes to understanding the brain/gut connection in terms of health and disease," said Andersen.
FXR is regulated by bile salts which are formed in the gut microbiome. "The gut microbiome impacts the body's use of bile acids. Aging impacts our microbiome," said Chamoli. "If levels of bile acids aren't correct it hinders mitophagy. That's how FXR can impact neuronal health. Neurons have a lot of mitochondria which makes mitophagy important in terms of neurodegeneration," he said, noting that experiments are underway to explore neuronal FXR as a therapeutic target for Alzheimer's disease as part of a jointly funded grant shared by the Andersen and Lithgow labs.
MIC as a general geroprotective therapeutic
"There's a bottleneck in efforts to develop potential therapeutics in the field of geroscience, and the bottleneck is that we don't have enough molecules in the pipeline," said Gordon Lithgow, PhD, Buck Professor and Vice President of Academic Affairs and senior co-author. "MIC is a great candidate to bring forward given its therapeutic effect across multiple models and the fact that it is a naturally occurring molecule."
Chamoli highlighted the direct links between mitophagy and aging, suggesting that drugs enhancing this process could offer treatment well beyond neurodegeneration or muscle wasting. He added, "All these possibilities can be explored at the Buck where the research environment supports such endeavors."
Story Source:
Journal Reference:
Cite This Page: | Drug Discoveries |
A mother with a "debilitating" rare disease has said psychological support for people with uncommon conditions is lacking.
She said the syndrome caused "horrendous pain" and affects her eyes, skin and joints.
The Welsh government said addressing the mental health needs of patients with rare diseases was "fundamental".
Ms Humphreys said: "When it flares up it's really aggressive and it absolutely knocks me off my feet.
"You do need a lot of input from specialists because it can affect so many different areas of your body."
She has seen many specialists in Wales, but said there was a gap in mental health support.
She takes medication to control her anxiety, but said she has never been offered counselling.
"When you get diagnosed with a rare disease, or any kind of chronic health, you go through this grieving process," she said.
"Because you've lost your health, really, you've just been left to deal with a disease that's stampeded into your life.
"When you have a flare up that's, for me, when I go into really intense grief. Because you're in horrendous pain, but also because you're realising your body doesn't work properly."
Ms Humphreys said due to a "lack of support" she had set up her own group for people with Behçet's disease, which has about 50 members from Wales.
"In Wales, we don't have that specialist approach to Behçet's, we don't have that coordinated approach. It's about me having to try and signpost myself where they need to go", she said.
Prof Iolo Doull, chairman of the Rare Diseases Implementation Group in Wales, said about 170,000 people in Wales were affected by rare diseases.
"I think we need to recognise that some diseases are so rare that perhaps maybe there are only 10 people in the whole of the UK with that", he said.
"So if there are a number of patients in Wales, obviously we would aim [that care is] delivered as close to home with as much quality as possible. But sometimes we have to recognise that people will travel across the UK to single centres.
"It's important that within health boards, mental health support is equitably accessed by patients with rare diseases."
However, Disability Wales said its members often feel "pushed off" once they have a diagnosis.
"It can be a really hard thing to navigate when you're getting a mixture of support or across the border, just because the NHS in England and Wales are so different," said disability equality officer Alex Osborne.
"If people have to travel far for treatment or operations, that's one thing, but then they're coming home and being completely left to get on with it.
"We really want an increase in support for disabled people in general, but also more reactive support when people are getting new diagnosis as well."
Aneurin Bevan University Health Board said it was sorry to hear of Ms Humphreys' experiences.
"As participants in the Wales-focused action plan developed by the Rare Diseases Implementation Group, we are committed to playing our part in helping to improve the lives of people living with rare diseases," a spokesman said.
"We would encourage Ms Humphreys to contact us directly so that we can discuss her concerns and provide her with any support she may need."
The Welsh government said: "While health boards provide mental health support locally, patients may need to travel longer distances to receive specialist treatment for rarer conditions, including mental health support.
"We continue to increase our investment in a range of mental health and wellbeing support with an additional £50m in 2022-23, rising to £90m in 2024-25." | Mental Health Treatments |
Win McNamee/Getty Images
toggle caption
President Joe Biden and Vice President Kamala Harris at the White House event on August 29 where they announced the list of the first 10 medicines targeted for Medicare negotiations.
Win McNamee/Getty Images
President Joe Biden and Vice President Kamala Harris at the White House event on August 29 where they announced the list of the first 10 medicines targeted for Medicare negotiations.
Win McNamee/Getty Images
For the first time, Medicare is beginning to negotiate the prices of prescription drugs. Despite a pack of industry lawsuits to keep the negotiations from happening, the drugmakers say they are coming to the bargaining table anyway.
It's been more than a month since the Biden administration announced the first ten drugs up for Medicare price negotiation, which a provision in the Inflation Reduction Act. The drugs included blockbuster blood thinners Xarelto and Eliquis, as well as drugs for arthritis, cancer, diabetes and heart failure.
Although more than a third of the companies that make drugs on the list have sued the federal government, all the companies have signed agreements saying they will negotiate.
The agreements were due Oct. 1.
"They're taking steps to participate in the negotiating program so we can give seniors the best possible deal," President Biden declared from the Oval Office in a video posted to X.com, formally known as Twitter.
Many of the drugmakers told NPR they had no choice. They could either agree to negotiate, pay steep fines or withdraw all their products from the Medicare and Medicaid markets.
"While we disagree on both legal and policy grounds with the IRA's new program, withdrawing all of the company's products from Medicare and Medicaid would have devastating consequences for the millions of Americans who rely on our innovative medicines, and it is not tenable for any manufacturer to abandon nearly half of the U.S. prescription drug market," a Merck spokesperson wrote in an email to NPR.
Merck makes Januvia, a drug that treats diabetes and was selected for price negotiation. The company has also brought one of the many lawsuits against the government to keep negotiation from happening.
Overall, the industry has argued that negotiating drug prices would stifle innovation.
"In light of the statutory deadline, we have signed the manufacturer agreement for the [Medicare] price setting program," an Amgen spokesperson wrote in an email to NPR. "We continue to believe the price setting scheme is unlawful and will impede medical progress for needed life-saving and life-enhancing therapies."
Amgen makes Enbrel, a drug on the negotiation list that treats rheumatoid arthritis and other autoimmune issues.
A Congressional Budget Office report found that drug pricing provisions in the Inflation Reduction Act would have only a modest impact on new drugs coming to market, and would save Medicare an estimated $237 billion over 10 years, with $98.5 billion of that coming from drug price negotiation.
On Sept. 29, a Trump-appointed judge declined to halt the negotiations in response to a lawsuit filed by the U.S. Chamber of Commerce, dealing another blow to the pharmaceutical industry.
The administration will tell companies its proposed prices for the first group of drugs on Feb. 1 of next year, and the drugmakers will have 30 days to accept or make a counter offer. The final negotiated prices will be announced in September 2024, and the new prices will go into effect in 2026.
Under the inflation Reduction Act, Medicare can negotiate the prices of more drugs each year, with up to 20 drugs eligible for negotiation 2029. To be eligible, they must meet certain criteria, including being on the market for a number of years and having no competition from generic or biosimilar products. | Health Policy |
Subsets and Splits