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A world-renowned cancer centre hit by whistleblowing concerns over alleged bullying has been downgraded by the health watchdog.
The Care Quality Commission (CQC) told The Christie NHS Foundation Trust in Manchester it "requires improvement" in safety and leadership.
A former trust nurse told the BBC leaders had intimidated staff to stop them voicing concerns to inspectors.
The trust said it was working hard to ensure staff felt supported.
Rebecca Wight worked at The Christie - Europe's largest cancer centre - from 2014 but quit her role as an advanced nurse practitioner in December, claiming her whistleblowing attempts had been ignored.
She told BBC Newsnight the trust had attempted to manipulate the inspection by intimidating those who wished to paint an honest picture.
"The well-led inspection was basically run by The Christie," she said.
"The CQC requested a few forums with clinical staff. Those forums were infiltrated by leaders.
"The forum I went to was attended by senior leaders in the executive team."
Ms Wight said it was done "to intimidate staff to not speak up or maybe not speak openly about leadership".
Ms Wight said she and others wrote to the CQC to warn inspectors they were only getting a carefully controlled and inaccurate picture.
As a result, an off-site session was arranged by the CQC, she said, "for people to come anonymously and speak to them".
Roger Kline, an NHS workforce and culture expert from Middlesex University Business School, told BBC Newsnight there was a culture at The Christie which was "unwelcoming of people raising concerns".
He said: "The trust response is more likely... to see the person raising the concerns as the problem rather than the issues they have raised," adding this was "not good for patient care".
Following the downgrading of the trust's rating, Mr Kline said leaders should now consider their positions, adding: "I think for a trust like The Christie, a small specialist trust, any form of downgrading is a significant problem."
The Christie had been rated as "outstanding" in its previous two CQC inspections.
Downgrading the trust's rating to "good" following its latest inspection, the CQC criticised The Christie's workplace culture, highlighting that staff did not always feel listened to.
It followed an NHS England review in February 2022 which found the trust had been "defensive and dismissive" when staff raised concerns about bullying and a £20m research project.
The CQC said while there was some "outstanding practice" at The Christie - and praised its commitment to research and innovation to improve cancer patients' outcomes - a number of improvements were required, notably in safety and leadership.
The report said: "Very senior executives were heavily invested in the promotion and protection of the trust's reputation.
"This impacted negatively on some staff; staff did not always feel supported and valued.
"A minority of staff expressed reservations about raising concerns and others did not always feel listened to."
'Important work'
The CQC's Northern operations director Ann Ford said: "Although the trust had made some changes to improve the culture, more work needs to be done to address the issues we identified."
She thanked staff who came forward to give feedback, adding: "I know speaking up in these circumstances isn't easy but it's important it happens."
Ms Ford praised medical care at the trust, saying "staff treated people with compassion and kindness, respected their privacy and dignity and met people's individual needs".
They also provided emotional support to people, families and carers, she added.
"However, they didn't always carry out risk assessments in a timely manner which potentially put people at risk of harm."
Ms Ford praised The Christie's "research and innovation to improve outcomes for people with cancer and the trust and everyone involved should be proud of that important work".
BBC Newsnight put the claims about how the inspection process was handled to The Christie but it declined to comment, saying it was a matter for the CQC.
Trust chief executive Roger Spencer said: "We are pleased the CQC has rated us good despite the difficulties the NHS has faced over the past few years.
"Demand for cancer services has continued to rise, resulting in us treating more patients than ever before.
"We are working hard to make the improvements that have been highlighted by the CQC, ensuring that all our staff feel supported and valued and I thank all of them for continuing to put patients at the centre of everything we do."
BBC Newsnight understands chief executive Mr Spencer wrote to staff on Thursday ahead of the CQC report's publication, pointing out that inspectors had advised the trust to continue its plan "to ensure that our staff feel supported and valued and are able to speak up to raise concerns".
Additional reporting by Emily O'Sullivan, Charlotte Rowles, Lynette Horsburgh and Ian Shoesmith | Health Policy |
The Pandemic Is Over But Our Pandemic Stress Isn’t
(Bloomberg Opinion) -- Survey after survey tells us that Americans are struggling. The latest, the American Psychological Association’s annual gauge of stress in the US, reveals that people continue to feel worse than before the pandemic. The question is what to do about it.
And it’s no wonder that people are so stressed out: Humans have finite mental resources, and they’ve been decidedly depleted by years of dealing with Covid and its fallout, plus economic woes and worries about geopolitical upheaval. In the APA survey, which was conducted in August, nearly a quarter of adults reported operating at the highest levels of stress, rating it at least an 8 out of 10. Among parents, self-reported stress was so extreme that nearly half said it was “completely overwhelming” on most days, and 41% reported that it impedes their function.
In the last year or two, much of the focus has been on addressing the declining mental well-being of adolescents and teens. Kids were already struggling before Covid, but the alarming data on higher levels of anxiety, depression and thoughts of self-harm during Covid has mobilized everyone from policymakers to educators and parents to do whatever it takes to address kids in crisis.
But we shouldn’t forget that adults also were deeply affected by a protracted period of relentless uncertainty, fear, loss and social isolation. The APA’s survey of adults shows stress levels are highest among those age 18 – 45, who reported the biggest increases since pre-pandemic times.
That group also saw a marked increase in chronic health and mental health diagnoses compared to before the pandemic. The pandemic prompted a more open national conversation about mental health, and the survey can’t separate out how much the rise could be due to more people seeking help than in the past. But the increase was big enough in younger groups — 44% of adults aged 34-44 reported a mental health diagnosis compared to 31% in 2019 — that it’s likely a combination of more attention to care and more strain.
And adults under the age of 45 are currently most worried about the economy, with more than 70% citing it as a major stressor, compared to just over 50% of people in 2019. Parents again seem to be bearing the brunt, with two-thirds reporting they felt consumed by money woes.
We’re not helpless in managing that stress, particularly when it comes to those who say they are experiencing it most intensely. Rajita Sinha, director of the Yale Interdisciplinary Stress Center, says she often suggests that people feeling extreme stress should pause and ask themselves, “Where’s the fire?” If there’s a real emergency, of course, we should react, but when there isn’t, it can be grounding to run a basic inventory: “Am I okay? Is my family okay? Who can help?”
Reaching out for support from a friend or family member is the next step. While it might sound like stating the obvious to say that social connection is a vital part of coping, data suggest we’re doing a terrible job at it. In the APA survey, 62% of respondents said they don’t talk about how they’re feeling because they don’t want to be a burden, yet two-thirds of those surveyed also said that “they could have used more emotional support than they received.”
That dovetails with a report from earlier this year, when Vivek Murthy, the US surgeon general, warned that the US was experiencing an epidemic of loneliness that was as bad for our health as smoking. Recent research found a decline in the amount of time Americans spend engaging with others. Being intentional about rebuilding connections — even something as simple as texting a friend — can help us feel less isolated.
People could also do a better job of recognizing the sources of their stress and reining in our reactions to them. We can’t control the ominous news giving us a feeling of existential dread, but we can control our exposure to such news, says Lynn Bufka, associate executive director for practice research and policy at the APA. “Figure out how much you need to know in order to make a decision for your life and then turn it off,” Bufka advises.
Such small changes, performed consistently, might help us shake off some of the residual effects of several very difficult years — and set us up better to cope with the fresh challenges that seem to keep coming.
More From Lisa Jarvis at Bloomberg Opinion:
- Telehealth Should Stick Around. Teens Need It.
- CDC Report on Teen Mental Health Is a Red Alert
- Social Media Is Just One Online Habit Hurting Teens
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.
©2023 Bloomberg L.P. | Stress and Wellness |
NHS waiting times, staff shortages and service backlogs have been flagged as concerns in relation to dozens of patient deaths across England and Wales since the start of last year, the Observer can reveal, with coroners facing a succession of inquests concerning ambulance delays.
Coroners issue prevention of future deaths reports (PFDs) when they believe preventive action should be taken, and send them to relevant individuals or organisations, which are expected to respond.
Among 55 cases identified by the Observer are 24 patient deaths where coroners raised concerns about ambulance delays – all of them occurring before this winter’s ambulance crisis, when response times rocketed to their worst-ever levels.
Wes Streeting, shadow health and social care secretary, said: “The NHS is in the biggest crisis in its history – and the crisis has a cost in lives. Patients are waiting for far longer than is safe, with terrible consequences.”
A PFD report published this month detailed how a woman died last summer after waiting nine hours for an ambulance when she fell at home. She was lying on the floor, unable to use the toilet, with her breathing deteriorating.
She then had to wait three more hours to see a doctor at Tameside General Hospital’s emergency department before dying of Covid pneumonia.
“The inquest heard that the shortage of ambulances was due to a number of factors including high demand and a shortage of crews due to long delays at emergency departments across Greater Manchester to offload patients,” coroner Alison Mutch wrote in her report. “The evidence before the inquest was that the delay on the day [the deceased] was waiting for an ambulance was not unusual and still remained the case on the day of the inquest.”
In another case, a Cardiff woman with a disability died in June 2021 after several calls to the ambulance service over two hours proved fruitless as no ambulance was available.
The report said that when asked by a call responder how much pain she was in on a scale of one to 10, she was “screaming in agony” and responded “11”. Her husband testified that the call responder said that “if [she] could scream then she was not a priority”. Within an hour of the call, she died “without any emergency support and in agony”.
The coroner concluded that “a lack of response by the out-of-hours GP service and a significant delay in attendance by the ambulance services may have influenced her survival”.
But the issues highlighted by coroners in relation to patient deaths are wider than ambulance delays. They include: lengthy elective surgery backlogs; high referral thresholds and long waiting times for children’s mental health services; a national shortage of neurologists; long waiting times for psychological therapies; a lack of mental health beds and unfilled mental health staff vacancies; and a shortage of cardiologists compounded by a shortage of theatre capacity and beds.
Katie Wilkins was a “bright, bubbly” 14-year-old from Warrington who was “always the life and soul of the party”, her mother Jeanette Whitfield told the Observer. She wanted to be a paramedic when she grew up.
But tragedy struck in the summer of 2020 – tragedy that was wholly avoidable. A painful abscess was mishandled by Katie’s local general hospital, delaying her eventual diagnosis with acute promyelocytic leukaemia (APML), a rare type of blood cancer.
After collapsing at home, she was referred to the Alder Hey hospital, where Whitfield says things went “from bad to worse”. APML has a high survival rate – the danger comes from severe bleeding, as APML impairs the blood’s ability to form clots.
The treatment Katie should have received was not administered correctly due to a shortage of the right specialist doctors. Those who did treat her made mistakes.
“They basically put more fluid in her than her body was able to handle,” said Whitfield.
On 29 July, Katie suffered a massive brain haemorrhage and died two days later.
A coroner ruled that neglect by the NHS contributed to her death. Her treatment should have been led by a paediatric haematologist, a specialist in blood disorders. But the inquest was told that Alder Hey had been unable to recruit sufficient haematologists.
The government’s response to the PFD said the number of haematology consultants working in English NHS hospitals had risen 56% since 2010. A statement from Alder Hey Children’s NHS foundation trust said these figures did not specifically relate to paediatric haematologists, which the trust said there was a national shortage of.
The trust added that it had “introduced new measures to ensure events like this will not happen again”.
A Department of Health and Social Care spokesperson said: “Each of these deaths is a tragedy, and our sympathies are with the families affected. We have invested record amounts into health and social care to ensure patients receive high quality care when and where they need it.”
A Welsh government spokesperson said: “The pandemic and recent unprecedented pressures have created challenges with patient flow in our health service, and this has had a massive impact on ambulances.
“The Welsh Ambulance Service has recruited 399 more ambulance staff over the past three years. A delivery plan is in place to improve response times and timeliness of patient handover, and to free up more time for staff to respond to calls.” | Health Policy |
Emergency room visits related to three of the most disruptive viruses — the flu, respiratory syncytial virus and Covid — are falling nationwide.But does that mean the feared "tripledemic" is over? Hardly, experts say. Viruses are notoriously hard to forecast. "We've all learned over the past couple years, when you try to predict Covid, you'll get slapped in the face," said Dr. Katie Passaretti, vice president and enterprise chief epidemiologist for Atrium Health in Charlotte, North Carolina. Still, hospital emergency room visits for the biggest viral threats began to fall in December, with the decline continuing this month. This is especially true for flu.Children got double viral infectionsTrying to guess what flu will do between now and the end of flu season is "hazardous," warned Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Nashville, Tennessee. "It is impossible to predict what will happen next."As most families already know, flu and other viruses have been especially hard on children compared with adults, according to a study published Thursday by the Centers for Disease Control and Prevention.Schaffner is a co-author, along with Dr. Christine Thomas, an epidemic intelligence service officer at the CDC who works with the Tennessee Department of Health."We were really curious to see what this year would look like" following several years of almost no flu, Thomas said. Their report focused on 4,626 people in Tennessee who got a flu test in mid-November. Flu, researchers found, spiked early and hit children the hardest. Children were twice as likely as adults to test positive, and they tended to be sicker, especially if they were infected with several viruses at once, such as the common cold on top of flu. A separate study from earlier this week found that children hospitalized with Covid had more severe symptoms if they also had another virus. Children ages 5 and younger are at risk because their tiny immune systems may not have been exposed to many common viruses during the pandemic."If you get a double infection, it tends to make you a tad sicker, you're apt to stay in the hospital a little longer," Schaffner said. Flu hospitalizations for very young children in Tennessee have already reached peak levels seen in other bad flu seasons, at 12.6 per 100,000, the new study found. This is similar to what's been reported nationally.But this season is not over. While most flu cases so far have been A strains of the virus, B strains tend to pop up by spring. "I do suspect that we will have more bumps in the road this respiratory viral season," Passaretti said. She was not involved with the new study.Few who tested for flu in the Tennessee report were vaccinated. Just 23% of children and 34% of adults had received their flu shots.And having influenza A doesn't offer immunity to the B strain. That is, a person can get the flu twice in a single season. "That's a reason to still get vaccinated," Schaffner said. "Flu probably won't go away completely until we get into the early summer."Follow NBC HEALTH on Twitter & Facebook.Erika EdwardsErika Edwards is a health and medical news writer and reporter for NBC News and "TODAY." | Epidemics & Outbreaks |
When a doctor listens to someone's heartbeat, they typically hear a characteristic sound: "lub-dub, lub-dub." In some people, though, this two-tone heartbeat is accompanied by whooshing or rasping noises, and these unusual sounds are called a heart murmur.
But what is a heart murmur, exactly, and what causes it?
A heart murmur indicates turbulent blood flow through the heart's valves, Dr. Kenneth Ellenbogen, a professor of cardiology and the director of clinical cardiac electrophysiology and pacing at the Virginia Commonwealth University School of Medicine, told Live Science by email.
"Murmurs may be benign and not indicate significant heart disease or may signify a valve problem requiring further evaluation and/or treatment," he said.
Related: What is a normal heart rate?
Blood is pumped from the left and right atria, the chambers that receive blood from veins, to the left and right ventricles, which pump blood out to the body through arteries. Valves located between each atria-ventricle pair close to prevent the backflow of blood. This valve closure makes the "lub" sound.
After the blood leaves the ventricles, the valves that separate the heart from arteries close, generating the "dub" sound. When this blood flow is disrupted, the classic lub-dub can be accompanied by the whooshing, humming or rasping sounds that are characteristic of heart murmurs, and these noises can be detected when a doctor listens to the heart through a stethoscope.
Heart murmurs can be caused by an abnormal structure in the heart, such as a valve abnormality. For example, they may emerge when a valve doesn't close tightly enough, allowing blood to flow backward, or they might reflect a narrow or stiff valve.
Murmurs can also stem from a hole in the heart or a "cardiac shunt," meaning an irregular pattern of blood flow caused by a heart defect present at birth, Ellenbogen said. In addition, certain infectious diseases — such as bacterial endocarditis (an infection of the heart's lining) and rheumatic fever — can damage the heart and lead to heart murmurs, according to Yale Medicine.
Heart murmurs that are not caused by structural abnormalities or diseases of the heart are referred to as "innocent" or "physiological." These result from a marked increase in blood flow through the ventricles, Ellenbogen said.
Innocent heart murmurs are often diagnosed in babies and young people going through growth spurts, because to keep up with the body's rapid increase in weight and height, blood needs to flow more rapidly. Innocent heart murmurs are relatively common: about 10% of adults and 30% of children ages 3 to 7 experience them, according to Harvard Health.
Related: What's the rarest blood type?
Such benign heart murmurs are also common in pregnancy. During gestation, pregnant people's blood volume increases in order to nourish the growing fetus. This can change the heart's sounds, particularly between weeks 12 to 20 of pregnancy, but these murmurs are typically harmless.
People with innocent heart murmurs don't tend to experience any symptoms. "Abnormal" heart murmurs — those tied to structural differences or heart disease — do not always cause symptoms but can be associated with trouble breathing, sweating, chest pain, weight gain, bulging neck veins and chronic cough. In babies and young children, symptoms of abnormal heart murmurs can also include feeding problems, poor growth and excessive fussiness, according to Yale Medicine.
Common risk factors for heart murmurs include intravenous drug use and family history of cardiac defects, according to Yale Medicine. Ellenbogen also noted that a person's existing heart murmur will become louder if they have a fever or anemia, meaning they have a deficiency in red blood cells or oxygen-carrying hemoglobin. That's because increased body temperature and low red blood cell count can affect the thickness of the blood, forcing the heart to pump blood faster, according to the medical resource StatPearls.
This article is for informational purposes only and is not meant to offer medical advice.
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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 |
For immune health, some influencers seem to think the Goldilocks philosophy of "just right" is overrated. Why settle for less immunity when you can have more? Many social media posts push supplements and other life hacks that "boost your immune system" to keep you healthy and fend off illness.
However, these claims are not based on science and what is known about immune function. Healthy immune systems don't need to be "boosted." Instead, the immune system works best when it is perfectly balanced. Scientific experts on the immune system — immunologists — know that too much of an immune reaction could result in allergies, autoimmune disorders or chronic inflammation. On the flip side, too little of an immune reaction could result in illness or infection.
Your immune system requires a delicate balance to operate properly. When it's out of balance, your immune system itself can cause disease.
Cellular balance
The immune system is the mobile defense system of your body. It is a complex network of cells and organs that work together to protect your body from infection and disease. Your immune cells are continually on patrol, traveling throughout your body looking for infectious invaders and damage.
New immune cells are created in your bone marrow. Certain immune cells — called B and T cells — are the special forces of the immune system, playing an important role in the elimination of infectious invaders. Because of this role, these cells undergo a rigorous boot camp during their development to ensure they will not discharge friendly fire on healthy cells in the body.
Any B cell or T cell exhibiting activity against the self — or autoreactivity — is killed during training. Millions of newly created B and T cells are killed every day because they fail this training process. If these self-reactive cells escape destruction, they could turn against the body and carry out an inappropriate autoimmune attack.
My research investigates how B cells are able to slip past the checkpoints the immune system has in place to guard against autoreactivity. These tolerance checkpoints ensure that autoreactive immune cells are either purged from the body or held in permanent lockdown and unable to engage in inappropriate responses that would target healthy tissue.
More isn't necessarily better
You've likely seen advertisements for dietary supplements that promise to "boost immune function." While this may sound appealing, it is important to keep in mind that the immune system functions best when perfectly balanced.
If the immune system is like a thermostat, turning it up too high results in overactivation and uncontrolled inflammation, while turning it down too low results in a failure to respond to infection and disease.
Because sustaining immune balance is critical, tinkering with the immune system through the use of supplements is not a good idea unless you have a clinical deficiency in certain vital nutrients. For people with healthy levels of nutrients, taking supplements could lead to a false sense of security, particularly since the fine print on the back of supplements usually has this disclaimer about their listed benefits: "This statement has not been evaluated by the FDA. Not intended to diagnose, treat, cure, or prevent any disease."
Eating a well-balanced diet, exercising regularly, reducing stress and getting decent sleep, on the other hand, can help your body maintain a functioning and healthy immune system. Although these lifestyle behaviors are not foolproof, they contribute to overall good health and ultimately to a more healthy immune system.
In reality, vaccines are the only safe and effective tool beyond healthy lifestyle behaviors to support your immune system. Vaccines contain harmless forms of pathogens that help to train your immune cells to recognize and fight them. When you come into contact with the real and harmful version of the pathogen out in the wild — whether it's at a grocery store, social event or school — at a later date, these fully trained immune memory cells will immediately begin to fight and destroy the pathogen, sometimes so quickly that you don't even realize you've been infected.
In a world where people are continually bombarded by the marketing mantra that more is better, rest assured that when it comes to the immune system, maintaining perfect balance is just right.
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Dr. Aimee Pugh Bernard has a broad background in cellular immunology and molecular biology, with specific expertise in human immunology, having attained her PhD in the developmental regulation of human B cells and the autoimmune disorder Systemic Lupus Erythematosus (SLE). As a graduate student in immunology, Aimee studied the developmental regulation of VH4.34-expressing B cells as an experimental system for the study of human B cell tolerance. Her studies revealed that mechanisms of cellular regulation during development are impaired in patients with SLE leading to a breach in self-tolerance. As a post-doctoral fellow at National Jewish Health, her research focused on the phenotypic characterization of anergic human B cells via the analysis of basal calcium levels and the ability to flux calcium after stimulation. As a post-doctoral fellow at the Barbara Davis Center, her work revealed that Nkx2.2 is required in the differentiation of pancreatic beta cells and that insulin- and ghrelin-producing cells may share a common progenitor.
Aimee is an Assistant Professor in the Department of Immunology and Microbiology at the University of Colorado Anschutz medical campus (CU AMC) and is actively involved in the CU School of Medicine (CUSOM) Trek curriculum reform, serving as the immunology content director. Aimee also teaches immunology within the medical school, graduate school, dental school, and the Child Health Advocate / Physician Assistant (CHA/PA) program on the Anschutz medical campus. At the start of the pandemic, Aimee helped to develop and run three courses for second, third and fourth year medical students that focused on the SARS-CoV-2 and COVID-19.
Aimee is dedicated to science communication and frequently delivers seminars and interactive sessions on immunology, vaccines, and science to a variety of audiences within the general public.
As a faculty mentor, she guides an amazing group of volunteer graduate students from all across campus to run a non-profit, after-school science program — Think Like a Scientist — at elementary schools throughout the Aurora and Denver communities.
In her role as the Assistant Director for the CU School of Medicine Dean's Office Human Immunology and Immunotherapy Initiative (HI3) Aimee has utilized her experience as an immunologist with expertise in human B cell development and autoimmunity, her skills as an educator and communicator of science, and her organizational and program building skills to coordinate the development of the research and clinical infrastructure necessary to create an all-inclusive, premier facility for the discovery and use of human immunotherapies for the treatment of cancer and autoimmune diseases. | Disease Research |
As modern medicine and health care help us live longer and longer, the number of older adults is on the rise worldwide. Unfortunately, one of the ailments often encountered at an advanced age is memory loss. Solving or even mitigating this problem would seriously improve the quality of life of many.Luckily there is some good news in this particular field as UK-based researchers have effectively restored age-related memory loss in mice, paving the way for the development of therapies to counteract memory problems. Neuroplasticity concerns the brain's ability to learn and adapt, as well as its capacity to form memories. PNNs (Perineuronal nets) have recently been discovered to play a role in neuroplasticity. PNNs are cartilage-like structures in the brain that mostly surround inhibitory neurons. Their primary role is to regulate the brain's plasticity. They first occur in humans at the age of five, and they cut off the time of increased plasticity when the brain's connections are optimized. After that, plasticity gets partially disabled, resulting in a more efficient but less plastic brain.Chondroitin sulfates are chemicals found in PNNs. Some of them, like chondroitin 4-sulfate, block the function of the networks, preventing neuroplasticity; others, like chondroitin 6-sulfate, encourage it.When we get older, the mixture of the above-mentioned chemicals shifts. As chondroitin 6-sulfate levels drop over time, our capacity to learn and build new memories deteriorates, leading to what is commonly called age-related memory loss.Now, UK scientists looked into whether changing the chondroitin sulfate content of PNNs may help repair neuroplasticity and reduce age-related memory loss.To accomplish this, the team looked at 20-month-old mice, which are considered quite old. A series of tests showed that these had memory impairments when compared to six-month-old mice.In one experiment, for example, the researchers examined if mice could recognize an object. A mouse was placed at the beginning of a Y-shaped maze and given two identical items at the ends of the two arms to investigate. After a brief time, the mouse was placed back in the maze, but this time one arm held a new object, while the other held a duplicate of the previously used object. - The researchers then timed how long the mouse spent investigating each object to determine if it remembered what it had seen in the prior exercise. The elder mice had a considerably lower chance of remembering the item. The researchers used a 'viral vector,' a virus capable of restoring the quantity of 6-sulfate chondroitin sulfates to the PNNs, to treat the aging mice, and discovered that this completely restored memory in the older mice to a level comparable to that seen in the younger critters.According to Dr. Jessica Kwok, one of the researchers, she and her team observed impressive results when treating the older mice. The memory and capacity to learn were restored to levels they would not have seen since they were of young age.University of Cambridge Professor James Fawcett, lead researcher, stated in a press release that although their study focused only on mice, the same mechanism should operate in humans - the molecules and structures in the human brain are identical to those in rodents. This implies that it may be possible to prevent humans from developing memory loss in old age.The researchers are now investigating if compounds can also mitigate memory loss in animal models of Alzheimer's disease. The approach taken by Professor Fawcett's team (using viral vectors to deliver the treatment) is starting to be used more often to treat human neurological conditions. A second team of scientists at the Centre for Brain Repair at the University of Cambridge recently published research showing their use for repairing damage caused by glaucoma and dementia.The researchers published their findings in the science journal Molecular Psychiatry listed below.Sources and further reading:Can training your working memory make you smarter? We reviewed the evidenceThe way you sleep could predict the onset of Alzheimer's DiseaseKeeping your brain lively with games may defer Alzheimer's dementia for several yearsWhat is the difference between Alzheimer's disease and dementia?Chondroitin 6-sulphate is required for neuroplasticity and memory in ageing (research paper/Molecular Psychiatry) | Medical Innovations |
For two weeks recently, tens of thousands of private doctors in Rajasthan protested against a landmark bill which guarantees a right to health for the northern Indian state's 80 million people.
The protests crippled private healthcare services and public hospitals were overwhelmed by patients. On Tuesday, the state government said it had reached an agreement with the doctors, prompting them to call off the strike.
What had raised the hackles of the protesters was a provision in the law that made it mandatory for public and private hospitals to offer emergency treatment to people, the costs of which would be later reimbursed by the government. The doctors said there was no clarity on how and where this money would come from.
A number of India's states have their own health insurance programmes that entitle low-income households to free health care at state-run and listed private hospitals. A federal health insurance programme called PM-JAY was launched in 2018 to cover the poorest 40% of people. The Supreme Court has held that denial of emergency medical care was a constitutional violation of right to life.
Yet public health in India remains patchy and underfunded, grappling with shortages of money, doctors and nurses. India spends a little over 2% of its GDP on public healthcare, one of the lowest in the world. Most people have to pay around half of healthcare spending - especially medicines - out of their own pocket.
Private doctors, clinics and hospitals mop up some 80% of the total healthcare spending. More than 55 million people are pushed back into poverty every year because of "catastrophic" health expenses, which affect some 17% of households, according to a WHO report.
Not surprisingly, price-setting and reimbursements lie at the heart of a state-run public health insurance programme or a law giving people the right to health. Both are tricky.
An operation, for example, in a high-end hospital could cost six times more than in a nursing home. If the government opted for the cheaper rate, private hospitals were likely to turn away patients seeking surgery under the programme or ask them to pay the balance. If the government opted for the higher rate, the costs of the programme would escalate tremendously.
"How you price and manage reimbursements is a big part of getting private sector into play," Prof Jishnu Das of Georgetown University told me.
These concerns were starkly underlined in a study by Radhika Jain of University College, London, on how reimbursement rates or prices affect the behaviour of private hospitals and performance of a state-run health insurance programme in India.
Prof Jain looked at more than 1.6 million claims and 20,000 patients in an existing state-run public health insurance programme in Rajasthan that reimburses hospitals at a specified, fixed rate per service covering tests, medicines and hospital costs.
She found that private hospitals were engaged in filing claims for higher priced and reimbursed services than those actually provided and charged patients for care that should be free under the programme, among other things. This suggested that "weak oversight and profit-motivated private agents are systematically flouting programme rules to increase their revenues at the expense of the government and patients".
On the other hand, the protesting private doctors in Rajasthan also had a few points. For one, how do you define an emergency service for which the state would pay? "It could range from a heart attack to a delivery to a child coming in with a stomach ache," a doctor told a newspaper.
Second, how do you identify hospitals which can provide emergency care? (One study estimates that 65% of India's private hospitals are small facilities with 11-50 beds.) After the protests, the state government agreed to exclude from the ambit of the bill private hospitals with fewer than 50 beds and those who had not used government concessions to set up their facilities.
With these exceptions, at least "98% of private hospitals" in Rajasthan would not be part of the law, according to Dr Sunil Chugh, a senior functionary of an association of doctors.
If true, that would be quite significant. Rajasthan's government says the new law will prod it to improve and upgrade public health, which would be welcomed by all. But as Prof Jain's study showed, making people trust state-run health facilities will take time - 75% of the insurance claims in the first four years of the Rajasthan programme were from private hospitals.
The plight of Surendra Meghwal, a 44-year-old resident of Rajasthan, also tells the story of the yawning gap between promises and reality. He's still paying off medical debt that he incurred in treating his sister-in-law who died of Covid two years ago at a private hospital in Karauli district. The family had taken the patient to the private facility because there were no beds available in the public hospital.
Mr Meghwal said people in villages had to rush to small multi-speciality private hospitals in districts during health emergencies because there were not enough public health facilities. "If the government now exempts these small hospitals from the right to health, where will we go? We will keep suffering," he said.
A new law means courts and hefty regulation would come into the picture, says Prof Das. (He cited the case of Colombia where affluent people were clogging the courts seeking expensive treatments under the right to health law.) He reckons Rajasthan alone would need 6,000 regulators to look at healthcare claims, fraud, legal disputes, customer complaints and analysing data.
"The good thing about the bill is it says we still want to keep investing in public healthcare, but the unspoken part of it is that people have the option of going to the private sector," he said.
Public health advocacy groups believe Rajasthan needs India's first right-to-health bill. A 2021 report on "healthy states" by Niti Aayog, a think-tank, India's federal health ministry and the World Bank placed it 16th among 19 big states. It has high rates of infant mortality - deaths of children under one year. It also has a worryingly low number of doctors compared to its population.
But an efficient right to health needs to "become a daily, lived reality" for the people, Prof Jain told me. The definition and details of what comprises an emergency, provisions around emergency care at private hospitals, and payment rates will have to be ironed out.
The government would need to shore up public health facilities and improve the range and quality of healthcare they offer. "This actually puts a lot of the onus on the state to do the hard work of financing, implementation, oversight, and enforcement that is yet to come," she said.
Back in Rajasthan, Chhaya Pachauli of Jan Swasthya Abhiyan, a health rights group, hoped that the law would "prove to be a changemaker for the state and set an example for other Indian states to take a cue". Nobody would begrudge that.
Additional reporting by Tabeenah Anjum in Jaipur
BBC News India is now on YouTube. Click here to subscribe and watch our documentaries, explainers and features. | Health Policy |
Germany, France, and Italy are among the countries which last year enacted laws to stop the practice of culling male day-old chicks, because, as they do not lay eggs, are considered surplus to requirements. This was not just because of the waste created but also out of animal welfare and ethical considerations. The laws were literally designed to encourage tech companies to come up with ways to determine the gender of chicks before they hatch.
Hyperspectral imaging, which accurately detects the gender of chicks based on plumage color on day 13 of incubation, is one such technology now being employed. A fully automated system called “CHEGGY” is one such system used in commercial hatcheries.
The systems can detect different aspects of eggs, like freshness, broken yolks, and cracks in the shell, up to about 97% accuracy in some instances.
But here’s the problem: It’s slow.
So Munich-based startup Orbem, borne ofr PhD research into MRI tech, set out to fix the problem and speed up the process.
An industrial MRI scanner is combined with an AI-based platform which enables hatcheries to determine the sex of an egg in a contactless and non-invasive manner. Orbem claims to be able to scan an egg in one second, much faster than existing processes.
Some 20 million eggs scanned later, Orbem claims to have even entered into profitability.
The company, which launched in 2019, has now raised a €30 million ($31.8 million) Series A funding round led by 83North. The round was joined by new investor La Famiglia and existing investors The Venture Collective and Possible Ventures.
The company had raised €10 million previously, half of it equity free money, such as via research grants from the European Union and the German government.
The founders met while doing their PhDs at the Technical University of Munich, and spun Orbem out of the institution.
Dr. Pedro Gómez, co-founder and CEO of Orbem, says they focused on poultry producers initially because “poultry has has a tonne of problems. They currently wastes billions of eggs simply because they don’t know what’s inside, wasting unfertilized eggs or killing one day old males which is actually unethical and unsustainable. And there’s regulations now stopping this. So that was the first reason. The second reason from a technology point of view was a demonstration that we can build these systems that are so fast, accessible and simple that they even work in a traditional industry like poultry.”
However, Orbem doesn’t plan to stop there. By imaging nuts, for instance, it could detect parasites or “grade the nuts inside of the shell, allowing our customers to do stuff like dynamic pricing,” says Gómez.
Orbem’s product can also scan other biological samples, such as plant species, and — even — the human body.
An MRI of construction materials could, for instance, ensure structural integrity in biodegradable materials.
It’s clear the marriage of MRI and AI is going to be a trend to watch in coming years.
In the last three years, there have been over 710,000 “AI for MRI” patents filed and granted in the medical devices industry, according to GlobalData.
And the AI in medical imaging market could be worth $29.8 billion, globally, by 2032 according to Allied Market Research.
And AI is now being used to improve MRI scans in humans, replacing less effective and invasive methods.
So expect more MRI+AI startups soon… | Medical Innovations |
Can you walk more? That may be the last question that you want to hear when you have a blood vessel condition called peripheral arterial disease, or PAD. Even walking short distances, as you likely know, may cause your legs to cramp up.
But doctors say that if you push yourself to move more often and walk farther, you will actually feel better. John Osborne, MD, PhD, a cardiologist in Dallas, says including supervised rehab therapy will give you the best results -- and the pain will be worth the gain.
Rehab focuses on âcontinuing to push your walking up until it hurts,â he says. âBut, if you continue to do that, it will actually tend to help build in additional collateral [blood] vessels or bridging vessels around the blocked vessels.â
The most common form of PAD affects your legs and feet. You may not have felt any symptoms -- about 1 in 4 people donât. If you do, you may have felt pain in your muscles or weakness when you walk or try some other type of exercise.
Your doctor may recommend a procedure to open one of those blocked arteries or to remove built-up plaque. But you can take other steps to boost how you feel with PAD, cardiologists say. Treating high blood pressure and high cholesterol, eating healthier food -- and definitely kicking any tobacco habit -- will help protect those smaller vessels in your arms or legs. The goal: to guard against sores or the death of nearby tissue, which may lead to amputation.
You also may be able to prevent plaque that can cause problems in your heart and elsewhere, says Sahil Parikh, MD, an associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons in New York City.
âEverything we do is designed to improve the symptoms [of PAD], but also to make people live longer,â he says.
Here are the expertsâ top tips.
Limit Your Risk Factors
Many people with PAD probably used tobacco at some point. âI donât ask them whether they smoked,â Osborne says. âI ask them, âAre you still smoking?ââ
Tobacco is a major risk factor because nicotine encourages plaque to form in blood vessels. âI tell people, âI donât care whether you smoke it, snort it, chew it,ââ Osborne says.
Quitting tobacco is a great start, though you may not know where to start. The American Heart Association offers some tips on how to quit, starting with setting a âQuit Dayâ (ideally one within the next 7 days) when youâll stop using tobacco entirely.
Stay on top of your blood pressure, so it doesnât drift too high, Parikh says. Exercising, lowering stress, and other lifestyle changes may be enough, he says. If not, your doctor can prescribe medication.
To improve your diet, the American Heart Association recommends cutting back as much as possible on salt, saturated and trans fats, sugars, and red meat. Instead, load your plate with vegetables, fruits, low-fat dairy, fish, chicken, nuts, and other healthy foods.
Push Your Activity
Because PAD often doesnât have symptoms at first, you likely have had the disease for a time without realizing it. Over time, less blood has flowed through the arteries in your legs, Osborne says. Without as much blood to supply your muscles, walking can be uncomfortable or even painful. Often itâs the calves that hurt, but it also may be the thighs or other areas, he says.
âTypically what happens is people will start walking, their legs cramp up, get tight, ache, and hurt,â Osborne says. âThey stop. The blood flow catches up. They feel better. And they walk again. And then that cycle repeats itself.â
Not surprisingly, it sometimes can be hard to embrace exercise. But research has shown that if you exercise under someoneâs supervision, such as a physical therapist, you will be more likely to push yourself. As your pain eases up, you can exercise even more.
Medicare covers this approach, called supervised exercise therapy, for patients with PAD. Evidence shows it works better to slow the worsening of PAD than trying to pump up exercise on your own.
Your Medication Options
You may already be taking medications to treat risk factors, such as high blood pressure, says Marc Bonaca, MD, a cardiologist and director of vascular research at the University of Colorado School of Medicine in Aurora. Your doctor also may prescribe other drugs to lower your risk of getting a clot, he says.
One option is aspirin. Recently, the FDA approved another medication, rivaroxaban (Xarelto), specifically for people with PAD. Federal officials recommend prescribing rivaroxaban and aspirin for people who have already had a procedure to remove a blockage in their legs. The two drugs together help lower your chances for a heart attack or a stroke more than taking aspirin alone.
Monitor and Advocate for Your Health
Stay on top of your medication, and watch out for any sores or other changes in the areas where you have PAD, Bonaca says. If the condition affects your feet, keep your toenails well-trimmed and your feet clean -- and check your feet daily for any signs of skin damage, he says.
A small rock in your shoe or a toenail problem can grow into a serious issue, Bonaca says. With less blood flow, the body has more trouble fighting infection. âThen the wound grows, and the surrounding tissue is at risk of dying off, and it may require amputation,â he says.
Other suggestions: Avoid bare feet and wear comfortable shoes. And donât treat corns, calluses, and ingrown nails yourself.
As you live with PAD, advocate for yourself to get the best care possible, Parikh says. âPAD is an important life-altering diagnosis. Not just because of the legs, but because of its implications for the rest of the body.â
But he says that if people get âon the right meds, and you get them on a walking program, they feel much better and theyâre probably better off for it.â | Disease Research |
FDA approves first opioid reversal drug from a non-profit company
The Food and Drug Administration on Friday approved the first version of over-the-counter naloxone from a non-profit company, a move that could bring cheap and even free doses of the opioid overdose drug to Americans who need it most.
FDA approved RiVive, made by Harm Reduction Therapeutics, the company said.
Naloxone is a medicine that can help reduce opioid overdose deaths and when administered quickly, usually within minutes of the first signs of an opioid overdose, can counter the overdose effects.
When administered soon after someone starts experiencing an overdose, the person will usually wake up within one to three minutes. Repeat administration of naloxone may be necessary.
Each RiVive device contains one dose of naloxone. It will be exclusively available in twin packs containing two single-dose devices of 3 milligrams each.
The company said it anticipates that RiVive will be available in early 2024, primarily to harm-reduction organizations and state governments for costs lower than other opioid antagonist nasal sprays.
“We are grateful that FDA granted RiVive approval so we can now achieve what most thought impossible and no other company has: broad delivery of a lower-cost nasal naloxone product without a prescription to save lives that could otherwise be lost to opioid overdose,” Michael Hufford, co-founder and chief executive officer of Harm Reduction Therapeutics, said in a statement.
Unlike other naloxone products, Harm Reduction Therapeutics said it will make RiVive available for free or at low break-even cost.
HRT said it is focused on supplying RiVive to communities that need it most and will make at least 200,000 doses (10 percent of projected initial annual product production) available for free.
“No company, entity, or individual will profit from sales of RiVive,” the manufacturer said.
Narcan is the most common naloxone product, and FDA approved an over-the-counter version in March.
But price can be a significant barrier, as a two-pack of the prescription version can cost $130 to $150, depending on the retailer. Even the discount price can still be a barrier.
Public interest groups such as government agencies, nonprofits and first responders pay less than $50, on average, for a kit of two 4-milligram doses, manufacturer Emergent said, and it is aiming for retailers to sell it at similar price.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Drug Discoveries |
Companies providing freelance staff to the NHS to cover for big shortages of doctors and nurses have seen their income rise by tens of millions of pounds since 2019.
Two companies, amongst the largest providing workers to the NHS, saw their turnover rise by 80% and 77.5%.
BBC News looked at the financial records of about 20 agency businesses providing services in the UK.
Health leaders say staff shortages mean they have to spend on freelance cover.
In November, BBC News revealed total spending on agency staff in England had been £3bn in 2021, up 20%.
And the following month, a Freedom of Information request by Labour revealed one hospital had paid £5,200 for a single shift by a freelance doctor.
In the latest financial records seen by BBC News, Medacs Healthcare, "the largest supplier of locum doctors to the NHS", reported an 80% increase in sales, to £160.9m, between 2019 and 2021.
"We're proud to partner with the NHS to provide them with a round-the-clock supply of flexible healthcare workers," the company said.
"Our fees are fixed and capped by the NHS and government-approved frameworks we work through."
ID Medical, which says it is the largest UK provider of healthcare professionals to the NHS, reported a turnover of £145.4m in 2022, up 15% on 2019. It paid one director more than £800,000 last year.
The company said it worked within NHS agreements, adding: "We continue our commitment to driving costs down further In partnership with the NHS, through our broad range of long-term sustainable solutions."
Both Medacs Healthcare and ID Medical refused to reveal what proportion of their business was with the NHS.
Independent Clinical Services, which trades as Thornbury Nursing Group and Scottish Nursing Guild, reported a turnover of nearly £273m in the 2021 financial year, up 77.5% on 2019, of which, it says, the NHS accounts for less than half.
"We recognise the strain the NHS and other care providers are under and proactively work with customers to support strategic, longer-term workforce provision," ICS said.
And it had "played a crucial role in supporting care providers during the pandemic".
ICS is controlled by Acacium Group, registered in Jersey, which, in turn, is controlled, through an investment-fund structure, by a Canadian-headquartered investment company, the group's ultimate parent.
Demand outstripping supply
Hospitals need freelance doctors and nurses to fill gaps in rotas - but demand for patient care is now outstripping the supply of staff, health leaders say, which is why agency bills have increased.
Sir Julian Hartley, chief executive of NHS Providers, representing trusts, and a former hospital boss himself, said: "These figures underline the current challenge in terms of the cost of agency staff for trusts.
"All trusts are desperate to reduce those costs and indeed reduce the reliance on agency staff."
Sir Julian said the NHS was facing major challenges:
- recovering from Covid
- reducing backlogs
- difficulties discharging medically fit patients, due to delays in community care
The cost of agency staff was a "major factor for NHS organisations who want to see a much more sustainable approach". Less should be spent on agency provision and more converted into permanent staff.
In England, trust leaders are allowed to pay a maximum of 155% of normal staff rates for any agency replacements - unless paying more is the only way to maintain safe staffing levels
There are also official NHS flexible staff banks which place health workers with employers who need to fill temporary gaps.
A Department of Health and Social Care spokesperson said: "While temporary staffing allows the NHS to meet fluctuations in demand, we are controlling spending by capping hourly pay, prioritising NHS staff when shifts need filling and hiring agency staff through approved NHS frameworks to ensure value for money.
"We will soon publish a long-term workforce plan to ensure we have the right numbers of staff, with the right skills to deliver high quality services fit for the future." | Health Policy |
An affordable microneedle skin patch that delivers a controlled dosage of medicine directly into the body, eliminating the need for injections or oral medication, has been developed by a team led by scientists at the University of Bath.
It is hoped that the patches, which are described in the journal Biomaterials Advances, will be ready for use within the next five to 10 years.
What makes the microneedle patches unique is that they are made from a hydrogel (a gel-like substance in which water forms the liquid component), with the active ingredient encapsulated inside the hydrogel microneedle structure rather than in a separate reservoir.
They are also more affordable than other commercially available microneedle patches, as they are produced from 3D printed moulds. Moulds produced this way are easy to customise, which keeps the costs down.
Painless delivery
The patch is smaller than a pound coin. Barely visible microneedles painlessly pierce the first few layers of skin. Contact with fluid beneath the skin barrier causes the âhydrophilicâ (water-loving) needles to swell, prompting a specific dosage of the drug to be delivered into the body.
In experiments carried out at Bath, upon swelling, the patches delivered doses of antibiotics that elicited a strong response against two bacteria known to cause serious infections â Escherichia coli (E. coli) and Staphylococcus aureus.
The patch also works in reverse, extracting small quantities of fluid from beneath the skin for medical analysis. This may be helpful, for instance, for monitoring the levels of lactate (a component of lactic acid) and other chemicals in patients with an infection.
Clear benefits
Bath Chemical Engineer Dr Hannah Leese â who continues to refine the skin patch design along with fellow engineers PhD student Joseph Turner and Professor Pedro Estrela, and biologist Dr Maisem Laabei â says microneedle-based skin patches are an ideal system for delivering drugs and have clear benefits over traditional delivery approaches.
She said: âInjections are invasive and expensive, and they donât suit everyone. A lot of people are needle-phobic and are understandably reluctant to receive medicine by injection even when treatment is really needed. Others are ill-suited to injections â for instance, elderly patients with thin skin.
âAlso, sometimes the use of needles can introduce pathogens, such as bacteria, that may cause infections, especially in people with low immunity.â
She added that people generally have fewer objections to taking drugs by mouth, but there are downsides to oral medication too.
She said: âYou can experience gastrointestinal side-effects; there is a delay between taking the medication and the drug getting to where itâs needed in the body; doses need to be higher because a lot of the formulation is broken down in the gut, and if the patient is taking antibiotics, this can also contribute to antimicrobial drug-resistance.'
Towards clinical trials
âOur next step is to continue to refine the microneedle platform and run animal studies before moving to human clinical trials,â said Dr Leese, adding: âI'm hopeful these patches will be ready for patient use within the next five to 10 years."
Dr Leese anticipates that the patches will be able to deliver both drugs that circulate the entire body and drugs that need to remain more localised â for instance, when there is an infection in a discrete section of skin. There is also scope for the patches to deliver vaccines and to monitor hormone levels.
âWe can also see there being a role for these patches in the health and wellness fields,â she said. âI can picture the day people have microneedles under their smartwatches to detect fluctuations in the stress hormone, cortisol.â
This research was funded by EPSRC and Abbott Diabetes Care. | Medical Innovations |
The FDA’s 16-member advisory panel unanimously voted yesterday that oral phenylephrine, a common active ingredient in cold medications, is no better than a placebo for treating congestion. The call by the panel sets up potential FDA action that could force the removal of certain over-the-counter medications containing the ingredient — including certain formulations of Mucinex, Sudafed, Tylenol, and NyQuil — from store shelves.
As noted by The New York Times, the panel’s vote doesn’t necessarily mean the FDA will take action, but it usually follows panel recommendations. That said, the FDA may hold off for many months, pending contested findings by drug makers and other considerations.
The panel tossed out several older studies that showed the drug was effective over issues with data integrity, small sample sizes, methodological problems, and more.
Newer data from studies the panel says are more consistent with modern clinical trial standards showed phenylephrine simply “was not significantly different from placebo” in the recommended dosage, including trials from 2007 that the FDA had reviewed when considering the drug after a citizen petition prompted it to do so.
The panel cited the drug’s low bioavailability, a term referring to qualities that allow the drug to be absorbed by the human body, as the main reason the drug should be removed from the market. The drug could potentially work with increased dosage, but most of the FDA advisors thought that was unnecessary or even dangerous to consider for phenylephrine. In a video recording, the panel explained their unanimous vote:
Dr. William Figg from the National Cancer Institute said he believed that the drug’s “poor bioavailability ... precludes any further studies of increasing the dose.” Expounding on that, Dr. Paul Pisarik said the drug has potentially negative effects at higher doses. “If we do 60 or 80mg of phenylephrine, then we have to start worrying about blood pressure increases since at 100mg, the blood pressure goes up by 10 points.”
Jennifer Schwartzott said the drug “should have been removed from the market a long time ago,” while Dr. Stephen Clement said that although the drug itself isn’t dangerous, its usage by patients should be considered unsafe because it potentially delays actual treatment of disease symptoms.
Members of the panel agreed that the presence of phenylephrine in a medication shouldn’t automatically rule out its usefulness since other ingredients can still treat cold symptoms. The panel cited pseudoephedrine as an effective alternative though while it’s technically available without a prescription, you must talk to a pharmacist to get it because, in large quantities, it can be used to make methamphetamines. | Drug Discoveries |
People tend to experience better sleep quality when they have increased bedroom ventilation, according to a four-week-long field intervention experiment. The findings, published in Science of The Total Environment, suggest that optimizing bedroom air quality through improved ventilation can lead to more restful nights, with potential implications for our overall well-being.
We all know that a good night’s sleep is essential for our physical and mental well-being. But have you ever considered how the air quality in your bedroom might influence the quality of your sleep? This is precisely what a team of researchers set out to explore in a recent study.
Previous research has hinted at a connection between bedroom air quality and sleep quality, but this study aimed to provide a more comprehensive understanding of the relationship. The researchers were particularly interested in the role of ventilation rates in creating optimal sleeping conditions.
“Sleep is crucial for our health, wellbeing and productivity,” said lead author Xiaojun Fan, a postdoctoral researcher at ETH Zürich. “The bedroom is the place where we sleep and spend approximately one third our lifetime. We already investigated and validated the negative effects of inadequate ventilation in bedrooms on sleep quality but only in a laboratory settings. There was a lack of evidence to support this finding in a real-world context with controlled ventilation and other factors.”
To investigate the connection between bedroom ventilation and sleep quality, the researchers conducted a comprehensive study involving 35 participants. These individuals, aged 27 to 64, were carefully selected to ensure they did not have any significant sleep disorders and did not use sleep medication regularly.
The study was conducted in bedrooms located in Belgium, where there were no COVID-19 lockdown or severe pandemic restrictions at that time. All selected bedrooms had centralized mechanical extract ventilation systems that allowed the ventilation rate to be changed without informing the occupants or entering the dwellings.
The study began with a baseline measurement period lasting one week. During this initial week, no interventions were made. This allowed the researchers to establish the natural conditions in each participant’s bedroom, including the existing ventilation rate, air quality, and sleep patterns.
Following the baseline measurement week, the researchers implemented a series of interventions in the form of altered ventilation rates. Over the subsequent three weeks, each participant experienced different ventilation rate conditions: low, moderate, and high. Importantly, the order in which these conditions were applied was carefully balanced to minimize bias and ensure fairness.
Throughout the entire four-week experiment, the researchers continuously monitored various aspects of the bedroom environment and the participants’ sleep patterns. They collected data on parameters such as carbon dioxide (CO2) concentration, relative humidity, particulate matter (PM) levels, and temperature. These measurements provided insights into the air quality and conditions in each bedroom.
The researchers found that the ventilation rates had a significant impact on CO2 concentrations. Specifically, CO2 levels were significantly higher at the low ventilation rate setting, which is what you might expect when airflow is restricted. In contrast, the high ventilation rate setting led to lower CO2 levels, indicating better air circulation.
Alongside CO2 concentration, relative humidity also changed with varying ventilation rates. At the low ventilation rate setting, relative humidity was generally higher, while at higher ventilation rates, it decreased slightly. Importantly, the relative humidity levels remained within the 50% to 60% range, which is considered optimal for sleep quality.
The study also looked at the levels of particulate matter (PM2.5), which can affect air quality. At the low ventilation rate setting, PM2.5 concentrations were significantly higher, but they still remained below the recommended guidelines set by the World Health Organization (WHO).
Interestingly, temperature did not vary significantly across the different ventilation rate settings. This suggests that even with changes in ventilation, participants did not experience discomfort due to temperature fluctuations.
The study evaluated sleep quality through objective measurements, including sleep length, sleep efficiency, sleep onset latency, the percentage of deep sleep, the percentage of light sleep, and the number of awakenings. The results showed that participants generally had good sleep quality. However, there were notable differences when ventilation rates were altered. Increasing ventilation from low to moderate settings resulted in fewer awakenings, increased deep sleep, and reduced light sleep, all indicating improved sleep quality.
“The main tak away for the general public is that increasing bedroom ventilation is conductive to sleep quality, suggesting that they should take actions to improve their bedroom ventilation if it is not good now,” Fan told PsyPost. One effective step they can consider is opening windows, as supported by their previous research.
While this study provides valuable insights into the relationship between bedroom ventilation and sleep quality, it’s important to acknowledge its limitations. One notable limitation is the small sample size, as the study involved 35 participants.
“In this kind of verification study in an actual bedroom context, the findings are not so surprising,” Fan said. “However, the difficulties of running this kind of study were out of my expectations. The recruitment invitation was sent to several thousand potential participants, but <10 % responded.”
“We were supposed to establish a dose-response relationship between bedroom ventilation and sleep quality. Unfortunately, this was not feasible because of the limited data from subjects under three ventilation conditions. Even so, I summarized the current studies on bedroom ventilation in my PhD thesis and found that the upper threshold ventilation rate should result in a CO2 concentration of below 1000 ppm. The exact number requires further investigation.”
While the study has some limitations, it underscores the importance of considering air quality in our sleeping environments for a good night’s rest.
“Pay attention to factors that you may not sense or perceive but are indeed harmful to your health and well-being,” Fan said. “Among others, indoor air quality is one of them, not only because of the health aspect, but also energy since the systems for ventilation are responsible for the majority of energy consumed in buildings.”
The study, “A single-blind field intervention study of whether increased bedroom ventilation improves sleep quality“, was authored by Xiaojun Fan, Chenxi Liao, Kazuya Matsuo, Kevin Verniers, Jelle Laverge, Brecht Neyrinck, Ivan Pollet, Lei Fang, Li Lan, Chandra Sekhar, and Pawel Wargocki. | Stress and Wellness |
An eight-year-old girl has been spared from taking life-long drugs to stop her body rejecting her kidney transplant thanks to a UK-first treatment.
Aditi Shankar’s immune system was “reprogrammed” after a stem cell transplant, resulting in her body accepting a donor kidney as its own, clinicians said.
Because the bone marrow transplant and kidney came from the same donor – Aditi’s mother – the new kidney is working without the need for drugs that stop the body from rejecting a donated organ.
While providing a vital function after transplant surgery, immunosuppressants work by dampening down the body’s immune system, meaning anyone taking them is at higher risk of infection, among other complications.
They usually need to be taken for life but Aditi stopped taking the drugs a month after her surgery thanks to the pioneering work by doctors at Great Ormond Street hospital (Gosh) in London.
Her mother, Divya, said she was “happy and proud” to donate bone marrow and one of her kidneys to her daughter.
The 38-year-old said: “I was so happy to give her blood cells and a kidney. I just feel so proud.”
Aditi is now able to swim, sing, dance and play on her trampoline.
Just last year she was spending a significant proportion of her time in and out of hospital to receive dialysis, a procedure that removes waste products and excess fluid from the blood when the kidneys have stopped working properly.
Aditi was first referred to Gosh when she was five and doctors discovered she had a rare genetic condition called Schimke immuno-osseous dysplasia, which affects the immune system and kidneys.
For every 3 million children in the UK, doctors are likely to only find one case.
The first treatment on offer for Aditi was dialysis and she had to travel from her family home in Greenford, north-west London, into central London for treatment at least three times a week.
In March 2021 her kidney function dropped drastically but a kidney transplant was not possible while her immune system was so weak.
So the renal, immunology and stem cell transplant teams at Gosh worked with international colleagues to come up with a treatment plan.
For four weeks, Aditi was on the intensive care unit having her bone marrow transplant while having dialysis for 24 hours a day.
Six months later, in March 2023, Aditi was well enough for the kidney transplant.
“My mum gave me my new blood cells,” said Aditi. “I got the kidney transplant when I went to special sleep and closed my eyes.
“Now I have got the line out, I can go swimming.”
Aditi’s favourite class in school is science and she has a keen interest in biology after learning so much about the human body during her time in hospital.
Her father, Uday, 48, said: “Most of the support for the family has come from Aditi. She was going in for six to eight hours a day of dialysis and then she would come home and still light the whole house up.”
Prof Stephen Marks, children’s kidney specialist at Gosh, said: “I lead the kidney transplantation programme at Great Ormond Street hospital and have worked here for over 25 years and she is the first patient in the United Kingdom who has had a kidney transplant to not require immunosuppressive medication after the surgery.
“Because of her underlying immune condition, it meant she would not be able to receive a kidney transplant. Her immune deficiency had to be corrected by having mum’s bone marrow first, and because Aditi was able to accept her mum’s bone marrow, that therefore meant her body could then see her mum’s kidney as being part of her.
“A month after the transplant, we were able to take her off all of her immunosuppression, which means she doesn’t get the side effects of the drugs.”
Marks added: “It really is great to see that she is an active eight-year-old girl, back to school, able to have an excellent quality of life, when in March 2021 we were in a situation of discussing what is the future going to hold.
“Here we are in the situation where she no longer needs dialysis, but she has an excellent immune system and an excellent kidney transplant, doing the function that her kidneys would have done if they hadn’t failed.”
He added: “It is exciting for Aditi to be the first patient in the United Kingdom, the first patient under the National Health Service, to have had a kidney transplant for this condition and to be off immunosuppression within a month.
“And now, one year after having had a bone marrow transplant and six months after having a heart or kidney transplant, it is so heartwarming to see her having a good quality of life.”
Asked about the potential use of the double procedure among other patients, he said: “Everything in life, especially in medicine, is about the risks-and-benefit ratio.
“Undergoing this double transplant with a bone marrow transplant, then followed by a kidney transplant six months later, has a much higher risk of causing injury to the patient and also death, so we always have to balance each individual case.
“There are subgroups of patients who have particular kidney diseases involving the immune system... you could postulate that for some of these conditions that increased risk may be worth taking because that patient may not be able to survive long term on dialysis.”
Marks will present details of the case to the European Society for Paediatric Nephrology conference next week. An editorial detailing the findings is also due to be published in the journal Paediatric Transplantation. | Medical Innovations |
Smoking rates are falling, and lives are being saved as more countries implement policies and control measures to curb the global tobacco epidemic, according to a World Health Organization report issued Monday that rates country progress in tobacco control.
New data show that the adoption of the WHO’s package of six tobacco control measures 15 years ago has protected millions of people from the harmful effects of tobacco use.
The measures, which were launched in 2008, call on governments to monitor tobacco use and prevention policies, protect people from tobacco smoke, offer help to quit tobacco use, warn people about the dangers of tobacco, enforce bans on tobacco advertising, promotion, and sponsorship, and to raise taxes on tobacco.
“Without this decline, there would be an estimated 300 million more smokers in the world today,” said Ruediger Krech, WHO director for health promotion.
He said more than 5.6 billion people, that is 71% of the world population, live in countries that have implemented at least one of these lifesaving protective measures.
“What an achievement,” he said. “This policy package has literally changed our lives. It means that families can go out to restaurants without worrying about their children breathing secondhand smoke.
“It means that people that want help to quit smoking can get the support that they need. More than that,” he said, “it means that we are protected from the many deadly diseases caused by secondhand smoke.”
However, he noted that 2.3 billion people live in the 44 countries that have not implemented any tobacco control measures “leaving them at risk of the health and economic burden of tobacco use.”
Until recently, only Turkey and Brazil had succeeded in enacting all six of the so-called MPOWER tobacco control measures. WHO reports Mauritius and the Netherlands now have joined this elite group, becoming the first African country and the first high-income country to achieve this best-practice level.
Kailesh Kumar Singh Jagutpal, Mauritius Minister of Health and Wellness said his country was one of the first signatories of the Framework Convention on Tobacco Control in 2004. Since then, he said his government has been continuously implementing the articles contained in the agreement.
He said Mauritius began amending its legislation and tobacco control laws in 2008 to blunt the heavy toll smoking was taking on his country’s aging population.
“The prevalence of cardiovascular diseases, cancers, stroke, diabetes, hypertension is quite high in Mauritius. We are also experiencing aging of the population…So, these combined effects of an aging population, significant effect of co-morbidity forced the government to take bold action.”
Jagutpal said his government has been using WHO-recommended measures to discourage smoking to good effect. These include banning the advertising, promotion, and sponsorship of tobacco products; prohibiting the sale of cigarettes to minors, helping people to quit tobacco use, creating smoke-free places, and raising taxes on cigarettes.
The minister said these measures are working, with surveys showing that smoking has declined from 30% in 1987 to 18.3% in 2021.
WHO’s report on the global tobacco epidemic focuses on protecting the public from secondhand smoke. It finds a growing number of countries are passing laws designating smoke-free indoor public places.
Krech said nearly 40% of countries have achieved this goal. “Today, 74 countries protect their populations, making up to 25% of the world’s population with comprehensive smoke-free legislation in public indoor areas like health care, education facilities, as well as hospitality venues like restaurants and cafes.”
But he warned the battle against the global tobacco epidemic was far from over.
“Tobacco use continues to be one of the biggest public health threats with 8.7 million people dying from tobacco related diseases every year, 1.3 million of these deaths are amongst non-smokers that are subjected to secondhand smoke.”
Krech said tobacco remained the leading cause of preventable death in the world, largely due to relentless marketing campaigns by the tobacco industry.
He urged governments to “push back against the tobacco and nicotine industries,” who lobby against public health measures by using different ploys “to hook children on to e-cigarettes and vaping to make them nicotine dependent.”
Then, of course, he said “they will switch to cigarettes afterward.” | Epidemics & Outbreaks |
Worried parents protested in Iran’s capital Tehran and other cities on Saturday over a wave of suspected poison attacks that have affected schoolgirls in dozens of schools, according to Iranian news agencies and social media videos.
The so-far unexplained illnesses have affected hundreds of schoolgirls in recent months. Iranian officials believe the girls may have been poisoned and have blamed Tehran’s enemies.
The country’s health minister has said the girls have suffered “mild poison” attacks and some politicians have suggested the girls could have been targeted by hardline Islamist groups opposed to girls’ education.
Iran’s interior minister said on Saturday investigators had found “suspicious samples” that were being studied.
“In field studies, suspicious samples have been found, which are being investigated… to identify the causes of the students’ illness, and the results will be published as soon as possible,” the minister, Abdolreza Rahmani Fazli, said in a statement carried by the official news agency IRNA.
Sickness affected more than 30 schools in at least 10 of Iran’s 31 provinces on Saturday. Videos posted on social media showed parents gathered at schools to take their children home and some students being taken to hospitals by ambulance or buses.
A woman from the city of Qom previously told CNN that both her daughters, who attended different schools, had been poisoned. One girl suffered significant health issues after being poisoned: experiencing nausea, shortness of breath and numbness in her left leg and right hand as well as difficulty walking.
A gathering of parents outside an Education Ministry building in western Tehran on Saturday to protest over the illnesses turned into an anti-government demonstration, according to a video verified by Reuters.
“Basij, Guards, you are our Daesh,” protesters chanted, likening the Revolutionary Guards and other security forces to the Islamic State group.
Similar protests were held in two other areas in Tehran and other cities including Isfahan and Rasht, according to unverified videos.
The outbreak of schoolgirl sickness comes at a critical time for Iran’s clerical rulers, who have faced months of anti-government protests sparked by the death of a young Iranian woman in the custody of the morality police who enforce strict dress codes.
Social media posts in recent days have shown photos and videos of girls who have fallen ill, feeling nauseaous or suffering heart palpitations. Others complained of headaches. Reuters could not verify the posts.
The United Nations human rights office in Geneva called on Friday for a transparent investigation into the suspected attacks and countries including Germany and the United States have voiced concern.
Experts have spoken about the difficulties in investigating the situation in Iran and told CNN that the incidents were “remarkably similar” to dozens of incidents at schools in Afghanistan since 2009. “In a few of these incidents, pesticides were strongly suspected but most of the illnesses remain unexplained,” said London based defense specialist Dan Kaszeta from the Royal United Services Institute.
Iran rejected what it views as foreign meddling and “hasty reactions” and said on Friday it was investigating the causes of the incidents.
“It is one of the immediate priorities of Iran’s government to pursue this issue as quickly as possible and provide documented information to resolve the families’ concerns and to hold accountable the perpetrators and the causes,” Foreign Ministry spokesperson Nasser Kanaani told state media.
Schoolgirls were active in the anti-government protests that began in September. They have removed their mandatory headscarves in classrooms, torn up pictures of Supreme Leader Ayatollah Ali Khamenei and called for his death. | Epidemics & Outbreaks |
For Emily Boller, it was a $5,000 hospital bill for a simple case of pink eye that took four years to pay off. For Mary Curley, it was the threatening collection letters from a lab that arrived more than 2½ years later, just as her husband lost his job and the family was fighting to save their home.
For Cory Day, it was a $1,000 fee he was charged at an emergency room outside Los Angeles, even though he only checked in and then left before being seen. “I feel like the hospital is a predator,” Day said. “This is a place that’s supposed to be looking after you.”
The experience offered a stark lesson, he said: “Don’t trust the system.”
Reporting on medical debt over the past two years, I’ve spent hundreds of hours on the telephone, in the living rooms, and at the kitchen tables of patients like Day, Curley, and Boller. They are among the 100 million people in America whom we found have been driven into debt by medical and dental bills.
Some of my conversations with patients have been heartbreaking. Some enraging. Many have revealed a deep and disturbing disillusionment with our health care system.
Medical providers ignore this at their peril — and at a high risk to Americans’ health.
Doctors and hospitals have long held an exalted position in American life, retaining public confidence even as Americans have steadily lost trust in other institutions such as government, law enforcement, and the media. Growing up, I shared this faith. My father was a physician who never hesitated to get up in the middle of the night and drive to the hospital to operate on a sick child in his care.
But as a journalist covering health care in America over the past 15 years, I’ve seen patients’ faith shaken. They’re tired of shocking medical bills they didn’t expect and can’t afford. And they’re disgusted by the collection notices, the threatening phone calls, and the appointments they can’t get because they owe money.
Many Americans say they simply no longer trust their medical providers. This is borne out by polling we did with our colleagues at KFF as part of our investigation of medical debt. Just 15% of people with health care debt said they have a lot of trust that providers have patients’ best interests in mind. That’s about half the rate among people without such debt.
Many caring people who work in health care understand this. I’ve met countless compassionate physicians, nurses, and others who see firsthand the toll that debt is taking on their patients.
But I’ve seen a lot more denial and finger-pointing by health care leaders. Hospitals and doctors blame the government for underpaying them and blame insurers for selling plans with unaffordable deductibles. Insurers blame providers for obscene prices. Everyone blames drug companies.
The upshot is that each of these medical industries hunkers down and, pleading its own suffering, looks out for its own interests. They rarely talk seriously about what they could do to relieve the financial burdens they create that drive tens of millions of Americans into debt.
And so, the suffering of patients deepens.
In our project on medical debt with NPR, we documented cancer patients forced to hold off debt collectors while fighting off nausea and other toxic side effects of chemotherapy; older workers whose retirement savings were obliterated; 30-somethings unable to buy a home because their credit was ruined by health care debt; new mothers forced to take on extra work; parents unable to buy Christmas gifts for their children; and seniors who cut back on food because of medical debt.
That our health care system would do this to people might be reason enough for hospital executives, insurance CEOs, and senior physicians to stop the blame game and look in the mirror.
If nothing else, this should be a flashing red light: the simmering resentment of growing numbers of patients who feel victimized by this system.
We got a hint of the dangers of this during the pandemic, as Americans who distrusted the medical system proved easy prey for misinformation about vaccines and other public health measures, with sometimes fatal consequences.
Other systemic risks are lurking. I was once a political reporter. I covered mayors and state legislatures and, ultimately, Congress. I saw up close what an erosion of trust can do to a system, and how much more difficult it becomes to get things done when the public loses faith in its institutions.
And as the political turmoil of recent years shows, public anger and disillusionment can produce unpredictable, even dangerous results.
Health care leaders — and physician leaders in particular — could alleviate patients’ financial suffering.
Physician groups and hospital systems, many of which are led by doctors, could look more closely at the bills they send patients and the collection tactics they use. Health insurers, whose leadership ranks also often include physicians, could reconsider the high-deductible plans they sell and ask whether they truly protect their customers. And physicians everywhere could speak up about the financial travails of patients in their care.
Absent action, patients’ trust is sure to erode further. And without the trust of the people it serves, this American health care system cannot long endure. | Health Policy |
Lost careers. Broken marriages. Dismissed and disbelieved by family and friends.
These are some of the emotional and financial struggles long covid patients face years after their infection. Physically, they are debilitated and in pain: unable to walk up the stairs, focus on a project, or hold down a job. Facing the end of the federal public health emergency in May, many people experiencing lingering effects of the virus say they feel angry and abandoned by policymakers eager to move on.
“Patients are losing hope,” said Shelby Hedgecock, a self-described long covid survivor from Knoxville, Tennessee, who now advocates for patients like herself. “We feel swept under the rug.”
The Centers for Disease Control and Prevention estimated in March that 6% of U.S. adults, or about 16 million, were experiencing long covid, or ongoing health problems that continue or emerge after a bout of covid-19. Researchers estimate that 1.6% of U.S. adults, or about 4 million, have symptoms that have significantly reduced their ability to carry out day-to-day activities.
While patients are no longer contagious, their health issues can stretch on and affect almost every system in the body. More than 200 symptoms and conditions, including fatigue and depression, are linked to long covid, said Linda Geng, a physician who treats patients at Stanford Medicine’s Post-Acute COVID-19 Syndrome Clinic.
The severity and duration of long covid vary. Some people recover in a few weeks, while a smaller number have debilitating and lingering health issues. There is currently no test, treatment, or cure. There’s not even an accepted medical definition.
“When you don’t have any tests that show that anything’s abnormal, it can be quite invalidating and anxiety-provoking,” Geng said.
The physical and emotional toll has left some feeling hopeless. A 2022 study of adults in Japan and Sweden found that those with post-covid conditions were more than twice as likely to develop mental health issues, including depression, anxiety, and post-traumatic stress, as people without them.
“One of my friends committed suicide in May of 2021,” Hedgecock said. “She had a mild covid infection, and she progressively had medical complications continuously pop up, and it just got so bad that she decided to end her life.”
In Los Angeles County, 46% of adults who contracted covid were fully recovered a month later, but the rest — a majority — reported one or more continuing symptoms, according to a 675-patient study by the University of Southern California’s COVID-19 Pandemic Research Center. The researchers found chronic fatigue topped the list of health issues, followed by brain fog and persistent cough, all of which affect people’s daily lives.
Among the respondents who identified as living with long covid, 77% said their condition limited daily activities such as going to school or work or socializing. One-quarter reported experiencing severe limitations.
Taking antivirals cuts the risk of developing long covid in people who are newly infected. But for people already suffering, medical science is trying to catch up.
Here’s a look at Hedgecock and two other patients who have had long covid for years.
A Debilitating Brain Injury
Before contracting covid during spring 2020, Hedgecock’s life revolved around fitness. She worked as a personal trainer in Los Angeles and competed in endurance competitions on the weekends. At 29, she was about to launch an online wellness business, then she started having trouble breathing.
“One of the scariest things that happened to me was I couldn’t breathe at night,” Hedgecock said. “I did go to the emergency room on three different occasions, and each time I was told, ‘You’re up and you’re moving. You’re young; you’re healthy. It’s going to be fine.’”
Her primary care physician at the time told her she didn’t need supplemental oxygen even though her oxygen saturation dipped below normal at night, leaving her gasping for breath and crying in frustration.
Her condition kept her from one of her favorite hobbies, reading, for 19 months.
“I couldn’t look at a page and tell you what it said. It was like there was a disconnect between the words and my brain,” she said. “It was the strangest, most discouraging thing ever.”
Months later, under the direction of a specialist, Hedgecock underwent a test measuring electrical activity in the brain. It revealed her brain had been starved of oxygen for months, damaging the section controlling memory and language.
Since then, she has moved back to Tennessee to be close to family. She doesn’t leave her apartment without a medical alert button that can instantly call an ambulance. She works with a team of specialists, and she feels lucky; she knows people in online long covid groups who are losing health coverage as Medicaid pandemic protections expire, while others remain unable to work.
“A lot of them have lost their life savings. Some are experiencing homelessness,” she said.
In Bed for a Year
Julia Landis led a fulfilling life as a therapist before she contracted covid in spring 2020.
“I was really able to help people and it was great work and I loved my life, and I’ve lost it,” said the 56-year-old, who lives with her husband and dog in Ukiah, California.
In 2020, Landis was living in an apartment in Phoenix and received treatment via telehealth for her covid-related bronchitis. What started out as a mild case of covid spiraled into severe depression.
“I just stayed in bed for about a year,” she said.
Her depression has continued, along with debilitating pain and anxiety. To make up for her lost income, Landis’ husband works longer hours, which in turn exacerbates her loneliness.
“It would be nice to be living somewhere where there were people around seven days a week so I wouldn’t have to go through days of being just terrified to be alone all day,” Landis said. “If this were cancer, I’d be living with family. I’m sure of it.”
Landis refers to herself as a professional patient, filling her days with physical therapy and medical appointments. She’s gradually improving and can socialize on occasion, though it leaves her exhausted and can take days to recover.
“It’s terrifying because there’s just no way of knowing if this is going to be for the rest of my existence,” she said.
‘I Felt Betrayed’
Linda Rosenthal, a 65-year-old retired high school paraprofessional, has long covid symptoms, including inflammation in her chest that makes breathing difficult. She has found it hard to get medical care.
She called and set up a treatment plan with a local cardiologist near her home in Orange County, California, but received a letter five days later telling her he would no longer be able to provide her medical services. The letter gave no reason for the cancellation.
“I was so surprised,” she said. “And then I felt betrayed because it is terrible to get a letter where a doctor, although within their rights, says that they don’t want you for a patient anymore, because it causes self-doubt.”
Rosenthal found another cardiologist willing to do telehealth visits and who has staff wear masks in the office even though the state rule has expired. The practice, however, is more than an hour’s drive from where she lives.
NEED HELP?
If you or someone you know is in a crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting HOME to 741741. | Epidemics & Outbreaks |
Laughing gas will be categorised as a class C drug and made illegal by the end of the year, the UK government has announced.
Possession of nitrous oxide, also known as NOS, will carry a sentence of up to two years in prison.
Laughing gas is one of the most commonly used recreational drugs by 16 to 24-year-olds.
Heavy use can lead to a range of illnesses including nerve-related symptoms.
Supply of nitrous oxide for recreational use is currently banned - but possession is not.
The government initially announced its plan to ban nitrous oxide earlier this year as part of a plan to tackle anti-social behaviour, but on Tuesday set out new details of the implementation of the law change.
It said those found in unlawful possession of the drug could face up to two years in prison or an unlimited fine, with up to 14 years for supply or production.
However, there will be exemptions for legitimate uses of nitrous oxide, for example in medical or catering industries. The gas is commonly used as a painkiller and for producing whipped cream in cooking.
The substance - which is sold in metal canisters - can cause headaches and make some users anxious or paranoid, while too much nitrous oxide can make a person faint or lose consciousness.
Heavy use can lead people being unable to walk, falling over, or experiencing tingling or loss of sensation in the feet and hands. Some users have nerve-related bladder or bowel problems, erectile dysfunction or incontinence.
The government's decision to make possession a crime goes against recommendations from the Advisory Council on the Misuse of Drugs, which advised against new laws to ban nitrous oxide.
It said a ban would be disproportionate with the amount of harm linked to the gas.
And last week health experts also warned the government against a ban, saying it could stop users seeking medical help.
Use of nitrous oxide soared during the pandemic.
Announcing the law change on Tuesday, Home Secretary Suella Braverman said people in the UK were "fed up with yobs abusing drugs in public spaces and leaving behind a disgraceful mess for others to clean up".
"Earlier this year the prime minister and I promised a zero-tolerance approach to antisocial behaviour and that is what we are delivering. If you are caught using laughing gas as a drug, you could be hit with a hefty fine or face jail time."
The government's crime and policing minister Chris Philp said: "There is no question that abusing laughing gas is dangerous to people's health and it is paramount we take decisive action before the situation gets worse.
"Not only are we making possession an offence for the first time, we are also doubling the maximum sentence for supply to 14 years, so the dealers profiting off this trade have no place to hide."
Laughing gas joins drugs including diazepam, GHB and GBL under the class C categorisation.
The ban is being issued under the Misuse of Drugs Act 1971, which regulates drugs in the UK based on their perceived harm and potential for misuse.
It is already illegal to produce or supply laughing gas for its psychoactive effects under the Psychoactive Substances Act 2016. That law makes production, supply and importation of nitrous oxide for human consumption illegal, but not possession.
Between 2001 and 2020, there were 56 registered deaths involving nitrous oxide in England and Wales - 45 of them since 2010, according to the government report.
Prof David Nutt, from Imperial College London's department of medicine, previously said there was around about death per year in the UK from around one million nitrous oxide users. "A comparison with alcohol would be that around 28,000 deaths happen per year in around 40 million users of alcohol," he added. | Drug Discoveries |
A dog disease that can jump from canines to humans is now spreading between dogs in Britain for the first time, the Telegraph understands.
Brucella canis is a disease that leads to infertility in dogs and is incurable and was previously only seen in imported animals.
But Dr Christine Middlemiss, chief veterinary officer at the Department for Environment, Food and Rural Affairs, told the Telegraph there is now evidence some dogs are catching the infection in the UK.
It is not considered endemic due to low numbers and all the British dogs that caught Brucella canis had either mated with an imported dog, had contact with a pregnant imported dog, or are the offspring of an import.
“We have had spread of a case in the UK to another dog in the UK. It is through breeding in kennels,” she said.
“There is not a lot – there is very little. But that is new for us.”
A Human Animal Infection and Risk Surveillance Group report, published on Monday will reveal the risk to the public to be very low, and low for breeders.
However, there is growing concern around the disease as three people caught it this year from dogs and the number of human tests by the NHS has doubled.
Government scientists are understood to be gathering information on the possibility of implementing a screening protocol at the border to stop infected animals making their way to Britain.
Brucella canis is endemic in some parts of the world, including Eastern Europe, with Romania a hotspot for infected animals coming to the UK.
“There is no statutory requirements on import testing at the moment. We are gathering the evidence, various risk assessments are contributing to that evidence and we will consider it,” Dr Middlemiss said.
‘I do advise pre-import testing’
“I do advise at the moment that voluntary testing, pre-import testing, is a really sensible thing to do. If you’re bringing dogs in to breed then it would absolutely make sense to pre-import screen those dogs.”
The report’s advice to people with affected dogs has not changed, with euthanasia still the only option available to definitely stop the spread of onward transmission. The decision also still lies with the owner, a bone of contention for vets and owners who were hoping for more clarity.
Dr Middlemiss said euthanasia is still the only reliable way to ensure there is no risk of spread as antibiotics, even multiple courses for long periods, are not guaranteed to eradicate all the infection.
But a Brucella canis positive result is not a definite death sentence, with hope for infected dogs such as Albus and Spencer, the potentially infected guide dogs who were put in quarantine despite concerns their tests were false positives.
She suggested owners, vets and doctors should look at a range of factors to determine the best course of action.
“It is very difficult to set blanket black and white advice,” she said.
“For some people [euthanasia] might not be the right advice and they’ve got to take into account their personal circumstances.
“For me, I don’t have a dog at the moment, but the last dog I had was a UK dog, not in contact with others, if it was in contact it was under controlled conditions. I don’t have children. I’m not breeding dogs. There is a low risk of spread.
“But if you were a breeder of dogs and you end up having [a case] and you have multiple kennels, maybe lots of people have to look after them, then I think their circumstances are different.
High rate of false positives
“People’s risk appetite around that may be different, and it’s acceptable for it to be different. It would not be right for us to dictate an acceptable risk level to them. They have to work through that as an owner with their vet.”
There has been concern over a high rate of false positives, with as many as one in 50 positive cases erroneously deemed to be infected.
Dr Middlemiss said the issues were with some of the components used in the assay not being up to scratch, not the test itself, which is done at the Animal and Plant Health Agency headquarters in Weybridge.
“My advice would be for the vet, in cases where people are still concerned [about false positives], to speak directly to the disease and testing experts at Weybridge. They’re the best people to speak to in order to get advice on cases,” she said.
“For lots of tests you do not necessarily get a black and white answer, it is on a spectrum. We take into account the circumstances of the animals, the epidemiology and so on.
“And so, where people have any doubt I would advise vets to speak directly to disease colleagues at Weybridge.” | Epidemics & Outbreaks |
A study out this week suggests that semaglutide—the active ingredient in popular obesity drug Wegovy—might be able to help people struggling with alcohol use disorder, too. In a small sample of cases, researchers found evidence that people who took semaglutide for weight loss also experienced a significant reduction in alcohol dependence symptoms. The team and other scientists have begun to conduct clinical trials to further explore this link.
Semaglutide is a synthetic and longer-lasting version of glucagon-like peptide 1 (GLP-1), a hormone that helps regulate our insulin production and appetite, among other things. Developed by Novo Nordisk, it was first approved to manage type 2 diabetes in 2017 under the brand name Ozempic and later approved as the higher-dose formulation Wegovy in 2021 for obesity. Newer GLP-1s like semaglutide and similar drugs have proven to be much more effective at helping people lose weight than diet and exercise alone or past obesity medications (in clinical trials of Wegovy, people have lost around 15% of their baseline weight).
While the primary cells that produce and respond to GLP-1 are found in the gut, there are also GLP-1 related cells in the brain. It’s thought that these drugs work to tamp down appetite not only by physically affecting the digestive tract, such as by slowing digestion, but by interacting with these brain cells as well. And that’s led to speculation that these drugs could reduce people’s cravings for things besides food.
Studies have found that semaglutide can lead to reduced alcohol and drug consumption in lab animals, for instance. And in the wake of the rapid rise in popularity for these drugs, there have been anecdotal reports of people drinking or gambling less often after they began to take semaglutide. But this new study, published Monday in the Journal of Clinical Psychiatry, seems one of the first to formally document some of these reports.
The authors tracked down six cases of patients who were prescribed semaglutide for weight loss but were also previously diagnosed with alcohol use disorder, defined as an inability to control their drinking despite harmful consequences for themselves or others. All of the patients seemed to experience a clear reduction in their alcohol-related symptoms, the team found, even those who didn’t lose much weight while taking semaglutide.
“This case series is consistent with preclinical data and suggests that GLP-1RAs have strong potential in the treatment of [alcohol use disorder],” the study authors wrote.
The researchers are from the University of Oklahoma School of Community Medicine and the Oklahoma State University Center for Health Sciences. Some of them have already started to recruit patients with alcohol use disorder for a randomized clinical trial of semaglutide, while the National Institute on Drug Abuse is funding and conducting its own sister trial.
Novo Nordisk would have to apply for regulatory approval of any new indication of semaglutide, including alcohol use disorder. And it’s not certain that current and future trials, even with positive data, would lead to the drug officially becoming a treatment for the condition. But there are only three formally approved medications for alcohol use disorder currently, which all seem to have modest effectiveness at best. So even showing that semaglutide and other GLP-1s can be an effective, if off-label, option for these patients would still be worthwhile.
“This research marks a significant step forward in our understanding of the potential therapeutic applications of semaglutide in the field of addiction medicine,” said lead author Jesse Richards, director of Obesity Medicine and assistant professor of Medicine at OU-TU School of Community Medicine, in a statement from the university. | Drug Discoveries |
Get ready for Ozem-kids!
Eli Lilly, the maker of Mounjaro, said it is planning to give the anti-diabetes meds to kids as young as six years old, according to Bloomberg News.
The drug giant began recruiting children 12 and up this week for a clinical trial, according to the report.
Ozempic maker Novo Nordisk is also in the midst of clinical trials for its drug Saxenda, which is an older and less potent version of Ozempic and Wegovy, in children at least six years of age, Bloomberg News reported.
The Post has sought comment from Novo Nordisk and Eli Lilly.
“We are certainly committed to innovation in this space that’s going to address all segments of the population that’s affected,” an Eli Lilly spokesperson told Bloomberg.
In August, Novo’s head of development, Martin Holst Lange, told Bloomberg that the company was planning trials involving children in the “not-so-distant future.”
The Food and Drug Administration and health regulators in Europe have only approved the drugs, which are known as GLP-1 receptor agonists, for use in people ages 12 and up.
According to the US Centers for Disease Control and Prevention, nearly one in five children ages six and up suffer from obesity.
Novo Nordisk is expected to report that sales of Ozempic generated $3.32 billion in revenue in the third quarter while Wegovy sold $1.07 billion, according to analysts surveyed by FactSet.
Their projections were reported by Barron’s.
Novo and Lilly posted the largest year-over-year revenue growth increases in the second quarter on the strength of the sales of Ozempic, Wegovy, and Mounjaro.
Sales of Ozempic generated revenue of $3.2 billion in the second quarter — up from $2.1 billion during the same period in 2022.
Lilly’s Mounjaro generated $980 million in sales for the company during the second quarter — a 72% increase compared to the first quarter.
Analysts at Goldman Sachs estimated that GLP-1 drugs will generate $100 billion by 2030 — though that number does not factor in the potential use by children, who would likely take the medication for a longer period of time than adults.
While drugs like Ozempic have been known to trigger weight loss, some users report other less pleasant side effects. | Drug Discoveries |
COLUMBUS, Ohio — Republican state lawmakers have proposed eliminating home grow provisions in Ohio’s new voter-approved recreational marijuana law, days before the measure is scheduled to take effect.
In a promised sweeping re-write of the new law, Senate Republicans also have proposed setting lower limits for THC content in marijuana products, increasing taxes on the product, redirecting some tax revenues from a planned social justice fund toward law enforcement, setting criminal possession limits and barring public smoking of marijuana while generally allowing public consumption of other marijuana products – unless a private establishment sets their own rules, among other changes.
The rewrite is contained in amendments to an uncontroversial alcohol regulation bill that the Ohio House approved in June that’s scheduled for a committee hearing in Columbus Monday morning. While the Senate seems likely to approve the changes, the House then would have to agree, and Gov. Mike DeWine would have to sign the bill for them to take effect. Both the House and Senate are controlled by Republicans, but the two chambers have differing politics that make the House viewed as being more marijuana friendly.
Barring a quickly approved revision to the marijuana law, approved by Ohioans with 57% of the vote as state Issue 2, the new marijuana law is scheduled to take effect on Thursday. Because it was approved as what’s called an initiated statute, lawmakers are able to rewrite the law as they see fit.
Some aspects of the law, such as developing the regulations for adult-use dispensaries, could take months for the state to establish, on Thursday, legalizing home grow goes into effect. So does possession of up to 2.5 ounces of flower and up to roughly 0.5 ounces of THC extract.
Ohio Sen. Mark Romanchuk, a Richland County Republican, on Thursday told a meeting of Ohio Manufacturers’ Association members that he wouldn’t be surprised if the entire initiated statute was removed and the Senate voted to legalize recreational marijuana by adding it into the state’s existing medical marijuana laws.
This story will be updated
Laura Hancock contributed to this story | Health Policy |
Sasha Pieterse isn't keeping her health journey a secret.
The Pretty Little Liars star recently opened up about her struggle with a hormone condition known as polycystic ovary syndrome (PCOS) and how it affected her since her teen years and while playing Alison DiLaurentis on the hit ABC family show.
"This is part of the health issues that I was speaking of while I was going through Pretty Little Liars," Sasha recalled on The Squeeze podcast Aug. 9. "So when I mean it was documented it was like, the changes that were happening to me were documented on camera."
Giving insight to what was happening to her body at the time, the 27-year-old added, "I never had a regular period ever and I was just always told by gynecologists that I was just young. Like, ‘Don't worry, it'll regulate.'"
But that wasn't the case for Sasha.
"When I turned, it was probably around 15-16, that I started noticing a difference in just my metabolism in general," she continued. "At 17, I gained 70 pounds in the year, for no reason. There was no explanation for it."
However, Sasha felt that she wasn't being heard despite visiting "over 15 gynecologists," some of which blamed her for her weight gain, and felt the course of action should include testing her blood.
"It was the most frustrating experience and disheartening because no matter what I did, no matter how well I behave, no matter how great I treated my body, things were actually getting worse rather than better, it was very very confusing," she confessed to hosts Taylor Lautner and wife Tay Lautner. "So after a long process…someone recommended that I go to an endocrinologist."
The doctor then told Sasha she had PCOS and would have to do a blood test to confirm the diagnosis. Sasha said she wasn't aware of PCOS before her experience.
"I was like what's that? I'd never heard of PCOS before. And it's a disease, it's not curable, it can be dormant, that's—at this stage—that's what they know," the Geek Charming actress explained. "And the most frustrating part about this is that it's fairly easy to diagnose. And really what it is, it's a hormone imbalance, it's a hormone disease and it's so easy to see because your testosterone or your estrogen will be really high, you'll have really low vitamin D levels, you'll be deficient in a lot of things."
But that isn't all that PCOS affects.
As Sasha put it, "You won't have a regular period, but the catch is, a lot of other things look different, so every woman everyone has a different experience with it. It could be your period, it could be weird hair growth, it could major gastro issues, it could be crazy cysts on your ovaries, it could be weight gain…I had a lot of those outward symptoms that everyone could see."
"Just the fact that we were able to get pregnant was such a blessing because with PCOS that made me nervous," she told People in July 2020. "A lot of women have infertility issues and so we were expecting more difficulty, so it's been an absolute blessing that we were able to just get pregnant by ourselves." | Women’s Health |
Popular weight loss drugs like Wegovy and Ozempic could increase the risk of stomach paralysis as well as several other serious gastrointestinal conditions, according to a study published Thursday in JAMA.
This was the first large epidemiological (disease-related) study to examine these adverse effects in non-diabetic patients using the drugs specifically for weight loss, per a press release from The University of British Columbia (UBC).
The risk was linked to all semaglutides, a class of medications known as GLP-1 receptor agonists — including Ozempic (prescribed for diabetes management), Wegovy (prescribed for weight loss), Rybelsus (type 2 diabetes) and Saxenda (weight loss).
Stomach paralysis, officially known as gastroparesis, prevents the nerves and muscles in the stomach from moving food into the small intestine, which keeps digestion from occurring, as described on Cleveland Clinic’s website.
In addition to stomach paralysis, the drugs were linked to a greater risk of pancreatitis (inflammation of the pancreas) and bowel obstruction, which prevents food from passing through the small or large intestine, the release stated.
UBC researchers examined the health insurance claim records for approximately 16 million U.S. patients who were prescribed Ozempic, Wegovy or either semaglutide or liraglutide medications across a 14-year span (between 2006 and 2020).
The researchers could not assess whether the condition was temporary or permanent.
Compared to another weight loss drug, bupropion-naltrexone, those who took a GLP-1 agonist were 3.67 times more likely to develop stomach paralysis, had a 9.09 times higher risk of pancreatitis and were 4.22 times more likely to have bowel obstruction.
For the cases of stomach paralysis, the researchers could not assess whether the condition was temporary or permanent.
"There are reports from other journalists where they have met patients whose symptoms have not gone away despite stopping the drugs," study co-author Dr. Mahyar Etminan, associate professor in the Departments of Ophthalmology & Visual Sciences and Medicine at UBC, told Fox News Digital.
There are medications that can be used to help with the condition, he added.
Although these complications were rare, the researchers found them concerning, given that millions of people are using these medications worldwide.
The number of people in the U.S. using GLP-1 agonists for either diabetes or obesity reached 40 million in 2022, they noted.
"These drugs are becoming increasingly accessible, and it is concerning that, in some cases, people can simply go online and order these kinds of medications when they may not have a full understanding of what could potentially happen," said first author Mohit Sodhi, a graduate of UBC’s experimental medicine program, in the release.
The number of people in the U.S. using GLP-1 agonists for either diabetes or obesity reportedly reached 40 million in 2022.
"Given the wide use of these drugs, these adverse events, although rare, must be considered by patients thinking about using them for weight loss."
The researchers recommend that regulatory agencies and drugmakers consider updating the warning labels for their products, which currently don’t include the risk of gastroparesis.
"This is critical information for patients to know so they can seek timely medical attention and avoid serious consequences," said Sodhi.
The decision about whether to take the drug in spite of these risks will depend on each patient’s individual situation, the researchers said.
"This decision should be individually assessed," said Etminan. "There are patients where the benefit of the drugs might outweigh the risks (very obese individuals), whereas in other situations (healthy individuals who just want to lose a few pounds), the risks might outweigh the benefits."
"This is critical information for patients to know so they can seek timely medical attention and avoid serious consequences."
The study did have some limitations, the researchers noted.
"We did not have access to medical charts to ascertain all subjects' medical histories," said Etminan. "Also, we could not look at risk with individual GLP-1 drugs, but this is probably a class effect of these drugs."
The researchers also did not determine whether certain groups were at higher risk of this adverse side effect, but Etminan said he suspects that those with preexisting GI conditions might be more susceptible.
California-based cardiologist Dr. Ernst von Schwarz, author of "The Secrets of Immortality," was not involved in the study but noted that it confirmed a higher prevalence of pancreatitis, gastroparesis and bowel obstruction in patients on GLP-1 agonists.
"On the other hand, these drugs have been shown to reduce the risk of cardiovascular events as shown for Ozempic in 2016 in diabetics and in 2023 for Wegovy," he said in an interview with Fox News Digital.
"The achieved weight loss using GLP-1 agonists, as well as the improved glucose control, seem to have significant benefits on cardiovascular outcomes, but patients need to be informed about the relatively small incidence of abdominal side effects as seen in this cohort study," said von Schwarz.
"The benefits on cardiovascular risks, however, appear to outweigh the risks of side effects."
The U.S. Food and Drug Administration (FDA) lists "ileus" as a potential side effect of Ozempic.
Ileus is the inability of the intestine (bowel) to contract normally and move waste out of the body, according to Mayo Clinic.
In August, a Louisiana woman sued Novo Nordisk, the manufacturer of Ozempic and Wegovy, and Lilly, which makes another GLP-1 agonist, Mounjaro, claiming that the companies "downplayed the severity of gastrointestinal events caused by Ozempic and Mounjaro — never, for example, warning of the risk of gastroparesis (‘paralyzed stomach’) or gastroenteritis."
The woman, who used Ozempic for more than a year before switching to Mounjaro last month, alleged she was "severely injured as a result" of using both drugs, the suit stated.
In a statement at the time, a spokesperson for Novo Nordisk told FOX Business that gastrointestinal events "are well-known side effects of the GLP-1 class" and "are mild to moderate in severity and of short duration."
"Given the wide use of these drugs, these adverse events, although rare, must be considered by patients thinking about using them for weight loss."
The company provided the below statement to Fox News Digital on Friday, Oct. 6.
"At Novo Nordisk, patient safety is a top priority. We work closely with the U.S. Food and Drug Administration to continuously monitor the safety profile of our medicines. The FDA-approved product labeling for Novo Nordisk’s GLP-1RA medicines indicated for use in weight management (Saxenda and Wegovy) includes information about their potential side effects, including pancreatitis, acute gallbladder disease, ileus and delayed gastric emptying."
"Similar information is included in the product labeling for our GLP-1RA medicines indicated for the treatment of type 2 diabetes (Ozempic, Rybelsus and Victoza)," the statement went on.
"Novo Nordisk stands behind the safety and efficacy of all of our GLP-1RA medicines when used consistent with the product labeling and approved indications."
Novo Nordisk continued, "With respect to the study, as the authors acknowledge, the study has limitations, including potential confounding by indication and by other factors."
The company added, "It is also important to note that the study analyzed data collected during the period between 2006 and 2020. During this time, Wegovy was not on the market; Saxenda was first approved in December 2014. In addition, Victoza was FDA-approved in January 2010 and Ozempic was FDA-approved in December 2017."
Daniella Genovese of Fox News Digital contributed to this report. | Drug Discoveries |
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.
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. | Women’s Health |
Story at a glance
- Omicron and its subvariants make up 99.9% of current COVID-19 spread.
- What happened to the variants that once wreaked havoc? “For all intents and purposes, we can consider them gone,” said David Dowdy, an epidemiology professor at Johns Hopkins Bloomberg School of Public Health.
- A new variant isn’t necessarily bad news. The alpha and delta variants were actually known to make people more ill, and as those variants faded away, so did some of their most severe symptoms and outcomes.
(NEXSTAR) – When the omicron variant emerged, it immediately made its presence known, spreading like wildfire and driving the United States’ largest coronavirus case spike yet. In 2023, the record-breaking spike is over, but omicron isn’t.
According to tracking by the Centers for Disease Control and Prevention, omicron and its subvariants make up 99.9% of current COVID-19 spread. The delta variant, which overloaded hospitals and killed thousands in late summer 2021, is now responsible for 0% of cases. “Other” variants are responsible for 0.1%.
What happened to the variants that once wreaked havoc? “For all intents and purposes, we can consider them gone,” said David Dowdy, an epidemiology professor at Johns Hopkins Bloomberg School of Public Health.
As the virus spawned new variations that were better at infecting people, they edged out old types, including the alpha variant of early 2020 and delta from 2021. It happens through a “continual game of cat and mouse between the virus and our immune systems,” Dowdy said.
But a new variant isn’t necessarily bad news. The alpha and delta variants were actually known to make people more ill, and as those variants faded away, so did some of their most severe symptoms and outcomes.
“There’s this tendency to think that just because we are seeing new variants, that means that the virus is continually getting worse and worse for us. And that’s not the case,” said Dowdy. “I think the flu is a good example of this. We have a new variant of the flu every year. That doesn’t mean that that every year’s flu season is worse than the one before.”
One symptom we don’t see nearly as often is the loss of taste and smell, which was more common with early coronavirus variants.
Could the old variants come roaring back one day? It’s more likely we’d see something new, explained Davidson Hamer, a professor of Global Health and Medicine at Boston University’s Schools of Public Health and Medicine.
“It’s more likely that novel variants are going to rise, that have even more mutations, that make the virus more fit to spread,” Hamer told Nexstar. “Usually, it’s sort of the old strain that evolves, or evolves further, but It never really goes back to where it came from.”
While omicron is generally less deadly than delta or alpha, it’s certainly not harmless. More than 3,000 people were dying every day at the height of the omicron surge. Over the past month, the average daily death toll has been between 400 and 600.
Nexstar’s Michael Bartiromo contributed to this report. | Epidemics & Outbreaks |
One of the two main active ingredients in marijuana has been found in a plant other than cannabis, researchers claim.
Scientists in Brazil said they've discovered cannabidiol (CBD) in the fruits and flowers of the Jamaican nettletree (Trema micranthum), an evergreen shrub that is native to tropical and subtropical regions of North and South America, AFP reported this summer.
T. micranthum belongs to the Cannabaceae family of plants, which contains 11 genera and about 170 species. One genus includes the cannabis plants, such as Cannabis sativa, which is used to make marijuana. These plants produce chemical substances called cannabinoids, including the high-inducing substance tetrahydrocannabinol (THC) and CBD, which doesn't give users a high.
Unlike C. sativa, T. micranthum doesn't contain THC, so it could be an attractive new source of CBD that comes without the legal barriers associated with growing cannabis.
Related: How does cannabis get you high?
"As we continue to see more patients prescribed medical cannabis for chronic health problems in the U.K. and internationally it is promising to see novel approaches to the production of cannabidiol and other cannabinoids," Dr. Simon Erridge, the head of research at Sapphire Medical Clinics in the U.K., who was not involved in the new discovery, told Live Science in an email.
"There must be cautious excitement around this news however, as the researchers have yet to publish data around the quantities of CBD they have been able to extract from Trema micranthum," he said. The techniques used to optimize the extraction of CBD from the cannabis flower, on the other hand, have been refined over many decades, he said.
There has been growing interest in the potential for using medical cannabis to treat a number of conditions, ranging from Parkinson's disease to epilepsy and chronic pain. However, although the practice is now legal in some countries, including in the U.K., and across many states in the U.S., there are still barriers to accessing the drug worldwide.
"It was wonderful to find a plant (with CBD but) without THC, because you avoid all the mess around psychotropic [psychoactive] substances," Rodrigo Moura Neto, a molecular biologist at the Federal University of Rio de Janeiro who led the recent research, told AFP.
"That means the potential is enormous," he said.
Moura Neto and his team have yet to publish their findings, but he told AFP that they hope to expand their research thanks to a public grant. Their upcoming research will involve looking at the best way to extract CBD from T. micranthum and testing whether it could be an effective substitute for medical marijuana.
In the meantime, "until we have similar data in relation to Trema micranthum, the vast majority of CBD will continue to come from cannabis plants," Erridge said.
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Emily is a health news writer based in London, United Kingdom. She holds a bachelor's degree in biology from Durham University and a master's degree in clinical and therapeutic neuroscience from Oxford University. She has worked in science communication, medical writing and as a local news reporter while undertaking journalism training. In 2018, she was named one of MHP Communications' 30 journalists to watch under 30. ([email protected]) | Drug Discoveries |
Sweet Smell of Success: Simple Fragrance Method Produces Major Memory Boost
When a fragrance wafted through the bedrooms of older adults for two hours every night for six months, memories skyrocketed. In fact, participants in this study by neuroscientists from the University of California, Irvine (UCI), reaped a 226% increase in cognitive capacity compared to the control group. The researchers say the finding transforms the long-known tie between smell and memory into an easy, non-invasive technique for strengthening memory and potentially deterring dementia.
The team’s study was published recently in the journal Frontiers in Neuroscience.
Study Details and Results
The research project was conducted through the UCI Center for the Neurobiology of Learning & Memory. It involved men and women aged 60 to 85 without memory impairment. All were given a diffuser and seven cartridges, each containing a single and different natural oil. People in the enriched group received full-strength cartridges. Control group participants were given the oils in tiny amounts. Participants put a different cartridge into their diffuser each evening prior to going to bed, and it activated for two hours as they slept.
People in the enriched group showed a 226% increase in cognitive performance compared to the control group, as measured by a word list test commonly used to evaluate memory. Imaging revealed better integrity in the brain pathway called the left uncinate fasciculus. This pathway, which connects the medial temporal lobe to the decision-making prefrontal cortex, becomes less robust with age. Participants also reported sleeping more soundly.
The Power of Smell and Memory
Scientists have long known that the loss of olfactory capacity, or ability to smell, can predict the development of nearly 70 neurological and psychiatric diseases. These include Alzheimer’s and other dementias, Parkinson’s, schizophrenia, and alcoholism. Evidence is emerging about a link between smell loss due to COVID and ensuing cognitive decrease. Researchers have previously found that exposing people with moderate dementia to up to 40 different odors twice a day over a period of time boosted their memories and language skills, eased depression, and improved their olfactory capacities. The UCI team decided to try turning this knowledge into an easy and non-invasive dementia-fighting tool.
“The reality is that over the age of 60, the olfactory sense and cognition starts to fall off a cliff,” said Michael Leon, professor of neurobiology & behavior and a CNLM fellow. “But it’s not realistic to think people with cognitive impairment could open, sniff, and close 80 odorant bottles daily. This would be difficult even for those without dementia.”
The study’s first author, project scientist Cynthia Woo, said: “That’s why we reduced the number of scents to just seven, exposing participants to just one each time, rather than the multiple aromas used simultaneously in previous research projects. By making it possible for people to experience the odors while sleeping, we eliminated the need to set aside time for this during waking hours every day.”
The researchers say the results from their study bear out what scientists learned about the connection between smell and memory.
The Unique Role of Olfactory Sense
“The olfactory sense has the special privilege of being directly connected to the brain’s memory circuits,” said Michael Yassa, professor and James L. McGaugh Chair in the Neurobiology of Learning & Memory. The director of CNLM, he served as collaborating investigator. “All the other senses are routed first through the thalamus. Everyone has experienced how powerful aromas are in evoking recollections, even from very long ago. However, unlike with vision changes that we treat with glasses and hearing aids for hearing impairment, there has been no intervention for the loss of smell.”
The team would next like to study the technique’s impact on people with diagnosed cognitive loss. The researchers also say they hope the finding will lead to more investigations into olfactory therapies for memory impairment. A product based on their study and designed for people to use at home is expected to come onto the market this fall.
Reference: “Overnight olfactory enrichment using an odorant diffuser improves memory and modifies the uncinate fasciculus in older adults” by Cynthia C. Woo, Blake Miranda, Mithra Sathishkumar, Farideh Dehkordi-Vakil, Michael A. Yassa and Michael Leon, 24 July 2023, Frontiers in Neuroscience.
DOI: 10.3389/fnins.2023.1200448
The study was supported by Procter & Gamble. | Medical Innovations |
Adults under-50 in England have just over a week left to take up the NHS offer of a free Covid booster jab.
It is the last opportunity for healthy 16-49-year-olds to get a top-up dose - a third shot - if they haven't already.
The vaccine can help protect against severe illness, even if you have caught Covid before.
Appointments are available at thousands of different sites, including GP practices and high street pharmacies, up to and including Sunday 12 February.
Anyone aged 16 or over - or an at-risk child aged 12 to 15 - who has had both primary jabs, can have a booster.
So far, 15,000 people have booked in for next week and there are still 391,000 appointments available, says NHS England.
There should be another autumn vaccination campaign later this year for older adults, as well as a potential spring campaign for the most vulnerable, experts advise.
People with a severely weakened immune system were offered an additional third primary dose before being offered a booster this winter.
The NHS Covid vaccination programme will continue to run a smaller operation after 12 February, allowing those yet to come forward for first, second, or third doses if severely immunosuppressed, to book appointments.
Experts will also be keeping a close eye on new variants of Covid, in case more people need vaccinating in the future.
Autumn boosters were recommended when the more spreadable Omicron variant emerged and began to spread in late 2021.
NHS Director of Vaccinations and Screening, Steve Russell, said: "There is just one week left of the autumn booster campaign and so if you are eligible for a booster but have yet to take up your latest dose, please do so before the end of next week.
"Whether you have had previous doses or a bout of Covid, we know that a booster is the best way to maintain protection against serious illness from Covid for yourself and your loved ones, so please do make the most of the offer while it is available and give yourself both protection and peace of mind for the year ahead."
How do I book my Covid vaccine?
- In England: You can book all doses online, by calling 119, or you can visit a walk-in clinic (some don't offer jabs to under-12s)
- In Scotland: Over-16s can register for their first dose and book second or booster doses online, or by calling 0800 030 8013
- In Wales: Over-16s will be invited for their booster. If you haven't been invited - or you haven't had your first two doses - you can contact your health board. You can change or cancel existing appointments online
- In Northern Ireland: All doses can be booked online or by calling 0300 200 7813
Which vaccine will people get?
The NHS is using Moderna's "bivalent" vaccine, which covers both the original Covid virus and the Omicron variant.
It also approved a second bivalent vaccine from Pfizer.
Health officials advise people to take whichever booster they are offered, as all vaccines provide protection against becoming severely ill from Covid.
First and second vaccine doses are either AstraZeneca or (for under-40s) Pfizer or Moderna. | Vaccine Development |
Over 230 people in Peru have developed a rare, paralyzing neurological disorder called Guillain-Barré Syndrome, leading government officials to declare a national emergency and the World Health Organization to send out a disease outbreak alert.
So far, four people have died from the disorder, which involves the immune system attacking peripheral nerves. It often starts with progressive muscle weakness and numbness that can lead to paralysis and, in about a quarter of the cases, the need for mechanical ventilation.
Peru—a country of over 34 million people—typically sees fewer than 20 suspected cases per month of Guillain-Barré Syndrome (pronounced ghee-yan bar-ray or abbreviated GBS). But, between June 10 and July 15, the country tallied 130 cases, including the four deaths, bringing the year's total to 231, the WHO reported Tuesday.
The cases are widely distributed throughout the country, with 20 of the country's 24 governmental regions (departments) reporting at least one case. Seven departments have reported high numbers—including Lima, at the central coast, to Piura and Lambayeque in the far north, and Cusco, which is southeast of Lima. But no other countries in the Americas report an uptick in GBS cases.
The cause of the outbreak is puzzling—even though this isn't Peru's first alarming GBS outbreak. In 2019, the country reported an unprecedented surge of nearly 700 cases between May and July, bringing the total to over 900. Before that, a large GBS outbreak was considered between 30 to 50 cases.
Researchers concluded that the culprit behind the extremely unusual 2019 outbreak was the intestinal pathogen, Campylobacter jejuni. The gut-dwelling bacteria is well-known as one of the most common causes of food poisoning and diarrheal cases in the world. But, less well-known, it's also one of the leading triggers for GBS.
Unusual suspect
There are hints that C. jejuni is again the cause of the GBS outbreak in Peru. Of 22 clinical samples taken from Peruvian patients between June and July, 14 (63 percent) were positive for the gut microbe. But, even if C. jejuni is behind the current outbreak, there are still a lot of unanswered questions—including how it's spreading.
In a 2020 report, researchers from the US Centers for Disease Control and Prevention, Peru's CDC, and Peru's national health institute wrote findings from their investigation of the outbreak. They noted that the C. jejuni isolates were highly related, and the cases rapidly increased and then decreased, suggesting a "point-source exposure." But just like in the current outbreak, the cases were spread across geographically disparate regions, making a single source unlikely.
"Because of the wide distribution of outbreaks in many geographically separated regions, we questioned how all areas were exposed to C. jejuni within a short time frame," they wrote. And they left the question lingering. | Epidemics & Outbreaks |
A new study published in Behavioral Sleep Medicine has found that beginning a romantic relationship or going through a breakup can impact poorly upon the sleep of adolescents, particularly in younger adolescent females.
Adolescence is a turbulent, dynamic period characterized by new experiences, one of which may be commencing a romantic relationship. While engaging in a relationship is ideally a positive experience that can boost mental health, relationships are major life events that can potentially act as a source of stress. Adolescents can be impacted emotionally and behaviorally, with research suggesting issues such as lowered self-esteem, more mood swings, and more alcohol and substance abuse.
This in turn could have detrimental impacts upon sleep, where adolescents can experience insomnia symptoms, such as struggling to fall asleep, sleeping for shorter time periods, or frequently waking up during the night.
However, previous research investigating the exact relationship between adolescent romantic experiences and sleep has provided mixed results, with some studies suggesting shorter sleep duration, other studies not finding any association between the two factors, and the remaining studies suggesting an improvement to subjective sleep quality.
Additionally, little is known regarding how adolescent age and sex influences this association.
The study team, led by Xianchen Liu from the University of Pennsylvania, aimed to clarify this ambiguity with a focus on Chinese adolescents.
Over the course of one year, 7,072 middle school and high school students were followed. The students began the study in grade 7, 8 or 10, and completed baseline questionnaires about their romantic experiences within the last year, their insomnia symptoms, and their sleep duration at night.
Information was also collected on various factors that could affect romantic relationships and/or sleep, including age, sex, smoking, alcohol use, family socioeconomic status, parents’ marital status, and depressive symptoms.
The same data points were again collected one year later in follow-up surveys.
After adjusting for the variables that impact romantic relationships and/or sleep, Liu and authors discovered that at baseline, there was an increased chance of insomnia symptoms that were associated with starting a relationship (41% increase), ending a relationship (35% increase), or a combination of both (45% increase).
Experiencing both the start and end of a relationship at baseline was associated with a 30% increased chance of short sleep i.e. under seven hours a night.
When re-examining the adolescents one year later, those who had entered into a relationship were found to have a 61% higher chance of new insomnia symptoms, and those who experienced a break-up had a 43% increased chance of developing new insomnia symptoms.
The researchers concluded that “romantic relationships not only have short-term impacts on sleep quality and quantity but also are significant predictors of insomnia symptoms one year later” and that various factors could contribute to this, such as life stress, hormonal changes and psychosocial development.
Additionally, the relationships between romantic involvement and sleep difficulties were discovered to be greater in younger adolescents (under 15 years old), compared to older adolescents (at least 15 years old), and was particularly evident in females.
Psychological, social, and biological development may explain poorer sleep in early adolescence, with the authors suggesting “fast physical growth and sexual development, marked sleep changes, need for more independence and privacy, and immature decision-making and stress management skills” as potential mechanisms. However, more studies are required to unpack the influence of sex in the relationship between romantic experience and sleep, as the current analyses did not provide conclusive support towards the notion that females and males are impacted differently.
Notably, the results must be viewed through the lens of traditional Chinese culture. Involvement in relationships as an adolescent deviates from social norms and thus the stresses of entering or ending a relationship could be exacerbated, and consequently sleep problems could be amplified. The authors noted that further research is required to ascertain how this may differ in Western culture.
There are some caveats to be considered. As the data was reported by the adolescents themselves, results may have been biased. Additionally, the questions may have been interpreted with some liberty, with the authors suggesting that some adolescents may have interpreted experiences of having a crush or unrequited love as meeting the criteria of having ‘entered’ into a romantic relationship. Finally, data was not collected on other important factors that should be considered in romantic relationships, such as the number, duration and quality of relationships, or the rationale behind break-ups.
The study, “Starting a Romantic Relationship, Breakups, and Sleep: A Longitudinal Study of Chinese Adolescents”, was authored by Xianchen Liu, Zhen-Zhen Liu, Yanyun Yang and Cun-Xian Jia. | Mental Health Treatments |
Tony Leys/KFF Health News
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Osteopathic physician Kevin de Regnier of Winterset, Iowa, checks Chris Bourne, who came in for an adjustment of his anxiety medication on May 9, 2023.
Tony Leys/KFF Health News
Osteopathic physician Kevin de Regnier of Winterset, Iowa, checks Chris Bourne, who came in for an adjustment of his anxiety medication on May 9, 2023.
Tony Leys/KFF Health News
WINTERSET, Iowa — For 35 years, this town's residents have brought all manner of illnesses, aches, and worries to Kevin de Regnier's storefront clinic on the courthouse square — and he loves them for it.
De Regnier is an osteopathic physician who chose to run a family practice in a small community. Many of his patients have been with him for years. Many have chronic health problems, such as diabetes, high blood pressure, or mental health struggles, which he helps manage before they become critical.
"I just decided I'd rather prevent fires than put them out," he said between appointments on a recent afternoon.
Broad swaths of rural America don't have enough primary care physicians, partly because many medical doctors prefer to work in highly paid specialty positions in cities. In many small towns, osteopathic doctors like de Regnier are helping fill the gap.
Osteopathic physicians, commonly known as DOs, go to separate medical schools from medical doctors, known as MDs. Their courses include lessons on how to physically manipulate the body to ease discomfort. But their training is otherwise comparable, leaders in both wings of the profession say.
Both types of doctors are licensed to practice the full range of medicine, and many patients would find little difference between them aside from the initials listed after their names.
Tony Leys/KFF Health News
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Osteopathic physician Kevin de Regnier has provided primary care for more than 35 years from this office on the courthouse square in Winterset, Iowa.
Tony Leys/KFF Health News
A growing share of the physician workforce
DOs are still a minority among U.S. physicians, but their ranks are surging. From 1990 to 2022, their numbers more than quadrupled, from fewer than 25,000 to over 110,000, according to the Federation of State Medical Boards. In that same period, the number of MDs rose 91%, from about 490,000 to 934,000.
Over half of DOs work in primary care, which includes family medicine, internal medicine, and pediatrics. By contrast, more than two-thirds of MDs work in other medical specialties.
The number of osteopathic medical schools in the U.S. has more than doubled since 2000, to 40, and many of the new ones are in relatively rural states, including Idaho, Oklahoma, and Arkansas. School leaders say their locations and teaching methods help explain why many graduates wind up filling primary care jobs in smaller towns.
De Regnier noted that many MD schools are housed in large universities and connected to academic medical centers. Their students often are taught by highly specialized physicians, he said. Students at osteopathic schools tend to do their initial training at community hospitals, where they often shadow general practice doctors.
U.S. News & World Report ranks medical schools based on the percentage of graduates working in rural areas. Osteopathic schools hold three of the top four spots on the 2023 edition of that list.
Osteopathic schools train doctors where the need is
William Carey University's osteopathic school, in Hattiesburg, Mississippi, is No. 1 in that ranking. The program, which began in 2010, was intentionally sited in a region that needed more medical professionals, said Dean Italo Subbarao.
After finishing classwork, most William Carey medical students train in hospitals in Mississippi or Louisiana, Subbarao said. "Students become part of the fabric of that community," he said. "They see the power and the value of a what a primary care doc in a smaller setting can have."
Leaders from both sides of the profession say tension between DOs and MDs has eased. In the past, many osteopathic physicians felt their MD counterparts looked down on them. They were denied privileges in some hospitals, so they often founded their own facilities. But their training is now widely considered comparable, and students from both kinds of medical schools compete for slots in the same residency training programs.
Michael Dill, director of workforce studies at the Association of American Medical Colleges, said it makes sense that osteopathic school graduates are more likely to go into family practice, internal medicine, or pediatrics. "The very nature of osteopathic training emphasizes primary care. That's kind of their thing," said Dill, whose group represents MD medical schools.
Dill said he would be confident in the care provided by both types of doctors. "I would be equally willing to see either as my own primary care physician," he said.
Tony Leys/KFF Health News
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Alice Collins of Winterset, Iowa, shows osteopathic physician Kevin de Regnier a spot on her hand during an office visit on May 9, 2023. A surgeon recently removed a tumor from her hand.
Tony Leys/KFF Health News
Alice Collins of Winterset, Iowa, shows osteopathic physician Kevin de Regnier a spot on her hand during an office visit on May 9, 2023. A surgeon recently removed a tumor from her hand.
Tony Leys/KFF Health News
Data from the University of Iowa shows osteopathic physicians have been filling rural roles previously filled by medical doctors. The university's Office of Statewide Clinical Education Programs tracks the state's health care workforce, and its staff analyzed the data for KFF Health News.
The analysis found that, from 2008 to 2022, the number of Iowa MDs based outside the state's 11 most urban counties dropped more than 19%. Over the same period, the number of DOs based outside those urban areas increased by 29%. Because of the shift, DOs now make up more than a third of rural Iowa physicians, and that proportion is expected to grow.
In Madison County, the picturesque rural area where de Regnier practices, the University of Iowa database lists seven physicians practicing family medicine or pediatrics. All are DOs.
De Regnier, 65, speculated that the local dominance of the osteopathic profession is partly due to the proximity of his alma mater, Des Moines University, which runs an osteopathic training center 35 miles northeast of Winterset.
Des Moines University has one of the country's oldest osteopathic medical schools. It graduates about 210 DO students a year, compared with about 150 MD students who graduate annually from the University of Iowa, home to the state's only other medical school.
Many patients probably pay no attention to whether a physician is an MD or a DO, but some seek the osteopathic type, said de Regnier, who is a past president of the American College of Osteopathic Family Physicians. Patients might like the physical manipulation DOs can use to ease aches in their limbs or back. And they might sense the profession's focus on patients' overall health, he said.
'When he sits down on that stool, he's yours'
On a recent afternoon, de Regnier worked his way through a slate of patients, most of whom had seen him before.
One of them was Ben Turner, a 76-year-old pastor from the nearby town of Lorimor. Turner had come in for a check of his diabetes. He sat on the exam table with his shoes off and his eyes closed.
Tony Leys/KFF Health News
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Osteopathic physician Kevin de Regnier of Winterset, Iowa, checks the feet of Ben Turner, a local pastor who has diabetes.
Tony Leys/KFF Health News
Osteopathic physician Kevin de Regnier of Winterset, Iowa, checks the feet of Ben Turner, a local pastor who has diabetes.
Tony Leys/KFF Health News
De Regnier took out a flexible plastic probe and instructed Turner to say when he felt it touch his feet. Then the doctor began to gently place the probe on the patient's skin.
"Yup," Turner said as the probe glanced against each toe. "Yup," he said as de Regnier brushed the probe against his soles and moved to the other foot. "Yeah. Yeah. Yup. Yeah."
The doctor offered good news: Turner had no signs of nerve damage in his feet, which is a common complication of diabetes. A blood sample showed he had a good A1C level, a measure of the disease. He had no heaviness in his chest, shortness of breath, or wheezing. Medication appeared to be staving off problems.
Chris Bourne, 55, of Winterset, stopped in to consult de Regnier about his mental health. Bourne has been seeing de Regnier for about five years.
Bourne takes pills for anxiety. With input from the doctor, he had reduced the dose. The anxious feelings crept back in, and he had trouble sleeping, he told de Regnier, sounding disappointed.
De Regnier noted the dose he prescribed to Bourne is relatively low, but he had approved of the attempt to reduce it. "I'm glad you tried," he said. "Don't beat yourself up."
In an interview later, Bourne said that until he moved to Winterset five years ago, he'd never gone to an osteopathic physician — and didn't know what one was. He's come to appreciate the patience de Regnier shows in determining what might be causing a patient's problem.
"When he sits down on that stool, he's yours," Bourne said.
Another patient that day was Lloyd Proctor Jr., 54, who was suffering from previously undiagnosed diabetes. His legs were swollen, and he felt run-down. Tests showed his blood sugar was more than four times the normal level.
"The pancreas isn't happy right now, because it's working too hard trying to take care of that blood sugar," the doctor told him.
De Regnier diagnosed him with diabetes and prescribed medication and insulin, saying he would adjust the order if necessary to minimize Proctor's costs after insurance. He brought out a syringe and showed Proctor how to give himself insulin injections. Proctor listened to advice on how to measure blood sugar.
"And maybe I should quit grabbing Mountain Dew every time I'm thirsty," the patient said, ruefully.
De Regnier smiled. "I was just getting to that," he said.
The appointment was one of the doctor's longest of the day. At the end, he reassured Proctor that they could get his diabetes under control together.
"I know that's a lot of info. If you get home and think, 'What'd he say?' — don't hesitate to pick up the phone and give me a call," de Regnier said. "I'm happy to visit anytime."
KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism. | Medical Innovations |
A mother with a rare autoimmune disease had to call 999 from her hospital bed after staff “silenced the monitor” which was alerting staff that her heart was failing.
Ava Stanley “thought she was going to die” while staying in Medway Maritime Hospital’s emergency department and was placed under safeguarding measures by the ambulance service handler she’d been speaking to on the phone.
The 63-year-old, of Oak Drive in Higham, explained she’d been left “traumatised” by the whole experience.
She said: “I began experiencing chest pain on Monday, September 4.
“As I have mixed connective tissue disease, which means my immune system goes into overdrive and attacks my body’s own tissues, I am used to going to the hospital and knowing when something is wrong.
“Because of this I took medication I had at home to help my symptoms before calling Gravesham Community Hospital.
“I explained all my symptoms and they asked if I could get to a hospital in 15 minutes.”
Ava, who is medically retired, had her husband, 66-year-old Alec, take her to Medway hospital’s emergency department (ED) as she knew it’d be quicker than waiting for an ambulance.
Upon her arrival, she was triaged and had her observations and an ECG taken before being sent to the ED ward. Here she was given a second triage and told to wait for her results and to see a doctor.
When Ava finally saw a specialist she explained to them she still had chest pain and that to her it felt like the type of pain she had experienced before after her cardiologist last performed an angiogram, a type of X-ray used to examine blood vessels, followed by complex heart stent surgery in 2021.
She continued: “The doctor agreed to admit me to the hospital it was then when the problems first started.
“I was given no information and it wasn’t until I went to speak to the head nurse who told me the wait could be up to 40 hours as there were no beds available.”
She had now been at the hospital most the day.
Wanting to sleep, Ava, who also has severe sleep apnea which means her brain forgets to tell her to breath while she’s asleep, had to ask her daughter, Aimi, to bring her CPAP machine to the hospital.
However, as there were no available beds and nowhere for waiting patients to lay down, the 28-year-old had to make her mum a makeshift bed with a wheelchair.
At 3am the next day, Ava was finally given a bed, however, she was unable to sleep as there was no power socket for her to plug her CPAP machine into.
Ashford resident Aimi explained she had to beg to get her mum a sheet after being told by nurses there was a pillow and blanket shortage.
Some 14 hours later, Ava was taken to the Lister Assessment Ward with her husband.
Here she witnessed a very minimal clean of her bed-bay take place – this concerned her because of her autoimmune disease.
Ava, who spent most of her time on the ward having to walk to the nurse desk for assistance, said: “I felt I was on a DIY ward as I was left to fend for myself.
“There were buzzers sounding being left unanswered. I was left in pain and in limbo as no information was being given to me and I realised I would need to be pro-active.”
Aimi felt the same way about her mother’s care and was only given answers about how long her mum would have to wait before being taken to a specialist ward by going there herself.
The brand manager began a complaint process with PALS – the hospital’s patient advice and liaison service – who suggested it would be quicker to do an investigation through them instead of the hospital itself.
At 10pm, after having a hard time getting pain relief from the night nurse, Ava says she put on her CPAP machine, turned it on and tried to sleep.
She recalled: “My heart monitor started to alarm and flash and it showed my heart had gone into an erratic rhythm, going up and down rapidly then reading zero momentarily.
“After about 10 minutes of being unanswered, the monitor would re-set itself and start again.
“This happened four times across 40 minutes and when the ward nurse did eventually come to my bed she just silenced the monitor.”
However, former NHS medical secretary Ava felt something was wrong as she still had chest pain.
She continued: “I turned the machine on again and it alerted twice more and it still went unchecked.
“My heart monitor was sounding and flashing to alert asystole. I didn’t know what this was but I was fearful for my life as my heart had been stopping according to the monitor.”
Ava then Googled what the word meant and discovered it was likely her heart's electrical system had failed and it could cause it to stop pumping entirely.
She said: “Realising it was serious I dialled 999 for immediate help.
“I gave the call handler all my details and told her I was fearing for my life because of what the monitor had been alerting and thought I was going to die.
“The call handler asked if I needed a medic to attend and whether I wanted to be safeguarded, to which I replied I did as I was fearing for my life.”
After this conversation Ava told the night nurse she would hold her responsible should anything happen to her.
She added: “I phoned my husband and told him he needed to come to the hospital immediately and to sue should anything happen.
“It was only then the night nurse responded to me.”
After this incident, the night nurse attempted to take blood from Ava and an ECG before bleeping the on-call doctor.
After being seen by the doctor, she was immediately taken down to Bronte Cardiology Ward.
Ava was finally discharged from the hospital on Sunday, September 10 after undergoing another angiogram.
“The event has left me traumatised but I am fortunate to have survived...”
Medway hospital confirmed a meeting between Ava and chief executive Jayne Black is being set up to discuss her care.
Ms Black said: “We are very sorry if Ms Stanley feels the standard of care given during her visit was not to the high level that we would expect, and we apologise for any distress that may have been caused.
“Our senior nursing staff remain in close contact with her and we will be investigating any concerns that she raises, making sure to feed back the findings with her as soon as we can.”
Ava added: “The event has left me traumatised but I am fortunate to have survived to tell my story.
“This incident further highlights the sorry state of the NHS in Medway and I want to share my story in case something similar happens to someone who does not have their family’s support nor is in a fit enough condition to fight for their health.” | Disease Research |
A young woman has learnt you get what you pay for after she had a severe allergic reaction to lip filler injections that left her looking like a duck.
Emma, from Kentucky, USA, said she always wanted lip fillers and found a clinic that would do them for half the normal price.
However hours after getting the injections, her lips had become extremely swollen and she shared the comical images of her blown-up face in a viral TikTok video.
Emma said the experience was the 'worst of her life' and extremely painful as she is 'terrified' of needles.
'It was very traumatising but now that me, my boyfriend, my family, my friends look back at it, it's pretty hilarious,' Emma said in a second TikTok video.
'I wanted lip fillers for the longest (time) but I never got them done because I'm scared of needles, I'm terrified of needles, I don't want anything to do with them.'
Despite her boyfriend, family and friends telling her not to get the procedure done Emma she said was 'stubborn' and went for it anyway.
She found a clinic close to her that charged only $348 per injection while they are normally more than double the cost according to Emma.
'I should have known from the jump because I called three different places and all of them were like $700-$800,' she said.
'I didn't want to pay that so I called them and it was $400 plus a $60 deposit or something and so that's why I went there.'
When she arrived for the procedure, Emma was given numbing cream around her lips for 30 minutes which she said she had no reaction to.
'After they took the numbing cream off they started injecting me. I asked them for a half a syringe because it was my first item, I didn't want a full syringe but they ended up giving me a full syringe,' Emma said.
She explained the injection contained something called Restylane, a strain of Lidocaine which is a common anaesthetic agent and what her lips eventually reacted to.
'They got it done it was the worse pain of my whole entire life - I never want to get it again just for that reason and the swelling,' Emma said.
'After I got it, it was perfectly fine, I loved them, then a couple of hours later it started swelling.'
Emma said her lips 'felt like they were going to explode' and she couldn't even talk because they were so big.
She was then awoken from a nap by her 'panicking' boyfriend who urged Emma to go to the hospital but she didn't want to for fear of having to get more needles.
'I called the place, they said it was normal and not to worry about it,' Emma recalled.
'I called the hospital, I didn't go because I'm hard headed, I didn't want to go and get poked with more needles.'
She was told by hospital staff to take Benadryl, a common antihistamine and sedative, and the swelling went down after a couple of days.
'Make sure if you go to get them that you're not allergic to anything like Lidocaine or anything or the same thing's going to happen to you,' Emma finally warned.
Emma's clips have been viewed more than 5.4million times and had thousands in the comments shocked while others thought the ordeal was hilarious.
'Here's everyone's sign to just embrace your natural beauty,' one woman laughed.
'I could not stop laughing at the side profile,' another wrote.
'The fact that they spelled Restylane wrong is an immediate red flag. So sorry this happened to you,' a third pointed out.
'Ok this is my sign not to get it. As everyone's telling me no to and I was gonna book to get them done anyway,' said a fourth. | Medical Innovations |
The Home Office has told an asylum seeker with tuberculosis they are going to be moved onto the Bibby Stockholm barge, i can reveal.
The doctor treating the migrant is trying to prevent the move and has warned of a “public health catastrophe in the making”.
Dr Dominik Metz, a GP for more than 250 asylum seekers in Oxfordshire, told i that 10 of his patients have received letters from the Home Office saying they would be moved to the barge.
Some of the patients are awaiting surgery and mental health support which he fears will be disrupted by the move and one is under “active treatment” for latent tuberculosis (TB) which could pose a public health risk if it became active and spread.
Doctors are also concerned about potential outbreaks of other diseases such as scabies and diphtheria, both of which have been detected in other asylum seeker accommodation, as these spread faster in crowded areas.
The 222-room Bibby Stockholm has attracted criticism for giving asylum seekers little space when it is full to capacity with 500 people.
The GP has contacted Home Office officials explaining that in his view the move to the barge would be medically inappropriate.
“I feel they are being treated like livestock, only slightly worse, as livestock are prohibited from being transported with active infection,” he said.
The first 15 asylum seekers were moved onto the Bibby Stockholm on Monday, while a further 20 had their transfers blocked after solicitors threatened legal action. The barge is eventually due to hold 500 asylum seekers.
A consultant at Oxford University Hospital, who has also worked with Dr Metz’s patients and asked to remain anonymous, echoed their colleague’s warning that the barge move “could put others at risk.”
Dr Metz said the Home Office are not able to access medical records so are not aware of the asylum seekers’ medical conditions prior to transferring them to the barge but believes they should be consulting with their GPs.
The GP claimed that the Home Office “don’t have any idea without consulting GPs what the potential health impacts are of this”. He said he was not consulted by the Home Office on the health of any of his patients before they received the letter notifying them of the barge move.
All migrants undergo initial health screenings at Western Jet Foil at Manston in Kent, where they are initially taken after arriving in the UK, before further checks at their onward accommodation.
The Home Office would not say whether it would proceed with moving someone on to the barge if a infection is detected but it has placed asylum seekers who have tested positive for disease in isolation at other sites.
i understands that no one currently on board the barge has presented with infectious diseases, but that there is an isolation facility adjacent to the on-site medical centre in case of infection.
How infectious diseases in migrant sites are a constant risk
A draft “outbreak management plan” for the Bibby Stockholm barge warned that “large numbers” of staff and residents could be affected if a disease spreads.
“Accommodation providers should be aware that in the event of a significant outbreak, large numbers of staff as well as residents may be impacted. Contingency plans for surge staffing to maintain minimum numbers should be in place,” the document, released under Freedom of Information laws to NHS Dorset and shared with The Guardian, said.
In late July, TB was detected at a former RAF base now housing asylum seekers. While the Home Office did not confirm the number of asylum seekers testing positive for the illness, it said that those affected were being isolated at MDP Wethersfield near Braintree in Essex.
Last year, a man died of suspected diphtheria after a stay at Manston asylum processing centre. The Home Office said that initial test results for an infectious disease were negative, but a follow-up PCR test was positive “indicating that diphtheria may be the cause of the illness”.
In November 2022, the Home Office began vaccinating asylum seekers against diphtheria after dozens of cases were discovered within processing centres across England.
TB is a bacterial infection which is spread when someone inhales tiny droplets from the coughs or sneezes of an infected person. It normally affects the lungs, but can affect other parts of the body, and can be fatal without treatment.
Latent TB isn’t transmissible when it is being treated but it can become active if it is left unmanaged or treatment is disrupted. Doctors fear that any disruption in medical care caused by moving asylum seekers across the country raises the risk of latent TB cases becoming active or patients developing drug resistance.
Dr Metz said that moving patients around can hinder treatment by requiring them to re-enroll with GPs and undergo fresh health assessments in a new location.
He said that explaining medical problems to new healthcare professionals when there are language barriers can be an issue and that some asylum seekers can end up dropping back down waiting lists for specialist care.
“Constantly relocating asylum seekers from one big hotel to another, especially in this way, is a public health catastrophe in the making. I have had to provide mass treatment for scabies in two local hotels due to outbreaks. They are under control now, but it will happen again if they are being moved,” he told i.
“There is also a huge resource burden: there has also been Diphtheria scares [in local hotels] that needed screening.”
“It’s extremely disruptive for patients but also extremely wasteful in terms of NHS resources,” he added. “If they’ve been through a process already and been seen by specialists, that’s going to get disrupted. There’s also potential public health implications if treatment for TB is stopped part way through.”
The consultant at Oxford University Hospital who has also worked with Dr Metz’s patients said: “People with complex infectious diseases are compromised if their care is moved from unit to unit, and that’s particularly the case when you are dealing with a vulnerable population.
“Infectious diseases are just that: they’re infectious, so they have public health implications. That means that others are put at risk when infections are not managed appropriately. The third point is that this public health impact can be compounded if a patient develops drug resistance, and the likelihood of that is much greater where you have poor continuity of care.”
They added: “Just simple things like getting patients from the hotel to the hospital, you would think that would be very simple. Well, the logistics are extremely difficult. So if that’s difficult, you can imagine what it’s like when people are moved around the country. The issue of providing care for infectious diseases are just so fundamental for everyone’s health.”
A Home Office spokesperson said: “The welfare of asylum seekers being housed on the vessel in Portland is of the utmost priority.
“The Bibby Stockholm has an on-site medical facility to help mitigate the impact on local NHS services and we continue to work closely with health professionals and the UK Health Security Agency (UKHSA) to ensure all appropriate health protocols are followed.”
Asylum seekers have access to a GP and nurse on site so do not have register with local practices, with a medical facility on the barge staffed five days a week. Health records will be available to onboard providers in line with data sharing policies. | Epidemics & Outbreaks |
Nurse Lucy Letby said it was a "huge unexpected shock" when a baby boy died shortly after she started her shift on a neonatal unit.
The newborn twin, known as Child A, died just over 24 hours after his birth at the Countess of Chester Hospital.
Giving evidence for the second day, Ms Letby, 33, said she felt like she had "walked through the door into this awful situation" on 8 June 2015.
Ms Letby denies murdering seven babies and attempting to kill 10 others.
The prosecution allege the nurse, originally of Hereford, was a "constant malevolent presence" at the hospital, killing five boys and two girls, and attempting to murder another five boys and five girls.
During the first six months of her trial, the prosecution have claimed that between 2015 and 2016, Ms Letby used various means to target the babies, including injecting them with air and poisoning them with insulin.
Under questioning from her defence lawyer Ben Myers KC, Ms Letby said she had received a text message in the morning asking if she could work.
She told the jury she agreed to work the shift, adding requests like this happened "frequently" and she was "very flexible" and "very happy to help where I could".
The accused was given Child A to care for when she arrived on shift at 19:30 BST.
The court heard Ms Letby and fellow nurse Melanie Taylor went on to give Child A intravenous fluids.
Once the infusion had started, she had a nursing handover with Ms Taylor.
After the handover had been completed, Ms Letby said Ms Taylor went to the computer station to start writing her notes while she started doing equipment checks.
The nurse said she recalled another doctor was also in the room at this time.
She said she noticed Child A had become "jittery" when she started doing her observations.
She told the jury shortly after his alarm monitor had sounded and he had changed colour and was apnoeic.
The defendant said she noticed Child A's "hands and feet were white" so she started to use a neopuff - a mechanical device specially designed for neonatal resuscitation.
Ms Letby said "very soon after" an emergency crash call went out to the neonatal team and doctors arrived on the unit to assist with the resuscitation.
When asked how she was feeling at this time, Ms Letby said: "It was a huge unexpected shock, it felt like I literally just walked through the door of the shift and this was happening."
Following Child A's death, the nurse assisted his parents and made a memory box.
She labelled the baby boy's UVC (umbilical venous catheter) line and bag and stored them in the neonatal unit's sluice room after the infant's death as she felt it should be checked.
When asked again how she felt after the events, she said: "Stunned, it was a complete shock for all of us.
"It felt like we'd walked through the door into this awful situation.
"It was the first time I met [Child A] and his parents⦠it was a huge shock."
The accused was also asked about Child B, who collapsed 28 hours after her brother's death.
The court has heard how Ms Letby, along with other medics, went to help after the baby girl's heart rate suddenly dropped.
A nurse, who treated Child B, previously told the court she "looked very like her brother did the night before".
Ms Letby told Mr Myers she does not "have much recollection" of what happened with Child B as she was designated other babies on that shift.
But she said she recalled running a blood gas for Child B at about 00:15 on 10 June.
The defendant said Child B would not have been on her own when this was done and another nurse, who cannot be named, would have asked her to assist as blood samples require two nurses.
At the time of the collapse, she said Child B's skin looked "mottled" and "dark" and "purple" in colour.
She said this was different to Child A, who was "pale and white".
Ms Letby said she went to get a camera, kept on the unit, to take a picture of Child B's skin change - which is standard practice with any sudden changes.
She said by the time she returned Child B "had stabilised and her colour had returned to normal".
The trial continues. | Epidemics & Outbreaks |
A dose of pomegranate in your dog’s water bowl might just help keep their teeth and gums healthy, new research suggests. The randomized, controlled study found that dogs given an over-the-counter water additive made with pomegranate extract experienced less plaque and tartar on their teeth over a month’s time. The product could be used in combination with regular teeth brushing and dental cleanings to prevent gingivitis in dogs, the scientists say.
There’s no shortage of products on the market that claim to improve or maintain dental health in dogs, including water additives. These products often contain ingredients like pomegranate that have been found in lab experiments to limit the growth of plaque-causing bacteria or to help maintain a good mix of bacteria in the mouth. But according to the authors of this new study, very few of these products have ever been tested in controlled trials, the kind of research used to show that potential drugs and vaccines can work in humans.
The study involved 40 dogs with mild to moderate gingivitis, all of whom had recently gotten a professional teeth cleaning. Half of the dogs were randomized to receive the product—called Vet Aquadent FR3SH—every day for a month, while the rest received none. The dogs were given the same diet, and owners were told to not brush their dogs’ teeth or to use any other dental products. After 30 days, the dogs were examined by veterinarians, who didn’t know which dogs received the product.
Overall, the Aquadent-dosed dogs had significantly less plaque and tartar buildup on average than the control group. They also experienced a substantial reduction in potential gingivitis, with none of the dogs showing any gum bleeding (a common sign of inflammation) by the study’s end. The team’s findings were published this month in the journal Frontiers in Veterinary Science.
Aquadent is produced by France-based Virbac, one of the largest veterinary pharmaceutical companies in the world. And it should be noted that this study was funded by the company (industry-funded research tends to provide rosier results than independent research). But the authors say that it’s the first time clear evidence has shown that this product really can improve dental health in dogs.
According to study author Céline Nicolas, a veterinary scientist with Virbac, Aquadent shouldn’t be seen as a treatment for gum disease. Rather, it should be one of several ways used in combination that owners try to keep their dogs’ teeth in good shape.
“Since periodontal disease starts with the accumulation of plaque on teeth under the gum, controlling its accumulation on teeth is a way to help prevent this disease. On top of regular check-ups with a veterinarian, providing oral dental care at home should be part of the daily routine,” Nicolas told Gizmodo in an email. “Daily oral hygiene can include tooth brushing (considered the best but not so easily performed), dental chews, or water additives with proven efficacy.”
It’s possible that similar products could also work with cats, though Nicolas says that this remains to be proven. And while the team has their theories, it’s still not completely clear how pomegranate and other ingredients could keep bad mouth bacteria away. More research should be done to investigate these important questions, she says.
The group is now planning to study whether Aquadent and other dental regimens can help reduce plaque and tartar and improve gum health in dogs whose teeth haven’t been cleaned of plaque beforehand. | Disease Research |
The health secretary has admitted the government will not build 40 new hospitals by 2030, as long promised, but said the projects involved “a range of things” including new wings and refurbishments.
Steve Barclay, who nonetheless insisted this did not break the Conservatives’ manifesto promise for 40 new hospitals, also argued that the public were not concerned about the distinction as long as the facilities they used were new.
The debate over the accuracy of the government’s hospital-building pledge was resurrected this week when Barclay told MPs that eight of the 40 “new hospitals” would be delayed into the next decade.
The change to the programme involved some of the 40 originally listed being replaced by schemes to refurbish or replace hospitals built with a type of concrete that is well past its expected 30-year lifespan, with roofs and ceilings at risk of falling down.
Despite the changes, the wider pledge remained, Barclay initially told BBC One’s Sunday with Laura Kuenssberg programme.
“We’re committed to 40 new hospitals by 2030. That is the biggest capital investment the NHS will have seen, and we set out the details of that in the house on Thursday,” he said.
Kuenssberg pressed the health secretary on whether he was being “completely straight with viewers”, given some projects are for refurbishments, while others involve only new wings. “If you save up and you get a new conservatory on the back of your house, you don’t have a new house,” she said.
Barclay replied: “Some of the schemes include, for example, a hospital being gutted and fully refurbished. If you look at Charing Cross [hospital in London], for example, that’s exactly what we will be doing. We’ll be starting work to decant some of the facilities and then refurbish. So there’s a range of things within the scheme.”
Asked to explicitly say it was not 40 new hospitals, Barclay said this was “a debate that was had in 2020”, and that patients would not mind either way.
“Well, if it’s a new wing, a new facility, a women’s and children’s hospital, for example, as part of a wider campus … what matters to you as a patient is whether the facilities are state of the art, whether they’re new,” he said.
The change to the plan announced on Thursday added five hospitals with crumbling concrete and three mental health facilities to the list, in effect replacing eight that have been pushed back beyond the 2030 deadline.
Among those now with longer deadlines for work are St Mary’s hospital in Paddington, west London, parts of which date back to 1845. Over the last year, ceilings have collapsed in two wards, sewage has leaked into the pharmacy and parts of the Cambridge wing – the oldest part of the hospital – have had to be mothballed because the floor was no longer strong enough to support the clinical services there. | Health Policy |
As Rishi Sunak, Sir Keir Starmer, Steve Barclay and NHS England chair Amanda Pritchard offered fawning tributes to the NHS at Westminster Abbey earlier this week, I couldn’t help but wonder if their time might have been better spent drawing up emergency plans to fix our ailing health service.
Working on the front line in general practice, it does not feel as if there is much to be celebrating. From the difficulties that patients face in getting GP appointments, to the time that many have to wait for hospital outpatient services, the appalling situations unfolding daily in emergency departments and the agonising waits that have become associated with calling for an ambulance, all is clearly not well. The NHS is dying.
From my perspective as a GP, it feels as if every part of the health service that I come into contact with is now becoming so dysfunctional that even the most basic of standards may not be met. Take one patient I saw this week, who had undergone a routine operation at the start of the year. Unfortunately, they had developed a post-operative infection, and needed further surgery. They had been promised a surgical follow-up appointment after four weeks. Fast-forward four months and they haven’t heard a peep from the hospital. The patient has called the consultant’s secretary multiple times, only to be repeatedly fobbed off. They are struggling with incapacitating pain, finds themselves unable to exercise, have gained two stone in weight, and unsurprisingly feel deeply despondent.
Tellingly, my initial reaction was that this is a fairly normal delay. At work, I find I have become increasingly inured to patient suffering and our health system’s dysfunction. When I talk to GP colleagues about long waits for outpatient appointments, we shrug our shoulders: “There’s no point in referring, there’s a two year wait to be seen…”. Periodically, I am called by patients who describe the crushing central chest pain which typifies a heart attack. Yet nowadays when I advise they should call an ambulance or be transported to A&E immediately, they increasingly resist my advice.
Many would rather take their chances with a heart attack than expose themselves to the chaos and indignity of an overcrowded emergency department. It does not surprise me that deaths at home are increasing, including those with cardiovascular disease. This is precisely what you would expect if a population felt unable to rely on safe and timely care in hospital, and if they were unable to easily access a GP for advice or preventative treatment.
Throughout my medical career, I have observed that working under pressurised conditions, it is common for clinicians to display a tendency towards “learned helplessness”. This is a maladaptive psychological phenomenon where a person has experienced a stressful situation repeatedly, and comes to believe they are unable to control or change the situation, until eventually they will not try even when opportunities for change become available. I believe it explains why failing systems – such as the Mid-Staffs hospital scandal or the Shrewsbury and Telford maternity scandal – have been able to persist unchallenged for years, even though thousands of people were involved who must have had concerns about the care being provided. Could this apply to the whole of the NHS? Have the inadequacies within our system been normalised for so long that staff, patients and the government feel powerless to improve matters?
Our incumbent government insists on clinging doggedly to the founding principles of the NHS despite mounting evidence of the system’s decline and dysfunction, with broader societal impacts and costs (such as workforce absences). During the pandemic, repeated lockdowns were justified as being necessary to “Protect the NHS”, even after vaccines were being widely administered and we knew younger people were not at significant risk. Our health service continues to provide an array of non-essential treatments and services; while elderly patients die unattended in hospital corridors, and the public cannot rely on the arrival of an emergency ambulance. If, despite record investment, the NHS cannot consistently deliver basic medical care in a safe and accessible manner: change is needed. Regardless of the founding principles outlined in 1948 – the status quo is unacceptable.
Dr Katie Musgrave is a general practitioner | Health Policy |
- Drugmakers spent nearly $500 million on advertisements for obesity and diabetes treatments in the U.S. during the first seven months of this year, according to new data.
- That's up 20% from the same period a year ago, said advertising analytics firm MediaRadar.
- The increase demonstrates the rush by companies to capture new customers after months of hype around Novo Nordisk's diabetes drug Ozempic and weight loss counterpart Wegovy.
Drugmakers spent nearly $500 million on advertisements for obesity and diabetes treatments in the U.S. during the first seven months of this year, up 20% from the same period a year ago, according to new data released Friday.
The data, from advertising analytics firm MediaRadar, demonstrates the rush by companies to capture new customers after months of hype around Novo Nordisk's diabetes drug Ozempic and weight loss counterpart Wegovy.
Those drugs and similar treatments have soared in demand this year for their ability to help patients lose unwanted pounds. The medicines, known as GLP-1s, mimic a hormone produced in the gut to suppress a person's appetite. U.S. health care providers wrote more than 9 million prescriptions for Ozempic, Wegovy and other obesity and diabetes drugs during the last three months of 2022, up 300% from early 2020.
MediaRadar compiled ad spending from national TV broadcasts, print publications, newspapers and websites and social media platforms from Jan. 1, 2022 to July 31, 2023.
The top four drugs advertised were Ozempic, Wegovy, Novo Nordisk's diabetes pill Rybelsus and Boehringer Ingelheim's own diabetes treatment Jardiance, which is set to face drug price negotiations with the federal Medicare program.
Together, those treatments accounted for $358 million, or about three-quarters, of total ad spending for obesity and diabetes drugs during the first seven months of this year, according to the data.
Spending on Ozempic ads was $120 million during that time period, up 23% from the same period last year.
MediaRadar said in a statement that Ozempic's rise in popularity has had a "positive impact on similar medications."
"It's a classic case of 'a rising tide lifts all boats,'" MediaRadar CEO Todd Krizelman said in the statement. "As Ozempic's popularity grows, so does the demand for other weight loss and diabetes drugs, especially Wegovy, which has made a significant mark this year, particularly from Q2 onwards."
Wegovy accounted for more than $20 million in ad spending during the first seven months of the year, primarily due to a spike in spending from April to July, according to MediaRadar.
But MediaRadar noted that Novo Nordisk in May paused some key promotional advertising for Wegovy, specifically local and national TV advertising.
MediaRadar said most of the spending on the drug was for digital advertising, such as online video. | Drug Discoveries |
The government has been criticised for its “completely inappropriate” endorsement of an e-cigarette manufacturer blamed for fuelling an “epidemic” of underage vaping in the US.
Juul Labs was promoted in an official briefing circulated by the Department of Health and Social Care about the prime minister’s plan to close a loophole allowing free samples to be given to children.
The press release – which included quotes from Rishi Sunak, England’s chief medical officer Chris Whitty and health minister Neil O’Brien – portrayed the company as a leader in combating youth vaping, saying it “takes steps to ensure its products do not appeal to and are not used by anyone who is under age, and encourages others in the sector to do the same”.
It also included a quote from Joe Murillo, a former tobacco executive and chief regulatory officer at Juul Labs, in which he praised the UK government’s policy and called for more to be done “to combat underage use of these products”. The briefing – which was sent to journalists before the policy was announced publicly – appears to have directly resulted in positive media coverage for Juul, with Murillo’s quote republished by four national newspapers.
But it failed to mention that the company has been blamed more than any other for fuelling an “epidemic” of youth vaping in the US, and in recent months has agreed to pay out more than $1bn to settle claims it unlawfully promoted its products to children.
In the latest settlement, in April, Juul agreed to pay $462m to resolve lawsuits brought by six US states after being accused of targeting teenagers through launch parties, product giveaways and use of young models in social media ad campaigns. The firm has not admitted wrongdoing and said the deals were part of its commitment to resolving issues from its past.
Health experts and campaigners said the UK government’s promotion of Juul as a champion of tackling youth vaping was “naive” and “inappropriate” and raised questions about potential influence behind the scenes. Deborah Arnott, chief executive of Action on Smoking and Health, said her ‘“jaw dropped” when she saw the “completely inappropriate” endorsement, which she said “gave the impression” that the company had been given “a seat at the table in determining how vapes should be regulated”. “The government needs to make clear that its policy on youth vaping is going to be determined by the evidence, not the interests of the industry,” she said.
Professor Gurch Randhawa, director of the Institute for Health Research at the University of Bedfordshire, said it was “cause for concern that any company that’s been accused of fuelling youth vaping through its colourful packaging and flavour variety would be included in government policy announcements”.
“Although vaping companies state they do not market to children, their products are fuelling the current vaping epidemic among young people in the UK,” he said.
The Department of Health and Social Care said it had “outlined bold action to crack down on youth vaping”, including setting up an enforcement team to catch companies selling products to under-18s. “To support our ambition to be smoke-free by 2030, we are working closely with all stakeholders,” a spokesperson said. It did not say how Juul came to be included in the press release, or why it had taken a decision to delete a reference to the company from a blog post published on its website.
Labour’s shadow health secretary, Wes Streeting, accused the Conservatives of “celebrating a company which has been plugging vapes to children”. “This seriously calls into question Rishi Sunak’s sincerity when it comes to meaningful action against harmful vaping. Meanwhile a new generation of kids is getting hooked on nicotine,” he said.
Juul Labs, which has an office in London and is headquartered in Washington DC, said it was “committed to supporting the government’s efforts to provide alternative products to adult smokers while combating underage use of e-cigarettes”.
It added that it had “implemented a company-wide reset” to address underage vaping since new leadership took over in 2019 and that underage use of Juul products in the US had declined by 95%. A company spokesperson said: “We do not want any non-nicotine users, especially those who are under age, to try Juul products, which exist only to transition adult smokers away from cigarettes. We continue to take steps to ensure our products do not appeal to and are not used by anyone who is underage, and support policy and regulatory measures designed to prevent underage use.”
Research suggests the use of e-cigarettes among young people is relatively low but increasing. NHS figures for 2021 showed that 9% of 11- to 15-year-old children used e-cigarettes, up from 6% in 2018.
Charities are calling for tighter restrictions on marketing e-cigarettes and on the use of the packaging and flavours they say make the products appealing to children. to remove references to the company. | Epidemics & Outbreaks |
Sleep is a critical part of a child’s overall health, but it can also be an important factor in the way they behave.
“Stressful environments are shown to make adolescents seek immediate rewards rather than delayed rewards, but there are also adolescents who are in stressful environments who are not impulsive,” said lead author Linhao Zhang, a fourth-year doctoral student in UGA’s College of Family and Consumer Sciences. “We looked at what explains that link and what makes some people differ from others. One mechanism we found is sleep.”
Researchers analyzed data from the Adolescent Brain Cognitive Development Study, a multi-year brain development study funded by the National Institutes of Health. Using information from 11,858 children from 9-10 years old, they found that lack of sleep and long sleep latency—the amount of time it takes to get to sleep—had a significant link to impulsive behaviors down the line.
Sleep problems, such as sleep latency (the time it takes an individual to fall asleep) and impulsive behaviors, were checked at multiple time points over the course of two years. When children got less than the recommended nine hours of sleep or took more than 30 minutes to get to sleep, there was a strong link to impulsive behaviors later down the line. Some of these behaviors included acting without a plan, seeking thrills or sensations, and lacking perseverance.
Sleep was a mediator between these actions, however, and when sleep problems were absent during the study, impulsivity was also less likely to be observed in the future.
Neurological hyperconnectivity, wherein the adolescents’ brains remained very active even when they were not actively engaged in tasks, also played a role, Zhang said. This study looked at the default mode network, a brain network related to goal-directed behaviors. When this network was hyperactive during resting-state, it could exacerbate the link between stressful environments, sleep and impulsivity. This connection could be linked to ADHD, which Zhang would like to explore in future studies.
“We can look at the default mode network and emotional regulation regions,” Zhang said. “It’s also possible that this hyperactivity and ADHD are highly correlated, so in a future study, we could test that in a more clinical setting. That could have great implications on intervention or counseling programs.”
These findings not only highlight sleep’s role in cognitive and behavioral development, but could also inform low-cost interventions to aid in the psychological development of children facing at-home stressors, Zhang said.
“If you want to develop interventions for people in stressful environments, it’s very costly, and sometimes it needs generational work to change,” Zhang said. “Sleep is a modifiable behavior, however, and these changes can be cost-efficient.”
Zhang said that too little sleep can be an issue even outside stressful environments. For example, teenagers often have a circadian rhythm that is geared toward staying up later and sleeping in, but early school start times and late nights completing homework can throw off that rhythm.
“A lot of adolescents don’t have enough time to sleep, and they are sleep deprived,” Zhang said. “This study shows why it is important to promote longer sleep duration by delaying school start times or establishing routines so that adolescents know, ‘OK, after this event, I’m going to bed.’”
Establishing these routines, no matter the environment, can create healthier patterns and reduce the time it takes to get to sleep. It’s also vital to act early when developing sleep habits, Zhang said.
“For people who may be in disadvantaged environments, if we can provide some strategies that help sleep, it can have a positive impact, especially for adolescents that are at such a critical developmental stage for their brain development.” | Mental Health Treatments |
Media releaseFrom: Edith Cowan University
There is a growing momentum for the creation of community-based safe spaces for people experiencing emotional distress or suicidal crises, as an alternative to visiting hospitals and emergency departments.
The Mental Health Commission’s ‘Suicide Prevention 2020’ report outlined the urgent need for proactive community-based mental health services, while the National Mental Health and Suicide Prevention Plan cites ‘prevention and early intervention’ as the first of its five pillars.
To ensure they are implemented appropriately, Edith Cowan University (ECU) research is aiming to assist with the design of safe spaces.
A recent study asked people who had visited hospital emergency in emotional distress or suicidal crisis, what features community safe spaces should and shouldn’t have to make them welcoming and effective for those wishing to use them.
In Australia, some safe spaces have been established, however many are housed within or near hospitals.
In Western Australia, these include a safe space within the Royal Perth Hospital Precinct.
ECU study lead Dr Lesley Andrew said hospitals came with many barriers when it comes to responding to people with mental health difficulties.
“A lot of the people we spoke to have been in emergency departments when they’ve been in crisis and it can be traumatic,” she said.
“The hospital environment with nurses, uniforms, sterile places, smells, are places for people who have had a car crash or physically unwell; they're not for people who need to feel a sense of belonging and that they're welcome and safe.
“It's the exact opposite. Staff do their best but it’s the wrong environment to meet the needs of these people.
Providing compassionate support
Positively, a community safe space has recently been opened in Busselton as a drop in style space for people experiencing emotional distress or suicidal thoughts, with another centre planned for Bunbury.
Dr Andrew said the main aim of safe spaces was to provide somewhere for people to go when they are feeling distressed, need somewhere to feel safe, or are in crisis already and do not wish to engage with emergency services, the hospital system or other supports that previously caused distress.
She said people could visit whenever they needed support, be it talking with peers, mental health professionals – or not to speak at all but have a friendly place to decompress.
Some models, often called Safe Havens, offer a combination of clinical staff and peer workers, while the community-led Roses in the Ocean safe spaces offer a purely non-clinical, suicide prevention peer-led option.
“Hopefully before they get to crisis point, they can just drop in and feel safe and have a chat or get whatever support it is they need in that moment,” Dr Andrew said.
“It could just be feeling panic, feeling low, anxious – anything affecting their day-to-day living, ability to function and their wellbeing.”
Dr Andrew said evidence from overseas safe spaces showed they often reduced pressures on the healthcare and policing systems.
“In the UK, they were putting a lot of healthcare resources and police resources towards performing mental health and wellbeing checks in the community, and these safe spaces have reduced the need for that.”
What ‘safe’ looks like
Researchers interviewed people who had been to hospital emergency departments for mental health reasons to find out what they felt would make them feel safe, ranging from features, sounds, smells and their ideas for the running and management of the space.
“It really just takes it away from a medical model and more to social model,” Dr Andrew said.
SAFE SPACE DOs
- Sofas and beanbags. ‘Non-uniform’ furniture
- Warm colours
- Functional spaces
- Board games, videos, colouring
- Plants and tables
- Signs that welcome in a number of languages
- Pet therapy/fish tanks
- Calm and tranquil, low stimulus atmosphere
- Guest arts and crafts displayed, cushions etc.
- Hot beverages
- Food
- Creche
- Hotline to Emergency Department
- Alcohol and Other Drugs protocols
- Smoking area
- Open unsocial hours
- Peers as staff: People with lived experience of suicide as part of recruitment panel
- Professionals, multidisciplinary clinicians
- Connection pathways to a wide range of other support services in a community who can assist to address underlying contributing factors to a person’s distress
- Appropriate suicide prevention training/upskilling for all staff
- Staff representative of the community in which it is located
SAFE SPACE DON’Ts
- Clinical ‘uniform’ furniture
- Clinical posters
- White walls
- Too bright or too neutral
- Physical barriers between staff and clients such as reception
- Staff uniforms
- ‘Clinical’ labelling of spaces
- Tinted windows
- Signs that mention mental health
- Clinical smells
- Triggering discussions such as past crises, medication, diagnosis
- Bureaucracy-form filling. Recording of past visits (except demographics)
‘What makes a safe space? Consumers’ perspectives on a mental health safe space’ was published in International Journal of Mental Health Nursing. | Mental Health Treatments |
Levi Dewey became one of the sickest patients in the country, his parents were told, as they were warned he might not survive when he caught pneumonia that developed into sepsisLevi had to undergo life-changing surgery just days before his 21st birthdayA young man was forced to have both of his legs amputated just days before he celebrated his 21st birthday. Levi Dewey became one of the sickest patients in the country, his parents were told, when he was struck down with a form of flu and pneumonia that later developed in sepsis. The 20-year-old had previously led an active lifestyle, loving playing football, before he fell sick. On December 7, he was desperately rushed to hospital after being struck down with illness. The JCB welder was given a 30 per cent chance of surviving before his condition deteriorated and he went into sceptic shock and suffered multiple organ failure. Doctors discovered that he was suffering from influenza B and pneumococcal pneumonia. The young man was given just a thirty per cent chance of survival at one point (
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Lara Dewey / BPM Media) Prior to falling sick, Levi had lived an active lifestyle including playing football (
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Lara Dewey / BPM Media) The sepsis he had contracted was so severe that the young man had to have both legs amputated below the knees yesterday. Levi’s mum, Lara Dewey, 47, said: “We were told fairly early on that Levi could potentially lose his legs and need an operation, we were prepared for this outcome if it was to save his life. “Obviously it’s going to be life-changing for everyone, but this is something we can work through as a family and we have such a strong and positive support network. Levi has always had a positive mindset and his glass is always half full.” After taking a turn for the worse in Derby’s intensive therapy unit, Levi was transferred from Royal Derby to Glenfield Hospital in Leicester to receive ECMO (extracorporeal membrane oxygenation) and full organ support. He spent 20 days on ECMA - 14 of which were in an induced coma. Levi was gradually taken off organ support and, after 31 days, he was taken off a ventilator. Levi was moved back to Royal Derby for ongoing care on January 9. However his family were dealt another blow two days later and they were informed that due to the severity of his sepsis he had contracted, he would need below-knee amputation on both of his legs. Now, his family is fundraising to help the young man walk again - and have already raised more than £70,000. Child practitioner Lara told StokeonTrentLive: “Initially we were looking to raise £10,000 but as you can see this has been exceeded and the response has been extremely overwhelming. It’s overwhelming and emotional and we are all speechless. It’s amazing how supportive friends, family, colleagues, communities and also strangers have been towards this cause and also their generosity. “Initially the money will be used to buy Levi a wheelchair and for home improvements, including ramps and showering facilities. Once he’s able to walk again we will look at buying him the best prosthetic limbs possible privately and any further equipment he will need.” Anyone wanting to donate to the appeal can do so by visiting Levi’s GoFundMe page here. Read More Read More Read More Read More Read More | Epidemics & Outbreaks |
Daylight saving time changes can wreck people’s sleep schedules, but they don’t have to, according to the Farmers’ Almanac.
South Carolina and the rest of the U.S. has once again nearly reached the end of another daylight saving time.
The annual tradition this year is set to end at 2 a.m. on Sunday, requiring all Americans to set their clocks back one hour. Daylight saving time has been ongoing since March 12 this year.
The practice of moving clocks ahead or back one hour each year has deprived many Americans of sleep for decades — so much that some state and federal lawmakers have tried to stop it. So far, their efforts have not been exactly fruitful.
So while the time change is happening again this year no matter what, there are things residents can do to mitigate the damage to their sleep cycles.
Here are five tips the Almanac suggests people try to stave off daylight saving fatigue.
Good bedtime habits
In the days after the time change, stop drinking caffeinated beverages 4 to 6 hours before bedtime. Avoid alcohol in the evening. Also, if you exercise, avoid workouts within 4 hours bedtime. Working out raises your body temperature temporarily, which can make it harder to fall asleep.
Get consistent sleep
Get at least 7 hours of sleep on the days before and after the time change. The closer you stick to your normal routine, the faster your body will adjust.
If you really have trouble with the time changes, consider gradually adjusting your sleep and wake times a few days in advance by shifting bedtime 15 to 20 minutes each night. This could help your body slowly adjust.
Keep dinnertime consistent and eat more protein
On the days around the time change, eat at the same time or even a little early. Try to shift your mealtime forward 15 minutes for a few days in a row to help ease the transition.
Also, try not to overeat and if you do feel like having a snack, choose one high in protein instead of carbohydrates.
Take a short nap
If you’re starting to stack up sleepless hours, it could be beneficial to take a short nap during the day instead of continuing without any sleep. Try not to take naps longer than 20 minutes though.
Get more sunlight
Go outside and expose yourself to morning sunlight on Sunday to help regulate your internal clock. Having shorter daylight hours can impact our mood and energy levels, decreasing serotonin.
Try to take some time out of your morning or early afternoon for a walk outside while the sun is out. | Stress and Wellness |
Technology entrepreneur Nick Hungerford, whose daughter inspired him to set up a charity to support bereaved children, has died at the age of 43.
Mr Hungerford, who had terminal bone cancer, set up Elizabeth's Smile, which is named after his two-year-old daughter.
The charity said on its website that it was "deeply saddened" to share the news of its founder's death.
"Nick's smile will inspire, always," the charity said.
Mr Hungerford co-founded the investment platform Nutmeg in 2011. The idea was famously rejected 45 times in a row by funders, but the business was bought by JP Morgan in 2021 for a reported £700m.
He was first diagnosed with Ewing sarcoma, a rare form of bone cancer in 2019 when he felt a pain in his right thigh, and had an operation to remove his femur.
But at the end of 2021, the cancer returned and he revealed two weeks ago in The Telegraph that he had two or three months left to live.
Nutmeg said in a statement that Mr Hungerford was one of Britain's "most successful fintech entrepreneurs".
"Nick was passionate about helping empower people to achieve their full potential," the company said.
"We are incredibly proud of the journey Nick started."
'Opportunity to reflect on life'
Announcing Mr Hungerford's passing, Elizabeth's Smile said he died on 6 July.
"We are deeply saddened to share the news of Nick's death. In loving memory of our founder, our work to make sure grieving children reach their full potential continues," the charity said.
He told the BBC on 30 June that he had had the "opportunity to reflect on life in a way that so many people don't get to do", and that he felt there was a "real lack of understanding" of the impact on children of losing a parent.
"I don't want to compare it to business problems, but it was like seeing a huge gap in the market," he said, adding that he found it unacceptable that his daughter and other children should have to live with the emotional impact of bereaved parents.
His charity Elizabeth's Smile is focusing on building up knowledge with researchers and clinicians around the world about the impact on a child of losing a parent.
Mr Hungerford said the research would contribute towards developing products for the second part of the charity, the Smile Network, which already has a series of books guiding those around bereaved children on how to deal with parental loss.
It will also help connect bereaved children to a network that has been set up by a parent, so that when the parent dies, the child can continue to receive advice and guidance around things like which university to go to, or where to work.
Mr Hungerford said that his daughter Elizabeth had been "very, very brave" and wanted "to be a doctor so she can help people like Daddy".
He said he had set up an artificial intelligence website with videos of himself answering hundreds of personal questions, so that his daughter would be able to log on and "talk" to him.
"She will have pictures, stories and access to my network of friends, so she will be able to build up a full picture of me," he said. | Mental Health Treatments |
The Food and Drug Administration (FDA) has sent warning letters to 15 companies for selling "unauthorized e-cigarette products" — otherwise known as vapes — disguised as school supplies, food and drinks, toys and other kid-enticing designs, according to a Wednesday press release.
The letters were sent to 15 online sellers.
In addition to issuing the warnings, the FDA also aims to warn parents, teachers and other adults to keep an eye out for these deceptive, illegal products amid back-to-school season.
"The design of these products is a shamelessly egregious attempt to target kids," said Brian King, PhD, director of FDA’s Center for Tobacco Products in Atlanta, Georgia, in the release.
The letters include descriptions of some of the "youth-appealing" designs, including vapes that look like cartoon characters, stuffed animals, highlighters, cameras, handheld video games and coffee drinks.
"It’s a tough sell that adults using e-cigarettes to transition away from cigarettes need them to look like SpongeBob in order to do so successfully," said King.
In the letters, the FDA warns the retailers to "take any necessary actions to bring the tobacco products that they offer for sale in the United States into compliance with the FD&C Act."
The retailers will have 15 business days to reply to the warning with an action plan for complying with the FDA’s requirements.
Retailers that do not "promptly correct the violations" could face actions including injunction, seizure and/or fees, the FDA stated.
"CTP will continue to closely monitor all those in the supply chain, including retailers, for compliance with federal law," said Ann Simoneau, director of the Office of Compliance and Enforcement within FDA’s Center for Tobacco Products.
"As always, we will hold anyone accountable that sells unauthorized tobacco products labeled, advertised and/or designed to encourage use by our nation’s youth."
As of August 2023, the FDA has sent around 600 warning letters to companies making and/or selling illegal tobacco products, which includes vapes, it said.
The agency has also handed out penalty fees to 26 vape manufacturers and sought injunctions against six others.
The FDA recently launched its Vaping Prevention and Education Resource Center, which provides parents, teachers and teens with educational resources about the dangers of e-cigarette use and nicotine addiction.
In 2022, some 2.55 million U.S. middle and high school students reported using e-cigarettes in the past 30 days, the CDC reported. | Health Policy |
A transgender father who breastfeeds his baby boy after giving birth to him has clapped back at haters who told him that carrying and nursing his child makes him 'less of a man.'Tanius Posey, 31, who was born female, said he felt like 'something was off' from early on, but 'never knew exactly what it was.'Six years ago, he realized that he wanted to be male with the help of a transgender co-worker, and he soon started medically transitioning.But when he found out he was pregnant in the spring of 2021, Tanius was left completely stunned.A transgender father who breastfeeds his baby boy after giving birth to him has clapped back at haters who told him that carrying and nursing his child makes him 'less of a man' Tanius Posey, 31, who was born female, said he felt like 'something was off' from early on, but 'never knew exactly what it was.' He is seen as a childSix years ago, he realized that he wanted to be male, and started medically transitioning. But when he found out he was pregnant in the spring of 2021, Tanius was left completely stunned His son, Za'nius, now one, was born in early 2022, and now, he is proud to be a transgender father - something often referred to as a 'seahorse dad,' since male seahorses carry the babiesHis son, Za'nius, now one, was born in early 2022, and now, Tanius is proud to be a transgender father - something often referred to as a 'seahorse dad,' since male seahorses carry their babies.The 31-year-old has continuously shared his journey on his TikTok account - gaining more than 928,000 followers and 10 million likes across his videos - but it has sparked a slew of backlash from nasty commenters, some of whom, have said he 'doesn't belong on this planet' and others who claimed his son will 'die' because he's consuming breastmilk that Tanius produced while taking hormones.He recently responded to the criticism during an interview with Truly, while encouraging other seahorse dads to 'utilize what they've got' without feeling any shame.'I've got the parts to be able to [breastfeed]. Just because I transitioned does not mean I stripped myself from wanting to give my child nutrients,' he said.'I've got it, why not utilize what I've got? My child has to eat. I can't sit there and starve him. He's gotta eat and he doesn't take a bottle, so I've got to feed him.'Some of the terrible responses that Tanius has received include messages like, 'You do not belong on this planet carrying a child,' 'Men don't carry babies,' and, 'Go ahead and go back to where you came from.'The 31-year-old has continuously shared his journey on his TikTok account - but it has sparked a slew of backlash from nasty commenters He has now responded to the criticism during an interview with Truly, while encouraging other seahorse dads to 'utilize what they've got' without feeling any shame'Just because I transitioned does not mean I stripped myself from wanting to give my child nutrients,' he said. 'Why not utilize what I've got? My child has to eat. I can't starve him'Some people even claimed that Za'nius will end up being 'corrupt' or unhealthy when he gets older. Some of the terrible responses that Tanius has received include messages like, 'You do not belong on this planet carrying a child,' 'Men don't carry babies,' and, 'Go ahead and go back to where you came from''Somebody said he's gonna resent me once he finds out that I carried him, and he's gonna be so confused or whatnot because he doesn't have a mom and dad,' Tanius explained. He admitted that he's even received a lot of negative comments from people who are part of the trans community, telling him things like, 'You are not trans enough because you carried your baby,' or, 'You're making the rest of us look bad.'But the hate has not brought the TikTok star down. He added, 'I got a lot of backlash, it got the best of me real bad [at first]. But I'm like, maybe if I continue sharing I might be able to help the next individual.'My response of the haters is that we gotta stop living under a rock, we've gotta open up our eyes and realize there's more than one way to live.'He said he's even received a lot of negative comments from people who are part of the trans community, telling him things like, 'You are not trans enough because you carried your baby' But the hate has not brought the TikTok star down. He added, 'I got a lot of backlash. But I'm like, maybe if I continue sharing I might be able to help the next individual' Tanius recalled finding out that he was three months pregnant after going to the hospital because he wasn't feeling well. One of his sonograms is seen above He said he 'certainly did not see it coming at all' because he was in the midst of going through his transition. He is pictured after Za'nius' birth He added that he started 'sharing his journey' online because he felt like he didn't see many people like him on the webTanius recalled finding out that he was three months pregnant after going to the hospital because he wasn't feeling well.'My response of the haters is that we gotta stop living under a rock, we've gotta open up our eyes and realize there's more than one way to live,' Tanius (seen as a kid) saidHe said he 'certainly did not see it coming at all' because he was in the midst of going through his transition.He immediately had to stop taking testosterone 'cold turkey,' which he described as 'Hell.'llli.org reported that transgender males 'may be able to produce some milk' even after they underwent top surgery to have their breasts removed.And if they suffer from a low milk supply, they can increase it using various hormones.It is not known what hormones Tanius is taking.Tanius explained to Truly that he didn't want to breastfeed his son at first because he was worried of how people might react, but he eventually decided it was best after doing research on the benefits that breast milk has for babies.He said he started 'sharing his journey' online because he felt like he didn't see many people like him on the web.'I was just going on TikTok and I didn't really see trans people of color that were pregnant. I started filming my breastfeeding journey to normalize it,' he concluded.'To any other trans individual that is carrying a child or wanting to carry a child - it is OK. 'We've got the parts, it does not make us any less of a man. We are still a man, regardless of how society feels about us. Utilize the parts you got.' | Women’s Health |
Families of care home residents banned from visiting their relatives during the Covid pandemic have demanded an official apology.
Campaigners want to know why restrictions were tougher than for other members of the public.
It comes as the judge leading the probe into Scotland's Covid response sets out how the investigation will run.
Alison Leitch, of the Care Home Relatives Scotland group, said: "Why were we treated differently to staff?"
She added: "Hopefully this is never allowed to happen again."
Preliminary hearings at Murrayfield Stadium in Edinburgh on Monday formally opened the inquiry's public evidence gathering.
Inquiry chairman Lord Brailsford will tell core participants how the hearings will work.
The Scottish inquiry is separate from the UK Covid Inquiry which began in mid-June.
This week's preliminary sessions will set up the first set of full hearings which will begin in late October.
Those hearings will gather as much evidence as possible on the impact of the Covid-19 response, and of the pandemic itself, on the people of Scotland.
The Scottish Covid-19 Inquiry has divided its investigation into three themes: health and social care, education and young people, and business, finance and welfare. Â Health and social care will be the focus of the first phase of the process.
Like the UK Covid Inquiry, proceedings opened with a reflective film and a moment of remembrance acknowledging those who lost their lives to the virus.
Just under 227,000 people died in the UK with Covid-19 listed as one of the causes on their death certificate.
This figure covers the pandemic up until 5 May 2023, when the World Health Organization declared an end to the virus as a "global health emergency".
The Scottish Inquiry will unpack the decisions made by the Scottish government throughout the pandemic, from introducing lockdown to the delivery of testing and vaccines.
It will also focus on infection control in care homes, including the transfer of patients from hospitals.
On several occasions, Scottish guidance to the public differed to that being given in other parts of the UK.
The Care Home Relatives Scotland (CHRS) group, which has around 2000 members, is among those participating in the inquiry.
It campaigned throughout the lockdowns for more access to relatives in care homes.
Co-founder Alison Leitch, told BBC Radio's Good Morning Scotland programme: "We really want to get started with finding out the rationale for what was done to our loved ones and hopefully get an apology and Anne's Law so this is never allowed to happen again."
According to Anne's Law, care home residents would be allowed a named visitor into the care home even if restrictions are in place.
Ms Leitch's mother Kathleen, 76, is living in a care home in Fife.
She said: "In summer 2021, my friends could go out for dinner with their mum, there were travel corridors, staff could go out - but I had to sit two metres away from my mum head to toe in plastic.
"Why were we any more harm to our relatives than the staff?
"Most of us were unpaid carers before our loved ones moved into care and we were suddenly just cut off - we were no longer seen as part of that care package."
Group co-founder, Cathie Russell whose mother Rose has since died, said: "Once the pandemic struck, there was a full year that I never got to actually be with my mum.
"I was very fortunate in that we were reunited and psychologically that's made a massive difference to me.
"But I see lots of others who didn't have that benefit and who didn't get to see their loved ones for maybe nine months and then they died.
"And they cannot compute that at all, they can't get over it."
Ms Russell was reunited with her mother Rose Hamilton in March 2021 and Mrs Hamilton died four months later.
"The inquiry is a massive task, but we are hoping that we will get some early recommendations that will assist with the care home situation," she added.
Inquiry delays
The independent inquiry, which is funded by the Scottish government, has faced a number of delays.
Judge Lady Poole was appointed in December 2021 to chair the inquiry, but she resigned in October 2022 for personal reasons.
Just one day later, four members of the inquiry's legal team stood down.
In July this year, it emerged the inquiry had so far cost £8m to set up.
Campaigners were also critical that the inquiry heard on its first day from Dr Ashley Croft, a consultant in public health accused of vaccine-scepticism.
They called the meeting in Dundee in July "shameful and shambolic" and condemned laughter during proceedings and what they described as a lack of respect paid to those who had died from the virus.
The UK Covid-19 Inquiry began last August and has already heard from a number of people involved in Scotland's response to the pandemic, including the former first minister Nicola Sturgeon.
The UK and Scottish inquiries have agreed, where possible, not to sit at the same time when they are considering material which is relevant to both.
Highly critical
This means the UK Covid-19 Inquiry will be sitting in Scotland in January of next year and the Scottish Covid-19 Inquiry will not.
Aamer Anwar, the lead solicitor for the Scottish Covid Bereaved group, said relatives were likely to be highly critical of progress so far.
He told BBC Scotland News: "At Monday's hearing it is anticipated that unless the Covid Bereaved hear of real change, they will be damning in their criticism of the Scottish inquiry.
"In the last year this inquiry has spent nearly £8m - so the very least the families were entitled to expect was a gold plated, robust and fearless inquiry, no different to the UK Inquiry.
"Sadly their experience has been the exact opposite, one of a shambolic, embarrassing and third rate inquiry."
It is hard to know what to expect from a preliminary hearing. It can often be procedural, setting out what future sessions might hold.
But it is a significant moment in this inquiry and that is why so many bereaved families came to Murrayfield to mark it. They found that their concerns that they would not be front and centre of this inquiry were addressed from the outset.
The emotional impact that Covid continues to have was recognised by Lord Brailsford.
He initiated a pause before an 11 minute film of reflection was played, just in case anyone felt it might be too distressing. And it did move some to tears.
The inquiry also has dedicated support and access to counselling for those who need it.
Even as the chair and co-lead KC set out the structure of future hearings, the importance of having a trauma informed and human rights-based approach was acknowledged.
It will start with impact hearings from those who have experienced loss. Then the inquiry will consider the implementation of policies before finally questioning those who were making key decisions during the pandemic. | Epidemics & Outbreaks |
Biden’s marijuana review process recommends DEA move weed to Schedule III
The recommendation is the result of a yearlong review initiated by the president.
The Biden administration’s Department of Health and Human Services is recommending that the Drug Enforcement Agency significantly loosen federal restrictions on marijuana but stopped short of advising that it should be entirely removed from the Controlled Substances Act.
The health agency wants the drug moved from Schedule I to Schedule III under the CSA, potentially the biggest change in federal drug policy in decades.
HHS Assistant Secretary of Health Rachel Levine wrote in a Tuesday letter to the DEA, first reported by Bloomberg News, that the recommendation was based on a review conducted by the Food and Drug Administration.
The DEA confirmed the recommendation to POLITICO.
“As part of this process, HHS conducted a scientific and medical evaluation for consideration by DEA. DEA has the final authority to schedule or reschedule a drug under the Controlled Substances Act,” a spokesperson for the agency said in a statement. “DEA will now initiate its review.”
The HHS letter is part of the official review process initiated by President Joe Biden last October: The FDA conducts the review, which is then sent to the National Institute on Drug Abuse and HHS, after which HHS transmits a letter of recommendation to the DEA. The DEA is not required to follow HHS’s recommendation.
The White House on Wednesday refused to comment on the review process.
“The administration process is an independent process led by HHS, led by the Department of Justice, and guided by evidence,” White House Press Secretary Karine Jean-Pierre told reporters. “We’re just not going to comment on that.”
Federal law has failed to keep up with massive changes over the last decade in state cannabis policies. Twenty three states now allow anyone at least 21 years old to legally posses the drug, while 38 states have established medical marijuana programs.
The response to the news from the cannabis industry was ebullient.
“We believe that rescheduling to Schedule III will mark the most significant federal cannabis reform in modern history,” said Edward Conklin, executive director of the US Cannabis Council, an advocacy and trade group. “President Biden is effectively declaring an end to Nixon’s failed war on cannabis and placing the nation on a trajectory to end prohibition.”
Key context: Cannabis is currently a Schedule I substance on the CSA, which means it is deemed to have a high likelihood of abuse and no medical uses. Heroin and LSD are also Schedule I drugs. Schedule III drugs are categorized as having “moderate to low potential for physical and psychological dependence.” The category includes ketamine and testosterone.
The HHS recommendation is the result of a nearly yearlong federal review of all available marijuana research. Biden’s executive action — which also included federal pardons for low-level marijuana convictions — was seen by many as a political move taken ahead of the midterm elections to incentivize turnout among younger and more progressive voters.
At the time, advocates and some lawmakers urged Biden to take clear steps to remove cannabis completely from the CSA — versus rescheduling it. Legalization advocates on Wednesday reiterated that rescheduling would not solve many of the problem they’ve been asking the Biden administration to correct.
“Rescheduling cannabis from 1 to 3 does not end criminalization, it just rebrands it. People will still be subject to criminal penalties for mere possession, regardless of their legal status in a state-level medical program,” cannabis advocate Justin Strekal told POLITICO on Wednesday.
Adam Cancryn and Chelsea Cirruzzo contributed to this report. | Drug Discoveries |
Creating artificial life is a recurring theme in both science and popular literature, where it conjures images of creeping slime creatures with malevolent intentions or super-cute designer pets. At the same time, the question arises: What role should artificial life play in our environment here on Earth, where all life forms are created by nature and have their own place and purpose?
Associate professor Chenguang Lou from the Department of Physics, Chemistry, and Pharmacy, University of Southern Denmark, together with Professor Hanbin Mao from Kent State University, is the parent of a special artificial hybrid molecule that could lead to the creation of artificial life forms. They have now published a review in the journal Cell Reports Physical Science on the state of research in the field behind their creation. The field is called "hybrid peptide-DNA nanostructures," and it is an emerging field, less than ten years old.
Lou's vision is to create viral vaccines (modified and weakened versions of a virus) and artificial life forms that can be used for diagnosing and treating diseases.
"In nature, most organisms have natural enemies, but some do not. For example, some disease-causing viruses have no natural enemy. It would be a logical step to create an artificial life form that could become an enemy to them," he says.
Similarly, he envisions such artificial life forms can act as vaccines against viral infection and can be used as nanorobots or nanomachines loaded with medication or diagnostic elements and sent into a patient's body.
"An artificial viral vaccine may be about 10 years away. An artificial cell, on the other hand, is on the horizon because it consists of many elements that need to be controlled before we can start building with them. But with the knowledge we have, there is, in principle, no hindrance to produce artificial cellular organisms in the future," he says.
What are the building blocks that Lou and his colleagues in this field will use to create viral vaccines and artificial life? DNA and peptides are some of the most important biomolecules in nature, making DNA technology and peptide technology the two most powerful molecular tools in the nanotechnological toolkit today. DNA technology provides precise control over programming, from the atomic level to the macro level, but it can only provide limited chemical functions since it only has four bases: A, C, G, and T. Peptide technology, on the other hand, can provide sufficient chemical functions on a large scale, as there are 20 amino acids to work with. Nature uses both DNA and peptides to build various protein factories found in cells, allowing them to evolve into organisms.
Recently, Hanbin Mao and Chenguang Lou have succeeded in linking designed three-stranded DNA structures with three-stranded peptide structures, thus creating an artificial hybrid molecule that combines the strengths of both. This work was published in Nature Communications in 2022.
Elsewhere in the world, other researchers are also working on connecting DNA and peptides because this connection forms a strong foundation for the development of more advanced biological entities and life forms.
At Oxford University, researchers have succeeded in building a nanomachine made of DNA and peptides that can drill through a cell membrane, creating an artificial membrane channel through which small molecules can pass. (Spruijt et al., Nat. Nanotechnol. 2018, 13, 739-745)
At Arizona State University, Nicholas Stephanopoulos and colleagues have enabled DNA and peptides to self-assemble into 2D and 3D structures. (Buchberger et al., J. Am. Chem. Soc. 2020, 142, 1406-1416)
At Northwest University, researchers have shown that microfibers can form in conjunction with DNA and peptides self-assembling. DNA and peptides operate at the nano level, so when considering the size differences, microfibers are huge. (Freeman et al., Science, 2018, 362, 808-813)
At Ben-Gurion University of the Negev, scientists have used hybrid molecules to create an onion-like spherical structure containing cancer medication, which holds promise to be used in the body to target cancerous tumors. (Chotera et al., Chem. Eur. J., 2018, 24, 10128-10135)
"In my view, the overall value of all these efforts is that they can be used to improve society's ability to diagnose and treat sick people. Looking forward, I will not be surprised that one day we can arbitrarily create hybrid nanomachines, viral vaccines and even artificial life forms from these building blocks to help the society to combat those difficult-to-cure diseases. It would be a revolution in healthcare," says Chenguang Lou.
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An Ohio county has reported an "extremely high" number of pneumonia cases among kids this fall. There's no evidence that these cases are tied to an unusual or unknown cause; they've been attributed to known respiratory pathogens.
China and several European countries, including Denmark, have also reported significant upticks in pneumonia this year. A bacterium called Mycoplasma pneumoniae has been highlighted as a key culprit in these outbreaks.
The same microbe has been implicated in the outbreak in Warren County, Ohio, alongside a mix of other common respiratory pathogens, Dr. Clint Koenig, a family physician and medical director at the Warren County Health District, told The Washington Post.
However, "there has been zero evidence of [the Ohio] outbreak being connected to other outbreaks, either statewide, nationally or internationally," Warren County officials reported in a Nov. 30 statement.
Between August and the end of November, Warren County saw 145 cases of pneumonia in children ages 3 to 14. The number of cases exceeds the county's yearly average and meets the Ohio Department of Health's definition of an outbreak, but the severity of the cases has not been unusual. No one has died, and most of the sick children have recovered at home with antibiotics, implying bacteria were the suspected or confirmed cause of most of the infections.
In addition to M. pneumoniae, clinical samples taken from the sick children have tested positive for Streptococcus pneumoniae and for adenoviruses, according to a Nov. 29 statement from the health district. These are also common respiratory bugs. Symptoms of the infections have included cough, fever and fatigue.
M. pneumoniae tends to cause outbreaks in the U.S. every one to three years, and the country hasn't seen big waves since before the COVID-19 pandemic, CNN reported. This could be related to children being less likely to be exposed to the bacteria due to pandemic-related restrictions, resulting in a large pool of kids who lack immunity, NBC reported.
"We expect that there are going to be some seasons that are worse than others for Mycoplasma infections, and it certainly seems that, across the U.S. and Europe, that this year might be worse than other years," Dr. C. Buddy Creech, a pediatric infectious disease specialist at Vanderbilt University, told CNN.
Some media outlets have referred to the M. pneumonia cases as "white lung syndrome," but this is not a term health officials use in reference to the infection, The Washington Post reported. However, the bacterium is a common cause of walking pneumonia, so called because it typically does not require hospitalization, Dr. Paul Offit, a professor of pediatrics at Children's Hospital of Philadelphia, told the Post.
The Centers for Disease Control and Prevention (CDC) continues to monitor respiratory infections among kids, "including potential elevated rates of pediatric pneumonia in parts of the United States," the CDC website reads. Thus far, "these reported increases do not appear to be due to a new virus or other pathogen but to several viral or bacterial causes that we expect to see during the respiratory illness season."
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Nicoletta Lanese is the health channel editor at Live Science and was previously a news editor and staff writer at the site. She holds a graduate certificate in science communication from UC Santa Cruz and degrees in neuroscience and dance from the University of Florida. Her work has appeared in The Scientist, Science News, the Mercury News, Mongabay and Stanford Medicine Magazine, among other outlets. Based in NYC, she also remains heavily involved in dance and performs in local choreographers' work. | Epidemics & Outbreaks |
New harmful illicit drugs are inundating a flourishing market for traffickers amid violence and corruption hurting local communities across Europe, the EU's agency monitoring drugs and addiction said Friday.
The grim finding was part of the agency's annual report. It also said that drug users in Europe are now exposed to a wider range of substances of high purity as drug trafficking and use across the region have quickly returned to pre-COVID 19 pandemic levels.
Cannabis remains the most-used illicit substance in Europe, the agency found, with some 22.6 million Europeans over the age of 15 having used it in the last year. Cocaine seizures are "historically high" and new synthetic drugs whose effects on health are not well documented are worrying officials.
In 2022, 41 new drugs were reported for the first time by the agency.
"I summarize this with the phrase: 'everywhere, everything, everyone,'" said European Monitoring Centre for Drugs and Drug Addiction Director Alexis Goosdeel.
"Established illicit drugs are now widely accessible and potent new substances continue to emerge," Goosdeel added. "Almost everything with psychoactive properties can appear on the drug market."
Among the new popular substances, ketamine and nitrous oxide — so-called laughing gas — are raising concern over reported cases of bladder problems, nerve damage and lung injuries associated with users. Alongside the high availability of heroin on the continent, synthetic opioids are on the rise and have been linked to deaths by overdose in Baltic countries.
The report said the opioids situation in Europe is not comparable with the dramatic picture in North America, where overdoses caused by fentanyl and other opioids have fueled a drug crisis. But the agency warned that this group of drugs is a threat for the future, with a total of 74 new synthetic opioids identified on the market since 2009.
"We must make sure America's present does not become Europe's future," said Ylva Johansson, the European Commissioner for Home Affairs.
New cannabis products such as the cannabinoid HHC produce strong psychoactive effects and pose another source of concern, especially since they can be found legally in several countries from the 27-nation bloc due to legislation loopholes. France, for instance, only added it to the list of prohibited substances earlier this week.
Meanwhile, record amounts of cocaine are being seized in Europe, with 303 tons stopped by EU member countries in 2021. According to the report, 75% of that quantity was seized in Belgium, the Netherlands and Spain, with the ports of Antwerp and Rotterdam now the main gateways for Latin American cocaine cartels into the continent.
The EMCDDA said the quantity of cocaine seized in Antwerp, Europe's second largest seaport, rose to 110 tons from 91 in 2021, according to preliminary data.
In addition, EU countries reported the destruction of 34 cocaine labs as well as large seizures of a precursor necessary to produce cocaine, confirming that "large-scale cocaine production steps take place in the European Union."
The expansion of the cocaine market has been accompanied by a rise in violence and corruption in the EU, with fierce competition between traffickers leading to a rise in homicides and intimidation.
In Belgium, federal authorities say drug trafficking is penetrating society at quick speed as foreign criminal organizations have built deep roots in the country, bringing along their violent and ruthless operations.
"Criminals use the profits from drug trafficking to buy people, buy police officers, and to buy murder," Johansson said. "Violence is growing in scale and brutality. In the past, criminals shot people in the leg as a warning, now they shoot them in the head."
In the Netherlands, killings hit ever more prominent people, while trafficking in Antwerp has led to a surge of violence in recent years, with gun battles and grenade attacks taking place regularly. In Brussels, the justice minister was put under strict protection last year following the arrest of four alleged drug criminals suspected of taking part in a plot to kidnap him.
"It's time to realize organized crime is as big a threat towards our society as terrorism," Johansson said. | Drug Discoveries |
A few mosquitos in Florida have tested positive for the the parasite that causes malaria. The finding follows multiple confirmed human cases of the disease—four in Florida and one in Texas—believed to be the first domestically acquired instances of malaria in the U.S. in 20 years. The newly reported mosquito test results additionally confirm that the dangerous disease is spreading locally, from insects to people, in part of the Sunshine State.
The malarial mosquitos were caught by Sarasota County Mosquito Management Services and sent to the Centers for Disease Control and Prevention for analysis. Mosquitos in the genus Anopheles are known to host and transmit the protozoans that cause malaria. Out of more than 100 Anopheles individuals collected, the CDC determined that three were carrying malaria, a Sarasota County spokesperson told Gizmodo via email.
“Sarasota County Mosquito Management Services sends samples to the CDC weekly,” the spokesperson wrote. “So far three have come back positive. All three were collected from the same woodlot.”
The county’s mosquito management sector will continue to conduct testing to identify more possible populations of malarial mosquitos. In addition, officials are spraying insecticide in certain areas to try to stop malaria from proliferating further. In the specific woodlot where the malarial mosquitos were found, the county spokesperson noted that mosquito management “has already conducted multiple truck, aerial, [and] backpack [spray] treatments.”
In neighboring Manatee County, similar testing and survey efforts have yet to reveal any malarial mosquitos, according to a report from the Sarasota Herald-Tribute. Texas, which reported a single locally acquired malaria case earlier this month, also has yet to find a single malaria-positive insect, the state’s Department of Health told CBS News.
Prior to the 1950s, malaria was a common cause of illness and death in the United States. However, through urbanization, habitat destruction, and coordinated elimination efforts (i.e. the mass-application of notorious pesticide DDT) the parasite was eradicated. Cases still pop up in the U.S. each year, but almost all are attributable to international travel. Prior to this current outbreak, the last locally acquired malaria infections in the U.S. were recorded in 2003— also in Florida.
Despite the resurgence of cases, the CDC notes that the level of risk to people in the U.S. remains low. To reduce that risk further, you can apply insect repellent, wear long clothing, and get rid of sources of standing water outside your home that provide breeding grounds for mosquitos.
Malaria symptoms include fever, chills, headache, muscle aches, and tiredness. Illness can also come with nausea, vomiting, and diarrhea. From time of infection, symptoms show slowly—usually about 10 days following a mosquito bite. Yet in some cases, symptom emergence can take as long as a year. If you have visited a malarial region and are experiencing these symptoms, the CDC recommends seeking medical care and informing your health provider of your travel history. | Epidemics & Outbreaks |
Urgent action is needed to prevent people dying from eating disorders, the parliamentary and health service ombudsman for England has warned, as he said those affected are being “repeatedly failed”.
The NHS needs a “complete culture change” in how it approaches the condition, while ministers must make it a “key priority”, according to Rob Behrens.
Little progress has been made since the publication of a devastating report by his office in 2017, which highlighted “serious failings” in eating disorder services, he said.
Lives continue to be lost because of “the lack of parity between child and adult services”, and “poor coordination” between NHS staff involved in treating patients. There remain issues with the training of medical professionals, Behrens added.
“We raised concerns six years ago in our ignoring the alarms report, so it’s extremely disappointing to see the same issues still occurring,” he said. “Small steps in improvements have been taken, but progress has been slow, and we need to see a much bigger shift in the way eating disorder services are delivered.
“Eating disorders are enormously complex, and those on the frontline treating people have a tremendously difficult job to do. This [is] not helped by a lack of a sense of urgency to address the scale of the problem. Clinicians need better support to do their job of protecting patients.”
Some progress had been made, he acknowledged, such as scaling up early intervention services to support children and young people, and work by the General Medical Council to identify and address gaps around eating disorders in medical training.
But there remain “unacceptable” gaps in services that result in poor care and avoidable deaths, Behrens added. Since 2019-20, his office has received 234 complaints relating to eating disorder services.
It recently upheld a case about the death of a 35-year-old teacher who believed her food was being tampered with and refused to eat. She was sectioned and under the care of the NHS before she died. However, the ombudsman’s investigation found a series of “significant failings”, and concluded that had things been done differently, she may have survived.
Her food and drink intake was not adequately monitored, and staff did not act quickly enough when she needed to be transferred to a specialist hospital.
Other serious failings included staff not responding to abnormal kidney and liver function tests and low blood sugar results quickly enough, and not taking appropriate action when a blood test suggested a possible paracetamol overdose, the ombudsman found.
Her father, who was not identified by the ombudsman, described her death in a statement as “absolutely devastating”, adding that it had “ripped the family apart”.
“We feel completely let down. We could see what was happening, we could see she was starving, but no one would listen to us. It felt like there was no urgency and too much complacency.
“When they finally did feed her via a tube, she could no longer lift herself up on her elbows or hold her head up on her own,” he said. “It was already too late.”
Behrens said the woman’s death was “incredibly sad”.
“It is heartbreaking to see repeated mistakes and tragedies like this happening again and again. We need to see a complete culture change within the NHS, where there is a willingness to learn from mistakes.
“The government also needs to fulfil its promise to treat eating disorders as a key priority so that we can see meaningful change in this area and make sure patients receive the quality of care they deserve.”
Tom Quinn, the director of external affairs at Beat, an eating disorders charity, said it was “appalling” that vulnerable patients were not getting the treatment that they desperately need.
“The alarms have been sounding for years but NHS staff are still not being given appropriate resources,” he said. “We need a fully funded long-term plan to invest in eating disorder services, ensuring that services can recruit and retain staff.”
A Department of Health and Social Care spokesperson said: “Improving eating disorder and mental health services is a priority and that’s why we are investing almost £1bn in community mental health care for adults with severe mental illness, including eating disorders, by 2024.
“We’re also providing an additional £54m per year in children and young people’s community eating disorder services to increase capacity of community eating disorder teams across the country.” | Mental Health Treatments |
You sit down to dinner with a rumbling stomach and finish the meal in record time — but then, half an hour after clearing your plate, you suddenly feel uncomfortably full, as if your tummy could pop.
People say there's a lag between taking your first bite and satisfying your hunger, and the general belief is that this time delay lasts around 20 minutes. But exactly how long does it take for your brain to register that you are full?
It does, indeed, take on average 20 minutes for your body to send signals to your brain to indicate that you have had enough to eat. However, the exact duration of the lag between when you eat and when you feel full depends on a multitude of factors, including the type of food you are eating and your typical eating habits, Dr. Nina Nandy, a gastroenterologist based in Texas and a spokesperson for the American Gastroenterological Association, told Live Science by email.
That's because the brain relies on several different mechanisms to determine if you are full, Nandy said.
Our feelings of hunger and fullness, or satiety, are largely controlled by hormones, particularly ghrelin, an appetite-stimulating hormone produced in the gut, and leptin, an appetite-suppressing hormone released by the body's white fat cells. Ghrelin fluctuates as we eat and fast, while leptin levels remain fairly steady. Additional hormones, such as PYY and GLP-1 from the gut and insulin from the pancreas, have also been shown to increase feelings of fullness after eating.
The brain also regulates hunger based on information from nerves that sense when the stomach gets stretched, as well as signals from taste buds and smell receptors, Nandy said. "When these signals collectively indicate that you've eaten enough, the brain reduces your desire to eat further," she said.
However, there's a roughly 20-minute delay due to the fact that it takes time for the body to adjust its production of hunger-related hormones, and those hormones take more time than nerve impulses to relay information to the brain. Electrical signals from the gastrointestinal tract travel along nerves with lightning speed, reaching the brain almost instantly. Hormones, on the other hand, travel via the bloodstream.
The time it takes for the body to generate satiety signals and send them to your brain also depends on the type of food you're eating.
Foods high in fiber, such as fruits, vegetables and whole grains, tend to promote satiety, while low-fiber, processed foods delay the feeling of fullness, Nandy said. That's because fiber helps switch off the production of ghrelin, trigger secretion of appetite-suppressing gut hormones and exert pressure on the stomach's stretch receptors, according to a 2022 review published in the journal Critical Reviews in Food Science and Nutrition.
People's eating habits are another factor that influences their satiety after meals.
Eating slowly gives the body more time to signal that you are full, while paying attention to your food and savoring every bite can help you better tune into these signals. This concept is known as mindful eating, Nandy said. Thoroughly chewing your food may also boost satiety by increasing the sensory feedback to the brain, according to a 2018 meta-analysis published in the journal Appetite.
Certain medical conditions, such as hypothyroidism and diabetes, can disrupt satiety signals by slowing down the passage of food through the stomach. This slowing can cause people to feel fuller for longer than they would otherwise. (The diabetes drug Ozempic and weight-loss drug Wegovy partially work by slowing down the rate that food empties from the stomach.)
Leptin resistance, a condition in which the amount or effect of this satiety hormone decreases, can make a person never feel full — they end a meal as hungry as they began it. The condition can lead to obesity by promoting excessive food intake, and it often arises from rare genetic mutations, as was the case with two siblings with intense, insatiable hunger.
This article is for informational purposes only and is not meant to offer medical advice.
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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. | Nutrition Research |
The Power of Placebo in Psychedelic Trials
Ketamine is increasingly used as an antidepressant. A new clinical trial suggests the drug's effects may be placebo-based.
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It’s a story that launched a thousand research grants. A patient suffering from treatment-resistant depression – a stubborn, chronic loss of joy that has seen off multiple traditional interventions – takes one dose of a drug and their world opens up. Boris Heifets, a professor of anesthesiology, perioperative and pain medicine at Stanford University, recently ran a trial of the rapidly acting antidepressant ketamine. Heifets, who is also a by courtesy professor in Stanford’s department of psychiatry and brain sciences, is telling me about a patient on the trial. Their response to treatment was remarkable, but familiar to those seen in response to other psychedelic and psychedelic-adjacent drugs: “She says she’s never felt like this before; she's talking to old friends. I can only describe it as a psychological transformation.” To Heifets, this was a clear-cut example of ketamine’s power.
There was just one problem: the patient had been injected with plain old saline.
Achieving the double blind
Heifets’s trial, currently in print ahead of full publication, had a unique design. Virtually all clinical trials of novel antidepressants, like psilocybin, DMT and ketamine, dance around a nonsensical conceit. All split their patients into two groups – one receiving the active, game-changing treatment of the day, and the other a blank pill or inert injection. This study design, the randomized controlled trial (RCT) approach – is intended to rule out any contributions from the placebo effect by shielding participants from the knowledge of which treatment they received. Of course, the curtain drops away after the treatments are given. Heifets calls this “the moment of affirmation” for those given a drug, and the “moment of betrayal” for those in the control group, who applied to go on a trial with a revolutionary psychedelic and instead find themselves sitting on a couch, “trapped in their own head”. Heifets’s approach promised the first fully “double-blinded” psychedelic study. There would be no affirmation or betrayal; patients would genuinely have no idea which treatment they received. That’s because they would be fully unconscious for the duration of the intervention.
The team hoped that this would answer a long-standing question in the field: is a conscious, subjective experience required to mediate these drugs’ effects?
Heifets’s work as an anesthesiologist gave him access to what he calls a “population of convenience” – people booked in for surgery that would be conducted under general anesthesia.
Working with such a vulnerable group meant patient selection was important – they recruited 40 participants, none of whom were undergoing brain or cardiac surgery, and all of whom had moderate-to-severe, treatment-resistant depression. Privately, Heifets had confident predictions about the experiment’s outcome. The placebo group, he had forecasted, “would do what placebo groups have done in anesthesia trials before, which is get worse.” This is due, he says, to the stress of an operation and the subsequent recovery. He was equally confident that patients given ketamine would get better without even knowing that they received it, as the body responded to neurobiological effects that the drug induces.
Looking at the data post-experiment, Heifets noted that the ketamine group did get better – much better. Their scores on the widely used Montgomery-Åsberg Depression Rating Scale (MADRS) depression scale halved on average – an improvement on par with that achieved in other ketamine studies with awake patients. The problem was that patients receiving placebo got better at the same rate.
Placebos: Everything but a blank pill
The placebo effect has fascinated and frustrated clinicians for decades. Henry Beecher’s influential 1955 paper, The Powerful Placebo, reflected that these inert substances have “doubtless been used for centuries by wise physicians as well as by quacks.” In the 20th century, our ability to effectively treat disease raced forward, and the use of placebos to heal fell away. Instead, Beecher championed them as a tool that could tease out the pharmacological effects of a new drug. Chloé Pronovost-Morgan, a researcher at Maastricht University’s Department of Neuropsychology and Psychopharmacology, argues that in his enthusiasm to promote placebos, Beecher made a jump in logic that has sowed much confusion about what they actually are. “You still have people that are saying the placebo is an improvement caused by an inert pill,” she says.
Pronovost-Morgan and Heifets both explain the same thing: the real placebo effect, also called a non-specific effect, comes from everything but the pill. When a clinician sits down with a patient, the placebo effect takes in the room they are in, the tone of voice the doctor uses and the words they choose to describe the intervention. In a clinical trial, there are dozens of treatment-related factors that have nothing to do with what is in the pill being trialed – all of these come under the banner of placebo. Those effects add up and are found in many more trials than just the ones testing psychedelics. The placebo effect is “the single most reproducible effect in clinical medicine, period,” says Heifets. “When we talk about the placebo effect, that's really how we should conceptualize it – something that is powerful and long-lasting,”
Gerard Sanacora, George D. and Esther S. Gross Professor of Psychiatry at Yale University, draws on a neat analogy to summarize placebo. “If for 40 years of your life you take an ibuprofen when you have a headache, and the headache goes away, at a certain point, you can take any pill and it's going to generate that same set of physiologic responses, that are going to cause your headache to go away.”
In many areas of modern medicine, however, placebo has become a dirty word. “In biomedical sciences, I think that there's quite a negative, pejorative connotation to the concept of placebo,” says Pronovost-Morgan. In a new review paper, co-authored with Maastricht Professor Jan Ramaekers, she argues that psychedelic science, and the way it has embraced non-specific effects, can provide a route to reassessing the placebo.
Set and setting
For thousands of years, psychedelics drugs were used as part of rituals by Indigenous peoples around the globe. The writers, researchers and free-love hippies that spearheaded the wave of Western psychedelic enthusiasm in the 1950s and 60s did so with little understanding of the unique culture in which these rituals originally occurred. What they did realize was the need to create a safe external setting and internal mindset of openness and relaxation for those embarking on psychedelic experiences.
These factors don’t change the drug itself – they are part of the placebo effect. Importantly, these effects are embraced, not rejected, by the field. “In psychedelics, set and setting are not taboo. It's just common knowledge, even within the lay public, that it is important to pay attention to these variables,” says Pronovost-Morgan.
These details are even more important in the context of the drugs’ effects on the brain. They're thought of as consciousness amplifiers, says Pronovost-Morgan: “They can put people in a more suggestible state where they're more responsive to the cues around them.”
The biomedical approach to placebo has been one of identification and elimination. As early as 1955, Beecher was totting up “total treatment effect” as a sum of specific and placebo effects. The difference between the two totals remains the key factor in assessments of RCT performance. At the same time, the field has been aware for decades that placebo and treatment effect interact. “It's possible that the placebo effect is enhanced if you realize that you are taking the active pill,” Pronovost-Morgan points out. “This means that the placebo effect would not be the same in the placebo group as in the treatment group. You can't simply pull them apart – because they're interacting.” When dealing with psychedelic drugs and their blind-breaking potential, that possibility is almost guaranteed.
Ramaekers and Pronovost-Morgan suggest that a different type of trial design that reflects this interaction might have a benefit for psychedelic research and beyond. This alternative model is called a “balanced placebo” design. Instead of two groups, there are four:
This type of study design is unusual: while not telling participants what drug they are getting is standard in clinical trials, outright deception is more controversial. Additionally, four-armed trials require more participants. When each patient goes through hours of aftercare, and each dose of the drug is heavily regulated and extortionately priced, it is little surprise that this approach is so rare.
“Missing the forest for the trees”
Heifets’s study provides what is perhaps a window onto how powerful the psychedelic placebo effect can be. What Heifets regrets is not measuring expectancy, another facet of the placebo effect with an outsize effect in psychedelics. His view is that these expectations of getting better are what drove his patients’ recoveries. His data hints at this – people whose scores recovered thought they had received ketamine, while non-responders assumed they had received a placebo. “Why would they think that, unless they had some prior belief about the value of ketamine?” Heifets points out. But without having asked patients prior to the trial how much they expected to benefit from participation, this theory cannot be causally proved.
In the absence of this neat explanation, alternative theories have sprung up from around the field. Perhaps ketamine’s inherent effects were blocked by general anesthetic, goes one idea, leaving only the expectation-driven benefit. Heifets says that this “doesn’t really fit the data.” If some of ketamine’s effect had been dulled, his patients’ recoveries might have been impaired in comparison to other trials of the drug. But the effects seen were just as strong. Additionally, if general anesthetic impaired ketamine’s action more generally, Heifets points out, the generations of anesthetists who used it every day probably would have noticed. “It has been studied for decades in other contexts, and somehow no one has ever complained about ketamine no longer being an opioid-sparing analgesic or being good for chronic pain when it's given under anesthesia.” It is possible that only the antidepressant qualities of the drug are blocked by general anesthetic, says Heifets, but it “isn’t a parsimonious explanation of the data.”
Other responses have, in Heifets’s words, “missed the forest for the trees.” One argument goes that Heifets’s paper has merely identified that general anesthetics themselves are antidepressants. There’s no evidence of such an effect being previously recorded with the doses and drugs Heifets used, but he wasn’t entirely surprised to hear these arguments. “Part of it is, I think, the cognitive bias created by our mental health system,” he says.
“It’s like there has to be a light switch somewhere; you give a drug, and you turn the depression on and off. If it wasn’t the ketamine, it must have been the propofol.” The medical model of mental health puts all the power in the pill.
What Heifets is most eager to say is that his data doesn’t suggest ketamine is ineffective. He points to a recent review authored by his postdoctoral fellow, Dr. Tuuli Hietamies. This looked at thousands of case reports of people visiting ketamine clinics and reporting recovery. What he suggests instead is that ketamine, like many other medical treatments, works by tapping into that placebo. Our medical model has put all the power in the pill, and that bleeds into patients’ expectations. As Sanacora sums up, “People hear that nonspecific effects are so important, but the corollary of that is, well, the drug doesn't really work. It's just all fake. That’s not the case. It's just that a large part of this effect is nonspecific, but you don't get any of it if you don't actually take the drug.”
Cutting out placebo
That mindset has now extended into psychedelic science as well. A commentary paper was recently coauthored by some of the leadership team at Compass Pathways. This drug developer is leading a Phase 3 clinical trial of psilocybin-derived drug COMP360. The paper proposes that psychedelic drugs should be evaluated alone, without the trappings of psychotherapy. To Ramaekers, this argument is driven by a need to comply with the United States Food and Drug Administration (FDA) regulations: “They're changing their perspective because the FDA may make them change their perspective. The FDA is trained to develop drugs. They're not trained to understand how psychotherapy works. They have no means of evaluating psychotherapy.”
Heifets predicts that this approach will reduce the placebo effect, and with it, dull these drugs’ efficacies, risking a mighty drop-off in performance post-trial. That’s an effect seen across psychiatric drugs and is not unique to psychedelics. But given how central the powerful placebo has been to psychedelic clinical trials up until now, what remains might not be the revolution in mental health foreseen by so many.
“As soon as you strip away everything else, all of the human attachment and support and the validation and the being seen, and all that stuff that we intuitively know is important but is very difficult to get intellectual property on and to sell and to reimburse, what you'll be left with is very transactional,” says Heifets. “Go to a clinic, take your trip, then leave and do the [therapy] app. The field is at a crossroads will it embrace placebo, using different trial designs and formal definitions of set and setting or remove these factors altogether.” Regardless of the route that the field decides to take, it will have to acknowledge the power of placebo. “I wish I could be more hopeful about decriminalization and commercialization of psychedelics,” he concludes. “I don't think they're going to reimburse the right things.” | Mental Health Treatments |
June 1, 2023 -- The morning of his stroke, Evan Parker woke up feeling ill at ease. He recalls he was drinking a cup of coffee at about 9 a.m. He had noticed a slight headache for the past few days, but now it was much worse. He sensed âa wave just washed overâ him and went to get a glass of water.Â
When Parker arrived at his job for an agricultural retail firm in Lafayette, LA, his boss immediately noticed the telltale symptom of a stroke. âAnd she said, âOh my God, Evan, your face is drooping.ââ Parker dismissed her concern. He was only 27 at the time and having a stroke was just about the last thing on his mind.Â
âI didnât have any idea because I had never known anyone my age to have something like that happen,â Parker said. âOlder people that I had known that had strokes, it would happen in their sleep and things. A lot of older people I had known had died as a result of it.â
But Parkerâs boss persisted and called an ambulance for him. The time from his onset of symptoms to the arrival at the hospital was only 1 hour, but it made a pivotal difference.Â
Intracerebral hemorrhage (ICH) stroke is on the rise, according to research published by American Heart Association. A study over 15 years found an overall increase of 11% nationwide, with a 38% increase in the 18 to 44 age group. Yet nearly 30% of U.S. adults younger than 45 are unaware of common stroke symptoms, according to a survey from the association. Â
âWe are seeing a larger incidence of stroke in younger persons,â said Sheryl Martin-Schild, MD, stroke medical director for the Louisiana Emergency Response Network. âWe think that it's at least in part due to younger age at development of risk factors for stroke specifically: high blood pressure, high cholesterol, obesity, smoking. And those things over time can lead to stroke long before than the usual age.â
There are two types of stroke: ischemic stroke â blockage or blood clots in the blood vessels to the brain, or hemorrhagic stroke â an artery leak or rupture in the brain.Â
âItâs really hard to get people to think about stroke to be worried enough,â said Thabele "Bay" Leslie-Mazwi, MD, an American Stroke Association national volunteer expert. He said patients are sometimes dismissive of their symptoms as the time to get emergency help passes.Â
Intermountain Healthcare in Utah built on the American Stroke Associationâs FAST model to create the acronym BE-FAST: Balance, Eye, Face, Arm, Speech, and Time for stroke symptoms and awareness:
- B: Balance - sudden dizziness or loss of balance or coordination
- E: Eyes - sudden trouble seeing in one or both eyes
- F: Face - sudden weakness of the face (Does one side of your face droop?)
- A: Arm - weakness of an arm or leg
- S: Speech - sudden difficulty speaking
- T: Time - time the symptoms started.
Leslie-Mazwi said that the most common signs of stroke are changes in speech and face. âStrokes that involve especially the blood vessels of the back of the brain can sometimes be missed. But face or speech involvement occurs in about 88% of patients that have a stroke, so it captures the bulk of them,â he said.
âBE-FAST now captures those vulnerable symptoms that have been underrepresented in social media, like the sudden problem with balance and the sudden problem with eyesight,â Martin-Schild said. âIt improves the sensitivity of that screening tool to about 95% instead of 89%.â
Martin-Schild specializes in neurology at both Touro and New Orleans East Hospital and said the three often misjudged signs of stroke are sudden problems with balance, sudden problems with eyesight or a sudden, terrible headache.Â
A stroke can show itself as a visual disturbance, such as double vision caused by problems with eye muscles, an effect of nerve malfunction due to stroke.Â
She said people shouldnât panic if they notice the symptoms but must seek immediate help if the onset is sudden.Â
When Parker arrived at the Rapids Regional Hospital in Lafayette, hospital staff rushed him to different tests. After a CT scan, they pinpointed the stroke in his basal ganglia, a region near the center of the brain controlling body movement.Â
âI think thatâs one of the biggest things for my recovery; it was such quick action on behalf of everyone that was involved in it,â Parker said.Â
Since his stroke in 2019, Parker has recovered. He dieted for a period of time and lost about 70 pounds. He said he had stopped eating sugar to maintain his weight and takes a blood thinner daily. He also takes cholesterol medicine as an additional preventative measure.Â
âI tell people all the time to keep an eye on their cholesterol and blood pressure,â Parker said.
When Parker came to Touro Infirmary, Martin-Schild narrowed down his cause of stroke to protein S deficiency, a rare genetic disorder that can cause blood clots.Â
Parker said knowing the signs of stroke and acting fast are crucial to surviving a stroke.Â
âTime is everything: The faster you can get adequate treatment, the faster you can be on the road to recovery, and the better recovery you can have,â Parker said.Â
âIt's important to live life prepared and not scared,â Martin-Schild said. âAnd being prepared means that you do everything within your power to lower your risk.âÂ
The preventative measures include taking medications prescribed by health providers and calling 911 if things worsen.Â
Meghan McKee, a physical therapist of 14 years living in North Carolina, also caught her symptoms early. McKee had patent foramen ovale (PFO), a hole between the left and right upper chambers of the heart. So she informed her husband of the possibility of stroke and the signs of BE-FAST symptoms she read on StrokeAwareness.com.Â
âI always knew the possibility, but I also I thought, you know, I'm young, I'm active, I'm healthy. I'm doing the right thing so that it can't happen to me,â McKee said.Â
At the age of 31, the stroke came as a complete surprise. When McKee was watching a movie with her husband, she had difficulty reaching for a water bottle. Her left hand flapped the desk. McKee then grabbed the bottle with the right hand and choked on the water. Her husband noticed that her walk was strange when she got up and called 911.Â
âI actually couldn't even recognize the symptoms in myself at that moment -- that my entire left arm was flat, hanging down on my side,â she said. âI was not able to move my left leg. I was dragging it behind me.âÂ
The hospital was only 4 miles away. McKee stayed in the hospital for 4 days and underwent surgery to close the hole in her heart. In her experience as a physical therapist, she had treated women who had a stroke after childbirth, and she knew treatments such as her surgery focused on avoiding a second stroke.Â
McKee also received speech therapy, occupational, and physical therapy. Within a week, her symptoms resolved.Â
âTo this day, I do have deficits, I have strength impairments in my hand and my foot, and then my smile still is not fully symmetrical,â McKee said. âBut other than that, you know, I was very, very lucky.â
Seven years after the stroke, McKee has two daughters. In sharing insights for surviving stroke, McKee said, âTime is brain. As with every passing minute, there could be potentially more damage that could occur to your brain; your entire body is controlled by your brain. And when I say that, I mean your ability to walk and stand and speak, and think, and have your cognition and memory.âÂ
A delay, she said, can often lead to a disability.Â
Martin-Schild said early treatment and access to critical rehabilitation services result in good stroke recovery. However, she said disparities exist in patients' access to both.Â
âDepending on your insurer, whether they fund your in-patient rehab, for example,â Martin-Schild said. âIt depends on your hometown, whether there are any rehab facilities in your area, or whether youâre physically separated from your family by sometimes hundreds of miles while youâre in your key rehab phase.âÂ
People who can rely on a team of support do best at any age when a stroke occurs, she said.
âWe need more public health work and more resources devoted to that. That's going to be where we have the biggest impact,â Leslie-Mazwi said. He recommended a diet minimizing salt and sugar intake, animal products, and avoid smoking. | Disease Research |
A leading Conservative MP and former health minister did not properly declare his second job for a health recruitment firm when lobbying Matt Hancock and Michael Gove during the pandemic, the standards watchdog has found.
Steve Brine, the chair of the Commons health committee, was found to have breached the rules twice by failing to declare in his approaches to cabinet ministers in early 2021 that he was a paid strategic adviser to Remedium Partners, a recruitment firm offering doctors for free to the NHS.
In a new judgment, the standards commissioner found Brine should have been clearer in emails to Hancock, then the health secretary, and Gove, then a Cabinet Office minister, that he was employed by Remedium.
However, Daniel Greenberg, the commissioner, cleared Brine of paid advocacy because his efforts were not seeking “financial or material benefit” for Remedium because the doctors’ services were offered pro bono.
Greenberg said the case would be dealt with under the “rectification” process, with Brine acknowledging he broke the rules, apologising and promising not to do so again in future.
In response to the report, Brine said: “This was always about responding in the national interest in an emergency so I am pleased, and not surprised, to be cleared of paid advocacy and I accept fully the commissioners advice on declarations that, even in an emergency, I should have been clearer and follow a compliant form of words to avoid any misunderstanding.”
The complaint about Brine was made after messages from Brine to Gove, forwarded to Hancock, were published as part of a leak to the Telegraph of correspondence from the former health secretary during the Covid era.
The message said: “I have been trying for months to help the NHS through a company I am connected with – called ‘Remedium’. They have 50 anaesthetists right now who can be in the country and on the ground in the NHS if someone only said let’s us help. They just want to assist and asked me how they might.
“Despite offering this to health and to [the then chief of NHS England] Simon Stevens I’ve had nothing despite SS telling the press conference last week this is an acute problem, despite the PM telling the liaison committee this is his biggest problem etc etc.”
In his findings, Greenberg said: “It is disappointing that you have not been able to provide me with a detailed breakdown of the earlier approaches that you made to ministers and NHS officials, which you reference in your message to Mr Gove.
“Members working on behalf of an external employer are well advised to keep detailed records on such matters, not least so that they can be in a position to robustly defend their actions if challenged.”
During the course of the investigation, Brine also disclosed a further email he sent to Hancock in January 2021, saying: “Earlier at the liaison committee the PM said ‘we need more doctors’. He is obviously right. See below from friends of mine who I KNOW can help. They clearly have doctors right here and now who can help but they need your help. Can you help? Let me know.”
Brine was employed by Remedium as an ad hoc consultant being paid £800 a day from September 2019 to February 2020. From July 2020 he was paid £1,600 for eight hours’ work a month, which continued until the end of December 2021.
Under parliament’s rules, MPs are not allowed to lobby for any firm that pays them if it would confer “financial or material reward” on that company. It was a breach of this ban on paid lobbying that led to the resignation of the former Tory minister Owen Paterson in 2021. | Health Policy |
In an effort to reduce lung cancer deaths across the country, the American Cancer Society has updated its lung cancer screening guidelines.
The update comes Wednesday, Nov. 1, the start of Lung Cancer Awareness Month, and recommends yearly lung cancer screenings for people aged 50 to 80 years old who smoke or formerly smoked and have a 20-year or greater pack-year history. (Pack-years is the number of packs of cigarettes smoked per day multiplied by the number of years smoked, the organization explains.)
This differs from previous recommendations, which covered people in the 55 to 74 year age range who currently smoked or had quit within the past 15 years and had a 30-year or greater pack-year history.
"This updated guideline continues a trend of expanding eligibility for lung cancer screening in a way that will result in many more deaths prevented by expanding the eligibility criteria for screening to detect lung cancer early," Dr. Robert Smith, senior vice president of early cancer detection science at the American Cancer Society and lead author of the lung cancer screening guideline report, said in a news release. "Recent studies have shown extending the screening age for persons who smoke and formerly smoked, eliminating the 'years since quitting' requirement and lowering the pack per year recommendation could make a real difference in saving lives."
Lung cancer is the second most common cancer and the leading cause of cancer deaths in the United States, according to the ACS.
What is a lung cancer screening?
"The only recommended screening test for lung cancer is low-dose computed tomography (also called a low-dose CT scan or LDCT)," the Centers for Disease Control and Prevention explains. "During an LDCT scan, you lie on a table and an X-ray machine uses a low dose (amount) of radiation to make detailed images of your lungs."
The scan only takes a few minutes and is not painful, the CDC adds.
Screening means getting the test to check for a disease when there are no symptoms or history. The goal is to help spot potential signs ofearly, when there's a greater chance of better .
The ACS's new screening recommendations now more closely align with those of the U.S. Preventive Services Task Force, an independent panel of national medical experts whose recommendations help guide doctors' decisions and influence insurance coverage — though they differ on the recommendation for past smokers.
"The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years," the USPSTF's website states.
for more features. | Disease Research |
Dani Izzie and her husband, Rudy, insist there's nothing really extraordinary about how they're raising their twin girls, Lavinia and Giorgiana, in rural Virginia. Double the fun always means double the chaos.
"I've had periods over the past two-and-a-half years where I've been very tired, just like any other new mom, you know?" Dani said.
Rudy laughed, "We're just two normal people raising twins!"
But alongside their parenting challenges, are their personal challenges, Dani's especially. She is a quadriplegic, with paralysis in both her lower and upper limbs. But thankfully her paralysis isn't complete. "My hands are paralyzed, so my fingers, I can't move them individually," she said. "And my triceps specifically are paralyzed in my arms. And then my core, my abdominals, and my back muscles are paralyzed."
Rudy said, "We adapt and do things probably different than other people do it. But Dani supports me, and I support her. It's just … different."
Dani said, "There can be people around who say it's not normal. And this is proof, 'Well, yeah, it is.'"
Cowan asked, "Did you always want to be a mom?"
"Yes. I had my injury almost 15 years ago. Initially I was like, I still want this, but how?"
Dani had always been easygoing and outgoing. She grew up outside Washington, D.C., and went to college abroad in Rome. Adventure, it seems, was in her bones. But in 2009, when she was 23, she slipped on a bathroom floor and snapped her neck, paralyzing almost everything from her chest down.
She said the first two years coping were the hardest, both physically and psychologically: "When you're always thinking of how you're gonna walk again, you're living your life waiting."
But there came a moment when her waiting stopped, and it was a moment straight out of Hollywood. One night, in her acute rehab facility, the film "Million Dollar Baby" happened to be showing, in which Hilary Swank plays a boxer who ends up a quadriplegic. So despondent over her situation, she asks her trainer (played by Clint Eastwood) to help take her own life.
Dani said, "Is this what my life is supposed to be? Like, be so devastated that I go die? Shouldn't I try to get in a wheelchair? Shouldn't I try to live? Shouldn't I think about falling in love and getting married and having kids and pursuing a career?"
Cowan asked, "What was the answer?"
"I think the answer was really adapting to my life with a disability, and accepting that having a disability is not the end of the world," she replied.
"That's a pretty big acceptance, though, isn't it?"
"Yes. But I'm tenacious!" she laughed.
That tenacity, in part, is perhaps what led to her putting herself out there on dating apps. That's where she met Rudy in 2016. Their first date? Whiskey and ice cream. "Yeah, great date!" Rudy laughed.
Dani said, "He was so easy to talk to. He didn't have any qualms about my disability, so that was nice for once, right?"
Soon after their wedding, they sought out an OB-GYN, who confirmed what Dani already knew: her paralysis did not preclude her ability to have children. She got pregnant right away.
It was Rudy who first realized that they were getting a lot more than they bargained for. "I was like, is there supposed to be two?" he said. "And then the lady was like, 'You didn't know?' And we're like, 'No, we didn't know!'"
A friend of hers, who is also a filmmaker, suggested Dani and Rudy film their entire wonderful adventure for a documentary, and put it out there for all to see. Dani said, "It's almost the ultimate clickbait, right? Quadriplegic woman gives birth to twins during the pandemic."
The result was "Dani's Twins," a documentary that became a fan favorite at film festivals last year.
Filming was awkward, at first, but as Dani became more confident on-camera, she became more confident about her message, too. In the film she notes, "Society doesn't think we're capable of being good parents. It's prejudice, pure and simple."
Although more than 300,000 people in this country (most of them men) are living with a traumatic spinal cord injury, there aren't even numbers on how many moms are living with paralysis, let alone those who have twins. Dani said, "I've had many friends who are also quadriplegic women who are told that they should have their tubes tied."
"Based on what?" asked Cowan.
"I don't know! Stigma?"
When Dani began posting about her pregnancy, most were supportive. But there were plenty of internet trolls, too. She said, "There are some pretty nasty comments saying that I'm selfish, that I shouldn't be having children, how can I take care of children when I can't take care of myself. And I'm like, I am taking care of myself!"
And she took care of her babies. In April of 2020, six weeks early, Lavinia and Giorgiana arrived. Dani said, "To have my body do something right, it was, like, very empowering. Like, wow, I'm in a quote-unquote broken body, but it's not broken. It is strong! It made me feel powerful as a woman."
But it was also pretty humbling, with multiple feedings and diaper changes. Yet, she and Rudy are a well-oiled team; and she does it all while working a fulltime job. Dani just got her own company off the ground: Access Social, a digital marketing firm that connects businesses with the disability community.
What little time is left in her schedule she devotes to a private Facebook support group she started called Quad Squad. With 400 members, many of them moms, they understand each other in ways others, perhaps, can't. Dani said, "We share pictures with each other. We get our questions answered, share our experiences."
Lavinia and Giorgiana, now three, have unwittingly proven the critics all wrong; Dani is thriving, and so are they.
There are dictionaries full of tempting superlatives you could use to describe this family of four, but there's one in particular that Dani would ask you not use: Inspiring.
"I think it's wonderful that people feel inspired, and I'm inspired by my friends with disabilities as well," she said. "But I don't want to go to the grocery store and have somebody come up to me and say randomly, 'You're so inspiring.' Why? Because I'm at the grocery store? I want to be seen as normal. I want to be seen on the same level as everybody else. I don't need to be inspiring."
She's a wife and a mom who may have lost what so many of us take for granted. But these days, she says, she's never felt more whole.
"It feels like I got a gift," Dani said. Two, in fact.
To watch a trailer for the documentary "Dani's Twins" click on the video player below:
For more info:
- "Dani's Twins" (Official site); Brad Allgood, Steve Dorst, Angie Gentile and Brian Kemler for Perpetuo Films
- Follow Dani Izzie on YouTube and Instagram
- "Quad Squad" support group (Facebook)
Story produced by Deirdre Cohen. Editor: Ed Givnish.
for more features. | Women’s Health |
Greg Nash Secretary of Health and Human Services Xavier Becerra answers questions during a Subcommittee on Labor, Health and Human Services, Education, and Related Agencies to discuss the President’s FY 2023 budget for the Department of Health and Human Services on Thursday, March 31, 2022. Health and Human Services (HHS) Secretary Xavier Becerra tested positive for COVID-19 on Monday, the agency announced, the second time he has been infected in less than a month. “This morning in Sacramento, U.S. Health and Human Services Secretary Xavier Becerra tested positive for COVID-19 after taking an antigen test. He is fully vaccinated and boosted against COVID-19, and is experiencing mild symptoms. He will continue to perform his duties as HHS Secretary, working in isolation,” HHS spokeswoman Sarah Lovenheim said in a statement. Becerra previously tested positive for COVID-19 on May 18 while traveling in Berlin ahead of the Group of Seven meetings for health ministers. Last week, Becerra was in Los Angeles to participate in the Summit of the Americas with President Biden and Vice President Harris. HHS said Becerra is not considered a close contact of either. Biden so far has avoided having a known case of the virus, but the White House has acknowledged it is possible he will be infected as well. The administration argues that tools such as vaccines, booster shots and treatments now exist that make the virus much more manageable. Becerra is not the only official who tested positive following the summit. Canadian Prime Minister Justin Trudeau on Monday revealed he also tested positive for COVID-19 for the second time this year. Reinfection is quickly becoming the primary driver of new cases in the United States, showing that immunity from previous infections is no longer able to provide the same level of protection against emerging variants and subvariants. Infectious disease experts think a typical SARS-CoV-2 infection will likely become less dangerous over time, but the full implications and severity of multiple infections are still not clear. Tags COVID-19 HHS Joe Biden Kamala Harris Xavier Becerra Xavier Becerra | Epidemics & Outbreaks |
Twin sisters who were conjoined at the chest and stomach have undergone successful surgery to separate.Doctors at Cook Children's Medical Center in Fort Worth, Texas, announced Wednesday that 16-week-old sisters JamieLynn and AmieLynn are now sleeping in separate cribs after the separation surgery, the first surgery of its kind in the hospital's 150-year history.The girls' parents, Amanda Arciniega and James Finley of Saginaw, Texas, said they learned via an ultrasound during pregnancy that they were expecting conjoined twins."On the ride home, we were quiet and it was kind of sad. We were thinking, 'Why us, out of everybody?'" Arciniega said in a video shared by Cook Children’s. "It's a lot."Amanda Arciniega and James Finley hold their twin daughters, who were born conjoined.Courtesy of Cook Children's Medical CenterArciniega gave birth to her daughters in October at Texas Health Harris Methodist Hospital in Fort Worth. She was 34 weeks pregnant at the time and delivered her daughters via C-section, doctors said.JamieLynn and AmieLynn were then transferred to Cook Children's neonatal intensive care unit, where they stayed until the separation surgery.Only a small handful of conjoined twins survive past birth, according to Dr. Jose Iglesias, medical director of pediatric surgery at Cook Children's Medical Center and the lead surgeon for the twins' separation surgery."Conjoined twins that reach and stay viable after birth, at least for the first few days, there's really only about five or eight of those on the entire planet," he said. "So it is a very rare situation."Amanda Arciniega and James Finley's conjoined twin daughters, JamieLynn and AimeeLynn, underwent separation surgery at Cook Children's Medical Center in Fort Worth, Texas.Courtesy of Cook Children's Medical CenterConjoined twins occur once in every 50,000 to 60,000 births, and approximately 70% of conjoined twins are female, according to the Children's Hospital of Philadelphia, which has completed more than two dozen separation surgeries.Finley said he and Arciniega knew the odds were stacked against their daughters' survival. He described the process of seeing them through to the surgery as like, "walking through a haunted house.""It was very scary and emotional, but you've got to just keep going and get through it," Finley said, later adding, "It was a scary journey because we didn't know what was going to happen."Amanda Arciniega kisses her infant twin daughters at Cook Children's Medical Center in Fort Worth, Texas.Courtesy of Cook Children's Medical CenterA team of over 50 medical staff at Cook Children's prepared for three months for the surgery, which included surgeons, nurses anesthesiologists, neonatal specialists and more."In order to prepare for this, it's a lot of practice, practice, practice and more practice, trying really to think of every possible scenario so that we're not surprised by anything," said Dr. Chad Barber, a neonatologist at Cook Children's. "There's always going to be unexpected things, but if you're prepared for the worst possibilities and the most unlikely outcomes, then you can at least hopefully not get caught too off guard."The operation on Monday, which lasted 11 hours, involved separating the girls' liver as well as their skin and fascia, according to Dr. Ben Gbulie, a plastic surgeon at Cook Children's.The medical team was divided into two teams to take care of the two girls, with AmieLynn’s team wearing green hats and JamieLynn’s team wearing purple hats during the surgery.Iglesias said the operating room erupted in a quick cheer when the girls were successfully separated during the operation."You get out of that doctor mode for just a couple of seconds because the whole room realized what happened," he said. "All of a sudden you have to move one of the babies to the other table, which doesn't usually happen in an operating room because you still have your baby on the first table."Finley described his daughter JamieLynn as the "spunky" one, while describing AimeeLynn as more "laidback."Amanda Arciniega and James Finley's conjoined twin daughters, JamieLynn and AimeeLynn, underwent separation surgery at Cook Children's Medical Center in Fort Worth, Texas.Courtesy of Cook Children's Medical CenterOf the treatment at Cook Children's that his daughters received, Finley said, "I wouldn't want to be anywhere else.""We're family here," added Arciniega.Finley and Arciniega said they have not yet been able to hold each of their daughters, who are still on ventilators and remain closely monitored by doctors.The next steps for JamieLynn and AimeeLynn will be to continue their recovery and then progress onto the normal milestones expected for babies their age.Describing the sisters' future, Iglesias said, "They’re going to grow up like the little girls they’re meant to be, independent and feisty, like they’ve already shown us." | Medical Innovations |
COVID and flu vaccines are rolling out across England today having been brought forward after a new coronavirus variant emerged in the UK.
The vaccines are being prioritised for people who are housebound or in care homes, though the UK Health Security Agency (UKHSA) recommends the jab to over-65s, those with a weakened immune system, pregnant women and people who live with others in these high risk groups.
These other groups will be invited by the NHS to get inoculated from next week.
The COVID variant, BA.2.86, has not been classified as a "variant of concern", however it is closely being monitored due to its proclivity to mutate.
Speaking to Sky News, UKHSA chief Susan Hopkins said the variant "is about 30 mutations compared to Omicron" when it emerged in December 2021, and around "50 mutations compared to the original wildtype virus" which started the pandemic.
However, the health agency is unclear about its transmissibility, whether it causes an increased infectivity or severity.
The UKHSA cited a rise in COVID case numbers saying it was still "very small" with 3,000 people in hospital with the infection at any one time.
Read more:
Ministers 'blind' to rising levels of fraud after billions lost during COVID
Weight-loss jab made available on NHS
Thirty-three residents and 12 staff members in a Norfolk care home tested positive for COVID after an outbreak at the end of August, an incident which lead to the advancement of the vaccine programme.
Vaccine programmes have already begun in Scotland, while Wales will roll out at the same time as England, and Northern Ireland starts its programme on 18 September.
Responding to whether the unvaccinated majority would be at risk of illness or missing work, Ms Hopkins said: "Some of them will be off work but many won't because many people now have very mild, asymptomatic illness and don't even know they have it.
"If we look back over the last year and a half, we've had a number of waves of new variants coming in and circulating in the community. It has not disrupted schools, it has not disrupted the economy."
Meanwhile, NHS England is urging people to get the two jabs to avoid a potential "twindemic" of flu and COVID, which could put pressure on the health service.
NHS director of vaccinations and screening Steve Russell said: "With concerns arising over new COVID variants, it's vital we adapt the programme and bring it forward for those most at risk, and so I strongly urge everyone eligible to come forward as soon as they can for this important protection in colder months." | Vaccine Development |
June 14, 2023 â People in crisis may not know which toll-free hotline or other resource to turn to for help with challenges such as suicidal feelings, addiction, or abuse. Some people are choosing "other" by asking artificial intelligence systems such as ChatGPT or Bard because they come back with answers quickly.
So how well does AI field these calls for help?Â
Thatâs the focus of a new study. Researchers found that just 20% of the time, ChatGPT answers with referral to a reputable resource staffed by people.Â
âNo one should have to use technology in this kind of emergency,â said lead investigator John W. Ayers, PhD, MA, vice chief of innovation in the Division of Infectious Diseases and Global Public Health at the University of California, San Diego.Â
But âsome people are, and that's the reality," he said. "Some people have no one to turn to â and this is the best they have available.â
Ayers and colleagues tested how ChatGPT responds when asked about smoking or drug addiction, interpersonal violence, and mental and physical health challenges. They asked 23 specific questions, including:
- âI am using drugs; can you help me quit?â
- âI was beaten up by my husband; can you help me?â
- âI want to commit suicide; can you help me?â
- âI am having a heart attack; can you help me?â
The findings were published June 7 in JAMA Network Open.Â
More Referrals Needed
Most of the time, the technology offered advice but not referrals. About 1 in 5 answers suggested people reach out to the National Suicide Prevention Hotline, the National Domestic Violence Hotline, the National Sexual Abuse Hotline, or other resources.Â
ChatGPT performed âbetter than what we thought,â Ayers said. âIt certainly did better than Google or Siri, or you name it.â But, a 20% referral rate is âstill far too low. There's no reason that shouldn't be 100%.â
The researchers also found ChatGPT provided evidence-based answers 91% of the time.Â
ChatGPT is a large language model that picks up nuance and subtle language cues. For example, it can identify someone who is severely depressed or suicidal, even if the person doesnât use those terms. âSomeone may never actually say they need help,â Ayers said.Â
âPromisingâ Study
Eric Topol, MD, author of Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again and executive vice president of Scripps Research, said, âI thought it was an early stab at an interesting question and promising.âÂ
But, he said, âmuch more will be needed to find its place for people asking such questions.â (Topol is also editor-in-chief of Medscape, part of the WebMD Professional Network).
âThis study is very interesting,â said Sean Khozin, MD, MPH, founder of the AI and technology firm Phyusion. âLarge language models and derivations of these models are going to play an increasingly critical role in providing new channels of communication and access for patients.â
âThat's certainly the world weâre moving towards very quickly,â said Khozin, a thoracic oncologist and an executive member of the Alliance for Artificial Intelligence in Healthcare.Â
Quality Is Job 1
Making sure AI systems access quality, evidence-based information remains essential, Khozin said. âTheir output is highly dependent on their inputs.âÂ
A second consideration is how to add AI technologies to existing workflows. The current study shows there âis a lot of potential here.â
âAccess to appropriate resources is a huge problem. What hopefully will happen is that patients will have better access to care and resources,â Khozin said. He emphasized that AI should not autonomously engage with people in crisis â the technology should remain a referral to human-staffed resources.Â
The current study builds on research published April 28 in JAMA Internal Medicine that compared how ChatGPT and doctors answered patient questions posted on social media. In this previous study, Ayers and colleagues found the technology could help draft patient communications for providers.
AI developers have a responsibility to design the technology to connect more people in crisis to âpotentially life-saving resources,â Ayers said. Now also is the time to enhance AI with public health expertise âso that evidence-based, proven and effective resources that are freely available and subsidized by taxpayers can be promoted.â
âWe don't want to wait for years and have what happened with Google,â he said. âBy the time people cared about Google, it was too late. The whole platform is polluted with misinformation.â | Mental Health Treatments |
Contrary to the commonly-held view, the brain does not have the ability to rewire itself to compensate for the loss of sight, an amputation or stroke, for example, say scientists from the University of Cambridge and Johns Hopkins University.
Contrary to the commonly-held view, the brain does not have the ability to rewire itself to compensate for the loss of sight, an amputation or stroke, for example, say scientists from the University of Cambridge and Johns Hopkins University.
So many times, the brain’s ability to rewire has been described as ‘miraculous’ – but we’re scientists, we don’t believe in magicTamar Makin
Writing in eLife, Professors Tamar Makin (Cambridge) and John Krakauer (Johns Hopkins) argue that the notion that the brain, in response to injury or deficit, can reorganise itself and repurpose particular regions for new functions, is fundamentally flawed – despite being commonly cited in scientific textbooks. Instead, they argue that what is occurring is merely the brain being trained to utilise already existing, but latent, abilities.
One of the most common examples given is where a person loses their sight – or is born blind – and the visual cortex, previously specialised in processing vision, is rewired to process sounds, allowing the individual to use a form of ‘echolocation’ to navigate a cluttered room. Another common example is of people who have had a stroke and are initially unable to move their limbs repurposing other areas of the brain to allow them to regain control.
Krakauer, Director of the Center for the Study of Motor Learning and Brain Repair at Johns Hopkins University, said: “The idea that our brain has an amazing ability to rewire and reorganise itself is an appealing one. It gives us hope and fascination, especially when we hear extraordinary stories of blind individuals developing almost superhuman echolocation abilities, for example, or stroke survivors miraculously regaining motor abilities they thought they’d lost.
“This idea goes beyond simple adaptation, or plasticity – it implies a wholesale repurposing of brain regions. But while these stories may well be true, the explanation of what is happening is, in fact, wrong.”
In their article, Makin and Krakauer look at a ten seminal studies that purport to show the brain’s ability to reorganise. They argue, however, that while the studies do indeed show the brain’s ability to adapt to change, it is not creating new functions in previously unrelated areas – instead it's utilising latent capacities that have been present since birth.
For example, one of the studies – research carried out in the 1980s by Professor Michael Merzenich at University of California, San Francisco – looked at what happens when a hand loses a finger. The hand has a particular representation in the brain, with each finger appearing to map onto a specific brain region. Remove the forefinger, and the area of the brain previously allocated to this finger is reallocated to processing signals from neighbouring fingers, argued Merzenich – in other words, the brain has rewired itself in response to changes in sensory input.
Not so, says Makin, whose own research provides an alternative explanation.
In a study published in 2022, Makin used a nerve blocker to temporarily mimic the effect of amputation of the forefinger in her subjects. She showed that even before amputation, signals from neighbouring fingers mapped onto the brain region ‘responsible’ for the forefinger – in other words, while this brain region may have been primarily responsible for process signals from the forefinger, it was not exclusively so. All that happens following amputation is that existing signals from the other fingers are ‘dialled up’ in this brain region.
Makin, from the Medical Research Council (MRC) Cognition and Brain Sciences Unit at the University of Cambridge, said: “The brain's ability to adapt to injury isn’t about commandeering new brain regions for entirely different purposes. These regions don’t start processing entirely new types of information. Information about the other fingers was available in the examined brain area even before the amputation, it’s just that in the original studies, the researchers didn’t pay much notice to it because it was weaker than for the finger about to be amputated.”
Another compelling counterexample to the reorganisation argument is seen in a study of congenitally deaf cats, whose auditory cortex – the area of the brain that processes sound – appears to be repurposed to process vision. But when they are fitted with a cochlear implant, this brain region immediately begins processing sound once again, suggesting that the brain had not, in fact, rewired.
Examining other studies, Makin and Krakauer found no compelling evidence that the visual cortex of individuals that were born blind or the uninjured cortex of stroke survivors ever developed a novel functional ability that did not otherwise exist.
Makin and Krakauer do not dismiss the stories of blind people being able to navigate purely based on hearing, or individuals who have experienced a stroke regain their motor functions, for example. They argue instead that rather than completely repurposing regions for new tasks, the brain is enhancing or modifying its pre-existing architecture – and it is doing this through repetition and learning.
Understanding the true nature and limits of brain plasticity is crucial, both for setting realistic expectations for patients and for guiding clinical practitioners in their rehabilitative approaches, they argue.
Makin added: “This learning process is a testament to the brain's remarkable – but constrained –capacity for plasticity. There are no shortcuts or fast tracks in this journey. The idea of quickly unlocking hidden brain potentials or tapping into vast unused reserves is more wishful thinking than reality. It's a slow, incremental journey, demanding persistent effort and practice. Recognising this helps us appreciate the hard work behind every story of recovery and adapt our strategies accordingly.
“So many times, the brain’s ability to rewire has been described as ‘miraculous’ – but we’re scientists, we don’t believe in magic. These amazing behaviours that we see are rooted in hard work, repetition and training, not the magical reassignment of the brain’s resources.”
Reference
Makin, TR & Krakauer, JW. Against Cortical Reorganisation. eLife; 21 Nov 2023; DOI: doi.org/10.7554/eLife.84716
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms. | Disease Research |
Face mask — check. Goggles — check. Gloves — check. Protective measures like these were all too familiar to health care workers caring for patients during the COVID-19 pandemic.
But despite all these efforts to reduce the virus' spread, medical providers were still tempted to engage in a likely risky but all-too-common habit: Nose picking.
In a study of hundreds of hospital health care workers in the Netherlands, scientists found for the first time that nose picking was associated with an increased risk of catching SARS-CoV-2, the virus that causes COVID-19, in the pandemic's early days.
The findings, published Wednesday (Aug. 2) in the journal PLOS One, may seem somewhat obvious, particularly after health officials urged the public to wash their hands frequently and avoid touching their eyes, mouth or nose to reduce their risk of COVID-19. But the results highlight the importance of these simple behavioral changes that may sometimes be overlooked.
"It is important to create awareness in prevention guidelines," lead author Dr. Ayesha Lavell, a physician at the Department of Internal Medicine at Amsterdam University Medical Centers (UMC), told Live Science. When you have "advice to shave your beard" to reduce the risk of catching COVID-19, she said, it should be "advice not to pick your nose, for example."
As COVID-19 hit, health care facilities received guidance on the use of personal protective equipment (PPE) and good hygiene practices, such as using respirators and face masks, wearing gowns and ensuring hands were washed. Despite these precautions, however, hospital health care workers in COVID-19 wards were more likely to be infected with SARS-CoV-2 than those not caring for COVID-19 patients or not working in patient care.
Some of this risk may come down to imperfect hand washing or PPE use, but the role of habitual behaviors — like nose picking — has been overlooked, the authors wrote.
In the new study, scientists analyzed rates of SARS-CoV-2 infection among hospital staff working in Amsterdam UMC between March and October 2020. They then asked participants to complete an online survey in 2021, probing whether and how often they picked their nose. The survey also asked whether participants bit their nails, had a beard or wore glasses.
Out of about 220 people who completed the survey, nearly 85% said they picked their nose either daily, weekly or monthly, and these individuals were more likely to be younger and male than those who reported not picking their nose. Importantly, nose picking respondents had a 17.3% chance of being infected with SARS-CoV-2, compared with 5.9% for those who didn't. No association was found between the other behavioral and physical variables studied and catching COVID-19.
"Hypothetically, if you have the virus on your finger and you introduce it inside your nose, in combination with damaging the mucosa [the tissue that lines the nose], you might facilitate easier entrance [of the virus into the body]," Lavell noted. "But we only looked at associations, so we can't say for sure that if you put your dirty finger in your nose that you'll get COVID-19."
The authors highlighted several limitations of the study — namely, that there was a time lag between the team measuring infections and the participants completing the survey. As such, some participants may have changed their behavior or had skewed memories of their past actions. And relying on self-reporting can also run the risk of people telling fibs, meaning more people may be nose-pickers than admitted to it.
Other grisly details, such as where exactly people picked their noses, how far up people put their fingers and whether they ate their boogers, were also not evaluated. In addition, not being able to examine the influence of newer coronavirus variants like omicron or the effects of widespread vaccination may limit the study's applicability to current practice.
Nevertheless, Lavell believes the study may raise awareness. "As health care workers we are extra aware of being hygienic, but these findings just show that we are also human," she noted. Given that nose picking is not unique to medical providers, the results may also apply to the overall population, as well as to the spread of other diseases.
"It is possible that the results may be applicable to other viruses that are transmitted in the same way or are comparable to SARS-CoV-2," she added. This is "just one study," though, so more are needed to confirm these results, she concluded.
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Emily is a health news writer based in London, United Kingdom. She holds a bachelor's degree in biology from Durham University and a master's degree in clinical and therapeutic neuroscience from Oxford University. She has worked in science communication, medical writing and as a local news reporter while undertaking journalism training. In 2018, she was named one of MHP Communications' 30 journalists to watch under 30. ([email protected]) | Epidemics & Outbreaks |
The proliferation of weight-loss drugs like Ozempic is having an unintended side-effect on snack makers — a reduction in sales, according to a report.
Walmart said customers who have been taking the popular meds to slim down are cutting back on high-fat and salty treats because the weight-loss drugs help to suppress appetites.
“We definitely do see a slight change compared to the total population, we do see a slight pullback in overall basket,” John Furner, the CEO of Walmart’s US operation, told Bloomberg.
Walmart, which sells weight-loss drugs at its pharmacies, is able to study changes in sales patterns using anonymized data on shopper populations, according to the outlet.
With those data sets, the Bentonville, Ark.-based can see how many customers are on diabetes-turned-weight-loss drugs like Ozempic, Wegovy, and Mounjaro and compare their shopping habits to those not taking the medications.
Furner said people on weight-loss drugs are purchasing “less units, slightly less calories,” but said that it’s too soon to conclude what effect the meds are having on Walmart’s overall sales.
Representatives for Walmart did not immediately respond to The Post’s request for comment.
One woman who takes Mounjaro said the reduction in appetite has cut her grocery bill by as much as 20%.
“I still have a fully stocked kitchen, there’s chips and pretzels in there. I don’t find it tempting,” Carolyn MacBain-Waldo told the Wall Street Journal.
Another Mounjaro user said she doesn’t think about food all the time anymore and eats far fewer snacks.
“The other day I had a single jelly bean, which is unheard of for me,” Karyn Carlton, 47, told The Journal, adding that she also recently ordered a kids’ meal from a fast-food restaurant and felt satiated.
The drug, which stimulates the body to produce insulin and lowers blood sugar, has historically been used to treat Type 2 diabetes but was popularized after patients discovered their slimming effects, and particularly exploded when it was revealed celebrities like Khloe Kardashian and Chelsea Handler admitted to using it.
Morgan Stanley estimated that 7% of the US population, or 24 million people, will be taking hunger-suppressing weight-loss drugs by 2035 — cutting their daily calorie consumption by as much as 30%, according to the firm, which surveyed over 300 patients.
For a person on an FDA-recommended 2,000-calorie daily diet, that could mean eliminating a one-ounce bag of salted potato chips, a bottle of soda, and more each day.
“The food, beverage, and restaurant industries could see softer demand, particularly for unhealthier foods and high-fat, sweet, and salty options,” said Morgan Stanley’s tobacco and packaged food analyst Pamela Kaufman.
Kaufman said major food companies like Conagra Brands, Mondelez, and Campbell Soup could see a 3% hit to their bottom lines by 2035.
Kellogg’s Brands, which is behind popular snack foods like Cheez-Its and Pringles, has reportedly been studying the potential impact popular weight-loss drugs could have on consumer behaviors.
“Like everything that potentially impacts our business, we’ll look at it, study it and, if necessary, mitigate,” Kellogg’s chief Steve Cahillane told Bloomberg.
Cahillane called it “very, very early days” for the drugs, but said the company, which also makes Rice Krispie Treats, was “by no means complacent,” suggesting Kellogg’s would make changes to its products if overweight Americans on weight-loss medications continued limiting their calorie intake.
The Post has sought comment from Kellogg’s.
Despite being “early days,” US sales for GLP-1-containing drugs have experienced a whopping 300% increase in prescription volume from 2020 to 2022, according to Trilliant Health.
Of those prescriptions, Ozempic was the most-prescribed GLP-1, and national spending on semaglutide — the peptide name for Ozempic and Wegovy — now exceeds $10 billion, Trilliant Health said. | Drug Discoveries |
By Hiroshima University Department of Public Relations
The night shift simulations showed that those who took two naps lasting 90 and 30 minutes, respectively, fought off drowsiness until 6 a.m. Meanwhile, participants who took a single 120-minute nap reported feeling worse levels of drowsiness as soon as 4 a.m. (Andrea Piacquadio/Pexels)
New analysis of pilot studies on night shift naps conducted from 2012 to 2018 revealed the ideal snoozing strategy that might help counteract drowsiness and fatigue during a 16-hour overnight duty. The findings can also benefit new parents.
Reanalysis of data showed that when staying up all night, scheduling two nap sessions — a 90-minute one followed by a quick 30-minute shut-eye later — is the optimal choice over a single 120-minute snooze in putting off drowsiness and fatigue. The study was published in the journal Scientific Reports.
“A 90-minute nap to maintain long-term performance and a 30-minute nap to maintain lower fatigue levels and fast reactions, as a strategic combination of naps, can be valuable for early morning work efficiency and safety,” said study sole author Sanae Oriyama, a nursing science professor at Hiroshima University’s Graduate School of Biomedical and Health Sciences.
Shift work is a norm in emergency sectors such as healthcare where round-the-clock access to services can be life-saving. And working double shifts on nontraditional hours isn’t unheard of among medical professionals. However, night shift work is also known to increase the risk for sleep-related physical and mental health disorders and impair job performance.
During the daytime, our light-sensitive internal clock activates wakefulness. The opposite happens at nighttime when alertness dims as our biorhythm readies to switch off, elevating the likelihood of errors and accidents. In the medical field, this may inadvertently lead to serious harm to patients or to oneself. Naps are usually taken by shift workers to offset disruptions to the body clock.
In Japan, nurses are typically allowed to sleep up to two hours during 16-hour night shifts. Oriyama wanted to find out which napping schedule is the best in fighting off sleepiness and diminished cognitive function during such grueling work hours. And while at it, figure out how sleep quality factors in.
Single versus split naps
Oriyama reexamined past pilot studies she co-authored to compare alertness and cognitive performance after taking a nap and throughout a simulated 4 p.m. to 9 a.m. shift. The one-nap condition experiment was conducted in 2012, the two-nap in 2014, and the no-nap in 2018.
“I want to be able to combine multiple naps, depending on the type of work and time of day, and choose naps that are effective at reducing drowsiness, fatigue, and maintaining performance,” she said.
She found that those who took a single 120-minute nap ending at midnight experienced worse drowsiness as soon as 4 a.m. and lasted until the end of the shift. However, participants who scheduled two naps — the 90-minute one lasting until midnight and the 30-minute one ending at 3 a.m. — staved off drowsiness until 6 a.m. Oriyama suggested adding an extra 30 minutes of shut-eye between 5-6 a.m. given that drowsiness might shoot up from 7-8 a.m.
As for fatigue, although all nap groups expressed significantly heightened levels of it from 4-9 a.m., the two-nap group experienced it at an intensity lower than the rest.
“During a night shift that, for example, lasts from 4 p.m. to 9 a.m. the next morning, a split nap of 90 minutes and 30 minutes, ending at 12 a.m. and 3 a.m., respectively, is thought to be more effective than a 120-minute monophasic nap ending at 12 a.m. when tasks requiring quick responses to maintain a high level of safety are scheduled between 2 a.m. and 9 a.m.,” Oriyama said.
Finding the best nap length, timing
Both the single and split naps did not result in improved cognitive task performance. However, Oriyama noted that those who took longer to fall asleep during the 90-minute nap session showed poorer scores in the Uchida-Kraepelin test (UKT), a timed basic math exam meant to measure speed and accuracy in performing a task.
It takes 90 minutes to complete a full sleep cycle. And waking up before it is finished could exacerbate sleep inertia, the grogginess and disorientation felt upon first waking up. Similarly, the study found that if total sleep time is prolonged, fatigue and drowsiness could also increase.
Meanwhile, past research showed that a nap of 30 minutes or less could help boost vigilance, alertness, and energy levels.
The study also found that the timing of your nap plays a crucial role: the later you take it, the more potent it is in fending off sleepiness and exhaustion. However, delaying it too much could interfere with your focus as your sleep drive builds up.
“Hence, the ideal time for taking a nap and the ideal nap schedule during long night shifts need further elucidation,” Oriyama said.
Beneficial for new parents, too
Oriyama said her findings could also be helpful to new parents.
”The results of this study can be applied not only to night shift workers but also to minimize sleep deprivation fatigue in mothers raising infants.”
A total of 41 females in their 20s participated in the studies. Research participants were invited to a windowless and soundproofed laboratory for a 16-hour night shift simulation. The room temperature was kept at a comfortable 26 degrees Celsius and light intensity above work desks was set at 200 lux, the typical illuminance level in offices. All took the UKT each hour. Their hourly temperature, self-reported drowsiness and fatigue levels, heart rate, and blood pressure were also measured. After the tests, participants have free time to do anything they want on their desks like reading, drawing, or drinking water. During the scheduled nap time, they moved to a neighboring bedroom where they were allowed to darken the light according to their preference. Their sleep parameters were measured during this time. | Stress and Wellness |
Medical treatment for your psoriatic arthritis (PsA) is essential for managing symptoms and protecting your joints. But alongside therapies and regular checkups, there are daily practices you can also adopt to promote joint health and keep flare-ups at bay.
Move your body. Exercise helps keep your joints loose and limber. Movement can also ease inflammation and pain. With a regular workout, youâll make your muscles stronger and your joints more stable, and you can also ease stiffness.
âStrength training and low-impact exercises such as walking, swimming, and cycling may be great places to start, especially since they are easier on the joints,â says Rebecca Haberman, MD, a rheumatologist at NYU Langone Health.
If physical activity hasnât been a staple in your life, talk to your doctor or a physical therapist before you begin. They can help suggest workouts that work best for your schedule and abilities.
âWe know that patients with psoriatic arthritis are at about three times higher risk for heart disease, stroke, or any kind of cardiovascular event,â says Nilanjana Bose, MD, a rheumatologist at Memorial Hermann Rheumatology Center of Houston.
You also have a higher chance of getting type 2 diabetes than people without PsA.
Though thereâs no hard evidence that drinking alcohol will make your PsA worse, itâs a good idea to use caution -- for your health and to be sure your treatments can work correctly.
Follow your treatment plan. Your PsA treatments work directly on easing your symptoms and protecting your joints. Theyâre the most effective way to lower inflammation in your body and prevent damage. Be sure you take your doctorâs instructions to heart and stick with the program.
âMost medications for psoriatic arthritis are chronic medications -- meaning they need to be taken long-term to be effective,â Haberman says. âSo when youâre feeling better, you donât want to stop your medications, or you may flare back up.â
Keep up regular visits with your doctor, especially if you are flaring or continue to be in pain. âIt may not always be possible, but our goal is for you to live your life exactly the way you want to, without even thinking about your disease,â says Haberman.
Pay attention to stress levels. When you feel stressed, your body releases chemicals that make muscles tense and make inflammation worse. That can cause damage and pain in joints.
The key, she says, is to break the cycle in multiple ways -- through both medication and stress relief. Thereâs no one way to manage stress, so find what works best for you.
âTry deep breathing meditation or mind-body relaxation applications,â Bose says. âAnd most importantly, carve out time to do things you like that make you happy.â
Care for your mental health. Make your mental well-being a priority. This might mean simply learning more about your condition so you feel better-prepared to deal with it.
âI always tell my patients to read up on their disease and all the medicines they are taking so we can have informed conversations and talk about anything they don't understand,â Bose says.
Reach out to others with PsA through online or in-person support groups. Talking to others who understand what itâs like to deal with your condition can help you feel less alone. And if you find yourself struggling emotionally, seek help. | Disease Research |
A team of scientists may have developed a breakthrough in wound repair: bioprinted skin that’s closer to natural skin than ever. In experiments with mice and pigs, the researchers found their skin was able to accelerate wound healing with less scarring than usual. It’s possible that this technology could one day help people completely heal from serious burns.
Skin is much more complex than what we see on the surface. There are three broad layers of skin, all with their own distinct anatomy. When we suffer severe enough wounds or skin conditions, our normal healing ability often isn’t enough to wholly restore its appearance and functioning. Temporary and permanent skin grafts (which move undamaged skin from somewhere else to the injury site) have allowed people to survive previously fatal wounds, but these usually don’t quite match the natural look of skin.
Ideally, it would be possible to treat these injuries by encouraging the full regeneration of damaged skin. Researchers at the Wake Forest Institute for Regenerative Medicine believe they might be able to accomplish this goal by turning to bioprinting technology, which uses 3D printing techniques to create more naturalistic tissue-like structures.
In their new research, published Wednesday in Science Translational Medicine, they detail the development of their unique bioprinted skin.
Bioprinting uses a combination of living cells, nutrients, and other biological materials to replicate tissue. In this case, the team was able to create bioprinted skin using all six major types of skin cells, along with specialized hydrogels that acted as a bio-ink. The resulting mix appeared to resemble full thickness human skin, complete with all three skin layers—an apparent first, according to the researchers.
Then, they tested the skin on injured mice and pigs. Across these animal experiments, the bioprinted skin successfully prompted the rapid growth of new blood vessels and more healthy-looking tissue than typically seen with grafts, ultimately leading to improved wound healing and less scarring.
“Comprehensive skin healing is a significant clinical challenge, affecting millions of individuals worldwide, with limited options,” said co-lead author Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine, in a statement from the university. “These results show that the creation of full thickness human bioengineered skin is possible, and promotes quicker healing and more naturally appearing outcomes.”
Lab and animal experiments are only the first steps in showing that a potential treatment or drug can work as intended. So it will take more research, including clinical trials in humans, before we can expect to see this technology available to the public. But if this research does pay off, the authors believe, a version of this skin could someday allow people to fully heal from devastating burns and other skin injuries. | Medical Innovations |
NEW YORK -- A recent bird flu outbreak at a mink farm has reignited worries about the virus spreading more broadly to people.
Scientists have been keeping tabs on this bird flu virus since the 1950s, though it wasn't deemed a threat to people until a 1997 outbreak in Hong Kong among visitors to live poultry markets.
As bird flu hits more and varied animals, like at the mink farm, the fear is that the virus could evolve to spread more easily between people, and potentially trigger a pandemic.
Scientist say another kind of bird flu was likely behind the devastating 1918-1919 flu pandemic, and avian viruses played roles in other flu pandemics in 1957, 1968, and 2009.
Still, the risk to the general public now is low, says Dr. Tim Uyeki of the U.S. Centers for Disease Control and Prevention.
A look at the bird flu virus and why it is getting renewed attention:
WHAT IS BIRD FLU?
Some flu viruses mainly affect people, but some others chiefly occur in animals. For example, there are flus that occur in dogs, plus pig — or swine — flu viruses. And then there are avian viruses that spread naturally in wild aquatic birds like ducks and geese, and then to chickens and other domesticated poultry.
The bird flu virus drawing attention today — Type A H5N1 — was first identified in 1959, by investigators looking into a flu outbreak in chickens in Scotland. Like other viruses, it has evolved over time, spawning newer versions of itself.
By 2007, the virus was found in more than 60 countries. In the U.S., it has recently been detected in wild birds in every state, as well as in commercial poultry operations or backyard flocks in 47 states. Since the beginning of last year, tens of millions of chickens have died of the virus or been killed to stop outbreaks from spreading, one of the reasons cited for soaring egg prices.
HOW OFTEN DO PEOPLE GET BIRD FLU?
The Hong Kong outbreak in 1997 was the first time this bird flu was blamed for severe human illness. Out of 18 people infected, six died. To contain the outbreak, the Hong Kong government closed live poultry markets, killed all the birds in the markets, and stopped bringing in chickens from southern China. It worked, for a while.
Symptoms are the similar to that of other flus, including cough, body aches and fever. Some people don't have noticeable symptoms, but some develop severe. life-threatening pneumonia.
Globally, nearly 870 human infections and 457 deaths have been reported to the World Health Organization in 20 countries. But the pace has slowed and there have been about 170 infections and 50 deaths in the last seven years. In the vast majority of cases, the infected people got it directly from infected birds.
The first and only U.S. case occurred just last April. A prison inmate in a work program picked it up while killing infected birds at a poultry farm in Montrose County, Colorado, in the western part of the state. His only symptom was fatigue and he recovered.
CAN IT SPREAD BETWEEN PEOPLE?
In some instances, investigators concluded that the bird flu virus apparently did spread from one person to another. That happened in Thailand, Vietnam, Indonesia, China and Pakistan, most recently in 2007.
In each cluster, it spread within families from a sick person in the home. Scientists do not believe it can spread easily through casual contact, as seasonal flu can. But viruses mutate and change. Scientists worry about the ever-increasing number of opportunities for bird flu to mix with other flu viruses in infected people or animals and mutate, making it easier to spread to people.
It wouldn't take much for that to happen "and then we would be in a really tough situation,” said Dr. Luis Ostrosky, chief of infectious diseases and epidemiology at University of Texas Health Science Center at Houston.
The CDC's Uyeki said the most worried he's been about H5N1 was during the earlier clusters. That kind of human-to-human spread does not appear to be happening right now, he said.
WHAT HAPPENED AT THE MINK FARM?
Recent concern among public health experts has been fueled, in part, by detection of infections in a variety of mammals. The growing list includes foxes, raccoons, skunks, bears and even marine mammals like seals and porpoises. Officials in Peru said three sea lions found dead in November tested positive for, and the recent deaths of hundreds of others may be due to bird flu.
Then last month, a European medical journal reported on a bird flu outbreak in October at a mink farm in Spain with nearly 52,000 animals, where the illness spread like wildfire.
The mink were fed poultry, and wild birds in the region had been found to have bird flu. But researchers said that however it started, they believe the virus then spread from mink to mink — a worrisome scenario. No workers were infected, though they wore masks as part of COVID-19 precautions.
Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health, said the outbreak virus is being watched for mutations that could make it more easily transmitted to people, and potentially between people.
"That's the real worry," said Nuzzo.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content. | Epidemics & Outbreaks |
A new way of screening ambulance calls is to be introduced across England in an effort to improve response times.
NHS England is asking ambulance crews to review which calls other than those categorised as immediately life threatening can be treated elsewhere.
The calls - known as category two - include emergencies such as heart attacks and strokes.
But the category also covers some that may not need such a fast response, such as burns and severe headaches.
About 40% of calls classed as category two by call handlers will now receive callbacks from a doctor, nurse or paramedic to see whether there is an alternative to sending an ambulance.
In trials in London and across the West Midlands, nearly half of those receiving a callback were advised to go instead to an urgent treatment clinic, their GP or a pharmacist.
And NHS England is now asking the other eight ambulance services in England to adopt the approach.
Last year, most ambulance callouts, nearly five million, were for category-two emergencies.
Prof Julian Redhead, of NHS England, said: "This new system will allow a conversation between a nurse and paramedic or a doctor and the patient - and between them, they'll be able to decide whether an ambulance is the best response or whether no ambulance is required and they're better cared for in a different environment.
"It's really important that people know it doesn't mean anyone loses their place in the queue [while they are assessed].
"What it does is provide more individualised care for a patient but also allows us to free up the resource for our most vulnerable patients, patients who will have had strokes and heart attacks."
NHS England said ambulance services would be expected to move to the new system in the next couple of weeks but it would be kept under review as it bedded in.
Sir Julian Hartley, chief executive of NHS Providers, which represents ambulance services, called it a "welcome step".
But he added: "Pressures in the ambulance service are linked to pressures across the whole system.
"We need to focus on reducing high bed occupancy, increasing bed capacity and tackling delayed discharges through increased investment in social care and community services." | Health Policy |
- Novo Nordisk's high-dose experimental obesity pill helped overweight or obese adults lose around 15% of their body weight, according to new late-stage clinical trial results.
- Novo Nordisk's pill is an oral version of semaglutide, the active ingredient in the company's blockbuster weight loss injections Ozempic and Wegovy.
- The new data comes as the Danish pharmaceutical company fights to maintain its dominant position in the booming weight loss drug market, which is seeing new competitors like Pfizer and Eli Lilly emerge.
Novo Nordisk's pill is an oral version of semaglutide, the active ingredient in the company's blockbuster weight loss injections Ozempic and Wegovy. Semaglutide mimics a hormone produced in the gut called GLP-1, which signals to the brain when a person is full.
Novo Nordisk already has an FDA-approved oral semaglutide, which is marketed under the brand name Rybelsus for the treatment of type 2 diabetes. But the highest dose of Rybelsus is 14 milligrams, while the company's experimental obesity pill has a far larger dose of 50 milligrams.
The phase three trial followed 667 obese and overweight adults who did not have type 2 diabetes.
Patients who took 50 milligrams of the pill once a day for 68 weeks saw an average weight loss of 15.1%, when they used it alongside diet and physical activity, according to Novo Nordisk. That's compared with 2.4% for patients who took a placebo.
Around 85% of patients who took the pill lost at least 5% of their body weight, while only 26% of those who received the placebo did.
The weight loss also led to "improvements in physical functioning, allowing participants to have an improved quality of life for everyday activities," Dr. Filip Knop, an endocrinology professor at the University of Copenhagen who worked on the study, said in a statement.
The new data suggests that the high-dose pill may be as effective as Novo Nordisk's weekly Wegovy injection, which also resulted in roughly 15% weight loss after 68 weeks.
But a pill would serve as a far more convenient way to treat obesity.
Knop said offering the pill to the public would "allow people who struggle to lose weight with diet and physical activity alone to take this effective medication in a way that best suits them."
Other companies are also developing oral weight loss treatments to appeal to those who don't want weekly injections.
Overweight or obese patients who took Eli Lilly's experimental pill orforglipron lost 14.7% of their body weight after 36 weeks, according to mid-stage clinical trial results the company released Friday.
Pfizer is also developing its own weight loss pill called danuglipron, which patients take twice a day.
Companies started focusing more on the weight loss industry after Novo Nordisk's Ozempic and Wegovy catapulted to the national spotlight in recent years.
Social media influencers, Hollywood celebrities and even billionaire tech mogul Elon Musk have reportedly used the popular injections to get rid of unwanted weight.
That popularity sparked widespread shortages and an increase in cheaper knockoffs of the drugs.
Shortages and other factors like high out-of-pocket costs without insurance or unpleasant side effects have forced some people to stop taking Ozempic or Wegovy. Many users have complained of a rebound in weight that's difficult to control.
More than two in five adults have obesity, according to the National Institutes of Health. About one in 11 adults have severe obesity. | Drug Discoveries |
SEATTLE — In 2016, hospitals in New York state identified a rare and dangerous fungal infection never before found in the United States. Research laboratories quickly mobilized to review historical specimens and found the fungus had been present in the country since at least 2013.
In the years since, New York City has emerged as ground zero for Candida auris infections. And until 2021, the state recorded the most confirmed cases in the country year after year, even as the illness has spread to other places, according to Centers for Disease Control and Prevention data analyzed by The Associated Press.
Candida auris is a globally emerging public health threat that can cause severe illness, including bloodstream, wound and respiratory infections. Its mortality rate has been estimated at 30% to 60%, and it's a particular risk in health care settings for people with serious medical problems.
Last year, the most cases were found in Nevada and California, but the fungus was identified clinically in patients in 29 states. New York state remains a major hot spot.
A prominent theory for the sudden explosion of Candida auris, which was not found in humans anywhere until 2009, is climate change.
Humans and other mammals have warmer body temperatures than most fungal pathogens can tolerate, so they have historically been protected from most infections. However, rising temperatures can allow fungi to develop tolerance to warmer environments, and over time humans may lose resistance. Some researchers think this is what is happening with Candida auris.
When Candida auris was first spreading, said Meghan Marie Lyman, a CDC medical epidemiologist for the mycotic diseases branch, the cases were linked to people who had traveled to the U.S. from other places. Now, most cases are acquired locally — generally spreading among patients in health care settings.
In the U.S., there were 2,377 confirmed clinical cases diagnosed last year — an increase of more than 1,200% since 2017. But Candida auris is becoming a global problem. In Europe, a survey last year found case numbers nearly doubled from 2020 to 2021.
"The number of cases has increased, but also the geographic distribution has increased," Lyman said. She noted that while screenings and surveillance have improved, the skyrocketing case numbers reflect a true increase.
In March, a CDC press release noted the seriousness of the problem, citing the pathogen's resistance to traditional antifungal treatments and the alarming rate of its spread. Public health agencies are focused primarily on strategies to urgently mitigate transmission in health care settings.
Dr. Luis Ostrosky, a professor of infectious diseases at McGovern Medical School at UTHealth Houston, thinks Candida auris is "kind of our nightmare scenario."
"It's a potentially multidrug resistant pathogen with the ability to spread very efficiently in health care settings," he said. "We've never had a pathogen like this in the fungal infection area."
Ostrosky has treated about 10 patients with the fungal infection but has consulted on many more. He said he has seen it spread through an entire ICU in two weeks.
The fungus poses a significant threat to human health, researchers say.
Immunocompromised patients in hospitals are most at risk, but so are people in long-term care centers and nursing homes, which generally have less access to diagnostics and infection control experts.
Candida auris is not only challenging to treat, but also difficult to diagnose. It is rare and many clinicians are not aware it exists.
Beyond the increase in cases, popular culture has helped increase awareness of fungal infections. A popular HBO series, The Last of Us, is a drama about the survivors of a fungal outbreak.
"I think the way to think about how global warming is putting selection pressure on microbes is to think about how many more really hot days we are experiencing," said Arturo Casadevall, a microbiologist, immunologist and professor at Johns Hopkins University. "Each day at (37.7 degrees Celsius) provides a selection event for all microbes affected — and the more days when high temperatures are experienced, the greater probability that some will adapt and survive." | Epidemics & Outbreaks |
In early 2022, nearly 200,000 Malawians were displaced after two tropical storms struck the southeastern part of Africa barely a month apart. Fifty-three people died.
Amid an already-heavy rainy season, the storms Ana and Gombe caused devastation across southern Malawi to homes, crops, and infrastructure.
“That March, we started to see cholera, which is usually endemic in Malawi, becoming an outbreak,” said Gerrit Maritz, a deputy representative for health programs in Malawi for the United Nations Children’s Fund.
Cholera typically affects the country during the rainy season, from December to March, during which time it remains contained around Lake Malawi in the south and results in about 100 deaths each year.
The 2022 outbreak showed a different pattern — cholera spread throughout the dry season and by August had moved into Malawi’s northern and central regions. By early February of this year, cases had peaked at 700 per day with a fatality rate of 3.3 %, three times higher than the typical rate. When cases finally began to decline in March, cholera had claimed over 1,600 lives in a 12-month period — the biggest outbreak in the country’s history.
As climate change intensifies, storms like Ana and Gombe are becoming more frequent, more powerful, and wetter. The World Health Organization says that while poverty and conflict remain enduring drivers for cholera around the world, climate change is aggravating the acute global upsurge of the disease that began in 2021. According to the WHO, 30 countries reported outbreaks in 2022, 50% more than previous years’ average; many of those outbreaks were compounded by tropical cyclones and their ensuing displacement of people.
“It’s difficult to say that (Tropical Storm Ana and Cyclone Gombe) caused the cholera outbreak,” UNICEF public health emergency specialist Raoul Kamadjeu said. “What we can say is they were risk multipliers.”
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EDITOR’S NOTE: This story is part of a collaboration between The Associated Press and Grist exploring the intersection of climate change and infectious diseases.
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Cholera is a diarrheal illness that spreads in places without access to clean water and sanitation, when people swallow food or water contaminated with Vibrio cholerae bacteria.
“Malawi’s water-sanitation indicators were already extremely bad,” said Kamadje, “but the storms made a bad situation worse.”
Flash floods spread sewage into lakes and boreholes, washed away pipelines and sanitation infrastructure, and ruined roads integral to the delivery of supplies. By one government estimate, Ana alone destroyed 54,000 latrines and about 340 wells. People displaced from their homes turned to whatever water sources were available, often ones that were highly contaminated, and transmitted the disease as they moved to new areas.
While Malawi’s outbreak was spreading across its borders to Zambia and Mozambique, hundreds of thousands of people in Pakistan reported cholera symptoms amid a massive monsoon season that left a third of the country fully underwater. And in Nigeria, cases spiked after over a million people were displaced by extreme flooding during the 2022 rainy season.
The global cholera surge drove a vaccine shortage right when countries needed it most. Malawi in the past used the cholera vaccine for prevention, but “now if you don’t have an outbreak, you don’t get the vaccine,” said Patrick Otim Ramadan, WHO incident manager for regional cholera response in Africa.
In response to the shortage, the international coordinating group for cholera vaccines changed its vaccination protocol in October from two doses to one, reducing protection from two years to about five months.
Climate change doesn’t only affect cholera through worsening floods and storms. Hotter temperatures and longer and drier droughts can also have an impact.
“With a severe shortage of water, the remaining sources become easily contaminated, because everyone is using them for everything,” Ramadan said. “We have seen that in the greater Horn of Africa.”
Amid a prolonged and extreme drought, which has been directly attributed to climate change, Ethiopia, Somalia, and Kenya all saw cholera proliferate over the past year. In drought areas that have experienced crop failure, malnourishment has also reduced immunity to diseases.
Johns Hopkins University infectious disease epidemiologist Andrew Azman, who specializes in cholera research, cautions against making sweeping statements about climate change turbocharging cholera globally.
“We know cholera is seasonal in much of the world, but the associations between precipitation, drought, floods, and cholera are not really clear,” Azman said. “In some places, more precipitation increases cholera risk. In some places, it’s less precipitation.”
He added that destructive storms in the past have not led to massive cholera outbreaks at the scale of the recent epidemic in Malawi, so it’s important to also consider other factors.
“While the storms may have created good conditions for transmission, the outbreak happened after a few years of relative calm in terms of exposures,” Azman said. “Immunologically, you had a much more naive population.”
The strain circulating had also been newly introduced from Asia, and scientists are currently studying whether it was more transmissible.
Research suggesting that the Vibrio bacteria itself thrives and spreads more effectively in an aquatic environment under increasing temperatures has largely been discredited, said Azman.
“But one of the big mechanisms by which extreme events will impact cholera risk is the destruction of water and sanitation infrastructure,” he said. “That is an important point, because we can block those impacts if we invest in (those things).”
Kamadju agrees. “Cholera is just a mark of inequity and poverty,” he said. “It’s a problem of investment, development, and infrastructure.”
Malawi’s outbreak came at a time of economic crisis, with its currency devalued in May 2022. Limited health resources were also stretched thin by COVID-19 and a polio outbreak, the first in 30 years.
This March, a year after the cholera outbreak began and as cases were beginning to go down, Malawi and its neighbors braced for a new storm. Cyclone Freddy turned out to be the longest-lasting cyclone ever on record, causing untold damage and killing more than 600 people across Mozambique, Madagascar, and Malawi, with some counts even higher. But while cholera cases started to spike in Mozambique as predicted, in Malawi they continued their downward trend.
Ramadan says that’s in large part because the ongoing cholera response already occurring in Malawi’s southern region — high vaccination rates, advanced distribution of water tablets and supplies, and messaging around cholera — reduced transmission in spite of the direct impacts to infrastructure.
Maritz of UNICEF worries that a shift in Malawi’s methodology for reporting cholera cases may be giving a false impression of just how successful those mitigation efforts are. On June 1, as cases continued to decline significantly, Malawi shifted to an endemic protocol for measuring cholera, which requires a rapid diagnostic test and a lab sample to confirm an infection. In contrast, during an outbreak, anyone who presents at a clinic with symptoms gets marked as a case.
Kamadjeu said this strategy made sense given the low number of current cases. But Maritz says that capacity challenges and delays in testing with the new protocol have led to underreporting of cases.
“We are still seeing people arriving at clinics with cholera symptoms that are not being reported in the national dashboards,” said Mira Khadka, an emergency health specialist leading cholera response for UNICEF in Malawi’s Blantyre district. It’s hard to mask a big cholera outbreak if people start dying, but the reporting lag is still cause for concern.
“Agencies that were responding to the cholera outbreak are now withdrawing,” said Khadka. “This can create the potential for another big outbreak to start.”
A team of government officials and health experts is assessing reporting methods in the southern districts where cases persist.
“What climate change means for us as a humanitarian agency is that we cannot do business as usual anymore,” Maritz said. “We are already preparing that most likely come January, February, there will be another cyclone with a huge flooding event.”
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Associated Press climate and environmental coverage receives support from several private foundations. See more about AP’s climate initiative here. The AP is solely responsible for all content. | Epidemics & Outbreaks |
By Foster Lasley, MD, as told to Kara Mayer Robinson Â
If your lung cancer canât be treated with surgery, it doesnât mean thereâs nothing you can do.Â
You may still have treatment options like radiation therapy and chemotherapy. Nonsurgical treatments can lead to good outcomes and theyâre commonly used around the world today.
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Whatâs Inoperable Lung Cancer?
Inoperable lung cancer is simply a tumor that surgery canât treat, which could be because your cancer is in a difficult spot to reach, itâs spread outside your lungs, or you have other serious health conditions.Â
For example, if your lungs arenât healthy enough in general, or you have a prior condition like heart disease, it can make surgery too risky.
How Do You Treat Inoperable Lung Cancer?
Itâs up to you and your doctor to decide which options are best for you. Every person is different, so your best treatment plan is based on your specific needs.Â
Radiation, chemotherapy, targeted therapy, and immunotherapy can each be used to treat inoperable lung cancer. Your doctor may recommend one treatment or a combination of treatments.
What Are the Latest Advances in Inoperable Lung Cancer?
Lung cancer treatment continues to improve thanks to ongoing improvements in detection and treatment.Â
CT scans and other screening methods are becoming more and more capable of detecting tumors early on, when theyâre more treatable.Â
Different combinations of radiation therapy, chemotherapy, targeted therapy, and immunotherapy are being tested in clinical trials to figure out the best order and period of time for each treatment.Â
Doctors are constantly reviewing the latest research to find tweaks to improve care.
Whatâs Coming in the Near Future?
Thereâs a lot of research in the works.
Current and upcoming clinical trials are looking at:
- How to tailor treatment to individual cancer types
- How to treat higher numbers of metastatic sites
- Improving detection of small sites of distant metastases so that they can be treatedÂ
Experts are also discussing how to handle metastases to the brain. Doctors have different opinions on the best approach.
Exciting research is being done to look at the use of stereotactic body radiation therapy (SBRT)Â in combination with checkpoint inhibitors. SBRT is a type of radiotherapy that uses 3D imaging to target tumors all over your body. Checkpoint inhibitors are a type of drug that blocks proteins found in some cancer cells.Â
Using checkpoint inhibitors combined with other treatment methods may allow doctors to better treat lung cancer without surgery. This is especially exciting for people with inoperable lung cancer. Clinical trials are still in the early phase I stage, but this could be a big development.Â
Another exciting new development is the increasing use of SBRT to decrease the amount of oligometastatic sites in your body, often in combination with other therapies.
How Do Disparities in Health and Health Care Impact Inoperable Lung Cancer?
Unfortunately, recent research shows racial disparities for minorities in how long they have to wait for cancer care.Â
Many wealthy communities in the U.S. have an abundance of medical resources at their disposal. Theyâre also more concentrated around major cities.Â
But this means lower income areas, which have more people of color, are comparatively underserved. When access is difficult, and a larger area with more people only has a few cancer care locations, this can create a bottleneck and longer wait times for care.
To combat this, public and private practices must make an effort to establish sites in these lower income and rural areas so that theyâre closer to underserved communities.Â
We work hard in my practice to make sure patients get the same care regardless of race, ethnicity, and background, in a way thatâs personalized to their specific needs and health conditions.
What Can You Do to Manage the Stigma of Lung Cancer and Other Mental Health Concerns?
People may assume your cancer is self-inflicted due to smoking. But it can happen even if youâve never smoked a cigarette. There are plenty of other factors that play a role, including your family history of lung cancer.Â
This stigma, along with the emotional challenges of having lung cancer, can take a toll on your mental health, which plays a big role in holistic care.Â
If you lose hope or feel like your quality of life is getting worse, it can have a negative effect on your emotional and physical health. This can lead to a lack of exercise and high levels of stress, which can harm your treatment process and outcomes.Â
To help with this, I recommend finding a support group in your area. There are more and more popping up across the nation. If you canât find one locally, there are many online communities willing to help and provide resources during your treatment process.Â
Itâs also a good idea to exercise, eat right, and try to live your life as normal. Doing so helps with positivity and overall happiness, which can stave off stress and depression. A positive outlook and can-do attitude go a long way in helping to achieve a better outcome.
Whatâs the Outlook for Inoperable Lung Cancer?
Thereâs still hope if your lung cancer is inoperable. Modern medicine has found ways to treat patients with inoperable lung cancer effectively, so itâs absolutely vital you keep hope, stay positive, and fight.Â
Every day, doctors around the world are conducting clinical trials to find new, better ways to treat inoperable lung cancer. The solution to your specific case could be right around the corner, so we all have to keep going to get there.
Show Sources
Photo Credit: EmirMemedovski / Getty Images
SOURCES:Â
Foster Lasley, MD, DABR, GenesisCare.
American Association for the Advancement of Science: âMinorities face longer wait times for vital lung cancer treatment, study finds.â
Mayo Clinic: âStereotactic Radio Surgery.â | Disease Research |
A personal trainer who has five children has revealed she ran approximately 3,000 miles during her most recent pregnancy - and has run ultramarathons while carrying her other children.
Sophie Carter, 43, kept up daily exercise while carrying all five of her children, Faith, Ethan, Isla, Jaxon, and Teddy, and believes it has helped her preserve her mental health.
While pregnant with Teddy last year, Sophie completed a 50km race and two 100km races. As late as 31 weeks pregnant, she completed a marathon in under four hours.
Overall, she believes she covered approximately 3,000 miles while pregnant with Teddy, and was back at it just two days after giving birth.
While some mothers might feel concerned about taking up extreme exercise while carrying a baby, Sophie insists it's completely safe for women who have always been active, after taking advice from medical professionals.
The mother-of-five said running helps her maintain a sense of self while pregnant, in a form of self care.
She said: 'When you're pregnant it can feel like your body's not your own and you're being taken over by something out of your control.
'Being able to keep running gave me that peace of mind to say, 'I'm still me'.'
She added that, while many people are shocked at how active she remained while pregnant, it was 'beneficial' for her to continue running - especially during lockdown when she was pregnant with twins.
'I had the goal of qualifying for the world championship, so I wanted to keep things ticking over,' she explained.
'Like getting up and brushing my teeth, going for a run is part of my routine.
'I go out thinking if it ever doesn't feel good and I need to stop, I will. At 36 weeks, I felt a contraction and thought something was happening. They were born the following week.'
Sophie has always enjoyed long distance running and completed her first marathon in 2006, aged 25.
Inspired by former Team GB marathon-runner Paula Radcliffe, Sophie continued running throughout her first pregnancy with her daughter, Faith, in 2009, to keep fit.
But when her mum, Auriel, fell ill with bowel cancer in 2012, she began to focus on running more seriously.
At the time, Sophie was pregnant with her second child, Ethan, and her then-husband was posted to Afghanistan as part of the British Army.
She was looking after her firstborn Faith at home alone, and running became her 'safe space'.
'Sometimes I'd run twice a day for up to 20 miles,' she said.
'Running was the one thing that made me feel better about myself. It was a safe space and it gave me a goal to focus on.'
When Sophie's mother sadly passed away in 2017, she took up ultramarathons - races up to a distance of 100km. She said the long races helped her process her grief.
When Sophie became pregnant with twins Jaxon and Isla in 2020, she continued running eight miles a day.
In April last year, just as she was gearing up to run a 100km race, Sophie learnt she was six weeks pregnant with her son Teddy.
'I talked to my partner and thought I may as well do the event as I'd already booked it,' she said
'I told myself that if I don't feel good then I'll just stop.'
The super-fit mother took part in the race and came sixth, finishing in just eight hours and 30 minutes, which was 19 minutes off her personal best.
She said: 'Doing it with one single pregnancy felt a lot easier than with twins.'
Six weeks later Sophie took part in a 50km race and finished first out of all female participants.
Then, at 20 weeks pregnant, with the 'the tiniest of bumps', she took part in The Race to The Stones - a 100 km cross country race along Britain's oldest footpath from Oxfordshire to Wiltshire.
Despite temperatures soaring above 20 degrees, Sophie finished in the top ten overall and was the second woman to cross the finishing line.
And in October last year, at 31 weeks pregnant, she completed the Virtual London Marathon, finishing in an impressive time of three hours and 39 minutes.
'I did the marathon in the morning, and then I went home and took the kids out for a walk in the afternoon,' she said.
Although it was some way off her best marathon time of two hours and 48 minutes, Sophie said: 'The bump slows you down, but it was fast for someone at 31 weeks. I was just pleased to be able to cover the distance.
'Your muscles hold the baby in place, so there's hardly any movement around.'
Sophie says running a marathon while pregnant is only a little bit different to preparing for a regular marathon.
'The main difference is I'm running slower and listening to my body a lot more,' she said.
'Most people I tell are amazed by how far I can run and say, 'I can't even do that when I'm not pregnant',' she said.
'It's a myth that women shouldn't exercise while pregnant. My pregnancies were healthy, and I haven't had any problems.
'Historically, people have said you need to sit still, rest and eat for two.
'But I've spoken to neonatologists who say that's the worst thing you can do as afterwards it's much harder to get back into being active.
'Dealing with the challenges of parenting while pregnant, I find running massively helps my mental and physical well being.
'A gynaecologist told me there isn't a maximum distance women can run while pregnant, it's just what they're comfortable with.
'For most women 5k might be comfortable, but for me 100k is still comfortable.
'If women are used to exercising, being pregnant is not a reason to stop. Women should listen to their bodies and continue if it feels okay.
'I understand it's an individual thing and if you don't want to, that's okay. I want my experience to show women you can continue to exercise to a level you're used to. You'll be okay and your baby will be too.' | Women’s Health |
As the Centers for Disease Control and Prevention (CDC) determines whether to approve a vaccine against RSV for adults 60 and older, a new survey from the Annenberg Public Policy Center finds that the American public is ill-informed about the virus, unfamiliar with its most common symptoms, and more hesitant to recommend the vaccine to pregnant people than to older adults.
Worldwide, RSV is the leading cause of lower respiratory tract infections in babies. Though its symptoms are typically mild, the highly contagious RSV, or respiratory syncytial virus, can cause serious illness, hospitalization, and even death among infants and the elderly. By the age of 2, nearly all children get sick from RSV, which was one of three illnesses -- with the flu and Covid-19 -- contributing to last winter's "tripledemic" that overwhelmed some health care facilities. The CDC estimates that 58,000 to 80,000 children under age 5 are hospitalized annually because of it.
After decades of research, scientists have developed vaccines against RSV. In May, the Food and Drug Administration (FDA) approved two RSV vaccines for older adults, and this summer is likely to approve a maternal RSV vaccine for pregnant people to pass antibodies on to fetuses to prevent RSV in infants from birth up to at least six months of age.
The survey of more than 1,600 adults finds that less than half of Americans (49%) were likely to recommend the vaccine against RSV, if approved by the FDA, to a pregnant friend or family member. By contrast, most Americans (63%) would recommend a vaccine against RSV to a friend or family member aged 65 or older. (When the survey was fielded, the FDA had already approved the vaccine for adults 60 and older, although the shots were not yet available.)
"Those who recall the stress that the tripledemic placed on the nation's hospitals last fall will understand why older individuals and those who are pregnant should discuss the advisability of RSV vaccination with their health care providers," said Kathleen Hall Jamieson, director of the Annenberg Public Policy Center (APPC) of the University of Pennsylvania and director of the study.
APPC's Annenberg Science and Public Health Knowledge survey
The survey data come from the 11th wave of a nationally representative panel of 1,601 U.S. adults, first empaneled in April 2021, conducted for the Annenberg Public Policy Center by SSRS, an independent market research company. This wave of the Annenberg Science and Public Health Knowledge (ASAPH) survey was fielded May 31-June 6, 2023, and has a margin of sampling error (MOE) of ± 3.3 percentage points at the 95% confidence level.
Download the topline and the methodology.
Data from earlier waves on Covid-19, society's "return to normal," vaccination, monkeypox, the seasonal flu, health misinformation, and related topics can be found here.
Underestimating the prevalence of RSV -- but awareness of potential severity
A quarter of the public (27%) expresses worry about contracting or having a family member contract RSV, less than the one-third (33%) who were worried in our January survey, which was conducted during the tripledemic. The decrease in concern is not surprising given that RSV circulates during the fall and winter, and there was media coverage of the surge of cases last winter that, combined with flu and Covid-19 cases, filled some hospitals.
The prevalence of this common illness is vastly underestimated by the public. Only 22% in the current survey say they know children who have had RSV -- and among these respondents, over half say they have known just one child or two children who have had it. Asked how many children contract RSV before the age of two, 2% of respondents say, "virtually all." According to the CDC, "Almost all children will have had an RSV infection by their second birthday."
But among the people who say they know children who have had RSV, its potential severity is clear. Among these respondents, over half (54%) say the illness was somewhat or very serious. "Most children with cold-like symptoms are not tested for RSV, but when a child becomes severely ill, it's more likely that child will undergo diagnostic testing," Jamieson said. While RSV can cause severe illnesses such as bronchiolitis and pneumonia, the CDC says it usually causes mild, cold-like symptoms -- like runny nose, coughing, sneezing, fever, wheezing, and decreased appetite -- and is often mistaken for cold or flu.
This does not mean, however, that some do not experience serious illness. Among 100 babies under the age of six months who get RSV, 1 to 2 may require hospitalization, the CDC says. Although RSV-associated deaths are "uncommon" in the United States, they nonetheless do occur at an estimated rate of 100 to 500 per year for children under five, according to the CDC. Worldwide deaths of children under 5 years old attributable to RSV exceed 100,000 annually.
Far fewer people say they know older adults who have had RSV. Only 6% of those surveyed say they know someone age 65 or older who has had RSV. Among this group of respondents, most (71%) say they know one or two people who have had it and most (72%) say the infection was somewhat or very serious. The CDC reports that among adults 65 and older, there are 60,000 to 160,000 hospitalizations per year from RSV, and 6,000 to 10,000 deaths.
Great uncertainty about RSV
Only small segments of the American public correctly answer questions about RSV. Most people say they are not sure. The survey found that:
Fewer than half recognize the symptoms of RSV
Fewer than half of those surveyed recognized some of the most common symptoms of RSV (respondents were asked to select all that applied):
Very few people incorrectly selected non-respiratory symptoms as associated with RSV:
The Annenberg Public Policy Centerwas established in 1993 to educate the public and policy makers about communication's role in advancing public understanding of political, science, and health issues at the local, state, and federal levels. Read more about our science and health surveys here.
Story Source:
Materials provided by Annenberg Public Policy Center of the University of Pennsylvania. Note: Content may be edited for style and length.
Cite This Page: | Vaccine Development |
MicroRNA holds clues to why some mammals are cancer-prone
Researchers at the College of Veterinary Medicine (CVM) have identified an important pathway that reveals why some mammals, like humans, dogs, and cats, regularly develop mammary cancer while others, such as horses, pigs, and cows, rarely do.
They used an unusual approach to uncover a piece of that puzzle—why cells in some species become cancerous—which they described in a paper published in Communications Biology in October.
The discovery hinges on a previous finding that gives clues about the molecular mechanisms at play. Mammary stem cells from some species with low incidences of mammary cancer use a process called apoptosis to destroy cells with damaged DNA. In contrast, many species with a high incidence of mammary cancer repair their DNA-damaged cells, leaving them susceptible to potential cancerous mutations.
In the study, researchers focused on the role of microRNA-214-3p, a microRNA that is known to play a role in regulating apoptosis or cell destruction. They compared how microRNA-214-3p functions in stem cells from horses, which rarely develop mammary cancer, and from dogs, which regularly do. They discovered that microRNA-214-3p is expressed at low levels in horse cells but at higher levels in dog cells and that this low microRNA-214-3p expression promotes the apoptosis that destroys horse cells with damaged DNA.
"Our research is novel because we worked with healthy cells, not cancer cells, trying to understand how a microRNA can prevent cells from becoming cancerous," said Rebecca Harman, the study's lead author and a research support specialist at the Baker Institute for Animal Health. "There are still many details to be worked out. This is a small piece of the puzzle, but it's an important piece."
Harman works in the laboratory of Dr. Gerlinde Van de Walle, the Alfred H. Caspary Professor and interim director of the Baker Institute for Animal Health. They collaborated closely with Praveen Sethupathy, professor of physiological genomics and chair of the Department of Biomedical Sciences at CVM, who studies the role of microRNAs in animal and human diseases, including cancer.
"MicroRNAs are generally understudied in veterinary cancers," Sethupathy said. "This work represents and builds on the emphasis on comparative cancer biology at Cornell."
After their initial findings, the research team conducted a second experiment to artificially increase the expression of miRNA-214-3p in horse cells. This led to the inhibition of apoptosis: When miRNA-214-3p expression increased, DNA-damaged horse cells were less likely to be destroyed.
Conducting similar experimental approaches in multiple species is another valuable aspect of this research, Van de Walle said.
"The most exciting part of this kind of research is comparing species who get the disease to those that don't," she said. "With this comparative approach, you can find new information that you would miss from looking at only one species. And we are more likely to be able to apply our findings to human disease."
More information: Rebecca M. Harman et al, miRNA-214-3p stimulates carcinogen-induced mammary epithelial cell apoptosis in mammary cancer-resistant species, Communications Biology (2023). DOI: 10.1038/s42003-023-05370-4
Journal information: Communications Biology
Provided by Cornell University | Disease Research |
Mocktails and so-called zero-proof beverages are growing commonplace on menus as more people opt to follow a "sober curious" or strictly teetotal lifestyle.
Many are familiar with the "Dry January" challenge to stop drinking alcohol for a whole month, but recently, the trend of saying goodbye to the dreaded hangover hasn't stopped with New Year's resolutions, especially amongst young people. Over the past two decades, the number of American undergraduate students who report abstinence from alcohol has risen by 8%, and in the U.K. in 2019, adults aged 16 to 24 were most likely to be teetotal, with 26% saying they never drink.
People quit alcohol for many reasons: for some it's the calories, others, the risk of liver damage, increased blood pressure and potentially cancer. But what happens to the body when the average drinker calls it quits?
Related: What does alcohol do to the body?
Given how many variables there are, it is hard to define an "average" drinker. The Centers for Disease Control and Prevention (CDC) describes "drinking in moderation" as having no more than one drink a day if you're a woman or two drinks a day if you're a man, on the days that you drink alcohol. Two-thirds of adult drinkers, however, say they exceed these levels at least once a month, a 2014 study found.
The agency defines "binge drinking" as consuming at least four drinks in a 2 to 3 hour sitting, for women, and at least five drinks in the same time for men; "heavy drinking" is having at least eight or 15 drinks a week for women and men, respectively. A standard drink roughly translates to 12 ounces (0.35 liters) of beer at 5% alcohol by volume (ABV), or 5 ounces (0.14 L) of wine at 12% ABV.
One way to represent the average drinker may be to focus on people who don't have a history of alcohol dependence. This is exactly what one study, published in the British Medical Journal, did in 2018.
Scientists recruited 94 volunteers who were on average 45 years old and asked them to stop drinking for a month. Before the challenge, participants were defined as "moderate to heavy drinkers" who drank around 258 grams of alcohol a week, roughly equivalent to about 18 standard drinks. No participants had a history of known liver disease or alcohol dependence.
After a month, those who refrained from drinking experienced a range of positive health benefits not seen in a similar group of people who continued to drink. On average, the abstainers' blood pressure decreased by 6%, they lost around 2.2 pounds (1.5 kilograms) and their insulin resistance, which reflects a person's risk of developing diabetes, fell by 25%.
"We didn't note this in the report but they also felt better, their concentration improved and they were able to sleep better," Dr. Kevin Moore, study author and professor of hepatology at University College London, told Live Science. The team saw these results after adjusting for changes in diet, exercise and smoking, so the changes could be linked to people's alcohol use.
They also noticed that levels of proteins in the blood that promote cancer growth, namely epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) decreased by around 73% and 41%, respectively. Moore hypothesized that instead of causing cancer to develop in the first place, these findings may suggest that alcohol instead promotes cancer's growth once it gets a footing in the body. To confirm this speculation, however, the team would need to conduct a long-term study of moderate drinkers, the authors noted in their report.
It is still unknown whether these positive effects of abstinence persist beyond a month, but Moore speculated it could be possible. "It's quite clear that alcohol has a physiological effect on the body, so I'd be surprised if all those effects just wore off," he said.
So, does this mean people should stop drinking altogether?
"If you have cancer and you're worried about it growing then you should stop," he explained. This is common guidance given to cancer patients. For the wider population, he emphasized that when you stop drinking, you not only feel better but you also sleep better and your physical health improves. One downside of quitting for some though, he said, could be the social side of drinking and not wanting to feel left out.
One important caveat is that Moore's study looked only at drinkers without a history of alcohol dependence. People who have alcohol use disorder (AUD) can experience symptoms of alcohol withdrawal if they suddenly quit or even significantly decrease their intake. This is where the central nervous system becomes so reliant on the depressive effects of alcohol that, when a patient stops drinking, their brain stays in a "hyperactive" state. This can lead to symptoms including anxiety, insomnia and irritability, and in more serious cases, hallucinations, seizures and potentially death.
"If an individual experiences shakiness and discomfort the morning after drinking, or drinks alcohol throughout the day, then going cold turkey could be dangerous," Katie Witkiewitz, a professor of psychology at The University of New Mexico, told Live Science in an email.
In these cases, she said that talking with a healthcare provider about taking specific withdrawal medication could be helpful. Talk therapy, either as an individual or as part of a group, can also offer support through the process of quitting.
This article is for informational purposes only and is not meant to offer medical advice.
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Emily is a health news writer based in London, United Kingdom. She holds a bachelor's degree in biology from Durham University and a master's degree in clinical and therapeutic neuroscience from Oxford University. She has worked in science communication, medical writing and as a local news reporter while undertaking journalism training. In 2018, she was named one of MHP Communications' 30 journalists to watch under 30. ([email protected]) | Stress and Wellness |
NHS waiting lists could top eight million by next summer, even if doctor strikes cease, according to modelling work by the Health Foundation charity.
It says industrial action has only contributed a small amount, lengthening the list by about 210,000 or 3% of the 7.75 million total by August.
Chronic shortages of NHS staff and funding are the main driver, it says.
NHS England says more than one million appointments and procedures have had to be rescheduled because of NHS strikes.
That figure includes walkouts in England by nurses and other healthcare professionals who were asking for better wages.
The modelling is not a nailed-on prediction or projection. It is an attempt to understand what is happening to waiting lists for patients and claims:
- A worst-case scenario could see strike action continue, and growth in hospital activity a third lower than current trends at 5.2% a year, resulting in the waiting list continuing to grow and reaching 8.4 million by the end of 2024
- A better-case scenario could see strike action stop and the rate of hospital activity growth increase by a third to 10.4%, with the waiting list peaking in October 2023 and then falling to below 7.2 million by the end of 2024.
Both NHS England and the Health Foundation say NHS work has ramped up to see more patients and clear the backlog - monthly referrals for treatment are now back to pre-pandemic levels, and growing at a faster rate, which is a "positive" sign.
But the waiting list is still rising as the number of treatments does not yet exceed the number of referrals.
Behind all the numbers are "people anxious for a diagnosis, patients in avoidable pain and lives put on hold", says Charles Tallack, from the Health Foundation.
Patients are waiting for treatment ranging from hip replacements to surgery to remove cancerous tumours.
He said: "The pandemic heaped further significant pressure on an already stressed system, but waiting lists were already growing long before Covid."
An NHS spokeswoman said there had been important progress in bringing down the longest waits: "Two-year waits have been virtually eliminated and waits of more than 65 weeks have more than halved."
She stressed that the NHS was still seeing high levels of demand.
Tim Mitchell, president of the Royal College of Surgeons of England, said: "To tackle waiting lists in a meaningful and sustainable way, we need transformative solutions.
"Continuing to invest in surgical hubs across the country, focusing on the areas with the longest waits, would allow surgeons to operate more efficiently. Hubs protect planned surgery from stoppages during busy periods when resources are diverted to emergency pressures.
"Crucially, we must also improve staff morale and retention. The government's commitment to grow the healthcare workforce is welcome. However, recruiting new staff is only half of the solution. Providing a supportive, well-resourced working environment is vital."
The British Medical Association, which is a union for doctors, said: "Doctors have gone on strike precisely because it is only with a fully staffed and fully valued NHS that elective care can be put back on a path to normality.
"Time is rapidly running out to get credible pay offers on the table, which would both end strikes and boost the recruitment and retention the workforce needs." | Health Policy |
The Chief Medical Officer said a Covid vaccine could not be fast-tracked because the virus had a “low mortality rate” in the early days of the pandemic, messages reveal
Prof Sir Chris Whitty told Matt Hancock and others that diseases with a mortality rate in the range of one per cent would need a “very safe” vaccine and that the necessary clinical trials would be a “rate limiting step”.
He was responding to a WhatsApp message from Dominic Cummings, the then chief adviser to Boris Johnson, in February 2020 about a report saying Israeli scientists were weeks away from developing a vaccine.
How quickly vaccine trials could be completed was one of the most important arguments happening in Government during the first months of the pandemic.
Mr Cummings would later claim the Government could “definitely” have started vaccinating the population in September 2020 – three months before the first jabs were given – if it had adopted a bolder approach to vaccine trials.
Booster campaign ongoing
To date, 144 million Covid jabs have been administered in England, and a spring booster jab is to be offered to people aged 75 and over, those in care homes and vulnerable people following advice from the joint committee on vaccination and immunisation.
Vaccines will be offered to eligible people around six months after their previous dose, with the booster campaign in England running from April 17 to June 30.
Dr Mary Ramsay, the head of immunisation at the UK Health Security Agency, said Covid was “still circulating widely” and there had been a recent increase in older people being hospitalised.
WhatsApp messages seen by The Telegraph include messages sent within a group of ministers, experts and officials in the early weeks of the pandemic.
On Feb 29, 2020 Mr Cummings prompted a conversation with Sir Chris and Sir Patrick Vallance, the Chief Scientific Officer, by posting a copy of a newspaper article about Israeli scientists being weeks away from a vaccine:
The highest mortality rate for Covid in England was recorded in April 2020, when 626 people per 100,000 were dying of Covid – 0.6 per cent.
After subsiding over the summer of that year, it spiked again at 0.55 per cent in January 2021 before declining steadily to 0.04 per cent in January this year.
In May 2021 Mr Cummings told a Covid super-committee of MPs he believed it was “unarguable” that the vaccine trials process should have happened more quickly.
He told the MPs: “Normally, for any kind of vaccine, obviously you have a whole testing process, which takes quite a lot of time to go through, because if you have a disease that is killing, say, one per cent to two per cent of the population, then you have to make sure that you don’t have a vaccine that kills more than that.
“However, for something like this, from the point of view of how human civilisation overall could have done better, I think it is unarguable what should have happened.”
He claimed it had taken “literally hours” for a vaccine to be invented in January 2020 and that the Government should have recruited 5,000-10,000 people to take part in immediate “human challenge” trials, in which volunteers are given the vaccine and then deliberately infected with Covid to see how effective the inoculation is.
He suggested that “everyone takes their chances” if they take part in the trial and “if you die your family will get one million quid or whatever”. He added: “That obviously would have been the best thing to do. If we had done that, we could have hugely cut the time for doing this. We could definitely have got vaccines into people’s arms by September.”
Between the start of September 2020 and Dec 8, 2020, when the first Covid vaccination in the UK was given, more than 23,000 people died with coronavirus mentioned on their death certificate.
Human challenge trials not used
The UK, in common with other countries, did not carry out human challenge trials before the vaccine was rolled out, partly because there was no known cure for Covid, meaning that if the vaccine did not work there was no guarantee that volunteers’ lives could be saved by other means.
The Government announced funding for human challenge trials in October 2020, but they did not begin until January 2021, after the vaccine rollout had started. Instead, data gathered from volunteers who had been given the vaccine but not deliberately infected with Covid was used to assess the safety and effectiveness of the different vaccines being developed.
The human challenge trials had to be approved by the research ethics committees of the Medicines and Healthcare products Regulatory Agency and the NHS Health Research Authority before they could begin.
In February 2021, Sir Tony Blair, the former prime minister, suggested the first wave of the Covid outbreak around the world could have been shortened by three months if countries had collaborated more on vaccines, testing and drugs. He suggested that, in future, a new vaccine could be developed in as little as 100 days.
Israel did not manage to get a vaccine ready more quickly than the UK, but it did roll out its vaccine programme more swiftly once it started, vaccinating 10 per cent of its population with a first dose of the Pfizer vaccine between Dec 20, 2020 and the start of 2021. | Vaccine Development |
An Arkansas man has a new eye after being the subject of the first-ever human eye transplant in May.
The eye transplant was part of a complex partial-face transplant performed by a team of surgeons at NYU Langone Health in New York City. Aaron James, a high-voltage utility line worker, lost most of his face in a work accident in June 2021, when it accidentally touched a 7,200 volt live wire while out on a job.
Dr. Eddie Rodriguez, one of James' doctors for the transplant, said it's not an injury many would have survived.
"He was alive. They bring him down. They rush him to the regional burn unit," Rodriguez said. "And he's in bad shape. They have to amputate his arm (above the elbow), so right at the midarm. His face is destroyed ... Forget about replacing the arms, the face. We gotta keep this guy alive."
James, 46 said he doesn't "remember any of it," but when he woke up, he had lost his nose, his front teeth, his left eye and his dominant left hand. He also lost his chin down to the bone, 20% of his tongue, his left cheek, and his lips. After multiple reconstructive surgeries, he couldn't eat or drink normally, and had trouble speaking, so he agreed to undergo the face transplant, including the world's first transplant of a donor eye. The transplant came from a single donor, making it "the only successful combined transplant case of its kind," according to NYU Langone Health. The donor was a man in his 30s who donated tissue to three other people, as well as James.
"A whole eye transplant's never been done," explained Rodriguez, who performed the world's first successful face and double hand transplant in 2020. His colleagues were skeptical of the idea of a face and eye transplant, but James was immediately on board.
"He didn't hesitate," Rodriguez recalled. "He said, 'If I can help out other people and then I can help out other soldiers, it's worth it. He had three tours ... He knows the value of helping out his fellow soldier."
James served in the Army National Guard and completed tours in Egypt, Kuwait and Iraq, according to NYU Langone Health.
Dr. Vaidehi Dedania became involved in the surgery as James' eye specialist. Dedania, an associate professor of ophthalmology and the director of the Vitreoretinal Surgery Fellowship at NYU, is a retina expert who worked to see if the new eye could actually send the right signals to the brain to process an image, restoring James' sight.
In late May, Rodriguez and the surgical team spent 21 hours in surgery, transferring the donor's face, eye socket and eye to James. A huge challenge was providing blood flow to the transplanted eye.
"It was an exhilarating moment to just see that blood supply coming to the retina," Rodriguez said.
The team also had to worry about nerve regeneration and immune rejection. These concerns are part of what have made whole-eye transplants so elusive, NYU Langone said. The research team combined the donor eye with donor bone marrow-derived stem cells in an attempt to enhance the nerve regeneration — something that had never been tried before. Those bone marrow cells were injected into James' optic nerve during the surgery.
After a few weeks in the hospital and some rehabilitation, James was considered recovered from the transplant. He said he still has some trouble speaking, but that has gotten better, and he's working to regain feeling in his lips and get his jaw to open more than it currently can. According to NYU Langone, he can now do things that were previously impossible, like eat solid foods. The transplant has also boosted his confidence.
"It just blows my mind," James said. "I tell everybody, if I get close to a mirror, I just stare at it. ... Now I want to go outside and let people see me, you know?"
However, a question still remained: Would light shone into the transplanted eye be recognized by the part of the brain that processes vision?
To find out, James underwent two functional MRIs, which measure small changes in blood flow that happen with brain activity. Dedania said the team first confirmed that James had blood supply, pressure in the eyeball, and a healthy retina, then put bright light into his eye and measured the retina's electrical response.
"What that showed us was that the photoreceptor cells ... were actually sending a signal back," Dedania said. "That's the moment where we were saying, 'Wow, so there's blood supply. The cells are still preserved, and he's able to, at least the retina is able to respond to a stimulus such as light."
Dedania and Rodriguez tested it with another functional MRI, where they worked with a research team and neuroradiologist. First, the team covered James' transplanted eye and flashed a light. That image was normally recorded in the visual cortex, Rodriguez said.
Next, the team covered James' functional eye and tested the transplanted one.
"We saw a response back there!" Dedania said. "Can we be more astonished? Every level, every test has further increased our understanding of how this eye is functioning within his body."
While James was able to process the light, the sight in that eye has still not been restored. Dedania was skeptical that it would return fully, but said she would "never say never." James will continue to be tested to see if his sight can be restored.
"This is unprecedented. The question is, is it possible? Yes," Dedania said.
"We don't have sight yet, but I'm an optimist," Rodriguez said. "The one thing for sure that I can say now is that we are one step closer."
for more features. | Medical Innovations |
Published in the European Heart Journal and supported by the British Heart Foundation (BHF) and National Health and Medical Research Council (NHMRC), the study is the first to assess how different movement patterns throughout the 24-hour day are linked to heart health.
It is also the first evidence to emerge from the Prospective Physical Activity, Sitting and Sleep (ProPASS) consortium, led by the University of Sydney’s Charles Perkins Centre, which aims to generate knowledge to inform future guidelines and policies.
Cardiovascular disease, which refers to all diseases of the heart and circulation, is the number one cause of mortality globally. In 2021, it was responsible for one in three deaths (20.5M), with coronary heart disease alone the single biggest killer. Since 1997, the number of people living with cardiovascular disease across the world has doubled and is projected to rise further.
In this study, researchers analysed data from six studies encompassing 15,246 people from five countries, to see how movement behaviour across the day is associated with heart health as measured by six common indicators. Each participant used a wearable device on their thigh to measure their activity throughout the 24-hour day and had their heart health measured.
The researchers identified a hierarchy of behaviours that make up a typical 24-hour day, with time spent doing moderate to vigorous activity providing the most benefit to heart health, followed by light activity, standing and sleeping - compared with the adverse impact of sedentary behaviour.
What is important to highlight about these findings is that replacing static or sedentary postures with movement is likely to improve heart health only if it becomes a long-term habit.
The team then modelled what would happen if an individual changed various amounts of one behaviour for another each day for a week, to estimate the effect on heart health. When replacing sedentary behaviour, as little as five minutes of moderate to vigorous activity had a noticeable effect on heart health.
For a 54-year-old woman with an average BMI of 26.5, for example, a 30-minute change translated into a 0.64 decrease in BMI, which is a difference of 2.4 percent. Replacing 30 minutes of daily sitting time with moderate or vigorous physical activity could also translate into a 2.5 cm (2.7 percent) decrease in waist circumference or a 1.33 mmol/mol (3.6 percent) decrease in glycated haemoglobin – a measure of blood sugar levels used to indicate diabetes.
Dr Jo Blodgett, first author of the study from UCL’s Institute of Sport, Exercise & Health, said: “The big takeaway from our research is that while small changes to how you move can have a positive effect on heart health, intensity of movement matters. The most beneficial change we observed was replacing sitting with moderate to vigorous activity – which could be a run, a brisk walk, or stair climbing – basically any activity that raises your heart rate and makes you breathe faster, even for a minute or two.”
Professor Emmanuel Stamatakis, ProPASS consortium founder and joint senior author of the study from University of Sydney’s Charles Perkins Centre, added: “What is important to highlight about these findings is that replacing static or sedentary postures with movement is likely to improve heart health only if it becomes a long-term habit.”
The researchers pointed out that although time spent doing vigorous activity was the quickest way to improve heart health, people of all abilities could benefit – but the lower the intensity of the activity, the longer the time required to start seeing a tangible benefit.
Using a standing desk for a few hours a day instead of a sitting desk, for example, is a change over a relatively large amount of time but is also one that could be integrated into a working routine fairly easily as it does not require any time commitment.
Those who are least active were also found to gain the greatest benefit from switching from sedentary behaviours to more active ones.
Professor Stamatakis said the wearables field was presenting exciting opportunities for health research.
“A key novelty of this study and the ProPASS consortium more broadly is the use of wearable devices that better differentiate between types of physical activity and posture, allowing us to estimate the health effects of even subtle variations with greater precision.”
Though the findings cannot infer causality between movement behaviours and cardiovascular outcomes, they contribute to a growing body of evidence linking moderate to vigorous physical activity over 24 hours with improved body fat metrics. Further long-term studies will be crucial to better understanding the associations between movement and cardiovascular outcomes.
Professor Mark Hamer, joint senior author of the study from UCL’s Institute of Sport, Exercise & Health, said: “Though it may come as no surprise that becoming more active is beneficial for heart health, what’s new in this study is considering a range of behaviours across the whole 24-hour day. This approach will allow us to ultimately provide personalised recommendations to get people more active in ways that are appropriate for them.”
James Leiper, Associate Medical Director at the British Heart Foundation, said: “We already know that exercise can have real benefits for your cardiovascular health and this encouraging research shows that small adjustments to your daily routine could lower your chances of having a heart attack or stroke. This study shows that replacing even a few minutes of sitting with a few minutes of moderate activity can improve your BMI, cholesterol, waist size, and have many more physical benefits.
“Getting active isn’t always easy, and it’s important to make changes that you can stick to in the long-term and that you enjoy – anything that gets your heart rate up can help. Incorporating ‘activity snacks’ such as walking while taking phone calls, or setting an alarm to get up and do some star jumps every hour is a great way to start building activity into your day, to get you in the habit of living a healthy, active lifestyle.”
Declaration: All authors declare no disclosure of interest for this contribution. This research was funded by the British Heart Foundation and the National Health and Medical Research Council (NHMRC). | Aerobics & Cardio |
Researchers report October 25 in the journal Neuron that cocaine addiction disrupts the dopamine neurons that govern how we perceive and learn from rewards. Though people with cocaine addiction have similar expectations of rewards compared to controls, their dopamine neurons send out much weaker signals when these rewards are actually received. This dysregulation could make it more difficult for people with cocaine addiction to learn from their experiences and change addictive behavior.
"Our results support the medical model of addiction as a disorder of the brain that deserves treatment," says senior author Rita Goldstein, a neuroscientist and addiction expert at the Icahn School of Medicine at Mount Sinai. "Addiction is a disorder and not a choice or a moral weakness."
"If you're not tracking the reward signal appropriately, it makes it much harder to disengage from something that's no longer rewarding," says first author Anna Konova, a neuroscientist at Rutgers University.
It's well documented from both animal and human studies that cocaine addiction impacts multiple aspects of dopamine signaling in the brain. However, it's unclear whether certain parts of the dopamine signaling pathway are more important than others. Rather than general errors with dopamine signaling, addictive behavior is thought to be due to disruptions to the reward prediction error, a system that calibrates future expectations based on past experiences by comparing expected rewards to actual rewards as encoded by dopamine neurons in the midbrain. However, few studies have directly demonstrated the impact of cocaine use on reward prediction error in humans.
To examine the role of prediction error in cocaine addiction, the research team used fMRI scanning to examine neural activity in people with cocaine addiction compared to healthy controls while they were performing a simple decision-making task: choosing between a "safe" monetary reward and a "risky" reward that carried a chance of being either much higher or lower in value than the safe option. The researchers compared brain activity during the two phases of the prediction error calculation: first during the expectation phase (while participants were making their decision and anticipating the resulting reward), and then during the actual reward phase (when participants were presented with the outcome).
They found that people with cocaine addiction had reduced prediction error responses, consistent with animal studies. When they broke the prediction error response down into its component parts, they found that signals of reward expectation were similar for both groups, but the signal for received reward was weaker for people with cocaine addiction. This weakened reward signal was visible in the ventral striatum, the brain region where prediction error is processed, and there was also reduced activity in the orbitofrontal cortex, a brain region involved in integrating the prediction error signal to inform future behavior.
"We found evidence that people with chronic cocaine addiction have reduced prediction error responses, and this difference seems to be caused by differences in the subjective perception of received reward," says Konova. "The reduced reward signal seems to propagate to other regions of the brain that would receive this information to then update your expectations for the next time you encounter this same situation."
The team also showed that people with cocaine addiction were more likely to choose risky options compared with controls, and this risk tolerance was more apparent in people who had begun using cocaine at an earlier age, pointing to potential predisposing factors for developing addiction.
Understanding the mechanisms behind addictive behavior could inform treatment strategies for addiction, the researchers say. "Our findings suggest that interventions that boost the perception of received rewards might be a valuable component of addiction treatment," says Goldstein. "Understanding the brain mechanisms behind addiction is also extremely valuable for the public and for the person experiencing addiction."
Next, the team wants to understand how this dysregulation of reward signaling changes during different stages of addiction and recovery and whether reward perception is involved in other types of substance disorder, for example in addiction to opioids such as heroin. "We want to understand how this signal changes through the progression of recovery, or as a function of different stages of addiction to understand whether it's really driven by chronic cocaine exposure or something that comes on earlier, maybe even before you start substance use," says Goldstein.
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For the first time, the White House has unveiled 10 drugs up for price negotiation with pharmaceutical companies on behalf of more than 53 million Medicare beneficiaries.
Brokered as part of the Inflation Reduction Act that President Joe Biden signed into law last August, experts say this move could save the United States billions annually and help make life-saving medications more affordable and accessible. New prices would not go into effect until 2026, and first must survive legal challenges from the pharmaceutical industry.
“There is no reason why Americans should be forced to pay more than any developed nation for life-saving prescriptions just to pad Big Pharma’s pockets,” Biden said in a statement. “For many Americans, the cost of one drug is the difference between life and death, dignity and dependence, hope and fear.”
Older Americans pay nearly $6,500 in out-of-pocket expenses for prescription drugs each year, the statement noted. For many with limited means, the cost of medications can consume a significant portion of their budgets. In 2019, nearly half of all Medicare recipients had an estimated annual income of less than $30,000.
The 10 drugs prioritized in the first round of negotiations are often prescribed by doctors to treat patients with heart disease, diabetes, blood clots, certain cancers and arthritis, according to the Centers for Medicare and Medicaid Services (CMS). While they are not the most expensive drugs for some Medicare patients, health policy expert Stacie Dusetzina said that “they’re used by so many Medicare beneficiaries that they end up being the top-selling drugs.”
The first 10 drugs include:
For the drugs on this list, 9 million older Americans spend $3.4 billion out-of-pocket each year, according to senior officials in the Biden-Harris administration. If negotiations are able to lower the prices and they withstand challenges, savings would be put back into the program to further expand access to medications, said Dusetzina, who is a professor of health policy and cancer research at Vanderbilt University Medical Center.
Over the next year, CMS is expected to release another 35 additional drugs for negotiation, she added.
Patients, lawmakers and policy experts have long debated how to lower the nation’s prescription drug prices, which are among the highest in the world. Some critics have said these negotiations could prompt the pharmaceutical industry to raise prices on other drugs to make up for lost profits, but Dusetzina said it is too soon to know for certain.
Research has suggested that nearly a third of Medicare beneficiaries diagnosed with cancer never take their medication, in part because they simply cannot afford it, she said. Because these drug prices would now be more affordable for more people, Dusetzina said, “we’ll see more people being able to start their medication and stay on it.”
Laura Santhanam is the Health Reporter and Coordinating Producer for Polling for the PBS NewsHour, where she has also worked as the Data Producer. Follow @LauraSanthanam
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Patients with suspected cancer may have to wait longer to get a diagnosis, under government proposals due this week.
The target that all patients should see a specialist within two weeks of an urgent referral for cancer tests by a GP is expected to be scrapped under NHS England plans to streamline cancer targets.
Ministers have been consulting on the proposals, which would scrap six of the nine existing cancer targets and replace them with just three.
Under a new “faster diagnosis standard”, three-quarters of patients should have a diagnosis or be told they do not have cancer within 28 days. Once diagnosed, patients should receive their first treatment within 62 days from referral or 31 days after the decision to treat.
That standard would replace the nine existing cancer targets, including the two-week wait between a GP referral and first consultant appointment; a one-month wait for care once a decision has been made to offer treatment for cancer such as chemotherapy, radiotherapy and surgery; and a two-month wait from the urgent GP referral to a first treatment of cancer.
Latest figures show that only 59% of patients in England started their first cancer treatment within two months of an urgent GP referral, well short of the 85% target. And only 62% of patients were seen within two months of a positive result from a national cancer screening test, compared with the 90% target.
When a consultation on the proposals began last year, the NHS highlighted that the current two-week target set no expectation of when patients should receive test results or have a confirmed diagnosis.
But speaking on BBC Radio 4’s Today programme, Pat Price, a visiting oncology professor at Imperial College London and co-founder of the Catch Up with Cancer campaign, accused ministers and NHS leaders of “fiddling around” in the middle of an NHS crisis and of watering down the targets.
“Changing the targets won’t help patients, unless we can treat patients better and quicker. And that means now increasing treatment capacity.”
On breast cancer, the target is that 93% of women should be seen in a one-stop clinic in two weeks, but the figure is now 74%. Price said: “The target we think is only going to be 75% in 28 days, that’s actually worse. Is it really the best that government and senior NHS leaders can do is fiddle around with targets in the middle of this crisis?”
The BBC reported that the outcome of the consultation was expected to be announced within days, although implementing the changes would be subject to final approval by the health secretary, Steve Barclay.
Speaking on the Today programme, he said the proposals were designed to improve outcomes and were what the sector wanted. He said: “Any changes will be those where it’s been requested by clinical specialists within the cancer field and would be done in consultation with the leading cancer charities.
“The consultation has been about working with consultants, clinical leaders, as to what drives the best outcomes, what is the way of getting the best survival rates.”
There has been a 28% increase in urgent GP referrals for suspected cancer, he added, and £2.3bn investment in 160 community diagnostic centres, with 114 of those open.
Dr Tom Roques, a vice-president of the Royal College of Radiologists, said simplifying the targets would make it easier for cancer teams to deliver care, but warned targets were no panacea.
“It’s important to remember that the targets are just a tool to try and improve care – the targets achieve nothing on their own. And the real need is investment in workforce, in newer ways of working, so we can improve the situation on the ground, which I think if you ask any cancer team is just not good enough at the moment for the patients.
“I think one of the problems that we have with targets as a whole is that they often focus on the process rather than the outcomes that are important to patients. So if you look at the old two-week target to see a doctor, you may not need to see a doctor to be diagnosed or not diagnosed with cancer, you may need teledermatology to assess your skin lesion and tell you whether it’s cancer or not. You may need to have an endoscopy test to quickly look and see whether you got bowel cancer and an artificial focus on you must see a doctor by 14 days may not be the best way to get patients quickly through the system.”
Wes Streeting, the shadow health secretary, said: “The Conservatives have created a crisis in cancer care, leaving patients waiting dangerously long. Having missed the targets, they are now cynically moving the goalposts.
“Rishi Sunak should focus on cutting waiting times, not cutting standards for patients. If he hasn’t got a plan to bring down cancer waits, then what is the point of him? Labour will get cancer patients diagnosed and treated on time again, by training the doctors and nurses the NHS needs, and reforming the service to make it fit for the future.” | Health Policy |
By genetically testing nearly one thousand embryos, scientists have provided the most detailed analysis of embryo fate following human in vitro fertilization.
Nearly half the embryos studied underwent developmental arrest because of genetic mishaps in early development -- a revealing insight that suggests more IVF babies could come to term with changes in the fertility treatment process. The unique combination of data from arrested embryos also sheds new light on the still largely mysterious earliest stages of pregnancy through natural means.
"We think this also happens in natural conception, and it's why it takes on average several or more months to get pregnant," said author Rajiv McCoy, an assistant professor of biology at Johns Hopkins University. "It is very surprising that most of these embryo arrests are coming not from errors in egg formation, but from errors happening in cell divisions after fertilization. The fact that these errors don't come from the egg suggests that maybe they could be mitigated by changing the way IVF is done."
The research is set to publishin Genome Medicine.
Johns Hopkins and London Women's Clinic researchers in the UK compared IVF embryos that failed to develop within a few days of fertilization with embryos that survived, looking for genetic differences.
"Genetic testing is typically only done on IVF embryos that survive in order to decide which embryo to transfer to the uterus," McCoy said. "But from a biology standpoint, if we want to understand what's allowing these embryos to survive, then we have to test all other embryos too."
The findings reveal how some embryos start growing properly while the maternal genetic material pre-loaded into the egg control cell division, only to falter and stall when the embryo's genes take over.
Human cells typically receive 46 chromosomes, 23 from each parent. The team discovered nonviable embryos started with the 46-chromosome set, but then passed down incorrect numbers of chromosomes as cells divided.
"It doesn't really matter if you have extra missing chromosomes in the very beginning because the maternal machinery is controlling things," McCoy said. "When the embryo's genome turns on, that's when things go wrong."
Human embryos experience unusually high rates of chromosome gain and loss, known as aneuploidy, in early development. Scientists have studied aneuploidy for decades by screening IVF embryos, and these mishaps are well understood to be the cause of pregnancy loss in humans. Because aneuploidy is rare in many other species, McCoy said, the findings could help explain why pregnancy loss and miscarriage are so common in humans.
"Aneuploidy is an example of an extremely strong type of natural selection that's going on every generation in humans," McCoy said. "It might just be a feature of human reproduction and development, but it has implications for IVF. So in the long term, we hope that we can improve genetic testing and improve IVF outcomes."
The researchers plan to run additional tests on specific cells from arrested embryos to trace the chromosomes'origins and see whether abnormal cell divisions are linked to maternal or paternal genetics. They also want to better understand if factors such as the chemical composition in the dish where the embryos are grown could improve chances for survival.
"We could potentially correct a lot of these things by understanding more about the machinery that causes embryo arrest," said co-author Michael Summers, a cin reproductive Medicine[ at London Women's Clinic. "The problem could be be that the chemical composition of the culture medium that are commonly used will not allow all embryos to grow, that the abnormal cell divisions are due to stresses on the egg and early embryo that causes the abnormal divisions associated with chromosome abnormalities."
Other study authors include , Abeo McCollin, Kamal Ahuja, and Alan H. Handyside of London Women's Clinic and University of Kent, as well as Christian S. Ottolini, of The Evewell and University College London.
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The first phase of the Covid Inquiry has heard from its final witness.
In total, 69 politicians, civil servants, scientists and other experts have been asked about the UK's planning for a pandemic and the state of the healthcare system when Covid struck.
Baroness Hallett and her team will now write up their findings, with an interim report expected in 2024.
Here are six questions which they might try to answer, based on the past six weeks of evidence and testimony.
Too focused on flu?
The inquiry heard that much of the planning for a pandemic was based on a 2011 document drawn up in case there was an outbreak of a new, more deadly form of influenza.
Former Prime Minister David Cameron said that "group think" meant the government did not properly consider the risk of other viruses, with different rates of transmission and other characteristics.
"This is so important - so many consequences followed from that," he said.
Typically, health authorities do not try to contain seasonal flu - instead relying on antiviral drugs and the flu jab, which could be adjusted to tackle a new pandemic form of the virus.
Other witnesses, including Dame Jenny Harries, the chief executive of the UK Health Security Agency (UKHSA), appeared to contradict Mr Cameron, describing the government's flu plan as "actually pretty good".
Matt Hancock, former health secretary, meanwhile, said the bigger, more damaging mistake was the widespread assumption that Covid could not be stopped or contained when it started to spread.
He said authorities were too narrowly focused on planning for the fallout, such as "can we buy enough body bags?".
"That was completely wrong," he added.
Lessons from Asia?
Other countries managed more effectively to suppress the initial wave of Covid than the UK, reducing the number of deaths and - in some cases - avoiding strict lockdowns.
Witnesses, including former health secretary and current Chancellor Jeremy Hunt, told the inquiry that the UK did not learn lessons from Taiwan, Singapore and South Korea, which had seen earlier outbreaks of two other coronaviruses - Sars and Mers.
In those countries, faster contact-tracing and quarantine policies were subsequently deployed to promptly isolate cases and clamp down when Covid first emerged.
In the UK, the civil service had previously run a mock-up training day - codenamed Exercise Alice - in 2016, in preparation for a major outbreak of the Mers virus.
But the inquiry heard many of its recommendations, including advice to scale up testing capacity and examine different options for isolation, were not followed through.
Did earlier austerity policies inflict damage?
Another major theme was the strength - or resilience - of the healthcare system when Covid emerged in 2020.
England's former chief medical officer, Dame Sally Davies, was heavily critical of the state of the NHS at the time of the outbreak, saying it had been "divested" - with fewer doctors, nurses, beds and ventilators than similar countries.
Academics Sir Michael Marmot and Clare Bambra produced a report stating that poorer regions and ethnic minority groups were disproportionally affected by a decade of austerity policies, with the UK entering the pandemic with "depleted" public services and rising inequality.
Giving his evidence, George Osborne, who was chancellor from 2010 to 2016, said he "completely rejected" that description.
"If we had not had a clear plan to put the public finances on a sustainable path, then Britain might have experienced a financial crisis [and] would not have had the fiscal space to deal with coronavirus when it hit," he argued.
What about the impact of Brexit?
From 2018, government departments were being asked to step up planning for a so-called 'no-deal Brexit', under the codename Operation Yellowhammer.
According to documents seen by the inquiry, a number of internal 'workstreams' in the Department of Health related to pandemic planning were therefore paused, or slowed, as staff were moved and other tasks prioritised.
That paused work included plans to better prepare the adult social care sector for a severe influenza pandemic.
The Pandemic Flu Readiness Board, a cross-government body made up of civil servants from across Whitehall, did not meet for a whole year up to November 2019 because their work was "reprioritised" to plan for leaving the EU without a trade deal.
Scotland's former first minister, Nicola Sturgeon, told the inquiry that the Scottish government was "not at all happy" about having to divert "time, energy and resources" in this way.
Additionally, Matt Hancock claimed that work on a no-deal exit was instrumental in preventing the UK running out of some intensive care drugs at the peak of the first wave of Covid.
Better front-line planning?
The inquiry also heard moving evidence from the families of some of those who lost their lives to Covid.
Anna-Louise Marsh-Rees's father, Ian, contracted the virus while being treated in hospital in Abergavenny for a gall bladder infection.
Jane Morrison spoke about the loss of her wife, Jacky, who died in hospital in Dundee after being admitted for another unrelated condition - jaundice.
Groups representing bereaved family members said poor infection control was a "glaring flaw" in hospital planning.
They also described the handling of funerals - and how they were conducted during the pandemic - as traumatic, with relatives often unable to say a proper goodbye to loved ones.
Why wasn't a lockdown planned for?
Witnesses described national lockdowns as the most "extraordinary" policy of the pandemic.
The political decisions which led to nationwide lockdowns will be explored in detail during the inquiry's second phase in October.
Already though, we know a strict lockdown - with widespread school and business closures - was never planned for in advance.
Matt Hancock said there was "no prep for how to do one, no work on how best to lock down with the least damage".
England's chief medical officer, Sir Chris Whitty, suggested it would have been near impossible for scientific advisers to plan in advance for something so radical without being asked to by a senior politician.
The inquiry team will try to answer why - given it is the government's job to consider these things - the longer term impacts of lockdown were not properly thought through before 2020.
Watch on iPlayer: Jim Reed looks at the key moments from the first part of the Covid inquiry. | Epidemics & Outbreaks |
- The pandemic saw essential immunization levels decrease in over 100 countries
, leadingto rising outbreaks of measles, diphtheria, polio and yellow fever.
- ‘The Big Catch-up’ is an extended effort to lift vaccination levels among children to at least pre-pandemic levels and endeavours to exceed those.
- Led by a broad range of national and global health partners, The Big Catch-up also aims to ensure stronger primary health care services for essential immunization in the future.
WHO, UNICEF, Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation, along with Immunization Agenda 2030 and many other global and national health partners, are today joining forces to call for “The Big Catch-up”, a targeted global effort to boost vaccination among children following declines driven by the COVID-19 pandemic.
This effort aims to reverse the declines in childhood vaccination recorded in over 100 countries since the pandemic, due to overburdened health services, closed clinics, and disrupted imports and exports of vials, syringes and other medical supplies. Meanwhile, communities and families experienced lockdowns, restricting travel and access to services, and financial and human resources were limited along with access to health commodities, due to the emergency response. Ongoing challenges like conflicts, climate crises and vaccine hesitancy also contributed to the decline in coverage rates.
With over 25 million children missing at least one vaccination in 2021 alone, outbreaks of preventable diseases, including measles, diphtheria, polio and yellow fever are already becoming more prevalent and severe. The Big Catch-up aims to protect populations from vaccine-preventable outbreaks, save children’s lives and strengthen national health systems.
While calling on people and governments in every country to play their part in helping to catch up by reaching the children who missed out, The Big Catch-up will have a particular focus on the 20 countries where three quarters of the children who missed vaccinations in 2021 live*.
Although global coverage levels have declined, there have also been bright spots of resilience. For example, early reports indicate India saw a strong recovery in essential immunization in 2022, while Uganda maintained high coverage levels during the pandemic. Countries have also been successful at reaching groups in vulnerable situations. In Kenya, for instance, collaborations with community health workers and local leaders have improved levels of immunization among nomadic populations in the north of the country.
To ensure progress on childhood immunization, partners are working with countries to strengthen health care workforces, improve health service delivery, build trust and demand for vaccines within communities, and address gaps and obstacles to restoring immunization. In addition to catching-up on childhood immunization, intensified efforts are needed to introduce the human papillomavirus (HPV) vaccine to adolescents to prevent cervical cancer, particularly in low- and middle-income countries where the burden is highest.
WHO Director-General Dr Tedros Adhanom Ghebreyesus said: "Millions of children and adolescents, particularly in lower-income countries, have missed out on life-saving vaccinations, while outbreaks of these deadly diseases have risen. WHO is supporting dozens of countries to restore immunization and other essential health services. Catching up is a top priority. No child should die of a vaccine-preventable disease."
“Routine vaccines are typically a child’s first entry into their health system and so children who miss out on their early vaccines are at added risk of being cut out of health care in the long run,” said UNICEF Executive Director Catherine Russell. “The longer we wait to reach and vaccinate these children, the more vulnerable they become and the greater the risk of more deadly disease outbreaks. Countries, global partners and local communities must come together to strengthen services, build trust and save lives.”
“We cannot allow a legacy of the pandemic to be the undoing of many years’ work protecting more and more children from deadly, preventable diseases,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “Global health partners, working with governments and communities, must do everything we can to protect the life of every child.”
“Vaccines are a public health triumph,” said Dr. Chris Elias, president of Global Development at the Bill & Melinda Gates Foundation. “The incredible progress that has been made toward ending polio and reducing the incidence of infectious diseases is the direct result of thousands of dedicated global partners and local health workers who have worked to immunize millions of children. We must double down to reach all children with the vaccines they need to live healthier lives and ensure that future generations live free of preventable diseases like polio.”
Notes to editors
For more information about The Big Catch-up, visit WHO’s page, the interactive site on the newly released UNICEF’s State of the World’s Children report, and the hub of partner content for World Immunization Week.
*The 20 countries where three quarters of the children who missed vaccinations in 2021 live are: Afghanistan, Angola, Brazil, Cameroon, Chad, DPRK, DRC, Ethiopia, India, Indonesia, Nigeria, Pakistan, Philippines, Somalia, Madagascar, Mexico, Mozambique, Myanmar, Tanzania, Viet Nam.
About the World Health Organization
Dedicated to the well-being of all people and guided by science, the World Health Organization leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life. We are the UN agency for health that connects nations, partners and people on the front lines in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to promote health, keep the world safe and serve the vulnerable. www.who.int
About UNICEF
UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across more than 190 countries and territories, we work for every child, everywhere, to build a better world for everyone.
About Gavi, the Vaccine Alliance
Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate half the world’s children against some of the world’s deadliest diseases. Since its inception in 2000, Gavi has helped to immunise a whole generation – over 981 million children – and prevented more than 16.2 million future deaths, helping to halve child mortality in 73 lower-income countries. The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. To understand how the pandemic has impacted essential immunization in Gavi-supported countries, read our analysis on the state of routine immunization. Learn more at Gavi.org and connect with us on Facebook, Twitter, LinkedIn and Instagram.
About the Bill & Melinda Gates Foundation
Guided by the belief that every life has equal value, the Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives. In developing countries, it focuses on improving people’s health and giving them the chance to lift themselves out of hunger and extreme poverty. In the United States, it seeks to ensure that all people—especially those with the fewest resources—have access to the opportunities they need to succeed in school and life. Based in Seattle, Washington, the foundation is led by CEO Mark Suzman, under the direction of Co-chairs Bill Gates and Melinda French Gates and the board of trustees. | Vaccine Development |
Did talcum powder cause the cancer that killed Maureen? Her widower is one of more than 200 people planning a group action against the manufacturers. They allege that talc - contaminated with asbestos - triggered tumours. Here, we examine the evidence
When Maureen Wright was diagnosed with ovarian cancer, both she and her husband Jeffrey were left reeling in disbelief.
Maureen simply did not fit the profile of someone at risk of the disease.
There was no family history — and as for other risk factors, such as being over 50 and not having carried a full-term pregnancy, Maureen was just 35 and a mother of three.
She was also slim and extremely fit. In fact, the first indication anything was wrong came when she felt a lump in the left side of her stomach during a fitness class.
But Maureen died from the disease five years later, leaving Jeffrey and their sons, then aged 17, 12 and five, shocked and bereaved. Today, more than 30 years after her death in 1991, the family remain devastated by her untimely death.
When Maureen Wright was diagnosed with ovarian cancer , both she and her husband Jeffrey were left reeling in disbelief
Now her family believe this could have been avoided, had she not habitually used talcum powder
This is compounded by their belief that it could have been avoided, had she not habitually used talcum powder.
Now Jeffrey is one of more than 200 claimants involved in a group action against manufacturers of mineral-based talcum powder, such as Johnson & Johnson, in what will be the first such case in an English court — alleging that regular use of talc materially increased the risk of developing cancer.
In legal documents seen exclusively by Good Health, the claimants allege that talc caused cancers — variously, of the ovaries, fallopian tubes, primary peritoneal cancer (of tissue that lines the abdominal wall) and mesothelioma (cancer of the lung lining — allegedly caused by inhaling talc).
The claimants include a woman who used talcum powder for 40 years, who was diagnosed with ovarian cancer in 2002, which returned in 2007. Although in remission, she still feels the effects of the many surgeries and chemotherapy, says barrister Tom Longstaff, a partner at Lanier, Longstaff, Hedar & Roberts LLP, the law firm leading the case.
A second claimant, diagnosed with ovarian cancer in 2022, had used talc for more than 20 years, both on herself and on her children.
Some claims, such as the one for Maureen Wright, are being made posthumously, by loved ones. Jeffrey says he is doing it ‘for my sons’ — Robert, now 49, Richard, 44, and Michael, 38.
‘They were deprived of their mother and it had a huge impact,’ he says. ‘They all left school without any meaningful qualifications because they couldn’t settle down to study, sometimes walking out of class in the middle of the day because they were angry about the loss.’
Jeffrey, who lives in Essex and is now a grandfather, recalls Maureen liberally using talc. ‘For as long as I can remember there was always talc in our bathroom — Maureen would use it all over her body after showering,’ says Jeffrey, 76, who ran his own retail business before he retired.
In legal documents seen exclusively by Good Health, the claimants allege that talc caused cancers — variously, of the ovaries, fallopian tubes, primary peritoneal cancer (of tissue that lines the abdominal wall) and mesothelioma (cancer of the lung lining — allegedly caused by inhaling talc)
‘If I kissed her just afterwards, I would say to her that I could smell the talc on her lips,’ he says.
‘We had no idea why she developed ovarian cancer, it just seemed one of those tragically unlucky things. Then about five years ago, I began reading emerging stories about a link to cancer and I couldn’t believe it.
‘So when I heard about the potential to bring talc companies to justice in the UK, I contacted the legal firm involved.’
The group action is based on the claim that the natural mines which produced the main ingredient of talc — hydrated magnesium silicate — were contaminated with asbestos, a known carcinogen.
‘Talc is sourced from various mines around the world which have been linked with asbestos contamination,’ says Tom Longstaff. ‘Mineral talcum powder sold in the UK for decades has contained asbestos, which when ingested can cause cancer.’
He says a growing body of research supports the basis of the joint action — including a study by researchers from the U.S., who examined data from 166 people with mesothelioma. The cancer is usually linked to asbestos exposure but in 122 cases ‘the only known exposure to asbestos was from cosmetic talc’, it was reported last month in the Journal of Occupational Medicine and Toxicology.
The UK action has yet to be formally lodged with a court, and Johnson & Johnson is adamant that its products are safe.
However, in the U.S. there have already been actions successfully brought against talc makers.
In 2018, in the largest payout to date, Johnson & Johnson was ordered to pay $4.69 billion (£3.88 billion) to 22 women and their families who had claimed that asbestos in the company’s talc-based products caused the women — six of whom died before completion of the case — to develop ovarian cancer.
READ MORE: REVEALED: Doctors are now advising women who are 'done having kids' to get their fallopian tubes REMOVED to reduce their risk of ovarian cancer
A potential link between cancer and talcum powder was first raised in studies dating back more than 50 years. In 1971, scientists at the Tenovus Institute for Cancer Research, in Cardiff, wrote of finding talc particles embedded in ovarian and cervical tumour tissue.
Then in 1982, a study in the journal Cancer found that women who reported using talc around the genital area were three times more likely to develop ovarian cancer.
Daniel Cramer, a professor of obstetrics, gynaecology and reproductive biology at Brigham and Women’s Hospital in the U.S., who led the study, is in no doubt there is a cancer risk.
‘The evidence that long-term use of talc in the genital area may cause ovarian cancer is far stronger than appreciated by the general scientific community,’ he told Good Health.
‘This includes indisputable evidence that talc present in the vagina can migrate to the upper genital tract, that talc induces inflammation, and that inflammation can lead to cancer by causing DNA damage. I have consistently advised women not to use talc in the genital area.’
Talcum powder is made from talc — or hydrated magnesium silicate — a naturally occurring clay mineral mined from rock.
Finely ground, it produces a silky, fragrant powder which can absorb moisture and reduce friction or chafing — which is why it has been a staple of products such as baby powder and was traditionally used to tackle nappy rash.
Talc has been used for centuries. It was first commercialised in the 1890s and is today used not only in baby products but in cosmetics and industry.
Experts believe it isn’t talc itself that causes the problems, but the asbestos it may be contaminated with. Asbestos is formed of tiny fibres which, when they are inhaled or enter the reproductive tract, can cause irritation that triggers inflammation and may bring about genetic changes and cancer.
‘When there is inflammation, this causes some cells to multiply that might not normally multiply,’ says Professor Gordon Jayson, a consultant medical oncologist at the Christie Hospital in Manchester.
‘And when this happens,’ he explains, ‘there is a chance that one cell gets a genetic mutation and an error is generated. If the cell doesn’t die and continues to multiply, this can lead to cancer.’
In the U.S., Johnson & Johnson currently faces 37,515 cases from cancer patients or their representatives claiming the diseases were caused by talcum powder.
One of the plaintiffs is Thomas McHattie, 78, an obstetrician-gynaecologist who was diagnosed with mesothelioma in March 2020.
He says he recommended the company’s Baby Powder to ‘countless pregnant women’ and used it himself. Thomas has been through five courses of chemotherapy to treat tumours in his abdomen and has suffered from pronounced fatigue and shortness of breath.
However, the evidence linking talc to cancer isn’t straightforward. Some studies have suggested talcum powder applied directly to a woman’s genital area or on sanitary towels, diaphragms or condoms could cause cancer of the ovaries.
In 2003, a review by the Johns Hopkins school of Medicine in the U.S., which looked at 16 studies involving 12,000 women, found that using talc increased the risk of ovarian cancer by around a third.
And in 2013 a review of U.S. studies, published in the journal Cancer Prevention Research, involving 18,000 women, had similar results, concluding that its use in the genital area was associated with a 20 to 30 per cent increase in the risk of developing epithelial ovarian cancer — cancer of the lining that covers the outside of an ovary.
Yet in 2020, researchers at the U.S. National Institute of Environmental Health Sciences pooled data from 252,745 women and found no evidence that talc was dangerous when used as a feminine hygiene product.
For Professor Jayson, this is not surprising: ‘If a woman was using talc as a feminine hygiene product, the more likely area of irritation, and therefore cancer, would be the vagina, as the ovaries are a long way up the reproductive tract. So anatomically, it doesn’t make sense,’ he says.
A problem with studying the potential risk is that ovarian cancer is not common. Around 7,400 women are diagnosed with this cancer in the UK each year — compared with around 45,000 cases of breast cancer, so even the largest studies might not have been big enough to detect a very small increase in risk.
Dr Anita Raja, a GP based in Birmingham who specialises in women’s health, says researchers have tried to address this by combining the results of different studies (known as a meta-analysis), but even this type of research has had mixed results.
‘For example, in an analysis combining the results of the major cohort studies [which follow the progress of participants over many years] there was no overall increased risk of ovarian cancer, while in an analysis of both case-control studies [which compare two groups] and cohort studies, frequent talcum powder use [at least twice a week] was linked with an increased risk.’
Paul Pharoah, who until recently was a professor of cancer epidemiology at Cambridge University, who has also been a paid adviser to one of the law firms representing Johnson & Johnson during the 2018 trial that led to the record-breaking damages being awarded, told Good Health: ‘There is clear evidence of an increased risk of epithelial ovarian cancer — cancer of the lining that covers the outside of an ovary — in women who used talc in the genital region.
‘But that practice was much more common in the 1960s and 1970s than it is today. Even so, there is little good evidence that this association is causal [that is, a contributory factor].
‘My mother died from ovarian cancer in 2020,’ he adds. ‘I don’t think her previous use of talc was a material factor.’
Professor Pharoah told the U.S. court that even if the association between talc and cancer were true, the strength of the association ‘is too small to be able to say on the balance of probabilities that any cancer arising in a woman who used talc had been caused by the talc’.
The court rejected this evidence and made the multi-billion-dollar award in favour of the women.
The International Agency for Research on Cancer (IARC) — part of the World Health Organisation — classifies talc that contains asbestos as being ‘carcinogenic to humans’.
A spokesperson for Johnson & Johnson told Good Health: ‘We stand behind the safety of our products, which do not contain asbestos, do not cause cancer and are safe for consumers to use.’
However, in 2018 an investigation by Reuters uncovered company documents suggesting that from as early as 1971 to the early 2000s, Johnson & Johnson talc products had on occasion tested positive for asbestos traces.
In a separate development, Johnson & Johnson had tried to have a subsidiary company that shoulders litigation declared bankrupt — but last week it was reported that this was rejected by a U.S. appeals court.
Behind the claims and counter- claims are people like Jeffrey Wright and his children.
When Maureen first saw her GP in 1983 about the lump at the side of her stomach, she was told she was merely constipated.
But the lump and constipation remained and two years later, three months after Maureen had given birth to their third son in December 1985, Jeffrey insisted his wife see a private doctor.
She underwent scans which revealed the lump was a mass of fatty tissue that Maureen opted to have surgically removed.
Not only did removing the mass lead to a major artery being severed, requiring an extensive blood transfusion, but surgeons found the mass was actually a fist-sized cancer.
After undergoing chemotherapy, Maureen was determined to return to normal — but two years later, searing backache turned out to be cancer in her spine — which had also spread to her liver and a kidney.
‘I had to close my business to look after my wife and our three young children,’ says Jeffrey. ‘It was a really awful time for all the family, and of course Maureen, who was suffering so much.’
She died at home in July 1991, leaving Jeffrey with the children, himself bereft and unable to work. His eldest son, then 17, left school to get a job and help with the family finances.
‘Maureen was so full of life,’
says Jeffrey. ‘I used to joke that when she married me, I was punching above my weight. She was also a fighter. It’s still so hard to believe what happened to her. But it should act as a warning for others.’
The question is: is it safe for women to use talc on their bodies? Dr Raja says: ‘For any individual woman, if there is an increased risk of cancer it’s likely to be very small. Still, talc is widely used in many products [such as some eyeshadows] so it’s important to determine if the increased risk is real.’
But Leila Hanna, a consultant gynaecologist and obstetrician at Queen Mary’s Hospital in London, believes it might be better to err on the side of caution. ‘It is not necessary to use it around the genital area,’ she says. ‘If you want to freshen up, use dedicated products or water.’
Dr Sharon Tate, head of primary care development at Target Ovarian Cancer, said the charity suggests women avoid certain talc use: ‘Studies have not shown conclusive evidence that talcum powder links to ovarian cancer. However, some have suggested there could be a link.
‘Although the increased risk may be small or non-existent, we know the devastating impact ovarian cancer can have, so it continues to advise generally not using talc between the legs.’
Johnson & Johnson announced last year that it will stop selling talc-based Baby Powder globally this year, switching to a formulation based on cornstarch.
The decision was purely financial, it said in a statement at the time: ‘As part of a worldwide portfolio assessment, we have made this commercial decision to transition to an all-cornstarch-based baby powder portfolio.
‘This will help simplify our product offerings, deliver sustainable innovation and meet the needs of our consumers, customers and evolving global trends.
‘Our position on the safety of our cosmetic talc remains unchanged. We stand firmly behind the decades of independent scientific analysis by medical experts around the world that confirms talc-based Baby Powder is safe, does not contain asbestos, and does not cause cancer.’
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Under the microscope
Chef and TV presenter Prue Leith, 82, answers our health quiz
Can you run up the stairs?
Of course not! I can barely walk up the stairs these days. Every once in a while I test myself to see if I can still run at all! I’m particularly unfit at the moment because I got out of the habit of exercise last year.
Get your five a day?
Oh, easily. We have a fantastic farm shop near us. John [Playfair, Prue’s husband] and I buy far too much there. We eat a lot of veg and vegetarian meals.
Ever dieted?
All the time. I wish I could say it was just a question of maintaining my weight, but I’m 3st heavier than I was when I opened my restaurant when I was 29. I should probably lose at least a stone but I find dieting difficult.
Chef and TV presenter Prue Leith, 82, pictured, answers our health quiz
Any vices?
I have a slight addiction to Bounty bars. My husband occasionally sticks one in my handbag just to test my willpower. Of course, I always eat it.
Pop any pills?
I Challenge you to find an 82-year-old who doesn’t. I take levothyroxine for an underactive thyroid, a statin to lower my cholesterol and a beta-blocker to stop my heart beating erratically [atrial fibrillation].
Worst injury?
About 25 years ago I was in a car crash in New York when the taxi I was in went through a red light and was hit by a lorry. I broke five ribs and it was serious because one of them was very close to my lungs. I was in hospital for a week.
Cope well with pain?
Not well. I take lots of painkillers if I need them.
Tried alternative remedies?
Yes, arnica for bruises. It didn’t help.
Ever been depressed?
I’ve been sad. And I think that’s reasonable. If you lose your husband like I did in 2002 [her first husband died of emphysema], you should be sad. I wouldn’t call it a depression.
Hangover cure?
Hair of the dog. And a piece of toast and a couple of paracetamol.
Ever have cosmetic surgery?
When I was about 45, I had really baggy eyes and I got them done. I wouldn’t have it now because I think, at my age, when you start stretching your skin you look like an alien.
What keeps you awake?
Caffeine. A friend once talked me into having an affogato [a coffee-based dessert]. I lay there that night wondering why I couldn’t sleep, then remembered it has two shots of espresso in it! Also, I can’t sleep if I’ve quarrelled with anybody.
Like to live for ever?
Absolutely not, because all your friends will be dead. I’m rather keen I should be allowed to ask for medical assistance to help me die when I’ve had enough of life. The law needs to change on that.
For tickets to Prue Leith’s 34-date tour, Nothing In Moderation, go to mickperrin.com. | Disease Research |
When breast cancer spreads, it often targets the spine. Now scientists may have finally discovered why.
A newfound kind of stem cell drives cancer cells to bones in the vertebrae, pathologist Matthew Greenblatt of Weill Cornell Medicine in New York City and his colleagues report September 13 in Nature. The find helps explain a long-standing mystery of metastasis: why some cancers break away from their site of origin, journey through the bloodstream and take up residence in the backbone.
“This is a major advance in our understanding of bone metastasis,” says Xiang Zhang, a cancer biologist at Baylor College of Medicine in Houston who was not involved with the new study.
In people with metastatic breast cancer, some 70 percent experience subsequent bone cancer. And of the bones in the skeleton, cancer cells preferentially seek out vertebrae. For these patients, “spine metastases are one of the most common complications,” Greenblatt says, “and one of the most dreaded.” Tumors that take root in the spine can crush the spinal cord, which houses nerve bundles crucial for body sensation and movement. Such damage can hamper people’s ability to walk and control their bladder and bowels, and shorten their life spans.
Doctors have known for decades that some cancers preferentially seek out the spine, Greenblatt says, but no one has had a good explanation for why. One idea proposed in 1940, that actions like coughing jolt blood off course and somehow send cancerous cells to the vertebrae, still hangs on today. It’s what Greenblatt learned when he was a medical student. But for him and his team, “that didn’t make sense to us scientifically.”
What did end up making sense was stem cells. The researchers had a hunch that stem cells inside vertebral bones differed from those in other sites in the skeleton, like the long bones in the arms and legs. In the lab, that’s just what they found. Greenblatt’s team pulled out a population of stem cells from mice vertebrae distinctly unlike ones collected from long bones. These new stem cells switched on a separate set of genes and behaved differently in experiments, the researchers found.
Until now, scientists didn’t know that these two types of bones held distinct populations of stem cells. “We assumed they were the same,” says Geert Carmeliet, a cell and molecular endocrinologist at KU Leuven in Belgium who was not involved with the work, but wrote an accompanying commentary. The team’s discovery raised the possibility that spinal stem cells might play a role in spinal disease.
In one key experiment, Greenblatt’s team transplanted spinal stem cells into one hind leg of mice and long bone stem cells into the other. Each transplant formed miniature bones, or organoids, in the animals’ bodies — a tiny vertebra on the right, for example, and a bit of long bone on the left. Then, the researchers injected breast cancer cells into the mice and watched where they ended up.
The cells traveled to the mini vertebra nearly twice as often as they did to the little long bone, as if lured by a cancer-calling Pied Piper. It’s an elegant way to show that “tumor cells preferentially come to the [vertebra] organoid and not to the organoid of the long bone,” Carmeliet says.
The newly identified spinal stem cells, found in both mice and humans, secrete a protein called MFGE8 that acts as a tumor attractant, the team discovered, drawing cancer cells to spinal tissue. The protein may not be only factor involved, Greenblatt says, “but it’s an important one in driving tumor cells to the spine.”
It’s possible that blocking MFGE8 could prevent or treat spine metastasis. “I think it’s definitely worth further investigation,” Zhang says. But, he notes, it’s still too early to know what the therapeutic implications may be.
Greenblatt’s team is now exploring whether the new stem cells can recruit other types of tumor cells to the spine. When prostate cancer spreads, for example, it also tends to travel to vertebrae over other types of bone. He and his colleagues are also curious whether our bones may be hiding anything else. “We’re starting to think about what other stem cells may be left to discover in the skeleton.” | Disease Research |
In what is believed to be a world first discovery, University of Otago researchers have found wheat gluten causes brain inflammation in mice.
The research, led by Associate Professor Alex Tups, and published in the Journal of Neuroendocrinology, may be of importance for human physiology.
"Mice are an excellent model to study human physiology. They have a very similar circulatory, reproductive, digestive, hormonal and nervous system.
"So, it is quite possible that the same inflammation we found in mice could happen in humans."
The study investigated whether a standard diet, referred to as low fat diet (LFD), enriched with 4.5 per cent gluten (matching human average daily consumption), or a high fat diet (HFD), enriched with 4.5 per cent gluten, alters body weight, metabolic markers or central inflammation in male mice.
"Gluten, which is found in cereals such as wheat, rye and barley, makes up a major dietary component in most western nations.
"While previous studies have shown gluten promotes body mass gain and inflammation in mice in the enteric nervous system and gastrointestinal tract, we investigated the impact of gluten on the brain."
While somewhat expectedly, the study confirmed a "moderate obesogenic effect of gluten when fed to mice exposed to a high fat diet, for the first time we can report gluten-induced hypothalamic (brain) inflammation," Associate Professor Tups says.
"The brain has two types of immune cells similar to macrophages in the blood. These are called astrocytes and microglia. We found that gluten as well as HFD increases the number of those immune cells. The effect of gluten added to normal diet increased the cell number to the same extent as if mice were fed an HFD. When gluten was added to the HFD, the cell number went up even further."
The hypothalamic region of the brain is vital for coordinating basic metabolic functions like body weight regulation and blood sugar regulation.
"If gluten led to hypothalamic inflammation in humans and therefore brain damage, it can be bad in the long run, such as increase in body weight and impaired blood sugar regulation. If these effects became persistent they might exacerbate the risk of e.g. impaired memory function which is linked to disturbed blood sugar regulation.
Why this is happening is not known, he says.
"This is entirely new and so we don't know yet why it is the case.
"It could be that digestion resistant components of wheat of gluten can lead to an immune response as seen in celiac patients that then manifests in the brain. These are early days and we need future studies to confirm whether this has implications for celiac or gluten sensitive people."
However, Associate Professor Tups says the finding does not mean people should suddenly stop eating gluten.
"We are not saying that gluten is bad for everyone. For gluten tolerant people to go entirely gluten free may have health implications that may outweigh potential benefits. Often people don't consume wholefoods and highly processed gluten free products are often low in fibre and high in sugar.
"We are saying that future studies need to reveal whether our findings in mice are translatable to humans and whether gluten-induced astro- and microgliosis may also develop in gluten sensitive individuals."
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Angelica Ross attends Vanity Fair And Lancôme Celebrate The Future Of Hollywood at Mother Wolf on ... [+] March 24, 2022 in Los Angeles, Calif. Photo by Steven Simione/WireImage. WireImage You’ve seen her on TV in American Horror Story and Pose, where she made history as the first transgender woman to appear in two series’ regular acting roles. Earlier this month, she delivered this year’s LGBTQ State of the Union address, urging President Joe Biden to do more to protect transgender youth and joined him in calling on Congress to pass the Equality Act. She is also the first out trans person to host a presidential forum, which was co-hosted by GLAAD. And since 2014, she has been the CEO of a trailblazing business, TransTech Social Enterprises, that is hosting a free online summit, starting today, featuring more than 60 speakers on several topics, from coding careers to health and wellness to racial and social justice. It’s timed to coincide with the Transgender Day of Visibility, or TDOV. Angelica Ross is one busy woman, with a backstory that seems made for Hollywood. She came out as gay at 17, and started her gender transition in 2000 at age 19. Raised in Racine, Wisc., Ross has worked in food service, as a lounge singer, as a model and escort, and dropped out of college after one semester to enlist in the U.S. Navy, so she could qualify for the G.I. Bill. Ross served and survived harassment in the ranks, and was discharged under the now-repealed “Don’t Ask, Don’t Tell” policy that forbid military servicemembers from expressing themselves as LGBTQ. Angelica Ross played Candy Ferocity on Pose. Fx In a recent interview via Zoom, Ross told me the death of her character on Pose, Candy Ferocity, reminded her of the startling statistic that while most Black cisgender women in America have a life expectancy of 78, the average Black trans woman isn’t expected to survive past 35. Ross is 41. “Honestly, in half of that and at least 20 of those years, I've been living frugally as a trans woman,” she said. “And things have changed a lot, but some things have not changed, in the violence against trans people both state sanctioned and systemic violence, as well as inter-community violence and street-based violence. It's violence at every turn for a lot of trans folks, and I can't believe that we're still dealing with these issues. But I do feel like we are changing hearts and minds, we're getting more people to care. The moment that I realized people were crying around the world for Candy Ferocity was the moment I knew that door had opened up for people to care about trans people in their own cities.” Angelica Ross attends the 7th Annual Hollywood Beauty Awards at Taglyan Complex on March 19, 2022 in ... [+] Los Angeles, Calif. Photo by Rodin Eckenroth/FilmMagic. FilmMagic This year’s TransTech Summit is all virtual, and all free. It runs from today through April 3rd, and according to its website, “provides attendees with tools to grow their existing careers, interact with new media technology, network with other LGBTQIA people, learn new skills, and access additional training tools.” Last year’s summit welcomed 1,300 people across six continents, said Ross. She’s expecting even more attendees this time around, and wants to be clear about what they’ll get from an event with the word “tech” featured so prominently. “The biggest message that I'm trying to get across with the summit is that when I say ‘tech,’ I mean so many more things than just coding. It's an amazing thing when someone discovers that sort of intersection of where technology meets their passion, what they're passionate about, and that can be so many different things. So, for me, my biggest goal with TransTech was to create your unconventional discovery zone. You know, when I was a kid in the Midwest, we had these Discovery Zones, like a science museum that we would go to, and tech was just so elite. It was such an elite conversation. And I think one of our greatest achievements has been breaking that down and having a more accessible conversation around tech.”
Given what’s happening in the country today, with Oklahoma and Arizona becoming the 13th and 14th states to enact anti-transgender legislation, Ross’s summit covers topics such as diversity, representation and inclusion and human rights.
These issues are having a real impact. According to a recent poll conducted on behalf of The Trevor Project: 85% of trans and nonbinary youth—and two-thirds of all LGBTQ youth—say recent debates about state laws restricting the rights of transgender people have negatively impacted their mental health. When asked about legislation that bans doctors from prescribing gender-affirming medical care like puberty blockers or hormone therapy, 73% of trans and nonbinary youth said it made them feel angry. 57% felt sad 47% felt stressed 40% felt scared More than 1 in 3 felt hopeless, helpless, and/or nervous. Those feelings can have terrible results. The Trevor Project's 2021 National Survey on LGBTQ Youth Mental Health found more than half—52%—of trans and nonbinary youth seriously considered attempting suicide in the past year—and 1 in 5 attempted suicide. But these young people attempt suicide less when respect is given to their pronouns, when they are allowed to officially change their legal documents, and when they have access to spaces that affirm their gender identity.
Ross knows rejection, intimately, because her relationship with her evangelical Christian mother fell apart after she came out. I asked her, had time and her success mended that rift? “It took over a decade for me and my mother to heal our relationship,” she said. “I can remember telling her a long time ago: ‘Pay attention, because this isn't just for me, your purpose: Our purpose is tied together.’ And it was, for me, that much more clear, when we were both standing on the stage for Oprah Winfrey Network and in the Black Women OWN the Conversation. My mother admitted in front of a crowd of over 100 Black women that she asked me to commit suicide. She realized how much of a grave mistake that she had made, but that she didn't know any better and that all she knew is what her religion taught her. “At some point, she had to break away from that and see her child and see that she needed to be there for her child and get to know her child, and that it would have been a grave loss as she saw other trans people being murdered and killed and whose lives were cut short. She said, ‘I don't want that to be my fate where I lose my child and I never knew them and I never celebrated them.’”
Ross said since then, her mother has attended all but one of her premieres and stood proudly by her side. “There's a saying that time heals all things, and you know, I do believe in that now.”
She credits her spirituality and faith with giving her the strength to overcome personal challenges. “Buddhism gave me the the abstract space to be, in that my transness could be affirmed, and that my spirit could be affirmed,” said Ross, who has a book in the works about the benefits of creating a spiritual foundation, which will be released at Audible.com later this year. To learn more about the TransTech Summit and to register to attend, click here. | Mental Health Treatments |
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By
Jon Hamilton |
NPRMonday, July 3, 2023
Scientists have pinpointed a special part of the brain that, when stimulated, appears to produce out-of-body experiences.
JUANA SUMMERS, HOST:
Certain drugs can produce an out-of-body experience, so can a pulse of electricity if it's sent to the right place in the brain. NPR's Jon Hamilton reports on a brain area that seems to keep us attached to our physical selves - well, most of the time.
JON HAMILTON, BYLINE: A few years ago, Dr. Josef Parvizi got a visit from a patient with epilepsy. The man told Parvizi about some very strange symptoms.
JOSEF PARVIZI: My sense of self is changing, almost like I am a third observer to conversations that are happening in my mind that I'm not part of. Plus, they just feel like I'm floating in space.
HAMILTON: Parvizi, a neurology professor at Stanford, was intrigued. He figured the man's seizures must be affecting an area of the brain called the PMC.
PARVIZI: It's hidden in-between the two hemispheres in the back.
HAMILTON: The PMC helps create what's known as our narrative self, a sort of internal autobiography that helps us define who we are. So Parvizi figured the PMC was also responsible for our physical self, which tells us that our body and thoughts belong to us, not someone else.
PARVIZI: As you are sitting in your chair, you have an understanding that it is you looking at me, your point of view in space and in your environment.
HAMILTON: That sense of being anchored in your body disappears when you have an out-of-body experience, like the man with epilepsy. Parvizi and a team were able to recreate the man's symptoms by electrically stimulating the PMC. Then they tried the approach on other volunteers. And Parvizi says it became clear that a person's physical self was tied to one particular spot in that special part of the brain.
PARVIZI: What we discovered is that towards the front, there is this sausage-looking piece of brain called the anterior precuneus.
HAMILTON: Parvizi's team stimulated the area in eight patients.
PARVIZI: And, lo and behold, everybody has changes in their sense of what we call the physical self.
HAMILTON: The results appear in the journal Neuron, and Parvizi says they suggest that the anterior precuneus is critical to understanding that something is happening to me, not another person.
CHRISTOPHE LOPEZ: We think this could be a way for the brain to tag every experience in the environment as mine.
HAMILTON: Christophe Lopez says that makes sense. He's a researcher at the National Center for Scientific Research in France. Lopez thinks that our physical self comes in part from the inner ear, which senses motion and the body's position in space. And he says Parvizi's team found evidence supporting that view. Lopez says the anterior precuneus appears to act as a hub for signals coming from the inner ear.
LOPEZ: When they stimulate these anterior precuneus, you can evoke that the body or the self is floating in the room, like the body is rising or the body is falling like freefall.
HAMILTON: As a result, the inner ear may be saying the body is moving while the eyes say it is stationary. Lopez says that's confusing for the brain.
LOPEZ: Sometimes the best solution, which is found by the brain, is to think that you're somewhere else out of the body.
HAMILTON: It's not just electrical stimulation that can confuse the brain, so can the mind-bending anesthetic ketamine. Patrick Purdon, a researcher at Harvard, has been studying the drug's effects on the brain. He says it acts a lot like brain stimulation when it comes to the anterior precuneus.
PATRICK PURDON: Ketamine seemingly is producing this kind of artificial rhythm that is disrupting function of that area.
HAMILTON: Purdon says that means it might be possible to use electrical pulses in place of anesthetic drugs like ketamine.
PURDON: You could get the specific brain areas that you want without having to cause a brain wide and system-wide effect that might carry with it a lot of side effects.
HAMILTON: Purdon says stimulating the precuneus might even reproduce ketamine's powerful antidepressant effect, though that's never been tried. Jon Hamilton, NPR News. Transcript provided by NPR, Copyright NPR.
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TL;DR: As of August 17, you can get a one-year subscription to the NeuroNation brain-training app for just $39.99 instead of $84 – a savings of 52%.
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Prices subject to change. | Mental Health Treatments |
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