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The first time a mother pulls her newborn close to her skin sets the tone of their relationship, but science shows this 'golden hour' is vital for their health.
Medical experts have found that the first 60 minutes of uninterrupted skin-to-skin contact helps regulate the baby's temperature, control respiration and lower the risk of low blood sugar.
Not only is it crucial for the new life that just entered the world, but the experience also provides oxytocin production in the mother, promoting bonding and milk supply.
Professionals recommend that the baby be immediately placed faced down on their mother's belly, with a blanket covering both of them.
This position slows the production of adrenaline hormones in the mother to not interfere with the production of oxytocin and prolactin hormones.
Tenelle Choal, a certified nurse-midwife at Sanford Health in South Dakota, said in a statement: 'The golden hour is very beneficial and critical for even years down the road between both mom and baby.
'It's super helpful to stabilize the newborn coming out of utero, as well as bonding.'
French obstetrician Michael Odent described in 1977 that newborns sought the breast within the first hour of life, which started the idea of the golden hour among the medical community.
And studies have shown that 60 minutes or more of instant skin-to-skin contact increases the percentage of a child breastfeeding at three months.
The golden hour has also proved to increase the time the baby is in a quiet alert state and reduce crying.
Once a mother brings her newborn close, oxytocin is immediately released in her body, decreasing postpartum bleeding and the risk of postpartum hemorrhage and providing more rapid delivery of the placenta and uterine involution.
'For baby, it helps for thermal regulation, or a fancy term for helping baby regulate temperature, as well as stabilizing blood sugar,' said Choal.
'And then for mom, it helps mom produce hormones that help her to breastfeed and produce milk, as well as decrease stress and anxiety and depression for her.'
Another way to facilitate bonding is to hold your newborn long after you leave the hospital.
New parents have long been advised to put their newborns down not to spoil them, but contrary to the popular myth, cuddling activates oxytocin, increases bonding and stimulates their brains to further development.
Not only does holding your little one close keep them warm, but it curbs crying, regulates breathing and heart rate, helps with weight gain and improves growth.
These findings are compared to children who have not had physical attention and are found to be at higher risk of behavioral, emotional and social problems as they grow up.
Years of studies have proven the importance of touch between a caregiver and a baby, Parents reports.
One paper, published in 2020, applauds the act of skin-to-skin contact, where an infant is dressed only in a diaper and placed on the mother's bare chest.
This outcome results in the release of oxytocin, which is associated with trust and relationship building, and the activation of sensory nerve fibers.
The study highlights several others, with one noting how the contact is also beneficial to the caregiver.
'Their findings indicate the nurturing and predictive quality of parents' touch as a primary means of early contact and communication,' reads the paper.
A team of researchers at Nationwide Children's Hospital in Ohio observed 125 premature and full-term infants to see how they responded to touch, such as cuddling with a parent or not-so-light touches during medical procedures.
The results showed that newborns touched gently had more brain responses than when they endured another touch during procedures.
This, according to Parents Magazine, suggests that 'good' touching helps with brain development.
Nathalie Maitre, who was involved in the study, said in a statement: 'We certainly hoped to see that more positive touch experiences in the hospital would help babies have a more typical perception of touch when they went home.
'But, we were very surprised to find out that if babies experience more painful procedures early in life, their sense of gentle touch can be affected.'
'For new parents, including those whose young children must undergo complex medical procedures, take heart: your touch matters more than you know.' | Women’s Health |
Most people will take a blood test at some point in their life, and commonly, this requires blood to be drawn from the vein on the inside surface of the elbow. However, this simple procedure can sometimes become a bruise-inducing ordeal when health care providers struggle to locate patients' veins.
But why are some people's veins so "hard to find?"
There are several reasons why patients may have been told their veins are difficult to locate, including the depth and size of their veins, whether they were dehydrated and their stress levels, Dr. Mark Whiteley, a consultant venous surgeon and phlebologist at The Whiteley Clinic, a vein treatment center chain in England, told Live Science in an email.
However, people's veins can also be hard to find due to external factors, such as the technique used to draw blood or the temperature of the room, Whiteley said.
"The standard technique for doing this [drawing blood] is to place a tourniquet on the upper arm around the biceps, with the aim to dilate the veins in the lower arm," he said. Once those veins are dilated, or widened, blood can be drawn using a "hypodermic" needle that's inserted beneath the skin, and a syringe. "However, if a tourniquet is placed too tight or too loose, veins may remain hidden," he said.
Arterial blood is pumped down the arms through the arteries at high pressure, while venous blood flows back out of the arms at a lower pressure. "If the tourniquet is too tight, no blood can get into the lower arm and so the veins do not fill," Whiteley said. "If the tourniquet is too loose, venous blood can leak out under the tourniquet … resulting in deflated veins."
Temperature is important because surface veins are part of the body's temperature control system. "When we are very hot, all of our veins dilate, helping us lose heat. When we are cold, our bodies secrete hormones to constrict the veins, reducing their diameter and making them virtually impossible to dilate," Whiteley said.
Setting these external factors aside, it is possible for a person's veins to be too small or too deep to be easily detected. "Patients who have veins that are deeper under the skin, particularly those with a high body mass, can make it very difficult for veins to be palpable through the skin," Whiteley said. In addition, some people have "rolling veins," meaning their veins move easily when touched and can change position during needle insertion, according to Cleveland Clinic.
People's stress and anxiety levels may make their veins difficult to spot because the blood vessels in the skin constrict as part of the "fight or flight" response, while the veins that supply muscles dilate. "Patients who are very nervous go pale, as all of the blood vessels in the skin constrict. As such, it is very difficult to dilate the veins to take blood," Whiteley said.
Veins may also be hard to find due to dehydration and other conditions that affect the volume of blood in the body, like surgical shock, he added. Past injuries can also make people's veins difficult to stick.
"Patients who have had a great many blood tests, or who have had drugs injected into veins, or who have had surgery affecting the veins in the arm can have scarred or even absent veins that are too damaged to take blood from," Whiteley said.
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. | Medical Innovations |
‘Turns out it’s all a con, then,” someone said to me. This was attention deficit hyperactivity disorder (ADHD) they were talking about, in reference to Monday evening’s BBC Panorama, which showed what looked like the decidedly doubtful practices of some reassuringly expensive private providers of psychiatry. So brilliant were some of the clinicians at the places featured that with the benefit of but a short questionnaire and a brief online chat, we were told they were able to diagnose ADHD and prescribe potent medication. Great! What service! And what a marvellous business plan: dosh for diagnoses, money for meds.
Panorama could hardly have made it clearer that while a handful of private clinics may be guilty of misdiagnosing ADHD, that doesn’t mean that ADHD itself isn’t a serious, debilitating condition. But if you’ve been a sceptic all along, or weren’t watching carefully enough, or you didn’t watch at all and merely half-heard or half-read something about the BBC programme, then you might well be the person who says to me: “Turns out it’s all a con, then.”
To be clear, it isn’t. Many lives are blighted by undiagnosed and untreated ADHD. It will often lead to chronic underachievement at school, in the workplace and relationships, and to generally terrible decision-making in every aspect of life. Self-medication often leads to addiction issues. Those with ADHD are vastly over-represented in the prison population. Suicide rates are appallingly high among men and women with ADHD. And these are overwhelmingly the kind of people who will wait for ever for diagnosis on the NHS and are extremely unlikely to have a grand to spare for a consultation at a private clinic, good or bad. This is an unfolding tragedy about which I’m available to make a Panorama show any time they care to ask.
My ADHD plainly didn’t manifest itself as described above. I have been rather successful in my line of work, so I can hardly say it held me back. What I can say is that for an awfully long time I found my life heart-stoppingly, nerve-shreddingly difficult, as I veered wildly between the thrill of it all, and the crippling anxiety and depression. More than anything else, it was simply unsustainably exhausting and, I came to realise, potentially life-shortening. For a long time I thought this all came with the territory. But my diagnosis showed me it didn’t have to. Once I knew what had been going on between my ears for all my life, with the help of therapy and some medication, I was equipped to make changes that slowly improved everything.
I wrote about my experience in these pages and banged on about it on the radio and television. Several people were kind enough to tell me that they recognised themselves in the picture I painted, and sought help. This is great, but the fact is that people like me – ie those who can afford to pay; apparently successful, high-profile ADHDers – seriously distort the whole picture. From a distance, it must look like all the adults with ADHD are doing rather well for themselves.
Not a week goes by without some actor, musician, writer or whoever sharing their diagnosis. I can see how this might sound like bleating self-pity and get on people’s nerves. To be honest, I get on my own nerves sometimes. This candour, or over-sharing perhaps, has helped to ease stigma around the condition and even – misguidedly in my view – seen it portrayed as some kind of superpower. But it has also had the unintended consequence of further overwhelming the already creaking NHS. ADHD has almost gone from being something no one wants to be labelled with, to a sought-after diagnosis – a demand the NHS can’t meet. And where there’s desperation, there’s money; so in gallops the private sector, for good or ill. For those who can afford it, the care you pay for can be a lifeline. But, as Panorama suggested, it can also be a disgraceful con.
The worst thing, in terms of the stigma around ADHD, is that we’re in danger of coming full circle. In the beginning it was a disorder with which no adult wanted to be labelled. It was something that particularly naughty schoolkids supposedly had. Then it became better understood. Those who could pay the money got the care they needed and sang hosannas about it. So the stigma slowly dissipated and demand for treatment rose. With drearily depressing inevitability some businesses saw a trough into which to put their snouts and, for a healthy price, hand out dodgy diagnoses. People see this is happening and so conclude that the whole thing is at best a bit of a craze and at worst a con. And before we know it, those with ADHD, or who think they might have it, are subject to a new, virulent variant of the stigma and shame we started out with in the first place.
Imagine being in their position, like a young woman I know in the same business as me. She’s pretty sure it’s ADHD that is making her life so miserable and wants to address it. With no hope of an NHS appointment any time soon, she has scraped together more money than she can sensibly spare to go private. So now she’s stuck between the NHS, which can’t help, and an expensive private consultation she possibly can’t rely on. “I just feel I’m now in this awful dilemma. Going private should be an easy, albeit very expensive, solution, but now people might dispute the diagnosis anyway,” she says.
“No one wants ADHD, no one wants to hand over a substantial amount of money, no one wants to take medication every day. All we want is clarity, and for everyday life not to be so damn difficult.”
Adrian Chiles is a broadcaster, writer and Guardian columnist | Mental Health Treatments |
Up to 75% of Americans suffer from chronic dehydration, according to multiple studies — and this becomes even more dangerous as summer temperatures heat up.
To help you stay hydrated in the heat, Dr. Sanjai M. Thankachen, a psychiatrist and physician in Fountain Valley, California, shared some tips and warning signs in an interview with Fox News Digital.
In the summer, the heat causes the body to sweat more in order to regulate temperature. This leads to a loss of vital fluids, which can create dehydration, he said.
"Maintaining hydration when it’s hot helps to regulate body temperature, supports organ function and improves overall well-being," Thankachen said.
What to watch for: Signs of dehydration
Some early signs of dehydration include thirst, fatigue, dizziness, lightheadedness, dry mouth, dry lips and dark urine, the doctor said.
If dehydration isn’t addressed, it can lead to heat exhaustion and heatstroke.
Heat exhaustion happens first — this is when excess sweating causes the body to lose large amounts of water and salt, per Healthline.
Signs of heat exhaustion include weakness, nausea, dizziness, lightheadedness, a weak but faster pulse, and pale, cold or clammy skin, per Healthline.
This can progress to heatstroke, which Healthline defines as "a serious medical emergency that occurs when your body is unable to control its internal temperature."
With heatstroke, the body can reach temperatures above 104°F. Other symptoms can include disorientation, loss of consciousness and hot, red, dry or moist skin.
Other dangers of dehydration
When left unchecked, severe dehydration can lead to kidney problems.
"Inadequate hydration can increase the risk of kidney stones or urinary tract infections," Thankachen warned.
Dehydration can also lead to low blood pressure and imbalances with electrolytes, which can lead to lightheadedness, fainting, irregular heartbeat and other complications, the doctor said.
Why you should avoid alcohol in the heat
As tempting as it might be to enjoy a margarita at the pool, alcohol has a dehydrating effect on the body, making it potentially dangerous on hot summer days.
Alcohol is a diuretic, meaning it promotes urination.
This causes the body to lose important fluids and electrolytes, Thankachen explained.
"When you consume alcohol, your body produces more urine than normal, which leads to dehydration," he said.
"Alcohol can also impair the release of vasopressin, an antidiuretic hormone, which helps regulate water balance in the body."
Dehydration from alcohol specifically includes such symptoms as thirst, fatigue, irritability, confusion and headache, the doctor said.
Water is always best
Water remains the best and most effective way to hydrate, according to Thankachen.
Other great options include drinks that are rich in electrolytes and don’t contain added sugars, like fruit-infused water, Pedialyte and herbal teas.
We’ve all heard the age-old guidance to drink eight cups of water a day, but the amount each person needs will depend on many factors, such as age, weight, activity level, climate and existing health conditions, per Cleveland Clinic.
Monitoring the color of your urine is one way to check hydration levels. Darker urine is a sign of dehydration, while clear or light-colored urine indicates that you’re drinking the right amount.
When in doubt, it’s best to talk to your doctor to determine how much you should drink to stay hydrated.
To read more pieces in Fox News Digital's "Be Well" series, click here. | Stress and Wellness |
Dr. Anthony Fauci struck a defensive tone during a recent interview in which he reflected on his and the government’s response to the COVID-19 pandemic, admitting that mistakes were made despite his best efforts.
“Show me a school that I shut down and show me a factory that I shut down. Never. I never did,” Fauci said when asked about the consequences of “heavy-handed” public health policies in a New York Times interview published Tuesday. “I gave a public health recommendation that echoed the CDC’s recommendation, and people made a decision based on that. But I never criticized the people who had to make the decisions one way or the other.”
The response was just one of several in which Fauci defended his guidance during the pandemic, pushing back against critics who have accused him of being wrong about everything, from masks to how effective vaccines would be.
While Fauci, who recently retired from his post as director of the National Institute of Allergy and Infectious Diseases, said public health officials were sometimes wrong, he argued that the ever-changing nature of the evidence meant it was nearly impossible to get everything right.
“Communication in pandemics is difficult under the best of circumstances,” Fauci said. “What has been so troubling to me as a health official is when you are dealing with a moving target, the evidence is evolving and new data becomes available, but you get so many different people with their own sets of data that are not real data, but even in a perfect world, it would not be easy.”
One of the most controversial issues Fauci confronted as the face of the pandemic response was the mask mandates that eventually spread across the nation.
Although Fauci had initially told Americans masking was unnecessary, he would later become a vocal supporter of the benefits of wearing face coverings.
When asked if his change of tune on masks and the divisive nature of the mandates may have intensified opposition to vaccines later, Fauci agreed that anything that “intensified the culture wars just made things worse.”
“When it comes to masking, I don’t know,” Fauci said. “But I do know that the culture wars have been really, really tough from a public health standpoint. Ultimately, an epidemiologist sees it as an epidemiological phenomenon. An economist sees it from an economic standpoint. And I see it from somebody in bed dying.”
The retired infectious disease expert noted that policies meant to spread use of the vaccine may have backfired as many across the country were already becoming skeptical of public health guidance.
“I think, almost paradoxically, you had people who were on the fence about getting vaccinated thinking, ‘Why are they forcing me to do this?’” Fauci said. “And that sometimes beautiful independent streak in our country becomes counterproductive.”
He also defended his views on the origins of the pandemic, arguing that he was open to the idea that the virus could have leaked from a Chinese lab despite believing more evidence exists to support the notion that the virus originated from a Wuhan wet market.
“I feel that until you have a definitive proof of one or the other, it is essential to have an open mind,” Fauci said. “But I want to highlight the difference between possible and probable. If you look at what’s possible, I absolutely keep an open mind until we get a definitive proof of one versus the other.”
Fauci also noted the limitations that scientists have when confronting a pandemic, arguing that future leaders should learn lessons from the country’s response to COVID-19 and that public health officials need to stay vigilant ahead of the next pandemic.
“We don’t need an infinite budget. We just need a sustained commitment to science and public health,” Fauci said. “The next pandemic may be 25 years from now. It could be 50 years from now. Remember, the last transforming pandemic was 1918. We had pandemics in 1957, 1968 and 2009, but nobody hardly even noticed them.” | Epidemics & Outbreaks |
Ryan Piansky, a PhD student at the Georgia Institute of Technology, has had eosinophilic esophagitis (EoE) since he was 2 years old. The condition causes swelling in your esophagus from too many white blood cells. Certain food allergies â meat, nuts, apples, rice, and sweet potatoes, in Pianskyâs case â trigger EoE. While itâs possible to lead a normal life with EoE, you have to take some extra steps to plan ahead.
Growing Up With Eosinophilic EsophagitisÂ
Many people with EoE are diagnosed at a young age. âFrom the day I was born, I was really, really sick,â Piansky says. âThroughout my entire infancy I had failure to thrive, I would throw up, I would refuse to eat, I wasn't gaining weight or growing.âÂ
As Piansky got older, his food allergies impacted his life in different ways. But the good news is that EoE is a treatable disorder. âPeople can live a really happy and healthy life,â he says. âI think it's super important to understand that this is not the end of the world. This shouldnât derail your life. You can live the exact life that you want to lead. EoE just makes you think a little more about things.â
With EoE, you might have heartburn, chest pain, regurgitation, or trouble swallowing. Because of these symptoms, Piansky has had to make certain adjustments throughout his life:
Some foods are off-limits. After his diagnosis, Pianskyâs mother began to work with him to find meals that he could safely eat.
This later helped develop Pianskyâs love for baking and cooking. âThat hobby started when I was young. As I've gotten older, and tried more foods and worked with my doctors to get on the right mix of medicines. I'm able to eat more,â he says.
At first, experimenting with ingredients was a way for Piansky and his mother to learn how to make nice-tasting recipes that worked with his allergies. âLiving on my own, I still really enjoy baking and cooking. Now that I have more foods available to me, I've really gotten to enjoy trying a bunch of new things.â
It might be hard to attend social events at times. If you have EoE, your symptoms might keep you from some activities. If an event revolves around food, you might be hesitant to go because itâs important to stay away from foods thatâll trigger your condition. This may mean you prefer to cook at home more often. But if you plan ahead for outings, itâs still possible to participate.
âThroughout elementary school and in high school, I was sick a lot so I would miss days of school. I wouldn't get to see my friends for sometimes a week at a time,â Piansky says. âTraveling is also tricky if there was a school trip or an overnight trip. I wasn't able to go on my senior trip because we were going out into the middle of the woods. There wasnât going to be food that Iâd be able to eat there. Itâs really challenging to bring 3 days of food with you on a school bus.â
Tiredness may affect you during parts of your life. âAll throughout high school, I was on a feeding tube. It was a little annoying because you have to keep that refrigerated and use certain supplies,â Piansky says. âDuring this time, I was exhausted. Because of that, I couldn't really do sports in high school. Luckily, I'm able to be more active now.â
How Can You Manage Your Social Life With Eosinophilic Esophagitis?
Make a game plan. âEoE can definitely impact your life a lot. But the really important thing to remember is that it doesn't need to if you can plan ahead and you can make things work,â Piansky says.Â
This might mean you have to pack your own meals beforehand or check a restaurantâs menu to see if you can eat the dishes they serve.
âIf youâre feeling well enough to make it out, you can lead a normal life â just with a lot of extra planning on top of it,â he says.
Make sure you have the energy. In order to have a good time out, you want to make sure you have the strength.
âOne thing that's really important to think about is if [going out] is necessarily the best decision. Because if you're not feeling well, you don't necessarily want to push yourself,â Piansky says. âItâs important to take time for yourself as well.â
âI spent years where I thought I should be able to do all of these things like other people. But I realized I needed to prioritize myself and take care of myself,â he says. âThis might mean I need to stay at home or sleep in a little bit, just to get energy back.â
Keep a good mix. Ultimately, you want to find the sweet spot between rest and recovery and a healthy social life. âWith EoE, it's really a balancing game of trying to figure out how much planning and work can you do to make sure youâre leading the life you want to live,â Piansky says, âand making sure it wonât impact your health and make you sicker than you really should be.â
Chat with your friends. âIn high school, my friends knew I had this disorder, and they knew about my food allergies. If we were ever planning to go out to dinner, theyâd defer to me to select where we went to eat,â Piansky says. âThat way I could find a restaurant that had things I was allowed to eat. That would be great for me so then I wouldnât have to bring food.â
Donât be afraid to tell your friends about your EoE. A good friend will help you take steps you need to enjoy your time out.
âIf I was going to stay overnight at a friend's place, theyâd let me know ahead of time if we were going to eat. Or theyâd ask if they should pick up anything to have in their house so I can snack on,â he says.Â
âCommunication with your friends is really, really important. That way, we can make sure weâre all on the same page. Youâll have the information you need to make sure that you can have a successful time out.â
Manage your expectations. You donât want to force yourself to attend every event if it truly doesnât work within your health needs. âSometimes my friends would have plans to go somewhere after school,â Piansky says. âBut if I didn't bring any extra food, I wouldnât be able to eat anything. I didnât want them to change their plans, so Iâd just see them next time.â
âItâs important to make sure they understand it's not an issue that they're doing something that you can't participate in. But for your health, you need to take a step back for this afternoon. I think that clear communication is really helpful.â
Save your energy. Even when Piansky was on his feeding tube and had low energy, he was able to do the things he cared for most. âI would spend a lot of time really tired, which definitely impeded my ability to go out and do things with people,â he says. âBut for things that I was excited about and I wanted to spend the energy on, I could absolutely make that work.â
Talk to your doctor. You may have to make lifestyle changes with EoE, but your social life shouldnât suffer. âThe best thing to do is talk to your doctor if you're having any symptoms that are really impacting your life. Discuss what options there are so you can move forward and thrive.
Show Sources
Photo Credit: monkeybusinessimages / Getty Images
SOURCES:
Ryan Piansky, student, Atlanta, GA.
Cleveland Clinic: âEosinophilic Esophagitis.â
The Journal of Allergy and Clinical Immunology: âVery early onset eosinophilic esophagitis is common, responds to standard therapy, and demonstrates enrichment for CAPN14 genetic variants.â | Disease Research |
Doctor shows the bizarre toilet position that can help with constipation
It's weird, but it works.
Around 4 million people in the United States suffer from frequent constipation (according to John Hopkins) resulting in 2.5 million doctor visits per year. In fact, constipation is the number one most common gastrointestinal complaint.
Constipation can actually be a complex issue to navigate because it can have a variety of causes, both big and small—a lack of fluids of fiber, reactions to medications, stress, abuse of laxatives. Even a sudden change in environment can trigger it. Ever suddenly have trouble going to the bathroom when you're traveling? You’re not alone.Our position on the toilet can also greatly affect whether or not we have a healthy bowel movement. And while you may have never attempted this unconventional configuration, one doctor swears it’s number one for number twos.
Daria Sadovskaya, 29, a nephrologist based in Singapore, often shares lesser-known health tips and common hygiene mistakes on TikTok.
Previously, Sadovskaya went viral after sharing why you should never use a loofah, keep a razor in the bathroom, or keep your hair down while using the toilet. (yes, really)
Now, the kidney expert has revealed a position guaranteed to “help you to poop fast.”
In the video, which has already been viewed 26 million times, Sadovskaya sits on the toilet doing a move that looks like it belongs in a yoga class—her left leg crossed over her lap, her foot on her right thigh.
Then she looks to the left, twisting her whole upper body in that direction. Kind of seems like even if this position doesn’t work, at least you’d get a good stretch out of it.
@sadovskaya_doctor What to do if you’re constipated and can’t poop? Try this position, it will help you to poop fast. #healthypooping #poopfast #constipationhelp ♬ original sound - Jazzzz
It might look bizarre, but Sadovskaya assures it’s an effective remedy against light constipation. “This hack works like a kind of self-massage, helping the stool to come out faster and easier,” she told NeedToKnow.co.uk, also suggesting regular exercise, plenty of fiber and water and avoiding caffeine and alcohol.
What’s more, Sadovskaya warned that an incorrect toilet position could lead to bigger problems, and should be taken seriously.
“Constipation is an issue itself but it [using the wrong position] can also lead to hemorrhoids, anal fissures, urinary problems, even increases the risks of colorectal cancer. In addition to all of the above, it can cause nutritional deficiencies, bowel dysfunction and even psychological issues,” she said.
In addition to going mega viral, Sadovskaya’s video received thousands of comments from viewers saying the trick worked–though it’s hard to say whether they were being sincere or saying it in jest.
“I’m pooping rn and it worked bless ur soul,” someone wrote.
“I’m on the toilet rn and it’s lowkey working LMAOOO,” another said.As weird as it might seem, it’s not like this is the first time unique pooping positions have found their way to legitimacy. Once upon a time, squatting seemed like something totally foreign (at least to Western societies). Now, millions own a Squatty Potty.
And sure, there’s plenty of pseudoscience out there, so we should all use a healthy dose of discernment when it comes to medical advice—especially in today’s digital age. But it’s also true that odd remedies do exist. So there’s no harm in trying, at least in this case. Who knows? Maybe your body will thank you for it.
And if you’re still on the fence, your could also try these more traditional options from Health.com:
- Going to the bathroom at the same time each day
- Going to the bathroom as soon as you need to, and never holding in a bowel movement
- Trying to poop about 15-45 minutes after breakfast or lunch
- Drinking coffee
- Exercising regularly
- Taking magnesium supplements
- Taking over-the-counter (OTC) stool softeners or stimulant laxatives, if necessary | Stress and Wellness |
The Met Office has confirmed Britain has enjoyed the hottest day of the year so far after beaches and parks were packed out and parts of London sizzled in 28C (82F) today.Forecasters had predicted glorious sunshine and clear skies across much of England and Wales during this week's heatwave, as temperatures of nearly 30C (86F) are recorded in parts of London and the South East today before surging to 34C (93F) on Friday.Tourists posed for selfies on Westminster Bridge in the capital and enjoyed ice cream in Richmond Park, while families flocked to Bournemouth and Brighton for a day at the beach. Others cooled down by punting on the River Cam behind Cambridge's historic colleges.And health bosses had urged people to watch for signs of heat exhaustion among the elderly and vulnerable, while hay fever suffers braced for a 'pollen bomb'.The warm flow of weather is coming from Spain and Portugal, where daytime temperatures have exceeded 40C (104F) on parts of the Iberian Peninsula.Britain's highest recorded June UK temperature was 35.6C (96F) at Southampton Mayflower Park in June 1976 - the year of a notorious summer heatwave. This year's hottest day so far was the 27.5C (81F) set in mid-May at Heathrow.The all-time temperature record for the UK is 38.7C (101F), which was set on July 25, 2019, in Cambridge University Botanical Gardens. Met Office Deputy Chief Meteorologist Dan Rudman said: 'Temperatures will continue to rise as we go through the week, becoming well above-average by Friday when many parts of the southern half of the UK are likely to exceed 30C and may even reach 34C in some places. Brighton beach is packed today as hundreds of Britons enjoy the sun by the seaside Students April Phillips and Lada Miller, both 19, enjoy ice cream in Richmond Park, south-west London today People enjoy the sunny weather on Westminster Bridge by the Houses of Parliament, London today Sisters Olivia (left) and Grace Jenman, both 19, from Southampton sit on the beach at Brighton today Families head to Weymouth beach to enjoy the sunshine today as temperatures rocket People take a selfie in front of the London Eye as they enjoy the sunny weather on Westminster Bridge today Racegoers seen arriving on Day 2 of Ascot Races today People using a pedal boat make their way along the river Avon during warm weather in Warwick today Sunbathers and picnickers enjoying the hot sunshine in Richmond Park, south-west London today Kings Meadow in Cambridge in full bloom today as people go for a walk on a beautiful sunny day People enjoying the hot weather in London's Hyde Park today as temperatures hit 28C Race-goers enjoy the second day of Royal Ascot in Ascot todayMet Office graphs show clear skies above England and Wales today, but a very high pollen count The hottest ever June days in Britain on recordThe hottest June days in the UK on record are June 29, 1957, and June 28, 1976.On both those days, in London and Southampton respectively, a staggering 35.6C (96.1F) was recorded.Met Office forecasters are saying that mercury levels could exceed even that on Friday - meaning we could be in for the hottest June day ever. 'This is the first spell of hot weather this year and it is unusual for temperature to exceed these values in June.'Many areas will also see some warm nights with minimum temperatures expected to be in the high teens or even low 20Cs for some overnight.'Met Office spokesman Grahame Madge said: 'We have got high pressure at the moment so we are getting a certain amount of natural homegrown heat building up because obviously we have got clear skies and fairly dry ground conditions across southern England.'We have also got warmer air being brought up from further south in Europe where there has been a major heat incident, particularly in Iberia, so that's leading to the sort of crescendo we will see on Friday.'Because of the direction of the flow, with the weather pattern we have got set up in our latitude, that is encouraging this warm flow of air to come further north.'We have got the heat building day by day. The next couple of days will be hotter than the preceding day. We think at the moment , although there is some uncertainty, that the weather temperatures will peak on Friday and then largely we will be in for a cooler day on Saturday.'Heat may remain potentially into Saturday but for most parts of the UK because we have got a cold front moving down from further north we will see temperatures coming back down - but they may just hang on in southern England.'Dr Mark McCarthy, head of the Met Office's National Climate Information Centre, said: 'Climate change has increased the average temperature of UK summers, and it is also increasing the likelihood of experiencing more extreme temperatures during hot spells and heatwaves.'Reaching 34C during June is a rare, but not unprecedented, event in the historical climate records for the UK. But if it should happen this week it would be notable that it would have occurred on three days during the last six Junes.' A young woman soaking up the sunny weather in Greenwich Park, London today Two women talking as they sunbathe in London's Hyde Park today amid sizzling sunshine Two women enjoy a picnic as they sit on the grass in London's Hyde Park and enjoy the sunshine today Ben Goodall, 23, and Ally Fry, 21, take their dog Ollie for a walk in the sea at Sandbanks in Dorset today Sunbathers on the beach at Lyme Regis in Dorset enjoying the scorching hot sunshine today Families flock to Bournemouth beach in Dorset today amid blue skies and glorious sunshine Sunbathers on the beach at Lyme Regis in Dorset sit under an umbrella today A male sunbather sits on the beach at Lyme Regis in Dorset today next to a woman A woman reads a book outside a seafront beach hut at Lyme Regis in Dorset today Sunrise in Roker in Sunderland this morning amid Britain's June heatwave A man standing on Glastonbury Tor at sunrise this morningWhat is the definition of a UK heatwave? A UK heatwave threshold is met when a location records a period of at least three consecutive days with daily maximum temperatures meeting or exceeding the heatwave temperature threshold. The threshold varies by region. Generally - In London and the South East, a heatwave has to be hotter than 26C (78F).In the North, West and Northern Ireland, a heatwave has to be more than 25C (77F). The map was recently updated to change the heatwave threshold for Surrey, Berkshire, Buckinghamshire, Bedfordshire, Hertfordshire, Cambridgeshire to 27CSource: The Met Office Agostinho Sousa, Head of Extreme Events and Health Protection at the UK Health Security Agency, said: 'Temperatures are forecast to reach 30C in some parts of the south on Friday and we want everyone to enjoy the hot weather safely when it arrives and be aware of good health advice for coping with warmer conditions.'During periods of hot weather it is especially important to keep checking on those who are most vulnerable, such as older people and those with heart or lung conditions.'Make sure to look out for signs of heat exhaustion and follow our simple health advice to beat the heat.'An Environment Agency spokesperson said: 'There is a low-risk of drought for public water supplies this summer. However, further hot, dry weather could put pressure on some areas.'Dry weather this spring has led to receding river flows and reservoir levels across central and south western England in particular.'Early June rainfall has offered some relief with river flows improving compared to the end of May, however a third of river flows remain below normal for the time of year.'As always, we continue to work with water companies and wider stakeholders to closely monitor water resources and take action, where necessary.'People should use water wisely and follow advice from their suppliers.'The British Red Cross, meanwhile, has encouraged people to protect themselves and to check in with vulnerable friends, family and neighbours during the soaring temperatures.It has given advice to help keep people healthy, including urging them to drink plenty of fluids but avoid excessive alcohol consumption, wear sun cream and keep workplaces and homes cool.The RSPCA is urging dog owners to be aware of the dangers of walking their pets - especially ones with thick coats and underlying health conditions - during the warmer seasons.Esme Wheeler, RSPCA dog welfare specialist, said: 'The truth is walking dogs in hot weather can be a silent killer. While the majority would never leave our dogs in a car on a hot day, or even take our dogs for a really long walk in the heat, many people may still be putting their dogs at risk even on a short walk, or taking them to places such as fields and beaches with little or no shade.'We have long-campaigned that dogs die in hot cars, but this year we're highlighting that dogs die on hot walks, too. The message remains very simple - never leave a dog in a hot car because 'not long' is too long, and when it comes to walks, 'if in doubt, don't go out.'The Blue Cross urged cat owners to be careful when leaving windows open after one kitten fell from a third storey window and fractured her leg.Some advice by the charity to cool pets down includes keeping cats indoors during the hottest points in the day, with windows open that have wire mesh or netting to prevent any injuries, and instead letting them out during the cooler parts of the day.Forecasters are predicting that July and August will be hotter still, as the British summer truly kicks into gear.The Weather Outlook forecaster Brian Gaze said: 'It looks like sun cream conditions ahead, with a hotter-than-average July expected, with more hot spells in August.' | Epidemics & Outbreaks |
July 21, 2023 â Richard Carter had spent the morning walking the picket line outside the Walt Disney Studios in Burbank, CA, with other striking actors. Now, at noon, the temperature had reached 93 F, with a hot breeze blowing. Yet Carter, a 50-something background actor who counts the television show This is Us among his credits, was still cheerful.
Some might call him an âiguana,â one of those people who, like the reptiles that prefer to bask in 95 degrees, donât complain when the temperatures skyrocket. He notices but doesnât dwell.
âI say, âDamn, itâs hot,ââ he said, then quickly adds, âIâd rather say that than âDamn, itâs cold.ââ
A transplant from Chicago, he can still describe in detail that sub-20-degree day long ago â with a wind chill that he said made it feel like 60 below â as he waited for a bus that was 20 minutes late. Thatâs when he and his wife decided to pack up and head west. âIt didnât feel that bad today,â he said of the 90 F-plus heat.
In Bend, OR, temperatures are toasty, too, reaching the mid-90s. Yet, the weather hasnât stopped Patrick Fink, MD, 35, an emergency medicine doctor and wilderness medicine specialist at St. Charles Health System, from getting in a couple of hours on his mountain bike regularly. âI donât mind it, and I have no problem exercising in it,â he said. âI think itâs a matter of serial exposure.â
This summer, the heat is on, and itâs been hard for most of us not to notice. As of July 20, more than 100 million Americans were under heat alerts, according to the National Integrated Heat Health Information System, a collaboration of federal partners to provide information on the risks of extreme heat. Cities that are typically hot, like Phoenix, are setting records this summer, on July 20 hitting 110 F degrees for 21 consecutive days. The world ended the hottest week on record July 10, according to the World Meteorological Association. And thereâs more heat â much more â to come, experts warn.
With extreme heat in the forecast, learning to cope in the heat is the new gotta-have skill. âI think we all have to learn to live with it,â Fink said, âbecause it isnât going to change anytime soon.â
But is handling the heat a skill, or is it all genetics? Are some people just able to cope with sizzling temperatures, while some can't? Itâs debated among experts, with some saying people may tend to have a better or worse tolerance to heat.
Genetics or Not?
Heat tolerance is likely is partly genetic, said Thomas E. Bernard, PhD, a professor of public health at the University of South Florida in Tampa, who studies occupational health and heat stress. Just as some people have higher natural athletic skills than others, some of us are better physically able wo withstand high temperatures, he said. But just as sports training can help athletes of any ability compete better in their sports, improving aerobic fitness can help improve heat tolerance, he said.Â
Hereâs why. âHeat stress is not so much a hot environment, but that you generate heat inside your body,â Bernard said, and for you to cool down, that heat must get out. Someone who is aerobically fit also has good cardiovascular capacity and can dissipate that heat out to the environment better, he said.Â
Genetics likely does not have a large role in heat tolerance, said Graham M. Brant-Zawadzki, MD, an assistant professor of emergency medicine and wilderness medicine specialist at the University of Utah Hospitals and Clinics in Salt Lake City. Many other things do affect heat tolerance, he said.Â
Being overweight or obese, with the extra layer of insulation, can make people less heat tolerant. Diabetes can damage blood vessels and nerves, affecting sweat glands and the bodyâs ability to cool. Certain medications, including blood pressure medicine such as diuretics, antihistamines, and psychiatric medication, can affect heat tolerance. Age plays a role in heat tolerance, with infants, young children, and older adults more likely to struggle with heat, Brant-Zawadzki said.
But, he said, âwe are all capable of becoming more heat-tolerant relative to our own baseline.âÂ
How to Train and Adapt
Regularly being active in the heat can be key to tolerating it, said Fink, the mountain-biking emergency medicine doctor. âI do think I am heat-acclimated because I do it regularly,â he said.Â
Training in the heat builds tolerance, agreed Brant-Zawadzki. Do it judiciously and with your doctorâs OK, he said.
âThe idea is to stress yourself for about 20 minutes at a time, and then give yourself 10 minutes to cool down.âÂ
Do that a few times a day. This, he said, causes a response on a cellular level, with the body producing more of what experts call âheat shockâ proteins. âProducing more of these proteins help drive some of the changes that help people deal better in the heat,â Brant-Zawadzki said.Â
Those with higher levels of these proteins hyperventilate less, for instance, he said.
The CDC and the National Institute for Occupational Safety and Health call heat acclimatization âthe improvement in heat tolerance that comes from gradually increasing the intensity or duration of work performed in a hot setting.â For employers hoping to keep workers from getting heat-related illness, the agencies offer a schedule. Workers increase the amount of time working in the heat gradually, working up to 100%.
âThe heat exposure and the physical exertion have to occur at the same time,â Bernard said. As you acclimate, âyou start to sweat earlier, sweat more, and lose less salt.â
Simple Strategy: Turn Down That Air Conditioning
âOne thing we can [also] do is decrease the level of air conditioning we use,â Brant-Zawadzki said. âIt limits our ability to acclimate ourselves.â Itâs typical for people to go from a very hot 105 degrees outside to a restaurant that could be as chilly as 65 degrees, he said. That wonât help boost tolerance to heat.Â
As a general goal, he suggests keeping the house or office air conditioner set at no more than 10 degrees cooler than outside. Of course, if itâs 100 degrees out, keeping the air conditioner at 90 degrees wonât be helpful. But try not to set the air conditioner 20 or 30 degrees colder than outside, he said.
What About Supplements?
Researchers are looking at the role of the supplement betaine, also called trimethylglycine, to improve heat tolerance. So far, it seems to help in animal studies, said Brandon Willingham, PhD, a registered dietitian and assistant professor of kinesiology at Coastal Carolina University in Conway, SC, who did the research while at Florida State University. It may act in a similar way as the heat shock proteins, he said.Â
But there is not yet evidence that it works in people, although research is continuing. âMaybe in a year, weâll have a different story to tell,â he said.
Real-Life Strategies
Conner Ohlau, 41, of Scottsdale, AZ, works as a project manager for a commercial construction company. âIâm a project manager who works with my hands,â he said, preferring outside work to days at a desk and computer. One day recently, he had worked outside from 10 until 5, with the temperature reaching 117 F. He said people often canât believe he works day in and day out in the intense heat.
Heâs learned how to handle the heat. âI keep the sun off me, thatâs the key,â he said, wearing a hat and neck covers when the sun gets intense. âWhen youâre outside, you have to be able to put something cool on your neck every 15-20 minutes.â He also changes shirts often and drinks a couple of gallons of water on the hottest days. He avoids alcohol, which can be dehydrating, during the workweek. | Stress and Wellness |
Angela Weiss/AFP via Getty Images
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Test strips used to detect fentanyl and xylazine in street drugs, are seen at St. Ann's Corner of Harm Reduction in New York City on May 25, 2023. Overdose deaths involving xylazine have soared.
Angela Weiss/AFP via Getty Images
Test strips used to detect fentanyl and xylazine in street drugs, are seen at St. Ann's Corner of Harm Reduction in New York City on May 25, 2023. Overdose deaths involving xylazine have soared.
Angela Weiss/AFP via Getty Images
The White House is marshaling a new plan to try to beef up testing, tracking and treatment for street drugs laced with xylazine, a veterinary tranquilizer that has contributed to a surge of overdose deaths across the country.
The administration listed xylazine combined with fentanyl as an emerging threat back in April. The Centers for Disease Control and Prevention has said that last year, the veterinary drug was linked to nearly 11% of all fentanyl overdoses.
Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, said xylazine has now been detected in nearly every state.
"If we thought that fentanyl was dangerous, fentanyl-combined xylazine is even deadlier," Gupta told reporters.
In a new plan released Tuesday, Gupta's office outlined several steps it plans to take to try to decrease the number of deaths from xylazine. Over the next 60 days, a group of federal agencies will add more details about how they'll put the plan into action.
Increased research and data collection are a priority, Gupta said, "to see the full picture of this threat."
The office also wants to focus on treatments for xylazine-related overdoses. When xylazine is combined with fentanyl, it can complicate the use of medications like Narcan that work to reverse opioid overdose, since xylazine itself is not an opioid.
Additionally, xylazine produces what Gupta described as "deep flesh wounds" that are challenging to treat. "As a physician, I've never seen wounds this bad at this scale," he said.
Gupta said the government is also working on ways to stop online imports of xylazine and its ingredients from China and Mexico for street drugs, while making sure that veterinarians can still get the legal supplies that they need. | Drug Discoveries |
In recent years, private equity firms have been gobbling up physician practices to form powerful medical groups across the country, according to a new report. The New York Times: In more than a quarter of local markets -- in places like Tucson, Ariz.; Columbus, Ohio; and Providence, R.I. -- a single private equity firm owned more than 30 percent of practices in a given specialty in 2021. In 13 percent of the markets, the firms owned groups employing more than half the local specialists. The medical groups were associated with higher prices in their respective markets, particularly when they controlled a dominant share, according to a paper by researchers at the Petris Center at the University of California, Berkeley, and the Washington Center for Equitable Growth, a progressive think tank in Washington, D.C.
When a firm controlled more than 30 percent of the market, the cost of care in three specialties -- gastroenterology, dermatology, and obstetrics and gynecology -- increased by double digits. The paper, published by the American Antitrust Institute, documented substantial private equity purchases across multiple medical specialties over the last decade. Urology, ophthalmology, cardiology, oncology, radiology and orthopedics have also been major targets for such deals. "It's shocking when you look at it," said Laura Alexander, director of markets and competition policy for the Washington Center, who said private equity firms dominated only a handful of markets a decade ago. By looking at individual markets, the researchers were able to document the local impact. "National rates mask this much more acute problem in local markets," she said.
When a firm controlled more than 30 percent of the market, the cost of care in three specialties -- gastroenterology, dermatology, and obstetrics and gynecology -- increased by double digits. The paper, published by the American Antitrust Institute, documented substantial private equity purchases across multiple medical specialties over the last decade. Urology, ophthalmology, cardiology, oncology, radiology and orthopedics have also been major targets for such deals. "It's shocking when you look at it," said Laura Alexander, director of markets and competition policy for the Washington Center, who said private equity firms dominated only a handful of markets a decade ago. By looking at individual markets, the researchers were able to document the local impact. "National rates mask this much more acute problem in local markets," she said. | Health Policy |
Illustration: Shutterstock (Shutterstock)Research from a team in Israel appears to offer encouraging news: The majority of symptoms tied to long covid might fade away over time for those who initially had a mild case of covid-19. The study found that mild cases had a higher risk of more than a dozen health conditions compared to uninfected controls in the months following infection, but this increased risk largely disappeared within a year.OffEnglishThe study was led by scientists from the KI Research Institute in Israel, in collaboration with Maccabi Healthcare Services, one of the country’s four health maintenance organizations (HMOs). In Israel, practically all health care is provided and covered through these HMOs—a universal system that makes it relatively easy for researchers to study the population’s health through deidentified electronic medical records. Relative to many other peer countries during the pandemic, Israel has also been more vigilant in providing residents easily accessible testing for acute cases of covid-19. The sheer amount of data available to these researchers meant that they could track people’s health following a bout of covid-19 to an extent that few others have been able to.The study included around 300,000 people who tested positive for covid-19 infection but weren’t hospitalized as a result between March 2020 and October 2021. The team tracked how often these people went on to later be diagnosed with 70 different health conditions possibly linked to long covid up to a year later, and compared them to controls matched in age and other factors who never tested positive for covid-19 during the same period of time. They intentionally focused on those with milder covid-19, since these represent the majority of covid-19 cases and, likewise, the majority of people who develop long covid.“The specific emphasis on patients experiencing mild disease, which are the majority of the infected population, is what adds and gives this [research] its unique point of view,” study author Maytal Bivas-Benital, a researcher at KI, told Gizmodo in an email.Bivas-Benital’s team found that mild covid-19 cases had a higher risk on average of being diagnosed with several different conditions compared to uninfected people within one to six months after infection. These conditions, 13 in total, included hair loss, chest pain, shortness of breath, and problems with memory or concentration, commonly referred to as “brain fog.” However, this increased risk declined over the next six months, with the risk of nearly all outcomes reaching or coming close to the baseline risk seen in uninfected controls. The risk of anosmia and dysgeusia (the loss of smell and taste), brain fog, shortness of breath, and general weakness did remain elevated a year later, but these conditions became less common over time, too.G/O Media may get a commissionUp to $100 creditSamsung ReserveReserve the next gen Samsung deviceAll you need to do is sign up with your email and boom: credit for your preorder on a new Samsung device.“Patients with mild covid-19 had an increased risk for a small number of health outcomes, with only a few symptoms persisting a year from SARS-CoV-2 infection and their risk decreased with time from infection,” Bivas-Benital said. The team’s findings were published Wednesday in The BMJ.Other studies have indicated that some people do recover from long covid, at least partially. But the authors say theirs is one of the most detailed and lengthy follow-ups of patients with initially mild covid-19.The extensive dataset also meant that Bivas-Benital’s team could make lots of different comparisons between groups of people. Children, for instance, seem to have a lower risk of any long covid symptoms than adults, while the highest risk may be in people between the ages of 41 and 60. The risk of shortness of breath was lower in vaccinated people who developed a breakthrough infection compared to unvaccinated people, though the risk of other conditions appeared to be similar. And interestingly enough, they found no difference in long covid risk from catching either the Alpha or Delta variant, compared to the original strain, though they only had a few months of data on Delta specifically.No study comes without caveats, though. The reliance on electronic health records and official diagnostic codes means that some cases of long covid may have gone unnoticed. And it’s possible that some people stopped reporting lingering symptoms to their doctors as time went on, even if they still felt sick. On the other hand, health care in Israel is free and considered high-quality, limiting some of the reasons why sick people would avoid or stop seeking care. And Bivas-Benital notes that people who got covid-19 may actually see the doctor more compared to uninfected people, simply because they’re paying more attention to their health following infection, “resulting in higher reporting and increased screening for potential covid-related outcomes in these patients.”Conversely, a key strength of the study is the ability to compare these cases to a large group of uninfected controls, which is important since many symptoms often associated with long covid can be caused by other things. As a result, these findings might also indicate that only a small proportion of mild covid-19 cases go on to experience any illness that’s possibly linked to the infection. At the same time, the findings do not mean that people haven’t and will continue to experience chronic, sometimes debilitating symptoms caused by covid-19.“It seems that as long as SARS-CoV-2 will be with us, there will be a small proportion of patients that will experience lingering symptoms of this infection,” Bivas-Benital said.The authors say that more study is needed to understand the specific risks of long covid posed by the Omicron variant, which has become the dominant variant worldwide since late 2021. Another critical and still underexplored area is the impact of reinfections on long covid risk. | Disease Research |
Infections with cytomegalovirus (CMV) are extremely common and often pose no major threat to the vast majority of people. They can however be deadly for people whose immune system is weakened, e.g., after bone marrow transplantation. Current treatments against CMV infections are very limited and can have severe side effects. Researchers led by Prof. Michael Sieweke at the Center for Regenerative Therapies Dresden (CRTD) at TUD Dresden University of Technology and the Center of Immunology of Marseille Luminy (CIML) propose a new way to protect against CMV. Instead of targeting the virus, their approach boosts the weak immune system and lets it fight the virus on its own. The results were published in the journal EMBO Molecular Medicine.
Some viruses can be dormant throughout a person's life and cause no harm but become dangerous when the immune system is weakened. One of such viruses is human cytomegalovirus (CMV). Harmless to the general public but life-threatening to patients with a supressed immune system.
"Patients undergoing bone marrow transplantations have their blood and immune system fully replaced by that of the donor. In the first months after transplantation they are defenseless. They can either catch CMV or have virus reactivated that was dormant in the patient. At the moment, there is no ideal treatment. The available ones work in a limited way or can cause severe side effects such as kidney failure, liver failure, deafness, sepsis, and others," explains Dr. Julien Subburayalu, a clinical scientist in the Sieweke group at the Center for Regenerative Therapies Dresden (CRTD), one of the leading authors of the study.
The Unusual Approach: Boosting Immune System
Teaming up with Dr. Marc Dalod, an expert on CMV immunity, the researchers led by Prof. Sieweke took an unusual approach. Instead of targeting the virus with antiviral treatments, they focused on strengthening the immune system to fight the virus on its own.
"So far, antiviral treatments focused on targeting specific viruses, either through vaccination or by drugs that work on viral molecular machinery," mentions Dr. Marc Dalod, group leader at the Centre d'Immunologie de Marseille-Luminy (CIML) and author of the study. "Our method intervenes at the level of patient's blood stem cells to boosts general antiviral defenses. It's ideal as a prophylactic or a general intervention strategy in immunosuppressed individuals," says Prof. Michael Sieweke, Alexander von Humboldt Professor and research group leader at the CRTD and CIML.
Cytokine: Small but Mighty Molecule
The new approach focuses on the cytokine known as macrophage colony-stimulating factor (M-CSF, CSF1). It's a small signaling molecule that works as a messenger and activator for the immune system. "The cytokine boosts the production of specific white blood cells, mainly monocytes and macrophages," says Dr. Prashanth Kumar Kandalla, one of the leading authors of the study.
Although normally monocytes and macrophages were not known as the primary defense force against viruses, the authors found that they activated other immune cells, so-called natural killer cells, that help fight the virus. "In case of immunocompromised patients, the number of white blood cells is very low. This is why their body is defenseless against infections. M-CSF treatment would boost the immune system by triggering the production of new white blood cells and restore the patient's ability to fight the pathogen," explains Dr. Kandalla.
The team could show that M-CSF boosted production of white blood cells in immunocompromised mice and in such a way protected them from an otherwise lethal CMV infection without affecting bone marrow transplantation.
Clinical Trials Are Needed
The study showed that the concept worked in mice and in human cells in a culture dish. "We are keen to expand our findings and support them with data derived from patients in the clinic. For example, we would like to test our cytokine approach as a prophylactic intervention following bone marrow transplantation to prevent CMV reactivation. For this, clinical trials are necessary. We are now looking for partners who could help us finance such trials," concludes Prof. Sieweke.
Because of its unique ability to boost the immune defence, the new approach is not limited to CMV or bone marrow transplantation patients. The authors expect that it could also be useful to treat other viral infections, and help other patients with a weakened immune system, for example after sepsis or chemotherapy.
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Dozens of young autistic people have died after serious failings in their care despite repeated warnings from coroners, BBC News has found.
Our investigation found issues that were flagged a decade ago are still being warned about now.
Two bereaved mothers told us lessons had not been learned by their local health authority after the deaths of their teenage sons, two years apart.
The government says £4.2m is being invested to improve services.
Former Justice Secretary Sir Robert Buckland described the findings as "deeply disturbing", and called for the government to investigate urgently.
In the first piece of research of its kind, the BBC combed through more than 4,000 Prevention of Future Death (PFD) notices delivered in England and Wales over the past 10 years.
Coroners are legally required to issue such warnings at inquests, if they believe there is a risk future deaths will occur unless action is taken by the authorities responsible. But there is currently no legal duty for them to act.
The BBC identified 51 cases where PFDs described serious failings in the care of autistic people, and health and social care bodies were urged to take action to prevent future deaths.
The majority of those who died were under 30, and nearly a third were children.
Life expectancy for autistic people is - on average - 16 years less than for the general population. There is no clear reason for this - people do not die of autism, it is a neurological condition that means the brain is wired differently. It affects how people interact with others, learn, and behave.
The causes of death in the inquests varied but nearly half were categorised by coroners as relating to mental health or suicide.
Our research identified five key concerns repeatedly flagged by coroners:
- A lack of trained staff with an understanding of autism
- Failure to treat autism and mental health problems as two separate conditions
- Shortage of specialised accommodation
- Lack of a health professional to co-ordinate the young person's care - as recommended in NICE guidelines
- Late diagnosis of autism
The charity Autistica says our research helps explain the avoidable reasons why many autistic people are dying young.
Sir Robert, who heads the all-party parliamentary group on autism, says there is clearly a "mounting concern".
"Lessons are not being learned. Fifty-one [deaths] is a lot. It suggests a systemic problem."
Two mothers whose autistic sons died as teenagers, say they are "tormented" by the lack of accountability.
The deaths of their autistic sons - Sammy Alban Stanley, 13, and Stefan Kluibenschadl, 15 - each resulted in a PFD being issued. The boys had gone to the same school and were failed by the same local health and care services. They died in the same hospital.
It was while Stefan was in intensive care - two years after Sammy's death - that Emma Kluibenschadl got in touch with Patricia Alban Stanley.
To lose a child, they agree, is a life sentence. And to know there was a chance that the deaths could have been prevented is "torment", says Ms Alban Stanley.
Sammy fell from a cliff near his home in Ramsgate, in April 2020. Witnesses reported his last words were: "I'm autistic."
"He meant 'Please help me'," his mother says.
As well as being autistic, Sammy had Prader Willi Syndrome (PWS), a rare neurological condition, which left him unable to regulate his emotions.
"It would be impossible to stop him at times," says Ms Alban Stanley. "He had no concept of danger. He would try to jump out of moving cars, or on one occasion he put needles up his nose."
Ms Alban Stanley - who has three other children and no partner - says she "begged the council for more support" and was "struggling to cope". Her safety net was the police, she says. She called them at least 29 times.
Their GP, senior social workers and the police also made many referrals calling for more support. "But it made no difference," says Ms Alban Stanley.
After six years, she was finally granted two hours of after-school care in January 2020. But it wasn't enough - Sammy died just three months later.
Without extra help, his mother couldn't stop him from leaving the house. Blind to the danger the nearby cliff posed, he fell. He died four days later in intensive care, in his mother's arms.
In her Prevention of Future Death notice to NHS Kent and Medway, coroner Catherine Wood said Sammy fell during an "episode of high risk behaviour" and criticised the local authority and mental health services for "inadequate support".
She also made it clear that it was "predictable that a similar incident may arise⦠if children with complex neurodevelopmental needs are excluded from accessing the care and treatment they require to keep them safe".
Kent and Medway responded to the coroner's PFD saying it was investing in services for children and young people with neurodevelopmental needs - and would make sure care was "co-ordinated rapidly around the child and family".
A few miles away, in Margate, Emma Kluibenschadl and her family were battling with the same health officials. Nearly two years later, the coroner's stark prediction would come true.
Ms Kluibenschadl's son Stefan was struggling with his mental health. He had been bullied for being autistic and spent many years watching his family try to get the help he desperately needed.
She believes this had a profound effect on her son, who felt nobody cared.
Stefan's mental health problems began when he was eight, a couple of years after his autism diagnosis.
Despite their GP making referrals, the family's pleas for help were rejected by NHS Kent and Medway.
Just over a month after their final application for autism-specific counselling was turned down, Stefan was found hanging. He died four days later in intensive care.
"Stefan didn't get any care - never mind co-ordinated care," says Ms Kluibenschadl. She thinks if they had received support they wouldn't be in this position now. Our lives have been destroyed."
Coroner Catherine Wood - who also oversaw Sammy Alban Stanley's inquest - said Stefan had died as a consequence of his own actions but she could not be sure of his intention.
She addressed her concerns to NHS Kent and Medway again - highlighting that the trust had not been following NICE guidelines, which state that every autistic child should have access to a designated social worker.
With such a health professional overseeing his care, Ms Wood said Stefan might have received the therapy he needed.
Sammy's and Stefan's stories are stark examples of a national problem.
Kent and Medway is one of 11 local health and social care authorities to be sent multiple PFD notices in the past 10 years. Twenty-one national authorities also received warnings.
Reports about "potentially life-saving recommendations for change" should be treated with the utmost seriousness, says Deborah Coles from the charity Inquest.
"The current system is simply not fit for purpose, and that betrays bereaved people. But it also betrays the public interest because it puts all of us at potential risk."
For Sir Robert Buckland, the ramifications are huge. "What is the point of PFDs if there is no accountability?" he says. "Autistic people carry on having to put up with poorer life outcomes."
The Department of Health and Social Care says a national autism training programme is being rolled out.
The chief nursing officer at NHS Kent and Medway, Allison Cannon, apologised on behalf of the NHS for the "tragic loss" of both Sammy and Stefan.
Many changes had been made, she said, including enhancing its community support and key worker programme to improve services.
"Judging by the responses we have, our children will die all over again," says Ms Kluibenschadl. | Mental Health Treatments |
SANTA ROSA, Calif. -- Madison Bernard climbed into bed before dawn with her toddler, Charlotte, who was asleep next to a nightstand strewn with straws, burned tinfoil and a white powder.
Hours later, the mother woke and found her daughter struggling to breathe, according to investigators who described the scene in court documents.
After being rushed in an ambulance to a hospital, the 15-month-old girl died from a fentanyl overdose. Her mother and father, whom authorities said brought the drugs into their California home, were charged with murder and are awaiting trial.
The couple has pleaded not guilty but are part of a growing number of parents across the U.S. being charged amid an escalating opioid crisis that has claimed an increasing number of children as collateral victims.
Some 20 states have so-called “drug-induced homicide” laws, which allow prosecutors to press murder or manslaughter charges against anyone who supplies or exposes a person to drugs causing a fatal overdose. The laws are intended to target drug dealers.
In California, where the Legislature has failed to pass such laws, prosecutors in at least three counties are turning to drunk driving laws to charge parents whose children die from fentanyl overdose. It’s a unique approach that will soon be tested in court as the cases head to trial.
Supporters of the ramped-up enforcement say that by now those who use the synthetic opioid know the lethality of the drug and, like drunk drivers, they should know the consequences of exposing their children to their actions.
Critics say the parents didn’t intend to kill their children but instead made poor choices because of their addictions and are being further punished instead of being offered help.
The debate comes as the country battles with how to effectively diminish the use of the highly accessible and extremely deadly drug.
Authorities believe some of the children died after touching something with the powdery substance and then touching their eyes or mouth. In one case, the drug may have been on the hands of a parent who prepared the baby’s bottle. The drug is not absorbed into the skin but experts say it can be lethal if as little as 2 milligrams, about the weight of a mosquito, enters the body.
“These are tragic cases because drug addiction has destroyed a precious life and the parents face the consequences of their reckless actions,” said Charlie Smith, the top prosecutor in Frederick County, Maryland, and president of the National District Attorneys Association.
Parents also can face charges if young children become seriously ill or die from crack, heroin and cocaine, but such cases are rare because a sizeable amount must be ingested, Smith said.
"This is really a first in the history of our country because we have a drug on the streets that can potentially kill you instantly with a minor amount of product,” Smith said.
Prosecutors have a difficult decision to make when determining whether to charge parents, but Smith said the goal is to deter others from doing the same.
He prosecuted a case in which parents in Maryland were convicted of involuntary manslaughter in the 2020 death of their 2-month-old son. The Mount Airy couple had mixed fentanyl in the same bathroom where they prepared bottles for their infant.
Jeremy Whitney Frazier and Heather Marie Frazier were each sentenced in December to five years in prison and five years of supervised probation.
The National District Attorneys Association doesn’t track how many parents have been charged for exposing their children to fentanyl, but news reports and interviews with prosecutors show such cases have been on the rise since the onset of the pandemic.
Last month, a Maine woman pleaded guilty to manslaughter after her 14-month-old son’s fentanyl overdose. Investigators found fentanyl on a blanket and sheet where Ashley Malloy’s son Karson had been sleeping.
States such as Maryland that don’t have “drug-induced homicide” laws often charge parents with manslaughter, Smith said.
In California, prosecutors have turned to a drunk driving law.
Prosecutors in Riverside, Sonoma and Stanislaus counties have charged parents with murder based on the “Watson advisement," a formal statement signed by anyone convicted of a DUI charge who says they understand driving under the influence can injure or kill people. The statement can be used against them if they cause another fatal, DUI-related crash.
“I’ve been a prosecutor 25 years now and I can’t recall any other drug that has led to this much destruction and death,” Riverside County Deputy District Attorney Daima Calhoun said.
Prosecutors say the parents, like drunk drivers, knew fentanyl can injure or kill people.
Among those awaiting a trial that will test the approach are Tehra Alexandra Waite and Collin Pascal Kittrell, both of Riverside. The boyfriend and girlfriend were charged with murder after their toddler died of a fentanyl overdose in June 2020. They pleaded not guilty.
Investigators said their 14-month-old daughter, Allison, likely touched her mouth or eyes after coming in contact with the drug, which was found on several things in their apartment, including the couch.
Detectives testified that when Waite found her daughter unresponsive she rushed to a pharmacy to buy naloxone, a drug used to reverse an opioid overdose. The couple did not call 911 until hours later when Allison started having trouble breathing.
The girl’s paternal grandmother also said in court documents that Waite used drugs while she was pregnant.
The Associated Press sought comment from multiple attorneys who have represented Waite and none responded. Her father declined to comment.
Kittrell's attorney, Graham Donath, said Allison's father did not intend for his child to die and the charge should be one of child neglect, not murder. But prosecutors don’t like to go that route because the maximum sentence for the offense is 12 years.
In Sonoma County, where Charlotte slept with her mom in a messy apartment in Santa Rosa, first responders testified at a preliminary hearing that they found fentanyl in powder form on a nightstand next to the bed.
Ryan Hughes, a Santa Rosa Police Department narcotics detective, told the court they also found text messages showing the couple was concerned about losing their daughter because of their drug use, the Santa Rosa Press Democrat reported.
A judge is expected to set a trial date at a Sept. 11 hearing for Charlotte’s mother, Bernard, who woke up to find her daughter struggling to breathe, and her father, Evan Frostick.
Defense attorneys for Bernard and Frostick and Frostick's parents all declined to comment when contacted by the AP. Bernard's stepmother did not respond to phone messages seeking comment.
“They need to be held accountable under the law because they allowed harm to come to their children and they let their drug use and addiction outweigh taking care of their children and keeping their children safe,” Sonoma County District Attorney Carla Rodriguez said. | Epidemics & Outbreaks |
Patients are taking home far fewer opioid painkillers now than a few years ago, data show, but the pandemic slowed the decline greatly
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Americans who have a tooth pulled or another painful dental procedure in the United States today are far less likely to get opioid painkillers than they were just a few years ago, a new study shows.
That’s good news, since research shows that opioids are not necessary for most dental procedures.
But the COVID-19 pandemic seems to have thrown a wrench into the effort to reduce opioid use in dental care – and not just in the few months after dentists and oral surgeons started providing routine care again after a pause in spring 2020.
The decline in opioid prescriptions filled by dental patients was much faster in the pre-pandemic years 2016 through 2019, compared with the rate of decline from June 2020 to December 2022, the study shows.
In all, dental opioids dispensed to U.S. patients of all ages declined 45% from 2016 to the end of 2022, according to the new findings published in PLOS ONE by a team from the University of Michigan Medical School and School of Dentistry.
But even with the decline, 7.4 million dental patients of all ages filled opioid prescriptions in 2022.
Fortunately, opioid prescriptions to teens and young adults – who face especially high risks related to opioids – kept declining at a rapid rate after the pandemic pause in dental care, the study finds. But for other groups, the rate of decline slowed after June 2020.
In all, the researchers estimate, 6.1 million more dental opioid prescriptions were dispensed between June 2020 and December 2022 than would have been if pre-pandemic trends had continued.
And American dentists and oral surgeons were still prescribing opioids in late 2022 at four times the rate that another study showed British dentists were in 2016.
“These data suggest the dental profession has made major strides in reducing opioid prescribing, but also suggest that progress is slowing,” said Kao-Ping Chua, M.D., Ph.D., the senior author of the new study and an assistant professor of pediatrics at U-M. He worked with first author and former U-M research assistant Jason Zhang, who is now in medical school at Northwestern University.
These data suggest the dental profession has made major strides in reducing opioid prescribing, but also suggest that progress is slowing.
“We know from research that dental pain in most patients can be controlled with non-opioid medications, avoiding the risks of opioids,” said co-author Romesh Nalliah, D.D.S., M.H.C.M., professor and associate dean for clinical affairs at the U-M School of Dentistry. “While it’s reassuring that dental opioid prescribing is declining, the recent slowing in the decline suggests the dental profession must redouble its efforts to reduce unnecessary opioid prescribing.”
The researchers couldn’t determine the procedure that led to each opioid prescription, nor could they determine the exact reason for the slowing of the decline in dental opioid prescribing during the pandemic. However, there are some likely culprits.
“One reason for the slowing might be that dentists were more likely to prescribe opioids just in case they were necessary, out of concerns that patients couldn’t easily follow up with their dentist during the pandemic,” said Zhang.
Right-sizing prescribing
Chua, Nalliah and their colleagues have studied dental opioid prescribing multiple times, and worked with the Michigan Opioid Prescribing Engagement Network (OPEN) to develop prescribing guidelines for dental and oral surgery care available at michigan-open.org/dentistry.
Reducing the number of opioids dispensed to dental patients, especially young ones, is thought to reduce the risk of opioid misuse and diversion of pills to other people besides the patient.
Poisoning of others in the household, and interactions between opioids and other substances including alcohol and prescription drugs, are other reasons to focus on non-opioid dental pain care.
But no studies have examined dental opioid prescribing trends using pandemic-era data.
Differences by provider type, insurance type and region
The new study is based on data from a company called IQVIA that tracks prescriptions dispensed at 92% of U.S. pharmacies. The researchers excluded data from March through May of 2020, when routine dental care in the U.S. stopped temporarily.
The study revealed pandemic-associated changes in dental opioid prescribing varied widely. For instance, the rate of decline in opioid prescribing by oral and maxillofacial surgeons – who perform more complex procedures on people with advanced dental conditions – slowed during the pandemic to a lesser degree than for general dentists and dental subspecialists.
For low income patients covered by the Medicaid program, the number of dental opioid prescriptions during June 2020-December 2022 was 57% higher than predicted than if pre-pandemic trends had continued. For privately insured patients, this percentage was 30% higher than predicted.
The authors speculated that worsened access to dental care in Medicaid patients – who have already have poor access to begin with – may have increased the number of painful dental emergencies and the need for opioids.
People living in the Southern U.S. made up nearly 46% of all people with dental opioid prescriptions in 2022, higher than any other region. But the researchers found that the decline in dental opioid prescribing to people in the Northeast slowed to a greater degree than in other regions. This meant that by the end of 2022, dental opioid prescribing was 69% higher in the Northeast than it would have been if declines had continued at pre-pandemic rates, compared with 23.8% in the South.
In addition to Chua, Zhang and Nalliah, the study’s authors include OPEN co-directors Jennifer Waljee, M.D., M.P.H., M.S. and Chad Brummett, M.D. All except Zhang are members of the U-M Institute for Healthcare Policy and Innovation, and Brummett co-directs the U-M Opioid Research Institute.
Chua is a member of the Susan B. Meister Child Health Evaluation and Research Center in the Department of Pediatrics, which also provided some of the funding for the study.
The study was also funded by the Benter Foundation and the Michigan Department of Health and Human Services.
Association Between the COVID-19 Outbreak and Opioid Prescribing by U.S. Dentists, PLOS ONE, DOI:10.1371/journal.pone.0293621, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0293621
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- The order by the U.S. 5th Circuit Court of Appeals is almost certain to be appealed to the Supreme Court.
- Mifepristone, used in combination with another drug called misoprostol, is the most common method to terminate a pregnancy in the U.S..
A federal appeals court on Wednesday imposed restrictions on the abortion pill mifepristone, though the ruling will not have an immediate impact.
The order by the U.S. 5th Circuit Court of Appeals is almost certain to be appealed to the Supreme Court. Justice Samuel Alito in April preemptively paused any ruling from the appeals court pending a petition for the high court to take the case.
If the Supreme Court does not take the case, the restrictions will go into effect.
Should the restrictions go in to effect, women would no longer be able to obtain the abortion by mail. Patients would have to receive a prescription from a doctor and have follow-up appointments in person.
The restrictions would also shorten the time period when women can take the pill to 49 days into their pregnancy, down from 70 days.
The court battle over mifepristone comes more than a year after the Supreme Court abolished federal abortion rights by overturning the landmark 1973 Roe v. Wade ruling.
Mifepristone, used in combination with another drug called misoprostol, is the most common method to terminate a pregnancy in the U.S.
A panel of three judges at the 5th Circuit heard arguments May 17 from lawyers representing the Food and Drug Administration, mifepristone distributor Danco Laboratories, and a group of anti-abortion doctors called the Alliance for Hippocratic Medicine.
The judges were all appointed by Republican presidents. Judges James Ho and Cory Wilson were appointed by Donald Trump. Judge Jennifer Elrod was appointed by George W. Bush.
The FDA and Danco argued that the lawsuit seeking to pull mifepristone from the U.S. market is unprecedented, has no basis in science and will jeopardize women's health.
The panel of judges pushed back hard on those arguments.
The judges questioned whether allowing women to receive mifepristone by mail without having to see a doctor would result in more patients seeking emergency care. Ho pushed back on the FDA and Danco's characterization of the case as unprecedented.
"I don't understand this theme — the FDA can do no wrong. That is basically the narrative you all are putting forth — nobody should ever question the FDA," Ho said during Wednesday's hearing.
"We are allowed to look at the FDA just like we are allowed to look at any agency, that's the role of the courts," Ho said.
This is breaking news. Please check back for updates. | Health Policy |
Our relationships counsellor answers your problems: I never told my sister how much I loved her
Q My sister, who was my best friend for 73 years, died two years ago after suffering from breast cancer for some time. She had missed an annual scan because of the pandemic and developed a bad cough.
I visited every day to help as she had lost her husband and lived alone. One day I found her struggling for breath so I called an ambulance and she was admitted to hospital where they diagnosed severe heart failure and secondary cancer.
We were devastated. She got the medical help she needed, but sadly passed away three weeks later. I can’t get over a feeling of guilt that I should have got her help sooner.
An anonymous woman reveals that she wished she'd spent more time with her sister. She explains how her sister was diagnosed with secondary breast cancer and passed away three weeks later
When the doctor told her she only had weeks to live I froze emotionally. My sister asked if I was OK and I could only answer that I’d be fine, and told her not to worry and that I’d look after the family. What I wanted to tell her was how much I loved her, and how I’d miss her. I can’t get over feeling that she died not knowing that.
A I’m so sorry to hear of your terrible loss. It must be devastating to lose a sister who was also your best friend – and it’s not surprising that the pain is so raw. But please try to stop blaming yourself and questioning whether she could have been saved if you’d got help earlier.
It is definitely not your fault. It is sadly another Covid tragedy. You were doing so much to help her. It is hard work, both physically and emotionally, looking after someone sick at any age, but even more so when you are in your 70s – and it can be difficult to see beyond the day-to-day.
Even if she had received help sooner it is entirely possible that it might have prolonged her life for a short time, only for the illness to be more drawn out and perhaps much more painful – we can never know how things might have been different. The nub is that you miss her.
Many people regret that they didn’t have the conversation they wanted with someone they loved, because death is not predictable and can leave us unprepared. It must have been a huge shock to discover that she had just weeks to live. It is only natural that you froze emotionally at this news.
So while you might not have told her you loved her in those final weeks, I promise you she knew. You had shown her how much you loved her for every day of those 73 years by always being there for her – by being her best friend and confidante and, in those final months, by doing so much for her when she needed you the most.
It would help you hugely to get support for your grief and to talk through your feelings of loss. So please contact one of the brilliant bereavement charities such as Marie Curie (mariecurie.org.uk) or Cruse (cruse.org.uk) for help.
SHOULD I GET BACK TOGETHER WITH MY EX-HUSBAND?
Q My husband and I divorced ten years ago when our children were teenagers, after being together for 19 years. He was under a lot of pressure at work and had become very bad-tempered, with no time for me or them.
Eventually I’d had enough. He was devastated when I said I wanted a divorce but we managed to be civilised about it and are now good friends. I have often regretted leaving and wished that I’d tried harder to save our marriage.
I wondered if he felt the same but he remarried a year ago after a whirlwind romance. I’ve had a couple of short relationships, but I’m single. However, a few days ago, we met for coffee and he told me his new marriage was a terrible mistake and that he still loved me. It’s completely thrown me. I want him back but it’s so complicated now.
A It’s always sad when two people who were once in love find that external pressures drive them apart. But yes, it is complicated now. You need to approach this with caution.
I know you don’t want to hurt his new wife but to be honest if he feels this strongly that this marriage has been a mistake, then the chances are he would leave her anyway. However, it is important that he doesn’t leave for you – he needs to do so because he doesn’t want to be with her, with no rose-tinted glasses about the past.
But if you do decide to get back together in the future, I would recommend that you take it slowly and perhaps have counselling before becoming too involved in order to work through what went wrong in the first place. It would help you navigate the future together as a team. Visit relate.org.uk. | Mental Health Treatments |
LM Otero/AP
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A pregnant woman stands for a portrait in Dallas on May 18. U.S. health officials have approved the first pill specifically intended to treat severe depression after childbirth, a condition that affects thousands of new mothers in the U.S. each year.
LM Otero/AP
A pregnant woman stands for a portrait in Dallas on May 18. U.S. health officials have approved the first pill specifically intended to treat severe depression after childbirth, a condition that affects thousands of new mothers in the U.S. each year.
LM Otero/AP
WASHINGTON — Federal health officials have approved the first pill specifically intended to treat severe depression after childbirth, a condition that affects thousands of new mothers in the U.S. each year.
The Food and Drug Administration on Friday granted approval of the drug, Zurzuvae, for adults experiencing severe depression related to childbirth or pregnancy. The pill is taken once a day for 14 days.
"Having access to an oral medication will be a beneficial option for many of these women coping with extreme, and sometimes life-threatening, feelings," said Dr. Tiffany Farchione, FDA's director of psychiatric drugs, in a statement.
Postpartum depression affects an estimated 400,000 people a year, and while it often ends on its own within a couple weeks, it can continue for months or even years. Standard treatment includes counseling or antidepressants, which can take weeks to work and don't help everyone.
The new pill is from Sage Therapeutics, which has a similar infused drug that's given intravenously over three days in a medical facility. The FDA approved that drug in 2019, though it isn't widely used because of its $34,000 price tag and the logistics of administering it.
The FDA's pill approval is based on two company studies that showed women who took Zurzuvae had fewer signs of depression over a four- to six-week period when compared with those who received a dummy pill. The benefits, measured using a psychiatric test, appeared within three days for many patients.
Sahar McMahon, 39, had never experienced depression until after the birth of her second daughter in late 2021. She agreed to enroll in a study of the drug, known chemically as zuranolone, after realizing she no longer wanted to spend time with her children.
"I planned my pregnancies, I knew I wanted those kids but I didn't want to interact with them," said McMahon, who lives in New York City. She says her mood and outlook started improving within days of taking the first pills.
"It was a quick transition for me just waking up and starting to feel like myself again," she said.
Dr. Kimberly Yonkers of Yale University said the Zurzuvae effect is "strong" and the drug likely will be prescribed for women who haven't responded to antidepressants. She wasn't involved in testing the drug.
Still, she said, the FDA should have required Sage to submit more follow-up data on how women fared after additional months.
"The problem is we don't know what happens after 45 days," said Yonkers, a psychiatrist who specializes in postpartum depression. "It could be that people are well or it could be that they relapse."
Sage did not immediately announce how it would price the pill, and Yonkers said that'll be a key factor in how widely its prescribed.
Side effects with the new drug are milder than the IV version, and include drowsiness and dizziness. The drug was co-developed with fellow Massachusetts pharmaceutical company Biogen.
Both the pill and IV forms mimic a derivative of progesterone, the naturally occurring female hormone needed to maintain a pregnancy. Levels of the hormone can plunge after childbirth.
Sage's drugs are part of an emerging class of medications dubbed neurosteroids. These stimulate a different brain pathway than older antidepressants that target serotonin, the chemical linked to mood and emotions. | Drug Discoveries |
Orlando Gili for NPR
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"It's really life-changing," says Victoria Gray, when describing the gene-editing treatment for sickle cell disease that she received as part of a clinical trial in 2019.
Orlando Gili for NPR
The Food and Drug Administration may soon approve a therapy that uses the gene-editing technique called CRISPR to treat sickle cell disease. It would mark the first time gene editing moves from the lab into clinical use.
A committee of advisers to the FDA meets Tuesday to review the scientific evidence for the treatment, including whether sufficient research has been done to assess its long-term safety. The agency has until Dec. 8 to make a decision about the therapy, known as "exa-cel."
In an analysis posted by the FDA Friday, agency scientists conclude exa-cel is highly effective at preventing episodes of excruciating pain that plague sickle cell disease patients. The treatment worked in 29 of 30 patients followed for at least 18 months and doesn't appear to cause any serious short-term safety concerns, the FDA concluded.
However, the FDA scientists raised concerns about whether sufficient research had been done to spot "off-target" effects of the treatment — unintended editing errors that missed their mark in the DNA and that could potentially cause long-term health problems.
Because of the high stakes of approving an entirely new kind of technology to treat people for the first time, the FDA plans to focus the advisory committee's discussion about the long-term safety of gene editing and whether additional analyses are needed.
First patient says the treatment changed her life
The committee will hear presentations from Vertex Pharmaceuticals Inc., the Boston company that led the development of exa-cel along with nearby CRISPR Therapeutics. FDA scientists and independent researchers will also brief the committee.
During the public comment portion of the meeting, the committee will also hear from Victoria Gray, a Mississippi woman who in 2019 was the first sickle cell patient to receive the treatment as part of the clinical trial that was conducted by Vertex to win FDA approval. NPR has chronicled Gray's experience.
"I think they should approve this treatment," Gray told NPR in her most recent interview. "It's really life-changing."
The treatment would be the first of what researchers hope will be many new medical treatments that use CRISPR. The gene-editing technology allows scientists to easily make precise changes in DNA. Researchers are studying CRISPR-based therapies for conditions including muscular dystrophy, diabetes, cancer, Alzheimer's, AIDS and heart disease.
"It's extraordinary to think that we're on the verge of an approval of the first CRISPR therapy," says Jennifer Doudna of the University of California, Berkeley, who shared a Nobel Prize for her role in discovering the technique.
"As a scientist, I think we always hope that our work will affect people in a positive way — and this is one of those moments," Doudna says. "It's kind of a landmark moment for the technology, industry and hopefully the people who will benefit from it."
A genetic illness that afflicts millions
Sickle cell disease is caused by a genetic defect that produces an abnormal form of the protein hemoglobin, which red blood cells need to carry oxygen through the body. These red blood cells become misshapen and get jammed inside blood vessels.
The jagged cells cause unpredictable attacks of intense pain and damage vital organs. Throughout their lives, sickle cell patients are repeatedly rushed to the hospital for powerful pain drugs and blood transfusions. They often can't finish school, hold jobs or care for themselves or their families. They're also prone to strokes and other serious complications. Patients usually die about 20 years prematurely.
The disease disproportionately occurs among people of African, Middle Eastern and Indian descent, affecting millions around the world and about 100,000 in the U.S. Although a rare disease, sickle cell is one of the most common genetic disorders. About 20,000 patients in the U.S. have the severe form of the disease the CRISPR treatment would initially be used to treat.
For the treatment, doctors remove cells from each patient's bone marrow, edit a gene with CRISPR and then infuse billions of the modified cells back into patients. The edited cells produce a form of hemoglobin known as fetal hemoglobin, restoring normal red blood cell function. While not a cure for the disease, the hope is exa-cel will be a one-time treatment that will alleviate symptoms for a lifetime.
In a study involving 30 patients, the treatment resolved the severe pain crises for at least 18 months for 29 of the subjects — 96.7%. That transformed the lives of Gray and the other patients, enabling them to work, go to school and care for themselves and their families. The treatment has also produced similar results for patients suffering from a related condition known as beta thalassemia.
"These results are incredible," says Dr. Haydar Frangoul, director of pediatric hematology, oncology and cellular therapy at the Sarah Cannon Research Institute in Nashville, Tenn., who led the study. "They are truly transformative."
Other independent experts agree.
"The amount of change in peoples' lives is super encouraging," says Dr. Lewis Hsu, a professor of pediatric hematology at the University of Illinois Chicago and chief medical director of the Sickle Cell Disease Association of America. "It's very significant."
Cost and complexity are likely barriers
One concern, however, is the likely cost of the therapy, which could be as much as $2 million per patient. The treatment is also complex, requiring a bone marrow transplant and lengthy hospitalization. Those factors may put it out of reach for those who need it most in the U.S., as well as in less affluent countries where the disease is most common.
"I'm worried that this will be a very highly lauded technology that people will not be able to use," says Melissa Creary, an assistant professor at the University of Michigan School of Public Health who studies sickle cell. "I think the people who need this therapy the most will not be able to afford it."
Many of the countries where most sickle cells patients live don't have enough sophisticated medical centers to provide the complicated treatment, Creary notes.
"I have to ask the question: How many people are going to be able to actually benefit from the technology?" Creary says.
Vertex officials say the company is working with Medicaid and private insurance companies to pay for the treatment and developing other ways to make the treatment accessible.
University of Illinois Chicago's Hsu argues that while the price is high, it's still cost-effective given how much it costs to care for sickle cell patients their entire lives.
"There is a return on investment to the health care system," he says. "These cost savings would make it worthwhile for those upfront costs." | Medical Innovations |
The government is likely to miss its target to build 40 new hospitals by 2030, the spending watchdog has said.
The National Audit Office (NAO) said in a report that the project had been beset by delays. It also warned that cost-cutting and inaccurate modelling of future demand could mean new hospitals are too small.
The health department remained "firmly committed" to delivering the England building pledge, a spokesperson said.
But Labour called the report "damning".
The hospitals plan was a Conservative manifesto commitment during the December 2019 election campaign, and it was made policy the following year.
When the health department officially set out the plan in October 2020, eight hospital construction projects already under way were not included in the target. But recent government statements about building 40 new hospitals include these eight projects, referred to as "legacy hospitals".
And in May, the government changed the scope of the scheme to include hospitals in urgent need of repairs, including five judged to be at risk of collapse because of crumbling concrete infrastructure.
Now the National Audit Office has analysed the plans and found that, by the definition set out in 2020, the target will be missed, and only 32 will be built in time. The NAO said the government has used a "broad" definition of "new", which includes refurbishment of existing buildings as well as completely new hospitals.
The 32 that will be built in time include 24 from the original new hospitals programme, five that were added in May, and three new mental health hospitals.
It said a further eight do not count towards the original definition of "new" because they were already under way when the commitment was made.
Questions have been asked for some time about whether the programme is on track and it is significant that the watchdog has now ruled that, judged by the original template, it is not.
In May, a BBC News investigation found that building work had not started on 33 of the projects.
The NAO said staff shortages mean a planned design for a standardised hospital has been delayed until May 2024.
It also warned that a push to meet the target at the lowest possible cost - combined with optimistic forecasts about how much care will be outside hospitals in the future - could result in new hospitals that are too small.
The government had failed to achieve good value for money, the NAO said, as it called for a review of the underlying assumptions behind the plans to make sure the new hospitals are fit for purpose.
Health Secretary Steve Barclay had already told MPs in May that some of the original group included in the new hospitals programme might not be completed by 2030.
He made the admission as he updated the department's building plans to deal with hospitals built with a lightweight concrete that was used in the 1980s and is now judged to be unsafe.
But he restated the commitment to deliver 40 new hospitals by the end of the decade.
Gareth Davies, head of the NAO, said the programme included "innovative plans" to improve efficiency and quality. But there are important lessons to ensure future major projects were affordable, transparent and delivered on time, he said.
Sir Julian Hartley, chief executive of NHS Providers, urged the government to "shift gears" to get the hospitals built and warned that costs had "spiralled due to high inflation".
He said many NHS trusts were "deeply disappointed" by delays and said the government "could have better managed expectations about the funding available, given the uncertainty involved and the impact of inflation".
Liberal Democrat deputy leader Daisy Cooper said the "utterly damning report demolishes the government's claims to be building 40 'new hospitals'".
She called on the health secretary to make an urgent statement in Parliament addressing its findings, saying "the public deserves answers".
Labour's shadow health secretary Wes Streeting said: "The Conservatives have overpromised, under-delivered, and they've been found out.
"Meanwhile patients are being treated in outdated, crumbling hospitals."
A health department spokesperson said: "The NAO's report acknowledges that despite changes to the original programme, 40 new hospitals are still expected to be delivered by 2030 and praises the programme's innovative plans to standardise hospital construction, deliver efficiencies and improve quality.
"We remain firmly committed to delivering these hospitals, which are now expected to be backed by over £20 billion of investment, helping to cut waiting lists so people can get the treatment they need quicker.
"Three new hospitals have already opened and more will open this year so patients and staff can benefit from major new hospital buildings, equipped with the latest technology." | Health Policy |
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NEW YORK (AP) — Surgeons have performed the world’s first transplant of an entire human eye, an extraordinary addition to a face transplant — although it’s far too soon to know if the man will ever see through his new left eye.
An accident with high-voltage power lines had destroyed most of Aaron James’ face and one eye. His right eye still works. But surgeons at NYU Langone Health hoped replacing the missing one would yield better cosmetic results for his new face, by supporting the transplanted eye socket and lid.
WATCH: Biden administration proposes overhaul of organ transplant system
The NYU team announced Thursday that so far, it’s doing just that. James is recovering well from the dual transplant last May and the donated eye looks remarkably healthy.
“It feels good. I still don’t have any movement in it yet. My eyelid, I can’t blink yet. But I’m getting sensation now,” James told The Associated Press as doctors examined his progress recently.
“You got to start somewhere, there’s got to be a first person somewhere,” added James, 46, of Hot Springs, Arkansas. “Maybe you’ll learn something from it that will help the next person.”
Today, transplants of the cornea — the clear tissue in front of the eye — are common to treat certain types of vision loss. But transplanting the whole eye — the eyeball, its blood supply and the critical optic nerve that must connect it to the brain — is considered a moonshot in the quest to cure blindness.
Whatever happens next, James’ surgery offers scientists an unprecedented window into how the human eye tries to heal.
“We’re not claiming that we are going to restore sight,” said Dr. Eduardo Rodriguez, NYU’s plastic surgery chief, who led the transplant. “But there’s no doubt in my mind we are one step closer.”
Some specialists had feared the eye would quickly shrivel like a raisin. Instead, when Rodriguez propped open James’ left eyelid last month, the donated hazel-colored eye was as plump and full of fluid as his own blue eye. Doctors see good blood flow and no sign of rejection.
Now researchers have begun analyzing scans of James’ brain that detected some puzzling signals from that all-important but injured optic nerve.
One scientist who has long studied how to make eye transplants a reality called the surgery exciting.
“It’s an amazing validation” of animal experiments that have kept transplanted eyes alive, said Dr. Jeffrey Goldberg, chair of ophthalmology at Stanford University.
The hurdle is how to regrow the optic nerve, although animal studies are making strides, Goldberg added. He praised the NYU team’s “audacity” in even aiming for optic nerve repair and hopes the transplant will spur more research.
“We’re really on the precipice of being able to do this,” Goldberg said.
James was working for a power line company in June 2021 when he was shocked by a live wire. He nearly died. Ultimately he lost his left arm, requiring a prosthetic. His damaged left eye was so painful it had to be removed. Multiple reconstructive surgeries couldn’t repair extensive facial injuries including his missing nose and lips.
James pushed through physical therapy until he was strong enough to escort his daughter Allie to a high school homecoming ceremony, wearing a face mask and eye patch. Still he required breathing and feeding tubes, and longed to smell, taste and eat solid food again.
“In his mind and his heart, it’s him — so I didn’t care that, you know, he didn’t have a nose. But I did care that it bothered him,” said his wife, Meagan James.
Face transplants remain rare and risky. James’ is only the 19th in the U.S., the fifth Rodriguez has performed. The eye experiment added even more complexity. But James figured he’d be no worse off if the donated eye failed.
Three months after James was placed on the national transplant waiting list, a matching donor was found. Kidneys, a liver and pancreas from the donor, a man in his 30s, saved three other people.
During James’ 21-hour operation, surgeons added another experimental twist: When they spliced together the donated optic nerve to what remained of James’ original, they injected special stem cells from the donor in hopes of spurring its repair.
Last month, tingles heralded healing facial nerves. James can’t yet open the eyelid, and wears a patch to protect it. But as Rodriguez pushed on the closed eye, James felt sensation — although on his nose rather than his eyelid, presumably until slow-growing nerves get reoriented. The surgeon also detected subtle movements beginning in muscles around the eye.
Then came a closer look. NYU ophthalmologist Dr. Vaidehi Dedania ran a battery of tests. She found expected damage in the light-sensing retina in the back of the eye. But she said it appears to have enough special cells called photoreceptors to do the job of converting light to electrical signals, one step in creating vision.
Normally, the optic nerve then would send those signals to the brain to be interpreted. James’ optic nerve clearly hasn’t healed. Yet when light was flashed into the donated eye during an MRI, the scan recorded some sort of brain signaling.
That both excited and baffled researchers, although it wasn’t the right type for vision and may simply be a fluke, cautioned Dr. Steven Galetta, NYU’s neurology chair. Only time and more study may tell.
Still, the surgery marks “a technical tour de force,” said Dr. David Klassen, chief medical officer of the United Network for Organ Sharing, which runs the nation’s transplant system. “You can learn a tremendous amount from a single transplant” that could propel the field.
As for James, “we’re just taking it one day at a time,” he said.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
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Learn more | Medical Innovations |
Acoustic touch: Vision via sound for the blind
Australian researchers have developed cutting-edge technology known as "acoustic touch" that helps people "see" using sound. The technology has the potential to transform the lives of those who are blind or have low vision.
About 39 million people worldwide are blind, according to the World Health Organization, and an additional 246 million people live with low vision, impacting their ability to participate in everyday life activities.
The next generation smart glasses, which translate visual information into distinct sound icons, were developed by researchers from the University of Technology Sydney and the University of Sydney, together with Sydney start-up ARIA Research.
"Smart glasses typically use computer vision and other sensory information to translate the wearer's surrounding into computer-synthesized speech," said Distinguished Professor Chin-Teng Lin, a global leader in brain-computer interface research from the University of Technology Sydney.
"However, acoustic touch technology sonifies objects, creating unique sound representations as they enter the device's field of view. For example, the sound of rustling leaves might signify a plant, or a buzzing sound might represent a mobile phone," he said.
A study into the efficacy and usability of acoustic touch technology to assist people who are blind, led by Dr. Howe Zhu from the University of Technology Sydney, has just been published in the journal PLOS ONE.
The researchers tested the device with 14 participants; seven individuals with blindness or low vision and seven blindfolded sighted individuals who served as a control group.
They found that the wearable device, equipped with acoustic touch technology, significantly enhanced the ability of blind or low-vision individuals to recognize and reach for objects, without causing too much mental effort.
"The auditory feedback empowers users to identify and reach for objects with remarkable accuracy," said Dr. Zhu. "Our findings indicate that acoustic touch has the potential to offer a wearable and effective method of sensory augmentation for the visually impaired community."
The research underscores the importance of developing assistive technology in overcoming the challenges such as locating specific household items and personal belongings.
By addressing these day-to-day challenges, the acoustic touch technology opens new doors for individuals who are blind or have low vision, enhancing their independence and quality of life.
With ongoing advancements, the acoustic touch technology could become an integral part of assistive technologies, supporting individuals to access their environment more efficiently and effectively than ever before.
More information: Howe Yuan Zhu et al, An investigation into the effectiveness of using acoustic touch to assist people who are blind, PLOS ONE (2023). DOI: 10.1371/journal.pone.0290431 | Medical Innovations |
The family of Nicola Bulley have said the missing mother-of-two suffered from "significant side effects" of perimenopause.
It comes after Lancashire Police revealed yesterday that Ms Bulley, 45, suffered from "significant issues with alcohol" in the past brought on by "ongoing struggles" with the menopause.
But what are the symptoms of perimenopause and how do they affect women?
Menopause is when your periods stop due to lower hormone levels, while perimenopause is when you have symptoms before your periods have stopped, according to the NHS.
Menopause usually happens between the ages of 45 and 55.
Perimenopause can last for up to 10 years before your periods stop altogether and it most commonly occurs in women in their 40s.
The NHS says menopause and perimenopause symptoms can have a big impact on a person's life, including their relationships and work.
Symptoms can be severe and debilitating
Common symptoms of perimenopause and menopause include: anxiety, mood swings, brain fog, hot flashes, difficulty sleeping and headaches and migraines, among others.
Whilst not all women will experience menopausal symptoms, up to 80-90% will have some symptoms, with 25% describing them as severe and debilitating, according to the British Menopause Society.
Last year, NHS England said there were around an estimated 13 million people who were currently peri or menopausal in the UK, according to Wellbeing of Women, which is equivalent to a third of the entire UK female population.
On Thursday, Ms Bulley's family said in a statement that she suffered from side effects of the perimenopause including brain fog and restless sleep.
She has been missing since 27 January after vanishing when she took her dog for a walk by the River Wyre in Lancashire.
Ms Bulley's family also said she stopped taking hormone replacement therapy (HRT), which is commonly used to treat menopausal symptoms.
In their statement, they said the mother-of-two was taking HRT but this "was giving her intense headaches" which caused her to stop taking them "thinking that may have helped her but only ended up causing this crisis".
HRT is a method of managing symptoms of perimenopause and menopause and is taken by millions of women worldwide, however, it does not work well for everybody. It involves taking oestrogen to elevate the body's levels of the hormone and is often combined with progesterone.
There are different types and doses of HRT, including tablets, sprays, implants and patches.
According to the NHS, the risks of HRT are small and usually outweighed by the benefits but HRT may worsen headaches in some people and GPs may suggest an oestrogen skin patch is used.
Symptoms of menopause can be so debilitating that a survey published last year found that one in 10 women have quit their job because of it.
The survey, of more than 4,000 UK women aged 45 to 55, who are currently or have previously experienced perimenopause or menopause, also found that 14% of women had reduced their hours at work, 14% had gone part-time, and 8% had not applied for promotion.
Campaigners and celebrities have called for better support for women experiencing symptoms including recognising menopause under the Equality Act as a protected characteristic.
They are a specific set of characteristics which it is illegal to discriminate against including age and race among others.
Last year, the Women and Equalities Committee warned in a report that the impact of menopause was causing the UK economy to "haemorrhage talent".
However, in January, ministers rejected a recommendation to make menopause a protected characteristic and also rejected calls for a trial of menopause leave for women, claiming it could cause discrimination against men with long-term medical conditions.
Diane Danzebrink, psychotherapist and menopause expert, said there is still a "lack of education" around menopause, as she urges the government to take action.
She told Sky News: "Menopause is an individual experience and is simply not the same for everybody.
"There is still such a lack of public information and education about all aspects of menopause. I would very much like to see the government back a public health campaign for menopause to bring education and information to everybody." | Women’s Health |
The government has cut the funding for its proposed overhaul of adult social care by 58%, according to a report from the National Audit Office (NAO).
The watchdog said that despite being just two years into the 10-year scheme, plans to cap the cost of lifetime care had been delayed and other proposals had been scaled back, with even revised policies falling behind schedule.
The NAO said over £1bn of the £1.7bn allocated by the Treasury for the reforms had now been "diverted to other care priorities", with the cash being "reprioritised... in favour of helping to stabilise the sector", as soaring inflation continued to "compound long-standing pressures".
A Department of Health and Social Care (DHSC) spokesperson insisted ministers "remain committed to reform".
But Labour said the report "makes clear that the Conservatives will break their promise to 'fix the crisis in social care once and for all' by the next election".
The Liberal Democrats said it showed a "chronic neglect of adult social care" under the Tories.
Read more: Social care system 'would collapse' without 4m unpaid carers, report warns
In its report, the NAO pointed to the ministerial decision last autumn to postpone putting £3.6bn into cost reforms, and instead commit up to £7.5bn to the care sector.
That included £2.7bn to dish out to local authorities to help ease immediate pressures - something the watchdog described as "welcome relief".
But it warned funding "may not be reaching areas that need it most", with the government having failed to update its formula for distribution since 2014 - meaning up-to-date local variations in need hadn't been taken into account.
According to figures from the DHSC, one in six councils expected demand for adult social care to exceed capacity over the coming winter.
The NAO said there had been "recent signs of improvement" in adult social care, but overall it remained "under significant pressure", with double the number of people waiting more than six months for a care assessment in March 2023, compared to the end of 2021 - around 82,000.
And vacancies in the sector still stand at around 152,000 - an equivalent of 10% of the workforce.
The watchdog said that, despite there being "much to do" for the government to achieve its 10-year goals, the DHSC had no "overarching programme to coordinate its reforms, making it difficult to know if it is on track to achieve its objectives", and no "long-term funded plan for transforming adult social care".
It called for the department to assess the impacts of its current plans and set out how it intends to fund its future ones.
"Adult social care reform has been an intractable political challenge for decades," said Gareth Davies, head of the NAO.
"Government has set out its ambition to meet this challenge and now needs to demonstrate how it is delivering on these plans."
He added: "If [the] government is to successfully reform adult social care, it will need to manage some significant risks, including its own capacity and that of local government to resume charging reform activity alongside system reform.
"To maximise its chances of succeeding, [the] government will need to ensure it understands the impact of its ambitions on local authorities and other stakeholders and establish a costed plan which ensures delivery of its long-term goals."
A spokesperson for the Labour Party said: "This report makes clear that the Conservatives will break their promise to 'fix the crisis in social care once and for all' by the next election.
"Delays and watered-down workforce reforms will leave the sector without the care workers it needs. People will wait longer and longer for care, as there simply aren't enough staff."
Lib Dem health spokesperson Daisy Cooper added: "This damning report shows the chronic neglect of adult social care under this Conservative government.
"The shockingly dismal state of care is putting huge pressure on the NHS while leaving the elderly and vulnerable to suffer."
Ms Cooper also accused the Tories of having "repeatedly broken their promises on social care and delayed proposals for a lifetime cap on care costs".
But a DHSC spokesperson: "We remain committed to reform, and are investing up to £700m over this year and next to make major improvements to the adult social care system.
"This includes £42.6m to support innovation in care and increasing the Disabled Facilities Grant by £50m.
"Additionally, we have made up to £8.1bn available to help local authorities tackle waiting lists, low fee rates, and workforce pressures, £570m of which will help local authorities improve adult social care provision, in particular by boosting the workforce." | Health Policy |
Ivermectin and its use as a treatment for COVID-19 was catapulted to centre stage when the pandemic erased all rhyme and reason in 2020. However, even as the totality of evidence demonstrated Ivermectin’s efficacy, mainstream media and governments across the world dismissed its use based on the absence of randomised control trials. Further to that, virtually anything related to Ivermectin that made mainstream media was negative coverage of a drug that could’ve saved countless lives. Now, at last, a large randomised control study on Ivermectin efficacy for preventing and treating COVID-19 has been released, as discussed in this article by Professor Colleen Aldous, one of the drug’s fiercest advocates. Aldous, a geneticist and clinical researcher at the University of KwaZulu-Natal, raises some critical questions that we ignore at our peril. – Nadya Swart
Large, well-designed randomised control study shows Ivermectin efficacy in preventing and treating COVID-19
By Colleen Aldous, Phillip Oldfield
Another large randomised control study on ivermectin efficacy for preventing and treating COVID-19 has been released to the public ahead of publication in an academic journal. But unlike negative results trials, there has not been a big international splash across the mainstream media coordinated by a large publicity agency such as Bell Pottinger. Why? Because the results are undeniably positive, showing the efficacy of ivermectin in reducing infection after exposure by 72%, documented in a press release on Jan 5 2023(1).
This is the best quality RCT we have yet seen published on ivermectin. It is called the SAIVE Trial (NCT 05305560)(2) and is part of MedinCell’s research supporting their development of a novel slow-release form of ivermectin. Although sparse results have been released so far, the quality of the study is apparent. A total of 399 unvaccinated participants completed the study as per the protocol. The number intended for treatment is not available yet, but I anticipate that the only difference would be that the ITT number for the control group may have been 200. Those participants who received daily oral ivermectin showed a 72% reduction in COVID-19 infection compared to the control group.
The study was carried out in Bulgaria between March and November last year when we saw a global reduction of SARS-COV2 infections and a decrease in the severity of COVID-19. Vaccination could have been a confounding factor in the results, but the inclusion criterion of being unvaccinated accounted for that. It was a multi-centre study, which shows replicability to some degree, a central tenet of good science. It was a parallel-group, double-blinded, randomised and placebo-controlled study. There is little that can be done to improve the rigour of this study design. It was also overseen by a U.S.-based independent Data Monitoring Committee to ensure compliance and provide further quality assurance. Participants were included in the study within five days after close exposure to somebody with a confirmed infection. This ensured very early treatment that some could consider prophylactic. The dosages were more than adequate, with daily doses of ivermectin taken orally at 200 microgram/kg on Day 1, followed by 100 microgram/kg daily from Day 2 to Day 28. This long-term daily dose design was likely to reflect future trials of MedinCell’s planned slow-release ivermectin injectable.
Of the 200 participants who received ivermectin, 30 showed laboratory-confirmed infections between Days 1 and 28 of the study. Of the 199 participants who received the placebo, 105 showed infections in the same period. For those who like Fisher’s p-value, this renders a p < 0,0001. There were no unexpected side effects, and safety and tolerability were once again demonstrated. Mortality data is not available, but this study occurred during the omicron infection period, where mortality was markedly reduced compared to the prior strains. MedinCell has undertaken to publish its results in a scientific journal in future. I am keen to see the details of when PCR tests in the patients across both groups came back as positive, how long before they were negative, symptom onset and symptom severity comparisons between the groups.
Looking at the history of research into ivermectin as a treatment for COVID-19, I can identify a few, amongst many, critical papers along with this latest research, where science has shown us a tool that could have saved millions of lives. To put it into a bullet story:
Australian lab experiment of 2020(3): Prof Kylie Wagstaff, whose previous work showed that ivermectin is a specific inhibitor of importin α/β-mediated nuclear import and thus can inhibit replication of HIV-1 and dengue viruses, showed that ivermectin killed SARS-COV2 in the laboratory experiment. This experiment led to some doctors initially using ivermectin at the same dosages used for treating scabies. Some dismissed it as irrelevant because of the ivermectin concentrations used, but the experiment was a proof-of-concept study only, with no intention of reflecting dose responses.Zimbabwean blood oxygenation improvement paper of 2022(4): Dr Jackie Stone successfully treated patients on her regimen, which included ivermectin. For some patients, records of blood oxygenation had been kept from the start of treatment for several hours. She showed how quickly the blood oxygenation improved after the initiation of therapy. These results were also found in other studies in Nigeria and the US. This paper shows another possible mechanism of action for ivermectin in its success against the virus. Along with the repeated studies, the drug has an undeniable effect in SARS-COV-2 infected patients.Hemagglutination (blood clumping) paper of 2022: In another laboratory experiment, Boschi et al. (5) were able to explain why Dr Jackie Stone was able to show such an immediate response to ivermectin treatment. Using the Wuhan, Alpha, Delta and Omicron B.1.1.529 lineages of SARS-CoV-2 mixed with human red blood cells (RBCs), they showed that ivermectin prevented blood clumping when added to RBCs before infection and reversed it when added after infection. The earlier strains of COVID-19 were characterised by virus in the lungs, where its spike protein would cause RBCs to clump, thus reducing their capacity to carry oxygen and resulting in a fall in blood oxygenation levels. Omicron did not affect the lungs as badly. By reversing the blood clumping, oxygenation improved.MedinCell’s RCT(1) – yet to be published in an academic journal: This is the best RCT design yet to test ivermectin efficacy. Unvaccinated people exposed to people diagnosed with COVID-19 showed a much lower likelihood of contracting the illness after taking ivermectin. More than half of the placebo group got infected. Although the treatment protocol is different to other RCTS, testing a longer regimen following their further product development of a longer-acting ivermectin injectable, it shows a reduction in infection amongst people who had ivermectin post-exposure to a confirmed COVID-19 case.
Why are the SAIVE study findings not heralded with the same media-trumpeted fanfare? All the previous RCTs that showed negative results for ivermectin were “celebrated” quickly and globally in the mainstream media, particularly those aligned with the Trusted News Initiative. The TOGETHER Trial results for ivermectin were released weeks ahead of the published paper in the New York Times and other international media. Many lauded it as the final coup de gras for ivermectin. But we are not horses or cows, nor are many of us who keep questioning and looking at the evidence scientifically, sheep. There are some other questions I would like answered, such as:
Who employs multinational public relations, reputation management and marketing companies to put out the anti-ivermectin propaganda? Remember the FDA’s widely reported “You are not a horse. You are not a cow. Seriously, y’all. Stop it.” A slogan that became as well-known globally as the “It’s not inside, it’s on top” slogan in South Africa. The problem is that those in the know who are aware that ivermectin won its developers a Nobel Award for its human use could see through this propaganda immediately. Still, the general public is led to respect the utterings of authorities such as the FDA in the States, SAHPRA in South Africa and indeed the World Health Organisation (WHO) globally, and are taken in by this kind of mis- / dis-information.
Who controls what information is published in mainstream media and academic journals? The poor ivermectin studies, which showed an apparent ineffectiveness of ivermectin to treat COVID-19 received significant media airplay. But the studies that showed the positive results were not treated equally. In October 2022, we looked at all the published data on ivermectin and COVID-19 that we could find in PubMed. At that point, the totality of evidence leaned towards showing evidence for efficacy, with more studies showing efficacy or potential efficacy than those showing a lack of efficacy. The science is therefore being misrepresented in the mainstream media in favour of a skewed focus on the negative and gaslighting those studies showing efficacy. The TOGETHER Trial for ivermectin has several flaws, which many scientists across the globe responded to by writing letters to the editor of the New England Journal of Medicine (NEJM), but not one was published. In fact, they were returned stating that the journal had limited space etc., and one person on the editorial team went as far as publicly stating that no letters of concern about the trial were received! Trying to get anything positive about ivermectin published anywhere has become nearly impossible. Why do so many people still follow the predominant and distorted narrative that ivermectin has no place in COVID-19 treatment in the face of all the evidence that it works? Some colleagues whom I respect still try and point out to me that my defence of ivermectin as a COVID-19 treatment is misplaced. I cannot determine why they cannot accept that science would involve looking at the totality of the evidence. Why do they dismiss all evidence that is not an RCT? Now, at last, there is an RCT that is appropriately designed that shows efficacy. Let’s see how many can change their thinking and understand that evidence-based medicine involves more research than RCTs. That laboratory studies can be used to explain clinical findings. That observational studies can provide good honest results that can be backed up by RCTs but are the first research to appear in a pandemic. While scientific scepticism is essential, adversarial dismissiveness has proven to be harmful.
Two years ago, in a radio interview, I (the first author) calculated that over 350 people who were healthy at the time of the discussion would have died of COVID-19 by the end of January, using old statistics from before the delta wave hit its zenith. That was about two weeks, and I made a plea to allow the use of ivermectin, knowing its safety record, at least by making a TYPE I error decision. In late 2020, the anti-ivermectin propaganda campaign began. I was powerless in my plea against all those with much more academic credibility than I have, who are so much better funded than me and against an industrial propaganda machine. Based on my statistics, fewer than 100 patients would have died if the MedinCell protocol or similar had been followed. But my stats were so very wrong. In those two weeks, thousands died in South Africa, well over 350 per day.
Hindsight is 20/20, but we need to make sure that when the next pandemic hits, we are not herded like gullible sheep over another precipice of higher mortality than there could and should be. Where will our humanitarian instincts be? Our moral courage and conscience? These virtues did not lie with our trusted advisors as we had all thought they should. Let’s get our act together before this happens again.
Acknowledgement
The authors are grateful for the proofreading and comments made by Dr Warren Parker on the draft of this article.
References
1 MedinCell announces positive results for the SAIVE clinical study in prevention of Covid-19 infection in a contact-based population. Press release. Available online: https://www.medincell.com/en/2023/01/05/medincell-announces-positive-results-for-the-saive-clinical-study-in-prevention-of-covid-19-infection-in-a-contact-based-population/
2 A Study to Evaluate the Efficacy and Safety of Ivermectin in COVID-19 Prevention (SAIVE). ClinicalTrials.gov Identifier: NCT05305560. [Available online]: https://clinicaltrials.gov/ct2/show/NCT05305560
3 Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral research. 2020 Jun 1;178:104787.
4 Stone JC, Ndarukwa P, Scheim DE, Dancis BM, Dancis J, Gill MG, Aldous C. Changes in SpO2 on Room Air for 34 Severe COVID-19 Patients after Ivermectin-Based Combination Treatment: 62% Normalisation within 24 Hours. Biologics. 2022 Sep;2(3):196-210.
5 Boschi C, Scheim DE, Bancod A, Militello M, Bideau ML, Colson P, Fantini J, Scola BL. SARS-CoV-2 Spike Protein Induces Hemagglutination: Implications for COVID-19 Morbidities and Therapeutics and for Vaccine Adverse Effects. International Journal of Molecular Sciences. 2022 Jan;23(24):15480.
Read Also:
Dr Jackie Stone’s persecution another attempt to stop ivermectinIvermectin, supported by evidence-based medicine, was cast aside during Covid at great costThe Ivermectin clampdown continues – Professor Colleen Aldous on a new study
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FILE – A vial of the Moderna COVID-19 vaccine is displayed on a counter at a pharmacy in Portland, Ore. on Dec. 27, 2021. A government advisory panel met Tuesday, June 14, 2022, to decide whether to recommend a second brand of COVID-19 vaccine for school-age children and teens. The Food and Drug Administration’s outside experts will vote on whether Moderna’s vaccine is safe and effective enough to give kids ages 6 to 17. If the panel endorses the shot and the FDA agrees, it would become the second option for those children, joining Pfizer’s vaccine.(AP Photo/Jenny Kane, File) A Food and Drug Administration (FDA) advisory panel on Tuesday recommended the agency expand the authorization of Moderna’s COVID-19 vaccine to children and teenagers ages 6 to 17. The vaccine is currently approved for adults only. The panel voted 22-0 to recommend authorizing Moderna’s two-dose vaccine for adolescents and teenagers ages 12 to 17. The panel similarly voted 22-0 to recommend authorizing the shot for 6-to-11 year olds. The FDA is likely to follow the panel’s advice in the coming days, but there ultimately won’t likely be much of an impact on vaccination rates, since children and teenagers have had access to Pfizer-BioNTech”s vaccine since last year. After the FDA, the Centers for Disease Control and Prevention will consider the matter as early as Friday. Moderna initially asked FDA to clear its vaccine for adolescents ages 12 to 17 last June, but concerns over a rare heart condition led officials to delay authorization. On Tuesday, health officials said the risks for myocarditis and pericarditis may be higher in adolescent males, but the overall incidence is relatively rare and not statistically significant enough to draw definitive conclusions. In addition, the vast majority who suffer the side effect fully recover. Tags Coronavirus coronavirus pandemic coronavirus vaccine COVID-19 COVID-19 vaccine COVID-19 vaccines FDA Food and Drug Administration Moderna Moderna vaccine | Vaccine Development |
Jaxon Garvey was diagnosed with a rare and aggressive brain tumour after being taken to hospital just two days before Christmas. His parents, who also have a nine-month-old baby, were left devastatedJaxon Garvey was admitted to Royal Manchester Children's Hospital on December 23 last yearA family was left heartbroken after a four-year-old boy was given a tragic cancer diagnosis on Christmas Day. Jaxon Garvey, from Leigh in Greater Manchester, was admitted to Manchester Children's Hospital on December 23 and two days later was diagnosed with multiple brain tumours. The boy's parents Melissa Roberts and Callam Garvey said Jaxon had complained of a sore neck three weeks before, but they decided to bring him to the hospital as a precaution when the boy's pain got worse. Jaxon's blood result came back clear but hours later, the boy lost his ability to walk properly and was referred for an MRI scan. His parents received the devastating results on December 25 last year and doctors referred the boy for chemotherapy, reports the Manchester Evening News. Melissa Roberts and Callam Garvey with little Jaxon in happier times (
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Melissa Roberts/MEN Media) The boy has been diagnosed with multiple brain tumours (
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Melissa Roberts/MEN Media) Jaxon's aunt Ashley Roberts said the family is "devastated" and that Melissa and Callam have a nine-month-old baby too but have never left their four-year-old boy's side. Ms Roberts explained: "Three weeks before they went to A&E he started complaining of a sore neck. That turned into crying and then screaming so we took him to hospital on December 23. "He was seen by the doctors there who did some blood tests which came back clear. We were hopeful that everything was okay but as we were waiting to see the paediatrician which we thought was just a precaution. But then we noticed that he had lost his ability to walk properly. "Doctors looked at the way he was walking and wanted to do an MRI scan. They kept us in until the results came back." Jaxon's aunt added: "They did a biopsy and tried to remove what they could. His first 11.5-hour surgery took place and they removed 95% of three of the four tumours. "All they can tell us at the moment is that it's a very rare and aggressive type of cancer but they can't tell us for sure what cancer it is. They don't want to wait any longer for the results and we’re starting chemotherapy straight away." Ashley, who described her nephew as "gorgeous, hilarious, loving and kind", also set up a GoFundMe page to support Jaxon's parents financially, to allow them to look after Jaxon without money worries. She explained: "Melissa was due to go back to work after her maternity leave in January but she hasn’t been able to go back and neither has Callam. "The length of time Jaxon might be in the hospital is definitely up in the air at the moment. It’s very difficult because someone needs to look after their baby whilst they are in the hospital. "His parents have not left since before Christmas. They have got a room at Ronald McDonald house. Finley has been able to visit them but not as much as they would like. "Although it isn’t known what lies ahead for Jaxon and his treatment, we want to raise money to help take away any financial worries for his family at this unimaginably difficult time." To donate, click here. Read More Read More Read More Read More Read More | Disease Research |
In the WebMD webinar âDiabesity: When You Have Diabetes and Obesity,â Robert F. Kushner, MD, explained what diabesity is, what raises your risk, and how weight loss, lifestyle changes, and medications can help.Â
Kushner is medical director of Northwestern Center for Lifestyle Medicine in Chicago and professor of medicine and medical education at Northwestern Universityâs Feinberg School of Medicine. Heâs also a founder of the American Board of Obesity Medicine.
âHistorically, we've treated diabetes as an isolated condition,â he said. âBut now we know that having excess body fat, or obesity, is one of the major factors in developing diabetes - controlling your weight may be the key to improving diabetes.â
Poll Questions and Results
More than 1,000 attendees were asked during the webinar about lifestyle habits and weight loss efforts.Â
Over a third said getting more exercise would be the hardest lifestyle habit for preventing belly fat and diabetes. Just under a third said itâd be hardest to improve their diet. Â
In another poll, nearly three-fourths of respondents said that in addition to dieting, theyâve exercised in efforts to lose weight.Â
Viewer Questions
Can you get diabetes just from eating too much sugar?
For someone who takes injected insulin for diabetes, why is there more focus on carbs than proteins?
Is there a certain diet, like the Mediterranean Diet, that's best for both weight loss and blood glucose control?
Itâs unlikely youâd get diabetes from just eating too much sugar. For most people, we think you have to have a genetic factor. That's why your doctor usually asks if anyone else in your family has been diagnosed with diabetes.
Your genetics boost the likelihood of developing diabetes. Then it depends on things like your activity, your diet, what you're actually eating, and other medications you're taking.
In terms of insulin, how well it works is going to depend, in large, on how many carbohydrates you're ingesting.Â
If you eat a lot of carbohydrates, you're going to need a lot of insulin to clear your blood sugar. If you've eaten a low amount of carbohydrates, itâs easier for insulin to clear your blood sugar.
Where people may run into trouble is when you're on a fixed dose of insulin, and the carbohydrates in your diet are going up and down. You're at risk of suffering hypoglycemia, which is low blood sugar, or hyperglycemia, which is high blood sugar.
So to regulate a normal blood sugar with constant insulin, it's very important to focus on dietary carbohydrates, so they both work together.
For weight loss, thereâs no diet that's better than another, as long as your diet is calorie controlled and balanced and sufficient in nutrients, vitamins, and minerals. The best diet is the one youâll follow and enjoy.
But for diabetes, it varies a little bit more because it's not just about weight loss.Â
For this, the best diet actually is the Mediterranean Diet. Itâs plant-based with high amounts of healthy oils, fats, fish, cheese, and nuts. Itâs very low in simple carbohydrates, like bread.Â
If you have any questions about diet, see a registered dietitian.
Can lifestyle changes alone keep prediabetes from progressing to diabetes?
What do you recommend for those who want to make these lifestyle changes but lack motivation?
We now know that if you focus on a healthy diet and healthy body weight -- especially if you have more upper body weight -- you can reduce or delay the development of diabetes.
Metformin (Glucophage) has also been shown to do that, which may be prescribed by your doctor.
Finding motivation to make lifestyle changes is really a mindset problem. Itâs dealing with daily stressors and the need to develop new habits.Â
My recommendation is, first identify targets that are short-term, achievable, and realistic.
That could be a healthy breakfast every day, changing your nighttime routine to get more sleep, or getting a little more physical activity.
Don't bring enticing food into your home. Talk to family members about having a meatless dinner or more plant-based food.
Second, get help if you need help. Either by talking to a friend, getting social support, talking to your health care professional, or reading a helpful book.
Whatâs the difference between "having obesity" and "being overweight?"
Does the risk for diabetes increase with age? Is that also true for the risk of diabesity?Â
Right now, body mass index (BMI) is the standard way of measuring body size, but itâs problematic. You may have a larger body but no medical problems. We're trying to do away with BMI and get to a much better definition of what obesity really is.
But if you use BMI, obesity is defined as a BMI of 30 or greater. Whereas, overweight is defined as a BMI of 25 to 29.9. It varies, though, among different ethnic groups.
In terms of your risk with age, weight gain usually happens in your 20s, 30s, 40s, and 50s. This is because as we become adults, we start a career, have a lot of time restraints, weâre thinking about other things. But when you turn 50, 60, and 70, your obesity risk starts to go down.Â
However, diabetes risk climbs as time goes on. So the risk of diabetes continues to go up, but the risk of obesity does not.
If we combine the two, the risk of diabesity probably peaks more in our 50s and 60s and likely starts to drop as we age.
What Lifestyle Habits Increase Your Risk of Diabesity?
If you have belly fat, it may be because of your genetics. Your body shape can be different, based on things out of your control. Risk factors you may be more able to control include:
- Lack of exercise of activity
- Low fitness level
- Unhealthy diet (very processed foods, sugar-sweetened drinks, high calorie options)
- Stress
- Smoking
- Not getting enough sleep
âIf you're looking for things to get your weight under control that would also have an effect on your diabetes, these are the behavioral targets that you want to work on,â said Kushner.
How Can Weight Loss Lower Your Risk?
Studies show that weight loss improves your insulin levels, which then improves your diabetes.
Similarly, weight loss through lifestyle changes can lower your risk of developing diabetes. This is especially important if diabetes runs in your family or if you have pre-diabetes.
One study focused on people with diabetes and weight loss. Some people took only metformin, while others focused on lifestyle changes.
It found that metformin lowered diabetes risk by 31% for those with prediabetes. But those who made lifestyle changes reduced that risk by 58%.
âBecause of this study, we now work with people who have pre-diabetes using lifestyle management, weight reduction, and possibly other medications,â said Kushner.
Other research shows that weight loss improves your health (if you already have diabetes), whether the weight loss results from medications or lifestyle factors alone.
Another study showed that some people may reach diabetes remission. This is when your blood sugar is under control and youâre not on diabetes medication anymore.Â
âThe more weight loss you achieve, the greater likelihood of going into remission,â said Kushner. âOver 80% of people who lost 33 pounds or more reached remission.â
But people in this study were diagnosed with diabetes for only 4 years and they werenât on insulin.Â
âThe less time youâve had diabetes and the easier it is to control, the more likely it is you can achieve remission,â he said.Â
Watch an online replay of âDiabesity: When You Have Diabetes and Obesity.â
Watch other free WebMD health webinars by leading experts on a variety of topics. | Nutrition Research |
Once thought to be a danger largely reserved for travelers, a flesh-eating parasite known as Leishmania mexicana is now likely spreading locally through some sand flies native to the southern U.S., a new Centers for Disease Control and Prevention analysis has concluded.
Skin sores caused by Leishmania mexicana typically erupt weeks to months after people are bitten by an infected fly. The parasite can continue to inflict damage for years, leading to long-term scarring in its wake.
Hospitals have some options for drugs to use in trying to treat patients suffering from this disease caused by the parasite, which doctors call cutaneous leishmaniasis, though experts acknowledge there is "low certainty" about their effectiveness. Many patients who initially respond to treatment remain at risk of their leishmaniasis relapsing.
No vaccine is available for leishmaniasis.
The immediate concern triggered by the discovery is raising awareness of the parasite, officials say, which now appears to be "endemic" in Texas as well as some southern border states.
"This genetic information adds credence to this idea that leishmaniasis is occurring here in the United States, it's endemic here in the United States, at least in Texas and maybe southern border states," Dr. Mary Kamb, of the CDC's Division of Parasitic Diseases and Malaria, said in an interview with CBS News.
Kamb co-authored the new findings, which were released Thursday in an abstract at the annual meeting of the American Society of Tropical Medicine and Hygiene.
A "very distinct" genetic fingerprint
When trying to diagnose patients, doctors typically collect samples by taking biopsies from their infected lesions.
Those are then often shipped off to the CDC, which until 2020 ran the only lab outside the military that could test for these parasites.
"For every case that we got, we reported this data. And after those years, you're just pulling those results together to do this report, on cases collected during 2005 to 2019," said Marcos de Almeida, who had helmed the CDC lab at the time.
The CDC's review found a majority of leishmaniasis patients without travel history were infected by Leishmania Mexicana.
Among these cases, 50 were infected by a strain of the parasite which carried a slight but distinctive set of genetic changes that set them apart.
"Those two snips, those two polymorphisms in the sequence, are very distinct between those who reported travel history compared to those who did not," said the CDC's Vitaliano Cama, a microbiologist and veterinarian who also worked on the study.
At least one case with this genetic fingerprint had been reported each year, Cama said.
How leishmania parasites spread
Battling so-called "vector-borne" diseases like leishmaniasis often focuses on stamping out bugs that transmit the between humans, as well as controlling the risk posed by other animals like rodents that can also serve as a "reservoir."
Controlling sand flies can pose steep challenges compared to other larger insects. Sand flies are a fourth of the size of mosquitoes and do not need standing water to breed.
The World Health Organization estimates that leishmania parasites infect up to a million each year. Most cases in the Americas are diagnosed in Brazil, though infections from these parasites have also been reported throughout Latin America.
For U.S. doctors, leishmaniasis is not a reportable disease in most states, limiting the CDC's ability to track whether cases are now accelerating.
However, Cama said the agency has been fielding a growing volume of requests to help with diagnosing leishmaniasis cases.
"It's a trend, it's not a huge jump, but there's a trend of increasing requests," said Cama.
Dogs could bring a more deadly parasite
The discovery also underscores the urgency of new recommendations now being drawn up to help officials address concerns that a deadlier cousin — Leishmania infantum — could also gain a U.S. foothold.
Leishmania infantum causes a more severe form of the disease called visceral leishmaniasis. More than 90% of visceral leishmaniasis patients who are not given timely treatment die, the Pan-American Health Organization says.
Symptoms include fever, weight loss and swelling of the liver and spleen.
In countries battling outbreaks of visceral leishmaniasis, dogs are considered "the main reservoir" of the parasite. Now a boom in recent years of dog arrivals from abroad, either through travel, adoptions or moving, has raised concerns of this parasite's spread.
"All of us have been fielding these calls from state public health veterinarians, from Army veterinarians, that are trying to figure out what to do," said Christine Petersen, director of the University of Iowa's Center for Emerging Infectious Diseases.
Sporadic cases of leishmania infantum have already been reported spreading into dogs who have not traveled abroad. In addition to giving the parasite to flies, dogs can also spread the parasite directly through contact or bites.
Humans can also be unwitting carriers. Blood tests suggest as many as 1 in 5 American soldiers who were deployed to Iraq may have developed asymptomatic infections.
Working with scientists from the military and the CDC, Petersen co-authored a new "risk assessment tool" they hope will help veterinarians and public health officials figure out how to handle infected dogs if they catch the parasite. A draft of the tool was previewed at the ASTMH's meeting.
Decisions on whether to euthanize the dog can be made guided by weighing factors like where the dog is from and the likelihood of local sand flies which might transmit the parasite.
"That's what this whole risk assessment thing was about. Aside from rabies, maybe we should actually start talking about the other things that dogs carry that can kill us," said Petersen.
for more features. | Epidemics & Outbreaks |
Biden admin revises drug negotiation program amid legal onslaught
The Centers for Medicare and Medicaid Services (CMS) announced on Friday it has revised its guidance for the Medicare drug price negotiation program set up within the Inflation Reduction Act (IRA), seemingly in response to the several lawsuits challenging the program’s constitutionality.
Negotiations under the Medicare Drug Price Negotiation Program are set to take place over course of 2023 and 2024. Before those talks could get very far, several organizations filed lawsuits seeking to block the program and void any agreements that might be reached.
Merck, Bristol Myers Squibb, the Chamber of Commerce and the pharmaceutical trade group PhRMA have all filed lawsuits against the Biden administration, alleging the program violated the First, Fifth and Eighth Amendments of the Constitution.
CMS responded to some of the claims of unconstitutionality. Several plaintiffs had argued the implication that companies believe the negotiation process to be fair to be a violation of their First Amendment right.
While legal experts have found this claim to be dubious, CMS said it would publicize a “narrative explanation of the negotiation process” for the sake of “balancing transparency and confidentiality.”
The agency also directly stated it does believe the program violates the Fifth Amendment, which states private property may not be taken for public use “without just compensation.”
When reached for comment, a spokesperson for Merck said, “We are reviewing the guidance, but it does not and cannot cure the fundamental constitutional problems with the statute.”
The plaintiffs in the other cases did not immediately respond when reached for comment.
PhRMA’s lawsuit was filed most recently and the organization’s CEO Steve Ubl argued the negotiation program lacked transparency when it came to deciding the price of negotiation.
The IRA states that the drugs that are chosen for negotiation shall not be subject to judicial or administrative review, which plaintiffs in the numerous cases argue gives the Department of Health and Human Services (HHS) too much unchecked power.
CMS on Friday provided additional details on how it plans to identify drugs eligible for price negotiations. The agency laid out how it will define the drugs up for negotiation, what data it will take into account and how the data will be used.
Much of the revisions announced on Friday sought to clarify how CMS planned to carry out the negotiations.
If a manufacturer does not wish to take part in negotiation it can either face potential, heavy excise taxes on its products or end its relationship with Medicare, losing out on the lucrative income stream. The excise tax penalty was particularly grievous to the plaintiffs as it can go as high as 95 percent on a product’s sales in the U.S.
Among the revision, CMS said it had set up a process in which a manufacturer can “expedite its termination” from the Medicare program. Industry stakeholder had complained that the options presented were not easy as leaving leaving Medicare was not a quick process.
CMS also stated that before any civil monetary penalties are put into effect, manufacturers will be given the opportunity for “corrective action in applicable circumstances.”
The agency also clarified that manufacturers may avoid an excise tax by submitting notice and a termination request at least 30 days before the excise taxes are set to go into effect.
“The Biden-Harris Administration isn’t letting anything get in our way of delivering lower drug costs for Americans,” HHS Secretary Xavier Becerra said in a statement.
“Pharmaceutical companies have made record profits for decades. Now they’re lining up to block this Administration’s work to negotiate for better drug prices for our families,” he said. “We won’t be deterred. President Biden made it possible for Medicare to negotiate prescription drug prices. Today’s action is a critical step in reaching that goal.”
The first 10 drugs selected for negotiation will be announced on Sep. 1 and the negotiated prices will go into effect beginning in 2026.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Health Policy |
Almost 3,000 people died in England and Wales due to pneumonia and influenza in December, a quarter higher than in a typical year, in what is expected to be the worst flu season in a decade.Flu and pneumonia were the leading cause of “excess death” in England in December with 574 extra deaths, 26% above the average, while flu deaths in Wales were 11% higher and the fourth-most common cause of death that month.Despite this, full-year figures for 2022 show that the mortality rate fell below average for the first time since the Covid pandemic reached the UK in early 2020, with fewer people dying across the two countries last year when age and the size of the population was taken into account. Just 4% of deaths had Covid as the primary cause last year compared to 11% in 2021.The data also shows that 14% more people died in households last year than is typical, indicating the increase in home deaths that took place during the Covid pandemic is continuing. There were 2% fewer deaths in hospitals and only 0.3% more deaths in care homes.More than 576,000 people died in 2022, an increase of 6% compared to the five-year-average – 2020 was excluded because of an atypically high number of deaths as a result of Covid – the latest data from the Office for National Statistics shows.But, when the size and the age structure of the population (the age-standardised mortality rate) is considered there were 0.7% fewer deaths in England and 1.1% fewer in Wales than the average, giving 2022 the third lowest rate since 2001.The mortality rate in 2022 was the third lowest since 2001Weekly surveillance reports published by the UK Health Security Agency show that flu infections reached a three-year-high this winter.There are, however, signs that a spike in flu cases has now peaked: the latest NHS England figures showed a 35% drop in the number of beds required for flu patients in the second week of 2023 – the first significant drop in the winter to date. However, the number of 3,447 beds is still 84 times higher than in the same week in 2022.The number of critical care beds occupied by flu patients also fell slightly to an average of 221 beds in the week to 15 January. This was higher than the number required for Covid patients in the same week (191) as a combination of the prevalence of the Omicron variant of Covid and the success of the vaccine rollout has made contracting the virus generally less dangerous than it once was.Separate figures released by the ONS earlier in the week showed there were 1,383 deaths due to flu and pneumonia (as opposed to the virus/infection being a secondary cause of death) during the first week of January, the highest figure in three years.Friday’s figures shows that the number of excess deaths was above average in December using both metrics. There were almost 6,400 more people dying in the last month of the year than expected, up by 14% compared with the average of the last five years (5.8% up in England and 9.4% up in Wales using the age-standardised mortality rate).NHS figures show that about one in seven beds across England were occupied with a Covid or flu patients at the beginning of January, with as many as one in five beds in some trusts. Bed occupancy rates were very high in most of the trusts, while a lack of social care beds meant that about 14,000 beds were occupied with patients medically fit to be discharged.Some of England’s hospital trusts have more than two in five beds with a patient with Covid or influenza or someone who could be discharged to home or a care home.The figures are still small compared to the height of the pandemic, but it gives an indication of how sick some people are getting as a result of the virus this winter. | Epidemics & Outbreaks |
- A man in Australia tried to sue a Melbourne hospital for A$1 billion for psychological damage.
- He alleged that he was "encouraged" to watch his wife have a cesarian section.
- He said seeing his wife's blood and organs led to him developing a "psychotic illness."
A man in Australia accused a hospital in Melbourne of causing him to develop a "psychotic illness" after he watched his wife undergo a cesarean section, local news outlet 7News reported.
Anil Koppula tried to sue the Royal Women's Hospital for letting him watch his wife give birth via C-section in 2018.
He sued for A$1 billion, which is about $643 million, 7NEWS reported.
The cesarean was a success, but the man claims the hospital failed in its duty of care to him by letting him watch the procedure, the 7News report says.
He said the hospital "encouraged" or "permitted" him to watch the operation and that seeing his wife's organs and blood caused the mental illness he claimed to have, it adds.
A cesarean section is a common operation in which an surgeon delivers a baby "through a cut made in your tummy and womb," according to the National Health Service.
The surgical procedure is often performed when another course is dangerous or difficult and poses a risk to the mother or baby.
According to the Centers for Disease Control and Prevention, 32.1% of all baby deliveries in the US in 2021 were by cesarean section.
Koppula filed the lawsuit several years after the operation, claiming he is owed damages because of the life-changing psychological injury he allegedly obtained.
In his legal claim, he said the "psychotic illness" led to a "breakdown of his marriage," per 7News.
Koppula chose to represent himself in court, where Justice James Gorton dismissed the suit and deemed the claim an "abuse of process," according to Global News.
The trial proceedings included a medical examination of Koppula. The panel concluded that the alleged psychological effect on Koppula was insufficient.
It found that "the degree of psychiatric impairment resulting from the injury to the claimant alleged in the claim does not satisfy the threshold level," 7News reported. | Mental Health Treatments |
Using laboratory engineered tissue, scientists at the University of Colorado Anschutz Medical Campus have created a full thickness, biodegradable patch that holds the promise of correcting congenital heart defects in infants, limiting invasive surgeries and outlasting current patches.
The findings were published this week in the journal Materials Today.
“The ultimate goal is to make lab-grown heart tissue from a patient’s own cells that can be used to restructure the heart to correct for heart defects,” said the study’s senior author Jeffrey Jacot, PhD, associate professor of bioengineering at the University of Colorado School of Medicine.
About 10,000 babies are born with a complex congenital heart defect every year in this country, requiring surgery in the first year of life. Some of these operations require the implantation of a full-thickness heart patch. But the current materials used in the patch are non-living and non-degradable. They don’t grow with the patient and often fail because they don’t integrate with the heart.
Jacot said these surgeries are largely palliative, extending survival only until the next surgery.
New patch engineered for longevity
But his lab’s patch, called a tissue engineered myocardial patch, could survive the mechanical forces of the heart wall and integrate into the heart itself. Ideally, it would last for as long as the patient lives.
“The current patch materials available to pediatric heart surgeons are exclusively non-living and non-degradable, which often fail in their long-term therapeutic efficacy due to low compliance, an increased risk of thrombosis and intimal hyperplasia, and their inability to remodel and integrate with the heart,” the study said.
Permanent fixes require biomaterials that are degradable but that also promote heart regeneration so that the patches are eventually replaced by healthy myocardium, the middle muscular layer of the heart and the thickest.
“Any patches that are not replaced by healthy tissue prior to their degradation will inevitably fail and lead to long-term complications,” Jacot said.
More testing needed before human trials
The patch was created in the lab using a technique known as electrospinning, where electricity is applied to liquid solutions to create nanofibers used to make a "scaffold." The scaffold is then injected with living cells. This eventually becomes the patch.
“The scaffold was found to be mechanically sufficient for heart wall repair,” Jacot said. “Vascular cells were able to infiltrate more than halfway through the scaffold in static culture within three weeks.”
The patch requires more tests before it can be used in humans.
Jacot is optimistic that it will play a critical role in the future treatment of congenital heart defects and other cardiac conditions.
“This is the first successful demonstration of a very thick, porous electrospun patch specifically for cardiac tissue engineering,” he said.
Photo at top: Jeffrey Jacot, PhD, poses in his lab. | Medical Innovations |
Two scientists who laid the groundwork for what would become among the most influential vaccines of all time have been awarded the 2023 Nobel Prize in medicine or physiology.
Biochemist Katalin Karikó, now at the University of Szeged in Hungary, and Drew Weissman of the University of Pennsylvania were honored for their research on modifications of mRNA that made the first vaccines against COVID-19 possible (SN: 12/15/21).
“Everybody has experienced the COVID-19 pandemic that affects our life, economy and public health. It was a traumatic event,” said Qiang Pan-Hammarström, a member of the Nobel Assembly at the Karolinska Institute in Stockholm, which awards the medicine or physiology prize. Her remarks came on October 2 after a news briefing to announce the winners. “You probably don’t need to emphasize more that the basic discovery made by the laureates has made a huge impact on our society.”
As of September 2023, more than 13.5 billion COVID-19 vaccine doses — including mRNA vaccines as well as other kinds of shots — had been administered since they first became available in December 2020, according to the World Health Organization. In the year after their introduction, the shots are estimated to have saved nearly 20 million lives globally. In the United States, where mRNA COVID-19 shots made by Moderna and Pfizer/BioNTech accounted for the vast majority of vaccinations, the vaccines are estimated to have prevented 1.1 million additional deaths and 10.3 million hospitalizations.
A different kind of vaccine
RNA is DNA’s lesser-known chemical cousin. Cells make RNA copies of genetic instructions contained in DNA. Some of those RNA copies, known as messenger RNA, or mRNA, are used to build proteins. Messenger RNA “literally tells your cells what proteins to make,” says Kizzmekia Corbett-Helaire, a viral immunologist at the Harvard T. H. Chan School of Public Health in Boston. Proteins do much of the important work that keeps cells, and the organisms they’re a part of, alive and well.
The mRNA vaccines work a bit differently than traditional immunizations. Most traditional vaccines use viruses or bacteria — either weakened or killed — or proteins from those pathogens to provoke the immune system into making protective antibodies and other defenses against future infections.
The COVID-19 vaccines made by Pfizer/BioNTech and Moderna instead contain mRNA that carries instructions for making one of the coronavirus’s proteins (SN: 2/21/20). When a person gets an mRNA shot, the genetic material gets into their cells and triggers the cells to produce the viral protein for a short amount of time. When the immune system sees the viral protein, it builds defenses to prevent serious illness if the person later gets infected with the coronavirus.
Vaccines using mRNA were a good choice to combat the pandemic, Corbett-Helaire says. The technology allows scientists to “skip that step of making large amounts of proteins in the laboratory and instead … tell the body to do things that the body already does, except now we make an extra protein,” she says.
In addition to protecting people from the coronavirus, mRNA vaccines may also work against other infectious diseases and cancer. Scientists might also use the technology to help people with certain rare genetic diseases make enzymes or other proteins they lack. Clinical trials are under way for many of these uses, but it could take years before scientists know the results (SN: 12/17/21).
A long time coming
The first mRNA vaccine for COVID-19 became available just under a year into the pandemic, but the technology behind it has been decades in the making.
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In 1997, Karikó and Weissman met at the copy machine, Karikó said during a news conference October 2 at the University of Pennsylvania. She told him about her work with RNA, and he shared his interest in vaccines. Although housed in separate buildings, the researchers worked together to solve one fundamental problem that could have derailed mRNA vaccines and therapies: Pumping regular mRNA into the body gets the immune system riled up in bad ways, producing a flood of immune chemicals called cytokines. Those chemicals can trigger damaging inflammation. And this unmodified mRNA produces very little protein in the body.
The researchers found that swapping the RNA building block uridine for modified versions, first pseudouridine and then N1-methylpseudouridine, could dampen the bad immune reaction. That nifty chemistry, first reported in 2005, allowed researchers to rein in the immune response and safely deliver the mRNA to cells.
“The messenger RNA has to hide and it has to go unnoticed by our bodies, which are very brilliant at destroying things that are foreign,” Corbett-Helaire says. “The modifications that [Karikó and Weissman] worked on for a number of years really were fundamental to allowing the mRNA therapeutics to hide while also being very helpful to the body.”
In addition, the modified mRNA produced lots of protein that could spark an immune response, the team showed in 2008 and 2010. It was this work on modifying mRNA building blocks that the prize honors.
For years, “we couldn’t get people to notice RNA as something interesting,” Weissman said at the Penn news conference. Vaccines using the technology failed clinical trials in the early 1990s, and most researchers gave up. But Karikó “lit the match,” and they spent the next 20 years figuring out how to get it to work, Weissman said. “We would sit together in 1997 and afterwards and talk about all the things that we thought RNA could do, all of the vaccines and therapeutics and gene therapies, and just realizing how important it had the potential to be. That’s why we never gave up.”
In 2006, Karikó and Weissman started a company called RNARx to develop mRNA-based treatments and vaccines. After Karikó joined the German company BioNTech in 2013, she and Weissman continued to collaborate. They and colleagues reported in 2015 that encasing mRNA in bubbles of lipids could help the fragile RNA get into cells without getting broken down in the body. The researchers were developing a Zika vaccine when the pandemic hit, and quickly applied what they had learned toward containing the coronavirus.
The duo’s work was not always so celebrated. Thomas Perlmann, Secretary General of the Nobel Assembly at the Karolinska Institute, asked the newly minted laureates whether they were surprised to have won. He said that Karikó was overwhelmed, noting that just 10 years ago she was terminated from her job and had to move to Germany without her family to get another position. She never won a grant from the U.S. National Institutes of Health to support her work.
“She struggled and didn’t get recognition for the importance of her vision,” Perlmann said, but she had a passion for using mRNA therapeutically. “She resisted the temptation to sort of go away from that path and do something maybe easier.” Karikó is the 61st woman to win a Nobel Prize since 1901, and the 13th to be awarded a prize in physiology and medicine.
Though it often takes decades before the Nobel committees recognize a discovery, sometimes recognition comes relatively swiftly. For instance, Emmanuelle Charpentier and Jennifer Doudna won the Nobel Prize for chemistry in 2020 a mere eight years after the researchers published a description of the genetic scissors CRISPR/Cas 9 (SN: 10/7/20).
“I never expected in my entire life to get the Nobel Prize,” Weissman said, especially not a mere three years after the vaccines demonstrated their medical importance. Perlmann told him the Nobel committee was seeking to be “more current” with its awards, he said.
The timely Nobel highlights that “there are just a million other possibilities for messenger RNA therapeutics … beyond the vaccines,” Corbett-Helaire says.
The researchers said at the Penn news conference that they weren’t sure the early morning phone call from Perlmann was real. On the advice of Weissman’s daughter, they waited for the Nobel announcement. “We sat in bed. [I was] looking at my wife, and my cat is begging for food,” he said. “We wait, and the press conference starts, and it was real. So that’s when we really became excited.”
Karikó and Weissman will share the prize of 11 million Swedish kronor, or roughly $1 million. | Vaccine Development |
Researchers at Tufts University and Harvard University’s Wyss Institute have created tiny biological robots that they call Anthrobots from human tracheal cells that can move across a surface and have been found to encourage the growth of neurons across a region of damage in a lab dish.
The multicellular robots, ranging in size from the width of a human hair to the point of a sharpened pencil, were made to self-assemble and shown to have a remarkable healing effect on other cells. The discovery is a starting point for the researchers’ vision to use patient-derived biobots as new therapeutic tools for regeneration, healing, and treatment of disease.
The work follows from earlier research in the laboratories of Michael Levin, Vannevar Bush Professor of Biology at Tufts University School of Arts & Sciences, and Josh Bongard at the University of Vermont in which they created multicellular biological robots from frog embryo cells called Xenobots, capable of navigating passageways, collecting material, recording information, healing themselves from injury, and even replicating for a few cycles on their own. At the time, researchers did not know if these capabilities were dependent on their being derived from an amphibian embryo, or if biobots could be constructed from cells of other species.
In the current study, published in Advanced Science, Levin, along with PhD student Gizem Gumuskaya discovered that bots can in fact be created from adult human cells without any genetic modification and they are demonstrating some capabilities beyond what was observed with the Xenobots. The discovery starts to answer a broader question that the lab has posed—what are the rules that govern how cells assemble and work together in the body, and can the cells be taken out of their natural context and recombined into different “body plans” to carry out other functions by design?
In this case, researchers gave human cells, after decades of quiet life in the trachea, a chance to reboot and find ways of creating new structures and tasks. “We wanted to probe what cells can do besides create default features in the body,” said Gumuskaya, who earned a degree in architecture before coming into biology. “By reprogramming interactions between cells, new multicellular structures can be created, analogous to the way stone and brick can be arranged into different structural elements like walls, archways or columns.” The researchers found that not only could the cells create new multicellular shapes, but they could move in different ways over a surface of human neurons grown in a lab dish and encourage new growth to fill in gaps caused by scratching the layer of cells.
Exactly how the Anthrobots encourage growth of neurons is not yet clear, but the researchers confirmed that neurons grew under the area covered by a clustered assembly of Anthrobots, which they called a “superbot.”
“The cellular assemblies we construct in the lab can have capabilities that go beyond what they do in the body,” said Levin, who also serves as the director of the Allen Discovery Center at Tufts and is an associate faculty member of the Wyss Institute. “It is fascinating and completely unexpected that normal patient tracheal cells, without modifying their DNA, can move on their own and encourage neuron growth across a region of damage,” said Levin. “We’re now looking at how the healing mechanism works, and asking what else these constructs can do.”
The advantages of using human cells include the ability to construct bots from a patient’s own cells to perform therapeutic work without the risk of triggering an immune response or requiring immunosuppressants. They only last a few weeks before breaking down, and so can easily be re-absorbed into the body after their work is done.
In addition, outside of the body, Anthrobots can only survive in very specific laboratory conditions, and there is no risk of exposure or unintended spread outside the lab. Likewise, they do not reproduce, and they have no genetic edits, additions or deletions, so there is no risk of their evolving beyond existing safeguards.
How Are Anthrobots Made?
Each Anthrobot starts out as a single cell, derived from an adult donor. The cells come from the surface of the trachea and are covered with hairlike projections called cilia that wave back and forth. The cilia help the tracheal cells push out tiny particles that find their way into air passages of the lung. We all experience the work of ciliated cells when we take the final step of expelling the particles and excess fluid by coughing or clearing our throats. Earlier studies by others had shown that when the cells are grown in the lab, they spontaneously form tiny multicellular spheres called organoids.
The researchers developed growth conditions that encouraged the cilia to face outward on organoids. Within a few days they started moving around, driven by the cilia acting like oars. They noted different shapes and types of movement – the first. important feature observed of the biorobotics platform. Levin says that if other features could be added to the Anthrobots (for example, contributed by different cells), they could be designed to respond to their environment, and travel to and perform functions in the body, or help build engineered tissues in the lab.
The team, with the help of Simon Garnier at the New Jersey Institute of Technology, characterized the different types of Anthrobots that were produced. They observed that bots fell into a few discrete categories of shape and movement, ranging in size from 30 to 500 micrometers (from the thickness of a human hair to the point of a sharpened pencil), filling an important niche between nanotechnology and larger engineered devices.
Some were spherical and fully covered in cilia, and some were irregular or football shaped with more patchy coverage of cilia, or just covered with cilia on one side. They traveled in straight lines, moved in tight circles, combined those movements, or just sat around and wiggled. The spherical ones fully covered with cilia tended to be wigglers. The Anthrobots with cilia distributed unevenly tended to move forward for longer stretches in straight or curved paths. They usually survived about 45-60 days in laboratory conditions before they naturally biodegraded.
“Anthrobots self-assemble in the lab dish,” said Gumuskaya, who created the Anthrobots. “Unlike Xenobots, they don’t require tweezers or scalpels to give them shape, and we can use adult cells – even cells from elderly patients - instead of embryonic cells. It’s fully scalable—we can produce swarms of these bots in parallel, which is a good start for developing a therapeutic tool.”
Little Healers
Because Levin and Gumuskaya ultimately plan to make Anthrobots with therapeutic applications, they created a lab test to see how the bots might heal wounds. The model involved growing a two-dimensional layer of human neurons, and simply by scratching the layer with a thin metal rod, they created an open ‘wound’ devoid of cells.
To ensure the gap would be exposed to a dense concentration of Anthrobots, they created “superbots” a cluster that naturally forms when the Anthrobots are confined to a small space. The superbots were made up primarily of circlers and wigglers, so they would not wander too far away from the open wound.
Although it might be expected that genetic modifications of Anthrobot cells would be needed to help the bots encourage neural growth, surprisingly the unmodified Anthrobots triggered substantial regrowth, creating a bridge of neurons as thick as the rest of the healthy cells on the plate. Neurons did not grow in the wound where Anthrobots were absent. At least in the simplified 2D world of the lab dish, the Anthrobot assemblies encouraged efficient healing of live neural tissue.
According to the researchers, further development of the bots could lead to other applications, including clearing plaque buildup in the arteries of atherosclerosis patients, repairing spinal cord or retinal nerve damage, recognizing bacteria or cancer cells, or delivering drugs to targeted tissues. The Anthrobots could in theory assist in healing tissues, while also laying down pro-regenerative drugs.
Making New Blueprints, Restoring Old Ones
Gumuskaya explained that cells have the innate ability to self-assemble into larger structures in certain fundamental ways. “The cells can form layers, fold, make spheres, sort and separate themselves by type, fuse together, or even move,” Gumuskaya said. “Two important differences from inanimate bricks are that cells can communicate with each other and create these structures dynamically, and each cell is programmed with many functions, like movement, secretion of molecules, detection of signals and more. We are just figuring out how to combine these elements to create new biological body plans and functions—different than those found in nature.”
Taking advantage of the inherently flexible rules of cellular assembly helps the scientists construct the bots, but it can also help them understand how natural body plans assemble, how the genome and environment work together to create tissues, organs, and limbs, and how to restore them with regenerative treatments.
Journal
Advanced Science
Method of Research
Experimental study
Subject of Research
Cells
Article Title
Motile Living Biobots Self-Construct from Adult Human Somatic Progenitor Seed Cells
Article Publication Date
30-Nov-2023
COI Statement
The authors report no conflicts of interest | Medical Innovations |
‘No one really wants to talk about COVID anymore,’ the WHO’s pandemic lead laments. But the ‘worst case’ possibility of a new coronavirus exists
The pandemic is drawing to a close, World Health Organization officials said Wednesday. But they refused to rule out a plot twist that could reverse some, if not all, progress made on the disease over the past three years.
“The acute phase of the pandemic is ending,” Dr. Sylvie Briand, director of Global Infectious Hazard Preparedness and Emergency Preparedness at the WHO, told viewers of a COVID webinar hosted by the organization. She was referencing the first and often worst phase of a pandemic, during which a new virus presents a global emergency. The WHO late last month extended the COVID-19 global health emergency status by another three months, but noted that the pandemic “may be approaching an inflexion point.”
But “until no one is at risk, everyone is at risk” of a disease that continues to evolve and affect different countries to different extents, Maria Van Kerkhove, technical lead for COVID-19 at the WHO, added.
While Omicron subvariant BA.5, which surged this past summer, and its descendents continue to dominate globally, “the virus has not stabilized into a predictable pattern of evolution,” Dr. Lorenzo Subissi, technical officer of emerging zoonotic diseases at the WHO, told those tuning in.
COVID will, in all likelihood, continue to spawn variants that are increasingly more transmissible and immune-evasive—and they may or may not be more severe, he added.
Dr. Arurag Agrawal, director of the Council of Scientific and Industrial Research Institute of Genomics and Integrative Biology in India, raised the possibility of a more severe strain of COVID in the future, Omicron or otherwise.
There exists a popular belief that Omicron is a weakened version of the original COVID. But its generally more mild presentation is likely due, at least in part, to widespread T-cell immunity in many areas of the world. While T cells can’t stop disease, they blunt its impact, often making it appear more mild than it might in a population with virtually no immunity—like China before the lifting of “zero COVID” measures.
“Omicron can cause severe disease,” Agrawal said. “It is not nature’s vaccine.”
Recombinants, or combinations, of two COVID variants, like XBB.1.5—a mix of two spinoffs of so-called “stealth Omicron” BA.2—are a bit of a wildcard, according to experts.
XBB.1.5 has not shown signs of increased disease severity. But experts can’t exclude the possibility that COVID will combine with another coronavirus altogether—either in humans or in animals, from which it could spill back into humans, Lorenzo said.
What’s more, with variant surveillance on the decline and surveillance of variants in animals anemic as always, it’s possible such a development has occurred or will occur, and that humanity will be caught by surprise.
“We need to make sure this is not happening,” he said, referencing the possibility of a new coronavirus via recombination.
Agrawal called such a scenario “worst case.”
Dr. Jay Varma, chief medical adviser at the New York-based think tank Kroll Institute, told Fortune that the potential of recombination of COVID and another coronavirus doesn’t concern him any more than the potential of a more dangerous COVID variant.
“The most dangerous variant would be one that develops mutations that make it evade pre-existing immunity against severe illness and death,” he said. “In that situation, vaccines and prior infection would no longer greatly reduce the risk of hospitalization and death, as they do now, and there would, effectively, be a new pandemic.
WHO panel members on Wednesday expressed hope that the current pattern of relatively mild disease for many will hold. But, as experts point out, hopes don’t always align with reality.
Now in its fourth year of the pandemic, the world is in a difficult position, Van Kerkhove said, adding, “No one really wants to talk about COVID anymore.”
A misconception exists that the world should wrap up the COVID-19 emergency and prepare for the next, she said. But “everything we’re doing—strengthening systems, building new systems … that’s preparedness for the next one,” she said.
“Responding to COVID is pandemic preparedness for the future.”
Eventually, the once novel coronavirus will become one of the many global diseases the WHO works to keep in check, according to Van Kerkhove.
But “we’re still not there yet,” she said, adding that she remains “optimistic that we will end the emergency of COVID this year.” | Epidemics & Outbreaks |
I wanted a girl and I was upset when I found out I was having twin boys - but gender disappointment is nothing to be ashamed ofAshley Cesare, 21, was disappointed to find out that she was having twin boysThe stay-at-home-mom, from New York, had her heart set on having a girlREAD MORE: Pregnant mum sparks backlash with gender reveal reaction Published: 04:57 EST, 27 January 2023 | Updated: 04:59 EST, 27 January 2023 A woman has revealed that she was 'upset and disappointed' when she found out she was having twin boys after having her heart set on one of each. Ashely Cesare, 21, had always dreamed of having a little girl and was hoping for a boy and girl when she found out she was expecting twins in August 2021. The stay-at-home-mother, from New York, couldn't hide her disappointment when only blue confetti fell on her and her fiancé, Heath Boyle, 27, who works in construction, during their gender reveal.Ashley was 'scared' about raising boys but quickly got over her fear and now admits she couldn't imagine her 10-month-old twins, Carter and Jaxon, as girls. Ashley Cesare with her twin sons Carter and Jaxon. Ashley revealed that she was initially disappointed to find out she was having boys She said: 'In the moment I was anxious, and the suspense was killing me.'In my gut I knew it was twin boys, so I was trying to prepare myself and willing myself not to cry.'When the confetti fell, I stamped my foot in disappointment. But the feeling only lasted for five or 10 minutes.'However, she quickly got over the disappointment and thought 'here we go'. Ashley and her fiancé, Heath Boyle, 27 at their gender reveal, where Ashley was initially upset as she had wanted one of each - one girl and one boy The stay-at-home-mom says that she wouldn't be without her boys now and was only disappointed for five minutes She said: 'I used to feel guilty because I didn't want my boys to feel unwanted. But now I realise that wasn't that moment was.'It was my natural emotions. Now I couldn't imagine them being girls. I love my boys more than anything and me wanting a girl isn't wrong.' When Ashley found out she was pregnant with twins in August 2021, she had set her hopes on one or both being a girl.As a 'girly girl' Ashley wanted a 'mini me' and so when she and Heath found out they were having twin boys at their gender reveal in October 2021, she was shocked and unprepared. When Ashley found out she was pregnant with twins in August 2021, she had set her hopes on one or both being a girl Ashley said that she wants to normalise that gender disappoint is a very real thing and has nothing to do with how much you will love your babyThe 21-year-old said: 'Heath didn't care either way. But it was really scary for me.''I have all girls on my side of the family. I didn't think I would be good at raising boys. 'But after five minutes or so I snapped out of it, and I was excited. I was just happy to be a mom.'It was a disappointment like you have when you get the fast-food restaurant gets your order wrong, but you still eat it. Ashley said that she feels guilty as she doesn't want her two sons to feel as though they were unwanted 'We should be able to have emotions.'Ashley fell in love with her boys when they were born at St. Peter's Hospital, Albany, New York, on March 25, 2022 - Jaxon weighing 4lbs 11oz and Carter 4lbs 8oz.She said: 'It felt like they were meant to be mine. They are both very attached to me.'They said "mumma" first.'Jaxon is clingy, and Carter is more independent but still has his moments when all he wants is me.' Ashley fell in love with her boys when they were born at St. Peter's Hospital, Albany, New York, on March 25, 2022 - Jaxon weighing 4lbs 11oz and Carter 4lbs 8ozAshley and Heath want to complete their family with a third child, who they hope will be a girl.Ashley said: 'If we have another boy, I might be disappointed. But I'll still be happy, and we'll still stop at three.' Ashley was worried about feeling 'judged' for her emotions surrounding her gender disappointment, but plans to show them the video of her reaction when they are old enough.Ashley said: 'They'll see that I was disappointed but know I love them more than anything.'I'm assuming they'll laugh about it. I want them to understand feelings are normal.' Advertisement | Women’s Health |
The first minister has clarified that WhatsApp is installed on his Senedd issued phone, after he told the Welsh Parliament he did not use it.
But Mark Drakeford said he does not use the app to regularly send messages.
The Welsh Labour leader had been challenged to correct the record by Welsh Conservatives.
On Tuesday he said that some government figures may have deleted messages during the pandemic.
He told the Senedd that he did not use "deletion arrangements" and would not know how to do so.
Welsh Conservative Senedd leader Andrew RT Davies welcomed the correction of the record from the first minister, but said questions remained about how many messages were lost in the early stages of Covid.
He had written to the first minister after he obtained a screenshot of which, Mr Davies said, demonstrated the first minister had a WhatsApp account.
WhatsApp messages between UK officials and ministers have been a key part of recent evidence heard by the Covid inquiry.
In Scotland SNP ministers have been embroiled in a row over whether messages have been deleted.
On Tuesday Mr Drakeford said: "I know, in my case, I've never had any deletion arrangements on the phone, because I would have no idea how to make it happen. I don't use WhatsApp either."
In a letter to the presiding officer, Elin Jones, the next day, he said he would "like to clarify that I have WhatsApp downloaded on my Senedd-issued mobile phone.
"I do not use it regularly to send messages."
"I reiterate that the Welsh government did not use informal means of communication to make decisions during the pandemic, in sharp contrast to the evidence the UK Covid-19 inquiry has taken in recent weeks."
A spokesman for the Welsh government said it continues "to co-operate fully with the UK Covid-19 inquiry and will disclose all material requested, including WhatsApp messages".
On Tuesday Mr Drakeford that as soon as his government was aware that the inquiry would wish to have material disclosed to it, "no instruction of any sort was issued in the Welsh government that material should be deleted".
"So as soon as we knew that the inquiry wanted something, there's no deletion beyond that point."
But he said many colleagues working for the Welsh government "will have had devices with deletion instructions already on them".
"Deletion may have taken place."
The first minister's official spokesman later added that "staff were regularly reminded of the need to maintain and retain robust records relating to decisions taken throughout the pandemic".
In a statement Welsh Conservative Senedd leader Andrew RT Davies said: "It is welcome that the first minister has corrected the record after not being clear in the Senedd yesterday.
"However, more questions remain about how many Welsh government devices used WhatsApp during the pandemic and by who.
"Crucially we need to know how many were deleting messages in the early stages of Covid when life and death decisions were being made in Wales, especially over care home testing." | Epidemics & Outbreaks |
Benzodiazepine use and discontinuation is associated with nervous system injury and negative life effects that continue after discontinuation, according to a new study from researchers at the University of Colorado Anschutz Medical Campus.
The study was published today in the journal PLOS ONE.
Use leads to long-term neurological complications
“Despite the fact that benzodiazepines have been widely prescribed for decades, this survey presents significant new evidence that a subset of patients experience long-term neurological complications,” said Alexis Ritvo, M.D, M.P.H., an assistant professor in psychiatry at the University of Colorado School of Medicine and medical director of the nonprofit Alliance for Benzodiazepine Best Practices.“This should change how we think about benzodiazepines and how they are prescribed.”
Previous studies had described this injury with various terminologies, perhaps the most well-known being protracted withdrawal. As part of the study, a scientific review board unified these names under the term benzodiazepine-induced neurological dysfunction (BIND) to more accurately describe the condition.
To better characterize BIND, Ritvo and colleagues analyzed data from a previously published survey of current and former benzodiazepine users that asked about their symptoms and adverse life effects attributed to benzodiazepine use. The survey of 1,207 benzodiazepine users from benzodiazepine support groups along with health and wellness sites is the largest of its kind. Respondents included those taking benzodiazepines (63.2%), in the process of tapering (24.4%) or fully discontinued (11.3%).
More than half reported suicidal thoughts or attempted suicide
Symptoms were long-lasting, with 76.6% of all affirmative answers to symptom questions reporting the duration to be months or more than a year. The following ten symptoms persisted over a year in greater than half of respondents: low energy, difficulty focusing, memory loss, anxiety, insomnia, sensitivity to light and sounds, digestive problems, symptoms triggered by food and drink, muscle weakness and body pain. Particularly alarming, these symptoms were often reported as new and distinct from the symptoms for which benzodiazepines were originally prescribed. Notably, 54.4% of the respondents reported suicidal thoughts or attempted suicide.
BIND is thought to be a result of brain changes resulting from benzodiazepine exposure. A general review of the literature suggests that it occurs in roughly one in five long-term users. The risk factors for BIND are not known, and more research is needed to further define the condition, along with treatment options.
“Patients have been reporting long-term effects from benzodiazepines for over 60 years. I am one of those patients. Even though I took my medication as prescribed, I still experience symptoms on a daily basis at four years off benzodiazepines. Our survey and the new term BIND give a voice to the patient experience and point to the need for further investigations,” said Christy Huff, M.D, one of the paper’s coauthors and a cardiologist and director of Benzodiazepine Information Coalition.
The survey was a collaborative effort between CU Anschutz, Vanderbilt University Medical Center, and several patient-led advocacy organizations that educate on benzodiazepine harms. Several members of the research team have lived experience with benzodiazepines, which informed the survey questions. | Drug Discoveries |
When Dr. Drew Weissman found out he hadfor developing effective mRNA vaccines for COVID-19 with fellow recipient Katalin Karikó the first thing he did was call his parents.
"Congratulations," his 91-year-old father, Hal,, which was filmed by Penn Medicine and has gone viral.
"Oh, how fabulous. I don't know what to say. I'm ready to fall on the floor," his 90-year-old mother, Adele, said. "You kept saying, 'No, no. It's never going to happen.' And you did it!"
His parents always believed their son could win the coveted prize, Weissman, a professor at University of Pennsylvania's Perelman School of Medicine and director of the Institute for RNA Innovation told CBS News.
"They visited Stockholm when I was about five years old and they went into the Nobel auditorium with a guide and said, 'Reserve these two seats for us.' And they remember that story and would tell us every so often. So it was always on their minds," Weissman said.
Weissman, who now has two daughters of his own, said growing up he wanted to be an engineer, like his dad. But once he started learning about biology in school, he changed course. Weissman, who grew up in Lexington, Massachusetts, graduated from Brandeis University in 1981 and then went on to get his M.D. and Ph.D. in Immunology and Microbiology from Boston University in 1987.
Weissman has been studying RNA, a molecule in most living organisms and viruses, for nearly 30 years at UPenn. mRNA, or messenger RNA, tells your body how to make proteins and the mRNA vaccine tells your body how to copy coronavirus' spike proteins. By learning how to copy the spike proteins, your body will later recognize them if you contract the virus and will already know how to fight it off.
After developing the successful vaccine, Weissman started to believe a Nobel Prize was possible. But he thought it would come in five years. "We get nominated every year because we've got a lot of people who support our work and submit nominations," he told CBS News. But, "usually Nobel waits eight or nine years after a big finding before awarding," he said.
The Nobel Prize committee first called Karikó, a Penn Medicine researcher who has worked with Weissman on RNA since 1997. He said she relayed the message to Weissman, but they both thought it was a prank. "I thought some anti-vaxxer was playing a joke on us or something like that," Weissman said.
Even after getting a call himself, Weissman waited for the official web conference to be sure they had won.
When asked when it hit him that he could win an award for developing the innovative vaccine, Weissman said: "I think it was after the phase three trial results showing 95% efficacy and the billions of doses that were distributed and taken around the world."
On Dec. 10, the date of the Nobel Prize Ceremony, Weissman will be back in that auditorium his parents visited all those years ago.
He credits his success to growing up in a household that "always had an interest in learning." He said his parents always showed "incredible support" throughout his career – and their love helped buoy him towards the Nobel win.
"Drew, you are the product of our hearts," his mom told him on that dream-fulfilling phone call.
for more features. | Vaccine Development |
Britons die sooner from cancer and heart disease than people in many other rich countries, partly because of the NHS’s lack of beds, staff and scanners, a study has found.
The UK “underperforms significantly” on tackling its biggest killer diseases, in part because the NHS has been weakened by years of underinvestment, according to the report from the King’s Fund health thinktank. It “performs poorly” as judged by the number of avoidable deaths resulting from disease and injury and also by fatalities that could have been prevented had patients received better or quicker treatment.
The comparative study of 19 well-off nations concluded that Britain achieves only “below average” health outcomes because it spends a “below average” amount for every person on healthcare.
The sobering findings come 10 days before celebrations across the four home nations to mark the 75th anniversary of the NHS’s creation on 5 July 1948 by the postwar Labour government.
The King’s Fund pinpoints the NHS’s lack of doctors and nurses as one of the main reasons the service is struggling as judged by many of the criteria used in the thinktank’s analysis. On Thursday, the government will finally publish its long-awaited workforce plan to tackle staff shortages, which Rishi Sunak said on Sunday would be “one of the most significant announcements in the history of the NHS”.
The 118-page report compares the resources available to the NHS across the UK, and its performance, with those of the health systems in countries including France, Germany, Sweden, Japan, Singapore and the US. Among its main conclusions are that in the UK:
Life expectancy is second worst among the 19 countries studied.
People who have a heart attack or stroke are more likely to die as a result than in almost every other country studied, including within 30 days of admission to hospital.
Survival rates for many of the most commonly occurring cancers, including breast, colon, cervix, rectum, lung and stomach, are “below average”
Access to NHS dental care is “worryingly threadbare in some areas”.
There are fewer CT and MRI scanners than in any of the other countries studied, and the number of hospital beds is the second smallest, owing to historical underinvestment in capital spending.
“The NHS … trails behind its international cousins on some key markers of a good healthcare system. We are not by any means where we should be,” said Siva Anandaciva, the author of the report and the King’s Fund’s chief analyst.
Anandaciva dismissed assertions by ministers in recent years that Covid-19 was to blame for much of the NHS’s increasing fragility and inability to provide urgent care promptly. The impact of the pandemic merely “compounded the consequences of more than a decade of squeezed investment in staff, equipment and wider services that keep us well”, he added.
On Sunday, Sunak repeated to the BBC’s Laura Kuenssberg that the delays in care provision, which are the worst in the history of the NHS, and England’s waiting list of 7.3 million, were “because we’ve had a pandemic”.
The report, which draws on data collected by bodies such as the Organisation for Economic Co-operation and Development and the Office for National Statistics, also found that “people in the UK are profoundly dissatisfied with the current state of health services”. Despite the NHS’s difficulties, though, support for its founding principles – as a taxpayer-funded system that is available to all and free at the point of use – remains strong, with little appetite for radical reform.
The report also highlights the fact that in Britain, unlike in some other countries, people do not have to pay to access healthcare, though long waiting times are forcing growing numbers to do so. It also praises the NHS for its efficiency, low use of second-line antibiotics and management of diabetes.
Dr Sonya Babu-Narayan, the British Heart Foundation’s associate medical director, said that Britain’s poor record on cardiovascular health was a result of “a deadly combination of the Covid-19 pandemic, extreme and ongoing pressure on what was an already stretched health service, not enough NHS staff and space, deep-rooted health inequalities, and poor population health”
Michelle Mitchell, Cancer Research UK’s chief executive, urged ministers to make smoking obsolete, increasing the number of cancer screenings and plugging gaps in the cancer workforce to improve diagnosis and survival.
The Department of Health and Social Care did not respond directly to the King’s Fund’s findings. Instead, a spokesperson said only that: “This report recognises the NHS is one of the most efficiently run healthcare systems and we are investing up to £14.1bn to improve services and cut waiting lists, one of the government’s top five priorities.
“There are record numbers of staff working in the NHS with over 53,600 more people compared to a year ago, including over 5,400 more doctors and over 12,900 more nurses.” | Global Health |
Ashley believed she had one last shot to get help. Like millions of Australians every year, she looked for it in a hospital emergency department.
Myree Webb was in the middle of settling the sale of the family home when she got her daughter's text.
They had just moved into a new house east of Perth, set with a sweeping verandah and bushland vistas.
Her adult daughter Ashley was living with her during a rough patch after losing her baby to stillbirth.
Myree hoped the bushland setting would bring her daughter some peace.
Ashley was experiencing pins and needles, muscle weakness, burning and numbness, and was racked with whole-body twitches and trembling which would wake her during the night.
But most worrying to her mother, Ashley sometimes described feeling like her brain was "on fire".
In November last year, her pain was so acute the 31-year-old sought urgent care.
She texted her mother that she was at the Midland Hospital Emergency Department trying to get help.
Ashley told her she wanted an MRI because she believed that would reveal the cause of her pain.
Ashley
I’m going to lie and say I was unconscious … a week ago, so they will scan my brain. I can't keep living like this.
6:58PM November 12
Ashley
This is my last chance of going to hospital, isn't it?
10:03AM November 13
This was not Ashley's first time seeking help in Midland Hospital, a new public facility run by private contractors St John of God.
Her mother believes by November 2022 she had been to the ED at least five times.
Along with her physical pain, Ashley was experiencing poor mental health and had been taken to hospital by ambulance multiple times.
Her mother said she had attempted suicide, and in July, was admitted to a psychiatric ward for two weeks.
"She just went downhill really fast," Myree said.
"We were just on this hamster wheel of the three — the hospital, GP [and] Midland community mental health.
"And none of those seem to be of any benefit to her."
Her last hospital visit
Myree can't stop looking back at the dozens of text messages she exchanged with Ashley while she was in hospital in November.
Ashley
They want to admit me to mental health but I am so f***in sick. Please tell them when they call you Mum, it's not mental health, it's brain damage.
1:32PM November 13
Ashley
They found [self-harm] stuff in my bag from when I collected them, but told them I tried [taking my life] again yesterday so they will scan.
1:32PM November 13
Ashley
I shouldn't be sent to the psyche ward sick, I can't even taste food.
1:46PM November 13
Mum
Not necessarily. Just stop freaking out and go with the program.
1:50PM November 13
Ashley
I need help, not to be shoved in a psyche ward
1:50PM November 13
Some hours after these texts, a staff member called Myree.
"[They] said, 'I don't know what to do with her'," Myree said.
"And I said, 'Excuse me?', and they said, 'She's being quite belligerent and difficult'.
"I told [them], 'She's desperate'."
Frantic texts reveal complex medical history
Ashley had struggled with postnatal depression in the past.
After her second child was born, she was also diagnosed with functional neurological disorder (FND).
It's a complex condition that affects the parts of the brain that control movement and can cause pain and muscle weakness.
It's difficult for clinicians to diagnose and measure because it presents symptoms that are similar to other neurological disorders.
Ashley carried a note with her to medical appointments describing her symptoms to make sure she remembered to list them all.
"It's really just heartbreaking to have seen her in pain for so long and I couldn't do anything about it," Myree said.
"I tried to advocate for her and speak so many times.
"I would see her trembling, her legs would shake.
"She'd be like someone with Parkinson's disease, her body trembled."
The next day
On November 14, the hospital called her parents. Myree said they told her Ashley would be discharged.
Mum
They are trying to get you out of there. Dad was angry and went right off at the doctor.
12:05PM November 14
Ashley
So what's going to happen then?
12:07PM November 14
Mum
Not sure. They are going to talk to you again. But so far everything they test has come back normal. Dad doesn't want to keep going through this.
12:10PM November 14
Mum
He went ballistic at them on the phone, I really mean it. He doesn't want them to release you to us again.
12:10PM November 14
Ashley
Does dad not believe me? Or is he done with them not helping?
12:17PM November 14
Mum
He is annoyed by the same thing happening over and over ... we are just regular people who have no support.
12:17PM November 14
Myree said a staff member called her again and said Ashley would be discharged and needed to go to a community mental health service.
She said she told the hospital on the phone that her daughter would die.
Her husband grabbed the phone and told them they were "signing her death warrant".
Mum
They want to release you no matter what.
12:23PM November 14
Ashley
I don't want to be!
12:23PM November 14
Ashley
They are kicking me out to go in the waiting room.
12:52PM November 14
Ashley did not return to hospital after that.
Less than three weeks later, she took her own life.
Ashley's mother said when she was discharged, the hospital gave her back her bag which contained self-harm implements.
"We as her parents begged them not to release her," Myree said.
"How can there not be a process where if someone presents to an ED and admits they've tried to commit suicide, they've got the article in their bag?
"Should there not be some kind of protocol there where they're not released?"
Questions left unanswered
Myree sought a copy of Ashley's medical records to try to verify what her daughter told her in her texts — that she'd told hospital staff she'd attempted suicide and had self-harm implements in her bag.
But the hospital told Myree that because she was not the executor of Ashley's will they would not release her medical records to her due to privacy restrictions.
For the same reason, the ABC was unable to independently verify what transpired in the ED beyond what Ashley said in her texts.
The WA Health Minister's office told Ashley's family it would escalate the matter to the Department of Health, which has overarching responsibility for the hospital, for "urgent attention and investigation".
In a statement, St John of God Midland Public Hospital confirmed a patient attended the emergency department and said they received "appropriate care".
"The hospital has commenced a thorough internal review," the statement said.
"The initial recommendations do not suggest that any changes to existing processes or policies are required.
"On behalf of the hospital, we offer our heartfelt sympathy to the patient's family for their loss."
More people seeking help for mental health in EDs
Ashley was just one of about 300,000 mental health patients accessing emergency care around the country each year.
In 2020-2021, this represented about 3.5 per cent of all presentations, according to data from the Australian Institute of Health and Welfare.
That rate has been steadily rising over the last 10 years.
Nationally in 2021-2022, only 64 per cent of mental health patients were seen within the clinically recommended time frame based on their triage score.
The Australasian College of Emergency Medicine (ACEM) found mental health patients typically became "stuck" in emergency departments.
They held a summit in 2018, and in 2020, published "Nowhere else to go", a report which called for more funding for inpatient mental health beds, better-connected community care services and better reporting on excessive lengths of stay in EDs.
ACEM president Clare Skinner said the mental health system was under enormous pressure.
"We're seeing shortages with beds, shortages with staff and also unfortunately gaps and shortages in the community services available for people who need them for mental health problems," she said.
"We choose to work in emergency departments because we really care deeply for people.
"The situation where we have people presenting in increasing numbers to seek our help, and we're not able to provide that care because the system is letting us down is deeply heartbreaking."
Myree hopes Ashley's story will help prompt reforms.
She and her sister have started a group in Ashley's memory focused on improving Australia's mental health system.
"Every mother says that their children are the light of their lives, and she was for us," Myree said.
"I'm really sad she's no longer here.
"She was my only child and so the gap in my life is huge." | Mental Health Treatments |
Westend61/Getty Images/Westend61
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Hospice provides vital end-of-life support and palliative care to terminally ill patients. But it's costing Medicare billions. A new approach would eliminate waste in the program.
Westend61/Getty Images/Westend61
Hospice provides vital end-of-life support and palliative care to terminally ill patients. But it's costing Medicare billions. A new approach would eliminate waste in the program.
Westend61/Getty Images/Westend61
Hospice doctor Bethany Snider sees the writing on the wall: "The hospice care we've known and loved won't be the same 10 years from now."
Hosparus Health, the Louisville-based hospice agency where Snider serves as chief medical officer, is one of more than 100 provider organizations partnering with some of the country's largest health insurers on a federal experiment that could transform hospice care for millions of people.
For the last four decades, Medicare has covered hospice services – including grief counseling, spiritual support and pain management – for terminally ill people. The benefit has helped more than 25 million Americans die more on their own terms, often at home, with the support of chaplains, social workers, nurses and others.
Research shows hospice can reduce unwanted medical interventions, improve families' satisfaction and, in some cases, save Medicare thousands of dollars.
Now Snider and others believe this popular benefit, whose structure has remained largely unchanged since its debut in 1983, is in the early days of an inexorable overhaul. Critical aspects of the 40-year-old policy no longer fit the needs of the people using the service – or the providers delivering it. Concerns about access, fraud and runaway costs – which topped $20 billion in 2019 – dog the program.
In response, Medicare has begun a federal pilot project to test handing the reins of some hospice care over to private insurers, giving them more flexibility to reign in costs while also expanding access. The experiment, which began in 2021, involved several thousand patients in its first year, but multiple experts told Tradeoffs they believe it is likely to eventually become national policy and reshape the hospice care available to roughly 30 million Americans.
In an email to Tradeoffs, Liz Fowler, deputy administrator at the Centers for Medicare and Medicaid Services, said the agency hopes the effort will help ensure all beneficiaries have "access to high quality and coordinated care."
The changes to hospice are "inevitable," said Torrie Fields, a consultant who has advised Medicare and private insurers. "The hope is this pilot sheds some light on the guidelines and guardrails needed."
One sign Medicare is seriously considering the policy: an announcement on March 23 that the pilot, initially slated to end in 2024, will continue through 2030.
JON CHERRY for Tradeoffs
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Bethany Snider encouraged her nonprofit hospice agency to participate in a federal experiment to revamp Medicare's 40-year-old hospice policy, but she worries about its potential unintended consequences.
JON CHERRY for Tradeoffs
Bethany Snider encouraged her nonprofit hospice agency to participate in a federal experiment to revamp Medicare's 40-year-old hospice policy, but she worries about its potential unintended consequences.
JON CHERRY for Tradeoffs
Medicare pilots a makeover for its 40-year-old hospice benefit
This federal experiment, known by wonks as "the hospice carve-in," is designed to revitalize a pair of particularly outdated hospice policies: how the program determines patient eligibility and the way it pays providers. Neither has changed significantly since 1983.
Here's how the traditional program works now: To become eligible for hospice, patients must have two doctors certify they have less than six months to live and agree to stop all attempts at curing their terminal illness.
Many experts believe that harsh choice between giving up hope and getting help from hospice – along with the arbitrary 6-month cutoff – combine to repel many patients who could otherwise benefit. Only about one-third of Native, Asian, Black and Hispanic patients elect hospice compared to about half of white patients.
"One of the reasons that Black people shy away from hospice is because there isn't room to reevaluate," said Karen Bullock, a licensed clinical social worker and a professor at Boston College. "It's too finite."
Medicare covers much less at-home medical or social support for people who decline hospice. "They're still ill. They're still struggling," Snider said. "But Medicare does not offer us a great way to serve that population."
An outdated payment policy leaves hospice vulnerable to waste and abuse
For those who do enter hospice, Medicare has historically paid providers a flat rate for every day a person is enrolled in their care – even on days when they need little or no help.
That payment policy, experts say, made more fiscal sense in the early days of hospice when most patients had cancer and died within two months. Since then, hospice has become more popular with a wider range of patients with diseases that are generally less predictable, such as dementia and heart failure. People, on average, now use hospice for almost 100 days.
Experts blame the program's antiquated flat day rate as one reason for its ballooning costs, which are up more than 50% over the last decade. More than half of that budget is now consumed by stays longer than six months.
"The way Medicare pays for this benefit has not evolved to meet the changing needs of the people who use it," said David Stevenson, a health policy professor at Vanderbilt. Adding to those doubts is the flood of for-profit hospice businesses that have poured into the market.
About three-quarters of all providers are now for-profit and data suggest some are exploiting the program's payment structure, averaging much longer stays and profits three times higher than nonprofit providers. Reports, including by ProPublica and the federal government, have also highlighted hundreds of millions of dollars in fraud and disturbing anecdotes of abuse.
Medicare banks on insurers' incentives to reduce waste and improve care
Medicare's experiment gives private insurers the flexibility to both expand eligibility and rein in costs. The same insurers already manage most other care for roughly 30 million Medicare beneficiaries through the program known as Medicare Advantage.
The hope is they can take that experience and those skills, like coordinating care and vetting the quality of providers, and apply them to improve hospice. Because private insurers get paid a lump sum to manage each Medicare patient, they are also motivated to keep costs down.
"There's a natural alignment here," said Susanne McComic, who's overseeing the health insurer Humana's involvement in the hospice demonstration. McComic said Humana had two main reasons for participating. First, they wanted to deliver better care to vulnerable members, and second, it made business sense: They own 40% of Gentiva, a large hospice chain.
A larger role for private insurers makes some experts uneasy, especially when it comes to end of life care. Joan Teno, a Brown University researcher and former hospice medical director, points to the United Kingdom's experiment known as the Liverpool Care Pathway as a cautionary tale.
That program used financial incentives to encourage doctors to enroll more hospital patients in hospice-like services. Some families reported clinicians rushed their loved ones down a path toward death that they did not want or understand. Public outrage erupted and the government ultimately ended the initiative in 2013.
While Medicare's hospice pilot has many differences, its reliance on financial incentives to change behavior still gives some experts pause.
In other areas of care, some Medicare Advantage insurers have aggressively declined requests for medical services – as much as 13% of the time, according to one federal report.
Insurers' early efforts include cutting rates, cleaning carpets and expanding eligibility
Bethany Snider of Hosparus Health is also wary of what the pilot portends for nonprofit hospice agencies like hers – and their patients. But she encouraged Hosparus to take the leap and partner up with Humana. She valued the chance to shape – or at least glimpse – the likely future of hospice care for most Americans.
"I wanted us to have as much time as possible to plan," she said.
The first big change providers like Hosparus are adapting to is the need to negotiate. The pilot lets insurers abandon Medicare's day rate and pay providers however they want. An evaluation of the pilot's first year by the RAND Corporation showed some insurers had already slashed payment rates by up to 12%.
The pilot also lets private insurers decline to contract with hospices that, for example, don't meet certain quality standards. Soon, insurers can begin requiring patients to use only preferred providers.
The hope is this new power helps insurers weed out waste and bad actors. But Snider and others also worry that it could put some nonprofit hospices with thinner margins out of business and lead to further consolidation of the industry.
In an email to Tradeoffs, Medicare's Liz Fowler emphasized the demonstration's guardrails designed to protect patient choice. She also pointed to the agency's "comprehensive monitoring strategy to address and track any unintended consequences."
The other major shift being tested is an expansion of hospice's eligibility criteria. Private insurers can choose to offer hospice care to people still pursuing chemotherapy or other curative treatments – and they can offer some services to seriously ill people with more than six months left to live. They can even give patients additional funds for nontraditional help, like carpet cleaning and rent – two uses Humana's McComic said the insurer has tested.
Together, these experimental changes to who receives and who delivers hospice care, when, and at what cost represent relatively large shifts for a program that's seen little change over the last 40 years. The overall effect on the cost and quality of care remains to be seen. Participation in the pilot was slow to start but has grown over time. The experiment, which this year includes 15 insurers serving patients across 23 states and Puerto Rico, was slated to end in 2024.
In a surprise announcement, Medicare made public on March 23 that they are extending the pilot through 2030. By then, private insurers are projected to manage the care of nearly 70% of Medicare beneficiaries – including, if this pilot becomes national policy, how they spend their final days.
This story comes from the health policy podcast Tradeoffs. Dan Gorenstein is Tradeoffs' executive editor, and Leslie Walker is a senior producer for the show. Tradeoffs' coverage of Medicare sustainability is supported, in part, by Arnold Ventures. | Health Policy |
Humans are hardwired to feel good when performing acts of kindness towards others, an imperative trait in any animal that evolves to live and hunt in social groups.
This is such a truism that performing random acts of kindness for other people was more effective in reducing symptoms of depression than specifically planning activities for the sake of enjoyment, a new study found.
The study sought to test methods of cognitive behavioral therapy, a non-pharmaceutical treatment for depression and anxiety that’s proven to work through confronting patterns of thought and behavior that lead to depressive or anxious thoughts, and consciously moving away from them by retraining one’s brain.
The methods included random acts of kindness, such as buying a stranger’s coffee at Starbucks or baking cookies for the mailman, as well as planning fun activities twice a week and “cognitive reappraisal,” which coaches people with depression or anxiety to record triggering thoughts, and actively contemplate what would make the resulting stress diminish.
The participants would record a variety of feelings as measurements before the study, during the study, and five weeks after its conclusion. These included feelings of social isolation, self-consciousness in public, or life satisfaction.
“We did think that, if there was going to be an advantage of one group over another, it might be the thoughts record group, since that’s such a tried-and-true way of addressing depressive [and anxiety] symptoms,” coauthor Jennifer Cheavens of Ohio State University, told the Greater Good Magazine.
“But the kindness group did as well or better, and that group also had increases in social connection that didn’t happen in the other two groups.”
Indeed, all three groups experienced improvements in the measurements. The random acts of kindness group had a much bigger impact on positive cognition and emotions early on which tapered off as the study period advanced. The thoughts records, or cognitive reappraisal group had the opposite effect, where it started off negative, but became stronger and stronger over time.
MORE HOLISTIC HUMAN HEALTH: A New Holistic Patch Is Cutting Anxiety Successfully – Without Drugs
Another surprise was just how easy it was for the random acts of kindness group to perform the kind acts.
“I was surprised it was not a particularly hard sell,” Cheavens continued. “The people in the acts of kindness group had better uptake in some ways than the people in other groups.”
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The kindness acts is a particularly important finding because it necessitates a connection with other people. Social isolation is a high-risk factor for survival; the same as smoking 15 cigarettes a day.
Cheavens felt that as well as being a powerful therapeutic strategy, random acts of kindness can be “add-on therapy” to pretty much most mental health disorders, reasoning that anytime we can get out of our own heads, it seems to be of benefit to our well-being.
ACT On This Finding And Perform A Random Act Of Kindness Towards Others… | Mental Health Treatments |
Masturbating may have several positive effects, including boosting hormones and chemicals that promote positive emotions, feelings, and sensations.
Many myths and misconceptions continue to spread the idea that masturbation is somehow harmful to health. However, deciding whether to masturbate or not is a personal choice, and it may have several health benefits.
Meanwhile, most negative effects associated with masturbation focus on how someone feels about the act itself, rather than the physical implications on the body.
Read on to learn how masturbation affects the brain, as well as what masturbation addiction is, treatment and prevention methods, and when to see a doctor.
There are numerous potential health benefits of masturbation.
Hormone and chemical release
Research shows that masturbation, as well as other sexual activities leading to sexual pleasure or orgasm, trigger the release of hormones and chemicals involved in the brain’s pleasure-reward center. These include:
Dopamine: Known as the “happiness” hormone, dopamine is an important neurotransmitter involved in motivation, movement, and reward-seeking.
Oxytocin: The “love” hormone oxytocin has a wide range of behavioral and physiological effects, such as promoting sexual, social, and maternal behaviors associated with happiness. The hormone also helps support well-being, positive social interaction, growth, and healing.
Serotonin: Serotonin is a neurotransmitter that
Endorphins: Endorphins are known as “feel-good” chemicals that reduce pain better than morphine. They are responsible for the pleasurable rush or high associated with exercise.
Prolactin: Prolactin is a hormone that
Endocannabinoids: These neurotransmitters are
Norepinephrine/noradrenalin: This is a stimulating neurotransmitter that increases and regulates dopamine transmission, a substance linked to levels of happiness.
Adrenaline: Adrenaline lowers stress by
Release of these various hormones can, in turn, lead to the following health benefits:
Reduced stress and anxiety
Improve sleep
A 2019 study that surveyed 778 adults found there was a clear perception of favorable sleep outcomes associated with orgasm. Many respondents felt masturbation helped reduce the time it takes to fall asleep and improve sleep quality.
Reduced pain
Endorphins are the body’s natural painkillers. Endocannabinoids are also known to help regulate pain and inflammation processes. These natural painkillers could also help ease menstrual pain.
Improved immune function
Masturbation raises levels of prolactin and endocannabinoids, which help regulate the immune system. It also boosts the hormones and neurotransmitters that lower stress.
Improved mood
Masturbation may increase hormone levels associated with a positive mood, such as dopamine, oxytocin, and endorphins.
Improve focus and concentration
By increasing levels of hormones and neurotransmitters involved in learning, memory, and motivation, masturbation may improve focus and concentration.
Improve self-esteem
Masturbation can raise adrenaline levels.
Improve sexual function
Many of the hormones and neurotransmitters involved in the human sexual response cycle help regulate the cycle themselves by promoting the release of stimulating compounds at higher levels.
Improved cognition
Prolactin has a
Reduced blood pressure
Oxytocin and endocannabinoids may also help reduce blood pressure.
For more research-backed information and resources for men’s health, please visit our dedicated hub.
While most people experience positive effects from masturbating, this is not true for everyone.
Some may be morally or religiously opposed to masturbation and
Excessive masturbation can also cause physical problems such as irritated or broken skin, swelling of the genitals, and cramps.
Masturbation is also difficult for some people to engage in positively, especially in those with sexual dysfunction or a history of abuse. These people may find it very embarrassing or even distressing to engage in masturbation.
Currently, the American Psychological Association do not recognize masturbation or sex addiction as a mental health condition. Rather, most specialists classify excessive masturbation as a compulsive sexual behavior (CSB) or out of control sexual behavior.
The American Association of Sexuality Educators, Counselors and Therapists state that there is not enough evidence to support the classification of sex or porn addiction as a mental health condition.
Treatment and prevention
Some people are more prone to CSBs because of certain health conditions, such as:
In people with these conditions, treating the underlying medical issue often helps reduce sexual compulsions and behaviors.
Some illicit drugs and prescription medications, especially those that increase dopamine levels, may also increase someone’s sex drive. These include:
- methamphetamine
- Parkinson’s medications
- cocaine
In these cases, stopping or altering medication or drug use can often reduce sexual compulsions such as excessive masturbation.
Some forms of psychological therapy may also help reduce CSBs and manage their negative repercussions, including:
Limited research also shows that some medications may help reduce CSB, such as:
- citalopram
- naltrexone
- selective serotonin reuptake inhibitors
Support groups, such as Sex Addicts Anonymous, offer programs to help people manage or reduce CSB.
Some tips and techniques can also help reduce or prevent excessive masturbation. These include:
- avoiding pornography
- seeking help from a mental health professional or doctor who specializes in sexual health
- getting enough exercise
- improving social connections and relationships
- staying busy
- understanding a person’s triggers, for example, boredom, fear of intimacy, or shame
When excessive masturbation starts to interfere with daily life, psychological well-being, or physical health, ask a doctor or therapist for help.
People should also consider seeking professional help if feelings of guilt, shame, or other negative emotions interfere with sexual functioning, pleasure, or relationships.
Masturbation triggers the release of hormones and neurotransmitters linked with positive emotions, sensations, and physiological responses.
Masturbation is generally a healthy, risk-free way to engage in sexual activity. It could also allow a person to learn about personal likes or dislikes. It may even improve elements of well-being, such as happiness, relaxation, self-esteem, and body image.
However, a person should speak with a doctor or therapist if masturbation interferes with daily life, relationships, sexual function, or physical health.
Additionally, people can seek professional help if masturbation causes intense or pervasive negative feelings, such as guilt, shame, regret, distress, and embarrassment. | Mental Health Treatments |
An Iranian deputy minister on Sunday said "some people" were poisoning schoolgirls in the holy city of Qom with the aim of shutting down education for girls, state media reported.
Since late November, hundreds of cases of respiratory poisoning have been reported among schoolgirls mainly in Qom, south of Tehran, with some needing hospital treatment.
On Sunday the deputy health minister, Younes Panahi, implicitly confirmed the poisonings had been deliberate.
"After the poisoning of several students in Qom schools, it was found that some people wanted all schools, especially girls' schools, to be closed," the IRNA state news agency quoted Panahi as saying.
He did not elaborate. So far, there have been no arrests linked to the poisonings.
On February 14, parents of students who had been ill had gathered outside the city's governorate to "demand an explanation" from the authorities, IRNA reported.
The next day government spokesman Ali Bahadori Jahromi said the intelligence and education ministries were trying to find the cause of the poisonings.
Last week, Prosecutor General Mohammad Jafar Montazeri ordered a judicial probe into the incidents.
The poisonings come as Iran has beensince the death in custody last year of a 22-year-old woman, , for an alleged violation of country's strict dress code for women.
Amini's father said she was beaten by the morality police, the enforcers of those rules. Her cousin, Erfan Mortezaei, who lives in self-exile in Iraq, believes she was tortured.
"She was tortured, according to eyewitnesses,"in September. "She was tortured in the van after her arrest, then tortured at the police station for half an hour, then hit on her head and she collapsed."
Meanwhile, Iran's currency fell to a new record low on Sunday, plunging to 600,000 to the dollar for the first time as the effects of nationwide protests and the breakdown of the 2015 nuclear deal continued to roil the economy.
The Associated Press contributed to this report. | Epidemics & Outbreaks |
At the first sign of a migraine, WebMD blogger Michele Jordan tackles it head-on. She knows her triggers â the three Cs: cheese, chocolate, and cocktails. Â But patience with herself and understanding from others goes a long way, she says.
Video Transcript
MICHELE JORDAN: Hi, my name is Michele Jordan. I'm from Los Angeles, California. I have had migraines for over 30 years. And I am a writer. I do a lot of health and medical writing mostly for WebMD.
There are many triggers that I have for my migraines, first what I call the three Cs: cheese, chocolate, and cocktails. Those three things get me every time. And they're three of my favorite things. Those are some of my triggers. I've noticed that stress, not getting enough sleep, not getting enough food. Whenever my body feels out of balance, I tend to have a migraine.
I often have severe nausea with my migraines, occasionally some vomiting, dizziness, fatigue. Sometimes it can affect your speech, your eyesight. It really does impact other areas of your body than just your head.
Whew, my relationship with migraine has changed over the years. I remember being very young and very scared. Even though migraine runs in my family on my mother's side, I didn't know just how intense the pain would be and how serious and debilitating the symptoms are, nausea and sensitivity to light and other things.
So when I had migraines, I really was afraid that I wouldn't be able to address them on my own as I got older. I was grateful that I started having them while living with my parents. But as I moved out on my own, and I started working, driving a lot more around the city, I really was nervous that I would have a migraine episode without anyone to help me. I even had to go to the emergency room a few times to get pain relief for severe migraine.
I have learned so many lessons about dealing with migraine episodes. Two important lessons I've learned, one, the first one is to attack them right away. I used to ignore migraines. I used to continue with my day, continue working, running errands, whatever I was doing, thinking it would go away, or I could just brush it under the rug.
Not so. I have learned that when a migraine episode happens, the best thing for me and many others is to address it, take medication if needed, lay down. In some cases, I've taken the day off from work. But I really can't ignore it. It's not effective to do that.
Second thing is to communicate to friends, family, coworkers around me that I have a migraine episode. It's kind of a warning. I may need your help. I may have to take time out for whatever we're working on. And fortunately, I've found most people are very accommodating and understanding. I've even heard folks say, sure, whatever you need because I also have migraine.
Fortunately I have a lot of people who have shown up for me in my life with migraines. And the biggest person has been my husband. And when I'm just not up to having fun in that moment or I have to change some things that I'm eating, if I'm laying down, and I'm suffering through a migraine, and I can't cook, and I need food, he will show up with my favorite meal and leave it for me to eat when I'm ready. And so I am grateful that I married such a compassionate and supportive husband.
The biggest thing I want people to know who don't have migraines is that it's more than just a headache. I think some people who don't have migraines feel, oh, it's a headache, a typical headache that they themselves might have. And it's different.
We really need patience from folks who are hearing about our migraines in the moment or just in general and understanding that we are doing our best to make it through the day. We're doing our best to remain productive. But we have this big monster that's preventing that. So patience and understanding are the things that we need most. | Mental Health Treatments |
A small molecule previously shown to enhance strength in injured or old laboratory mice does so by restoring lost connections between nerves and muscle fibers, Stanford Medicine researchers have found.
The molecule blocks the activity of an aging-associated enzyme, or gerozyme, called 15-PGDH that naturally increases in muscles as they age. The study showed that levels of the gerozyme increase in muscles after nerve damage and that it is prevalent in muscle fibers of people with neuromuscular diseases.
The research is the first to show that damaged motor neurons -- nerves connecting the spinal cord to muscles -- can be induced to regenerate in response to a drug treatment and that lost strength and muscle mass can be at least partially regained. It suggests that, if similar results are seen in humans, the drug may one day be used to prevent muscle loss of muscle strength due to aging or disease or to hasten recovery from injury.
It's estimated that sarcopenia, or debilitating muscle frailty, affects about 30% of people over 80 and costs the United States around $380 billion each year.
"There is an urgent, unmet need for drug treatments that can increase muscle strength due to aging, injury or disease," said Helen Blau, PhD, professor of microbiology and immunology. "This is the first time a drug treatment has been shown to affect both muscle fibers and the motor neurons that stimulate them to contract in order to speed healing and restore strength and muscle mass. It's unique."
Blau, the Donald E. and Delia B. Baxter Foundation Professor and director of the Baxter Laboratory for Stem Cell Biology, is the senior author of the study, which was published online Oct. 11 in Science Translational Medicine. Postdoctoral scholar Mohsen Bakooshli, PhD, and former postdoctoral scholar Yu Xin Wang, PhD, are the lead authors of the study. Wang is now an assistant professor at the Sanford Burnham Prebys Medical Discovery Institute in San Diego.
Addressing loss of strength
The finding is the latest from the Blau laboratory focused on understanding how muscles weaken from aging or disease, and whether it's possible to combat this decline. In 2021, the group showed that blocking the activity of 15-PGDH in 24-month-old laboratory mice significantly enhances the animals' leg strength and endurance when running on a treadmill. (Laboratory mice typically live about 26 to 30 months.) But it wasn't clear exactly how.
The new research shows that the effect is due to the restoration of lost connections between the nerves and the muscle. These connections, called neuromuscular junctions, are how the brain signals muscles to contract, allowing us to pick up a water glass, jog to the mailbox or hoist a toddler into a car seat. As we age, some of these connections are lost, causing muscle contractions to become less powerful and muscles to atrophy. People typically lose muscle mass and strength -- as much as 10% per decade -- after the age of 50.
Conditions other than aging can also destabilize these connections, including the disuse of muscles due to bedrest after illness or injury, or muscle-wasting diseases like spinal muscular atrophy or amyotrophic lateral sclerosis (also known as ALS).
Blau's previous research showed that a molecule called PGE2 is critical to the function of stem cells in muscle fibers that repair damage -- including the microtears from exercise that lead to an increase in muscle mass and strength. They subsequently showed that levels of 15-PGDH, which breaks down PGE2, increase in the muscles with age and that the loss of strength with aging could be overcome by inhibiting the activity of this PGE2-degrading enzyme.
"PGE2 is part of the body's natural healing mechanism, and its levels increase in muscle after injury," Blau said. "We wanted to learn how age triggers an increase in 15-PGDH, and therefore the degradation and loss of PGE2."
A lack of nerves
The researchers knew that muscles become less innervated, or infiltrated with nerves, as people and animals age. They wondered if that loss could be what triggers the rising levels of 15-PGDH.
"We found that when you cut the nerve that innervates the leg muscles of mice, the amount of 15-PGDH in the muscle increases rapidly and dramatically," Blau said. "This was an exciting new insight. But what surprised us most was that when these mice are treated with a drug that inhibits 15-PGDH activity, the nerve grows back and makes contact with the muscle more quickly than in control animals, and that this leads to a faster recovery of strength and function."
Additional experiments showed that treatment with the drug restored neuromuscular junctions lost during aging and increased muscle strength and function in old laboratory mice. The researchers also identified discrete clumps of 15-PGDH in the muscle fibers of people with several types of neuromuscular disorders suggesting that the gerozyme may have a role in causing these human disorders.
Blau and her colleagues plan to investigate at a molecular level how neural growth is stimulated by blocking 15-PGDH activity. Blau has also co-founded a company, Epirium Bio, to develop similar drugs for use in humans. Although her lab is still conducting animal studies, the company hopes to launch a clinical trial within the next year or so.
"Our next steps will be to examine whether blocking 15-PGDH function in people with spinal muscular atrophy can increase lost muscle strength in combination with gene therapy or other treatments," Blau said. "We are also looking at ALS to see if something like this might help these patients. It's really exciting that we are able to affect both muscle function and motor neuron growth."
The research was supported by the National Institutes of Health (grants K99NS120278, R00NS120278, R01-AG020961, R01-AG069858 and R01-RHG009674), the Canadian Institutes of Health, a Stanford Translational Research and Applied Medicine pilot grant, the Donald E. and Delia B. Baxter Foundation, the Li Ka Shing Foundation, the Milky Way Research Foundation and the California Institute for Regenerative Medicine.
Blau is an inventor on several patents related to the research and a co-founder, consultant and equity holder of Epirium Bio, which has licensed patents regarding 15-PGDH inhibition to improve muscle strength.
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The Digital Sisterhood provides a space where religion, faith, and community can mix with discussions about mental health, love, and the internet.Posted on June 10, 2022, 11:01 am This is an excerpt from Please Like Me, BuzzFeed News’ newsletter about how influencers are battling for your attention. You can sign up here.Podcasts voiced by Muslim women have often stayed in niche communities, but The Digital Sisterhood, a podcast launched last year, is on the brink of mainstream success.The series focuses on the empowerment of Muslim women and it has struck a chord with listeners all over the world for its discussions aimed at hyperconnected Gen Z and millennial Muslim women, often discussing taboo topics and building an online community whose members now attend offline events together.On Apple Podcasts, The Digital Sisterhood hit the fourth spot on the “Top New Show” chart and is currently No. 1 in the Islam & Spirituality category for the US, UK, New Zealand, and Australia. As of this spring, the podcast has reached 1 million downloads. The Digital Sisterhood gained more popularity during Ramadan, when many young Muslims try to observe their faith more. I first came across the pod at that exact time, as I cut back on music and replaced it with podcasts, including this one. The founder and host of the podcast is Cadar Mohamud, 29, from Toronto, who graduated university last year with a major in human rights and equity studies from York University.We spoke on a Zoom call, and if you’ve listened to a Digital Sisterhood episode, then you know that it usually involves tears, sometimes a lot of them, so it was entirely on brand that we both cried during our conversation.“The whole thing about TDS is that we are driven by empathy,” Mohamud said. “I really believe empathy can save the world. Call me corny.”The podcast came together after Muna Scekomar, a former intern for NPR’s Terrible, Thanks for Asking and founder of Beautiful Light Studios, approached Mohamud, after struggling to get story ideas about Black and Muslim people accepted elsewhere. On the podcast Mohamud has interviewed mainly Muslim women who have experienced different hardships in a raw, vulnerable way, and they talk about how their faith has helped them. The podcast hasn’t shied away from topics that might be seen as taboo by the Muslim community. Mohamud had her mom come on the podcast to talk about love; women have come on to talk about dealing with grief, how they dealt with their cancer diagnosis, and finding strength after sexual trauma and violence. And listeners are connecting with it. Alimat Diallo Mahmoud is a 28-year-old from New York who started listening to the podcast last year. “I was seasoning chicken very late into the night, and instead of opting for some Afrobeats or Bollywood jams, I wanted something else,” she said.“Whenever I would listen to an episode, it felt like I was in the studio with [Mohamud],” Mahmoud said. “At times it felt like pieces of my own story were being shared.”Mahmoud said episodes 2 and 3 — a two-part story about a woman named Hilaal, who ended up relocating to a new city due to her ~rebellious~ behavior, and then how she processed the death of a friend — broke her in the best ways. “Heartache, societal pressures, sadness, and love were the parts of her story that made me feel seen,” she said. “I remember listening to her cry and I cried along with her and Cadar. Her love for Allah and his words, Al-Qur’an, reaffirmed that I wasn’t alone.” There are very few publications and online spaces available for young Muslim women — perhaps minus joking on MuslimTok or on alt accounts on other social media platforms. The Digital Sisterhood provides a space where religion, faith, and community can mix with discussions about mental health, love, and the internet. Hafsah, a 21-year-old listener from Canada who asked that her last name not be published for privacy reasons, said she discovered The Digital Sisterhood through an Instagram story. Hafsah said she finds the stories relatable, but that two episodes featuring Hilaal are also ones she has returned to when she’s feeling low because they strengthened her connection to her religion. “Listening to Hilaal’s story and how she tied her healing so close to the Qur’an sparked something within me,” Hafsah said. “It made me realize that deep down I’ve had this passion to seek Islamic knowledge and begin my journey to memorizing the Qur’an.”Lamisah Chowdhury, 18, from London, found the podcast through social media and decided to start listening on her way to university, and was particularly drawn to Episode 19, where author Asmaa Hussien discusses love and longing.“It was how she overcame the tragedies that she lived through, was able to talk about it openly and now happy and successful after it,” Chowdhury said, explaining that the episode gave her hope at a time she personally needed it. Some cover dark topics. In Episode 13, a woman under the alias “Sabryna” spoke about her experience of being sexually assaulted. That interview resonated deeply with listeners. Mohamud noted that many people reached out asking if they could get in touch with Sabryna to share their own story and took comfort in hearing from other survivors of sexual assault.“You see the numbers, and it's a little bit alarming,” said Mohamud, who added it was often younger women and children reaching out about the episode, including one as young as 11. While Cadar and I spoke about the episode and the response it got from the community, Mohamud started to get tearful, and so did I.What was most powerful about Sabryna’s story was that she told listeners that what happened to them wasn’t their fault and reminded them of their worth — a message that is not always spoken about loudly in Muslim communities. “She's affirming the people who experienced this particular violence at this age group,” Mohamud said.Sabryna later created an Instagram account to talk to some of the listeners, but after a few weeks, she was overwhelmed and had to stop. “I am so sorry that you've all experienced this,” she posted. “But hearing your stories is particularly taking me to a really bad place, and I need a break.” Not all episodes are heavy, but listeners who may have experienced a similar situation as the guests of that episode often share that they go away feeling stronger. Running a faith-based podcast means focusing on building a community, said Mohamud, who is now running podcast events for The Digital Sisterhood across the US, including hosting live recording in a burqa, a far cry from the usual white man from Brooklyn podcast cliché. The podcast has led to a Discord server, whose more than 1,600 members talk about Islam and nonreligious related topics, such as anime, parenting, and cooking.“I understand that this work is not about gaining this and that,” Mohamud said. “I just want to do something that matters.” Having seen some of their older video clips, I asked if they plan on pivoting to video, like a lot of podcasts have nowadays, but Mohamud said any visual storytelling would be through illustrated art. “Our designs and our images are very animation-based because I wanted to avoid the objectification of women,” she said. “Obviously these women are telling intimate stories. I don't want them to also have to think, Do I look good?” Instead, the focus is exactly where it should be: on their stories. | Mental Health Treatments |
(CNN) The US Centers for Disease Control and Prevention said Friday that there is a possible safety issue with the bivalent Covid-19 vaccine made by Pfizer and BioNTech but that it is unlikely to represent a true risk. The agency said it continues to recommend that people stay up-to-date with Covid-19 vaccines. The CDC said one of its vaccine safety monitoring systems -- a "near real-time surveillance system" called the Vaccine Safety Datalink -- detected a possible increase in a certain kind of stroke in people 65 and older who recently got one of Pfizer's updated booster shots. A rapid response analysis of that signal revealed that seniors who got an bivalent booster might be more likely to have ischemic strokes within the first three weeks after their shots, compared with weeks four through six. Ischemic strokes, the most common form, are blockages of blood to the brain. They're usually caused by clots. The Vaccine Safety Datalink, or VSD, is a network of large health systems across the nation that provides data about the safety and efficacy of vaccines through patients' electronic health records. The CDC said it had identified possible confounding factors in the data coming from the VSD that may be biasing the data and need further investigation. Of about 550,000 seniors who got Pfizer bivalent boosters and were tracked by the VSD, 130 had strokes in the three weeks after the shot, according to a CDC official who spoke to CNN on condition of anonymity because they weren't authorized to share the data. None of the 130 people died. The number of strokes detected is relatively small, said Dr. William Schaffner, an infectious disease expert at Vanderbilt University and a member of the CDC Advisory Committee on Immunization Practices' Covid-19 Vaccine Work Group. "These strokes are not a confirmed adverse event at the moment," he said. "It's like a radar system. You're getting a blip on the radar, and you have to do further investigation to discover whether that airplane is friend or foe." The same safety signal has not been detected with the bivalent Moderna booster, the CDC said in its notice. The agency noted that it has looked for and failed to find the same increase in strokes in other large collections of medical records, including those maintained by Medicare, the US Department of Veterans Affairs, as well as its Vaccine Adverse Event Reporting System, known as VAERS. Neither Pfizer nor other countries that are using the vaccine have seen any increase in this kind of stroke, the agency said, and the signal was not detected in any other databases. The CDC says that it does not recommend any change to vaccination practices at this time and that the risks of Covid-19 for older adults continue to outweigh any possible safety issues with the vaccine. "Although the totality of the data currently suggests that it is very unlikely that the signal in VSD represents a true clinical risk, we believe it is important to share this information with the public, as we have in the past, when one of our safety monitoring systems detects a signal," the notice says. "CDC and FDA will continue to evaluate additional data from these and other vaccine safety systems. These data and additional analyses will be discussed at the upcoming January 26 meeting of the FDA's Vaccines and Related Biological Products Advisory Committee." Pfizer said in a statement Friday, "Neither Pfizer and BioNTech nor the CDC or the U.S. Food and Drug Administration (FDA) have observed similar findings across numerous other monitoring systems in the U.S. and globally and there is no evidence to conclude that ischemic stroke is associated with the use of the companies' COVID-19 vaccines. "Compared to published incidence rates of ischemic stroke in this older population, the companies to date have observed a lower number of reported ischemic strokes following the vaccination with the Omicron BA.4/BA.5-adapted bivalent vaccine." The bivalent boosters from Pfizer/BioNTech and Moderna protect against the original strain of the coronavirus as well as the Omicron BA.4 and BA.5 subvariants. Only about 50 million Americans ages 5 and up have gotten them since they were authorized last fall, according to CDC data. Schaffner said he was part of a briefing Thursday with members of the Covid-19 Vaccine Work Group. He couldn't share specific details about the briefing but said the safety signal was discussed. His biggest takeaway was that the safety surveillance system is working. It's very likely that this is a false signal, he said, but it's being investigated, which is important. "You want a surveillance system that occasionally sends up false signals. If you don't get any signals, you're worried that you're missing stuff." Schaffner said he would absolutely tell people to get their Covid-19 booster if they haven't done so yet -- even those 65 and older. "Undoubtedly, the risk of a whole series of adverse events, including hospitalization, is much, much greater with Covid-19 than it is from the vaccine," he said. He also said the signal -- if real -- may be more a factor of numbers than an indication that one manufacturer's vaccine is riskier than the other. Nearly two-thirds of the people in the US who've gotten an updated booster -- 32 million -- have gotten Pfizer, compared with about 18 million Moderna shots. | Vaccine Development |
Amy Schumer is getting candid about the side effects of Ozempic.
While the comedian "immediately invested" in the type 2 diabetes medication—which is now being popularly used as a weight-loss drugs in Hollywood—about a year ago, she said it left her unable to spend time with her and husband Chris Fischer's 4-year-old son, Gene.
"I was one of those people that felt so sick and couldn't play with my son," Amy explained on Watch What Happens Live with Andy Cohen on June 8, "I was so skinny, and he's throwing a ball at me and [I couldn't]."
Ultimately, the Trainwreck star decided using Ozempic was not "livable" for her. Nonetheless, she's still urging other celebrities to come clean about taking Ozempic.
"Everyone and their mom is gonna try it. Everyone has been lying saying, 'Oh, smaller portions,'" she continued. "Like, shut the f--k up. You are on Ozempic or one of those things, or you got work done. Just stop."
She added, "Be real with the people. When I got lipo, I said I got lipo."
Gracie said on Instagram she used Ozempic to assist with her polycystic ovary syndrome diagnosis, while Chelsea revealed in January that she was prescribed the medication.
"My anti-aging doctor just hands it out to anybody," the 47-year-old said on Call Her Daddy. "I didn't even know I was on it. She said, 'If you ever want to drop five pounds, this is good.'"
As for Golnesa, she was open about using injection shots of Semaglutide—the generic version of Ozempic—for weight loss.
"I don't see a reason to hide being on a weight loss [medication] or a cosmetic procedure," the Shahs of Sunset star told Entertainment Tonight last month, "just talk about it because there's so many people out there who want to do the same thing or they want to learn about what you did."
A rep for the pharmaceutical company Novo Nordisk, which makes Ozempic, previously told E! News in a statement that Ozempic is "not approved for chronic weight management." The organization said that Ozempic is intended to treat type 2 diabetes, improve blood sugar and minimize risks of major cardiovascular events for adults with the condition.
For the latest breaking news updates, click here to download the E! News App | Drug Discoveries |
Scientists recently investigated the use of neurofeedback training to help individuals with post-traumatic stress disorder (PTSD) regulate activity in their amygdala, a brain region which plays a key role in fear responses. Their findings, published in Translational Psychiatry, showed that the participants who received neurofeedback training were able to gain better control over their amygdala activity after recalling traumatic events.
PTSD is a debilitating disorder characterized by symptoms such as re-experiencing traumatic events, avoiding triggers, changes in mood and cognition, and heightened arousal.
Previous studies have suggested that reducing amygdala activity could lead to symptom reduction in PTSD. Psychotherapy and MDMA treatments have shown promising results in decreasing amygdala activity and improving symptoms. Based on these findings, the researchers hypothesized that training individuals with PTSD to control their amygdala activity using neurofeedback could be an effective treatment approach.
“PTSD seems like a promising disorder to target via neurofeedback because it is a disorder in which unhealthy brain patterns are learned during or following trauma exposure,” said study author Michelle Hampson, a professor of radiology and biomedical imaging at Yale School of Medicine and editor of “fMRI Neurofeedback.”
“This suggests the circuitry giving rise to PTSD symptoms is plastic and can be altered via natural learning. For this reason, I was hopeful that neurofeedback would be effective at training the brain circuitry involved towards healthier function. Also, neurofeedback is an empowering mental health intervention that I believe will appeal to PTSD patients.”
The study was conducted as a double-blind, randomized clinical trial with a total of 24 participants with chronic PTSD. Participants were recruited through online advertisements and community outreach. They underwent screening using standardized clinical interviews to confirm the diagnosis of PTSD.
Personal traumatic experiences were collected from each participant, and audio clips were created to evoke memories of these traumatic events. The brain imaging sessions were conducted using a 3-Tesla MRI system, and real-time fMRI neurofeedback was provided using specialized software.
Participants were randomly assigned to either the active group or the control group. The active group received real neurofeedback based on their amygdala activity, while the control group received sham feedback matched to a participant from the active group.
Before the neurofeedback sessions began, both groups of participants had a strategy development session with a clinical psychologist who was unaware of their group assignment. The purpose of this session was to provide participants with individualized mental strategies that could help them reduce their amygdala activity and anxiety levels after recalling traumatic events during the neurofeedback training.
The strategies discussed during this session included mental strategies such as progressive relaxation, mindfulness, and reappraisal of emotions. These are common approaches that have been shown to be effective in managing anxiety and regulating emotions.
During the neurofeedback training sessions, participants were instructed to downregulate their amygdala activity while listening to their personalized trauma scripts. The training sessions consisted of three sessions with six runs per session.
Participants were instructed to assess the success of each mental strategy they employed based on the feedback signal they received. The feedback signal provided real-time information about their amygdala activity, allowing them to see how well they were able to downregulate their amygdala. This process of trial and error helped participants identify and practice the most effective strategies for themselves.
To assess the effectiveness of the neurofeedback training, participants completed tasks before and after the sessions to measure their control over amygdala activity. They also completed clinical assessments of PTSD symptoms at multiple time points. Resting-state functional connectivity of the amygdala was measured pre-training, post-training, and 30 days post-training.
The researchers found that participants who received the neurofeedback training demonstrated improved control over their amygdala activity after recalling traumatic events.
Both the active group (neurofeedback training) and the control group (no neurofeedback training) in this study showed reductions in PTSD symptoms. Although the active group showed greater improvements, the difference between the two groups was not statistically significant, which might be a result of the relatively small sample size.
“The finding that neurofeedback enabled participants to better control their amygdala activity following trauma exposure suggests that neurofeedback has promise for helping individuals with PTSD learn to control the brain circuitry involved in emotional processing of their traumas,” Hampson told PsyPost. “It is important to bear in mind that our study was a small, early stage research study and does not provide evidence of clinical efficacy.”
“However, the findings are consistent with a growing body of early stage research that suggests neurofeedback targeting amygdala activity has the potential to be developed into an effective treatment for PTSD. The promising results we are seeing in this early stage research should motivate larger, well-controlled clinical trials that, if successful, may establish clinical efficacy.”
The researchers also noted that the COVID-19 pandemic occurred during the study, which could have influenced the participants’ clinical progress.
“The nonspecific effects were surprisingly large: participants in both groups in the study showed substantial improvements in symptoms. It’s not clear if this was related to the intervention running during the pandemic. That is, perhaps participation was particularly therapeutic in the context of ongoing social isolation,” Hampson explained.
“On the other hand, the large symptom improvements seen for both groups may be a result of the trauma exposure aspect of our training protocol. Trauma exposure is known to be therapeutic, indeed, exposure therapy is the frontline treatment for PTSD. Our study had very limited levels of trauma exposure compared to traditional therapy, but perhaps these limited levels are still highly therapeutic?”
Further research with a larger sample size is needed to evaluate if neurofeedback provides specific clinical benefits beyond the non-specific effects of the intervention. “Large, well-controlled trials are needed to establish efficacy, and explore which individuals are most likely to benefit from this kind of intervention,” Hampson said.
The study, “Amygdala downregulation training using fMRI neurofeedback in post-traumatic stress disorder: a randomized, double-blind trial“, was authored by Zhiying Zhao, Or Duek, Rebecca Seidemann, Charles Gordon, Christopher Walsh, Emma Romaker, William N. Koller, Mark Horvath, Jitendra Awasthi, Yao Wang, Erin O’Brien, Harlan Fichtenholtz, Michelle Hampson, and Ilan Harpaz-Rotem. | Mental Health Treatments |
The relatively new COVID-19 omicron subvariant XBB1.5 "is the most easily transmissible subvariant so far," Dr. Marc Siegel, a Fox News medical contributor, told Fox News Digital on Tuesday evening.That is because "it not only binds well to cells, but it is also the most immunoevasive," said Siegel, who is also a professor of medicine at NYU Langone Medical Center in New York City.The subvariant — now nicknamed "Kraken" by some — is spreading across the globe, too. NEW COVID OMICRON SUBVARIANT XBB.1.5 IS ‘SPREADING LIKE WILDFIRE’ IN US: HEALTH EXPERTS REVEAL WHYMaria Van Kerkhove, Ph.D, technical lead of the World Health Organization, said XBB1.5 is "the most transmissible subvariant that has been detected yet," WebMD reported.Though this subvariant continues to spread at a faster pace than other versions of COVID-19 did, the Centers for Disease Control and Prevention (CDC) on Friday did revise downward its estimate of how much XBB1.5 is circulating in the U.S. A medical technician performs a nasal swab test on a patient. (Getty Images)The CDC had previously said that XBB1.5 made up some 41% of sequenced cases for the week ending Dec. 31 — more than any other variant.However, the XBB1.5 subvariant comprised 27.6% of sequenced COVID cases nationally for the week ending Jan. 7, 2023 — compared with 18.3% for the week ending Dec. 31, the CDC said on Friday."The number of cases is far greater than anyone is reporting because of all the home tests that aren't being counted." Dr. Siegel also told Fox News Digital that while the XBB1.5 subvariant is immunoevasive, "studies show that the bivalent vaccine and recent immunity from [COVID] infection are both effective at decreasing severity and hospitalization" due to the virus."Not only that," Siegel continued, "but there is evidence that this immunity also decreases transmission of the virus to some extent in the short term."Dr. Siegel added, "The number of cases is far greater than anyone is reporting because of all the home tests that aren't being counted." XBB1.5 remains the only omicron subvariant showing significant growth in the U.S. right now, according to multiple reports. The CDC shares a "prevention action plan" on its site that includes staying up-to-date on vaccination. (Paul Hennessy/SOPA Images/LightRocket via Getty Images)"This means that overall, the subvariant remains mild — and if the number of hospitalizations are increasing, it is because of the sheer number of cases."Siegel added, "So far there are no monoclonal antibodies that work against it, so we are relying on Paxlovid as a mainstay of treatment."He emphasized that "one treatment that has been completely overlooked throughout the pandemic is convalescent plasma (collected after recent infection)."The CDC points out that "projections can be uncertain when a variant is just beginning to spread." Dr. Siegel said this treatment "is once again receiving attention because we don't have the synthetic antibodies to use against this."XBB1.5 remains the only omicron subvariant showing significant growth in the U.S. right now, according to multiple reports. It is second only to omicron BQ.1.1, according to the CDC.MAJOR FOOD BRANDS ARE ADDING SESAME TO ITEMS IN ‘SHORTCUT’ AFTER FDA DECLARES THE SEED A ‘MAJOR ALLERGEN’On its website, the CDC points out that "projections can be uncertain when a variant is just beginning to spread." When XBB1.5 infections were predicted at 41%, "there was a wide prediction range of about 23% to 61%," said the CDC. "Since then, more data have come in from mid-December, as well as additional data delayed by the holidays." The CDC had previously said that XBB1.5 made up some 41% of sequenced cases for the week ending Dec. 31 — more than any other variant. However, the XBB1.5 subvariant comprised 27.6% of sequenced COVID cases nationally for the week ending Jan. 7, 2023 — compared with 18.3% for the week ending Dec. 31, the CDC said this past Friday. (iStock)The CDC added, "As a result, the projection for the week ending December 31 was revised to 18%, but with a higher degree of certainty (prediction range of 9% to 33%), followed by an increase to 28% for the most recent week of January 6 (prediction range of 14% to 47%)."Overall, the CDC said, "these findings demonstrate that XBB1.5 is spreading quickly."In terms of treatment, the CDC said its COVID guidance "remains the same about how people can best protect themselves from serious illness."PENTAGON DITCHES COVID VACCINE MANDATE FOR TROOPSThe CDC recommends basic health and hygiene practices, such as hand-washing and improved ventilation.It also recommends staying up-to-date with vaccination; getting tested for COVID-19 if needed; staying home if you suspect you have COVID or have confirmation that you have COVID; seeking treatment if you have the virus and are "at high risk of getting very sick"; and avoiding those who have suspected or confirmed cases of COVID. CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTERDr. Ashish K. Jha, M.D., MPH, the White House COVID response coordinator, said people should stay up-to-date on booster shots. He also urged people to wear snug-fitting masks and avoid crowded indoor spaces, WebMD reported.Jha also tweeted on Jan. 4, "So am I concerned about XBB1.5? Yes. Am I worried this represents some huge setback? No. We can work together to manage the virus. And if we all do our part, we can reduce the impact it will have on our lives."CLICK HERE TO GET THE FOX NEWS APPAs always, anyone with questions about risks or symptoms should check with a health care provider or medical professional. Maureen Mackey is managing editor of lifestyle for Fox News Digital. | Epidemics & Outbreaks |
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You have 3,000+ different kinds of brain cells, and more insights from the largest human brain cell atlases created to date
By Rachel Tompa, Ph.D. / Allen Institute
10.12.2023
5 min read
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Scientists have just unveiled a massive effort to understand our own brains and those of our closest primate relatives.
In a suite of 21 papers published today in the journals Science (12), Science Advances (8), and Science Translational Medicine (1), a large consortium of researchers shares new knowledge about the cells that make up our brains and the brains of other primates. It’s a huge leap from previously published work, with studies and data that reveal new insights about our nervous systems’ cellular makeup across many regions of the brain and what is distinctive about the human brain.
The research consortium is a concerted effort to understand the human brain and its modular, functional nature. It was brought together and is funded by the National Institutes of Health’s Brain Research Through Advancing Innovative Neurotechnologies® (BRAIN) Initiative. Hundreds of scientists from around the world worked together to complete a range of studies exploring the cellular makeup of the human brain and those of other primates, and to demonstrate how a transformative new suite of scalable techniques can be used to study the detailed organization of the human brain at unprecedented resolution.
Understanding our brain at the cellular level is key to understanding how our brains function and who we are as a species, as well as more accurately pinpointing the cellular roots of brain diseases and disorders — knowledge that could ultimately lead to better treatments for those diseases.
The present suite of studies represents a landmark achievement that continues to build an important bridge toward illuminating the complexity of the human brain at the cellular level
Dr. John Ngai
Director of the NIH BRAIN Initiative
Scientists at the Allen Institute for Brain Science, a division of the Allen Institute, led five of these studies and made significant contributions to three others, including a study that greatly expands on existing knowledge about the number of types of cells in the adult human brain. Scientists at Karolinska Institute and the Allen Institute studied the genes switched on in individual brain cells, a technique known as single-cell transcriptomics, revealing an astonishing diversity of cell types: we have more than 3,000 different kinds of brain cells.
“I view this as a pivotal moment in neuroscience, where new technologies are now allowing us to understand the very detailed cellular organization of the human brain and of other primate brains,” said Ed Lein, Ph.D., Senior Investigator at the Allen Institute for Brain Science, who led several of the newly published studies. “At its core, this body of work is a triumph of molecular biology: Differential gene usage can be used to define cell types, and the tools of genomics could be used to create the first drafts of high-resolution, annotated maps of the cells that make up the entire human brain.”
The studies also tackle a range of important questions such as: How different are individual people’s brains at the cellular level? How different are our brains from those of our closest ape relatives? How many kinds of brain cells do we have? What are the properties of these cells? How do these cells emerge and mature in development?
Building off previous work mapping brain cell types in high resolution in single regions of the human cortex, the outermost shell of the brain, the newly published package expands those studies to dozens up to a hundred regions across the entire brain. Where the single region studies found over 100 different brain cell types, the newly released data shows thousands of different kinds of brain cells across the entire brain. For many parts of the brain, that complexity and variety had never before been described.
These studies are part of the NIH’s BRAIN Initiative Cell Census Network, or BICCN, a five-year funding program that was launched in 2017 to create a catalog of brain cell types. This body of work demonstrated the scalability of cutting edge cellular and molecular approaches to tackle the challenges of size and complexity of the human brain, and has set the stage for the next phase of this cell census effort. This next phase, part of which is underway at the Allen Institute, will build much more comprehensive atlases of human and other primate brains through the BRAIN Initiative’s Cell Atlas Network, or BICAN.
“The present suite of studies represents a landmark achievement that continues to build an important bridge toward illuminating the complexity of the human brain at the cellular level,” said Dr. John Ngai, Director of the NIH BRAIN Initiative. “The scientific collaborations forged through BICCN, and continuing in the next phase in BICAN, are propelling the field forward at an exponential pace; the progress – and possibilities – have been simply breathtaking.”
The human studies used postmortem tissue from people who had donated their brains to science, as well as healthy living tissue donated from patients who had undergone brain surgery and donated tissue to research.
The data from the newly released studies will also feed into the Human Cell Atlas, an international effort that is building a comprehensive reference atlas of cells across all organs, tissues, and systems of the human body.
The five Allen Institute-led studies include:
Research reported here was supported by the National Institutes of Health Brain Research Through Advancing Innovative Neurotechnologies® (BRAIN) Initiative. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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The Allen Institute for Brain Science is a division of the Allen Institute, an independent, 501(c)(3) nonprofit medical research organization, and is dedicated to accelerating the understanding of how the human brain works in health and disease. Using a big science approach, the Allen Institute generates useful public resources used by researchers and organizations around the globe, drives technological and analytical advances, and discovers fundamental brain properties through integration of experiments, modeling and theory. Launched in 2003 with a seed contribution from founder and philanthropist, the late Paul G. Allen, the Allen Institute is supported by a diversity of government, foundation and private funds to enable its projects. The Allen Institute for Brain Science’s data and tools are publicly available online at brain-map.org. | Disease Research |
Rishi Sunak has announced a plan to increase the number of people working for the NHS in England, which he says will put the service on a secure footing for the long-term. But despite the prime minister's pledge there are still many questions.
Will it work?
That answer is yes for recruitment, though with a caveat.
The plan is funded for the first five years but for 10 years after that there is an assumption that future governments will find the money to keep up with the required growth in training places.
It is hard to believe a new administration would dilute NHS workforce growth and the training of thousands more doctors and nurses.
But, never say never when it comes to public finances.
Expanding the number of clinical staff to the extent which is envisaged in the plan will eventually have a positive impact for patients - but retention will be a bigger ask.
The plan's policies to improve morale and hang on to staff look a little vague. Recruitment will not achieve much if there is a continued exodus at the same rate as now.
Is it the right approach?
Recruit and retain have long been held up as the required twin-track approach for the NHS.
Health think tanks and charities were queueing up to welcome the plan as it had adopted the policies called for by most experts.
Then again the enthusiasm must in part have been relief that at long last there was an NHS workforce plan after nothing comparable in the previous two decades.
Modelling of future patient demand seems reasonable and health think tanks were invited to kick the tyres of the numbers.
Productivity assumptions were included. Some of the medical Royal Colleges have noted the plan is ambitious and they want to see more detail.
The idea of medical apprenticeships is radical with staff in other NHS jobs training to be doctors.
But, the precise workings of this scheme will need time to work out.
Why is pay not part of the plan?
Pay is certainly the elephant in the room.
Most large organisations drawing up a workforce plan would have a section on appropriate remuneration to attract and motivate the best staff.
That is one thing NHS England can't do with its strategy.
NHS pay is the preserve of the government and it is ministers who decide. Most of the NHS pay disputes have been settled but the doctors' campaign is far from over with further strikes planned.
Health unions have long argued that the best way to hold on to staff is to raise wages at a time of acute cost of living pressures.
Senior management have had to stand on the side-lines of the argument and cope with the consequences of walkouts.
Is it going to make a difference?
In the short-term - no, when it comes to raising the number of doctors, nurses and other health staff.
It takes several years to train clinical professionals and the expansion of new places at medical schools and universities won't begin until the autumn of 2024.
Implementation may be slowed if there are not enough experienced doctors and nurses to set aside time to run the training.
Retention initiatives aimed at reducing the number of NHS staff quitting might make a bit of a difference over the next year or so.
But, patients currently frustrated at not getting a GP appointment or are on a long waiting list for an operation probably won't notice.
Is now not the time for a broader strategy?
Planning the training of tens of thousands of health staff right through till beyond 2030 is admirable.
There has been nothing comparable in recent years with only sporadic time-limited initiatives.
But, what will the rest of the NHS look line by then? Will the service have kept up with the increasing burden of sickness linked to an ageing population?
Will the public be willing to keep funding the NHS through taxation? Might payment for some services have been introduced? How much difference will technology and AI make?
There is no long-term plan for investment in buildings and IT - in other words the hospitals and clinics where the new staff will work and the computers they will use.
Perhaps the publication of a multi-year workforce plan will spur politicians to come up with broader strategies for health funding and reform over a decade or more.
But don't hold your breath. | Health Policy |
Covid hospital admissions have plateaued ahead of another expected wave fuelled by 'the Kraken' variant, figures suggest.NHS stats show virus pressures peaked in mid-December, when XBB-1.5 first started to be detected across Britain, and have been falling ever since. Flu admissions also plunged during the last week of 2022.Experts hope both drops are genuine, with ailing hospitals currently being battered by a 'twindemic' that has sparked calls for a return of pandemic-era restrictions like face masks and mass testing. But officials admit the downturn could be a blip caused by reporting delays over the Christmas period. The graph shows the weekly hospital admissions per 100,000 people for Covid (red) and flu (blue). UK Health Security Agency surveillance figures showed Covid admissions feel from 12 to 11 per 100,000 people, while admissions fell to 8 per 100,000 in the week to January 1 The flu-nami has swept across the NHS in England, the latest round of health service data shows, with over 3,800 admissions for the virus on December 23. Graph shows the number of beds on wards taken up by those with flu (red) and the number of beds occupied due to the virus in critical care (blue) NHS England data today showed that an average of 63,000 staff were off work every day in the week to Christmas (red line). Around 8,000 of the absences were due to Covid (blue line) Ambulance handover delays peaked on December 19 with more than 3,000 patients forced to wait over an hour in the back of an emergency vehicle, unable to be offloaded to a hospital bedThe massive strain on the NHS, triggered by staff shortages and record levels of bed-blockers as well as Covid and flu, has led to a surge in excess deaths, analysts fear. Almost 15,000 people died in England and Wales in the week before Christmas when the pressures across the health service were described as being their most intense. Fatalities were around a fifth higher than typically seen at the time of year before the pandemic.The Royal College of Emergency Medicine (RCEM) warned the spike in deaths are 'undoubtedly' linked to record delays for urgent care.NHS data shows 995 people, on average, infected with Covid were admitted to hospitals across England in the week to January 2.The figures suggest that the number of people seeking NHS care due to the virus, on average, peaked on December 23 (1,154) and has been trending downwards since.The numbers include patients who aren't actually ill with the virus and incidentally tested positive. On top of this, weekly UK Health Security Agency (UKHSA) surveillance figures showed Covid admissions feel from 12 to 11 per 100,000 people.Rates for Covid admissions were highest among the elderly, at 131 per 100,000 for over-85s and 52 per 100,000 for those aged 75 to 84.Separate UKHSA data, also published today, suggest that influenza admissions have fallen drastically over the festive period.Hospitalisations for influenza soared to the highest level seen in a decade in the week before Christmas, with 15 admissions per 100,000 people. But admissions nearly halved in the week to January 1, hitting 8 per 100,000.Flu hospitalisations continue to be highest among the oldest age groups, at 62 per 100,000 for people aged 85 and over and 32 per 100,000 for 75- to 84-year-olds.Despite the drop, health chiefs warn that the rate is still running above any point in the previous four winters.And there can often be a slight reduction in recorded levels of hospital activity over the festive period, which this winter included the weekend of December 24 and 25 followed by bank holidays on both December 26 and 27.So the latest data might have been affected by some hospitals not returning a full set of figures, together with 'reporting delays and bank holidays over Christmas and New Year', the UKHSA said.But there may also have been a temporary reduction in the transmission of viruses due to 'reductions in social contact rates over the holiday', with fewer people travelling and many communal buildings closed, the agency said. Figures from the Sanger Institute, one of the UK's largest Covid surveillance centres, shows 4 per cent of cases in the week to December 17 were caused by XBB.1.5 (shown in purple, bottom right corner) December 17 marked the first time XBB.1.5 was listed on the institute's virus dashboard, which is updated weeklySteve Russell, the health service's director of vaccinations and screening, said the NHS had delivered almost 20million flu jabs to around four in five over-65s. It means 13million have not come forward for the vaccine. But flu admissions 'continue to be very high' so it 'remains vital' that anyone eligible — including pregnant women and children aged two and three — who have not had their flu jab book one as soon as possible.UKHSA chief executive Dame Jenny Harries said there had been a 'dramatic increase' in the number of flu admissions before Christmas, but they have started to fall in recent days.She said: 'I urge all those eligible to come forward for their free flu vaccination, which is the best way to protect yourself from serious illness.'Uptake of the flu vaccine is particularly low in children aged two and three, so if your child is eligible, please urgently take up the offer.'Covid also continues to circulate at high levels and anyone eligible for a booster who has yet to take it up should come forward.'Dame Jenny added: 'Try to stay home when unwell and if you do have to go out, wearing a face covering can help prevent germs spreading to other people. Don't visit vulnerable people if you're unwell.' In response to the surge in seasonal viruses and in a plea to reduce pressure on the NHS, health chiefs issued fresh calls for ill Britons to stay off work if they are unwell and wear a mask if they must go outside. Children who are sick and have a fever should stay home from school, UKHSA bosses said.Other gloomier experts have gone even further amid record pressures on the NHS an the emergence of Omicron sub-variant XBB.1.5, which has been labelled the most contagious strain yet by World Health Organization officials. Some scientists urged people to work from home where possible, reduce their social contacts and wear masks in crowded places, even if they are not ill. But a group of Tory MPs and scientists have dismissed these calls, however. They warned that the NHS's annual winter crisis can't be used as an 'excuse to reintroduce Covid-era restrictions'. | Epidemics & Outbreaks |
At Johnnie Cochran Middle School in Los Angeles this spring, three students suffered from a suspected overdose on the same day. School personnel quickly sprayed a substance up the noses of the children, and they revived. They were taken to the hospital as a precaution, but all three recovered.
The life-saving substance? Naloxone – a nasal spray also sold under the brand name Narcan — that works to reverse the effects of opioids.
Most often it works to combat fentanyl, a drug that is up to 50 times more potent than heroin. The fentanyl crisis around the country has created special challenges for schools and is having tragic consequences for young people.
"Never would I have imagined that students would today have contact with a substance where even just a small bit of a pill could kill you," says Alberto Carvalho, superintendent of the Los Angeles Unified School District.
LAUSD, the second largest district in the country, is an early adopter of using naloxone in schools. The 2022-23 school year was the first year they stocked it in all schools. The move came in response to a 15 year-old student dying from an overdose in a school bathroom nearly a year ago.
Last school year, naloxone was administered 31 times in the school system. "That's 31 times that we possibly saved a life," Carvalho says.
Which may sound like a big number, but in the Prince George's County, Md., schools outside Washington, D.C., officials there used it even more.
"I'm going to say 45," says Richard Moody, the director of alcohol, tobacco and drug prevention intervention for the district. That's more than once a week.
Prince George's County officials are trying to get naloxone everywhere they can. This year is the first time it's officially in all of its schools, and, like LAUSD, the district is now allowing students to carry the spray themselves.
The medicine itself is a small nose spray that experts say is easy to dispense. It's a fast-acting counteragent to an opioid overdose. In some places – including public libraries in large cities like Chicago and Philadelphia, it's available for free.
A national movement to get naloxone in schools is gaining momentum. An NPR analysis found that, last school year, only 5 of the 20 largest school districts in the country stocked naloxone in all of their schools. This year, 11 of 20 do. Three more told NPR that getting the medicine in every school is a priority.
A dangerous game
That's because fentanyl is killing kids at an alarming rate. In 2021, the drug was involved in the large majority of all teen overdose deaths – 84% – according to the Centers for Disease Control and Prevention. Fentanyl-related overdose deaths among adolescents nearly tripled from 2019 to 2021, with nearly a quarter of those deaths involving counterfeit pills.
"But we know that all of the circumstances and things we look at are underestimates," says Julie O'Connell, an epidemiologist and lead author on the CDC's most recent report on counterfeit pills.
She says that, for a particular incident to be counted in their data, there has to be physical evidence at the scene, or a witness has to come forward.
In short, there are lots of cases falling through the cracks: "We know that it's a bit higher," than what CDC reports, O'Connell says. "We just don't know how much."
How to train a community
The CDC firmly encourages naloxone as a solution for a suspected overdose, and provides fact sheets and training materials on its website. Training to dispense the drug is a large part of the challenge schools face in adopting it.
"It's not as simple as just saying, 'Hey, we're going to have Naloxone in our school tomorrow,' " says Kate King, a school nurse in Columbus, Ohio, and the president of the National Association of School Nurses. She looks at the drug as a tool – but a tool that requires procedures and protocols.
Some districts agree. Michael Ollendorff, a spokesperson for the Orange County public schools in central Florida, said his immediate response to the question of whether or not the district stocks naloxone was "no." But later, he explained that at least one person on school grounds does have it – the school resource officer. SROs in Florida are law enforcement officers who partner with the school. The schools themselves, including the nurses, don't keep naloxone on hand, Ollendorff said.
In Prince George's County, Moody agrees that training is important, but thinks that the knowledge should be spread as far and wide as possible. He has spent the past few years trying to get that training out to as many community members as possible – visiting 80 schools.
To him and many educators, there's no time to waste. | Epidemics & Outbreaks |
Having a twice-a-week yoga practice has recently been shown to be effective at reducing symptoms of fatigue in people with cancer, as well as reducing the likelihood of a beaten cancer from returning.
18 million people around the world develop various forms of cancer every year, and it’s well known that physical inactivity increases the risk of getting cancer.
On top of that, it’s known that most forms of exercise prevent it—the same is true for yoga, which was just the subject of an investigation by what the Guardian newspaper called “the world’s leading cancer researchers.”
Three studies presented at the annual meeting of the American Society of Clinical Oncology (ASCO), the world’s largest cancer conference, together suggest that prescribing rest for a patient suffering from low energy levels or fatigue is not the best health measure.
In one of the studies, directed by the University of Rochester Medical Centre, 500 cancer patients that had received a treatment program for their cancer between 2 weeks and 5 years in the past were randomly assigned to either a control group or an intervention group that involved two 75-minute yoga classes per week.
“Our data suggest that yoga significantly reduces inflammation among cancer survivors,” the study’s authors wrote in a report published at the ASCO meeting. “Clinicians should consider prescribing yoga for survivors experiencing inflammation, which may lead to a high chronic toxicity burden and increased risk of progression, recurrence, and second cancers.”
One of the many, many societal benefits enjoyed worldwide from the existence of Indian culture, yoga is probably the best form of low-intensity exercise available to a human, as it increases heart rate, engages whole muscle groups, and deepens the breath.
“What I say to doctors is you should recommend to them [cancer patients] yoga as an option and you should help them find places in their community where they can do it,” Karen Mustian, the paper’s lead researcher, told the Guardian.
MORE FUNCTIONAL MEDICINE: Man’s Biological Clock Set Back 10 Years After 93 Days Living Under the Ocean in a Research Station
In the second study, also led by Rochester, researchers examined yoga’s impact on fatigue and quality of life.
Senior cancer patients who attended the same yoga class schedule showed lower levels of fatigue and reported higher statistically significant levels of life satisfaction.
A third study found cancer patients who are classified as “active” such as those who might take a 30-minute brisk walk, have a reduced risk of death by almost one-fifth.
“We also have to educate the family,” said Dr. Jurema Telles de Oliveira Lima, who oversaw the third study. “Because it’s very common that the family wants to protect the older person when they have cancer, like: ‘I’m not going to let him do anything or go anywhere.’ We have to tell the family that it [physical activity] can be best for the patient and also on a psychological level as well.”
SHARE This Important Cancer Health And Yoga News With Your Friends… | Stress and Wellness |
In a makeshift container village around an area known as the barracks in Zurich, addicts can consume drugs in a protected environment.
The problem became apparent this summer: an open drug scene had spread in Zurich's District 4. Addicts had set up shop at a park in the city centre and openly consumed the cheap drug, crack.
It was assumed that the closure of a drop-in centre where addicts can consume drugs in a protected environment was responsible for this.
Now the city of Zurich has reacted and is putting a new, temporary location into operation on Thursday - after a long and intensive search. The city has built a container village on the barracks area, close to Zurich main train station, where severely addicted people can now consume crack.
Notably, this is the same location where the former drop-in centre was closed to make room for asylum seekers. Now the problem of the open drug scene on in the area is to be defused with a temporary solution.
Central location of great importance
For Zurich's social director Raphael Golta, it is important that there is now a contact point in the centre of the city again. The alternative location at Allmend on the outskirts of the city was too far for many addicts, which is why they moved to the centrally located area.
“These people are there, these people need support,” said Golta. “And to ensure that the problem in public spaces doesn’t get bigger again, such institutions are needed.”
The facility offers space for 60 people. After 30 minutes, however, the drug addicts have to leave the protected, so-called inhalation room again to make room for the next addicts.
The city expects up to 300 people a day. “If possible, there should be no waiting times so that addicts don’t go back to using on the streets,” says Florian Meyer, head of the city’s contact and contact points.
In order to come down again, drug addicts are provided with sofas, drinks and food. You can also take a shower or wash your clothes. “The main goal is to reduce damage,” says Meyer. This also means that micro-trafficking in drugs is tolerated so that it does not take place on the streets.
The provisional arrangement remains for two years
The problem of the open drug scene will not be solved with this measure, emphasizes Zurich city councilor Raphael Golta. “We can't sit back. We have to be ready to adapt our instruments again and again if the situation requires it.”
The container system will now remain on the meadow area for two years. After that, another temporary arrangement is planned before the contact point finally moves into a room in the barracks in 2030. The approximately 1,000 addicts in the city were informed about the opening last week.
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Still, the stigma surrounding HIV hasnât disappeared. Misconceptions about how the virus spreads and who is at risk still abound.
Four people with HIV share what they want you to know about the realities of living with the virus.
Vince Crisostomo: More Than 3 Decades With HIV
I've been HIV-positive for 34 years. It seems weird to talk about being an older person with HIV because I wasn't expected to live to 30. And now I'm 60.
I was infected in 1987, but I didn't find out officially until I was tested in 1989. There was a rumor going around that Asian people didn't get HIV, so I didn't think I was going to be positive.
I remember that the doctor blurted out, âYou're HIV positive.â
I asked, "Am I going to die?" And she said, "Most likely you won't live to see 30." There was no treatment at the time. There was nothing. It was a totally different time.
I was the first one in my little group of friends to test positive. It was challenging. My friends and I used to go out for meals. I noticed that if I took something off a plate, nobody ate after me. If I smoked a cigarette, nobody smoked after me. If you were gay, people didn't want you to be around their children. Not because you were going to do something to them, but because they were afraid their kids might get HIV.
Things have changed a lot. For the most part, people tend to be much more sensitive and much more kind. There are a lot of things we got right. The treatment, access to health care, that kind of stuff. But there's a lot of stuff we're still working on, like issues related to gender and race.
And there are still a lot of misconceptions. Some people think HIV is done. Or they think HIV is a moral issue. It's not. People have had sex since the beginning of time, and our young people should be educated and given the tools they need to protect themselves.
I think one of the best things people can do for someone with HIV is to listen. Be empathetic, but don't try to rescue them. We're not a project. And if you can't listen, write a check. Support the organizations that help people with HIV.
Richard Hutchinson: HIV Affects Everyone
I was diagnosed in June 2015. It was shocking. There was a moment when I stopped breathing.
Because I am a public health professional, I was doing a lot of health education and counseling for other Black men with HIV. I thought of their stories, their courage, and the way theyâve gotten through their diagnosis. Though I was scared, I felt blessed by all the peopleâs shoulders that I was able to stand on.
The support that poured out from my friends was amazing, but it hasnât always been an easy journey. I already have so many things on my back. Iâm young, Iâm Black, Iâm gay, and I have HIV. And the world is filled with so much stigma.
In the Black community, HIV is even more stigmatized, which is proliferated by the values of the Black church. Sex and sexuality are demonized. When youâre gay, your sexuality is even more demonized.
People think of this as a gay manâs disease, but HIV affects everybody. Everybody in the world can contract HIV. Weâre all at risk, so we should be talking about it.
Another misconception is that people with HIV are promiscuous. Weâre seen as sexual deviants. Thatâs a label that a lot of us have to carry and internalize. But that is often not our lived experience.
I think a lot of people believe that you can tell when someone has HIV, but we no longer live in a time when people with HIV are dying. Because of advances in biomedical research, people like me are living longer. There are people in their 50s, 60s, and 70s who are living with HIV.
Then there are the relationship issues. People with HIV may be in the headspace of, âNo oneâs going to love me,â or, âIâm going to have to date people with HIV to find love.â Iâm undetectable, which means my viral load is low, which means I cannot pass HIV on to you.
Treatment works. Pre-exposure prophylaxis, or PrEP, the medicine people take to prevent HIV, works. Iâve dated people on PrEP and Iâve had sex with people on PrEP. Theyâve maintained their HIV-negative status.
The work I do with my organization, He is Valuable Inc., grew out of my HIV diagnosis. Our mission is to identify, reinforce, and celebrate the value of queer Black men through anti-stigma campaigns and other programs.
I want people to know that HIV is a social justice issue and a human rights issue. If we all work together, we can really eliminate this thing. All of us have a role in ending this.
Leigh Owens: I Don't Feel Any Different
In 2016, I had been getting sick a lot. I had this virus that wouldn't go away. I was surfing, and I thought maybe I'd gotten a parasite from the water. Over a 6-week period, I had constant malaise. My body was aching. I went to several doctors and they told me, "It's viral. Take ibuprofen and you'll feel better."
Finally, I had a blood test and the doctor told me, "You tested positive for the HIV antibody." I said, "What? How is that possible?" HIV wasn't even close to what I thought was wrong with me.
What I didn't know was that I actually had AIDS. I went to the ER and tested positive for pneumonia.
When I was first diagnosed, I remember feeling like I was this dirty person. It's a label that was put on me. There was this assumption that it was my fault. I obviously did something wrong to get HIV, and I should have known better. People assumed that I must have been having sex with lots of people to get HIV, without even hearing my story. But in reality, I was in a committed relationship with a man I loved.
One thing I've learned through my advocacy work over the years is that women mainly get HIV from men who are bisexual or who share needles while using drugs. I'd gotten it from an ex-boyfriend who had a history of drug use. I started my YouTube channel and Instagram page to correct these and many of the other misconceptions that are out there.
I didn't know anything about HIV when I was diagnosed. I assumed my life was over. But my doctor told me that it's very manageable. And it has been. The medicine basically stops the virus from replicating. About 2 months after I went on treatment, my viral load dropped from 507,000 particles in a drop of blood to 35 particles. My pneumonia cleared up, and I started surfing again.
People think having HIV means I am full of the virus, like a flashing red light -- the HIV lady! But if you tested me for it today, you wouldnât find it. I've been undetectable for 5 years. My immune system is in the same shape as it was before I had HIV. Truly I don't feel any different than I did before.
Angel Vazquez: Living Well With HIV
I tested positive in 2009. At the time I was doing volunteer work for the Gay and Lesbian Center in San Francisco, and I had been involved in HIV prevention. We had rapid HIV tests available, so I just grabbed one and I did it on myself. When it was ready, my co-worker told me, âYou know what those two lines mean.â And I was like, âYes. I'm HIV-positive, and I know what I need to do. Donât worry. Iâm going to get through this.â
I'm on medication now. And as long as I take it daily, I'm healthy.
The hardest part for me of living with HIV has been dating. I've had people who, when I told them I was HIV-positive, rejected me or said, "I donât want to hang out with you. Iâm not comfortable dating someone who is HIV-positive." That was hard to hear. There is so much more about Angel than just that one thing.
I know that the virus is dormant because the medication I take suppresses it. I don't create enough virus to be able to pass it to someone else. Still, I have made it a routine that if I meet someone, before we even go on a coffee date, I tell them, "Iâm HIV positive and Iâm undetectable. You can say no now, or you can say yes." Nowadays, I donât get as many people who say, "I'm going to pass." But theyâre still out there.
We have come very far, but we still have a long way to go. Even today, thereâs a lot of fear around HIV. Can people die from it? Yes. But people can die from diabetes and other diseases, too. If we take care of ourselves, weâll be fine.
If I weren't HIV-positive, I donât think I would be here at the San Francisco AIDS Foundation, working with our 50-plus members and being able to understand them. It has opened my eyes and helped me understand the clients Iâm working with. I've reached a point in my life where I just accept my HIV and love myself. It's part of who I am. | Disease Research |
Admitting that I’m scared of my son is almost impossible and no one knows all the details of our life behind closed doors. I’m small and very slight and Robbie is now nearly 6 feet tall and quite solid so he can inflict a lot of damage on me if my husband David isn’t there to stop it. The first time Robbie hurt me he was 11 and I’m still not convinced it was deliberate. We’d had a week of terrible weather and on the Sunday we decided to take the boys to a museum.
We rarely do things as a family, as Robbie needs so much attention that his brother Joe ends up upset and frustrated, but we thought if we went early in the morning there wouldn’t be many people there. The first half hour was peaceful and David suggested he went to get coffees as we didn’t want to risk going to the cafe in case Robbie had a screaming fit. Two minutes later a big noisy family group came in and within seconds Robbie lost it, screaming and throwing himself on the floor.
Joe turned his back and I tried to calm Robbie while the family gazed at us in horror. Robbie was thrashing around and I was trying to put my arms round him, a mix of consoling and restraining, and he punched me right on the nose. I could feel it crack and I literally saw stars, something I’d never thought was real. Tears were pouring from my eyes through sheer shock and I could feel my nose starting to bleed. One of the older men said something like “Young man stop this at once!” but that meant nothing to Robbie, who punched me in the head over and over. All these people gathered round us but obviously had no idea what to do and then David appeared and dropped both cups of coffee all over the floor as he rushed to grab Robbie. It was utter, humiliating pandemonium, with one of the men shouting at David that Robbie needed a good hard smack and David shouting back “You stupid bastard, he’s autistic!”
All the way back to the car David held Robbie like a prisoner and Joe just said over and over, “I hate him. I wish he wasn’t my brother.”
It took us all weeks to recover. I had two black eyes and my nose and cheeks were bruised. Neither Joe nor David could look at me properly until my face was better. David was worried about me being in the house alone with Robbie when he came home from school but he has to work as I gave up my job to be at home with the boys.
When Robbie was a toddler he was cute, with a solemn little face and curly blond hair. He was quite controllable at that point as I could remove him from any difficult situation easily. When Joe was born my sister helped a lot, as Robbie clearly hated the change to his routine with the arrival of the baby. When he was formally diagnosed I thought support would be put in place to help us all. I was really naive and assumed there would be help available as soon as I asked for it, but I now think something was only done because I turned up in such a state and they could see the damage he’d caused. I believe that they only worry that we might harm or kill him and have no concern that one day he might actually kill me. We now live in fear of that couple of days respite being withdrawn for any reason so I would never, ever rock the boat by asking for more, unless things got really desperate. There’s very little respite care available, even if you can afford to pay for it privately, which we can’t. I also know from people in the same situation that it’s impossible even to hope that Robbie will be able to move into some sort of long-term care. There’s no money and hardly any places. No one sees us as important.
We were grief-stricken at his diagnosis but each had a different reaction. David wanted to find out everything about the condition in the hope of a cure. I just wanted someone to tell me that with the right approach he could still have a lovely life.
We came home and Joe was toddling round the living room, laughing at my sister tickling him and gleeful to see us. Robbie was tired and started banging his head off the wall and making the strange screeching noise that indicates he’s very distressed and might take hours to calm down. I burst into tears and David walked out of the room and slammed the door.
Severe autism is difficult to understand if you don’t live with it. Everything we do is centred on Robbie’s condition, which is really hard on Joe. Our house is like a minimalist fortress with every window and door bolted, anything potentially dangerous shut away and even ornaments or pictures taken down now. The third time Robbie swept his hand across the mantelpiece and shattered everything on it I decided it wasn’t worth the bother. Robbie won’t sleep by himself and although David takes his turn at sleeping with him through the weekend, I’m completely shattered most of the time as Robbie wakes if I move at all. I can’t sleep properly and I wake constantly because I’m stiff and sore from lying in one position.
The hitting started again six months ago, when he’d just turned 14. There had been a lot of tension with him at school and I’d been in and out for countless meetings. That’s frustrating because these people are meant to be professionals and trained to deal with children like him but it all came back to us and I felt judged because if his behaviour.
I asked about respite care and was told quite sharply that it was unlikely because Robbie was loved and cared for, and not in any danger. Two days later he followed me around the house, coming up close to me, making a humming noise. He does this to David sometimes, or to strangers, and David hates it – he says he does it on purpose to irritate but I don’t actually think Robbie knows how to annoy someone deliberately – but he never normally does it to me. Then he beat me up. He punched me over and over in the face, coming after me when I tried to get away and constantly hitting me as I tried to defend myself. Then he just stopped, sat down on the couch and started leafing through a store catalogue. I was scared to move in case he started again and just lay huddled on the floor till David and Joe came in. My lip was so badly burst I needed stitches and again my face was a mess.
That was the end of any sort of relationship between my sons. Joe hates Robbie and won’t listen to us trying to explain how frustrated he is at being unable to communicate and that is why he’s violent and also self harms. The tension in our house now is constant. David goes into work early as Robbie seems calmer in the mornings and goes to school all right, but after school is hard.
David tries to get home with Joe just half an hour after Robbie is dropped off. I’m always on edge. If Robbie does hit me when I’m alone I curl up in a ball on the floor and try to protect my face, and if David’s in he physically stops him and shuts him into his bedroom. He lashes out at David but he’s taller and bigger than Robbie, so he can hold him back. Joe goes to afterschool care so he doesn’t get in the middle of any violence.
So far we’ve managed to avoid Robbie attempting to hit his brother and Joe watches with complete disgust if Robbie starts self-harming. He told me last week that he wishes Robbie would die, which broke my heart because I know Robbie only hurts me because he is in such pain himself.
I went to the social work department with my battered face and begged for help which is why we now get the two nights of respite every six weeks. I couldn’t tell anyone else he was attacking me but then he tried to hit my sister so she can’t babysit anymore and David and I never go out as a couple, as we devote all our time to Joe during respite. I live from respite to respite and I never think about the future because that’s the only way I can cope with this life sentence.
As told to Joan McFadden.
Names have been changed. Information: autism.org.uk, helpline 0808 800 4104 | Mental Health Treatments |
Members of Birmingham's Sudanese community have accused mental health care providers of a lack of support and other failures after two men died.
One man, Mohammed Ahmed, died after being sectioned and another, Khalid Yousef, was killed by a man whose illness had not been identified.
A relative of Mr Ahmed said the way he was treated by providers was unfair.
Birmingham and Solihull Mental Health NHS Trust said it would work with the Sudanese community to address concerns.
"They just think it's another asylum seeker coming from somewhere in Africa - he doesn't have any relatives here and what's going to happen?," said Mr Ahmed's uncle, Alsadiq Khamis.
"They don't care. That's what I believe because the way they treated him wasn't fair."
Mr Ahmed arrived in the UK in 2020 as an asylum seeker.
He was sectioned in December last year and admitted to the Oleaster Centre in Birmingham after setting fire to his accommodation.
His family said he was released without their knowledge on 20 January.
Three days later, a community organisation wrote to the ward to express concerns about his safety and that of the public.
Mr Ahmed went on to try and attack a man with a knife and was arrested. His family said they heard nothing from authorities until he was found dead in his cell on 30 January.
His death came five years after Mr Yousef, 28, was decapitated in a betting shop in Handsworth.
His killer and friend, Hassan Mustapha, had previously detailed delusions he was having about the Queen to police officers.
He was diagnosed with paranoid schizophrenia after the killing and an inquest into Mr Yousef's death heard he would not have been killed had his attacker been referred to mental health services the month before.
Speaking for the first time, Mr Yousef's cousin, Khadidja Fadoul, said: "It's very difficult when you see a loved one killed in such a horrific way.
"We live in pain every day. It's traumatic for us and to see it happening again. We want to see action taken."
Abdallah Idriss is secretary general of The Zaghawa Community Association - originally from the Darfur region of Sudan. He said these members of his community had escaped genocide there only to die in England.
Speaking about Birmingham and Solihull Mental Health Trust, he asked: "If they have two such cases - how many others?"
"If prevention measures had been put in place after Khalid's death, we wouldn't have lost this life," he said.
In a statement, Birmingham and Solihull Mental Health Trust offered its condolences to the families and said it strived to provide the best possible assessment and treatment and gave thorough assessments to people in custody.
"On our in-patient units, we adopt a collaborative discharge process - working with other system partners - which enables us to support our service users with regards to accommodation, social care needs and further follow-up," it said.
"We would like to work with the Zaghawa Community Association to help address their concerns and ascertain how we can best support them." | Mental Health Treatments |
Eddie Holmes
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These two photos, taken in 2014 by scientist Eddie Holmes, show raccoon dogs and unknown birds caged in the Huanan Seafood Wholesale Market. GPS coordinates of these images confirm that the animals were housed in the southwest corner of the market, where researchers found evidence of the coronavirus in January 2020.
Eddie Holmes
These two photos, taken in 2014 by scientist Eddie Holmes, show raccoon dogs and unknown birds caged in the Huanan Seafood Wholesale Market. GPS coordinates of these images confirm that the animals were housed in the southwest corner of the market, where researchers found evidence of the coronavirus in January 2020.
Eddie Holmes
The World Health Organization is calling on officials in China to release data that may show a link between animals and the virus that sparked the COVID-19 pandemic.
The data was posted briefly on an international database but then abruptly taken down over the weekend.
Noel Celis/AFP via Getty Images
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Security guards stand in front of the Huanan Seafood Wholesale Market in Wuhan, China, on Jan. 11, 2020, after the market had been closed following an outbreak of COVID-19 there. Two studies document samples of SARS-CoV-2 from stalls where live animals were sold.
Noel Celis/AFP via Getty Images
Security guards stand in front of the Huanan Seafood Wholesale Market in Wuhan, China, on Jan. 11, 2020, after the market had been closed following an outbreak of COVID-19 there. Two studies document samples of SARS-CoV-2 from stalls where live animals were sold.
Noel Celis/AFP via Getty Images
The data was from environmental samples collected at a Wuhan seafood and meat market in the early days of the pandemic. International scientists spotted the material online and made copies of it before it was taken down. The information appears to show that genetic material from raccoon dogs and the virus that causes COVID were found in the same swabs, implying that the animals may have been an initial host.
"A scientist on the team noticed the data come online by happenstance, and because they often check the GISAID database," says Alexander Crits-Christopher, senior scientist in Computational Biology at Cultivarium, a nonprofit group focused on open source tools for research. "She shared the data with an international team and realized the relevance and importance of the data. This team then immediately contacted the data generators in the hopes of open communication and collaboration. The team then immediately alerted the WHO about the presence of the data, and the WHO has helped mediate that communication. All three of the parties above have iterated a shared goal of making data and analyses as open as possible, as soon as possible."
"The big issue right now is that this data exists and that it is not readily available to the international community," says WHO epidemiologist Maria Van Kerkhove, who along with the head of the WHO is calling on Chinese officials to release all of the data they have around the potential origins of COVID. She adds that this information should have been shared years ago: "Any data that exists on the study of the origins of this pandemic need to be made available immediately."
Noel Celis/AFP via Getty Images
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Staff members of the Wuhan Hygiene Emergency Response Team investigate the shuttered Huanan Seafood Wholesale Market on Jan. 11, 2020, after it was linked to cases of COVID-19.
Noel Celis/AFP via Getty Images
Staff members of the Wuhan Hygiene Emergency Response Team investigate the shuttered Huanan Seafood Wholesale Market on Jan. 11, 2020, after it was linked to cases of COVID-19.
Noel Celis/AFP via Getty Images
She stressed that many more studies need to be carried out: "These studies have been recommended over many years, looking at the source of the animals of the market, looking at potential intermediate hosts, looking at breaches in biosafety biosecurity. These studies have yet to be conducted, and until they are conducted, until we have the data, we aren't able to conclusively say how this pandemic began."
Since the SARS-CoV-2 pandemic began three years ago, its origin has been a topic of much scientific — and political — debate. Two main theories exist: The virus spilled over from an animal into people, most likely in a market in Wuhan, China, or the virus came from the Wuhan Institute of Virology and spread due to some type of laboratory accident.
But there is in fact a substantial body of evidence, first published in 2022 and covered by NPR at that time, pointing to the raccoon dogs as a likely starting point for the spread of SARS-CoV-2.
In particular, scientists published two extensive, peer-reviewed papers in Science in July 2022, offering the strongest evidence to date that the COVID-19 pandemic originated in animals at a market in Wuhan, China. Specifically, they conclude that the coronavirus most likely jumped from a caged wild animal into people at the Huanan Seafood Wholesale Market, where a huge COVID-19 outbreak began in December 2019.
Neither of the Science papers provide the smoking gun — that is, an animal infected with the SARS-CoV-2 coronavirus at a market.
But they come close. They provide photographic evidence of wild animals such as raccoon dogs and a red fox, which can be infected with and shed SARS-CoV-2, sitting in cages in the market in late 2019. What's more, the caged animals are shown in or near a stall where scientists found SARS-CoV-2 virus on a number of surfaces, including on cages, carts and machines that process animals after they are slaughtered at the market.
The data in the 2022 studies paints an incredibly detailed picture of the early days of the pandemic. Photographic and genetic data pinpoint a specific stall at the market where the coronavirus likely was transmitted from an animal into people. And a genetic analysis estimates the time, within weeks, when not just one but two spillovers occurred. It calculates that the coronavirus jumped into people once in late November or early December and then again few weeks later.
At this exact same time, a huge COVID outbreak occurred at the market. Hundreds of people, working and shopping at the market, were likely infected. That outbreak is the first documented one of the pandemic, and it then spilled over into the community, as one of the Science papers shows.
At the same time, the Chinese Center for Disease Control and Prevention found two variants of the coronavirus inside the market. And an independent study, led by virologists at the University of California, San Diego, suggests these two variants didn't evolve in people, because throughout the entire pandemic, scientists have never detected a variant linking the two together. Altogether, the new studies suggest that, most likely, the two variants evolved inside animals.
Evolutionary biologist Michael Worobey helped lead two of the studies and has been at the forefront of the search for the origins of the pandemic. He has spent his career tracking down the origins of pandemics, including the origin of HIV and the 1918 flu.
University of Arizona
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Michael Worobey is a top virus sleuth. He has tracked the origins of the 1918 flu, HIV and now SARS-CoV-2. Worobey is a research professor in the Department of Ecology and Evolutionary Biology at the University of Arizona.
University of Arizona
Back in May 2021, Worobey signed a letter calling for an investigation into the lab-leak theory. But then, through his own investigation, he quickly found data supporting an animal origin.
When the studies were first published online, NPR spoke to Worobey, who's at the University of Arizona, to understand what the data tells us about the origin of SARS-CoV-2; how, he believes, the data may shift the debate about the lab-leak theory; and the significance of photos taken five years before the pandemic. Here are key points from the conversation, which has been edited for clarity and length.
Live animals that are susceptible to COVID-19 were in the market in December 2019
It's clear-cut these wild, live animals, including raccoon dogs and red foxes, were in the market. We have photographic evidence from December 2019. A concerned customer evidently took these photos and videos of the market on Dec. 3 and posted them on Weibo [because it was illegal to sell certain live animals]. The photos were promptly scrubbed. But a CNN reporter had communicated directly with the person who took the photos. I was able to get in touch with this reporter, and they passed on those photos from the source. So we don't completely verify the photos.
Live susceptible animals were held in a stall where SARS-CoV-2 was later detected on a machine that processed animals in the market
Worobey and Holmes et al.
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An anonymous user on the Chinese social media platform Weibo posted pictures of live animals for sale in the southwest corner of the Huanan Seafood Market in Wuhan, China, in 2019. Researchers investigating the origins of the SAR-CoV-2 virus are including these images in a forthcoming academic paper that pinpoints the southwest corner as the most probable origin point of the pandemic.
Worobey and Holmes et al.
An anonymous user on the Chinese social media platform Weibo posted pictures of live animals for sale in the southwest corner of the Huanan Seafood Market in Wuhan, China, in 2019. Researchers investigating the origins of the SAR-CoV-2 virus are including these images in a forthcoming academic paper that pinpoints the southwest corner as the most probable origin point of the pandemic.
Worobey and Holmes et al.
We analyzed a leaked report from the Chinese CDC detailing the results of this environmental sampling. Virtually all of the findings in the report matched what was in the World Health Organization's report. But there was some extra information in the leaked report. For example, there was information not just on which stalls had virus in them — or had samples positive for SARS-CoV-2 — but also how many samples in a given stall yielded positive results.
We found out that one stall actually had five positive samples — five surfaces in that stall had virus on them. And even better, in that particular stall, the samples were very animal-y. For example, scientists found virus on a feather/hair remover, a cart of the sort that we see in photographs that are used for transporting cages and, best of all, a metal cage in a back room.
So now we know that when the national public health authorities shut down the market and then sampled the surfaces there, one of the surfaces positive for SARS-CoV-2 was a metal cage in a back room.
What's even weirder — it turns out that one of the co-authors of the study, Eddie Holmes, had been taken to the Huanan market several years before the pandemic and shown raccoon dogs in one of the stalls. He was told, "This is the kind of place that has the ingredients for cross-species transmission of dangerous pathogens."
So he clicks photos of the raccoon dogs. In one photo, the raccoon dogs are in a cage stacked on top of a cage with some birds in it.
And at the end of our sleuth work, we checked the GPS coordinates on his camera, and we find that he took the photo at the same stall, where five samples tested positive for SARS-CoV-2.
So we connected all sorts of bizarre kinds of data. Together the data are telling a strong story.
Earliest known cases of COVID-19, even those not directly related to individuals who had been in the market, radiate out from the market
With a virus, such as SARS-CoV-2, that causes no symptoms or mild symptoms in most people, you don't have any chance of linking all the early cases to the site where the outbreak started. Because the virus is going to quickly spread to people outside of wherever it started.
And yet, from the clinical observations in Wuhan, around half of the earliest known COVID cases were people directly linked to the seafood market. And the other cases, which aren't linked through epidemiological data, have an even closer geographical association to the market. That's what we show in our paper.
It's absurd how strong the geographical association is [to the market].
NPR: Absurd? How? In the sense that the seafood market is so clearly bull's-eye center of this outbreak?
Yes. And I don't understand how anyone could not be moved, at least somewhat, by that data and then take this idea [of an animal origin] seriously, especially given the other things we've found in these studies.
The virus jumped into people right before the outbreak in the market
For example, our new genetic analysis tells us that this virus was not around for very long when the cases occurred at the market. For example, the earliest known patient at the market had an onset of symptoms on Dec. 10, 2019. And we can estimate that at that point in time, there were only about 10 people infected with the virus in the world and probably fewer than 70.
So if the pandemic didn't start at the market, one of the first five or 10 people infected in the world was at the market. And how do you explain that?
You have to remember: Wuhan is a city of 11 million people. And the Huanan market is only 1 of 4 places in Wuhan that sold live animals susceptible to SARS-CoV-2, such as raccoon dogs.
It's highly unlikely that the first COVID-19 outbreak would occur at the market if there weren't a source of the virus there
Step back and think, "Where is the first cluster of a new respiratory infection going to appear in this city?" It could appear at a market. But it could also appear at a school, a university or a meatpacking plant.
NPR: Or a biotech conference?
Yes. In Washington state, SARS-CoV-2 first appeared in a man who had traveled back from China. In Germany, it was at an auto-parts supplier.
There are thousands, perhaps 10,000, other places at least as likely, or even more likely, to be the place where a new pathogen shows up. And yet, in Wuhan, the first cluster of cases happens to be one of the four places that sells live animals, out of 10,000 other places. If you're not surprised by that, then I don't think you're understanding the unlikelihood that that presents.
NPR: So what is the likelihood of that coincidence happening — that the first cluster of cases occurs at a market that sells animals known to be susceptible to SARS-CoV-2, but the virus didn't actually come from the market?
I would put the odds at 1 in 10,000. But it's interesting. We do have one analysis where we show essentially that the chance of having this pattern of cases [clustered around the market] is 1 in 10 million [if the market isn't a source of the virus]. We consider that strong evidence in science.
The analyses that we've done are telling a very strong story.
The evidence is amongst the best we have for any emerging virus.
NPR: Really?
It's important to note we haven't found a related virus from the intermediate host. But we have a bunch of other evidence.
And the data zeroing in on the Huanan market, to me, is as compelling as the data that indicated to John Snow that the water pump was poisoning people who used it. [John Snow was a doctor in London who helped launch the field of outbreak investigations by figuring out the source of a cholera outbreak in the city in the mid-19th century.]
Making these findings brought tears
Sometimes you have these rare moments where you're maybe the only person on Earth who has access to this kind of crucial information. As I just started to figure out that there were more cases around the market than you can expect randomly — I felt that way. And no exaggeration, that moment — those kinds of moments — bring a tear to your eye. | Epidemics & Outbreaks |
- Gov. Gavin Newsom has vetoed a measure that could have prevented a monthlong supply of insulin from being priced over $35.
- Newsom cited that instead of overcharging for insulin, health insurance companies would have increased monthly premiums instead.
- The governor said California also has a contract to produce its own brand of insulin, which may provide a more financially friendly option for those struggling with diabetes.
Gov. Gavin Newsom has vetoed a bill that would have stopped insurance companies from charging more than $35 for insulin.
The bill would have banned health plans and disability insurance policies from imposing any out-of-pocket expenses on insulin prescription drugs above $35 for a 30-day supply. That would have included deductibles and co-pays.
Newsom, a Democrat, said earlier this year that California would soon start making its own brand of insulin. The state has a $50 million contract with the nonprofit pharmaceutical company Civica Rx to manufacture the insulin under the brand CalRx. The state would sell a 10 milliliter vial of insulin for $30.
"With CalRx, we are getting at the underlying cost, which is the true sustainable solution to high-cost pharmaceuticals," Newsom wrote in a message explaining why he vetoed the bill on Saturday. "With copay caps however, the long-term costs are still passed down to consumers through higher premiums from health plans."
State Sen. Scott Wiener, a Democrat from San Francisco who crafted the bill, called Newsom's veto "a major setback that will keep tens of thousands of diabetic Californians trapped in the terrible choice between buying insulin and buying food."
"This is a missed opportunity that will force them to wait months or years for relief from the skyrocketing costs of medical care when they could have had it immediately," Wiener said in a news release.
Insulin is a hormone produced by the pancreas that converts sugar into energy. People who have diabetes don't produce enough insulin. People with Type 1 diabetes must take insulin every day to survive.
In January, California Attorney General Rob Bonta sued the companies that make and promote most of the nation's insulin, accusing them of colluding to illegally increase the price.
In March, the largest insulin makers announced they would voluntarily reduce the price of their products. | Health Policy |
One conservative group is encountering more and more people looking to detransition from their previous sex change operations. These individuals claim they are being abandoned by the doctors who helped them transition in the first place.
According to the Independent Women’s Forum, a leading women’s conservative non-profit, multiple detransitioners have reported being "abandoned by medical and mental health professionals after deciding to detransition."
Conservative activist and detransitioner Chloe Cole claimed that she "didn’t really get any help with detransitioning" after seeking guidance on the process from doctors and therapists involved with providing gender-affirming care.
TRANSITION SURGERY STUDY RAISES QUESTIONS ABOUT LONG-TERM RESULTS ON QUALITY OF LIFE AFTER 'TOP SURGERY'
"I basically did it all on my own and never got any guidance," Cole claimed in an IWF testimonial video.
Now regretting her decision to undergo treatments to transition at the age of 15, Cole claimed that the doctors who "pushed her" to change her gender were nowhere to be found when she wanted to reverse these medical procedures.
She explained, "My gender specialist who referred me to the surgery really was at a loss of what to do with me. And I’ve talked to my surgeon, I’ve reported that I regret my surgery and that I’m having complications with it years afterward. And his response was ‘OK, just put some Vaseline on it. That’ll fix things.’"
Cole said that suggestion "temporarily made it worse." As a result, she claimed, "I feel like now I can’t depend on my healthcare provider or any doctors at all."
Prisha Mosley, another young woman looking for help detransitioning from her sex change operations, spoke to IWF senior policy analyst and The Federalist contributor Kelsey Bolar about feeling abandoned by her doctors.
She said, "I was under the impression that my doctors, who were transitioning me, loved me. They said they didn’t want me to die, they were saving my life, they were worried about me, and they wanted me to be healthy and happy. Clearly, they don’t love me. As soon as it’s not profitable, they don’t want to help."
SHOULD STUDENTS BE ALLOWED TO BEGIN GENDER TRANSITION WITHOUT PARENTAL CONSENT? TWO VIRGINIA MOTHERS WEIGH IN
Ever since Mosley underwent procedures to transition, she has developed many medical complications, particularly involving her endocrine system. She now has to take psychiatric medicine to regulate her testosterone and estrogen levels to keep her from depression and anxiety.
She claimed, "I was hoping that if I could get my endocrine system working, I could be on less psychiatric medicine because low testosterone and estrogen will cause depression and anxiety, both of which I’m medicated for and don’t really like being medicated for."
Though she insisted that professionals haven’t helped her with these complications, Bolar reported that "every primary care physician, endocrinologist, obstetrician, and gynecologist she’s approached on her insurance list has turned her away or said they can’t help."
She added, "I could call and be rejected every single day."
These women are just a couple of many who have given testimony to IWF about how they’ve felt discarded by the medical professionals who were so willing to help with their original transitions.
The IWF claimed that many of these professionals belong to a "a one-sided echo chamber" that "pushes an ‘affirmation-only’ model" to those thinking they are in the wrong body.
The group claimed this model "promotes ‘preferred’ names and pronouns, experimental drugs, and medically invasive surgeries that leave children with irreversible damage to their developing bodies." | Mental Health Treatments |
The surprising news that 35-year-old Peloton instructor Leanne Hainsby was diagnosed with breast cancer back in August puts the spotlight on younger women with the disease.“The whole thing is so eerie and bizarre,” said Paul Baron, MD, who, in addition to being chief of breast surgery at Lenox Hill Hospital in New York City, is a Peloton member and does 80% of his rides with Hainsby. On his recent birthday, he got up at 2 a.m. to do a ride with her (it was 7 a.m. in the UK, where Hainsby is based).Breast cancer in women under 45 is not common, but it happens. According to the Centers for Disease Control and Prevention, about 9% of the 264,000 new cases of breast cancer diagnosed in the US each year are in women under the age of 45. In the UK, about 5,000 women younger than 45 get breast cancer each year, according to the British charity Breast Cancer Care. That’s about 11% of all new cases of the disease.Younger women who are diagnosed with breast cancer are more likely to get it from hereditary genes than older women are. But not all cases are hereditary. In general, the majority of breast cancer cases are not due to genetics, and people often don’t have a family history of the disease.Hainsby posted on Facebook that she found a lump in her breast two days after her best friend’s funeral. She visited one doctor who dismissed her concerns.A second doctor ordered tests and, indeed, found a malignant tumor. She was scheduled for surgery and has completed 12 weeks of chemotherapy, all the while continuing to exercise and teach. “Chemo is no joke,” she wrote.Chemotherapy's side effects can include hair loss, serious nausea, vomiting, and fatigue. While treatment largely depends on the type of cancer and stage, younger women with some types of cancer may do better with chemotherapy, Baron said.Hainsby will probably preserve much of her long blonde hair thanks to wearing a cold cap during treatment, she said. These are tight skull caps that contain a cold gel or liquid that seem to work by constricting blood vessels to minimize how much chemo penetrates the hair follicles.Cold caps, she wrote on Facebook, are also “no joke.” Hainsby also posted that she “was lucky enough to be given time ahead of chemotherapy to do a round of IVF.” That means she and her fiancé, Ben Alldis, a fellow Peloton instructor, may be able to start a family. “There’s a high likelihood that chemotherapy can affect fertility,” Baron said. “This can have a huge impact on younger women’s lives.”A spokesperson for Peloton, where Hainsby has been teaching since 2018, issued a statement to BuzzFeed News via email: “Our love and support is with Leanne and Ben at this time but, as a policy and to respect their privacy, we don’t comment on the personal lives of our team members.”Hainsby has done everything right, Baron said. She felt a lump, got a second opinion, and is continuing to exercise while getting treatment, although the ability to do so is obviously highly individual and may not be achievable for everyone with breast cancer. “The biggest mistake you can make is to find a new lump and ignore it,” he said.Exercising while undergoing treatment may help improve survival, Baron said. That’s even if you’ve never exercised before and you start when you’re diagnosed.Different organizations have different screening recommendations for breast cancer. The American Cancer Society states that women who have an average risk should have the option of getting annual mammograms when they are aged 40 to 44. Women 45 to 54 should get mammograms each year, while those 55 and older can do either yearly or every other year. | Women’s Health |
July 7, 2023 â If you clicked on any major news site this week, there was one consistent headline that would be difficult to miss, let alone ignore: âHottest Day Ever Recorded on Earth.â
That day was July 3, when average global temperatures reached 62.62 F. But that record was short-lived, as July 4 saw temperatures rise again, to 62.92. Dig a bit deeper, and that seemingly unspectacular average temperature translated into highs of 122 F in Africa. In Antarctica, where itâs currently winter, temperatures reached 47.6 F. And in the U.S., The Washington Post warned that as many as 54 million Americans were in danger of exposure to dangerous (aka âextremeâ) heat on that day alone. Scientists are warning that weâre in uncharted territory. And humans are close to reaching the peak of their ability to adapt.
âWhen weâre talking about evolution, weâre talking about millions of years for [humans] to generate this capacity to thermoregulate,â said Camilo Mora, PhD, a professor of data analytics at the University of Hawaii-Manoa. âSo, whenever you increase the temperature outside, itâs going to take millions of years for us to adapt logically to it,â he said.
Mora and his colleagues have spent decades modeling that risk of extreme heat as it relates to global climate change, showing that in the last decade, the planet has warmed by about 1 C (1.8 F), resulting in a greater than 2,300% increase in the loss of human life to heat waves alone.
Multiple Ways Heat Can Kill You
When most people think about the effects of extreme heat, they naturally consider things like fatigue, headaches, or feeling a bit faint or nauseated. But these symptoms are simply the tip of a melting iceberg: Heat exposure is linked to many things that can damage vital organs, sometimes permanently.
It all starts with thermoregulation, a concept that describes how the body maintains a steady internal (or core) temperature of 98.6 F. Thermoregulation is controlled by a gland in the brain called the hypothalamus, which responds to higher air temperature by signaling the blood vessels to expand and redirect blood, salt, and fluids to the skin in order to cool off through the process of evaporation (sweating).
But is there such a thing as "too hot?"
âSome 10 or 12 years ago, a group of meteorologists came up with a concept: the wet-bulb temperature, which is the upper limit for human adaptability or sustainability,â said W. Larry Kenney, PhD, a professor of physiology and kinesiology at Pennsylvania State University in University Park.Â
He explained that the term âwet-bulbâ came from an experiment in which scientists took a wet cloth, wrapped it around the bulb of a thermometer, and used it as a proxy for human skin. If the moisture from the cloth evaporated, the thermometer reading went down. But if the air was too humid, less or no evaporation occurred.Â
âWet-bulb temperature is a given temperature of the air when itâs 100% saturated. And so, if your skin is 35 C (95 F), and the air temperature is 35 C but completely saturated with humidity, vapor, sweat, canât evaporate anymore. And so, we lose our primary means of cooling the body,â Kenney said.Â
The result isnât pretty.
In a 2017 review, Mora and his colleagues identified 27 ways that heat exposure can lead to organ failure and death. In simplest terms, when blood gets redirected to the skin surface, blood flow (and oxygen) to other organs (the brain, heart, intestines, liver, and pancreas) is decreased. When the body and cells surpass levels at which they can tolerate heat, cells die and their protective membranes break down.Â
Multiple organs then can't work well. In the heart, loss of cardiac function can lead to a heart attack, and dehydration thickens the blood, increasing the risk of blood clots and stroke. Kidney failure might occur. Injury to the lining of the lungs means that the lungs and bloodstream are eventually deprived of oxygen, leading to respiratory distress.
When cell membranes break down, pathogens and toxins can get into the organs, leading to things like increased inflammation in the pancreas, neurological damage in the brain, and the leakage of bacteria and toxins from the intestines into the bloodstream, which, in turn, can cause sepsis and a systemic inflammatory response that disrupts cellular balance. Combined with injuries to the lining of the veins and other parts of the vascular system, inflammation can trigger clots that cut off the blood supply to vital organs, leading to fatal bleeding. Damaged muscle tissue can release electrolytes and proteins into the blood, causing kidney failure.Â
The result is devastating. When the bodyâs core gets too hot during extreme heat events â such as the one that Texas and other states are experiencing â a vicious cycle of multiorgan breakdown and failure ensues, causing permanent disability and death.Â
Heat Perceptions and Risk
On June 23 of this year, a 31-year-old man and his 14-year-old stepson died in Texasâs Big Bend National Park, where air temperatures had reached 119 F.Â
What were they thinking when they embarked on their hike that morning?
Nicholas Ravanelli PhD, an assistant professor of kinesiology at Lakewood University in Thunder Bay, Ontario, and a clinical exercise physiologist, has been studying how people perceive, cope, and behave during heat waves â an area that has only recently gained attention in research circles.
âPerception is an important factor among our physiology [in terms of] how well we adapt in response to heat,â he said. âThereâs a missing link that we still donât have enough evidence on; that is, how people are perceiving the environment and making proactive or reactive decisions to cool or protect themselves.âÂ
âWhen you get into that [place] where youâre seeing end organ damage, itâs typically when temperatures are above 104 F, 105 F, and the body canât cool itself any longer to the degree it needs to be. And so, it affects the brain,â said Sara Andrabi MD, an assistant professor of emergency medicine at Baylor College of Medicine and assistant medical director at Ben Taub Hospital Emergency Center in Houston.Â
âYou see things like dysfunction in how people think. They might not answer questions, they can (have trouble walking). I always tell parents, if you see your kids really irritable and theyâre not acting like themselves, that can be a sign [of heat-related illnesses], because they're not able to verbalize whatâs going on,â she said.
When this happens, people may lose the ability to make rational decisions that might save their lives, Penn Stateâs Kenney said.Â
We may never know exactly what was going on that morning in Big Bend, nor the reasons why the man and his stepson embarked on the hike despite heat warnings from park officials and the National Weather Service.Â
But not everyone responds to heat the same way.Â
Kenney and his colleagues recently discovered that the wet bulb temperature is significantly lower for older adults and other vulnerable populations.Â
Older people are also more vulnerable to extreme heat because they can't get around as well, limiting their ability to move to dissipate heat from their bodies. Some prescription medications also interfere with temperature, including certain drugs for depression and high blood pressure.Â
Younger children have smaller surface-to-body ratios, meaning that heat can get to their core much faster, leading to dehydration, electrolyte imbalances, and heat stress.Â
Aside from these obvious groups, Kenney said that some people are simply able to tolerate certain heat conditions better than others.
âThere are four main drivers,â he said. âThe first is genetics. The second is heat acclimation or acclimatization, meaning that the body has gone through a series of adjustments slowly over time, making it better tolerant of conditions of high heat and humidity. The third would be aerobic fitness. And the fourth is hydration status, whether people are or are not well-hydrated.â
Even with a leg-up, all humans are ultimately vulnerable to what the warming planet has in store.Â
âThis is not something that is happening to people in other parts of the world,â said Mora. âItâs happening to us, and itâs happening everywhere. Weâre screwed.â | Global Health |
Transphobia is a "deliberate policy" within the NHS, the family of a young trans woman has said.
Alice Litman, from Brighton, took her own life aged 20 in May 2022.
She had been on an NHS waiting list for almost three years for gender-affirming healthcare.
Following a three-day inquest in Hove, Alice's family told Sky News her death should be a "wake-up call".
"Transgender people are hung out to dry," her mother Dr Caroline Litman, who was an NHS psychiatrist, said.
"Alice was a smart, intelligent young person and she could see that no one was taking care of her, and no one cared."
Alice was 16 when she told her family she wanted to live as a woman.
She was referred to specialist NHS services at the Tavistock and Portman Gender Identity Clinic in 2019.
She had been waiting 1,023 days for her first appointment when she died.
"It's kind of an act of aggression really," Alice's father, Peter, told Sky News of the long waiting list.
"If you know something's there and you do nothing about it, it's not a neutral act.
Coroner Sarah Clarke described the services involved in Alice's care as "underfunded and insufficiently resourced".
Telling the court she would be issuing a prevention of future deaths report, Ms Clarke added: "It's extremely important we recognise how important these issues are, not just here in Brighton and Hove, but everywhere."
During the inquest, the head of the gender identity clinic said the number of trans people needing gender-affirming healthcare was an "order of magnitude" greater than the service could provide.
About one in 200 people in the UK did not identify with the sex on their birth certificate, according to the 2021 census.
Referring to her sister's death, Kate Litman said: "I think it shows what the stakes of the debate are and what the conversation should be about.
"It's not about trans women in sports and in toilets. We are literally talking about life and death."
Ms Clarke adjourned the inquest to give a narrative conclusion in two weeks' time.
Read more:
NHS threatened with legal action over transgender fertility policy
Why are trans people self-medicating?
The Tavistock and Portman NHS Foundation Trust, and Alice's GP, WellBN, told the inquest there was no denial of lifesaving emergency treatment but accepted there was a delay.
A Department of Health and Social Care spokesperson said: "Every death is a tragedy and our sympathies go out to Alice Litman's family.
"We support the action NHS England is taking to increase the capacity of specialised gender services, by investing nearly £8m in the new gender identity pilot clinics. These new services are already having an impact, removing 3,400 patients from the waiting list between July 2020 and May 2022," the spokesperson said.
"In line with these changes, a new gender identity clinic is opening in Sussex next month, which will continue to help patients get the treatment they need sooner."
Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email [email protected] in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK | Mental Health Treatments |
Neanderthal gene variants may boost the pain sensitivity of people who carry them and may be most common in populations with prevalent Native American ancestry, a new study finds.
The research, published Tuesday (Oct. 10) in the journal Communications Biology, focused on three versions of the SCN9A gene, which codes for a protein that shuttles sodium into cells and helps pain-detecting nerves send signals. People with any of the three variants are more sensitive to pain caused by being prodded with a sharp object, but not pain caused by heat or pressure.
"In 2020, another group of researchers studied people of European ancestry and linked these Neanderthal gene variants to increased pain sensitivity," first study author Pierre Faux, a geneticist at the French National institute for Agriculture, Food and Environment, told Live Science.
"We extend these findings by studying Latin Americans and showing that these Neanderthal genetic variants are much more common in people with Native American ancestry," Faux said. "We also show the type of pain these variants affect, which wasn't known before."
In the new study, the scientists analyzed genetic samples collected from more than 5,900 people living in Brazil, Chile, Colombia, Mexico and Peru. On average, the participants had 46% Native American ancestry, 49.6% European ancestry and 4.4% African ancestry, but these proportions varied significantly between individuals.
The analysis revealed that around 30% of the participants had one of the SCN9A gene variants, called D1908G, while roughly 13% of participants had the other two gene variants, known as V991L and M932L, which tend to be inherited together.
The participants living in Peru, who had the highest proportion of Native American ancestry among the countries studied, were most likely to carry these Neanderthal gene variants. Conversely, participants recruited from Brazil had the lowest proportion of Native American ancestry and were least likely to carry the variants.
"We know that modern humans and Neanderthals interbred something like 50,000 to 70,000 years ago, and that modern humans first crossed over from Eurasia into the Americas by 15- to 20,000 years ago," Faux said.
"The high frequency of the Neanderthal variants in people with Native American ancestry could potentially be explained by a scenario where the Neanderthals carrying these variants happened to breed with the modern humans who eventually migrated into the Americas," he said.
Following the genetic analysis, the researchers carried out pain threshold tests on more than 1,600 volunteers in Colombia, 56% of whom were women, who had on average 31% Native American ancestry, 59% European ancestry and 9.7% African ancestry. In these tests, participants were asked to tell the researchers to stop as soon as they felt discomfort. The team also analyzed the gene variants carried by each of these tested participants.
In one of the tests, the team applied mustard oil, which irritates the skin, to the forearm skin of participants before pushing plastic filaments of increasing widths onto the same area of skin. In this test, wider filaments exerted a stronger force on the already-irritated skin. Participants who had any of the Neanderthal gene variants tapped out after being prodded with filaments that were significantly smaller than those who did not carry the gene variants.
"When we tested the participants' pain threshold by applying pressure, heat or cold, the gene variants did not affect pain sensitivity, so the Neanderthal variants only affected their response to pinprick pressure," Faux noted.
It is possible that carrying these gene variants gave Neanderthals, and the modern humans who first settled the Americas, some sort of survival benefit, Faux said. But that survival benefit wasn't necessarily related to pain sensitivity, he added.
"The modern humans who first reached North America would have had to bear harsh and cold conditions, so it could be that these variants have other effects beyond pain — for example, they could have somehow helped humans to cope with the cold," he said. In other words, the heightened sensitivity to sharp objects might have been just a side effect of another evolutionary change.
However, the evolutionary pressures that acted on SCN9A were likely complex, and "why Neanderthals might have had a greater pain sensitivity and whether introgression in SCN9A represented an advantage during human evolution remains to be determined," the authors wrote..
Nevertheless, it is interesting to know these gene variants, which have previously been linked to small fiber neuropathy — a painful nerve condition — would have also caused pain in our Neanderthal ancestors, Sulayman Dib-Hajj, a professor of Neurology at the Yale School of Medicine who was not involved in the study, told Live Science in an email.
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Carissa Wong is a freelance reporter who holds a PhD in cancer immunology from Cardiff University, in collaboration with the University of Bristol. She was formerly a staff writer at New Scientist magazine covering health, environment, technology, nature and ancient life, and has also written for MailOnline. | Disease Research |
By Bruce A. Cohen, MD, as told to Keri WigintonÂ
We know so much more about multiple sclerosis (MS) than we used to. But one important theme is that weâve become much better at treating the relapsing form of this disease and changing its natural history. That wasnât the case early in my career.Â
Iâm old enough to remember when the only thing we could do for someone with MS was help manage their symptoms. Today, if youâre diagnosed with relapsing-remitting MS, thereâs a very high chance treatment will help you live a largely normal life.Â
But thereâs still this idea that MS is a seriously debilitating disease, especially if you donât know anyone with it. Thereâs a reason for that. Most of the people I treat donât go around telling people theyâre sick. And if you saw them walking down the street, youâd have no way of knowing.
Whatâs Changed With Multiple Sclerosis Over the Last 20 Years?
In 2006, the FDA approved natalizumab. That was the first monoclonal antibody used to treat relapsing-remitting MS. Itâs a type of disease-modifying therapy (DMT). Thereâs been an explosion of effective DMTs since then.
Thereâs no cure for MS. But DMTs can slow or stop damage caused by the disease. And we have evidence they can lower the rate at which people with MS progress to disability. According to some studies, they may even help people with MS live longer.
This treatment breakthrough came from a better understanding of the biology of MS and how the immune system is involved. We no longer focus solely on T cells.Â
We use more selective therapies to go after proteins in other parts of the immune system, including B cells and innate immune cells.
We also use more advanced tools to understand MS. We use MRI to get a more detailed look at how the disease affects the brain and spinal cord. These scans can also give us a good idea about whether your treatment is working.
In the future, PET scans may be used to locate MS-related damage better and earlier than we can now. But this is just a research technique at this point.
There isnât one way to detect MS, and a misdiagnosis isnât uncommon. But the tools we use to diagnose people now are more sensitive and specific. That includes something called the McDonald criteria. These are agreed-upon expert guidelines. The goal is to diagnose MS faster and accurately according to a set of typical signs and symptoms.Â
And weâre starting to find likely biomarkers for MS. Going forward, in addition to imaging, we may be able to use body fluids as another way to diagnose the disease.Â
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The Importance of Early and Effective Treatment
We know from imaging studies and long-term research that MS is active under the surface. It may cause damage thatâs hard for you and your doctor to pick up on at first.
For example, there are studies in which MRI scans are done on a monthly basis in people with relapsing MS. Researchers saw that lesions appear and disappear more frequently than people have symptoms. That tells us the disease is active even though the central nervous system seems to have some functional reserves, especially early in the disease course.
So we know that damage happens early on, even though the tools we use to measure MS activity at the doctorâs office may not be sensitive enough to measure it. And we know that when we treat the disease early and control that activity, we can lessen the number of attacks and symptoms people have later on.
But itâs not just the early part thatâs key. The medication youâre on needs to work. The good news is weâre learning more about how to keep an eye on the effectiveness of each therapy, which includes monitoring MS activity with MRI.Â
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Comprehensive Multiple Sclerosis Care
I think this concept of a comprehensive approach to MS â which includes both the treatment of the immune aspects of the disease as well as the damage caused by MS â has also evolved over the past couple decades.
For example, weâve gained a great deal of information on symptom management. And we have better treatment for things like bladder dysfunction and mobility issues. There are more options for high-tech orthotics and adaptive devices. And weâre starting to see the benefits of physical activity, including adaptive exercises.
Thereâs also a greater understanding of the impact of other health issues on disability. That includes tobacco smoking and heart and blood vessel problems. Obesity, metabolic syndrome, and diet may also play a role in the course of the disease.
If you have MS, addressing all these can boost your quality of life and help you keep doing the things you care about.Â
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Whatâs Next for Multiple Sclerosis Treatment?
Thereâs a lot of research interest in Bruton's tyrosine kinase (BTK) inhibitors. Among other things, these drugs target inflammation caused by B cells. As mentioned earlier, scientists think these immune cells play a big part in the development of MS.
It looks like BTK inhibitors can get into the central nervous system. We need more research, but this kind of treatment could impact things going on inside the brain and spinal cord. Current therapies canât do that. They mostly act on the whole immune system, affecting cells that circulate in the blood.
    Â
If BTK inhibitors work the way scientists think they do, they might help people with progressive MS. But thatâs something researchers are still looking into.
Weâre also starting to explore therapies that might protect the central nervous system from damage and help make the brain and spinal cord better able to fix themselves. This kind of research is promising, but we donât have anything thatâs been shown to do this yet.
And that leads us to other areas of development, which is the unmet needs of people with progressive MS. I think weâre going to see further evolution of our understanding of this form of the disease. And, potentially and optimistically, some development of therapies to further limit progression. Â
Â
Show Sources
SOURCES:Â
Photo Credit: Image Source / Getty Images
Bruce A. Cohen, MD, Davee Department of Neurology and Clinical Neurosciences, Feinberg School of Medicine, Northwestern University, Chicago.
National Multiple Sclerosis Society: âUpdated McDonald Criteria Expected to Speed the Diagnosis of MS and Reduce Misdiagnosis.âÂ
Cells: âBrutonâs Tyrosine Kinase Inhibitors: A New Generation of Promising Agents for Multiple Sclerosis Therapy.â | Disease Research |
Republicans are already attacking Biden’s CDC pick on Covid
Mandy Cohen’s experience parrying GOP assaults is seen as a key attribute she’ll need in leading the CDC.
President Joe Biden’s announcement on Friday that Mandy Cohen will lead the Centers for Disease Control and Prevention is stoking the Covid wars once again.
If Biden had hopes that Cohen would quell passions on Capitol Hill about how the U.S. government responded to the coronavirus, they were dashed earlier this week when 28 Republican lawmakers wrote him to disparage her for, among other things, sporting “a Dr. Fauci-themed cloth mask” while she served as secretary of North Carolina’s Department of Health and Human Services.
Cohen’s charge is, officially, to restore trust in an agency that its outgoing director, Rochelle Walensky, has acknowledged “did not reliably meet expectations” after Covid arrived. And Biden said Cohen was “recognized by leaders from both parties for her ability find common ground and put complex policy into action.” At the same time, in picking a proven communicator, Biden has also selected an ally better equipped to spar with the GOP. That suggests the Biden administration understands it will be impossible in the short term to reestablish the CDC’s mostly collegial, pre-Covid relationship with Congress.
“She’s more of an operator and also politically sophisticated,” Andy Slavitt, who worked closely with Cohen in the Obama administration, told POLITICO. “She’s going to come in with a little bit less of a pure academic perspective.”
The CDC became a lightning rod during the pandemic, as many Republican leaders rejected its guidance around social distancing, masks and vaccinations, and accused it of bowing to the fears of teachers unions in setting school reopening guidance. Democrats are far more supportive, but have found fault, too, with the agency’s shifting recommendations and inability to quickly process data.
Walensky, an infectious-disease specialist who joined the CDC in January 2021, departs June 30. She cited the end of the Covid public health emergency last month when she announced her decision to leave.
As North Carolina’s top public health official, Cohen spoke for the administration of Democratic Gov. Roy Cooper in the face of a GOP-controlled state House and Senate. Before that, she held high-level roles in the Centers for Medicare & Medicaid Services during former President Barack Obama’s administration.
In their letter, Cohen’s GOP detractors, including two North Carolinians, Sen. Ted Budd and Rep. Dan Bishop, and five other senators, Ted Cruz of Texas, Mike Lee of Utah, Eric Schmitt of Missouri, J.D. Vance of Ohio and Mike Braun of Indiana, told Biden they weren’t ready to let Covid go, or give Cohen a pass.
“Dr. Cohen is unfit for the position,” they wrote. “Throughout her career, Dr. Cohen has politicized science, disregarded civil liberties, and spread misinformation about the efficacy and necessity of COVID vaccinations and the necessity of masks,” they wrote.
Her congressional critics have no hope of blocking her appointment; Cohen doesn’t need Senate confirmation.
But the Republicans’ opposition, especially if it’s more widely shared in their caucus, could make it harder for Cohen to complete Walensky’s agency reorganization, which aims to communicate faster during disease outbreaks, be more transparent with the public and prepare for the next pandemic.
Walensky’s plans rely on Congress; she has asked lawmakers to help the CDC respond better to the next pandemic by requiring states to share more data with the agency.
The question of trust dogged Walensky and made it difficult to get congressional buy-in for her plan. Lawmakers focused little attention on it during her last congressional appearance earlier this month.
Cohen did not respond to an interview request. But in a recent commencement speech at Guilford College, she described her own tenure in North Carolina as productive.
“It was those states and communities that were able to build and maintain trust that saw the best long-term results, and I can say with certainty trust was built here in North Carolina,” she said.
And some prominent critics of the CDC’s Covid response, such as Stanford University Health Policy Professor Jay Bhattacharya, have credited her with pushing to reopen schools earlier than others.
But the Republican lawmakers’ position indicates there’s no going back to the agency’s pre-Covid relationship with Congress. With the pandemic years now under the House GOP’s oversight microscope, the CDC director cannot stay out of the political fray. “We all want to see that job removed from politics,” Slavitt said. “But for it to be removed from politics, you actually have to understand politics.”
“A boatload of common sense”
She got a degree in public health at Harvard and another in medicine from Yale, then trained in internal medicine at Massachusetts General Hospital, where her interest in policy was evident.
Along with now-Surgeon General Vivek Murthy, an internist at nearby Brigham and Women’s Hospital at the time, Cohen worked on Doctors for Obama, a physician group that campaigned for the future president, and later rebranded as Doctors for America to work on health care reform.
“From when she was a medical student to her time as secretary of health in North Carolina, Dr. Cohen has always been guided by an enduring desire to help improve the lives of people and communities,” Murthy told POLITICO in a statement.
Cohen would go on to work at the Department of Veterans Affairs and at CMS, where she was instrumental in implementing the Affordable Care Act, according to those who worked with her.
During the “eight weeks from hell” in 2013 when the health care website HealthCare.gov failed to launch, Cohen was part of the SWAT team that made sure it got up and running, said Kathleen Sebelius, who was Health and Human Services secretary when Cohen was at CMS and calls her “a terrific talent.”
Cooper named Cohen to head the North Carolina Department of Health and Human Services after his 2016 election win, which also returned a Republican Legislature.
In an interview, Cooper described Cohen as clear-eyed and transparent about that challenge, “with a boatload of common sense,” and credited her with laying groundwork that resulted in bipartisan legislation expanding Medicaid.
“She had excellent relationships with both Democratic and Republican leaders in the Legislature. They respected her intellect and also appreciated the way she could get things done,” Cooper said.
Mark McClellan, who led the Food and Drug Administration and later CMS under former President George W. Bush, worked closely with Cohen in North Carolina during the pandemic from his current perch at Duke University.
He described Cohen holding virtual meetings with lawmakers on both sides of the aisle throughout the pandemic, as well as small group discussions, where she thrived.
Cohen has a “proven ability to actually do stuff in government,” said McClellan, now the director of Duke’s Margolis Center for Health Policy. He described Cohen’s effort to bring together people with different viewpoints to solve pandemic problems, including health care workers, community and business leaders.
In some arenas, the fruits of her efforts seemed to pay off. A 2021 POLITICO analysis of how each state fared during the pandemic gave North Carolina above average marks for health and the economy. (The state scored below average for well-being and education.)
Cooper dismissed the GOP lawmakers’ letter to Biden. “I think that’s to be expected from anti-science election deniers,” he said. “Dr. Cohen inspired confidence in the vast majority of North Carolinians, despite those who constantly politicize the pandemic for partisan gain.”
While it might be politically advantageous to deride Cohen now, Cooper noted that Republican state senators commended her work when she stepped down in 2021. State Senate President Pro Tempore Phil Berger, for example, praised her leadership during turbulent times and called her instrumental in the state’s successful Medicaid transformation.
Another Republican, former state Sen. Tommy Tucker, told North Carolina Health News that he’d gotten along better with Cohen than any previous health secretaries. “Secretary Cohen and I had major policy differences. But it was always a civil debate,” Tucker said.
For her part, Cohen says she was always honest with the public.
“I think folks misconstrue trust being the same thing as perfection,” she told POLITICO’s Ben Leonard in September, when asked about her Covid-era messaging.
Cohen has estimated she held roughly 150 Covid press conferences, sometimes up to three a week.
“We tried really hard in North Carolina to just tell folks what we knew in the moment we knew it, and tell folks what we didn’t know and what we were working toward trying to understand and find out,” she told Leonard. “I think that builds credibility and builds trust.”
Still, the GOP reaction on Capitol Hill in advance of her appointment shows Cohen’s return to polarized Washington politics will be more fraught than her time in North Carolina.
While North Carolina Republican Sen. Thom Tillis did not sign the letter opposing Cohen’s appointment, he told POLITICO in a statement that he thinks Cohen has her work cut out for her in restoring faith in the CDC.
“While Dr. Cohen has a wealth of medical experience, there are legitimate questions being raised about her role in recommending school shutdowns and enforcing the state’s emergency declaration for far longer than was necessary,” Tillis said.
Been there before
Cohen’s official work at CDC will revolve around the agency overhaul that Walensky started — either completing it or revising it — while restoring workforce morale and public trust.
But she’ll also be the Biden administration’s advocate on public health policy on Capitol Hill, and will be asked by Republicans to defend CDC Covid guidance she had no role in formulating.
It’s a tough job, but she’s been there before. In 2014, for example, Cohen garnered media attention for cooly fielding questions from Republicans on Obamacare’s maternity coverage requirement during a congressional hearing — while eight months pregnant herself.
“She’s someone who doesn’t run away from tough stuff,” Slavitt said. He described Cohen’s instinct to be the one to deliver bad news, a quality she honed as a doctor, when delivering it sometimes meant telling patients they were going to die.
“She’s someone who brings humanity and compassion when people are inclined to kind of close up and be very robotic and buttoned up,” he said.
Walensky is leaving Cohen with a plan of action for the CDC, which Sebelius sees as a benefit.
She’ll enter the agency with a roadmap for improvements from someone who has done on-the-ground interviews about where the agency is falling short. “She doesn’t have to make this up, and she also doesn’t have to start all over again,” Sebelius said.
Like the CDC, North Carolina’s health department was beaten down and suffering from low morale when Cohen came on, according to Cooper, who said she injected hope and vision into the agency and gave it a plan of action.
She’s also never lost sight of the reason for the work, he said, which is keeping Americans healthy.
“She keeps that as a polar star for her even during times when politics tries to thrust itself into the public health arena,” Cooper said. “She understands that that’s a reality. She’s battle-tested.”
Ben Leonard contributed to this report. | Epidemics & Outbreaks |
Megan Swanson has warily watched the erosion of her family’s savings as inflation chips away at a reserve for emergencies.
She often postpones any regular doctor’s appointments, including her yearly dermatology appointment, even though annual skin checks are typically recommended for residents of sunny Florida, where she lives in Naples with her husband and their three children.
“Each month we are seeing our costs go up, but not our bank account,” she said.
Swanson, 37, is a part-time student and has not worked since she was laid off during the pandemic when the local Nordstrom store closed in 2020. Her husband, Brett, 37, is employed as the director of wellness at a retirement community.
“I put the priority on the kids,” she said.
Last March, the Swansons had to come up with $8,000 to cover their share of hospital bills after their baby daughter was hospitalized with a febrile seizure. “What if something happens again in the future, and how will we afford it?” she asked.
Rising out-of-pocket costs are weighing heavily on the scale, pushing aside tests or procedures when troublesome symptoms emerge. And these days, the grocery list (and even the price of eggs) feel more pressing to many families. While some people avoided seeking medical care during the worst of the pandemic, worried about the risk of infection or unable to get an appointment because hospitals and doctors were overwhelmed, now many are finding that inflation and the uncertain economy have thrown up another barrier.
“We are starting to see some individuals who are putting off some care, especially preventive care, due to the costs,” said Dr. Tochi Iroku-Malize, the president of the American Academy of Family Physicians and the chair of family medicine for Northwell Health in New York. Choosing between going to the doctor or paying for rent and food, “the health issue is no longer the priority,” she said.
The inability to afford medical tests and treatment, a perennial concern in the United States, began emerging as a much more striking issue last year. Nearly 4 of 10 Americans said they had put off care in 2022 because of cost, the highest number since Gallup started asking people about delaying care more than 20 years ago. The percentage reporting they or a family member delayed health care because of cost rose to 38% from 26% in 2021.
With the prices of prescription drugs, hospital stays and other treatments expected to increase significantly this year and next, some doctors expect families to have an even harder time affording medical care. A recent report from the Commonwealth Fund found that 29% of people with employer-based coverage were underinsured, because they had such high out-of-pocket costs even with insurance. The coming roll back of health coverage under the state-federal Medicaid program will very likely lead many people to become uninsured.
About one-fourth of respondents in Gallup’s poll said they put off care last year for what they considered a “serious” condition. When Margaret Bell, 71, found that her cancer had returned four years ago, she hesitated to resume her chemotherapy because she could not afford it, and higher prices have made it even harder. She would regularly skip appointments near her home in Lancaster, South Carolina.
“It is impacting patients’ access to care,” Bell’s oncologist, Dr. Kashyap B. Patel, said. As the chief executive of Carolina Blood and Cancer Care Associates in Rock Hill, South Carolina, he recently set up a nonprofit group, No One Left Alone, to help cancer patients like Bell and to connect them with local charities. The organization is covering the cost of her treatments, and Patel has assured her that his office will find the money for her visits.
On a limited budget, “it’s been very difficult for me,” Bell said. Having her family over for dinner can be a strain because of high grocery bills, and she is faced with deciding which of her medical needs is the most urgent. She has postponed receiving a pacemaker.
A new federal report suggests fewer Americans’ health bills are being sent to collection, but medical debt still accounts for more than half of all kinds of collection debt, exceeding unpaid credit card or cellphone bills. It remains a serious issue: about a fifth of Californians said they had medical debt of at least $5,000, according to another recent survey. A little over half of those asked said they had skipped some kind of care in the last year, with half of those reporting their condition got worse as a result.
“This is about trade-offs that people have to think about that are really hard,” said Dr. Jay Bhatt, the executive director of the Deloitte Center for Health Solutions, a research unit of the consulting firm. He also sees patients at the Family Christian Health Center outside of Chicago. In a survey by Deloitte last year, 28% of respondents said they were less able to afford care than in the previous year.
Some of the clinic’s patients are losing their jobs and insurance, he said. “We’ve seen this before, and we are going to see it in big numbers now,” Bhatt said.
In Hammond, Indiana, Tameaka Smith and her husband, Stevenson Lloyd, are coping with tighter finances and trying to save where they can. She is disabled and covered through Medicare, the federal insurance program, while her husband, who works at an auto parts factory, has private insurance through his employer.
Still, they are skimping a bit on medicines they need. Her husband takes his thyroid medication every other day, and she sometimes uses her father’s asthma medicine. “We’re self-medicating, trying to stretch it out and doctor ourselves,” Smith said.
With two children, their family has not recovered from the financial strains of the pandemic. “It’s hard catching up when you’re so pushed back,” Smith said.
Her husband also weighs the merits of going to the doctor, knowing that if he doesn’t have to pay right away during the visit, “then next month we’re getting a big bill,” she said.
Any turbulence in the economy has historically resulted in the loss of medical care for an increasing number of people, either because they no longer have health insurance or because they cannot afford their share of medical bills. During the Great Recession, millions of Americans lost their health coverage, and many people are predicting a similar wave in the coming months. Millions of people could lose Medicaid coverage as states begin the process of dropping individuals from the program now that states will no longer have to keep people enrolled and extra federal funds are going to disappear.
The cost of treatments is also likely to rise next year as hospitals, many of whom reported losses in 2022, will raise their rates, said Sean Duffy, the co-founder and chief executive of Omada Health, a company in San Francisco that provides virtual care and coaching to people with chronic health conditions like diabetes. The company’s employees were already starting to see an increase in patients wrestling with how to pay for medicine and healthy food.
“2024 is the reckoning, unfortunately,” Duffy said.
In addition to medical bills, patients often cannot afford to take off work for a doctor’s visit, let alone find the funds to cover child care or the transportation needed to get there. A colonoscopy to determine why a patient may be bleeding could result in missing a day’s work and a medical bill equal to a week’s work, said Dr. Rajeev Jain, a gastroenterologist at Texas Digestive Disease Consultants. “We’re seeing an uptick in patients canceling for those reasons,” he said.
“You have a finite number of dollars to spend on your family,” Jain said. When you’re worried about having enough food or stable housing, “at that moment, you’re not thinking of preventing something five years from now.”
In 2021, a fifth of Americans either delayed or went without medical care because of the pandemic because of a lack of available appointments and fear of infection, according to a recent analysis by KFF, a nonprofit research group. Only 5% cited cost alone.
The catch-up in visits and procedures by people who are now able to see the doctor and the increased number of people seeking care caused by the winter season’s respiratory illnesses could mask any recent declines in seeking out medical care.
“It’s possible that this is the calm before the storm, especially since a lot of people are going to lose Medicaid coverage,” said Cynthia Cox, a vice president at KFF.
© 2023 The New York Times Company | Health Policy |
COVID infection levels have continued to fall in the UK, according to data recorded by the Office for National Statistics.In the week ending 17 January, an estimated 1.1 million people in private households are likely to have had COVID, which is down 39% from 1.8 million in the previous week.
This is the lowest total since late November.The number of people in hospital with the virus has also fallen by 40% since the start of the year, according to NHS data, providing further evidence the virus is less prevalent.The ONS survey showed in England, an estimated one in 60 people tested positive, in comparison to one in 55 in Wales, one in 30 in Northern Ireland and one in 55 in Scotland.
Infections peaked at 3.0 million at the end of December 2022 after a surge in cases in the run-up to Christmas.The majority of current COVID infections are due to the variant known as BQ.1, which is part of the Omicron family. More on Covid-19 Spring and autumn boosters planned for people most at risk from COVID Doomsday Clock moves 10 seconds closer to midnight as Ukraine war rages Fireworks, family reunions and hazmat suits - how China is celebrating the Lunar New Year COVID-19 by region and age Infections fell in all regions across the UK.In London around one in 57 (1.3%) people had the virus, while in the South West it was one in 50 (2%).Analysis also showed that infection rates decreased in all age groups, except those aged two-10, where the trend was uncertain.The 70 and overs category has the highest rate at one in 48 (2.1%) followed by 50-69 at around one in 62 (1.8%) on previous weeks. Michelle Bowen, ONS head of health surveillance, said the "picture is generally a positive one", with infections in England "back below one million and the lowest they've been in seven weeks".The number of people in hospital in England with COVID currently stands at 5,632. This figure peaked at 9,535 on 29 December - still significantly below previous waves.Booster vaccines planned for autumn and springThe latest survey keeps in line with data obtained from the 2022 COVID autumn booster programme, which launched back in early September.More than 82% of people aged 75 and over have received the jab. A total of 64.5% of those aged 50 and over have also had a booster vaccination.Dr Mary Ramsay, head of immunisation at the UK Health Security Agency, said that although flu and COVID cases are falling, "winter is not over yet and we need to guard against further surges". Spreaker Due to your consent preferences, you’re not able to view this. Open Privacy Options Click to subscribe to the Sky News Daily wherever you get your podcastsShe encouraged eligible individuals to come forward and get a booster vaccination, which was echoed by the Joint Committee on Vaccination and Immunisation (JCVI) in order to "reduce severe disease across the population," and "protect the NHS". | Epidemics & Outbreaks |
The former chair of the NHS trust where serial killer Lucy Letby worked believes the board was "misled" by hospital executives.
The nurse was convicted on Friday of murdering seven babies and trying to murder another six at the Countess of Chester Hospital.
Sir Duncan Nichol, who was the board's chair, said it was told there was "no criminal activity pointing to any one individual" despite concerns.
A public inquiry has been ordered.
Letby targeted the babies between June 2015 and June 2016, when they were dying or suddenly collapsing at five times the average annual rate at the hospital's neonatal unit.
However the board was not alerted to the problems until July 2016, by which time 13 babies had died.
At a meeting, the board then agreed to ask for the deaths to be externally investigated.
The trust initially turned to the Royal College of Paediatrics and Child Health, who conducted a review of the unit but told the hospital executives they should conduct a separate "thorough external independent review of each unexpected neonatal death".
Ian Harvey, who was then medical director at the hospital, contacted London-based neonatologist Dr Jane Hawdon.
The doctor, who specialises in the care of newborns, did a brief review of each baby's medical notes.
However she told the trust she did not have the time to conduct the thorough investigation the Royal College had recommended.
It is understood Dr Hawdon did not speak directly to the board but sent her report and it was up to executives to brief the board on its findings.
In a statement to the BBC, Sir Duncan said: "I believe that the board was misled in December 2016 when it received a report on the outcome of the external, independent case reviews.
"We were told explicitly that there was no criminal activity pointing to any one individual, when in truth the investigating neonatologist had stated that she had not had the time to complete the necessary in-depth case reviews."
In response to Sir Duncan's statement, the hospital's then chief executive Tony Chambers - who went on to lead three other NHS trusts on an interim basis after leaving Chester in 2018 - said that "what was shared with the board was honest and open and represented our best understanding of the outcome of the reviews at the time".
In a BBC interview, Dr Susan Gilby - another former chief executive at the hospital - said she also had concerns the board may have been misled.
When she joined the trust shortly after Letby's arrest in 2018, she examined internal information about the nurse's actions.
"The documents that I have seen from the neonatologist [Dr Hawdon] and the briefing and the papers that were presented to the board are diametrically opposed.
"It's hard to understand - unless there is something that I haven't seen - how the board were led to believe that a comprehensive review had taken place."
Mr Harvey, who was medical director at the hospital trust until 2018, said: "The statements I gave to the board were true to the best of my knowledge."
Three years ago, Sir Duncan, who stepped down in 2019, and Dr Gilby commissioned an external review by the health consultancy Facere Melius into how the hospital trust had handled the allegations.
It has not been published.
Both have welcomed the public inquiry into the events at the trust and said they would cooperate.
Paediatric consultants who raised concerns about Letby's conduct have recently told the BBC of being bullied, ignored and forced to send her a letter of apology.
- Neonatal nurse Lucy Letby has been convicted of murdering seven babies and trying to murder another six babies while working at the Countess of Chester Hospital.
- She targeted the babies between June 2015 and June 2016.
- A BBC investigation found hospital bosses failed to investigate allegations against her and tried to silence doctors, according to a lead consultant.
- The hospital also delayed calling the police despite months of warnings that the nurse may have been killing babies.
- The government has ordered an independent inquiry, which will look at how clinicians' concerns were handled.
- The 33-year-old, who refused to enter the dock for the most recent verdicts, is due to be sentenced on Monday after a 10-month trial at Manchester Crown Court. | Epidemics & Outbreaks |
SACRAMENTO, Calif. -- Gov. Gavin Newsom has vetoed a bill that would have stopped insurance companies from charging more than $35 for insulin.
The bill would have banned health plans and disability insurance policies from imposing any out-of-pocket expenses on insulin prescription drugs above $35 for a 30-day supply. That would have included deductibles and co-pays.
Newsom, a Democrat, said earlier this year that California would soon start making its own brand of insulin. The state has a $50 million contract with the nonprofit pharmaceutical company Civica Rx to manufacture the insulin under the brand CalRx. The state would sell a 10 milliliter vial of insulin for $30.
“With CalRx, we are getting at the underlying cost, which is the true sustainable solution to high-cost pharmaceuticals,” Newsom wrote in a message explaining why he vetoed the bill on Saturday. “With copay caps however, the long-term costs are still passed down to consumers through higher premiums from health plans.”
State Sen. Scott Wiener, a Democrat from San Francisco who crafted the bill, called Newsom's veto “a major setback that will keep tens of thousands of diabetic Californians trapped in the terrible choice between buying insulin and buying food.”
“This is a missed opportunity that will force them to wait months or years for relief from the skyrocketing costs of medical care when they could have had it immediately,” Wiener said in a news release.
Insulin is a hormone produced by the pancreas that converts sugar into energy. People who have diabetes don't produce enough insulin. People with Type 1 diabetes must take insulin every day to survive.
In January, California Attorney General Rob Bonta sued the companies that make and promote most of the nation's insulin, accusing them of colluding to illegally increase the price.
In March, the largest insulin makers announced they would voluntarily reduce the price of their products. | Health Policy |
I have Narcan in my house. Now you can, too.
“Do you know where I can get Narcan? I am going on the senior trip, and I want to take some with me,” a fellow physician mom asked me. I did, and by the time she boarded the plane, this mom had three Narcan nasal spray dispensers in her handbag and a quick primer on how to administer them — along with some ibuprofen, acetaminophen, and a few bandages. She was prepared.
In March, the Food and Drug Administration (FDA) announced that it had approved the naloxone nasal spray, Narcan, for purchase without a prescription. The nasal spray is used to reverse an opioid overdose in a matter of minutes (Narcan binds to opioid receptors and can block the effects of opioids, such as heroin, fentanyl, or prescription opioids, and can quickly restore normal breathing due to an overdose). This nasal spray now can be sold directly to consumers in places like drugstores, convenience stores, grocery stores and gas stations, as well as online.
This couldn’t have happened at a more important time. According to provisional data from the Centers for Disease Control and Prevention (CDC), 30,000 more people in the United States died from a drug overdose in 2021, compared with 2019, bringing the total number of fatalities to more than 100,000 people. This coincides with a growing mental health crisis and an increase in substance use before, and during, the COVID-19 pandemic.
As an emergency room physician, mom, and now Regional Director at the U.S. Department of Health and Human Services, I know these numbers are hard to absorb but all too real. I have seen firsthand the increasing frequency of overdoses and the risk that sometimes reversal agents have not been administered in time. As a new attending physician working in an ER on Staten Island more than a decade ago, I revived patients who had unintentionally overdosed on heroin and tried to save teenagers who had experimented with pills. What I didn’t realize then was how long this epidemic would last, and how much worse things would get.
Getting naloxone into the hands of parents, teachers, coaches, and even young people — and having it on hand in clubs, hotels, and restaurants — will save lives. Here’s how we can be sure: A CDC study found that, in 46 percent of the fatal overdoses that occurred in 2021, a bystander was present, someone who had the potential to intervene and prevent the person from dying.
This resulted in tens of thousands of parents, friends, and loved ones helplessly waiting for an ambulance to arrive when a life-saving intervention could have been used. That is not the case anymore.
The Biden-Harris administration has taken bold action to prevent and treat substance use disorder at its roots and to keep illicit drugs off the streets. Importantly, it has maintained a flow of resources to local communities most in need, with efforts such as last September’sawarding $1.6 billion for all states and territories to address addiction and the opioid crisis.
Nonetheless, we still have a long way to go. The overdose epidemic has left no corner of this country untouched. Since 2000, more than 1 million lives have been lost to overdose. Millions of people continue to struggle with the disease that causes them to use drugs, despite negative consequences. And for every life lost, and every person with substance use disorder, tens of millions more struggle as family and friends.
As a mom of teenagers, I value nothing more than keeping my kids safe. The over-the-counter naloxone will make that possible. As an emergency physician, I understand how many lives will be saved simply by having Narcan available when it is needed. Yet our medical interventions can only be as efficacious as our policies that deliver them to those in need. Now, with this decision, the policy is meeting the moment. It is time for all of us — parents, siblings, community members and friends — to understand the opportunity in front of us and arm ourselves with this simple tool that quite literally can save a life.
To find out more, we encourage you to talk with your local pharmacist, health care provider or visit https://www.hhs.gov/overdose-prevention/.
Dara Kass, MD, is the Regional Director for Region 2 of the U.S. Department ofHealth and Human Services — serving New York, New Jersey, Puerto Rico, the U.S. Virgin Islands and eight Federally Recognized Tribal Nations.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Drug Discoveries |
I delight in messages from UK Biobank, making me feel useful for minimal effort. Back in 2006, with half a million others aged between 40 and 69, I signed up to this magnificent project, the world’s most advanced genetic database.
They took blood, saliva and urine, measured bone density and made notes on exercise, alcohol and family history, with social class, ethnicity, education, employment and income included. They have sequenced my genome and stored samples in freezers at -80C for future researchers seeking causes and cures long after my death.
We volunteers signed to allow our pseudonymised NHS data to be used for all time by researchers whose bona fides are strictly checked by gatekeepers of this unique treasure trove. It’s not for sale, it’s not for trivial or suspect use, but for the good of humankind. I glow with (slightly smug) pleasure whenever I am contacted by them.
But not this time, not this alarming email. Headlined “We are asking your GP for help”, it explains that they get automatic updates from the NHS if participants have hospital treatments, get cancer or die. But, “until now we have been unable to routinely receive important updates of health information held by the majority of GP practices – this is despite you giving us your permission when you first joined UK Biobank”.
I’m astonished. I assumed Biobank had automatic access to my records, but that appears not to be the case. Biobank says it needs our GPs’ “health data such as diagnoses, referrals, prescriptions, lab test results and symptoms – and no written notes – to be transferred securely”. Even though it is de-identified, and should present no privacy issues, this vital data languishes in GP computers, “a catastrophic loss of information on conditions such as dementia, Parkinson’s, depression or diabetes treated by GPs”, says Biobank’s chief scientist, Prof Naomi Allen.
Recently, a letter signed by Biobank, the Royal College of GPs and NHS England asked GPs to share this data. “We recognise GPs are extremely busy,” says the letter, but this very small task takes less than one minute to click one button, once, to hand over records of anyone registered with Biobank. It isn’t happening: only one in five Biobank volunteers have their GP information collected, despite our wishes.
GPs are mainly independent private practitioners – Aneurin Bevan’s one much regretted failure when setting up the NHS. (Wes Streeting intends to entice them to become NHS salaried, voluntarily.) It seems GPs can’t be ordered: legally they are data controllers, though Welsh and Scottish law allows use of their records. In a trial testing their willingness to share data, Biobank persuaded only 20% of English GPs to press the magic button. The other 80% ignored it, had never heard of Biobank, were not influenced by a fee, or were worried about liability for breaching data privacy, although the information commissioner declares it legal because we have consented.
Briefly during the pandemic, an emergency act ordered GPs to hand over Covid information, vital to track the disease, identify vulnerable people and test treatments such as dexamethasone, which saved up to 1 million lives worldwide. But that temporary order lapsed, the data is no longer available to seek long Covid cures: it’s time to restore it.
The British Medical Association refused to sign the Biobank letter sent to GPs, saying the relevant BMA IT committee was not consulted. It’s not a yes and not a no, but a “not yet”. It informs me the concern is that we who signed up in 2006 could have changed our minds, but that’s equally true of a will, a lasting power of attorney or other signatures given years ago.
Anxiety about abuse of NHS data may not be helped by news that the frontrunner for the £480m contract for an NHS federated data platform (FDP) is Palantir, originating in US defence, linked to US spying, whose owner, Peter Thiel, finances anti-abortion candidates and previously Donald Trump, while saying of the NHS that it would be ideal to “rip the whole thing from the ground and start over”. NHS England swears the contract only provides software without access to data, which stays within the NHS, but public mistrust dogged previous attempts when Tories foolishly suggested data might be privatised and sold. What’s not in doubt is that the NHS urgently needs this FDP to link fragmented systems, as advocated by a letter signed by a string of doctors today.
It means no more repeating your history at every NHS appointment: the tiny risk of misuse of records needs balancing with the immense value to treatment. Success depends on public trust, yet the very name Palantir strikes fear – and trust in this corrupted government is at absolute zero.
How tragic if the simple matter of GPs giving Biobank our information gets caught up in the issue of awarding a totally separate contract to that operator. To dispel needless fears, the admirable campaign UseMYdata, founded by cancer patients, urges people to give their information for research, while scrutinising privacy safeguards. Britain’s strong biosciences sector relies on NHS data, other countries lack our unified system, but post-Brexit and flight of the EU medicines agency, life sciences are losing key clinical trials as companies relocate. We need public trust in research.
I contacted my (excellent) GP practice to ask them to hand my data to Biobank. An administrator replied saying they never received the letter asking for it – maybe overworked, exhausted practices are swamped with requests. Whatever the reason for this non-communication, it would help if the BMA joined in the plea to GPs to hand over our data to spur on Biobank – and worldwide research.
Polly Toynbee is a Guardian columnist | Disease Research |
- Published
The parents of a 20-year-old amateur footballer have criticised the NHS over the sudden death of their son.
Luke Abrahams, from East Hunsbury, in Northampton, died on 23 January from a bacterial infection and a flesh-eating disease.
His parents Richard Abrahams and Julie Needham said his condition was initially wrongly diagnosed, which might have led to his death.
Integrated Care Northamptonshire said a review into the case was under way.
Mr Abrahams initially complained of a sore throat and was given antibiotics for tonsillitis, which his father said was diagnosed over the phone.
After another few days, his condition worsened, leading to pain in his legs so great he was unable able to walk.
He went to hospital but was sent home and had a zoom call with a doctor where he was told he had sciatica, his parents said.
On the 22 January, Luke was taken to hospital again where the full extent of the condition was finally discovered.
He had his leg amputated in an effort to save his life, but later died, as first reported in the Northampton Chronicle and Echo, external.
'Things need to change'
His parents said a post-mortem examination showed he died of natural causes.
It also found he had septicaemia, Lemierre syndrome, which is a bacterial infection, and necrotising fasciitis, known as the "flesh-eating disease", according to the NHS, external.
Richard Abrahams told BBC Radio Northampton the family "just can't let it go" and were now looking at legal action.
Ms Needham said she believed several "red flags" were missed by health services.
She said there were unanswered questions over his care, such as "what checks had been done" when he was in hospital.
"I just don't understand how he could walk into an ambulance and he's not come home. Things need to change, we don't want this happening to another child," she said.
Ms Needham said her son had "a massive network of friends".
"I can't thank them all enough. They've been amazing," she said..
She said they had taken Luke's 16-year-old bother Jake "under their wing" and he had "gained hundreds of big brothers".
A fundraising page set up by two of his friends has raised more than £12,000 and Ms Needham said it had has raised the profile of her son's death.
In a statement, Integrated Care Northamptonshire said: "On behalf of the NHS in Northamptonshire, we wish to express our sincere condolences to the family and our thoughts are with them at this very difficult time.
"All providers are reviewing the care and treatment provided in this case and until such time as their reviews are completed, it would not be appropriate to comment further." | Disease Research |
- Merck, the U.S. Chamber of Commerce and Bristol Myers Squibb have sued the Biden administration over Medicare's new drug-price negotiations.
- The lawsuits are the opening salvo in a historic and potentially decisive battle over the federal government's efforts to bring rising drug prices under control.
- Legal experts say the pharmaceutical industry will likely file many more lawsuits this fall, as big drugmakers are ultimately aiming to take their battle to the Supreme Court and strike down the law.
Drugmaker Merck, the U.S. Chamber of Commerce and Bristol Myers Squibb filed separate lawsuits within days of each other this month asking federal courts in Washington, D.C., the Southern District of Ohio, and New Jersey to declare the price negotiations unconstitutional under the First and Fifth amendments.
The lawsuits are the opening salvo in what will go down as a historic and potentially decisive battle over the federal government's efforts to control rising drug prices.
The Inflation Reduction Act, passed in a narrow party-line vote last year, gave Medicare the power to negotiate prices for the first time in the program's nearly 60-year history — a watershed moment that the Democratic Party had long fought for.
The pharmaceutical industry views the program as posing a major threat to revenue growth and profits. The companies claim the program will stifle future drug development in the U.S.
Merck fears its blockbuster cancer therapy Keytruda, which generated 35% of the company's $59 billion in revenue for 2022, will be targeted by the program in the future. The company also worries the federal government will select its Type 2 diabetes drug Januvia, which generated $2.8 billion in revenue in 2022, for negotiations this year.
Drugmaker Abbvie, a member of the Chamber of Commerce's Dayton, Ohio, chapter, is defending its blood cancer drug Imbruvica, which generated $4.6 billion in revenue last year, or about 8% of its total sales.
And Bristol Myers Squibb is trying protect its blood thinner Eliquis, which brought in $11.8 billion in sales last year, or about 25% of the company's $46 billion total revenue for 2022.
These are the first lawsuits challenging Medicare's new powers, but they are unlikely to be the last.
The big drugmakers' lobby group, the Pharmaceutical Research and Manufacturers of America, told CNBC in a statement that it supports the claims made in the lawsuits.
A spokesperson for PhRMA said the organization is also considering litigation against Medicare. PhRMA's members include other big drugmakers like Eli Lilly, Pfizer and Johnson & Johnson.
Legal experts and financial analysts who cover the pharmaceutical industry said Merck, the chamber and Bristol Myers Squibb will try to litigate their claims all the way to the high court.
"These lawsuits were written with the Supreme Court in mind," said Robin Feldman, an expert on intellectual property and health law at the University of California College of the Law in San Francisco.
Nicholas Bagley, a former Justice Department attorney, said the high court is the "big fish." Any decision striking down the Medicare price negotiations would ultimately have to be made by the justices, said Bagley, former chief legal counsel to Michigan Gov. Gretchen Whitmer.
Chris Meekins, an analyst with Raymond James, noted that the all four attorneys representing Merck previously served as clerks to conservative Supreme Court justices: They clerked for Antonin Scalia, Brett Kavanaugh and Neil Gorsuch.
"That is noteworthy in that it is clear to us that Merck is ready and willing to take this all the way to the Supreme Court if needed," Meekins wrote in analyst note.
Merck, the chamber and Bristol Myers Squibb filed their lawsuits ahead of two key deadlines.
Health and Human Services Secretary Xavier Becerra will publish a list by Sept. 1 of the 10 drugs that Medicare has selected for the negotiations. The drugmakers then have to agree to participate and file manufacturing data to the Centers for Medicare and Medicaid Services the following month.
The actual price reductions that come out of the negotiations, which conclude in August 2024, won't take effect until January 2026.
The companies face severe financial penalties that are several times higher than their drug's daily revenues if they do not enter the negotiations and comply with the program's conditions. Drugmakers can avoid the taxes only if they pull their drugs out of Medicare and Medicaid rebate programs.
Meekins said in his analyst note earlier this month that Merck might try to get the federal courts to block the law before the deadlines.
But Bagley noted that Merck and the chamber did not file motions for preliminary injunctions to immediately block the law's implementation. Bristol Myers Squibb did not either. He said the plaintiffs can't plausibly claim an immediate injury now because the price cuts wouldn't go into effect until 2026.
Bagley said the parties could ask for an injunction that is tied to the October deadlines when they sign agreements to participate in the negotiations and start submitting data.
The odds are that the lawsuits will be a long slog, Bagley said. "Any fight over the proper remedy will come at the end of the case, once the legal merits are finally resolved," he said.
The judge assigned to Merck's case is Randolph Daniel Moss, who was appointed by former President Barack Obama. The chamber's case is assigned to Judge Thomas M. Rose, who was appointed by former President George W. Bush.
Bagley said both judges would probably be skeptical of a motion for preliminary injunction tied to the October deadlines, though Rose could perhaps be persuaded to allow it.
Kelly Bagby, vice president of litigation at the AARP Foundation, said more lawsuits will almost certainly come when HHS publishes the list of 10 drugs in September.
AARP is the influential lobby group that represents people older than age 50. The organization has strongly advocated in favor of Medicare's new negotiation powers.
Bagby said pharmaceutical companies whose drugs are selected for negotiation will likely ask federal courts for preliminary injunctions to block the law's implementation when the list publishes in September.
The list of drugs subject to negotiation could include Pfizer's Ibrance, Johnson & Johnson's Xarelto, Eli Lilly's Jardiance, Amgen's Enbrel and AstraZeneca's Symbicort, among others, according to a March analysis published in the Journal of Managed Care and Specialty Pharmacy.
Pfizer CEO Albert Bourla told Reuters in May that he expects legal action to be taken against Medicare over the negotiations, though he said it is unclear if the drugmakers will be able to stop the law's implementation before the 2026 cuts go into effect.
Eli Lilly, in a statement to CNBC, said the company shares the companies' concerns and will evaluate the negotiations implementation to "determine any possible actions."
Bagby also believes the issue is heading for the Supreme Court. She said the companies will probably scatter their cases around the country — like Merck, the chamber and Bristol Myers Squibb did — in an attempt to get federal appellate courts to issue competing decisions.
The Merck case in Washington, D.C., district court would move on appeal to the D.C. Circuit Court of Appeals, which has a majority of judges appointed by Democratic presidents.
The chamber's case would be appealed to the U.S. Sixth Circuit Court of Appeals, which has a majority of judges appointed by Republican presidents, particularly Donald Trump.
And Bristol Myers Squibb's case would head to the U.S. Third Circuit Court of Appeals, which also has a slight majority of judges appointed by Republicans.
If circuit court decisions on the matter contradict one another, the Supreme Court would step in to decide the issue, Bagby said.
White House press secretary Karine Jean-Pierre said the Biden administration is confident it will succeed in the courts.
"There is nothing in the Constitution that prevents Medicare from negotiating lower drug prices," Jean-Pierre said in a statement.
And Beccera added that "we'll vigorously defend the President's drug price negotiation law, which is already lowering health care costs for seniors and people with disabilities."
"The law is on our side," Becerra said in a statement.
Feldman, the intellectual property and health law expert, said the success or failure of the pharmaceutical industry's attempt to take down Medicare's new powers will hinge to a large degree on whether the courts consider patents a form of private property.
Merck claims in its complaint that the negotiations violate the Fifth Amendment, which prohibits the government from taking private property for public use without just compensation. Bristol Myers Squibb made an identical argument in its complaint.
Merck and Bristol Myers Squibb argue that Medicare is taking pharmaceutical companies' private property — patented drug products — and coercing them to accept a price that is much lower the market value of the medications. The chamber made broader due process claims under the Fifth.
Feldman said the Fifth was written with property such as land in mind. Patents differ substantially from land because they are issued by the federal government, she said. And, she noted, drug prices are driven to a significant degree by the value derived from government-issued patents.
The Supreme Court has not ruled that patents are private property under the Fifth's "takings clause," Feldman said, pointing to the 2018 case Oil States Energy Services v. Greene's Energy Group.
Justice Clarence Thomas said in his majority opinion in the case that the high court has long recognized patents as a matter involving "public rights," but the court hasn't definitively explained the difference between these government-derived public rights and private rights.
"Applying the takings clause to patents would be like the shot heard round the world — it would be an extraordinary shift and the companies will have a heavy lift to convince the courts that those words apply to patents," Feldman said. | Health Policy |
Neurosurgeon Charlie Teo used inappropriate language with a desperately ill patient and her husband, according to one of the complaints lodged against the doctor.
“What the f--- are you crying about? I’m here to fix you, you should be happy,” Teo is alleged to have said to a Geelong woman and her husband in 2019.
The woman, who was wheelchair-bound, had just been told by Teo’s surgical fellow that her tumour was increasing rapidly.
“I’m not going to bullshit anything. If you don’t have the surgery by Tuesday, you’ll be f---ing dead by Friday,” the husband recalls Teo telling them after they were ushered in for a consultation.
The husband has also complained that the controversial neurosurgeon offered that “brain tumours are the best f---ing way to die. You’ll just gradually fall asleep.”
Kate Richardson SC, representing the Health Care Complaints Commission, told an expert witness that she wanted him to assume that Teo had said those words, but ultimately, it was up to the HCCC’s professional standards committee panel of inquiry to determine.
Based on Teo’s dire prediction that she would be dead by Friday, the woman agreed to have the surgery straight away, the inquiry has heard.
The operation on the 61-year-old Geelong woman’s brain stem glioma had a dreadful outcome and on February 26, 2019, the day after the operation, Teo slapped the unconscious woman in front of her family in an attempt to rouse her.
Three neurosurgeons told the hearing on Wednesday that the slap was “totally unacceptable” and was “actually assault.”
The three expert witnesses said that Teo’s operation on the Geelong woman had resulted in the largest removal of brain matter they had ever seen. Teo took out most of the right frontal lobe, removing normal brain tissue and leaving behind a significant amount of the tumour.
The woman did not recover and died the following month.
On Thursday, two professors of medical ethics agreed that patients had to be given time to give proper consent.
Professors Chris Ryan and Paul Komesaroff agreed that in high-risk procedures such as brain tumour removal, it was incumbent upon the doctor for him to explain to the patient the magnitude of the risk of the surgery.
The husband has told the inquiry that Teo told them his surgery might buy his wife more time.
He said that the possibility she might never wake up was not told to them. Instead, the risks given were paralysis down one side and some memory loss. Based on these risks, and the fact that she only had until Friday to live, they chose to have the surgery.
The Health Care Complaints Commission’s professional standards committee inquiry is hearing two complaints of unsatisfactory conduct by Teo including that he did not sufficiently inform patients about the risks of their surgeries.
The hearing continues.
The Morning Edition newsletter is our guide to the day’s most important and interesting stories, analysis and insights. Sign up here. | Medical Innovations |
Patients are being offered powerful drugs and told they have attention deficit hyperactivity disorder (ADHD) after unreliable online assessments, a BBC investigation has discovered.
Three private clinics diagnosed an undercover reporter via video calls.
But a more detailed, in-person NHS assessment showed he didn't have the condition.
The clinics say they conduct thorough assessments and follow national guidelines.
Panorama spoke to dozens of patients and whistleblowers after receiving tip-offs about rushed and poor-quality assessments at some private clinics, including Harley Psychiatrists, ADHD Direct and ADHD 360.
All three diagnosed undercover reporter Rory Carson with the neurodevelopmental disorder - a recognised medical condition which affects behaviour and can be considered a disability under the Equality Act 2010.
The investigation found that:
- Clinics carried out only limited mental health assessments of patients
- Powerful drugs were prescribed for long-term use, without advice on possible serious side effects or proper consideration of patients' medical history
- Patients posting negative reviews were threatened with legal action
- The NHS is paying for thousands of patients to go to private clinics for assessments
Commenting on Panorama's findings, Dr Mike Smith - an NHS consultant psychiatrist - said he was seriously concerned about the number of people who might "potentially have received an incorrect diagnosis and been started on medications inappropriately".
"The scale is massive."
There has been a big increase in the number of adults seeking ADHD diagnoses in recent years - because of the success of treatments and more awareness of the condition. Support groups say it has long been under-diagnosed.
Discussion about ADHD is widespread on social media, with #ADHD attracting more than 20 billion hits on TikTok alone.
In some areas, it can take more than five years to secure an NHS assessment - so many patients are instead prepared to pay hundreds of pounds to be seen at private clinics. The NHS is also picking up the bill for thousands of these private assessments, as part of the government's drive to bring down waiting lists.
Having ADHD can be considered a disability - it depends whether or not someone's condition has a "substantial" and "long-term" negative effect on their ability to carry out normal day-to-day activities.
Panorama's undercover reporter answered questions about his symptoms truthfully throughout each of the assessments. Although, he didn't tell the private clinics the real reason he'd booked the appointment.
His first assessment was at a face-to-face meeting with Dr Smith - who leads a specialist adult ADHD service in the NHS.
Carson and his family filled out questionnaires about his habits and childhood history ahead of an appointment that lasted more than three hours. It involved a full psychiatric assessment. His assessment followed the guidelines issued by the National Institute for Health and Care Excellence (NICE).
Some of the symptoms of ADHD can include things many people experience, such as fidgeting, getting distracted and acting impulsively. But NICE guidelines say someone should only receive a diagnosis of ADHD if those symptoms severely impact their life.
Dr Smith concluded that Carson does not have ADHD.
There are 18 recognised symptoms that can indicate someone has ADHD and Carson was found not to meet the clinical threshold for a single one of them.
But when the journalist went undercover at Harley Psychiatrists, he was scored 15 out of 18 - after a 45-minute video call with a psychologist.
He paid £685 for his assessment and was told by the psychologist: "There's no expiration date for this. You're diagnosed for life."
More and more people are turning to private clinics for an assessment to determine whether they have ADHD. Panorama investigates whether some are giving unreliable diagnoses
Watch the full investigation on BBC iPlayer and on BBC One on Monday 15 May at 20:00 in England and Scotland and 20:30 in Wales and Northern Ireland
There was a follow-up appointment with a psychiatrist a week later, lasting less than 10 minutes, at which Carson was prescribed a stimulant called methylphenidate.
This is a standard treatment for ADHD. The medication interacts with chemicals in the brain and can help someone with the condition concentrate better, be less impulsive and feel calmer.
The drug is considered safe and effective for most people who have the condition, but can have serious side effects for some patients, such as those with heart problems or certain mental health issues.
Being exposed to this medication if you don't have ADHD can be a dangerous health risk, according to Dr Smith, and it can also exacerbate existing mental health conditions. Stimulants used to treat ADHD are Class B drugs - controlled substances under the Misuse of Drugs Act.
Harley's psychiatrists didn't ask the BBC reporter any detailed questions about his mental health before prescribing the drugs and he wasn't warned about the potential for serious side effects.
Lawyers for Harley Psychiatrists told Panorama clinicians also take account of information in pre-assessment forms: "The suggestion there is a high risk our client is misdiagnosing adults with ADHD is untrue and unsubstantiated - as is the suggestion that adequate checks are not conducted."
They said, "diagnosis of ADHD⦠depends on the answers given by the patient", and there have been "numerous patients who have not been diagnosed with ADHD".
The lawyers said the clinic accepted that Carson "should not have been able to obtain a prescription" and has updated its processes.
Lawyers for the Harley psychologist who assessed Carson told us that while her testing produced results "indicative of a patient having ADHD", such a "diagnosis is formally made by a psychiatrist".
Lawyers for the psychiatrist - who prescribed the drugs - said their client stood by his diagnosis. He would "normally take between 30 and 45 minutes" to complete consultations, they said, but in this case he "did not consider it necessary" because of the psychologist's report.
Carson also had an assessment with ADHD Direct, based in Glasgow.
He was assessed by a nurse who was new to the clinic and being supervised by another nurse. NICE guidelines say assessments must be conducted by a psychiatrist or a suitably qualified clinician.
The assessment lasted an hour and 40 minutes, and cost £1,095. The nurses asked more thorough questions than Harley Psychiatrists about Carson's medical history - and he and his family were asked to fill out a questionnaire beforehand. But Carson says the assessment still felt "like a tick-box exercise".
Once again he was diagnosed with ADHD at a follow-up appointment and offered a prescription for stimulants.
The journalist revealed to the clinic that he was an undercover reporter before going any further.
Lawyers for ADHD Direct said there would have been more checks before Mr Carson got the drugs. They say his assessment included a "full developmental and psychiatric history" and the clinic "stands by its diagnosis".
"ADHD is under-identified, under-diagnosed and under-treated," the lawyers added - stating that the clinic has "no incentive⦠to over diagnose" and that an audit had found that "10% of the patients seen did not have ADHD".
The undercover reporter also booked an online appointment with ADHD 360, a clinic based in Lincolnshire, which assesses thousands of NHS-funded patients.
Patients and former staff had told the BBC that appointments were short and almost everyone who went there got diagnosed with ADHD.
One clinician said that while working for ADHD 360 he would see a patient "on the hour, every hour" and that he didn't think this was safe. ADHD 360 says clinicians are only expected to do two assessments a day.
If you are affected by any of the issues in this story, visit the BBC Action Line.
Carson was assessed by a pharmacist. He didn't take a full psychiatric history but diagnosed the reporter with ADHD after an hour and 15 minutes. He also prescribed stimulant medication, without proper checks.
ADHD 360 says it is regulated as an NHS provider and delivers "high standard assessment, diagnosis, treatment and care" for thousands of patients. Its "qualified clinicians" are trained in its own academy and its "assessments meet all accepted best practices".
It says on this occasion its "prescription policy was regrettably not followed" and "procedures have now been reviewed" and enhanced.
People who spoke to Panorama also expressed their concerns about the quality of care being offered by private clinics to vulnerable patients who turn to their services in desperation because NHS waiting lists are so long.
Casey faced a three-year wait for an ADHD assessment with the NHS and borrowed almost £700 to be seen by Harley Psychiatrists instead.
She says she was diagnosed with ADHD - by the same psychologist as the BBC reporter - after a video call lasting about 40 minutes.
Casey posted a number of negative reviews online, and the clinic sent her a letter - seen by Panorama - which said she had written "potentially unlawful" reviews and that the matter had been passed to the company's legal department.
The BBC is aware of a number of other apparent legal threats made to patients, after they left negative reviews about Harley Psychiatrists.
Lawyers for the clinic said it was entitled to request the removal of false and defamatory reviews.
There is no doubt that many people who go to private clinics will have ADHD, but experts say patients might not get the right treatment if the assessment was unreliable.
"These people were supposed to help me and they took advantage of me," Casey told the BBC.
"I wasn't someone who was struggling with their mental health and needed help, I was just money to them."
Follow BBC Panorama on Twitter | Mental Health Treatments |
Dozens of hospitals have signed up to be graded by trans rights charities who tell them to stop using the terms 'mother' and 'woman'.
Angry MPs have called for ministers to step in after 77 trusts joined the NHS Rainbow Badge Scheme, which rewards them for dropping 'gendered language' from policies, forms and signs.
The trusts gain points for referring to maternity patients as 'clients' and calling cervical screening clinics 'colposcopy' instead of women's health.
A former Cabinet minister last night accused the NHS of being 'willing to erase women so they can please radical ideologically-driven campaign groups'.
The scheme is commissioned by NHS England but run by vocal trans rights lobbying groups including Stonewall and the LGBT Foundation, who carry out the grading.
They also tell hospitals to introduce gender-neutral toilets and get medics to ask patients their pronouns, leading to fears that the lobby groups are dictating NHS policy.
Staff who just want to treat patients and so speak out against the NHS's focus on gender identity are branded homophobic and transphobic, while facing 'tougher consequences' from bosses.
The revelations will deepen concerns about gender ideology becoming embedded in the health service, after a Mail investigation found that even patients who only temporarily identify as women are allowed into female-only wards.
And it comes even though health bodies have been warned by ministers to rethink their close ties with the likes of Stonewall.
A source close to Health Secretary Steve Barclay told the Mail last night: 'Any scheme which does not recognise the role of women and biological sex in the NHS directly contradicts ministerial steers and raises serious questions of propriety.
'The Secretary of State has been very clear that women should be called women and freedom of speech upheld. He expects that guidance to be followed.'
Former Cabinet minister Ranil Jayawardena said: 'It's extraordinary to learn that the NHS are prioritising pronouns over patient care.
'Surely the simple biology that women are mothers is not lost on today's NHS management?
'It seems that the NHS is willing to erase women so they can please radical ideologically-driven campaign groups. Ministers must step in now.'
And Caroline Ffiske from Conservatives for Women said: 'We have to ask ourselves who is running the NHS?
'We are in the absurd situation whereby Stonewall dictates important policies by the back door.'
The NHS Rainbow Badge scheme was initially devised as a way for staff to show they supported LGBT+ people, by wearing a small enamel pin badge bearing the NHS logo and the pride rainbow.
But it has been turned by NHS England into an 'assessment and accreditation model' to grade trusts according to their inclusivity.
NHS England agreed a £220,000 deal whereby leading charities would grade health organisations on their inclusion work – even though some of them have highly contentious views on gender ideology.
Stonewall supports people being allowed to 'self-identify' as the opposite sex while the LGBT Foundation helped write a recent guide for health bosses that said patients have no right to know if they are being treated by transgender medics.
Figures obtained by this newspaper show that 77 trusts have either completed or are undergoing the Rainbow Badge assessment.
So far, 35 have been awarded a bronze award and just one silver going to Newcastle Hospitals NHS Foundation Trust, with 28 getting only an 'initial stage certificate'.
The assessment involves managers being asked if they have trans inclusive policies, are supportive of LGBT employees and patients – and if they use gender-neutral language.
Gynaecology units face questions including: 'Do clinics have gendered names (e.g. 'Women's Health') or are they named for the purpose (e.g. colposcopy)?'
A patient survey question asks: 'Did you notice that the clinical staff avoided using gendered language (using partner instead of husband/wife, or parent instead of mother/father)?'
A report into one hospital, Royal United Hospitals Bath NHS Foundation Trust, reveals it scored zero out of five marks in this area.
The assessment noted disapprovingly: 'The maternity and adoption policy refers to 'mothers' without expanding to include gender-neutral terms.'
The assessment report into the Bath trust highlighted what it alleged were 'unusually high number of homophobic and specifically transphobic views' expressed by staff in a survey, and recommended further investigation as well as 'tougher consequences for homophobic and transphobic language'.
However many staff had simply asked why the trust was so focused on diversity and inclusivity.
One said: 'I feel that focus on these issues has gone too far and in fact has a negative impact.
'Other than when it is clinically or administratively necessary, a person's sexuality and or gender identity should be irrelevant.'
The LGBT Foundation said: 'The Rainbow Badge Scheme has had a profoundly positive impact on LGBTQ+ healthcare across England.'
Stonewall said: 'We do not write these policies ourselves, and the idea that we have the power to 'tell' other organisations what to write in their policies is clearly nonsense.'
The NHS said: 'While it is obviously important the NHS supports those that face barriers to accessing care, all trusts must also ensure they are spending every pound of taxpayers' money wisely.'
A spokesman for the Royal United Hospitals Bath NHS Foundation Trust said: ‘The report highlighted excellent pockets of work across the hospital which we are committed to building on. It also highlighted that improving support for LGBTQ+ people is something that really matters to our staff, with the majority of staff seeing knowledge of LGBTQ+ status as key to providing high quality care and feeling that further training and education on around LGBTQ+ matters would be beneficial.
'We are committed to continuing with this work, to ensure that the RUH is able to provide high quality, patient-centred care in a welcoming, inclusive environment for all.'
This finger-wagging wokery is stopping us doing our jobs
If you want to know why the NHS has such a problem with staff retention, just watch the 'diversity and inclusion' video that all doctors have to sit through every two years.
Based on cartoons depicting various scenarios, it seems to have one purpose: To tell us that we are all a bunch of transphobic racists.
It is humiliating and patronising, and causes genuine distress. At the end you have to complete an exam based on the video's content and, if you don't get the answers right, you have to go back to the beginning. That, by the way, is just one of 23 videos we are made to watch in order to retain our licences to work in the NHS, all of them riven with the same kind of right-on material.
The whole process takes much-needed doctors away from patients for two to three weeks, as well as having a dreadful effect on staff morale.
I pity those who work at the 77 NHS Trusts whose bosses have inflicted upon them the Rainbow Badge assessment, which seems to be nothing more than a finger-wagging audit of wokery.
I know these admonishing assessments only too well, as they've become an ever greater feature of working in the NHS, as I do. It is not sufficient now for doctors to save the life of a patient, they must know their preferred pronouns first.
I refuse to ask a patient if they would like me to address them as 'he', 'her' or 'they'. This isn't a heinous act of transphobia, it's because I am an oncologist and I need to know about people's symptoms, not what gender they would like to be in their notes.
Besides, such a question is unnecessary for the vast majority of non-trans patients in whose faces I imagine I would see confusion, if not hostility, if I asked it. The edict is Orwellian. Patients are even being handed questionnaires to check up on us, with questions such as: 'Have you been asked by staff, or on a form, if you have a trans history, or if your gender is not the same as the gender you were given at birth?'
When organisations such as Stonewall were started, there was a problem with discrimination but, having helped, with admirable and assiduous work over decades, to greatly reduce such intolerance, the diversity and inclusion industry has morphed into an uncontrollable behemoth, forever looking out for new things on which to hound doctors. We are told, for example, that we must not ask people where they are from. But we need to know that because certain conditions are more common in certain parts of the world.
I once had a patient who was proving very difficult to treat until I found out that they had an Italian grandfather.
It turned out that they were suffering from familial Mediterranean fever, which as its name suggests, is a rare genetic condition which afflicts people with Mediterranean ancestry.
These impractical decrees are usually the brainchild of diversity and inclusion officers, often on salaries twice that of junior doctors, despite the latter having trained for far longer.
But clearly, there is money to burn. All these videos and questionnaires are provided by private companies handsomely remunerated by the NHS. Yet we are paying them to make us less productive.
I am past retirement age, and I don't need to be working. I do because we are really short of doctors. But I'm afraid to say that, when I am forced to sit down in front of yet another diversity and inclusion video, I wonder whether I can stand working in the NHS much longer.
Angus Dalgleish is a professor of oncology at a major London teaching hospital | Health Policy |
A popular Peloton instructor has revealed she has been diagnosed with breast cancer.Leanne Hainsby, 35, said in an Instagram post that she was diagnosed with cancer in August 2022.
Describing the period as "unimaginably tough", she said she has completed 12 weeks of chemotherapy and surgery.In the social media post, she described finding a lump two days before the funeral of her close friend Danielle Hampson - the fiancée of X Factor star Tom Mann.She wrote: "After multiple scans and appointments with both consultants and cancer nurses, and being completely terrified for a few weeks, in August 2022 I was diagnosed with breast cancer.
"Where possible, I have continued to show up as 'normal' but my reality most of the time has looked very different."In terms of treatment and navigating my way through up until this point, it has been something I've kept very private," she said. Image: Leanne revealed she was diagnosed with breast cancer in an Instagram post. Pic: Instagram She added: "As a Peloton instructor, a huge part of my role is all about the members, and despite my diagnosis, that has always mattered to me hugely."My classes have given me a focus and some sparkle in an otherwise incredibly tough time so thank you to the members who had no idea the amount of joy they were bringing to me every day. "To be in the early stages of grief after losing Danielle, and then faced with something like this, has been unimaginably tough, and that still feels like an understatement."Read more from Sky News:Inside the NHS facing 'endless' demandDelivery men 'abandoned sofa stuck on stairs'Shopping habits could help spot ovarian cancer'I've always felt one of the lucky ones'Ms Hainsby said she was confident after receiving an early diagnosis and treatment, despite enduring a "cruel 2022"."I'm in fantastic hands, and I've got this," she said."Nobody wants to be sat in a room and told they have cancer, and yet I've always felt one of the lucky ones."Lucky to be diagnosed early, lucky to be moving fast through treatment, lucky to know I will be ok."The next stages of her treatment will involve undergoing surgery to have her portacath - used during chemotherapy - removed, followed by two weeks of radiotherapy, she added. Image: Leanne Hainsby joined Peloton in 2018. Pic: Instagram Image: Popular Peloton instructor Leanne Hainsby. Pic: Instagram Ms Hainsby joined Peloton in 2018 as one of the first British instructors. Her following grew as the brand became popular during the pandemic as people locked indoors turned to home workouts.The popular instructor, from Kent, is a former professional dancer who has worked with the likes of Taylor Swift, Katy Perry and Kylie Minogue.She has also danced at events such as the London 2012 Olympics and Paralympics, the Royal Variety Show, and television programmes The X Factor and Strictly Come Dancing.She became engaged to fellow Peloton instructor Ben Alldis in July 2021 after three years of dating. | Women’s Health |
Marc Gauthier was 36 years old when he was diagnosed with Parkinson’s disease. At the age of 44, Marc, who lives in Pessac, France, was treated with a deep brain stimulator device that helps to control tremors in his arms. As he grew older, the disease made it difficult for Marc to walk, causing him to lose balance and fall up to five or six times a day.
In 2021, at the age of 61, Marc underwent an experimental medical procedure that has given him back his mobility. Scientists and doctors with the NeuroRestore group at the Swiss Federal Institute of Technology (EPFL) in Lausanne, Switzerland have surgically implanted an array of epidural electrodes within Marc’s vertebrae. These electrodes can stimulate neurons in Marc’s spine in a way that enables his nerves and muscles that control his gait and balance to function more like they did before he developed Parksinon’s. The team documented the procedure in a paper published 6 November in the journal Nature Medicine.
Parkinson’s disease is a neurological disorder characterized by the progressive loss of motor control. While the disease develops differently in every individual, Parkinson’s generally leads to a nervous-system-wide inability to produce the neurotransmitter dopamine and a loss of the neurons that transmit it. These dopaminergic neurons are necessary for many brain functions, including fine motor control. As these neurons are lost, Parkinson’s patients develop the tremors commonly associated with the disease.
“You’re taking advantage of the circuitry of the spinal cord. The spinal cord is doing it for you.” —Eduardo Moraud, NeuroRestore
To counteract these tremors, the research team at EPFL developed a novel intervention: targeted electrical stimulation to the patient’s spine. The researchers had previously seen success using the same stimulator system for spinal injury patients. The team found that in primate models of Parkinson’s, tuned patterns of electrical stimulation applied to the spinal cord could restore a smooth and steady gait to primates with impaired mobility. The team then sought to translate these results to a clinical treatment, and found a willing participant in Marc through their connections to the Lausanne and Bourdeaux medical community. “He was never scared,” says researcher and NeuroRestore group member Eduardo Moraud. “He was very courageous in that sense.”
The technology works by electrically stimulating structures on the spine called dorsal root ganglia, where sensory nerves return to the spine from the body’s extremities. Normally, the dorsal roots coordinate the delicate balance of muscles required for smooth, easy walking. By stimulating the neurons in the dorsal ganglia, the epidural stimulator gets those reflex-driven circuits working as they were before the onset of Parkinson’s disease. “You’re taking advantage of the circuitry of the spinal cord,” says Moraud. “The spinal cord is doing it for you.”
The stimulator array—a pad of electrodes arranged in two columns—was surgically inserted alongside the back of Marc’s spinal cord. The array was positioned to specifically stimulate the dorsal ganglia that most directly controlled Marc’s gait. Once inserted between the vertebrae and the spinal cord, the stimulator was fastened to nearby vertebrae to keep it in place.
After surgical implantation and months of physical rehabilitation, Marc has recovered his ability to walk in a smooth, controlled manner. The device is capable of delivering different stimulation patterns, depending on the situation. The standard pattern is a constant stimulation to compensate for Marc’s baseline imbalances. While this baseline stimulation is enough to keep Marc walking at an easy pace, the stimulator system can drive more effortful leg motions—climbing stairs, getting up from chairs, or walking on uneven terrain—with a supplementary stimulation pattern driven by signals collected from a set of sensors placed on Marc’s feet and legs that measure his intended motions.
Speaking through a translator at a recent press conference, Marc stated, “I experienced a first rebirth twenty years ago when I received a deep-brain stimulation implant. I then experienced a second rebirth two years ago when I received the spinal stimulator. I can now walk with much more confidence and my daily life has profoundly improved.”With support from the Michael J. Fox Foundation for Parkinson’s Research and the medical device developer Onward, the research team at EPFL hopes to repeat the treatment in six more patients, beginning early next year.
Michael Nolan is a writer and reporter covering developments in neuroscience, neurotechnology, biometric systems and data privacy. Before that, he spent nearly a decade wrangling biomedical data for a number of labs in academia and industry. Before that he received a masters degree in electrical engineering from the University of Rochester. | Medical Innovations |
Children in some areas of England are waiting up to 18 months on average for dental general-anaesthetic treatment and teeth extractions, an investigation reveals.
Some have been left with prolonged dental pain, according to information shared with BBC News.
The parents of one girl who has waited three years for extractions say the pain keeps her up at night.
Removing decayed teeth is the most common reason for needing the service.
Rotten teeth
At the start of this year, more than 12,000 under-18s were on waiting lists for assessment or treatment at community dental service (CDS) providers, data obtained by the Liberal Democrats from the NHS Business Services Authority and shared with BBC News earlier this year reveals.
Children are referred to a CDS provider when they have tooth decay too severe to be treated in general practice.
They also treat those with physical or learning disabilities when general practice is not a practical option.
The longest average wait faced by children for general-anaesthetic treatment at a CDS provider is 80 weeks, at Harrogate and District NHS Foundation Trust.
But some providers have much lower average waits - at Mersey Care NHS Foundation Trust, it is just three weeks.
Ella Mann, eight, from Dovercourt, Essex, has been waiting three years to have rotten teeth removed.
She first went to the dentist with a painful milk tooth in December 2019, was given a temporary filling and told it needed to be removed but has still not had the NHS procedure - and now, seven more of her milk teeth need to be removed.
Ella's father, Charlie, says the pain "keeps her up at night".
He says: "It always seems to be in the evening that she suffers the pain. So then obviously we've got the problem of overnight and then fatigue because obviously she's awake most of the night.
"She's started to sort of resent brushing her teeth because it's giving her pain - and we're starting to get concerned it's going to cause further problems.
"You're waiting and waiting and waiting for something to be done about it. They are doing temporary fillings. They're doing temporary jobs on it.
"It's just not right that children should be waiting."
Decay-related extractions
Tooth decay is the most common reason six- to 10-year-olds are admitted to hospital.
In England, more than 42,000 teeth were extracted from under-19s in 2021-22, costing the NHS an estimated £81m.
Office for Health Improvement and Disparities analysis reveals a gap between regions in England.
In the 2021-22 financial year:
- Yorkshire and the Humber had the highest rate of decay-related extractions for under-19s, 378 per 100,000
- East Midlands the lowest, 71 per 100,000
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Staff at Maybury Primary School, in Hull, are doing their best to help keep pupils' teeth healthy.
Every pupil brushes their teeth after lunch.
Head teacher Alison Grantham says toothache "has a massive impact on learning because they're missing lessons".
"And if you're coming to school and you're trying to concentrate and trying to learn while you're in pain, then that's going to have impact, too," she says.
"Trying to get dental support in this area, it is really hard for parents to sign children up for a dentist. This area that the children come from, there is a high level of tooth decay.
"We don't like to see any of our children suffering or in pain - but a lot of the time, there's something you can do straightaway that can help that. "But with teeth, it's far more difficult. There's no magic solution."
'Exceptionally high'
Dentists from the charity Teeth Team visit children at primary schools across Hull and parts of East Yorkshire. And BBC News joined them at Maybury Primary in May.Among the 169 children given a dental check-up that day, there were 263 decayed teeth.Some of these children will need extractions under general anaesthetic in hospital.
Sara Feldt, from Teeth Team, says the needs in the school are "exceptionally high".
'Limiting sugar'
"A high proportion of those are in urgent need, which is four or more decays or cavities in the children's teeth," she says.
"We've had two today that have told us that they are in pain. One told us that they've got an abscess, so we're going to deal with that.
"It's disturbing. It's not very nice to see, because a child's going under a general anaesthetic for something that's preventable. It doesn't have to happen.
"Good oral hygiene, regular toothbrushing, limiting sugar, limiting the fizzy drinks. We need a little bit more education out there to prevent this happening.
"I like the fact that we're coming into the schools, because sometimes that's the only kind of time the children will see a dentist.
"We all know that the access to a dentist at the moment is really difficult. So to be able to do that, I think it's really positive.
"It needs to be rolled out nationwide, not just Hull."
A Department of Health and Social Care official said: "We are working to improve access to NHS dental care - investing more than £3bn a year into dentistry - and the number of children seen by NHS dentists rose by 43.6% last year.
"We have increased the funding practices receive for urgent care, to encourage dentists to provide more NHS treatments and we're also taking preventative measures to improve children's oral health, such as expanding water-fluoridation schemes - which can significantly reduce the number of children experiencing tooth decay. Further reforms are planned for this year." | Global Health |
Nearly five years ago, DeepMind, one of Google’s more prolific AI-centered research labs, debuted AlphaFold, an AI system that can accurately predict the structures of many proteins inside the human body. Since then, DeepMind has improved on the system, releasing an updated and more capable version of AlphaFold — AlphaFold 2 — in 2020.
And the lab’s work continues.
Today, DeepMind revealed that the newest release of AlphaFold, the successor to AlphaFold 2, can generate predictions for nearly all molecules in the Protein Data Bank, the world’s largest open access database of biological molecules.
Already, Isomorphic Labs, a spin-off of DeepMind focused on drug discovery, is applying the new AlphaFold model to therapeutic drug design, according to a post on the DeepMind blog — helping to characterize different types of molecular structures important for treating disease.
New capabilities
The new AlphaFold’s capabilities extend beyond protein prediction.
DeepMind claims that the model can also accurately predict the structures of ligands — molecules that bind to “receptor” proteins and cause changes in how cells communicate — as well as nucleic acids (molecules that contain key genetic information) and post-translational modifications (chemical changes that occur after a protein’s created).
Predicting protein-ligand structures can be a useful tool in drug discovery, DeepMind notes, as it can help scientists identify and design new molecules that could become drugs.
Currently, pharmaceutical researchers use computer simulations known as “docking methods” to determine how proteins and ligands will interact. Docking methods require specifying a reference protein structure and a suggested position on that structure for the ligand to bind to.
With the latest AlphaFold, however, there’s no need to use a reference protein structure or suggested position. The model can predict proteins that haven’t been “structurally characterized” before, while at the same time simulating how proteins and nucleic acids interact with other molecules — a level of modeling that DeepMind says isn’t possible with today’s docking methods.
“Early analysis also shows that our model greatly outperforms [the previous generation of] AlphaFold on some protein structure prediction problems that are relevant for drug discovery, like antibody binding,” DeepMind writes in the post. “Our model’s dramatic leap in performance shows the potential of AI to greatly enhance scientific understanding of the molecular machines that make up the human body.”
The newest AlphaFold isn’t perfect, though.
In a whitepaper detailing the system’s strengths and limitations, researchers at DeepMind and Isomorphic Labs reveal that the system falls short of the best-in-class method for predicting the structures of RNA molecules — the molecules in the body that carry the instructions for making proteins.
Doubtless, both DeepMind and Isomorphic Labs are working to address this. | Drug Discoveries |
NEWYou can now listen to Fox News articles! Speaking from the Senate floor, Senate Majority Leader Chuck Schumer said "we have a lot of work to do" Monday regarding a tentative bipartisan deal on a bill to curb gun violence. He noted the legislation "doesn't have everything we wanted" but would be "the most significant" on guns "in decades."The deal comes after protracted talks between Democrats and Republicans over various proposals, including an assault weapons ban for those under 21 that was ultimately rejected. The only proposal in the deal announced Sunday that deals with 18-to-21-year-olds is an "investigative period to review juvenile and mental health records, including checks with state databases and local law enforcement."DAN CRENSHAW: IT IS DIFFICULT TO LEGISLATE AWAY ‘EXTREMELY RARE AND ANOMALOUS EVENTS’ LIKE MASS SHOOTINGS Senate Majority Leader Chuck Schumer of N.Y., is seated before a Senate Rules and Administration Committee. On Monday, he addressed a gun legislation deal that could become law. (Elizabeth Frantz/Pool via AP)The final framework includes provisions on straw purchasing firearms; support for state red flag laws; closing the so-called "boyfriend loophole" that allows court-adjudicated domestic abusers to buy guns if they were not married to their partner; and a clarification on the definition of a firearms dealer. The deal also includes several provisions on mental health and school safety. Sen. Chris Murphy, D-Conn., who led the talk on behalf of Democrats, said he was willing to take incremental steps to ensure a deal gets passed. Talks on gun legislation began after several mass shootings in recent weeks, including one in Buffalo N.Y., that killed 10 people and another in Uvalde, Texas that resulted in 19 children and two teachers dead. Lawmakers still need to write the bill. PBS reported the package could cost somewhere between $15 and $20 billion, which could be offset by a Medicare rebate. Fox News has reached out to the office of Sen. John Cornyn, R-Texas, one of the negotiators for the bill. CLICK HERE TO GET THE FOX NEWS APP Fox News Tyler Olson contributed to this report. | Health Policy |
Sign up for the Sleep, But Better newsletter series. Our seven-part guide has helpful hints to achieve better sleep. CNN — Many people dread the blaring sound of an alarm clock, signaling the start of a busy workday. Others wish that they weren’t already awake and that the sound had actually woken them up. Waking up minutes or even hours before the alarm is not a new phenomenon, sleep experts tell CNN, but it can cause people incredible discomfort. The additional stress factors from the ongoing pandemic have exacerbated our collective sleeping struggles. More than a third of Americans get fewer hours of sleep a night than the minimum recommendation of seven hours, according to the US Centers for Disease Control and Prevention. According to the National Institute of Health, studies across the globe show anywhere from 10% to 30% of the population struggles with insomnia, defined as the consistent difficulty falling asleep and the inability to return to sleep after going to bed. Those experiencing insomnia can have a combination of “nocturnal awakenings” and what’s categorized as “early morning awakenings,” according to a 2009 study from the Stanford Sleep Epidemiology Research Center and other universities. The study finds that some people may experience early awakenings without other insomnia symptoms such as “difficulty initiating sleep,” “nocturnal awakenings” and “non-restorative sleep,” meaning sleep that isn’t substantial even with the recommended hours. “That’s a little bit of a myth that insomnia is only falling asleep,” said sleep specialist Rebecca Robbins, an instructor in the Division of Sleep Medicine at Harvard Medical School. “A common complaint is excessive sleepiness and waking up and feeling very unrefreshed.” While insomnia treatments include cognitive behavioral therapy and medication, other daily tips can have an impact on early morning awakenings. An acute sleep disorder could be at play for someone not experiencing chronic insomnia but waking up early. “Sleep is an artifact of our waking lives,” Robbins said. “If you’re experiencing hardship, trauma or something unsettling happening … those events loom large for our sleep.” The constant waking up before that daily sound is coupled with an immense frustration about not falling back asleep. The stress can feel isolating and all-consuming, taking more precedence than the initial sleep problem. “You start ruminating about it, and then you start doing things that make insomnia worse,” said Dr. Rajkumar Dasgupta, associate professor of clinical medicine at the University of Southern California Keck School of Medicine in Los Angeles. “Don’t start telling yourself … ‘I’m going to make myself stay in bed until I fall asleep.’ “ So, what can you do about it? If you wake up suddenly – in what feels like the early morning hours – resist checking the clock. Finding out it’s 3 a.m. when you set the alarm for 7 a.m. can cause increased stress about the hours of sleep you hoped to attain. “The anxiety and the frustration build. … Clock watching becomes habitual, and that habitual response of frustration and anxiety also causes a stress response in the body,” said sleep specialist Wendy Troxel, a senior behavioral scientist at Rand Corp. When the stress takes precedence, cortisol levels increase, and the body becomes alert. This process is counterproductive for maintaining drowsiness; the brain becomes hyper-engaged. “You look at the clock. It’s 3 o’clock in the morning like clockwork, and immediately tension might grit your teeth. You think of all the demands … how awful it is going to be when you’re sleep-deprived,” Troxel said. “All of this mental processing and agitation is antithetical to the sleep state. It’s making you more alert and aroused … versus sending the signal to the brain that it’s OK to drift.” If your alarm is on the phone, checking the clock can pose an even more significant trigger. Consider getting an alarm that isn’t attached to your phone. “Our phone is our strongest signal to our waking lives,” Troxel said. “You’re getting the light exposure from your phone, which can directly stimulate your circadian signal for alertness. The content of what we are consuming on our phones can be very activating, whether it’s scrolling through social media or reading the news. These can all stimulate emotional states that are more activating rather than relaxing.” So paradoxically, experts say to get out of bed. Yes, even at 3 a.m. “Abandon the idea of getting back to sleep,” Troxel said. “When you do that, when you let the pressure go that sleep isn’t so effortful, sleep is more likely to come back.” In a stimulus control technique, you can distract your brain with a mundane task to help bring back drowsiness faster than staying frustrated in bed. “As soon as that little voice comes on, change the environment. Get out of bed,” Robbins said. “Try to reset your brain and keep the lights low.” Mentally assigning the bed with sleeping helps people associate positive sleep thoughts with their space. Leaving the room when agitation sets in can separate the frustration from the bed. Anything from reading a book to knitting or listening to soft music (but not using a phone) can positively distract the brain. Once drowsiness sets in again, head back to bed. Dasgupta recommends keeping track not only of when you went to bed and woke up on a given night, but also the calming techniques, environmental factors – and even nutrition and exercise routines that seemed to help you sleep that day. “Perfect sleep is like having a puzzle, and you need all the right pieces,” Dasgupta said. “People who have insomnia, they’re missing one of those sleep hygiene pieces. When you make your recommendation, like a muscle relaxation, maybe that’s not the thing that they were missing. Maybe sound wasn’t the key part. Maybe you need more of that weighted blanket.” It also depends on our given circadian rhythm, or the 24-hour solar cycle the body runs on that alerts us when sleepiness sets at night. If any environmental factors change – such as travel, work schedule or lighting – the body’s circadian rhythm may be off, signaling an uncomfortable early wake-up before the alarm, Dasgupta said. In this case, changing the lighting in a given room or getting alternative lighting could help. Progressive muscle relaxation may work – start at the toes, clench the given muscles for three seconds and release. Breathe through this process. The 4-7-8 breathing exercise coupled with muscle relaxation can be successful, Dasgupta said. You breathe in for 4 seconds, hold it for 7 seconds and breathe out for 8 seconds. Relaxing breathFollow along as Dr. Ellen Vora guides you through the 4-7-8 breathing technique.Source: Courtesy Dr. Ellen Vora Others may find that yoga, meditation or reading can help when they wake up before their alarm. The key here as well is to get out of bed. The same techniques don’t work for everyone, but practicing various strategies that may affect sleep is critical, ultimately building a well-followed routine. “Take it in stride,” Robbins said. “That’s the reason we consciously use this word ritual before bed because it’s ideally strategies that you build into your routine. It’s your toolkit.” If the problem continues beyond three times a week for three months, Robbins recommends talking to a sleep specialist. It may require more than a simple habit change. | Stress and Wellness |
After being abused as a child, David spent decades searching for a treatment for his depression and anxiety. Like many people with treatment-resistant depression, he was cycled by psychiatrists through a variety of drugs and therapies, but David – who asked for only his first name to be used – said he remained “debilitated”.
Then in October 2021, at age 64, he began a fortnightly ketamine treatment – and it proved to be a “lifesaver”.
“I had a number of very significant bouts of suicidal ideation and I think without ketamine, I would have probably acted on those impulses at some stage,” David said.
However, the medication costs the retired veterinarian $14,000 a year, meaning he cannot afford to take holidays. Experts say many people cannot afford the therapy at all, despite a cheaper alternative being available.
An article published this month in the Australian and New Zealand Journal of Psychiatry (ANZJP) said patients with treatment-resistant depression are missing out on ketamine treatment because there are no commercial incentives to get the cheaper generic brand approved by the medicines regulator.
In 2021, Australia’s Therapeutics Goods Administration (TGA) approved Spravato, the patented ketamine nasal spray developed by Janssen Pharmaceuticals that costs between $600 and $900 a dose.
Applications to have Spravato subsidised by the government under the Pharmaceutical Benefits Scheme have failed, leaving researchers looking for more affordable alternatives.
Generic, or racemic, ketamine, commonly used as an anaesthetic, is not approved for use in treatment-resistant depression. It is significantly cheaper, at $5 a dose, although patients receiving the drug outside clinical trials pay an additional $350 for the consultation and monitoring.
The lead author of the ANZJP article, Prof Anthony Rodgers from The George Institute at the University of New South Wales, said there is good evidence for racemic ketamine’s use in treatment-resistant depression.
But he said there is a lack of commercial incentives to run the large trials needed for the TGA to approve the drug for treatment-resistant depression. Drugs that already exist – like ketamine – cannot be patented, meaning it is hard for companies to make money from them. Spravato managed to get a patent because it was adapted into a nasal spray.
Rodgers said while it may seem that trialing a drug that already exists would be cheap, his paper said substantial investment and specialist skills are required for trials to be conducted appropriately and to navigate complicated registration processes.
The article said new regulations need to be introduced to incentivise drug companies and other private entities to conduct trials on older drugs for treating new conditions, such as offering extended periods of market exclusivity if the drug proves successful.
Market exclusivity would allow the company that trialled the drug to market it for a period of time without direct competition from other manufacturers creating cheaper, duplicated products.
Companies could also be offered tax credits for research and development into exisiting drugs, the article said.
However, even if these measures were introduced, the article acknowledged the cost to patients for appointments to have the drug administered alongside psychotherapy may still be prohibitive. Patients require monitoring for at least two hours after receiving each dose of racemic ketamine and ongoing doses are needed for treatment to be effective.
Researchers supported by Australia’s peak body for psychiatrists have applied to have all methods of delivery and forms of ketamine, including the nasal spray and lower-cost injections, subsidised by Medicare.
A co-author of the ANZJP article, Prof Colleen Loo from the Black Dog Institute, said ketamine treatments should not be seen as a cure, with further research needed to understand whether the treatment’s effects are long-lasting.
Dr Adam Bayes, a psychiatrist at the Black Dog Institute who conducts clinical trials with ketamine in patients with mood disorders and was not an author of the article, highlighted the “huge” structural problems in accessing psychedelic treatments.
He said the expense means “a lot of people out there that have treatment-resistant depression” will be excluded from treatment.
“And often, because they’re depressed, they’re unemployed or they’ve had gaps in employment and they are often in a vulnerable financial situation,” Bayes said. “So there is a real need to address these issues.” | Mental Health Treatments |
Oregon has taken an unprecedented step in offering psilocybin, also known as magic mushrooms, to the public. Epic Healing Eugene - America's first licensed psilocybin service center - opened in June, marking Oregon's unprecedented step in offering the mind-bending drug to the public. The center now has a waitlist of more than 3,000 names, including people with depression, PTSD or end-of-life dread.
No prescription or referral is needed, but proponents hope Oregon's legalization will spark a revolution in mental health care. Clients do not need to live in Oregon to access psilocybin services but must be 21 years of age or older, said the state's Oregon Psilocybin Services. A preparation session must be completed with a licensed facilitator, the agency said.
Colorado voters last year passed a measure allowing regulated use of psychedelic mushrooms starting in 2024, and California's Legislature this month approved a measure that would allow possession and use of certain plant- and mushroom-based psychedelics, including psilocybin and mescaline, with plans for health officials to develop guidelines for therapeutic use.
The Oregon Psilocybin Services Section, charged with regulating the state's industry, has received "hundreds of thousands of inquiries from all over the world," Angela Allbee, the agency's manager, said in an interview.
"So far, what we're hearing is that clients have had positive experiences," she said.
As of September 15, 2023, Oregon Psilocybin Services has issued 11 service center licenses, 110 facilitator licenses, 4 manufacturer licenses, and 281 worker permits, the agency confirmed to CBS News.
While psilocybin remains illegal in most of the United States, the Food and Drug Administration in 2018 designated it a "breakthrough therapy." This summer, the FDA published draft guidance for researchers designing clinical trials for psychedelic drugs.
Researchers believe psilocybin changes the way the brain organizes itself, helping a user adopt new attitudes and overcome mental health issues.
The Oregon Psychiatric Physicians Association, however, opposed Oregon's 2020 ballot measure legalizing psilocybin, saying it "is unsafe and makes misleading promises to those Oregonians who are struggling with mental illness."
Allbee noted that psychedelic mushrooms have been a part of tribal spiritual and healing practices for thousands of years. Her agency is focused on safety, she said.
First, customers must have a preparation session with a licensed facilitator who stays with clients as they experience the drug. The facilitator can deny access to those who have active psychosis, thoughts of harming anyone, or who have taken lithium, which is used to treat mania, in the past month.
The clients can't buy mushrooms to go, and they must stay at the service center until the drug wears off.
Besides approving psilocybin, Oregon voters in 2020 decriminalized possession of hard drugs, cementing the state's reputation as a leader in drug-law reform. Oregon was the first state to decriminalize marijuana possession and one of the first to legalize its recreational use.
But these days, the regulated marijuana industry is struggling with massive oversupply. And drug decriminalization has not greatly expanded addiction treatment or reduced overdoses as hoped. According to AP VoteCast, 58% of Oregon voters in the 2022 midterm elections thought Oregon's drug decriminalization effort had been a bad thing.
It's too early to assess Oregon's mushroom legalization.
While Epic Healing Eugene has a long waitlist thanks in part to early media attention, other service centers say business is picking up as awareness spreads.
Omnia Group Ashland, which opened this month in southern Oregon, has a prospective client list of 150, said co-founder Brian Lindley. Jeanette Small, the owner of Lucid Cradle in Bend, said she intends to see only one client per week to give close attention to each and is already booked through December.
The law allows local jurisdictions to ban psilocybin operations, and several rural counties have done so.
There are complaints the cost is too high, but those in the industry expect prices to fall as more businesses are established. A client can wind up paying over $2,000, which helps cover service center expenses, a facilitator and lab-tested psilocybin. Annual licenses for service centers and growers cost $10,000, with a half-price discount for veterans.
Allbee said her agency requires every licensee to work toward social equity goals, with some already providing sliding-scale price models. She expects Oregon's psilocybin program, currently receiving millions in taxpayer dollars, to be fully supported by licensing fees by mid-2025. She promised to then boost efforts to lower prices.
Cathy Jonas, Epic Healing Eugene's owner, said she doesn't expect her service center to start making money for a while. Providing legal access to psychedelic mushrooms is a calling, she said: "The plant medicines have communicated to me that I'm supposed to be doing this thing."
State regulations allow doses of up to 50 milligrams, but when Jonas tested a 35-milligram sample of pure psilocybin - typically equal to about 6 grams of dried mushrooms - she found it so powerful that she decided it would be the most her facility would offer.
One of Jonas' first clients took 35 milligrams and described seeing a "kind of infinite-dimension fractal that just kept turning and twisting."
"It was kind of mesmerizing to watch, but it got so intense," said the client, who didn't want to be identified to protect his privacy. "I started to have this experience of dying and being reborn. And then I would kind of see large portions of my life going by in a very rapid way."
He said the session "was not particularly pleasant," but that it beneficially transformed how he views painful memories and provided a sought-after mystical experience.
Licensed grower Gared Hansen has come full circle from the 16 years he spent as a police officer in San Francisco. He once busted a psilocybin dealer in Golden Gate Park.
Today, he runs Uptown Fungus, a one-person psilocybin-growing operation in a nondescript building set among towering cedar trees near Springfield, Oregon. He tends mushroom varieties with names like Golden Teacher, Blue Meanies and Pink Buffalo. A 25-milligram dose costs $125.
Hansen said he sometimes meditates with the mushrooms, hoping to imbue them with healing energy.
Little, brown psychedelic mushrooms can be found growing in fields or in the woods, but they can closely resemble poisonous varieties. Hansen and others caution against obtaining psilocybin cheaper on the black market or tripping alone. Service centers provide measured - and often strong - doses in a controlled environment.
"Sometimes part of the healing could be a negative experience someone has to go through, to kind of flush negative emotions out or reexperience some trauma in a healthier way," Hansen said. "I'd hate to have someone that's never tried it before take it home, have a bad trip and hurt themselves."
for more features. | Mental Health Treatments |
A spring booster vaccine against Covid-19 is to be offered to people at most risk of serious illness from the disease to protect them this summer.
UK vaccine experts say it should be available to everyone over 75, care-home residents and anyone extremely vulnerable aged five and over,
Vaccinations at care homes in England are to start in early April, when Wales will also begin its programme.
The NHS in other parts of the UK have yet to announce their plans.
It's advised that the booster vaccine be given six months after someone's previous dose.
The Joint Committee on Vaccination and Immunisation (JCVI) said hospital admission rates for Covid-19 in autumn 2022 showed that the risk of becoming seriously ill from coronavirus was noticeably higher in people over 75.
As a result, they would gain the most from protection from an additional vaccine dose this spring, with health chiefs warning against complacency.
Anyone who lives in a care home for older adults and people aged five and over who are defined as immunosuppressed are also to be offered a booster jab.
They include people who've had organ transplants or who have blood cancer, and those undergoing chemotherapy treatment for cancer.
Bridging the gap
Professor Wei Shen Lim, JCVI chairman, said: "Vaccination remains the best way to protect yourself against Covid-19, and the spring booster programme provides an opportunity for those who are at highest risk of severe illness to keep their immunity topped up.
"This year's spring programme will bridge the gap to the planned booster programme in the autumn, enabling those who are most vulnerable to be well protected throughout the summer."
The NHS in England is expecting to offer the first spring booster doses to those eligible in April, and the campaign will last until late June. Wales has confirmed it will start on 1 April.
Four different vaccines, made by Pfizer-BioNTech, Moderna, Sanofi/GSK and Novavax could be used.
It's likely most doses will protect against the Omicron variant as well as previous ones.
Since last summer, different versions of the Omicron variant of Covid have been spreading the most - the latest being Omicron BQ.1.
Children under 12 years of age will be offered a children's formulation of the Pfizer BioNTech vaccine.
Dr Mary Ramsay, head of immunisation at the UK Health Security Agency, said Covid-19 was still circulating widely and there had been recent increases in older people being admitted to hospital.
"It is important those at highest risk of severe illness do not become complacent and I would encourage everyone who is eligible to come forward once the booster programme starts."
People at higher risk of severe Covid-19 are also expected to be offered a booster vaccine dose in autumn 2023 in preparation for the winter.
Last autumn, frontline health and care workers, adults aged 50 and over, and some carers and household contacts were offered a booster dose, too. | Vaccine Development |
Drug busts like this one in Indianapolis in 2019 have been a standard strategy for law enforcement targeting dealers for decades. Research suggests the raids may be doing more harm than good.
Indianapolis Municipal Police Department
A growing coalition of U.S. politicians want tougher police tactics used against gangs now selling fentanyl, methamphetamines and xylazine.
"We do need to stop the trafficking of these drugs and give law enforcement the tools they need," said Nevada's Democratic Sen. Catherine Masto Cortez, lead sponsor of a bill to toughen penalties for dealing the synthetic drug xylazine.
Big drug sweeps, narcotics seizures and mass arrests of dealers have been a cornerstone of America's war on drugs since the 1970s.
But new research published in the American Journal of Public Health suggests
drug busts and police crackdowns on dealers may actually be making the overdose crisis worse.
The study, which underwent a rigorous peer-review process because of its controversial findings, is based on data gathered in Indianapolis, Indiana that found patterns of overdose and death that followed drug seizures in the city.
"With opioids we saw overdoses double in the area immediately surrounding a seizure, within maybe a five-minute walk of that seizure over the next several weeks," said Jennifer Carroll, a medical anthropologist at North Carolina University and co-author of the article.
What happens after you arrest a drug dealer?
Law enforcement agencies have argued for years that arresting dealers and disrupting the supply of street drugs would make communities safer.
Lawmakers in state houses and Congress have raced to boost funding for drug interdiction, while toughening criminal penalties for trafficking fentanyl.
"We can't just allow the drugs to come in because we are seeing too many deaths," Sen. Masto Cortez told NPR.
Are harsher fentanyl sentences the solution to the opiate crisis? Experts say no
But Carroll says a growing body of data, including her own study, shows drug sweeps and seizures can destabilize the ecosystem of illegal activity.
People with addiction wind up buying fentanyl, methamphetamines and other high-risk street drugs from strangers selling drugs of different potency — often with different, more dangerous ingredients.
When people experiencing severe addiction are forced to go without drugs — even for a short period of time — it can alter their level of tolerance. Begin using again and they may be more vulnerable to overdose and death.
"When supply is disrupted, demand does not decrease," Carroll noted. "It's really drug market disruptions that are driving a lot of the harm of illicit substance use."
Brandon Del Pozo is a former police chief who now studies drug policy at Brown University. He's one of this new study's co-authors and says evidence is now clear that drug-bust tactics put lives at risk without actually cleaning up neighborhoods.
"There's a long history of big drug arrests followed by press conferences that say, 'This time will be different, this time will make a difference,'" Del Pozo said. "But except in the short term, where it leads to more overdose, it hasn't made a difference."
Research raises questions. Politicians call for tough action
Indeed, many of these tactics have been in use for half a century, but critics say they haven't worked.
The supply of street drugs is now cheaper, more readily available, and more toxic than ever before; roughly 110,000 people in the U.S. died of fatal overdoses last year alone, a devastating new record.
U.S. Drug Enforcement Administration
toggle caption
Indianapolis has seen huge drug seizures over and over. This one occurred in 2011. Critics question whether they are making the city safer or reducing the supply of street drugs.
U.S. Drug Enforcement Administration
"If the goal is to save lives, we have pretty good reason to save lives, then we have pretty good reason to believe that criminalization really isn't serving that purpose very well," Carroll said.
But fear of fentanyl is adding to political pressure to get even tougher on drug dealers.
"I don't see the enforcement side of it slowing down at all, many people are doubling down," said Brittney Garrett, a former cop who now advises police departments on drug fighting tactics.
Sen. Cortez Masto describes her xylazine measure - which has broad bipartisan support - as a necessary legal tool to toughen penalties and "crack down on traffickers."
Cliff Owen/AP
toggle caption
Sen. Catherine Cortez Masto, D-Nev., is a former state attorney general leading the bipartisan push to toughen penalties for xylazine dealers.
Cliff Owen/AP
Sen. Catherine Cortez Masto, D-Nev., is a former state attorney general leading the bipartisan push to toughen penalties for xylazine dealers.
Cliff Owen/AP
"I can just tell you what I'm seeing and hearing from my law enforcement," Sen. Cortz Masto told NPR. Xylazine is "becoming an emergent threat, one we need to get a handle on now and not wait to lose more lives."
Beau Kilmer, who heads the Rand Drug Policy Research Center, agrees police should play a major role cleaning up neighborhoods where drug-dealing is rampant.
"If you can just reduce the number of dealers on the street and allow residents get their neighborhood back that could be a real benefit," he said.
Can drug seizures be folded into a wider public health strategy?
But Kilmer says this study shows that before drug busts and seizures occur, police have to do more planning to prevent spikes of deadly overdoses.
"They're going to want to make sure they talk to folks at the department of health and make sure they have a thoughtful plan making sure treatment is available," Kilmer said.
Some experts say this kind of coordination, while increasing, remains rare.
NPR asked the U.S. Drug Enforcement Administration and Indianapolis police for an interview about this research to find out how these findings might shape their tactics. The DEA didn't respond.
Indianapolis police sent a brief statement saying they would review results from the study but remain committed to taking drugs off the streets.
"We look forward to working with other law enforcement agencies, health care providers and other organizations who are committed to reducing drug trafficking and substance abuse," said Indianapolis police spokesperson Alexa Boylan in an email.
Just days after the new study was published, cops across Indianapolis — working with the DEA — mounted another major drug sweep, seizing roughly two hundred pounds of fentanyl and methamphetamines.
"I think what you see here today sends a message to our community, we are unyielding, said Indianapolis Deputy Police Chief Kendale Adams.
He didn't mention the overdose study or its warnings but said police are partnering with public health agencies.
"We'll be working with [the Office of Public Health and Safety] going back to some of these neighborhoods to see what they can do to change people's lives, change people's mindset, so they can get out of the game."
Some experts on police drug enforcement tactics believe law enforcement must do much more to protect public health before drug seizures occur. That would mean more advanced planning and coordination with harm reduction groups and others focused on helping people with addiction.
"We don't have a choice is the way I look at it," said Brittney Garrett, the former cop who works now with a pro-reform group called the Police Assisted Addiction and Recovery Initiative.
"By not having law enforcement, public health, behavioral health, harm reduction all working together, we're going to end up with more people being harmed." | Drug Discoveries |
Hydrogen water is water that’s been infused with extra hydrogen gas to increase the antioxidant and anti-inflammatory potential, drawing on years of research by medical professionals who have been exploring the benefits of inhaled hydrogen for cardiac patients, people going into and coming out of surgery, and other medical applications. Hydrogen gas can nullify many of the reactive oxygen species responsible for oxidative stress, and pre- and peri-operative hydrogen inhalation does appear to help patients recover more quickly and avoid many of the side effects inherent to surgery. But that’s inhaled hydrogen gas in a medical setting. Does commercial hydrogen water have similar benefits?
I was actually surprised to find that the research is fairly compelling. Let’s dig in.
Hydrogen water improves physical performance
Both acute and long-term hydrogen water intake can improve your performance in the gym, on the bike, or on the field.
One study had cyclists either drink hydrogen water or placebo water prior to cycling. Those who drank hydrogen water had more endurance and reported less fatigue during training.1
Hydrogen water has also been shown to reduce lactate, an objective measure of fatigue, when consumed 30 minutes before a workout. Lactate builds up with exhaustive exercise—the harder and longer you go, the more lactate you produce and the more tired you get. The researchers hypothesized that hydrogen water reduces lactate by increasing mitochondrial respiration and ATP production.2
However, another study found that a 7-day course of hydrogen water only improved exercise performance in trained athletes. Non-athletes saw no benefit.3 To really see the benefits of hydrogen water for physical performance, you probably need to be doing serious training.
If you are doing serious training or competing and need to maintain performance despite fatigue, hydrogen water can help. One recent study found that drinking hydrogen water rescued the antioxidant capacity of athletes engaged in three unbroken days of intense physical training. Moreover, they experienced no performance decline.4
Hydrogen water improves metabolic health
Metabolic syndrome is the most common illness in the country. Your average diabetic, hypertensive adult with low HDL levels and high triglycerides who’s due for a heart attack any moment? He’s got metabolic syndrome.
In patients with probable metabolic syndrome, hydrogen water consumption raises HDL and lowers LDL oxidation.5 Since oxidized LDL are a causative risk factor for heart attacks, and high HDL is protective, everyone would agree that this is a positive development.
Another study of probable metabolic syndrome patients found that hydrogen water reduced inflammatory markers while improving blood lipids and antioxidant capacity.6 Higher antioxidant capacity combined with reduced inflammatory markers suggest an increased resistance to oxidative stress.
Hydrogen water lowers elevated oxidative stress
However, hydrogen water only lowers oxidative stress if there’s oxidative stress hanging around that needs lowering. Again and again, we see little no effect on healthy people who aren’t suffering from oxidative stress.
One study gave hydrogen water to people aged between 20 and 59 years of age. Only those aged 30 years or more saw an increase in their antioxidant capacity. The younger people with a presumably lower oxidative stress load didn’t really benefit, while the older people who’d had more time to pick up some stress along the way saw benefits.
Another study found that heathy people who drank hydrogen water for four weeks straight saw no effect (good or bad) on their oxidative stress levels compared to placebo.
Meanwhile, patients with chronic hepatitis B infections see large decreases in oxidative stress upon hydrogen water intake.7
Even the exercise research I discussed earlier bears this out. When you train hard, you’re creating a transient state of oxidative stress. You’re “unhealthy” for a moment in time, and that’s where hydrogen water has an effect.
Hydrogen water improves aging
All else being equal, the older you are, the more oxidative stress you’re exposed to. Older people also tend to be more inflamed and have lower antioxidant capacities. Hydrogen water can help with all three.
In adults older than 70, hydrogen water has been shown to increase brain nutrient content, lengthen telomeres, and improve how quickly a person can stand up from a chair—all extremely important as we age.8
In both mouse models and human studies, hydrogen water improves symptoms of mild cognitive impairment.9
How does it work?
The evidence is there, but how is hydrogen exerting its antioxidant effects? There are two main theories and they both have supporting evidence.
Theory 1: Hydrogen water is a direct antioxidant that selectively scavenges and nullifies harmful reactive oxygen species. For instance in one study, butter was washed either with normal water, hydrogen-infused water, or magnesium water. Washing with both the magnesium and hydrogen water prevented the formation of amines (metabolites of amino acid breakdown) in the butter during long term storage by scavenging the oxidant species responsible. Regular water allowed amine formation.10
Theory 2: Hydrogen water is a hormetic stressor. Hormesis describes exposing an organism to a mild stressor that provokes an adaptive response. Examples of hormesis include exercise (damage the muscles and get stronger as a result), intermittent fasting/calorie restriction (light “starvation” improves metabolic health), cold exposure, and even dietary polyphenols that act like mild pesticides that provoke an anti-inflammatory antioxidant response in the body. Hydrogen water does trigger the very same NrF2 pathway that other hormetic stressors also trigger.11
These aren’t necessarily contradictory. Both can be true to some extent. In fact, many researchers believe that the hydrogen water is both a direct scavenger and a hormetic stressor.12 What definitely seems to be the case is that hydrogen water exerts antioxidant effects and can stem the tide of oxidative stress.
Do you need hydrogen water?
Not everyone.
However, if you do need it, it really seems to work. The fact that it’s selectively effective—that it has little to no effect in otherwise healthy young people who don’t really have much oxidative stress happening, instead improving the health of people experiencing high oxidative stress—is a good sign. It’s not something everyone needs to take. It’s a supplement that can help people dealing with specific disease states: metabolic syndrome, inflammatory diseases, even something like depression.13 It’s probably also helpful for people engaged in hard physical training.
In other words, it helps if you need it and has little to no effect if you don’t. It’s good if you’re sick or stressed and it’s benign if you’re not.
Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples. | Nutrition Research |
Newly released WhatsApp messages and emails between Tory donors and the former health secretary Matt Hancock reveal the extent of ministerial access they enjoyed when government Covid contracts were being awarded.
Two major donors to the Conservatives, Mustafa Mohammed and Mohamed Amersi, had direct access to Hancock, and used it to promote companies offering Covid services with which they were involved. Amersi also had a phone meeting with James Bethell, a health minister at the time, in which he put forward projects with which he was connected.
Both Mohammed and Amersi said they made no financial gain from the contacts and that they acted purely to help in a time of national crisis. Hancock insisted the contacts were in response to a call for help with testing and that all leads were passed on to officials in an appropriate way. However, the messages raise new questions about the influence politically connected people had during the pandemic as a result of their relationships with Tory ministers.
The government has been forced to admit that it ran a controversial “VIP” PPE contracts lane for those with personal contacts, which was subsequently ruled unlawful. There is no suggestion that Mohammed or Amersi acted unlawfully.
Mohammed – who has donated £234,000 to the Conservatives, and his company Genix Healthcare, a further £156,000 – messaged Hancock on 11 June 2020 with a proposal.
He suggested that Genix, which operates UK dental clinics, partner with a global crisis management company, Ecolog, to set up a rapid testing service. Early the next morning, Hancock replied “very interesting”, and asked Mohammed to email details to his office. Ecolog was then referred by Hancock’s officials into the government’s VIP priority lane.
Within a week Mohammed had met the team at the Department of Health and Social Care. “My dear friend hope you are well …. I had the call today …which went well. Thank you so much for your kind help,” Mohammed messaged Hancock on 18 June.
A legal letter of intent was signed by the DHSC on 4 September 2020, which guaranteed a multimillion-pound payment to Ecolog even if a full contract was not issued. The following year the DHSC decided it did not want to proceed and gave Ecolog £38m in settlement for “mobilisation costs”, including a “profit component”. The DHSC confirmed that no services were provided by the company.
The messages were disclosed after freedom of information requests were made by the campaign group the Good Law Project. The GLP director, Jolyon Maugham, said: “No one who followed the ongoing scandal that is Covid procurement will be surprised to learn a minister was directly involved in a huge contract award that failed to deliver. What we desperately need is an independent review into how this happened over and over again.”
Mohammed’s access to the health secretary did not end with Ecolog. The day the preliminary contract for Ecolog was signed, he sent another WhatsApp message to Hancock.
This time Mohammed was promoting a company called Oxsed, which had developed rapid Covid tests. “As you will be aware my dear friend I am involved with Oxsed and have been liaising with [redacted] and [redacted] team who have been extremely helpful … is there anyone else we should be contacting to speed up the process my dear friend,” he wrote. Hancock replied promptly promising to look at a presentation he had been emailed. It is not clear if any further help was given.
In response to the disclosure of the messages, Mohammed said: “Many highly experienced individuals were working incredibly hard … doing everything they could to try to save lives. Any insinuation that anything improper or morally wrong was occurring is completely unfounded.”
Amersi, another Tory donor, also promoted Oxsed. He recommended the company in a phone meeting in June 2020 with the health minister Lord Bethell, according to minutes of the meeting. Bethell asked a DHSC team to report on whether the project had any merit.
Amersi also contacted Hancock on 5 September to highlight bottlenecks at the DHSC in relation to another Covid project. He signed off with a suggestion: “It would be wonderful if you think it appropriate to have a single senior person shepherd this along if it has merit.”
Amersi said the company was directed to the regulator’s website and that his approaches to ministers were “at all times on a philanthropic basis”. He said he had no financial interest in any of the projects he put forward, which had grown out of links with innovators at Oxford University to which he is a major philanthropic donor, and they did not receive favourable treatment. He added that his access to ministers was nothing to do with being a party donor.
Bethell said it was his job to talk to companies with innovative solutions to the crisis and to connect them with officials. “From your description, that’s what I did. What’s the problem?”
A spokesperson for Hancock said the messages showed he acted properly. “Government Covid contracts were decided, priced and signed off by the civil service, who are independent of ministers. To suggest any wrongdoing is offensive and false,” the spokesperson said.
A spokesperson for Oxsed’s parent company, Prenetics, said “zero business and zero approval” for Oxsed was facilitated by Mohammed or Amersi, and that it won no UK government contracts. Ecolog did not respond to requests for comment by the time of publication. | Health Policy |
New guidance to support women with periods or going through menopause has been described as a "magnificent step forward".
The British Standards Institution (BSI) has published a workplace standard to tackle taboos and help employers keep talented people in work.
It suggests more training for managers and offering flexible work patterns.
It also recommends introducing comfortable seating and desk fans to help with menopause symptoms.
One woman who left her job due to early menopause said she thought at the time she would never work again.
About a decade ago, Lauren Chiren was working as a senior executive in financial services. She loved her job, was thriving on the challenge and enjoyed juggling work with being a new mum.
"That was until I found myself in meetings unable to get my words out," she said.
Ms Chiren initially thought her symptoms of sleep deprivation, forgetfulness and losing her self-confidence were signs of early dementia before she realised she was going through the menopause.
She chose to leave work and has since founded a menopause at work consultancy called Women of a Certain Stage.
The CEO from Bristol, who was on the panel that helped develop the new workplace standard, said she was delighted with the guidance and hoped it would prevent businesses losing talented people.
Ms Chiren said it was important to raise awareness and train line managers, adding that people did not talk about the menopause when she went through it.
She said the new work standard was a "magnificent step forward" and if organisations did not take it forward they risked getting "left behind".
The BSI is the UK's official standards body responsible for setting out the agreed way of doing things across a variety of industries.
Launching the new workplace standard, the BSI said "only a minority of UK workplaces" had already introduced policies on menstrual and menopausal health and wellbeing, stressing that some women, transgender men and non-binary people needed adjustments to effectively carry out their work.
These could include comfortable seating and desk fans, it suggests, as well as using non-stigmatising language like "menstrual products" instead of "feminine hygiene products".
The standard is intended to help workers in a variety of roles - including jobs that involve being on your feet a lot, like police officers, and highly physical roles like construction workers, the BSI said.
It said adjustments could be made to things like uniforms, PPE and artificial lighting.
What is the new standard?
The menstruation, menstrual health and menopause in the workplace standard sets out practical recommendations.
It is also intended to help companies identify misconceptions about periods and peri-menopause.
Suggestions include:
- Increasing awareness of menstruation and menopause
- Training managers to understand potential impact
- Ensuring facilities are accessible
- Checking if policies consider menstruation and menopause
- Considering flexible work patterns for staff
Research from the Fawcett Society, a women's rights charity, suggested one in 10 women who worked during the menopause has left a job due to their symptoms.
The BSI said it recognised not everyone would want support as experiences differ.
Elysha Paige, who was also on the panel, said she previously felt she could not talk about her period and had to hide it at work.
She praised the accessibility of the guidance, adding that it was really good at recognising the shame and stigma that can exist in some work places.
Miss Paige runs an employers' programme for period awareness charity Bloody Good Period.
She said in a previous job she stayed on the contraceptive pill to control her periods to make her work life easier, "even though that wasn't the best thing for me and my mental health".
"I was the only woman and the only person who had periods," said the charity worker from London. She said if periods were discussed in the office, it was only ever in a degrading way.
It was a "rigid sales environment" where being away from your desk "was seen as a bad thing", said Miss Paige, adding that going to the toilet to change a sanitary pad would have been difficult.
But she said her experience was "definitely not one of the worst" and research from Bloody Good Period had found other people who were forced to take annual leave due to period problems.
Educating people in the workplace is important, says Tina Leslie from period poverty charity Freedom4Girls - but she wants the guidance to go further.
The charity worker, who has an MBE for services in tackling period poverty, wants policy changes made and for managers to adopt the standards set out by the BSI. One of the changes she would like to be made is free period products in workplace toilets, to help lower-paid workers access pads and tampons.
Fellow panellist Rachel Lankester said she was "absolutely delighted" with the new work standard, saying it would give organisations a framework to take action.
However, she said it was important that menopause and menstruation were "not seen as a medical conditions".
Women needed support, Ms Lankester said, but added "there is a fine line between giving women support and a reason for discrimination".
She said getting an early menopause diagnosis at 41 was "devastating".
"I didn't talk to anybody because I felt ashamed... but realised that was ridiculous," she said.
"If I'd known back then there was someone I could talk to⦠it would have made a real difference to my self esteem."
Ms Lankester, who has since founded Menoclarity and Magnificent Midlife to support women experiencing the menopause, said normalising the topic was "wonderful".
"I didn't have any information so I've created what I would have benefited from. I want women to have the correct information, to be prepared, not scared."
Additional reporting by Michael Sheils McNamee | Women’s Health |
NEW ORLEANS -- The mpox health emergency has ended, but U.S. health officials are aiming to prevent a repeat of last year’s outbreaks.
Mpox infections exploded early in the summer of 2022 in the wake of Pride gatherings. More than 30,000 U.S. cases were reported last year, most of them spread during sexual contact between gay and bisexual men. About 40 people died.
With Pride events planned across the country in the coming weeks, health officials and event organizers say they are optimistic that this year infections will be fewer and less severe. A bigger supply of vaccine, more people with immunity and readier access to a drug to treat mpox are among the reasons.
But they also worry that people may think of mpox as last year's problem.
“Out of sight, out of mind,” said Dr. Demetre Daskalakis, who is advising the White House on its mpox response. “But we are beating the drum.”
Last week, the Centers for Disease Control and Prevention issued a health alert to U.S. doctors to watch for new cases. On Thursday, the agency published a modeling study that estimated the likelihood of mpox resurgence in 50 counties that have been the focus of a government campaign to control sexually transmitted diseases.
The study concluded that 10 of the counties had a 50% chance or higher of mpox outbreaks this year. The calculation was based largely on how many people were considered at high risk for infection and what fraction of them had some immunity through vaccination or previous infection.
At the top of the list are Jacksonville, Florida; Memphis, Tennessee; and Cincinnati — cities where 10% or fewer of the people at highest risk were estimated to have immunity. Another 25 counties have low or medium immunity levels that put then at a higher risk for outbreaks.
The study had a range of limitations, including that scientists don't know how long immunity from vaccination or prior infections lasts.
So why do the study? To warn people, said Dr. Chris Braden, who heads the CDC's mpox response.
“This is something that is important for jurisdictions to promote prevention of mpox, and for the population to take note — and take care of themselves. That’s why we're doing this,” he said.
Officials are trying to bring a sense of urgency to a health threat that was seen as a burgeoning crisis last summer but faded away by the end of the year.
Formerly known as monkeypox, mpox is caused by a virus in the same family as the one that causes smallpox. It is endemic in parts of Africa, where people have been infected through bites from rodents or small animals, but was not known to spread easily among people.
Cases began emerging in Europe and the U.S. about a year ago, mostly among men who have sex with men, and escalated in dozens of countries in June and July. The infections were rarely fatal, but many people suffered painful skin lesions for weeks.
Countries scrambled to find a vaccine or other countermeasures. In late July, the World Health Organization declared a health emergency. The U.S. followed with its own in early August.
But then cases began to fall, from an average of nearly 500 a day in August to fewer than 10 by late December. Experts attributed the decline to several factors, including government measures to overcome a vaccine shortage and efforts in the gay and bisexual community to spread warnings and limit sexual encounters.
The U.S. emergency ended in late January, and the WHO ended its declaration earlier this month.
Indeed, there is a lower sense of urgency about mpox than last year, said Dan Dimant, a spokesman for NYC Pride. The organization anticipates fewer messages about the threat at its events next month, though plans could change if the situation worsens.
There were long lines to get shots during the height of the crisis last year, but demand faded as cases declined. The government estimates that 1.7 million people — mostly men who have sex with men — are at high risk for mpox infection, but only about 400,000 have gotten the recommended two doses of the vaccine.
“We're definitely not where we need to be,” Daskalakis said, during an interview last week at an STD conference in New Orleans.
Some see possible storm clouds on the horizon.
Cases emerged this year in some European countries and South Korea. On Thursday, U.K. officials said an uptick in mpox cases in London in the last month showed that the virus was not going away.
Nearly 30 people, many of them fully vaccinated, were infected in a recent Chicago outbreak. (As with COVID-19 and flu shot, vaccinated people can still get mpox, but they likely will have milder symptoms, officials say.)
Dr. Joseph Cherabie, associate medical director of the St. Louis County Sexual Health Clinic, said people from the area travel to Chicago for events, so outbreaks there can have ripple effects elsewhere.
“We are several weeks behind Chicago. Chicago is usually our bellwether,” Cherabie said.
Chicago health officials are taking steps to prevent further spread at an “International Mr. Leather” gathering this weekend.
Event organizers are prominently advising attendees to get vaccinated. Chicago health officials put together social media messages, including one depicting three candles and a leather paddle that reads: “Before you play with leather or wax get yourself the mpox vax.”
___
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 study to assess whether blood tests could help diagnose people with very early Alzheimer's disease, is being launched by the NHS.
Spotting the condition much sooner would mean people could have more support and new treatments to slow the disease, say experts.
The five-year project has £5m funding from the People's Postcode Lottery.
Currently, there is no single test for Alzheimer's, and patients can wait years for a diagnosis.
A blood test would not be able to rule in or out Alzheimer's 100% of the time, but might be a cheap and easy way to help doctors spot which patients have hidden physical signs of the disease, years before telltale symptoms appear.
There are lots of different ones in development around the world - some are already used in private clinics in the US.
They look for traces of brain proteins that have leaked into the bloodstream.
These proteins, such as tau and amyloid, start to build up in the brain a decade or more before people develop memory loss and confusion.
New Alzheimer's drugs, such as donanemab and lecanemab, can clear some of that brain build-up.
Most amyloid-lowering drug trials so far involve people with advanced disease, and many researchers believe that by the time symptoms set in, the window of opportunity for preventing cognitive decline may have passed already.
The drugs might be more effective earlier on, in people who have amyloid build-up but do not have symptoms yet, which is why a blood test could be really useful.
Fiona Carragher, from the Alzheimer's Society, said: "Nearly four in 10 people in the UK who have dementia have not received a diagnosis. We also know that those who do have a diagnosis have often waited many months, sometimes years, to receive it.
"This means thousands of families are stuck in limbo, trying to manage symptoms and plan for the future without access to the vital care and support that a diagnosis can bring.
"New drugs targeting early-stage Alzheimer's disease are just around the corner, but without a diagnosis, people simply won't be able to access them if they are approved."
Having a measurable biomarker for the disease would provide a way to monitor how well new treatments work too.
The NHS Blood Biomarker Challenge will look to recruit at least 1,000 NHS patients.
The Alzheimer's Society, Alzheimer's Research UK and the National Institute for Health and Care Research are working with the UK Dementia Research Institute at University College London for the project.
Dr Susan Kohlhaas, from Alzheimer's Research UK, said: "We need to move these tests out of the lab and assess their effectiveness in real-world settings like the NHS."
UK regulators would still need to approve a blood test, and research would need to show it is cost-effective for the NHS to use.
Emma Ruscoe, 55, from Solihull, said it took four years for her husband Simon to be diagnosed with young-onset dementia.
"When Simon received his diagnosis, I felt a sense of relief. I knew something was wrong and I was battling for so long. If a blood test had existed, it would have saved a lot of heartache. The uncertainty was really hard to deal with as a family."
Alzheimer's disease affects about six in every 10 people with dementia in the UK. Alzheimer's is not a normal part of ageing, but the chance of developing the disease increases as we get older. | Disease Research |
Boris Johnson told scientists he was in favour of a Swedish-style approach to the pandemic, rather than more lockdowns, in Autumn 2020, an Oxford University epidemiologist has told the Covid Inquiry.
As the inquiry prepares to hear from Mr Johnson’s closest advisers this week, evidence from Professor Sunetra Gupta suggests that the former prime minister was persuaded by a Swedish expert that lockdowns could be avoided by implementing less restrictive rules.
Professor Gupta took part in a “round table” with Mr Johnson, Rishi Sunak and several other scientists in September 2020 as the government debated how to tackle Covid. At the time, restrictions had been eased.
Mr Johnson had been keen to seek a range of views during the meeting on Zoom titled: “Should the government intervene now and if so how?” and he asked Professor Gupta and Professor Carl Heneghan, both prominent critics of lockdown, for advice as well as Anders Tegnell, Sweden’s state epidemiologist.
Unlike the rest of the world, Sweden took a different approach to the pandemic, only introducing social distancing, limited travel restrictions and bans on mass gatherings.
While Mr Johnson later introduced the tiered system of local restrictions and the country endured two further lockdowns, Professor Gupta said that other than one scientist, Professor John Edmunds, everyone else in the meeting agreed about the benefits of the Swedish approach. Her comments are the first time a scientist in the meeting has publicly spoken about Mr Johnson’s support for the Swedish model.
‘Humanitarian route’
Professor Gupta, a theoretical epidemiologist at Oxford’s Department of Biology, advocated a “focused protection” approach to protect the vulnerable, which she said was “the only humanitarian route out of the crisis” .
In her witness statement, seen by The Telegraph and submitted to the Inquiry, she said that Dame Angela McLean, now the government’s chief scientific adviser, who the Inquiry has heard mocked lockdown critics, was also in favour of a Swedish-style approach.
“Anders Tegnell gave a general outline of the ‘Swedish’ strategy, which corresponded to the opinions he had already expressed on multiple occasions in the press; Angela McLean expressed the opinion that we should be doing whatever Tegnell was doing,” her statement says.
“As the ‘Swedish’ strategy is effectively synonymous with focused protection of the vulnerable, it could be said that other than John Edmunds, all invitees were broadly in favour of proposals outlined by Tegnell. Boris Johnson interrogated each of us on our position, but there was no opportunity for a panel discussion.”
Mr Johnson was later reported to have said in September 2020 that he would rather let coronavirus “rip” than introduce a second lockdown because of the economic impact. However, a second lockdown was introduced in November 2020 and a third in January 2021.
The disclosure comes as the inquiry prepares for a crucial week with Lee Cain, the former director of communications at Number 10 and Dominic Cummings, the former chief adviser to the prime minister, set to give evidence.
The Inquiry is expected to ask Mr Johnson’s advisers about the decision-making process inside No 10 throughout the pandemic.
Professor Gupta has not been called to give evidence and the inquiry is yet to publish her witness statement. However she shared it with The Telegraph amid frustration from scientists critical of lockdown that they were not being given a fair hearing.
In her statement, she also reveals how she tried in vain to arrange a meeting with Michael Gove, then the Chancellor of the Duchy of Lancaster, and also met Theresa May in October 2020 because “she wished to interrogate me on my views regarding the necessity of lockdowns”.
“Michael Gove expressed an interest in speaking with me concerning my views on lockdowns but repeatedly cancelled. I have no idea why the meeting did not materialize.”
Harm done by lockdown
In her statement she urged the Inquiry to scrutinise the harm done by lockdown and said that she and other academics who spoke out against restrictions on civil liberties “became victims of a vicious campaign to silence and impugn us”.
“Focus on the key trade-off,” she told the Inquiry. “Rather than wasting time and energy on understanding why we were not more eager to implement such measures earlier in the epidemic, I believe a more useful line for the Covid Inquiry would be to examine why we did not distinguish between on the one hand the benefits the measures could have brought at an individual level to those at risk of severe disease and on the other the harms they were bound to cause at a population level, especially for the poor and the young”.
She said that her logic of focused protection for the vulnerable rather than lockdowns should have been “obvious to those whose responsibility it was to manage the response to the pandemic”.
“The blind adoption of lockdown and lack of debate as to how to respond to the uncertainties is a tragedy for which the whole of society is now paying a hefty price.”
The inquiry says it is independent and selects witnesses on the relevance of their evidence. It is understood that witness statements are shared with core participants even if not made public.
A spokesman for Mr Johnson declined to comment, but said he would give evidence to the inquiry in due course and that he was fully cooperating. | Epidemics & Outbreaks |
For most of the millions of people who get the flu each year in the U.S., the virus brings a few days of fever, body aches and weakness before it goes away.
But for some, the influenza virus can lead to severe illness, hospitalization — even death.
Allison Miller knows these risks all too well. This year marks a decade since serious complications from the flu led to a life-changing loss for the Virginia-based communications director.
At age 33, Miller was a healthy young woman when she came down with a sore throat and headache.
When her symptoms got worse, she went into urgent care for a chest X-ray, but it showed nothing alarming.
"It looked like it was just some sort of run-of-the-mill stuff — they gave me some prescription cough syrup and said to let them know if it got worse," she said in an interview with Fox News Digital.
Back at home that night, Miller started feeling worse — and began having intense back pain.
"Thinking it was the flu or something I could get over, I kept waiting to turn the corner — like, this is the worst of it. It'll get better. And clearly that wasn't the case," she said.
The next morning, when the back pain was causing her to have periodic blackouts, Miller managed to call a friend, who came over and called an ambulance.
That’s where Miller's memory stops.
"I remember being loaded into the ambulance — and then I really don't remember a whole lot after that for about three weeks to a month thereafter," she said. "It just escalated very quickly."
As Miller would later learn, her influenza had caused bilateral bacterial pneumonia — which affects both lungs and is more severe than viral pneumonia.
This led to sepsis, which quickly turned to septic shock.
"All of my organs were shutting down," Miller said. "Within a short amount of time, I was in the ICU and they were doing everything they could. But ultimately, my last best chance was to be put on life support."
"I had missed the memo that flu vaccines were for everyone, and being 33 at the time and otherwise healthy, it didn't even register as something I should consider doing."
After five days, Miller experienced a rare complication.
"A known complication of that form of life support is amputation," she told Fox News Digital. "Some patients lose blood circulation, and that's what happened to me."
Ultimately, doctors had to amputate Miller’s left leg above the knee — all while she was still in a medically induced coma.
"By the time I came out of it, it had been three weeks. I awoke in a very hazy position — and I didn’t have a left leg," she recalled.
She spent another two months in the hospital and then had to do weeks of inpatient rehabilitation.
Today, in what Miller refers to as her "new normal," she wears a prosthesis and — with the help of "very qualified people" — has learned to walk again and to "navigate the world and all of its terrain."
Miller has been able to get back to the things that she loves to do, such as traveling the world, without feeling limited by her disability.
"It's just different, and I have learned to adapt and adjust," she said.
In addition to the amputation, Miller still suffers from permanent lung damage and below-average heart function.
"There was some permanent organ damage because of the strain of the virus, as it was such a severe case of pneumonia," she said. "I have a terminal lung condition that needs regular treatment."
She added, "It's manageable, but it's something I will forever deal with."
The experience has given Miller a "renewed sense of how quickly things could change" — and has taught her to be as proactive as possible about her health to prevent a terrible outcome.
"A viral illness like influenza can set you up for something more serious further on."
Overall, Miller said she thinks most people don’t understand how severe the flu can be — so they don’t recognize the signs that they need immediate medical attention.
"In my case, it was very quick — it was within 24 to 48 hours that it went from just coming on, to me being in the hot seat."
Now, Miller is looking to spread awareness of the importance of getting the flu vaccine, which she did not get that year.
"I had missed the memo that flu vaccines were for everyone, and being 33 at the time and otherwise healthy, it didn't even register as something I should consider doing," she said.
"If there's anything you can do proactively to minimize the risk of something that severe happening to you, you absolutely should do it, I think."
Miller acknowledges that the vaccine doesn’t guarantee that someone won't get the flu, but noted that "it's more of a continuum, rather than either you're sick or you're not."
She said, "You still might get it, but you may not end up in the ICU like I did … Considering the benefits that you could get and what the extreme, worst outcome could be, it is an easy thing to do that is proven to make a tremendous difference for people," she added.
In addition to getting yearly vaccines, Miller takes steps to minimize her exposure and makes healthy lifestyle choices, such as eating nutritious foods and exercising.
Dr. Gregg Sylvester, chief health officer at CSL Seqirus, a New Jersey biopharmaceutical company, noted that while Miller’s experience is not typical of most women in her age range, "it probably occurs more often than we know."
The flu triggers inflammation of the respiratory tract, Sylvester said, which causes it to become irritated and can allow secondary or bacteria to enter.
"A viral illness like influenza can set you up for something more serious further on," he warned. "That's why it's so important to get a vaccine."
The more severe complications of flu often are markedly reduced for those who get an influenza vaccine, according to the doctor.
"You still may end up getting infected, but your symptoms will be milder," he said. "And hopefully, your respiratory tract will be in a little bit better shape."
Mid-October is the "perfect time" to get a flu vaccine, Sylvester said, as he noted that the U.S. is starting to see an upswing in cases.
"It's never too late, but it is important to be vaccinated before the season really gets started," he said.
Overall, Miller urged, "don't dismiss the flu as just the flu. It's so much more than that. And it can be life-altering."
She continued, "If you're sick and the symptoms are severe, don't waste time wondering if you should seek medical attention. Listen to your body — it’s better to go in proactively, rather than regret it later."
Sylvester agreed, stressing the need for people to be their own patient advocates.
"It's important to seek care early, especially if symptoms start to change dramatically," he said.
During the 2021-2022 influenza season, the Centers for Disease Control and Prevention (CDC) estimates that there were nine million illnesses, four million medical visits, 10,000 hospitalizations and 5,000 deaths related to the flu.
The CDC recommends that everyone 6 months and older get a flu vaccine every season, with rare exceptions. | Vaccine Development |
Subsets and Splits