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Sky Sports host Charlie Webster shared the sad news as she paid tribute to her 'courageous and strong' friend Katie and said that she was "so sad, hurt and pained'Video LoadingVideo UnavailableNowhere to Run: Abused by our Coach opening A rape survivor who helped jail her paedophile running coach, inspiring a BBC documentary, has tragically died by suicide. Sky Sports host Charlie Webster shared the sad news as she paid tribute to her "courageous and strong" friend Katie and said that she was "so sad, hurt and pained". Katie was found dead at her home in Australia on Sunday. Charlie, 40, wrote: "I’m so sad, hurt & pained to say Katie has sadly passed away. "Katie is my friend, was part of my running group that I made my BBC documentary Nowhere to Run: Abused by Our Coach about. Katie died by suicide." Rape survivor Katie tragically died by suicide (
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Twitter / gofundme) Sky Sports host Charlie Webster has paid tribute to her friend (
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Twitter) The presenter revealed how she met Katie when they were children at a running club in Sheffied and the pair became friends. However, both were groomed by the club's respected coach - Paul North - and subjected to his horrific sexual abuse. In 2021, Charlie made a powerful documentary for the BBC on the abuse, with both of the women coming face to face with North in court to testify and put him behind bars. A GoFundMe to bring Katie's body back to the UK to lay her to rest has been set up. Charlie is raising money so Katie's body can be flown back to the UK (
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S Meddle/ITV/REX/Shutterstock) Paying tribute, Charlie wrote: "She was incredibly courageous, strong and so brave to stand up in court and testify against him. Paul North got 10 years in prison. Katie saved so many other children from being sexually abused by this abhorrent rapist. We know there were girls abused before us but Katie made sure there were none after us. "This is not about him but it is about the long-term trauma sexual abuse causes. Katie tried to start a new life in Australia, coping the best way she could and fighting every step of the way, she was an incredible and dedicated athlete. Charlie and Katie were abused by coach Paul North (
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BBC) "Katie achieved an elite level in Muay Thai, CrossFit and yoga through adversity. The thing about the trauma of sexual abuse, it doesn’t just go away. What happened to Katie made her feel worthless like she wasn’t enough, and it impacted her mental health, as is common for all survivors, me including. "Her family was trying to get Katie to come home to the UK as of late. For Katie the pain was just too much, her mental health deteriorated and she devastatingly took her own life." She added: "Please help us, finally get Katie home, to be with her mum. Katie’s body is currently in Sydney, she is alone, we are raising funds to get Katie repatriated to the UK so her mum can lay her to rest and give her the peace she so desperately sought." Charlie told her story for the first time public in a moving BBC documentary (
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Dave J Hogan/Getty Images for Warner Bros.) Nowhere to Run: Abused by our Coach aired on BBC One in September 2021 and saw Charlie tell her story for the first time. When she was 12, Charlie joined an all-girls running group in Sheffield. Running became her passion and escape, and the girls in her running group were her best friends. It was a dream. But all that time their sports coach was abusing her. She never spoke to any of her friends about what was happening to her. "It became my own secret that I pushed really far down, but I carried it with me everywhere," the presenter recalled. Charlie was 19 when their coach was arrested and convicted. He was sent to prison for 10 years. Charlie saw a psychologist about the trauma in 2016 (
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Dave Benett/Getty Images) Following his imprisonment, Charlie then she realised she wasn’t the only victim, he’d been convicted based on the testimony of two other girls from her running club. Speaking to Grazia magazine shortly after the documentary premiered, Charlie said: "Since the documentary aired, I’ve had hundreds of messages from people reaching out with their own stories of abuse in sport. From my website form alone there’s been several hundred, then my Instagram DMs are filled with more hundreds, my Twitter DMs are the same." She went on to explain how she confronted her childhood trauma as an adult. "I tried to run away from it and that actually helped me survive because I was really in a lot of emotional pain and I was very depressed," she told the publication. "But I’ve started to realise that being constantly like that now [as an adult], how am I supposed to have a healthy relationship if I can’t trust people? "Or if I close down and won’t talk about things? If there’s a part of me deep down that’s so hurt and in pain, that feels like she’s not enough or going to be taken advantage of all the time? It’s a constant hyper-vigilant overwhelming exhaustion." Charlie continued to share how becoming critically ill with malaria after completing a 3,000-mile bike ride from the London Olympic Stadium to Rio de Janeiro changed everything in August 2016. She recalled how she broke down and became vulnerable will battling the illness - experience "nightmares about my coach" during that time period. Charlie continues to explain how she decided to see a psychologist about the trauma - saying: "I now realise it’s the best thing I’ve ever done in my life." Donate to Charlie's GoFundMe here. *If you're struggling and need to talk, the Samaritans operate a free helpline open 24/7 on 116 123. Alternatively, you can email [email protected] or visit their site to find your local branch Read More Read More Read More Read More Read More | Mental Health Treatments |
A public health concern with potentially deadly consequences is on the rise in Virginia, health officials said, as people are testing positive for Alpha-Gal syndrome.
Alpha-gal syndrome (AGS) is a little-known meat allergy that is contracted through tick bites and can be life-threatening. It primarily causes hives, angioedema, upset stomach, diarrhea, stuffy or runny nose, sneezing, headaches and a drop in blood pressure, but can even cause death, according to the Centers for Disease Control and Prevention (CDC), which issued a warning about the syndrome last month.
It is known to spread through tick bites, specifically from the lone star tick, which is prevalent in Virginia, according to Julia Murphy, a state public health veterinarian with the Virginia Department of Health (VDH).
"We do have a lot of lone star ticks here in Virginia, so we think that's driving a lot of what we are seeing in Virginia when it comes to Alpha-Gal and people testing positive for alpha-gal," she said, according to WSET.
Unlike other diseases spread through tick bites – which require the tick to remain attached to a human for hours – AGS is transmitted through the tick’s saliva.
According to the Virginia Department of Health, a tick carries a sugar molecule called alpha-gal in its saliva and injects it into an individual’s body by biting it.
"The tick’s saliva prompts an immune response from the human body to develop antibodies in an attempt to combat the foreign substance. However, now the immune system has a difficult time determining whether or not the alpha-gal carbohydrate floating around in your blood is from the tick or from the burger you just ate, potentially resulting in an allergic reaction," the VDH said.
Those who contract the allergy – perhaps during a summer or fall vacation as ticks become more active in warmer weather – have to avoid eating anything with the alpha-gal sugar molecule in it as it triggers allergies to certain types of meats high in fat (primarily pork, beef, rabbit, lamb or venison) or products made from mammals (including protein powders, dairy products, and gelatin).
Certain medications, including the cancer drug Cetuximab, can also cause an allergic reaction.
Symptoms can show approximately four to eight hours after consuming red meat.
"Once you have alpha-gal, your future is somewhat uncertain in regard to the kind of restrictions you might have and what you can eat and what other things you can take in orally such as medications and such," Murphy said.
Due to its connection with tick bites and red meat, AGS is also known as the "red-meat allergy" or the "tick bite meat allergy."
The CDC said in July that AGS was an emerging public health concern as, like other food allergies, an alpha-gal allergy can be life-threatening.
According to Murphy, the best way to avoid getting the syndrome is to avoid getting bitten by a tick in the first place. She recommends wearing light colors when outdoors in order to easily spot ticks, use the correct sprays, and check yourself when you get back inside.
The CDC has only been aware of alpha-gal Syndrome since 2008. Currently, there is no treatment or cure.
Henrico County health officials urge people to remain extra vigilant in warmer months and to avoid wooded and bushy areas with tall grass. People should also use repellents that contain 20 to 30% DEET (N, N-diethyl-m-toluamide) on exposed skin and clothing for protection or other products that contain permethrin on clothing, they said.
Fox News' Melissa Rudy contributed to this report. | Epidemics & Outbreaks |
Man goes to the doctor.
“As you know,” he says, “I’ve been struggling with obesity for many years. I’ve tried dieting but it’s incredibly hard to lose weight. I’ve been reading about these new injections that can help with weight loss. Do you think you could prescribe me that drug?”
“Oh, I don’t think so,” replies the doctor. “There’s something else we should try first.”
“What’s that?” asks the patient.
“Revolutionising our entire society.”
This is the kind of bizarre logic one often hears in the debate over the new weight-loss drug semaglutide (marketed as “Wegovy” for obesity and “Ozempic” for diabetes, though the latter is often used “off-label” for weight loss too), which suppresses appetite and thus makes dieting and weight loss dramatically easier for many people.
We’ll likely be hearing a lot more of these bad arguments now that the UK Government has announced that NHS patients with obesity will soon be able to get Wegovy from their GPs.
Commentators often agree that the clinical trials for the drug show impressive results—on average around 15% weight loss with semaglutide compared to placebo—but they still wring their hands about its benefits. For example, a Guardian article this April argued that using drugs like semaglutide to help tackle obesity would be “shortsighted” – instead, we should “promote healthy diets, redesign our towns to get people walking and help shift societal values towards food”.
To which all I can say is: good luck with that. Especially in the case of the last suggestion—“shifting societal values towards food”—the phrasing is so vague as to be useless as a goal. We’ve little-to-no evidence that we know how to use policy to do that, or how long it would take, let alone whether it would make any kind of dent in our societal obesity problem.
Compare that to a drug where trials have shown that it induces weight loss in the vast majority of those who take it, and which could help reduce huge numbers of cases of diabetes, heart attack, stroke, and other obesity-related illnesses that ruin lives and cost the NHS millions.
And, as we hear so regularly, a great many people in the UK—just over a quarter of the adult population—are currently suffering from obesity. Trying to affect some nebulous “societal values” isn’t going to help them lose the weight they want to lose right now.
To be sure, semaglutide comes with side effects: nausea, diarrhoea, constipation, and vomiting are the most common, occurring in between a third to a half of people who take the drug. But first, these are generally minor, given the powerful appetite-suppressing effects of the drug (and they’re arguably far less unpleasant than the side effects from previous, much less effective, weight-loss drugs like Orlistat).
And second, nobody is being forced to take the injections: the side effects are things that consenting patients can read up on and decide about for themselves. Do you feel like the weight-loss benefits outweigh a 1-in-2 risk of feeling nauseous, or the risks of much rarer but more serious side-effects? Then you can discuss the drug with your doctor. If not, you can try something else.
It’s also true that the data show that when patients stop taking semaglutide, they tend to put some of the weight back on. This is often used as an argument against the use of the drug, but it shows a strange double-standard. After all, how does this differ from what happens to your weight when you stop dieting or exercising? Or to your blood pressure when you stop taking beta-blockers? Or, indeed, to any medical condition when you stop taking the drugs you’re using to control it?
Not only that, but the weight takes a while to come back: in a recent follow-up to one of the trials, even after a year of being off the drug, semaglutide patients had regained two-thirds of their previous weight. The health benefits of being leaner, in terms of lower risk for all sorts of medical problems, will have applied all that time.
Incidentally, what this shows is that weight loss is really hard: obesity can be a chronic condition, and some people seem to be particularly vulnerable to it because of differences in the things semaglutide is affecting: appetite, cravings, and the speed of their metabolism. Recommending more dieting and exercise programmes for these people, or relying on ill-defined “societal changes”, will have limited results – but Wegovy can help the majority of them right away.
None of this is to say that the kinds of food that are most available to us in society—the “food environment”, to use the jargon—doesn’t have an effect on obesity rates. Something has to explain why UK obesity rates have been rising over time, and the easy accessibility of delicious but high-calorie foods must be playing some role.
But policies like changing the way such foods are sold or advertised (such as the government’s proposed but delayed ban on buy-one-get-one-free offers) or incentivising companies to reformulate their products to be less calorific (such as in the 2018 “Sugar Tax”), have only ambiguous evidence to back them up. Nobody’s saying that we should stop doing policy research on changes the government could make to impact people’s health (though it should always be at least a part of the equation that people enjoy eating delicious, high-calorie foods). For the weight-loss drugs, though, we already have more than enough evidence for their benefits right in front of us.
It all comes down to the question of whether, like the doctor in the above little vignette, you want to wait for dramatic societal change, or help patients improve their health right now. It’s great news that the government has chosen the second option. | Drug Discoveries |
An anonymous reader quotes a report from ABC News: Alpha-gal syndrome (AGS) is a serious, potentially life-threatening allergic reaction that arises after people eat red meat or consume products with alpha-gal, a type of sugar found in most mammals, the CDC says. The syndrome is typically caused by a bite from the lone star tick, which transfers alpha-gal into the victim's body which in turn triggers an immune system response. The CDC says the number of AGS cases are underdiagnosed in the U.S. and -- despite the spread of the condition -- many clinicians aren't even aware it exists, let alone how to diagnose it. Between 2010 and 2022, there were more than 110,000 cases of AGS identified, according to the CDC.
The agency estimates the actual number of cases may be as high as 450,000 but notes the syndrome is underdiagnosed due to factors including that diagnosis requires a test, some providers are not familiar with AGS and some people with symptoms don't get tested. AGS symptoms can include hives or itchy rash, nausea or vomiting, heartburn or indigestion, diarrhea, shortness of breath, and severe stomach pain. Symptoms can range from mild to severe and typically occur two to six hours after consuming products with alpha-gal. [...] From 2010 to 2018, more than 34,000 suspected cases were identified. However, over the 2017-2022 study period, some 357,000 tests were submitted, resulting in just over 90,000 positive results. The number of new cases increased by about 15,000 each year during the five-year study period, with most cases occurring in the Southern, Midwestern, and Mid-Atlantic U.S., the CDC found. "Alpha-gal syndrome is an important emerging public health problem, with potentially severe health impacts that can last a lifetime for some patients," Dr. Ann Carpenter, and epidemiologist and lead author of one of the CDC studies, said in a statement.
"It's critical for clinicians to be aware of AGS so they can properly evaluate, diagnose, and manage their patients and also educate them on tick-bite prevention to protect patients from developing this allergic condition," she added.
The agency estimates the actual number of cases may be as high as 450,000 but notes the syndrome is underdiagnosed due to factors including that diagnosis requires a test, some providers are not familiar with AGS and some people with symptoms don't get tested. AGS symptoms can include hives or itchy rash, nausea or vomiting, heartburn or indigestion, diarrhea, shortness of breath, and severe stomach pain. Symptoms can range from mild to severe and typically occur two to six hours after consuming products with alpha-gal. [...] From 2010 to 2018, more than 34,000 suspected cases were identified. However, over the 2017-2022 study period, some 357,000 tests were submitted, resulting in just over 90,000 positive results. The number of new cases increased by about 15,000 each year during the five-year study period, with most cases occurring in the Southern, Midwestern, and Mid-Atlantic U.S., the CDC found. "Alpha-gal syndrome is an important emerging public health problem, with potentially severe health impacts that can last a lifetime for some patients," Dr. Ann Carpenter, and epidemiologist and lead author of one of the CDC studies, said in a statement.
"It's critical for clinicians to be aware of AGS so they can properly evaluate, diagnose, and manage their patients and also educate them on tick-bite prevention to protect patients from developing this allergic condition," she added. | Disease Research |
Only 1 in 5 people with opioid use disorder received medication in 2021
A study published Monday found that only about 1 out of 5 U.S. adults dealing with opioid use disorder in 2021 received medications to treat their condition, despite newer guidance recommending the use of such treatments.
The research from the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health found that out of 47,291 participants in the National Survey on Drug Use and Health, only 22.3 percent reported receiving a medication for opioid use disorder (MOUD).
MOUDs include methadone, buprenorphine or extended-release naltrexone. In 2021, 2.5 million adults had had opioid use disorder in the past year. Outside of MOUDs specifically, 36 percent of people with opioid use disorder reported receiving any treatment for substance use disorder.
Among those who reported receiving MOUDs, 58.5 percent were men, 61.7 percent were over the age of 35, 67.1 were non-Hispanic white and 57.7 percent lived in metropolitan areas. Women, non-Hispanic Black adults, unemployed individuals, those with past cannabis use disorder and people living in non-metropolitan areas had lower odds of receiving MOUDs.
Telehealth use was associated with an increased likelihood of receiving MOUDs.
The study noted that the American Society of Addiction Medicine (ASAM) issued recommendations for MOUD use in 2020. The ASAM recommended in its revised guidance that “all FDA approved medications for the treatment of opioid use disorder should be available to all patients,” while also advising that clinicians consider each patient’s history and psychosocial needs.
“Medications for opioid use disorder are safe and effective. They help sustain recovery and prevent overdose deaths,” Nora Volkow, director of the National Institute on Drug Abuse, said in a statement.
“Failing to use safe and lifesaving medications is devastating for people denied evidence-based care,” said Volkow. “What’s more, it perpetuates opioid use disorder, prolongs the overdose crisis, and exacerbates health disparities in communities across the country.”
Treatments such as methadone are particularly difficult for patients to access if they live in rural, non-metropolitan areas. Federal law currently requires that methadone only be dispensed at licensed and accredited opioid treatment programs, where patients take the drug under supervision.
There are just under 2,000 opioid treatment programs in the U.S., and they tend to cluster around high-population metropolitan areas, meaning some patients may have to drive hours away in order to receive treatment. While there is a bipartisan congressional push to expand methadone access, the legislation has stalled.
“It is not a matter of whether we should address health disparities and inequities that many racial/ethnic minority groups face when trying to access substance use treatment. We must address these issues if we hope to reverse the trend of increasing drug overdose deaths,” said Christopher M. Jones, director of the CDC’s National Center for Injury Prevention and Control.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Drug Discoveries |
Sir Elton John is heading to Parliament to urge ministers to do more to hit a 2030 target of eliminating new HIV cases in England, the BBC has learned.
The rock legend will address MPs at a meeting on Wednesday evening.
It comes as more than 580 previously undiagnosed cases have been identified by a pioneering new testing scheme.
Under the scheme, anyone having a blood test in selected hospital A&E units has also been tested for HIV, Hepatitis B and Hepatitis C, unless they opted out.
According to NHS figures seen by the BBC, the "opt-out testing" pilot project has identified more than 3,500 cases of the three bloodborne infections since April 2022, including more than 580 HIV cases.
The trials have been taking place in 33 hospitals in London, Greater Manchester, Sussex and Blackpool, where prevalence is classed by the NHS as "very high".
Sam, whose real name is not being used, lives in Greater Manchester and is in his 40s. Last year, he had a blood test after going to A&E following an accident.
"I got a phone call two days after being in A&E," he says, "just saying to me we've got some concerns about a blood test that was done at the time. They asked me to come in and do some further tests.
"I hadn't realised about the opt-out testing at the time, so I wasn't expecting a phone call from a health clinic. I thought it was about a survey or something about my experience in A&E."
After a two-week wait, Sam was diagnosed with HIV.
"It felt like this was happening to somebody else. I wasn't expecting it. My family don't know, and I don't want to cause them any distress.
"And I feel maybe their lack of knowledge about the HIV virus and the 80s and how things were then, it makes me a lot more reluctant to tell them."
The opt-out trials, which cost £20m, were designed to identify cases in people unlikely to get tested at a sexual health clinic and are based on similar bloodborne infection testing programmes already in place for pregnant women.
The NHS says 42% of HIV diagnoses in the UK are made late, when the immune system has already been significantly damaged.
The UK Health Security Agency, which has been leading the pilots, says opt-out testing is more likely to lead to an early diagnosis, which they say will save the NHS money in the long term.
Sam now takes one tablet a day and goes for a check-up every six months.
"The rest of my life is completely as it was before," he says.
But that's not the case for everyone.
Jackie, who lives in the West Midlands where HIV prevalence is high but opt-out testing is not available, was given a late diagnosis.
"Nobody had got a clue what was wrong with me," she says,
"Losing my hair, losing weight, thrush in my mouth and I kept going back to the GP. And it wasn't until my breathing got so bad, which was a few years down the line, they put me in hospital."
Doctors still couldn't figure out what was making Jackie so ill. Then eventually, they decided to carry out an HIV test.
She believes there were opportunities much earlier on when she could have been given a test.
What is HIV?
- HIV stands for Human Immunodeficiency Virus - the immunodeficiency is the weakening of the immune system by the virus
- If untreated it can lead to late-stage HIV or Aids, the name for a collection of illnesses caused by the virus
- Medication helping those with HIV to live long, healthy lives has been available for decades
- Modern medication reduces the viral load to undetectable levels, meaning someone can't pass on HIV and their health is protected
Campaigners have been calling on the government to expand the testing to areas classed as having high prevalence, such as the West Midlands and Liverpool.
But neither the government nor Labour have yet committed to providing the extra funding for this expansion, which is estimated to be around £25m a year.
Conservative MP Steve Brine set the government's target of eliminating new HIV cases by 2030 when he was a health minister.
Mr Brine, who now chairs the the health select committee, says that target will not be hit, unless opt-out testing is rolled out to more areas.
"Government ministers have to decide whether they want to meet it," he says.
"And to do that, they're going to have to put their foot down.
"Given that the number of transmissions of HIV in the straight community now outstrip the gay, lesbian, bisexual community, then you know, where is HIV? It is all around us.
"We've got to do the opt-out testing in as many places as possible and if money were no object, we would do it everywhere. We want to see it rolled out further and faster."
Sir Elton John, whose Aids Foundation played a key role in pioneering opt-out testing, will be speaking at an event in Parliament later hosted by the all-party parliamentary group for HIV and Aids.
The event has been organised to mark World Aids Day and the end of Sir Elton's touring career and he is expected to specifically mention opt-out testing.
It's understood that the government is pleased with the results of the opt-out pilots, but the initial cost of rolling it out to further areas, means no decision has yet been confirmed.
Sam is supportive of further opt-out testing, but believes more could be done to make clear that people are being tested in the first place.
"I'm very happy that I went through it now," he says.
"At the time, I did feel a little bit ambushed. I felt that maybe some of my rights had been taken away from me. I thought that was my choice to make.
"However, it's obviously worked in my favour because I don't know for a fact I would have said yes or no to that test."
NHS National Medical Director, Professor Sir Stephen Powis, says opt-out testing should be seen as an "NHS success story".
"We have identified and treated thousands more people living with HIV and Hepatitis B and C, particularly from groups which are less likely to come forward for routine testing.
"Without this NHS testing programme, these people may have gone undiagnosed for years, but they now have access to the latest and most effective lifesaving medication, helping to prevent long-term health issues and reducing the chances of unknown transmission to others."
A spokesperson for the Department of Health said the government was "absolutely committed to ending new HIV transmissions within England by 2030".
They said the opt-out testing programme had been "highly successful" and that the department would "outline how we can build on this success". | Epidemics & Outbreaks |
Peripheral artery disease (PAD) develops over time. And in the early stages, you may not realize itâs happening. But there are things you can do to lower your odds of ever getting PAD. The first step is to understand how it takes hold, if youâre at risk, and how it happens.
PAD happens when certain arteries -- usually in your legs -- narrow because of plaque buildup. This keeps blood from flowing to your limbs like itâs supposed to.
Some people donât feel symptoms, while others may ignore them if theyâre subtle at first. If you donât pinpoint it and get treatment, PAD can lead to gangrene -- areas of dead tissue -- and require amputation. And this same process of plaque buildup might be taking place in the blood vessels that supply the heart or the brain, leading to heart attack or stroke. Treating PAD can help prevent this from happening. Thatâs why early detection is key.
âThe biggest problem that we see is people coming in late in a delayed fashion,â says Michael S. Conte, MD, professor and chief of the Vascular and Endovascular Surgery Division at the University of California, San Francisco.
â[Theyâre] waiting too long, thinking it's nothing, thinking it's old age, thinking that this spot on their foot will go away and waiting for things for so long that then we have to do really complicated surgeries and interventions to save a leg,â Comte says.
Know Your Risk
The three main risk factors for PAD are age, diabetes, and smoking.
Age. Itâs pretty uncommon to see this disease in people under age 50 unless they have a history of diabetes or smoking.
Diabetes. High blood sugar can prime artery walls for plaque buildup. Diabetes can also add more problems to the equation when coupled with PAD. About 15% of people with diabetes get foot ulcers, and if you have PAD too, the risk of limb amputation is five to 10 times higher.
Smoking. Smoking, which worsens the constriction and damage of your arteries, raises the odds of PAD by 400% and brings on PAD symptoms almost 10 years earlier.
PAD can also happen if you get radiation in the neck or legs. Radiation to treat tumors can cause artery blockages down the line -- anywhere from 3 to 10 or more years later.
Other things that can make your chances of getting PAD go up include:
- Obesity (a body mass index over 30)
- High blood pressure
- High cholesterol
- Peripheral artery disease, heart disease, or stroke in your family history
- High levels of homocysteine
Men are more likely to get PAD than women, and sooner -- about a decade earlier than women. PAD also disproportionately affects Black and Native American people, and that gap widens with age.
How Quickly Does PAD Develop?
PAD usually takes hold over time, not suddenly. But it doesnât always go from mild to moderate to very bad. How quickly it happens varies from person to person, too, and depends on things like where the blockage is and your overall health.
You can also have PAD without major symptoms at first. But in time, you would.
âIn terms of true peripheral artery disease, where there's a significant impairment of blood flow to the leg arteries, pretty much all those people [who have it] have some sort of functional limitation,â says cardiologist Aaron W. Aday, MD, assistant professor of medicine at Vanderbilt University Medical Center.
The most common PAD symptom is leg pain or weakness, usually in the calf muscle, when you walk. It can be slightly uncomfortable or extremely painful, making it hard for you to be active. A few minutes of rest usually eases the pain.
Other signs to look out for include:
- Pain in your hips, thighs, or calf muscles after you walk or climb stairs
- Weak or numb legs
- Coldness in a lower leg or foot compared to the other side
- Sores on your toes, feet, or legs that won't heal
- A change in the color of your legs
- Hair loss or slower hair growth on your feet and legs
- Slower toenail growth
- Shiny skin on your legs
- No pulse or a weak pulse in your legs or feet
- Erectile dysfunction
- Pain, such as aches and cramps, when you use your arms for basic tasks
Why You May Not Realize You Have Peripheral Artery Disease
The reason some people may not feel typical PAD symptoms is still a bit of a mystery. But here are a few reasons why you may not think you have it but do.
Itâs too early to tell. Since PAD unfolds over time, red flags may not be obvious yet. Many people with PAD donât have noticeable symptoms until the artery has narrowed by 60% or more.
You assume itâs aging or a joint problem. The symptoms that come with orthopedic conditions, such as lumbar spine disease and spinal stenosis arthritis, often feel the same as PAD. So can problems with nerves, which, when pinched, can cause similar pain. It takes a doctor to figure out whatâs causing your pain.
Other diseases can mask signs of PAD. Another condition might keep you from being active enough to feel symptoms. Or pain from another health problem masks aches from PAD.
The location of the blockage affects what you feel. Where your PAD is and how far it goes may affect what you feel. The farther out into your limbs the blockage is, the higher the chance that PAD might show up late and with a worse symptom, not at an earlier stage with more common red flags like leg pain.
How to Manage Your Symptoms
If you do have PAD, your doctor may prescribe medication, such as antiplatelet medication to ward off heart attacks and strokes and others for high blood pressure or high cholesterol, as part of your treatment. Youâll also want to make lifestyle changes to help ease your symptoms and stop PAD from getting worse:
Stop smoking. This includes avoiding other peopleâs secondhand smoke. Doing this can not only help ease your symptoms, but also lower your chances of more problems.
Take walks often. This may seem counterintuitive if itâs painful to walk, but this is the best exercise you can do to improve your PAD. In fact, the distance you can walk without pain can show how successful your treatment is.
It might not be comfortable.
âThe goal is not to avoid pain,â Aday says. âIt's to become comfortable with that pain in the legs, push yourself to that point of having pain -- if you need to rest, that's fine -- but then continuing on. The big-picture goal is increasing [your] functional capability.â
Walks can also help you control PAD risk factors such as high cholesterol and high blood pressure.
Eat healthy food. The same things that are good for your heart, your brain, and your whole body are also good for curbing PAD. Focus on foods that are high in fiber, and avoid salt and saturated fat. This will help to keep your blood pressure and cholesterol levels under control.
Check your feet and wash them every day. Take a close look at each foot. If you see a sore or injury, see your doctor. This is important especially if you have diabetes since your body may have a harder time healing injuries and sores on your lower legs and feet. Less blood flow to those areas makes that recovery process even harder, making infection and even amputation more likely. | Disease Research |
Erin Morse hears about her patients' food cravings a lot, especially for "ultra-processed" and "salty, sweet, crunchy" snacks. Chips and french fries top the list, followed by doughnuts, cookies, and cakes.Â
As the chief clinical dietitian at UCLA Health, Morse offers strategies to help them handle these hard-to-resist cravings. But why do people get them in the first place?
Food Cravings: 5 Triggers
Cravings are frequent, specific, intense desires to eat a particular type of food, says John W. Apolzan, PhD, a nutrition scientist and associate professor at the Pennington Biomedical Research Center of the Louisiana State University System.Â
It's not about hunger, Morse says. "Hunger is the need for food for fuel, for nutrition, for all the good things that our bodies and our brains need," she says. In contrast, with cravings, "Our bodies are telling us that we want something to eat."
- External cues. These are things like a favorite TV show that you have a habit of watching while eating ice cream. You'll become conditioned to reach for that bowl of ice cream when you watch an episode, Apolzan notes.Â
- Internal cues, such as sadness, can prompt people to crave certain foods, too.Â
- Deprivation. If you're restricting food or dieting, you may find yourself "craving lots of foods by the end of the day," Morse says.
- Poor sleep. "Studies show that lack of sleep can increase appetite and increase cravings," Morse says.Â
- Social environment. Think of the workplace vending machine or your partner who is constantly baking treats. "They're seeing it all the time; they want it all the time," Morse says.
Snack makers know this, Morse says. "Companies have tailored food to be extremely palatable, so people do eat a lot of it."Â
Just a Little, or None at All?
Experts don't agree on this.
It's best to avoid eating craved foods, even in small amounts, Apolzan says. According to his research, "the amount doesn't matter," he says. "Completely stopping the food will reduce the craving."Â
Morse takes another view. "Everyone has to think about what's good for themselves," she says. "I think it's best not to completely avoid things that people want. Food is not only good for nutrition, but also enjoyment."
How to Manage Food Cravings: 8 Tips
Stay hydrated. Being dehydrated can make you feel hungry or increase food cravings, Morse says. So make sure that you get enough water. If cravings strike at night when it's time to relax and unwind, a cup of caffeine-free herbal tea is an option, she says.
Get proper sleep. Not sleeping enough will rev up your appetite and hunger hormones, Morse says. The exact amount of sleep that you need might be different from someone else, but for most adults, it's at least 7 hours per night for good health.
Eat enough protein. It will help you feel satisfied longer and reduce cravings, Morse says. Some suggestions: a scrambled egg with breakfast, beans on a salad, or salmon at dinner. "Not just a big bowl of pasta," Morse says. Also avoid skipping meals, which could trigger cravings, she says. Â
Snack smart. Plan healthy snacks that give you fiber and protein, like Greek yogurt with berries and a handful of nuts, Morse says. A little bit of dark chocolate might satisfy a sweet tooth -- unless, like Apolzan has seen in his research, that small taste just makes you want a lot more. Swap chips for homemade popcorn made with a healthy fat, such as olive oil, which will spare you from the types with too much salt, sugar, and chemicals.Â
Chew gum. Gum or even brushing one's teeth with minty toothpaste are distractions that may take away a craving, Morse says. "It works for some and not for others."Â
Be careful with alcohol. It's famous for making people do things that they didn't plan to do. And it increases appetite, Morse says. When people drink, they may not realize how much food they're eating.Â
Find healthier ways to counter stress. Stress can increase cravings, Morse says. "Instead of reaching for the candy bin," Morse says, "go outside with a colleague to get fresh air or take a 5-minute walk." If emotions are spurring your food cravings, "the first step is to acknowledge the stress or the sadness or emotion," Morse says.
Remove triggers. "If you're keeping a lot of those foods that are triggers for you at home, do your best to replace those items with foods that will provide you with more nutrition," Morse says.Â
What if your family or friends want to have those foods around? Talk with them about how you can all support each other, Morse says. And if your food cravings spring from difficult emotions, Morse says, "seeking the help of a therapist or a registered dietitian who is knowledgeable on mental health" is a good idea, too. | Nutrition Research |
Spinal cancer, one of the most common secondary cancers, can lead to double incontinence, paralysis and death within 30 days. But a specialist service is extending patients' lives, giving people extra months for final holidays and proper goodbyes.
The BBC has been given exclusive access to the team at The Clatterbridge Cancer Centre in Liverpool and the patients they care for.
It has just gone 08:00 on a sunny Wednesday, and in a windowless boardroom, a team of emergency spinal cancer specialists are concerned.
Magnetic resonance imaging (MRI) scans of a woman's back are being projected on to a wall and they can see cancerous cells in her spine.
The patient needs radiotherapy treatment within 24 hours or risks paralysis and dying within weeks.
"We'll get an urgent ambulance to her this morning," the team coordinator says.
Within hours, the patient, Yvonne Naylor, arrives at The Clatterbridge Cancer Centre, where a team of health professionals specialise in the early detection and treatment of emergency spinal cancer.
The 73-year-old already knew she had lung cancer but came on to the team's radar after having back pain.
Urgent MRI scans at her local hospital, in Warrington, followed by computed tomography (CT) scans in Liverpool, confirmed cancerous cells had spread from her lung to her spine.
This is known as metastatic spinal-cord compression (MSCC), where the cancer presses on the nerves in the spine that carry messages between the brain and the rest of the body.
Without urgent action, it can cause serious disability, including permanent paralysis, incontinence and a drastically shortened life.
"This is an emergency but it [requires just] one radiation treatment and we can get that done today," consultant clinical oncologist Dr Clare Hart tells Yvonne.
What happens in the coming hours will probably dictate how the end of Yvonne's life will look.
Playing golf
"I have had a good innings, a good life," Yvonne tells BBC News from her hospital bed, as she waits for her treatment.
"I don't particularly want to leave all my loved ones but I'm OK with it. It's just everybody else that isn't. That's what hurts.
"I want to leave this planet comfortable and cared for and hopefully I will."
The BBC can reveal guidelines on how the NHS help people with MSCC will soon be updated - based partly on data collected by The Clatterbridge service, which has increased the average patient's survival rate by six months, while improving the quality of life.
Robert Glayzer, 75, was a patient in April.
What started as a complaint about back pain while playing golf quickly turned into an emergency.
He was told to lie flat on his back in a hospital bed, unaware he may never sit up again.
"The original shock was horrendous. I'm not a softie but I had tears in my eyes," Robert says. "There's no easy way to tell somebody you've got cancer. It is a massive word.
"Straight away they said, 'We haven't got a cure but we will hold it back for quite a long time.'"
Further tests showed Robert had primary cancer of the oesophagus, along with MSCC.
Within hours, he was treated at The Clatterbridge and within days he was home and back on his feet, eager to make every extra minute count.
He got down on one knee and proposed to his partner of 14 years, Lynda, conscious he may not make it to 15.
Final word
Lynda, 68, says: "I had left him in hospital with big wide eyes after he had just been told he cannot be cured and I thought, 'What's more important in life? He wants me to be his wife, so let's do it.'"
The couple, who both lost their first spouses to cancer, married in July, surrounded by their family and friends.
"It's absolutely right to carry on enjoying what you're doing rather than going into your shell and saying, 'I'm doomed,'" Robert says.
"We've both decided to live our life every day as if it's our last.
"My final word would be do not ignore back pain, see your doctor."
The Clatterbridge model of early detection, rapid intervention and education should be emulated across all services in England and Wales, new guidance from the medical body NICE is expected to say when published.
Local GPs and hospitals across Cheshire and Merseyside have been trained by the 13-person team to spot early warning signs, such as bladder or bowel dysfunction, difficulty walking, numbness and back pain, and are aware of the importance of carrying out urgent MRI scans when red flags are detected. A hotline is available for advice and support.
If secondary cancer is found on the spine, patients are admitted to The Clatterbridge for further scans and radiotherapy treatment. This should all happen within 24 hours of diagnosis.
The seven-day service brings together a range of specialities, including oncology, physiotherapy, palliative care and radiology, to ensure decisions are made quickly.
Kate Parker, who developed the approach seven years ago, says: "As a radiographer, I was regularly seeing patients coming for treatment paralysed, incontinent and dead within 30 days.
"Now, patients get to spend time with their families and friends for many months instead of lying flat on their back in a hospital bed."
Itchy back
NICE is expected to say the cost of extending this service should be regained in the first few years.
MSCC is one of the most common secondary cancers and figures suggest it affects at least 4,000 people each year in England and Wales. Although, Kate says this is an underestimate, as last year her service alone treated 1,200 cases.
Hours after arriving on Merseyside, Yvonne has had her radiation treatment and, aside from an itchy back, is in good spirits.
Her quick turnaround treatment frees up valuable NHS beds, while early detection reduces the chances of her coming to an accident-and-emergency unit with complex symptoms. It also benefits Yvonne.
"Half of the pain is waiting for answers, waiting for results, waiting for appointments. It's been really quick here," she says.
The Clatterbridge team cannot alter Yvonne's final destination, but they have given her precious extra time with her family at home in Runcorn.
Yvonne is hopeful other patients will benefit from the care she has had.
"I'm sure they'll go on to save a lot of people," she says. "I couldn't be more grateful." | Medical Innovations |
Matt Hancock was concerned that relaxing Covid isolation rules would imply ministers had been "getting it wrong", leaked messages suggest.
It appears the former health secretary was told in late 2020 that scientific advisers wanted to try out replacing 14-day quarantine for confirmed contacts with five days of testing.
He replied that the idea "sounds very risky" and "like a massive loosening".
He also questioned whether the 14-day period was "too long all this time".
The BBC has not been able to independently verify the messages, between Mr Hancock and England's chief medical officer Prof Chris Whitty.
The texts are the latest release from more than 100,000 WhatsApp messages leaked to the Telegraph by journalist Isabel Oakeshott.
An ally of Mr Hancock said the Telegraph's story was a "partial account," and the newspaper "only has partial information".
The leaked exchange between the two men took place on 17 November 2020, when confirmed contacts of Covid cases in England had to isolate for 14 days.
Prof Whitty is shown telling Mr Hancock that the UK's chief medical officers, as well as Sage, the government's group of scientific advisers, were "in favour" of a pilot "with presumption in favour of testing for 5 days in lieu of isolation (alternative 10 days isolation)".
He added that the pilot was to "check it works" - whilst the MHRA, the medicines regulator, had "not yet signed off for self use".
In the exchange published by the Telegraph, Mr Hancock replies that the idea "sounds like a massive loosening".
Prof Whitty then says that scientific modelling "suggests it's pretty well as good".
In a reply, Mr Hancock says he is "amazed" - adding that "this sounds very risky and we can't go backwards". He asks whether allowing people to test for 10 days would be "a safer starting point".
'Worry people'
Prof Whitty replies that "we could push to 7 [days]" but "the benefits really flatten off after 5".
Mr Hancock is then shown to reply: "So has the 14 day isolation been too long all this time?"
The chief medical officer then replies that a 14-day isolation period is "marginally safer than 10" - but at the expense of reduced compliance, meaning "it probably balances out".
Mr Hancock replies that cutting the isolation period to seven days would be "huge for adherence" but any lower than that would "worry people and imply we'd been getting it wrong".
Prof Whitty then says he will "go back" to the chief medical officers, adding, "I think they will be sympathetic to this".
The isolation period for close contacts was reduced to 10 days across the UK the following month.
Some exemptions for double-jabbed critical workers were introduced seven months later, in July 2021, following disruption to businesses and public services.
Self-isolation for all fully-vaccinated contacts was dropped the month after that.
The WhatsApp messages were handed to the Telegraph by Ms Oakeshott, who had been given them by Mr Hancock for the purposes of co-writing his book, Pandemic Diaries. She has argued there is a public interest in publishing the messages.
That argument was been rejected by Mr Hancock, who says he had already handed the messages over to the public inquiry into the pandemic, and their release constitutes a "massive betrayal and breach of trust".
The WhatsApp leaks
A collection of more than 100,000 messages sent between former Health Secretary Matt Hancock and other ministers and officials at the height of the Covid-19 pandemic have been obtained by the Telegraph. Here are some of our stories on the leaks: | Epidemics & Outbreaks |
Despite the World Health Organization’s recent warning about it, aspartame doesn't pose a cancer risk, the FDA and industry experts insist — but given that the artificial sweetener is used in many chewing gums and candies, does it pose any risk to the teeth and gums?
Chewing gum after meals is beneficial for the teeth because it increases saliva production, which helps to "dilute and neutralize acids produced by the bacteria in plaque on teeth," according to the American Dental Association (ADA) website.
However, chewing gum that contains sugar can lead to cavities, potentially.
"Chewing sugar-free gum may, when added to a regular home oral care routine of twice-daily brushing with fluoridated toothpaste and daily cleaning between teeth, contribute to reducing caries (cavities) risk," the ADA states.
Even so, sugar-free gum could have some potential side effects. And there are healthier options that don’t contain aspartame, dental health experts told Fox News Digital.
Aspartame doesn’t cause dental decay as regular sugar does, noted Fatima Khan, a dentist and co-founder of Riven Oral Care in Houston, Texas.
"Regular sugar is fermentable and acts as a food source for cavity-causing bacteria," she told Fox News Digital.
"However, artificial sugars like aspartame are not fermentable, and therefore cavity-causing bacteria cannot use them as a food source."
Although aspartame itself doesn't directly harm the teeth, some dentists warn that other ingredients in the gum could cause tooth decay.
Sugar-free chewing gum contains ingredients such as carbonic acid, phosphoric acid, malic acid, citric acid, tartaric acid and fumaric acid, all of which are found in various diet sodas, Khan said.
"All of these acids lower the pH in your mouth," she said. "When your mouth's pH falls below 5.5, your enamel demineralizes, the calcium and phosphate in your enamel weakens and breaks down, and your teeth erode."
Tooth enamel helps to protect the teeth from dental decay, Khan said.
"The layer beneath, known as dentin, is less mineralized and more prone to decay due to its softer nature," she added.
"Sugar and acid are two of the biggest culprits when it comes to tooth decay," Dr. Sean Kutlay, a general dentist in Santa Clarita, California, confirmed to Fox News Digital.
"Any sugar-free gum is fine, as it stimulates more saliva, which helps to reduce the acidity of the mouth and prevent cavities, especially after a meal."
While aspartame was recently deemed a possible carcinogen, Kutlay said the average person would need to ingest about 450 sticks of sugar-free gum to surpass the daily suggested limit.
"A stick of gum after each meal chewed for 10 to 15 minutes will provide so much benefit for your oral health," he said.
Aspartame-containing gum can also cause potential digestive health issues, which can indirectly impact oral health, according to Dr. Nicole Mackie, a dentist at the Dental Implant Specialty Center in Las Vegas, Nevada.
"This is because excessive consumption of artificial sweeteners like aspartame may not be able to be processed in the gut, leading to bloating, diarrhea and fatigue," she explained to Fox News Digital.
While aspartame doesn’t cause tooth decay or cavities, dentists recommend opting for xylitol, a naturally occurring sweetener found in plants, as a more beneficial sugar-free option.
"The reason xylitol is recommended is because cavity-causing bacteria cannot metabolize this sugar and use it as fuel, and it starves the cavity-causing bacteria and helps prevent tooth decay," Khan said.
"It decreases cavity-causing bacteria, increases saliva production and helps remineralize teeth."
A 2021 study published in Clinical Oral Investigations found that chewing gum containing xylitol was shown to reduce plaque build-up on teeth.
Xylitol is an "excellent sweetener," Kutlay agreed.
"In addition to sugar-free gum, it is also found in many toothpastes, mints and oral rinses aimed at reducing cavities and the bacteria that cause them," he said.
In terms of caloric intake, xylitol contains less than half the calories of sugar, Khan said.
"Aspartame is 200 times sweeter than sugar, so the amount of aspartame needed in products is minimal, much less than xylitol and sugar," Khan explained.
One downside to xylitol is that it can cause gastrointestinal issues, like gas and bloating, if consumed in large amounts, Khan warned.
The recommended daily intake of xylitol for dental cavity prevention is 6 to 10 grams, experts say. | Nutrition Research |
A diabetes medicine dubbed the "King Kong" of weight loss jabs has been approved in the UK for treating obesity.
Mounjaro, or tirzepatide, makes you feel fuller so you eat less.
In trials, people on it have lost a fifth of their body weight and UK regulators now say it is safe and effective enough to be sold and prescribed in the UK.
Unlike a similar jab called Wegovy, it is not recommended on the NHS yet.
Healthcare spending watchdog The National Institute for Health and Care Excellence (NICE) recently said the cost for benefit of Mounjaro may not be justified.
The NHS price of the pre-filled pens has not been made public because of commercial sensitivities.
Manufacturer Eli Lilly has been asked to submit more data for the committee to review.
Both Wegovy and Mounjaro, which work in similar ways, come as pre-filled injection pens that patients can self-administer - giving themselves a dose under the skin of their stomach area or thigh.
Wegovy and Mounjaro have not gone head-to-head in clinical trials, which makes it difficult to compare them. Both can help people shed significant weight.
But, in studies, users often put weight back on after stopping treatment.
They can have side effects though - the most common are nausea, diarrhoea, vomiting and constipation.
And the jabs - widely used in the US and endorsed by many celebrities - are not a quick fix or a substitute for a healthy diet and exercise.
Experts caution that Mounjaro may affect how well the contraceptive pill works. Women who are on it should consider using extra contraception, such as condoms or switching to a non-oral contraceptive method for four weeks after starting Mounjaro and for four weeks after each increase in dose.
Wegovy shots, which contain a drug called semaglutide, are being offered by some specialist NHS weight-loss management services, as well as some private clinics. There is a plan for GPs to offer it too.
Some High Street chains are prescribing and selling it too, although stocks are limited.
As more doses become available, it could help tens of thousands of patients in England, the NHS says.
In the future, Mounjaro might be added to the list of possible NHS treatments too.
The UK's drugs regulator says it can be used by adults who are obese or those who are overweight and have weight-related health problems such as high blood pressure.
Health and Social Care Secretary Steve Barclay said: "Although further approvals are needed to use this in the NHS, Mounjaro has the potential to help thousands of people living with obesity and support those suffering from weight-related illnesses - if used alongside diet and physical activity. Tackling obesity could help cut waiting lists and save the NHS billions of pounds." | Drug Discoveries |
It’s unofficially summertime, a time when things heat up and we all move around, mobilizing for road trips, summer camps, and swimming pools. These new-ish pop-ups are doing the same — moving around town, serving the dietary gamut from crispy-thin smash burgers to vegan banana peel barbacoa tacos — all at our favorite bars, breweries and bakeries.The uniquely unfettering advantage of pop-ups is that since there isn’t much to lose, chefs are having fun as they test niche markets to see what tracks. A few have concrete plans to open brick-and-mortars in the imminent future, but most do not. What they’re all doing is cooking food for the pure joy of sharing their passion, which is almost always a deliciously creative to-go plate made with heart.The Dallas Morning News has previously shared some impressive pop-ups that are still ongoing, like Picadera, Hustle Town Pizza, Fana’s Ethiopian, and Merienda Monster. But a lot of new kids have entered the pop-up block in the past year or so. Here are eight worth checking out.Related:55 Dallas-Fort Worth restaurants that are new, coming soon or relocatingBurger SchmurgerDave Culwell is combining his roots from Pasadena (purportedly the birthplace of the cheeseburger) with his wife’s Texas pedigree at his smash burger pop-up, Burger Schmurger. He grinds the 78/22 percent fat patty mix himself, using whole chuck, short rib and brisket. The brisket is the Texas part, he says, but he also adheres to West Coast preferences, using only sea salt to season the paper-thin patties, and never using tomatoes unless they’re in season.After ten years of grilling burgers in his Lake Highlands backyard, Culwell started doing pop-ups after his 13-year-old daughter said he should.Burger Schmurger began a month-long residency June 8 at Craft & Growler in Expo Park, Wednesdays through Sundays. Follow Burger Schmurger on Instagram for more dates, times and locations. instagram.com/burger_schmurger.Crack BrisketSmoking meats began as a hobby for Macario “Mac” Magalindan about six years ago, but it wasn’t until his wife’s aunt suggested he use Vietnamese peppercorns in his spice rub mix that his side hustle took off. Today, profits from his “crack brisket,” pork belly burnt ends, ribs and turkey legs are used to fund the fun for his family of five.Magalindan, who works as an IT project manager, says smoking meats is therapeutic for him. Opening a restaurant would incur rent, labor, and supply chain headaches, so he’s saving his hobby for weekend pop-ups and pick-ups from his house in Allen. His aunt continues to supply the peppercorns from Vietnam.Find Crack Brisket on Aug. 6 at Boba Latte in Richardson, a usual pop-up spot. Follow Crack Brisket on Facebook or Instagram for weekend orders and more pop-up dates. instagram.com/crackbrisket.Inu-san onigiri in Dallas specializes in Japanese onigiri.(Inu-san onigiri )Inu-San OnigiriNathan Bounphisai is a 24-year-old graphic designer who used extra time at home in 2020 to create a pop-up business. He says his family was confused when he told them about his idea to sell Japanese onigiri and sandos, but after a year and a half into it, Inu-San is beginning to compete with his day job.Sandos on feathery soft milk bread are spread with creams like purple yam and black sesame, then layered with fruit. Bounphisai thinks a big part of the recent obsession with sandos can be attributed to what his customers so frequently say: “They’re so cute!”Bounphisai primarily sells dessert sandos, designed to be a sweet chaser after an onigiri — a handheld rice ball stuffed with savory fillings like fried shrimp or umeboshi (pickled Japanese plums) with egg salad.Find Inu-San Onigiri on June 18 at Kung Fu Tea in Arlington, or June 19 at OneZo in Carrollton. After that, Bounphisai will take Inu-San on the road to Austin and Chicago before resuming at Asia Times Square in Grand Prairie on July 10. Follow on Instagram or Facebook for pre-ordering instructions. instagram.com/inusanonigiri.Molino Oloyo in Dallas specializes in many dishes made with heirloom masa.(Molino Oloyo)Molino OlōyōTwice we raved about Olivia Lopez’s heirloom tortillas here, but until now, we haven’t shared another goal of her and Jonathan Percival’s restaurant-in-the-making, Molino Olōyō — and that is to showcase all the shapes that masa can take.Find Oaxacan specialties, like triangular tetelas or crispy tlyudas, the foundation for what is commonly called the Mexican pizza. Masa can also transform into tlacoyos, a street food from Mexico City topped with nopales and cheese.Lopez also shows us the glory of tacos on heirloom tortillas. Her bright red, balanced tacos al pastor, which originated in Puebla, Mexico by Lebanese immigrants, are exquisite.There’s a lot more coming out of Lopez’s production kitchen near downtown Dallas, like squash blossom and cuitlacoche quesadillas, but the truth is that no matter what you get made by Lopez’s hands, you’re in for a treat by one of Dallas’ most masterful up-and-coming chefs.To stay up-to-date on bi-monthly pop-ups and pick-up opportunities, follow Molino Olōyō on Instagram and be sure to watch the stories. instagram.com/molino_oloyo.Nena Postreria in Dallas is an "elevated Gansito" pop-up.(Nena Postreria)Nena PostreriaPastry chef Diana Zamora is reviving childhood nostalgia with her elevated Gansito pop-up, Nena Postreria. While some kids grew up with Twinkies and Ding Dongs, Gansitos are the Mexican snack cake Zamora remembers buying from corner stores as a child.Similar to the original brand, Zamora’s version is filled with fruit preserves and cream and covered in chocolate, but her flavors are bolder and fresher. The mango flavor with fresh, sweet mango preserves on fluffy cake that’s covered in white chocolate and sprinkled with Tajín carries almost all adulthood worries away. Also try the original berry, coconut, coffee, and strawberry flavors.Find Nena Postreria on June 18 at ODD Muse Brewing Factory in Farmers Branch, and on June 25 at Dude, Sweet Chocolate in Bishop Arts. nenapostreria.com.Planta Potosí in Dallas offers plant-based tacos at pop-ups.(Planta Potosí)Planta PotosíPaul Hernandez’s seitan asada, soy al pastor, and banana peel barbacoa tacos are probably the most delicious science projects you’ll ever eat. His “meats” undergo a two-day texturing and seasoning process where he uses a variation of umami ingredients, including dried vegetables, infused oils, and vinegars, to create plant-based tacos that taste pretty darn similar to the real thing.He launched Planta Potosí “out of necessity” in late 2020 after realizing the vegan world needed more options. Fortunately for his fan base, he’ll eventually open a restaurant when the time is right.Find Planta Potosí at Double Wide every Tuesday evening this summer. Pop-ups are also scheduled at Tulips FTW’s LGBTQ Here to Stay music and market on June 15, and at Rubber Gloves Rehearsal Studio in Denton on June 25. Follow on Instagram for more information. instagram.com/plantapotositacos.The Thid Jai pop-up in Dallas offers authentic Thai food.(Thid Jai)Thid JaiFor Thai food that’s not watered down for Western palates, visit Sara Hangtagool at Thid Jai. She doesn’t hold back on fish sauce and shrimp paste when cooking her family’s recipes for panang short ribs, pad krapaw, and pad Thai folded into a delicate omelet. For Hangtagool, presenting Thai dishes the way her family makes them is a way of reclaiming her culture and identity.Hangtagool works in digital marketing and has no desire to open a restaurant after growing up in the business. But she is working toward a line of sauces, seasonings and meal kits that will empower people to make Thai food at home.“Sharing pieces of my family with cooking is special to me,” she says. Her flavor-bursting dishes prove it.Thid Jai pops up every other weekend at Haute Sweets Patisserie in Lake Highlands and in the Sam Moon parking lot in Arlington. Ordering instructions and updates can be found on Thid Jai’s Instagram and Facebook. instagram.com/thidjai.Wolf and the Fox in Dallas offers Japanese chirashi bowls.(Wolf and the Fox)Wolf and the FoxUnlike poke bowls with one or two types of raw fish and lots of sauce, chirashi bowls typically come with five or six types of fish, sushi rice, pickled vegetables, and a couple slices of tamago (Japanese omelet). The word chirashi means “scattered” in Japanese, but chirashi bowls are an art form. They’re possibly the most aesthetically pleasing health food in existence.To find a chirashi bowl in Dallas, look for chef Yoni Lang and Liz Scobee’s pop-up, Wolf and the Fox. After working at Rosella, a New York sushi restaurant that’s making big waves in the sustainable fish movement, Lang moved back to Dallas last year and resumed doing private omakase dinners and chirashi bowl pop-ups.Lang’s creations are packed with sustainably-caught sushi, like trout caught from California lakes and streams, fluke from the coast of New Jersey, and bluefin tuna from South Carolina. It’s an environmentally guilt-free meal: the tamago is made from eggs from Lang and Scobee’s backyard chickens, and the vegetables for the pickles are locally grown.Wolf and the Fox’s next pop-up will be at Strangeways on July 9. Follow them on Instagram for ordering instructions. instagram.com/wolfandthefoxdinners. | Nutrition Research |
The Scottish government says that the war on drugs has “failed” and it’s time to decriminalize currently illicit substances, while promoting harm reduction services like overdose prevention centers.
At a press conference on Friday, Scotland Drugs and Alcohol Policy Minister Elena Whitham called on the government of the U.K., of which the country is a part, to take a public health approach to addiction and abandon the criminalization model. Representatives of the U.K. prime minister—and even the country’s progressive party—have already dismissed the request, however.
Scotland’s position on the issue is partly informed by a policy paper that was released on Friday, outlining the country’s position on decriminalization and related matters.
In addition to ending the prohibition on personal possession of controlled substances, Scotland is calling for the legalization of safe drug consumption facilities, increased access to the overdose reversal medication naloxone and authority to expand drug checking services to mitigate the risk of contamination in the illicit market.
“These are ambitious and radical proposals, grounded in evidence, that will help save lives,” Whitham said. “We want to create a society where problematic drug use is treated as a health, not a criminal matter, reducing stigma and discrimination and enabling the person to recover and contribute positively to society.”
Decriminalisation of all drugs for personal supply is one of a number of polices which the Scottish Government is calling on the UK Government to implement in a new paper on drug law reform. #DrugLawReform
— Scot Gov Health (@scotgovhealth) July 7, 2023
“While we know these proposals will spark debate, they are in line with our public health approach and would further our national mission to improve and save lives,” the minister said. “We are working hard within the powers we have to reduce drug deaths, and while there is more we need to do, our approach is simply at odds with the Westminster legislation we must operate within.”
Friday’s report and announcement comes nearly four years since the country’s ruling party approved a resolution backing drug decriminalization in Scotland.
“Scotland needs a caring, compassionate and human rights informed drugs policy, with public health and the reduction of harm as its underlying principles, and we are ready to work with the U.K. Government to put into practice this progressive policy,” Whitham said.
The UK Government could make changes themselves or devolve the appropriate powers to the Scottish Government, allowing us to make the necessary changes at a time when drug deaths continue to be far too high.
Full paper on the link below 👇https://t.co/bgqRqs6asI
— Humza Yousaf (@HumzaYousaf) July 7, 2023
Scottish First Minister Humza Yousaf said that U.K. officials “could make changes themselves or devolve the appropriate powers to the Scottish Government, allowing us to make the necessary changes at a time when drug deaths continue to be far too high.”
“We’re willing to work with them to enable us to take a bold approach,” he said.
But the U.K. government in Westminster has been quick to dismiss the drug policy reform. Asked whether it would grant Scotland’s request for an overhaul of drug laws, a spokesperson for the prime minister told STV News that the answer is “no.”
That’s not especially surprising, as U.K. Prime Minister Rishi Sunak has made clear that he aligns with the criminalization model on drugs, saying on Monday that the government would be increasing enforcement against drugs, which involves a “strengthened” police force and ban on nitrous oxide.
💊 Crackdown on drugs.
We've strengthened police powers to stamp out illegal drugs in our communities by widening drugs testing on criminals. pic.twitter.com/KsHO9HTlJ1
— Rishi Sunak (@RishiSunak) July 3, 2023
A top official with the Labour Party, Rachel Reeves, also said that Scotland’s proposal is unlikely to advance.
“I don’t think this sounds like a good policy,” she said. “I find it quite stunning that this would be a priority for the Scottish Government ” amidst unrelated government controversies.
The report from Scotland’s Drugs and Alcohol Policy Ministry calls for a “change to the legal framework within which Scotland responds to its drug deaths crisis, to enable us to appropriately tailor policy decisions to our unique challenges.” That change could be enacted through legislation or a broader constitutional reform to grant Scotland full independence over its laws, it says.
“The overarching ambition of the Scottish Government National Mission is to reduce deaths and improve lives,” it says. “Our objective is that no person finds themselves dependent on substances, but that if they do, they should be supported and not criminalised for that health condition.”
“These objectives will continue to drive our drugs policy regardless of the legal framework in which we operate and we will work tirelessly to reduce drugs harms within the powers devolved to Scotland,” it continues. “There is much more we can and will do to reduce deaths and improve lives within those powers.” | Drug Discoveries |
ATLANTA - People from all over the world are leaving kind notes and sharing their favorite photos of the 39th U.S. president, Jimmy Carter.
In the wake of the announcement that Carter opted to spend the rest of his life at home receiving hospice care, surrounded by his loved ones, The Carter Center unveiled a new way for supporters to send messages of peace and comfort to him and his family.
"President Carter, you inspire Americans and citizens of the world to live a life of good work, loving relationships, and service to others. You will continue to inspire us and make a difference long after you leave this earth. Well done, good and faithful servant. Thank you - from a world that you made a better place," read a post from Mary Spencer.
Another admirer from the Dominican Republic thanked Carter for the years his center partnered with the Caribbean country, observing their presidential elections:
"President Carter, you’re a man of supreme integrity, honesty, and honesty. You helped my country, The Dominican Republic, with our elections and ensured they were true and honest, showcasing the will of our people," said Bryan Verdier-Pockels. "God bless you now and always."
It is called 'Kudoboard', and it works almost like a virtual greetings card.
To leave your own message, use this link to visit The Carter Center's official website. Click "Add to board" and then fill out the requested information. Once your post has been reviewed, it may be public for the world to see.
Former U.S. President Jimmy Carter, 2014.(Credit: LBJ Library/The Carter Center)
The Center: Former President Jimmy Carter enters hospice care
Former President Jimmy Carter, who at 98 years old is the longest-lived American president, entered home hospice care in Plains, Ga. on Saturday, Feb. 18. The Carter Center confirmed the decision in a statement shortly after.
According to a spokesperson with the center, Carter "decided to spend his remaining time at home with his family and receive hospice care instead of additional medical intervention." This came after the humanitarian took a series of short hospital trips.
(Credit: The Carter Center)
Timeline of Jimmy Carter's health over the last nine years
2015
Aug. 12, 2015 - Former President Carter to undergo cancer treatment
At 90, Carter shared he had received surgery to remove a small mass in his liver. The surgery ended up revealing he had cancer that was spreading.
A statement released by the 39th president read:
"Recent liver surgery revealed that I have cancer that now is in other parts of my body. I will be rearranging my schedule as necessary so I can undergo treatment by physicians at Emory Healthcare. A more complete public statement will be made when facts are known, possibly next week."
Aug. 20, 2015 - Jimmy Carter on brain cancer: 'it's in the hands of God'
In a news conference at The Carter Center, he revealed he had four small spots of melanoma on his brain and would begin radiation.
"I was surprisingly much more at ease than my wife was."
Carter said he found out in May, but didn't tell his wife until June.
At the news conference, Carter appeared to be upbeat and in good spirits.
"I'm ready for anything and looking forward to a new adventure," he said. "It's in the hands of God."
Dec. 7, 2015 - Jimmy Carter: Doctors Now Find No Sign of Cancer
Former President Jimmy Carter said a new brain scan showed no signs of cancer. The 91-year-old made the announcement during his Sunday School class at Maranatha Baptist Church.
"When I went in this week, they did not find any cancer at all, so I have good news," said the former president to a congregation of about 350 who followed with applause.
2016
Sept. 13, 2016 - Jimmy Carter: Latest scan monitoring health "turned out OK"
In March 2016, Carter announced that his recent scans still showed no signs of cancer and that he would no longer need doses of an immune-boosting drug.
Carter said he had an MRI in September "and it turned out to be OK." He said scars from the small tumors once detected on his brain were still visible but hadn't changed in size.
2019
May 14, 2019 - Former President Jimmy Carter suffers broken hip
According to a statement issued from the Carter Center, the former president was getting ready to go turkey hunting, something he is known to frequently do, when he suffered a fall.
The statement said he underwent surgery at Phoebe Sumter Medical Center in Americus, Ga. His surgeon said the operation was a success.
May 16, 2019 - Former President Jimmy Carter released from hospital
Former President Jimmy Carter was released from the hospital just days after the fall that broke his hip.
The Carter Center said he made plans to teach Sunday school that weekend at Maranatha Baptist Church in Plains.
May 18, 2019 - Jimmy Carter won't teach Sunday school days after procedure
Former President Jimmy Carter canceled plans to teach Sunday school just days after undergoing surgery for a broken hip.
"Though he is progressing well, he underestimated the amount of time he would need to recover from his recent hip replacement," Carter spokeswoman Deanna Congileo said in a statement.
Less than a month later, the former president returned to teaching Sunday school in Georgia for the first time since breaking his hip.
Carter told people gathered at the Maranatha Baptist Church in Plains that he and his wife, Rosalynn, have nursing care at home and are doing fine. He thanked those present for their prayers and good wishes.
DENVER, CO - OCTOBER 09: Former president Jimmy Carter works on building a home during Habitat for Humanity's Carter Work Project event in the Globeville Neighborhood in Denver, October 09, 2013. Since 1984 the former president and his wife have dedi
FOX 35 Orlando originally reported on Carter when he picked up a hammer and nails again just months after the surgery.
Carter and his wife Rosalynn were getting ready to build homes for Habitat for Humanity in Nashville, Tenn. by October.
A spokesperson for the nonprofit organization told The Hill: "There have been many times when people have tried to count President Carter out, and they have never been right. We are excited that they will both [be] back."
Note: The picture shown above is from 2013.
Oct. 22, 2019 - Jimmy Carter hospitalized after falling at home
Former President Jimmy Carter had another fall at his home in Plains, Ga. This time, he fractured his pelvis and went to the hospital for treatment and observation.
Carter Center spokeswoman Deanne Congileo described the fracture as minor. Her statement said that the then 95-year-old was in good spirits at the Phoebe Sumter Medical Center after falling, and that he was looking forward to recovering at home.
Carter was released from the hospital three days after his fall.
Former U.S. President Jimmy Carter speaks to the congregation at Maranatha Baptist Church before teaching Sunday school in his hometown of Plains, Georgia on April 28, 2019. Carter, 94, has taught Sunday school at the church on a regular basis since
It's going to take more than a fractured pelvis to prevent Jimmy Carter, a lifelong Baptist and the nation's oldest former president, from teaching Sunday school.
Carter's church in Plains, Ga. said the 95-year-old ex-president planned to teach his Sunday school class just a week after fracturing his pelvis in a fall.
Carter was admitted to Emory University Hospital to undergo a procedure to relieve pressure on his brain from a subdural hematoma, which was caused by his recent falls.
A spokesperson with The Carter Center told FOX 5 that there were no complications from the surgery, but he was expected to remain at the hospital for observation.
Former President Jimmy Carter was released from Emory University Hospital after successful brain surgery and recovery.
"The Carters are grateful for all the prayers, cards, and notes they have received and hope everyone will join them in enjoying a special Thanksgiving," a spokesperson with The Carter Center said in a statement.
Dec. 2, 2019 - President Jimmy Carter admitted to a south Georgia hospital
Deanna Congileo, a spokesperson for The Carter Center, said Carter was admitted to Phoebe Sumter Medical Center in Americus for treatment of a urinary tract infection.
Carter was discharged from the hospital following successful treatment.
2021
Former President Jimmy Carter and his wife Rosalynn returned to their beloved church in Plains, Georgia after being vaccinated against COVID-19.
In a Facebook post, Maranatha Baptist Church in Carter's hometown announced that the couple was back to attending worship in-person at the church.
The Carters sat in their usual spots and wore masks.
The Associated Press contributed to this report. | Disease Research |
The pain and distress of not being able to see an NHS dentist are "totally unacceptable", an inquiry has told the government.
A review was launched after a BBC investigation found nine in 10 NHS dental practices across the UK were not accepting new adult patients.
Some people drove hundreds of miles for treatment or even resorted to pulling out their own teeth, the BBC found.
The government says it invests more than £3bn a year in dentistry.
But the damning report, by the Commons' Health and Social Care Committee, says more needs to be done, and quickly.
Dental reforms - recommended to the government more than 15 years ago - have still not been implemented, it says.
Last year's BBC's investigation found eight in 10 NHS practices were not taking on children.
Between May and July 2022, BBC News contacted nearly 7,000 NHS practices - believed to be almost all those offering general treatment to the public.
In a third of the UK's more than 200 council areas, the BBC found no dentists taking on adult NHS patients.
Researchers could also not find a single practice accepting new adult patients in Lancashire, Norfolk, Devon or Leeds.
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Compared with other nations, Scotland was found to have better access to NHS dentistry for adults, with 18% of practices accepting new patients.
However Wales, England and Northern Ireland were at 7%, 9% and 10% respectively.
Conservative MP Steve Brine said hearing about someone in "such pain and distress" that they used pliers to pull out their teeth "demonstrates the crisis in NHS dental services".
"Rarely has an inquiry been more necessary than this one," said the chairman of the cross-party committee which wrote the report.
Declining levels of NHS dentistry should be "sounding alarm bells", he said, adding: "Today we register in the strongest terms possible our concern for the future of NHS dental services and the patients who desperately need access to them."
NHS dental treatment is not free for most adults, but it is subsidised - if you can get an appointment.
Danielle Watts, from Bury St Edmunds in Suffolk, found herself in a "dental desert" - an area where no dentists offer NHS care - and could not afford the thousands of pounds of private treatment needed to fix her teeth.
One by one, over several months, she pulled out 13 of her own teeth.
Following the BBC's report, a friend persuaded her to set up a crowdfunding page which has since helped raise enough money to enable her to have a set of dentures fitted.
She says the kindness of strangers has completely transformed her life.
"I'm in no pain at all, there is no bleeding, my teeth are all facing the same way," she says.
"I don't have to hide any more. To be able to talk to somebody face-on, to be able to smile at somebody, is something I haven't done for several years."
Some people are going to extraordinary measure to do DIY dentistry as they struggle to find affordable dental care. Are we witnessing the death of NHS dentistry?
Ensuring that everyone who needs an NHS dentist is able to access one within a reasonable timeframe and a reasonable distance, is one of the key recommendations in the report.
Other recommendations include:
- Ensuring the public are better informed about what they are entitled to
- Giving dentists financial incentives for seeing new patients and those with greater dental needs
- Prioritising prevention and patient-centred care
- Finding out how many full-time and part-time-equivalent dentists, dental nurses, therapists and hygienists work in the NHS and how much NHS and private work they carry out.
"We are concerned this will be too little too late for those dentists who have already left the NHS," the report says.
It adds the current dental contract, which pays dentists for batches or courses of treatments delivered rather than for every single item or procedure, such as a check-up or a filling, is not fit for purpose.
The system of paying NHS "units of dental activity" (UDAs) can be a disincentive to dentists seeing new patients, including those who have higher levels of disease and require more time to treat, the report warns.
For example, under UDAs, a course of treatment resulting in just one filling might attract the same fee as one containing five fillings, a root treatment and an extraction.
The British Dental Association says workload backlogs, made worse by Covid, will take many years to clear.
Some dental practices are struggling to deliver their NHS contractual commitments, often simply as a result of being unable to fill vacancies, the association claims.
The government says it recently announced a 40% increase in dentistry training places and has made changes "so dental therapists and hygienists can deliver more treatments".
"We invest more than £3bn a year in dentistry and have already increased the funding practices receive for high needs patients to encourage dentists to provide more NHS treatments," said a spokesperson from the Department of Health and Social Care.
It says the NHS dental contract has been reformed to encourage more dentists to provide NHS treatments and to allow dental therapists and hygienists to offer extra services.
The government also said it would set out further measures "to improve access shortly". | Health Policy |
Labour has accused former health secretary Matt Hancock of failing to place a “protective ring” around care homes during the pandemic. As health secretary, Mr Hancock repeatedly insisted that care homes were being protected, a line Labour has cast doubt on after the uncovering of leaked WhatsApp messages the then-health secretary sent through Covid.
The leaked messages, seen by The Telegraph, show Mr Hancock expressing concern that expanding testing in care homes could “get in the way” of his target of 100,000 Covid tests per day.
The Telegraph claims that chief medical officer Professor Sir Chris Whitty had told Mr Hancock in April 2020 that there should be testing for “all going into care homes and segregation whilst awaiting a result”.
However, the messages suggests Mr Hancock rejected that advice, telling an aide that the move “muddies the waters”, instead introducing mandatory testing just for those coming from hospitals.
According to the investigation, he said: “Tell me if I’m wrong but I would rather leave it out and just commit to test and isolate ALL going into care from hospital.
“I do not think the community commitment adds anything and it muddies the waters.”
He also expressed concerns that expanding care home testing could “get in the way” of the 100,000 daily test target he wanted to hit, the investigation said.
Speaking to Sky News this morning, shadow chief secretary to the Treasury Pat McFadden, said: “We were told at the time that the government was putting a protective ring around care homes.
“And it was particularly sensitive because I think even in the early days of COVID, we knew that elderly people in care homes were particularly vulnerable to this”.
He added: “So the stories this morning suggest that the protective ring wasn’t there, that people were being allowed to go into care homes who could have been positive, contrary to the advice of the chief medical officer at the time”.
Labour MP Jess Phillips has also tweeted: “If details about how Hancock was more bothered about hitting his target on testing by possibly wasting tests that led to less capacity in care homes is true then imagine how those who lost loved ones in that week will feel. This lot its always headlines before front lines”.
Mr Hancock has also come under criticism form within his the Conservative party, with MP Bim Afolami saying that there is a “real problem” of people in Government “making decisions on the fly” via WhatsApp messages.
He told TalkTV: “The Covid inquiry is going to flush all of this out anyway. There are two things that strike me from the snippets that we have heard.
“The first is people have to be incredibly careful about what they put on emails and WhatsApp messages and text messages and the reason why, by the way, is not out of some sort of political ‘oh, you have got to hide what you are doing’, I really don’t mean that”.
Mr Hancock’s messages were leaked by journalist Isabel Oakeshott, who received them while working on Mr Hancock’s “Pandemic Diaries” memoir.
She outlined that she was releasing them because it could take “many years” before an official inquiry is completed and “we absolutely cannot wait any longer for answers”. | Epidemics & Outbreaks |
SCOTLAND’S Drugs Policy Minister Elena Whitham on Friday launched a call for the UK Government to decriminalise drugs for personal use or devolve powers to the Scottish Parliament to take this step, a step that would stop people who use drugs receiving a criminal record for simple possession.
There are two reasons why this is important. One, most people who use drugs do so without any negative impacts on their lives. A criminal record can be more damaging than the drug use. Secondly, for people experiencing problems with their drug use, this would allow them to ask for help without fear of being punished.
Decriminalisation allows easier access to treatment such as opioid-agonist therapy (OAT) including methadone and buprenorphine, which is a key protective factor against fatal overdose. A recent study published in the Lancet from Professor Andrew McAuley et al looking at opioid therapy in Scotland concluded that rates of drug-related deaths more than tripled for those not on OAT.
When Whitham announced the call to the UK Government, she was flanked by Helen Clark, former New Zealand prime minister and chair of the Global Commission on Drug Policy – which was hosting a three-day event in Edinburgh – and former Swiss president Ruth Dreifuss, also a commission member.
Both spoke of international evidence to support decriminalisation and things like drug checking, which is completely legal now in New Zealand. Overdose prevention centres (OPCs) that Switzerland opened 37 years ago are no longer considered radical. In fact they are a standard part of services now operating in 16 countries.
Madame Dreifuss highlighted that in the 1980s the Swiss had major issues with drug deaths and harms, with high levels of HIV transmissions. However, opening OPCs coupled with widespread diamorphine or heroin-assisted treatment have brought great results. Drug deaths are rare now and HIV transmission has been practically eradicated in Switzerland.
However, within minutes of the call to either decriminalise or devolve the power to Scotland to do so, the UK Government came out with the usual hardline stance. Tory MSPs, along with so-called recovery activists, went straight to Twitter to make false claims about the Scottish Government wanting to “legalise heroin and crack”.
To be fair, that was the expected response from the current UK Government, which seems to think there is nothing wrong with drug deaths in England going up consistently every year now and 17 people a day dying on average across the whole of the UK.
One of the biggest shocks to me was the response from Labour MP Rachel Reeves, who said: “I find it quite stunning that this would be a priority for the Scottish Government when we’re here today talking about the Tory mortgage bombshell.”
That was a shocking statement when we consider thousands of people are losing loved ones every year. I was also shocked by the response of Anas Sarwar, the Scottish Labour leader, who seems content with continuing to punish rather than support people who are having problems with drug use.
The SNP are not without blame. They led the way on the doomed-for-failure drug-free utopia strategy the “Road to Recovery” in 2008, two years before the Tory government launched a similar strategy.
They also oversaw the stopping of prescription benzodiazepines. That led to the influx of “street benzos” which have had a devastating impact. More recently in 2016, budgets to alcohol and drug partnerships were cut, leading to a 27% rise in deaths in a single year in 2018.
However, they have now committed to an extra £50 million investment each year and are clearly looking to follow the evidence rather than an outdated war-on-drugs ideology fostered by the 52-year-old UK Misuse of Drugs Act which is not fit for purpose.
With the terrible stance taken by the Tories and Labour, the SNP must be brave and things can be done now. The Cranstoun drug DIVERT in operation across the West-Midlands can stop people getting a criminal record in the current frameworks. Diamorphine treatment needs a mass expansion – it has worked for people where all other treatments have failed.
We have offered a model to Scottish Government at a third of the cost of the Glasgow model meaning it could be rolled out further and faster. And, of course, overdose prevention centres – I proved they can run under current legislation.
Time for talk has come and gone. In key locations across major cities like Glasgow, Dundee and Edinburgh not only will these save lives, they will also save money. We know the evidence. There are fewer hospital admissions, less discarded equipment, fewer ambulance callouts and more people able to access support services.
If the Scottish Government really wants change, it won’t sit on its hands and wait for Westminster permission, it will invest in these core harm-reduction services now.
Scotland is tired of the devastation. I am tired of losing friends and family to preventable overdose. Let’s get on and do it. What will Westminster do, send in the tanks?
Peter Krykant is campaigns lead at Cranstoun | Drug Discoveries |
(Photo: Kevin Dietsch/Getty Images)
Sanders Says 'Much More Has to Be Done' to Cut Prescription Drug Prices
"Bottom line: We should not be paying any more for prescription drugs than other countries around the world," said Sen. Bernie Sanders.
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"Bottom line: We should not be paying any more for prescription drugs than other countries around the world," said Sen. Bernie Sanders.
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Sen. Bernie Sanders on Tuesday called for additional action to curb prescription drug costs in the United States after the Biden administration unveiled its list of the first 10 medications that will be subject to direct price negotiations with Medicare.
Sanders (I-Vt.), the chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, welcomed the administration's move as "an important step forward in taking on the greed of the pharmaceutical industry and their 1,800 paid lobbyists in Washington, D.C."
But "much more has to be done to protect the American people," the senator added, noting that the median annual price of medications approved by the Food and Drug Administration last year was over $222,000.
"Bottom line: We should not be paying any more for prescription drugs than other countries around the world," said Sanders. "I look forward to working with the president and my colleagues to make that happen."
Sanders has been demanding additional legislative and executive action to curb prescription drug prices since the passage of the Inflation Reduction Act (IRA) last year. That bill's prescription drug provisions, including those related to Medicare price negotiations, did not go nearly far enough, Sanders argued at the time.
"While the pharmaceutical industry makes huge profits every year, the American people pay, by far, the highest prices in the world for prescription drugs."
In June, Sanders pledged to stonewall President Joe Biden's health agency nominees until the administration puts forth a "comprehensive" plan to slash U.S. drug costs, which force millions to skip or ration medications—including lifesaving drugs such as insulin.
Sanders has repeatedly urged the president to use his executive authority to cut the prices of medications developed with public funding.
The senator has also proposed legislation that would require Medicare to pay no more for prescription drugs than the Department of Veterans Affairs, which paid about half as much as Medicare Part D for certain drugs in 2017. The change would save Medicare an estimated $835 billion over a 10-year period.
The Biden administration expects the IRA's drug price negotiation provisions to save Medicare $160 billion over the next decade.
"While the pharmaceutical industry makes huge profits every year, the American people pay, by far, the highest prices in the world for prescription drugs," Sanders said Tuesday. "And that situation is getting worse."
According to a recent analysis by Accountable.US, the nation's five largest pharmaceutical companies—Eli Lilly, Johnson & Johnson, Pfizer, Merck, and AbbVie—reported combined earnings of $81.9 billion last year.
Merck and Johnson & Johnson subsidiary Janssen are among the pharmaceutical companies suing the Biden administration in an attempt to block direct price negotiations with Medicare.
"Why is pharma suing to stop President Biden from lowering prescription drug prices? Follow the money," Sanders wrote in a social media post. "Januvia, Merck's diabetes drug, costs $547 in the U.S. but just $16 in France. Eliquis, Bristol-Myers Squibb's blood clot drug, costs $561 in the U.S. but just $63 in Germany."
"Big drug companies raked in billions in profits while standing in the way of lower prescription drug costs for millions of seniors," Tony Carrk, executive director of Accountable.US, said in a statement Tuesday. "The time of Big Pharma grossly overcharging American seniors on lifesaving medicines is coming to an end."
"This historic achievement is still under threat, however, because the MAGA House majority is hellbent on repealing the Inflation Reduction Act," Carrk added. "They would rather pad the profits of their major industry donors than help seniors who are literally choosing between food and medicines." | Health Policy |
Eat Right, Live Longer: Could A Moderate Protein Diet Be the Coveted Elixir of Youth?Wed, May 31, 2023
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Eat Right, Live Longer: Could A Moderate Protein Diet Be the Coveted Elixir of Youth?
Researchers from Japan decode the correlation between dietary protein intake and improved metabolic health in mice
Consuming nutritious food can improve metabolic health and delay aging. But what are the appropriate quantities of dietary macronutrients that can help achieve this? To answer this, researchers from Japan fed isocaloric diets with varying amounts of protein to young and middle-aged male mice. They found that the mice were metabolically healthier when fed moderate-protein diets. These findings could provide valuable insights into developing nutritional interventions and improving metabolic health in people.
As the proverb “You are what you eat” goes, the type of food we consume influences our health and longevity all through our lives. In fact, there is a direct association between age-related nutritional requirements and metabolic health. Optimal nutrition according to age can help maintain metabolic health, thereby improving the health span (period of life without diseases) and lifespan of an individual. Different nutritional interventions involving varied calorie and protein intake have been known to improve the health and lifespan of rodents and primates. Furthermore, recent studies have also reported the association of dietary macronutrients (proteins, carbohydrates, fats) with cardio-metabolic health and aging in mice. However, the amount of protein that must be consumed to maintain metabolic health is not known.
In a new study published in GeroScience on April 28, 2023, a team of researchers led by Assistant Professor Yoshitaka Kondo from Waseda University, Japan, investigated the amount of dietary protein needed to improve metabolic health in mice approaching old age. The team, which also included Dr. Takuya Chiba, Faculty of Human Sciences, Waseda University, Dr. Akihito Ishigami, Molecular Regulation of Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Dr. Hitoshi Aoki, Research and Development Division, Nichirei Foods Inc, and Dr. Shin-Ichiro Takahashi, Department of Animal Sciences and Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, University of Tokyo. They recruited young (6 months old) and middle-aged (16 months old) male C57BL/6NCr mice who were fed isocaloric diets with varying protein content (5 to 45 %) for two months. After two months, the effect of varying protein diets was assessed based on measurements of skeletal muscle weight, liver and plasma lipid profiles, and self‑organizing map (SOM) cluster analysis of plasma amino acid profiles.
When asked about the motivation behind their study, Kondo explains, “The optimal balance of macronutrients for ideal health outcomes may vary across different life stages. Previous studies show the possibility of minimizing age-specific mortality throughout life by changing the ratio of dietary protein to carbohydrates during approach to old age in mice. However, the amount of protein that should be consumed to maintain metabolic health while approaching old age is still unclear.”
The team observed that the consumption of a low-protein diet led to the development of mild fatty liver, with increased levels of hepatic lipids in middle-aged mice as compared to young mice. In contrast, a moderate-protein diet led to reduced blood glucose concentrations and lipid levels in both liver and plasma. These findings indicate that a moderate-protein diet (25% and 35%) kept both young and middle-aged mice metabolically healthier.
On examining the effect of varying protein diets on plasma amino acid concentrations in mice of both age groups, the researchers observed that the plasma concentration of individual amino acids varied with age and varying dietary protein content. This was further validated using SOM analysis of the plasma amino acids. Furthermore, the plasma amino acid profiles revealed using SOM analysis showed the correlation between different protein intake and the varying amounts of hepatic triglycerides and cholesterol levels.
Discussing the impact of their study on public health, Kondo remarks, “Protein requirements change through the course of life, being higher in younger reproductive mice, reducing through middle age, and rising again in older mice as protein efficiency declines. The same pattern is likely to be observed in humans. Therefore, it could be assumed that increasing daily protein intake in meals could promote metabolic health of people. Moreover, ideal dietary macronutrient balance at each life stage could also extend health span.”
In conclusion, a balanced diet with moderate amounts of protein could be the key to a long and healthy life.
Reference
Title of original paper: Moderate protein intake percentage in mice for maintaining metabolic health during approach to old age
DOI: 10.1007/s11357-023-00797-3
Journal: GeroScience
Article Publication Date: 28 April, 2023
Authors: Yoshitaka Kondo1,5, Hitoshi Aoki2, Masato Masuda3, Hiroki Nishi3, Yoshihiro Noda4, Fumihiko Hakuno3, Shin‑Ichiro Takahashi3, Takuya Chiba5, Akihito Ishigami1
Affiliations: 1 Molecular Regulation of Aging, Tokyo Metropolitan Institute of Gerontology, Japan
2 Research and Development Division, Nichirei Foods Inc, Japan
3 Department of Animal Sciences and Applied Biological Chemistry, University of Tokyo, Japan
4 Department of Animal Facility, Tokyo Metropolitan Institute of Gerontology, Japan
5 Biomedical Gerontology Laboratory, Faculty of Human Sciences, Waseda University, Japan | Nutrition Research |
The hospital where killer nurse Lucy Letby worked didn’t allow investigators to see clinical notes, the trial prosecution's lead medical expert has said.
The nurse was found guilty of murdering seven babies and attempting to murder six other infants while working on the hospital's neonatal unit between June 2015 and June 2016.
Consultant paediatrician Dr Dewi Evans, who gave evidence as an expert witness during her 10-month trial, was asked to look at cases where babies had died or collapsed unexpectedly on the unit during this period.
Dr Evans said there were three inquiries prior to his investigation, with one carried out by two consultant paediatricians and two nurses from the Royal College of Paediatrics and Child Health.
The investigation was organised by hospital management, but Dr Evans says the "terms of reference did not allow the clinical notes of the babies who had collapsed".
Speaking to Sky's Katerina Vittozzi, Dr Evans said Letby's colleagues had expressed concerns about baby deaths during her shifts very early on but "nobody was listening to them".
The consultant paediatrician says this doesn't surprise him after 30 years of working on clinical negligence cases.
He said: "Those of us who deal with child abuse cases, usually the sentence of a negligent parent, we say that these are parents who are unable to distinguish their own needs, from the needs of that child or the needs of their children.
"And I think that health managers are exactly the same. They are unable to distinguish their own needs from the needs of the public or the needs of the patient. And this is endemic, you know, this always happens."
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Asked whether the Countess of Chester Hospital has a case to answer after the deaths, Dr Evans said: "I think they're still in denial to be honest with you. I think they failed.
"That is not a matter for doctors, that is a matter for the police and other organisations."
Read more:
The psychology behind healthcare murders
Will killer nurse ever be released?
Mother fears Letby harmed her baby in act of revenge
More families told their babies may have been Letby victims
Dr Evans said when he began investigating the baby deaths and collapses he found that "a number of them" could not be explained on the "basis of any natural problem".
Some had collapsed due to an embolism after they had been injected with air, while others had been overfed with a "huge amount of milk".
Dr Evans said the "smoking gun" was when there was "no doubt" two babies had been "poisoned" after being found to have very high levels of insulin in their blood.
Jane Tomkinson, acting chief executive officer at the Countess of Chester Hospital NHS Foundation Trust, said: "Following the trial of former neonatal nurse Lucy Letby, the Trust welcomes the announcement of an independent inquiry by the Department of Health and Social Care.
"In addition, the Trust will be supporting the ongoing investigation by Cheshire Police.
"Due to ongoing legal considerations, it would not be appropriate for the Trust to make any further comment at this time."
Letby is due to be sentenced on Monday. | Epidemics & Outbreaks |
Sign up for CNN’s Stress, But Less newsletter. Our six-part mindfulness guide will inform and inspire you to reduce stress while learning how to harness it. CNN — In a time when traumatic events such as pandemics, shootings and loss seem never-ending, mindfulness can be a tool for feeling capable during periods of uncertainty. “Mindfulness is a collection of practices nowadays, aimed to help most of us cultivate moment-to-moment awareness,” said Monica Vermani, a clinical psychologist based in Toronto and author of “A Deeper Wellness: Conquering Stress, Mood, Anxiety and Traumas.” “You’re not only aware of your body; you’re aware of your surroundings and your world,” she added. “It forces you to pay attention to life (rather) than get caught up in your head with anxious thoughts, worries and ruminating about the future.” Meditation, a practice of mindfulness, doesn’t have a single universal definition. But as interest in mindfulness and meditation has grown, it has been summed up as “a mind and body practice focused on interactions between the brain, mind, body and behavior, containing four key elements: a quiet location with little distractions, a comfortable posture, a focus of attention and an open attitude,” according to a 2021 study. Scientists are still learning about exactly how meditation could induce positive impacts on other aspects of health, too – such as helping our immune systems function optimally, enhancing sleep, lowering cholesterol and alleviating pain. “It helps you with memory and concentration, increases resiliency, helps you manage stress better (and) helps you have a positive impact on relationships,” Vermani said. “In relationships, if you’re busy in your mind, you’re reactive. And when you’re mindful and you’re grounded, you have a tendency to respond versus react, meaning to pause and reflect before letting things go out of your mouth that are sometimes hurtful, or negative or judgmental.” Practicing mindfulness has been found to influence two stress pathways in the brain, altering brain structure and activity in regions that regulate attention and emotion, according to the American Psychological Association. People who practice mindfulness-based stress reduction and mindfulness-based cognitive therapy – which include meditation – have been less likely to have negative thoughts or unhelpful emotional reactions when facing stressful situations, according to a 2015 review. In addition to any structural changes in the brain, these benefits could be the result of physical processes, too. Meditation can help regulate the autonomic nervous system, the part of our nervous system that’s responsible for regulating involuntary physiological functions such as heart rate, blood pressure, breathing and digestion. “Whenever we’re anxious or we’re racing in that rat race of a world, we’re rushing so much that we do short and shallow breaths,” Vermani said. “When you do that, your muscles tighten up, your brain tends to get foggy, overwhelmed; you might ruminate.” Breathing meditations can reduce muscle tension and heart rate, Vaile Wright, a psychologist and senior director of health care innovation at the American Psychological Association, told CNN in 2020. The calmness felt during or after deep breathing meditations could be due to the delivery of more oxygen to the brain and body, Vermani said. “We did a one-week retreat on meditation,” said Dr. Deepak Chopra, founder of the Chopra Foundation and clinical professor of family medicine and public health at the University of California, San Diego. “In that one week, all the genes that cause self-regulation, homeostasis – in short, healing – they went up some 17-fold. All the genes that cause or complicated cancer, heart disease, autoimmune illness (and) accelerated aging went down. The level of the enzyme telomerase went up by 30%. This regulates the genetic lock or how we age.” Although there are some known benefits of meditation for mental and physical health, researchers are still looking into the best methods for objectively measuring how the practice affects the brain. Some researchers have increasingly used cognitive neuroscience methods – such as MRIs (magnetic-resonance imaging) – to determine what’s going on in participants neural networks during or after meditation, according to a 2019 review published in the journal Perspectives on Psychological Science. But pictures from MRIs and other imaging methods might not exactly depict the complex factors that would be involved in some of the conclusions other researchers have made about how meditation could change brain structure and function, the review authors said – potentially leading to “overly simplistic interpretations.” Also, there have been some studies whose findings challenged the idea of meditation being able to help anyone regardless of their personal differences. “Meditation-related experiences that were serious or distressing enough to warrant additional treatment or medical attention have been reported in more than 20 published case reports or observational studies,” according to the Perspectives on Psychological Science review. Those rare reports documented events including psychosis, mania, anxiety, panic, re-experiencing traumatic memories and depersonalization – a state of mind wherein one’s self appears unreal, and the person feels estranged from herself and the external world, and thoughts and experiences have a distant, dreamlike character, according to the American Psychological Association. The differences between people who do or don’t benefit from meditation could just boil down to figuring out what type of meditation is best for one’s body and mental state, Vermani said. “Even when we did our study (on meditative breathing for anxiety), we had to screen that generalized anxiety disorder was not complicated by other disorders that could be worse,” Vermani said. This was because one of the meditations Vermani and colleagues were using was bellows breath, an invigorative yogic breathing technique involving rapid inhalations and exhalations for energy and mental clarity. “If you have bipolar, (bellows breath) can actually induce mania, so it’s a big deal. You don’t teach a pregnant woman bellows breath because it’s so vigorous, you can induce labor. So meditation does have consequences.” Additionally, some people who turn to meditation have spent years avoiding or distracting themselves from distressing memories. “When you’re alone, your thoughts go to the things that you have not dealt with,” Vermani said. “Military, 9/11 responders or cops that I work with – many times, they have so many horrible things that they have seen, they just kind of push through life and function and push things aside. But when they sit in silence and meditate or breathe, all those things come back to the surface because they haven’t addressed it.” Practicing meditation in supervised settings with professionals who can educate about potential effects has been helpful for people with complicated emotional states, she added. Meditation is “very accessible,” said Dr. Robert Waldinger, a clinical professor of psychiatry at Harvard Medical School and director of the Harvard Study of Adult Development. “There are now so many apps that if you have a smartphone, you can learn to meditate. Often what’s really helpful is to use one of the apps … where someone guides you through a meditation.” You can also try an introductory class at a local meditation center, read a book, watch an online video, or practice alone. Whichever path you choose, see what resonates with you – find someone whose voice you like and whose words make sense, Waldinger said. For beginners, starting out in a professionally led setting can be helpful for reorienting yourself after any hurdles that could lead to quickly giving up or feeling discouraged, Waldinger said. “There are a lot of misconceptions about meditation,” he added. “One misconception is ‘If I’m doing it right, I’m not supposed to have thoughts.’ And that’s absolutely not the truth. The mind produces thoughts; that’s what it does. So, you won’t get rid of thoughts until you die.” Instructors can teach you about the aspects of meditation that aren’t intuitive or obvious, such as that having thoughts or a distracted mind is OK, Waldinger said. “If you just set the intention to be present, then whatever happens is what you’re doing, including being distracted.” Since meditation is about being present, it can be done anywhere, he added – but a quiet, uninterrupted area can be optimal for beginners still learning to focus on the present. You can start with just five minutes per day, then gradually increase. “Try it every day for a week and see if you notice anything,” Waldinger said. “But even after one time, many people say, ‘Oh, that was helpful. I want to do that again.’” If you notice that meditating makes you feel worse, talk with an experienced meditator about your experience or wait until you’re in a better emotional or mental state, Waldinger said. “People are catching on that meditation is more than stress management,” said Chopra, author of “Total Meditation: Practices in Living the Awakened Life.” “When people say meditation, these days, they refer to mindfulness, which is good. But meditation includes self-inquiries of awareness. It includes interoception, (which is) knowing how to navigate control of your autonomic nervous system consciously. It includes that whole aspect of mindful awareness of relationship, of the ecosystem, of emotions, of social emotional intelligence.” | Stress and Wellness |
Over 80 percent of people with periods have experienced some kind of pain associated with their menstruation cycles, research shows(opens in a new tab). The symptoms are that prevalent but there aren't too many systems in place to help tackle something that affects so many.
Gynaecological health startup Daye(opens in a new tab) is aiming to fix this, with the launch of a digital period pain clinic(opens in a new tab) that it claims is a world-first.
The clinic provides a 360° approach and full virtual service to support those experiencing period pain. The clinic will offer everything from a personalised pain relief routine, diagnosis of gynae health conditions, access to innovative treatments, and advice from specialists, including sexual health nurses, dermatologists, and chronic pelvic pain experts.
These specialists can help diagnose the root condition and cause of period pain, like endometriosis, adenomyosis, Polycystic Ovaries Syndrome (PCOS), and fibroids. The symptoms that can be examined thereafter range from infertility to hair loss to acne – all of which can be associated with periods but often go untreated. Treatments will then be suggested, with a holistic approach. This can mean anything from hormonal contraception to alternative treatments to lifestyle recommendations to some of Daye's products – such as CBD tampons(opens in a new tab) and organic bamboo pads(opens in a new tab).
"Like so many others, I've faced the dismissal of my period pain by medical professionals," says Valentina Milanova, Founder of Daye(opens in a new tab), in a statement. "My own experiences with ovarian cysts and the resultant pain were dismissed time and again. This should not be the case. Nobody’s menstrual pain should be dismissed, which is why we launched our Period Pain Clinic to ensure that nobody has to suffer in silence or be in the dark about the cause or management of their menstrual pain."
To access the service, users first take a 10-15 minute medical questionnaire that will develop a free preview report for keeps. To do so, participants must be aged 18 and above. The clinic then has three paid tiers: standard (£24.99) – which provides a period report and primary insights into your health; advanced (£54.99) – revealing a full report and including a 30-minute consultation with a nurse; or premium (£199.99) – a full report alongside a 30-minute consultation with a pelvic pain specialist who can provide a proper diagnosis of any associated condition.
The initial questionnaire was developed using guidelines from the Royal College of Obstetricians and Gynaecologists, the American College of Obstetricians and Gynaecologists, National Institute for Care Excellence, and the European Society of Human Reproduction and Embryology.
The data you provide will be de-identified and double-encrypted, so Daye and its partners will not be able to personally identify any of the data. However, the data will be shared, pro-bono, with research institutions like Liverpool Women’s Hospital.
As of now, the period pain clinic is only available in the UK but the company tells Mashable they have plans to expand globally.
Daye, a UK-based femtech founded in 2017, developed the clinic in collaboration with National Health Service (NHS) practitioners and gynaecologists. The period pain clinic is also an answer to a heavily-burdened public healthcare system in the UK. Telehealth services and companies like Daye can offer faster, on-demand services(opens in a new tab) for specific issues within women's healthcare. A 2022 McKinsey report on femtech(opens in a new tab) found that interest and funding in such companies are surging, as femtech can increasingly provide "a wide range of solutions...across a number of female-specific conditions", including menstrual health. | Women’s Health |
Leann Sutherland was 21 and suffering from chronic migraines when one of Scotland's top surgeons offered to operate.
She was told she would be in hospital for a few days and had a 60% chance of improvement. Instead she was in for months while Sam Eljamel operated on her seven times.
The BBC can reveal her surgeon - the former head of neurosurgery at NHS Tayside - was harming patients and putting them at risk for years but the health board let him carry on regardless.
NHS Tayside has consistently claimed it only knew about concerns from June 2013 and that they put him under supervision at that point but an NHS whistleblower has told the BBC the health board knew as early as 2009 that there were serious concerns.
BBC Scotland has spoken to three surgeons who worked under Mr Eljamel at Tayside. All three said he was a bully who was allowed to get away with harming patients.
All three said there was a lack of accountability in the department and that Mr Eljamel was allowed to behave as if he were a "god" - partly because of the research funding he brought to the department.
The health board told the BBC it was working with the Scottish government to support an independent review of patients' care under Mr Eljamel and that it could not comment on individual cases.
'I was his guinea pig'
Before her operation in 2011 Leann used to work full-time and go on holidays abroad with friends but her life was blighted by migraines.
Mr Eljamel, reputed to be the best neurosurgeon in Scotland, told her he could help.
It would be one operation and she would be home in a matter of days, she was told.
He would remove a small part of her skull to alleviate pressure and he told her he would use a new glue to seal the wound.
Leann told the BBC: "Unfortunately it did not seal properly and it burst.
"The wound burst open and the brain fluid started to pour out the back of my neck."
She says the next day her hospital bed was "soaked" with her spinal fluid.
When she got up to use the bathroom she collapsed and said the fluid went all over the floor. A nurse put a wet floor warning sign on the area.
Leann says that her mum had to chase Mr Eljamel down a corridor to get him to come and look at her - at which point she was rushed back into surgery.
Leann spent months in hospital. She contracted meningitis and developed hydrocephalus. Mr Eljamel ordered her to have four lumbar punctures - which her medical notes say she specifically should not have had.
Leann knows now he was using the glue as part of a research trial.
"Experimenting on me - that's what he was doing," she says.
"There can't be any other reason to try a glue, try different shunts, that's experimenting.
"I was his guinea pig."
She adds: "He had free rein on my body. He was playing God with my body and the NHS handed him the scalpel, seven times."
When Leann tried to raise concerns with staff she was told that Mr Eljamel had saved her life. She was not told that he was under investigation, nor that he had been later forced to step down.
It was only after seeing recent BBC coverage she realised she was not alone.
The impact
Leann is now 33. She lives in constant pain. She needs crutches to walk and has a tube - called a shunt - through her body controlling her spinal fluid.
"Everything is changed," she says. "My dream was to be a police officer and that will never happen.
"I struggle with that, not being able to have the career you want, not being able to have the lifestyle you want, not being able to have children.
"A lot of things have been taken away through no fault of my own."
Leann is one of 100 patients calling for a public inquiry to find out exactly what harm Mr Eljamel did.
The damage to her and other patients is irreversible but she wants to ensure the health board is held accountable and that no other surgeon can cause such damage.
She says she only realised he had harmed patients after seeing a story by BBC Scotland.
"I thought it was just me, I didn't know there was 99 other people," she says.
"I don't understand how he got to wash the blood off his hands and go home."
Whistleblower
Mr Eljamel was suspended by NHS Tayside following internal and external reviews in 2013 and went to work in Libya.
For the first time, three people who worked with Mr Eljamel have spoken to the BBC.
Mark, not his real name, says he is speaking out now because he fears the health board has still not learnt the lessons of the past.
"I did raise concerns at the time but I was shut down," he says.
"Part of me feels guilty I did not do anything [more] about it but I was too junior.
"We were told we would never get our traineeship."
He says nurses, senior surgeons and managers knew at least as early as 2009 that Mr Eljamel was regularly away from the hospital doing private work when he was meant to be operating on patients.
Mark says that on a weekly basis Mr Eljamel left junior surgeons to operate unsupervised.
"Letting a junior operate when you're not even in the building and a patient coming to harm is negligent," he says.
"NHS Tayside has covered things like this up for a long time in Dundee.
"It went all the way up to the board. They all knew about it."
'Untouchable'
Mark remembers on one occasion being in surgery to watch the junior operating on Mr Eljamel's patient when the junior surgeon accidentally cut through the spinal cord.
He said the spinal fluid was "pouring out" and that he and another surgeon were sent running to find a more senior surgeon. That patient was left permanently disabled.
"What has this top neurosurgeon done to these patients?" He says. "I think serious harm. Cover-ups happen so these things need to be looked into again.
"Drawing a line is easy to say but the culture will not change if you just draw a line in the sand. You need to change the culture first to protect the patients."
The three surgeons told us Mr Eljamel discouraged the use of X-rays because he was so arrogant and because it saved him money.
It is thought that as a result he operated in the wrong place on the spines of at least 70 patients - leaving many permanently disabled.
Mark says one of the reasons Mr Eljamel was considered "untouchable" was that he brought so much money in to the department through research projects which many of them considered to be "odd and even questionable".
A spokeswoman for NHS Tayside said: "The NHS Tayside medical director and chief executive met with the cabinet secretary and local Tayside MSPs in April to discuss the ongoing concerns of patients of Professor Eljamel.
"It was agreed at the meeting that NHS Tayside would work with Scottish government regarding the next steps to support individual patients through a process independent of both the health board and government.
"NHS Tayside remains committed to do whatever is required to support the independent process recognising it will be tailored to the circumstances of individual patients.
"While we cannot comment on individual patients and their treatment due to patient confidentiality, we would invite Ms Sutherland to contact NHS Tayside's Patient Liaison Response Team." | Medical Innovations |
LONDON -- A surgical tool “the size of a dinner plate” has been discovered inside a woman’s abdomen 18 months after undergoing a caesarean section while giving birth to her child, health officials have confirmed.
The unnamed woman from New Zealand, who was in her 20’s when she gave birth to her child in 2020, underwent a scheduled caesarean section at 36 weeks plus three days gestation, according to a report released by New Zealand’s Health and Disability Commissioner, Morag McDowell.
“An Alexis wound retractor (AWR), a device used to draw back the edges of a wound during surgery, was left in her abdomen following her C-section,” the report said. “This resulted in the woman suffering chronic abdominal pain until the device was discovered incidentally on an abdominal CT scan.”
At the time of her procedure, a host of operating room theatre staff were present at the C-section, including a surgeon, a senior registrar, an instrument nurse, three circulating nurses, two anesthetists, two anesthetic technicians, and a theater midwife, officials said.
However, the woman soon began to fee serious pains in her abdomen and began reporting this to her doctor “a number of times in the 18 months after the C-section,” including, on one occasion, going to the emergency room at Auckland City Hospital because the pains were so severe.
On the day of the procedure, the surgeon performed a midline laparotomy and initially used a large-sized AWR, according to the report.
“However, the surgeon stated that this was too small for the incision, so it was removed and replaced with an extra-large AWR,” officials said.
The senior registrar who was on site during the C-section said in the report that “a midline incision was made and an Alexis retractor was inserted, however it was too small for the incision.”
This instrument was subsequently removed and replaced with a larger with a larger Alexis retractor.
“The Case Review found that it was this second AWR (size XL) that was retained,” according to the report. “It should be noted that the retractor, a round, soft tubal instrument of transparent plastic fixed on two rings, is a large item, about the size of a dinner plate. Usually, it would be removed after closing the uterine incision (and before the skin is sutured).”
“As far as I am aware, in our department no one ever recorded the Alexis Retractor on the count board and/or included in the count,” an unnamed nurse is quoted as saying in the medical report. “This may have been due to the fact that the Alexis Retractor doesn’t go into the wound completely as half of the retractor needs to remain outside the patient and so it would not be at risk of being retained.”
Two of the nurses present said they had no recollection of the case. However, one of the nurses recalls opening a second AWR. She noted that this was very unusual, and they had never had to do so before or since.
“I remember being asked by the scrub nurse to open another Alexis wound retractor … We had none in the prep room, so I quickly fetched one from the sterile stock room,” the other nurse said. “I opened this to the scrub nurse and left it at that. I do not remember telling [one of the other nurses] that I opened it and I did not write this with the count, as at this time this item was not part of our count routine.”
The report released announcing this incident is a full assessment of what happened in the operating theater at the time of her C-section.
“I acknowledge the stress that these events caused to the woman and her family. The woman experienced episodes of pain over a significant period of time following her surgery until the AWR was removed in 2021,” the health commissioner said. “I accept her concerns regarding the impact this had on her health and wellbeing and that of her family.”
The commissioner recommended that the woman be provided a written apology by hospital staff and a review of hospital practices is now underway.
Said the commissioner: “However, I have little difficulty concluding that the retention of a surgical instrument in a person’s body falls well below the expected standard of care — and I do not consider it necessary to have specific expert advice to assist me in reaching that conclusion.” | Medical Innovations |
Tony Blair has urged ministers to tax junk food so it is too expensive for the poor in a bit to tackle obesity.
The former Labour prime minister urged an interventionist policy on public health, with an expansion of the sugar tax, new levies on foods high in fat and salt, and advertising bans.
He said ministers needed to help 'create the circumstances' in which poorer families choose healthy food, and likened the situation to the fight against smoking when he was in No10 - which included a ban on publicly lighting up indoors.
In an interview with the Times he dismissed concerns about a 'nanny state' approach as a 'minority view', and said direct action was needed to make Brits take personal responsibility for their health.
'We've got to shift from a service that's treating people when they're ill to a service that is focused on well-being, on prevention, on how people live more healthy lives,' he said.
'You can't run a modern healthcare system where people are going to live much longer unless they take some responsibility. You've got to help them do that.
'The way of helping them do that, particularly with poor families, is to create the circumstances in which [they can choose healthier food].'
This week it was revealed a record numbers of young girls are hitting puberty too soon - with some as young as four - as experts blame obesity as a key factor.
Britain's bulging waistline is stripping billions of pounds from the NHS each year with twice as much spent on obese patients than those of a healthy weight, a landmark study revealed earlier this year.
Costs per patient rise drastically the more people weigh, as they 'collect obesity-related conditions' such as type 2 diabetes, cancer and heart disease, according to research involving nearly 2.5million people.
The findings lay bare the enormous strain of obesity on NHS finances – suggesting the health service would stand to gain up to £13.7 billion annually if people maintained a healthy weight.
New data shows the number of times girls were seen at hospital for cases of 'precocious puberty' increased to 2,032 last year, up from 1,510 previously.
Of these, 79 children had not even reached their fifth birthdays, NHS Digital hospital data showed.
A study carried out by the National Child Measurement Programme with NHS Digital in 2021 revealed the largest rise in obesity rates in schoolchildren since records began.
However the former premier was less in favour of new taxes when it comes to the prospect of a Labour government.
In a separate interview with the Financial Times he urged Sir Keir Starmer to hold to the centre ground and avoid 'taxing and spending' the UK out of economic turmoil.
He credited Sir Keir with bringing his party back from 'the brink of extinction', but warned that if he entered No10 he would have to contend with a far more challenging situation than the one he faced when he swept to power in 1997.
He added: 'If Sir Keir Starmer wins the election, which I think he's got a good chance of doing, he'll be the sixth prime minister in eight years.
'That's a country that's in a mess. We are not in good shape.'
He said criticism of Sir Keir's policy offering as too bland was 'nonsense' and that Labour should not equate 'being radical with just taxing and spending'.
He added: 'The Conservative Party has taxed and spent to the point where we're in an economic crisis.
'The radical agenda today is all about understanding, mastering, harnessing the technological revolution - everything else is secondary to that.'
The political grandee, who led the Labour government of 1997 to 2007, told the newspaper that while he met Sir Keir 'reasonably frequently', he was 'his own person' who had shown 'agility and determination' in reshaping the party in the wake of Jeremy Corbyn's leadership.
Sir Keir has been open about seeking the advice of Sir Tony and Gordon Brown on moving into government. | Health Policy |
Crisis over suspected Iran schoolgirl poisonings escalates
A crisis over suspected poisonings targeting Iranian schoolgirls escalated Sunday as authorities acknowledged over 50 schools were struck in a wave of possible cases. The poisonings have spread further fear among parents as Iran has faced months of unrest.
It remains unclear who or what is responsible since the alleged poisonings began in November in the Shiite holy city of Qom. Reports now suggest schools across 21 of Iran's 30 provinces have seen suspected cases, with girls' schools the site of nearly all the incidents.
The attacks have raised fears that other girls could be poisoned, apparently just for going to school. Education for girls has never been challenged in the more than 40 years since the 1979 Islamic Revolution. Iran has been calling on the Taliban in neighbouring Afghanistan to allow girls and women return to school and universities.
Interior Minister Ahmad Vahidi on Saturday said, without elaborating, that investigators recovered "suspicious samples" in the course of their investigations into the incidents, according to the state-run IRNA news agency. He called for calm among the public, while also accusing the "enemy's media terrorism" of inciting more panic over the alleged poisonings.
However, it wasn't until the poisonings received international media attention that hard-line President Ebrahim Raisi announced an investigation into the incidents on Wednesday.
Vahidi said at least 52 schools had been affected by suspected poisonings. Iranian media reports have put the number of schools at over 60. At least one boy's school reportedly has been affected.
Videos of upset parents and schoolgirls in emergency rooms with IVs in their arms have flooded social media. Making sense of the crisis remains challenging, given that nearly 100 journalists have been detained by Iran since the start of protests in September over the death of 22-year-old Mahsa Amini. She had been detained by the country's morality police and later died.
The security force crackdown on those protests has seen at least 530 people killed and 19,700 others detained, according to Human Rights Activists in Iran.
The children affected in the poisonings reportedly complained of headaches, heart palpitations, feeling lethargic or otherwise unable to move. Some described smelling tangerines, chlorine or cleaning agents.
Reports suggest at least 400 schoolchildren have fallen ill since November. Vahidi, the interior minister, said in his statement that two girls remain in hospital because of underlying chronic conditions.
As more attacks were reported Sunday, videos were posted on social media showing children complaining about pain in the legs, abdomen and dizziness. State media have mainly referred to these as "hysteric reactions."
Since the outbreak, no one was reported in critical condition and there have been no reports of fatalities.
Attacks on women have happened in the past in Iran, most recently with a wave of acid attacks in 2014 around the city of Isfahan, at the time believed to have been carried out by hard-liners targeting women for how they dressed.
Speculation in Iran's tightly controlled state media has focused on the possibility of exile groups or foreign powers being behind the poisonings. That was also repeatedly alleged during the recent protests without evidence. In recent days, Germany's foreign minister, a White House official and others have called on Iran to do more to protect schoolgirls -- a concern Iran's Foreign Ministry has dismissed as "crocodile tears."
However, the U.S. Commission on International Religious Freedom noted that Iran has "continued to tolerate attacks against women and girls for months" amid the recent protests.
"These poisonings are occurring in an environment where Iranian officials have impunity for the harassment, assault, rape, torture and execution of women peacefully asserting their freedom of religion or belief," Sharon Kleinbaum of the commission said in a statement.
Suspicion in Iran has fallen on possible hard-liners for carrying out the suspected poisonings. Iranian journalists, including Jamileh Kadivar, a prominent former reformist lawmaker at Tehran's Ettelaat newspaper, have cited a supposed communique from a group calling itself Fidayeen Velayat that purportedly said that girls' education "is considered forbidden" and threatened to "spread the poisoning of girls throughout Iran" if girls' schools remain open.
Iranian officials have not acknowledged any group called Fidayeen Velayat, which roughly translates to English as "Devotees of the Guardianship." However, Kadivar's mention of the threat in print comes as she remains influential within Iranian politics and has ties to its theocratic ruling class. The head of the Ettelaat newspaper also is appointed by Supreme Leader Ayatollah Ali Khamenei.
Kadivar wrote Saturday that another possibility is "mass hysteria." There have been previous cases of this over the last decades, most recently in Afghanistan from 2009 through 2012. Then, the World Health Organization wrote about so-called "mass psychogenic illnesses" affecting hundreds of girls in schools across the country.
"Reports of stench smells preceding the appearance of symptoms have given credit to the theory of mass poisoning," WHO wrote at the time. "However, investigations into the causes of these outbreaks have yielded no such evidence so far."
Iran has not acknowledged asking the world health body for assistance in its investigation. WHO did not immediately respond to a request for comment Sunday.
However, Kadivar also noted that hard-liners in Iranian governments in the past carried out so-called "chain murders" of activists and others in the 1990s. She also referenced the killings by Islamic vigilantes in 2002 in the city of Kerman, when one victim was stoned to death and others were tied up and thrown into a swimming pool, where they drowned. She described those vigilantes as being members of the Basij, an all-volunteer force in Iran's paramilitary Revolutionary Guard.
"The common denominator of all of them is their extreme thinking, intellectual stagnation and rigid religious view that allowed them to have committed such violent actions," Kadivar wrote.
CTVNews.ca Top Stories
A crisis over suspected poisonings targeting Iranian schoolgirls escalated Sunday as authorities acknowledged over 50 schools were struck in a wave of possible cases. The poisonings have spread further fear among parents as Iran has faced months of unrest.
Why are Canadian banks quick to charge more for borrowing, but slow to increase savings account rates?
While Canada's largest banks are charging more to lend money due to high interest rates, experts say they are failing to increase savings account rates in a similar way. Aimed at taming inflation, the Bank of Canada began implementing a series of interest rate hikes in March 2022.
With tax season underway, a survey conducted by H&R Block Canada reveals that 44 per cent of Canadian gig workers are willing to risk the consequences of not claiming all their income.
Canada's spy service warns that climate change poses a profound, ongoing threat to national security and prosperity, including the possible loss of parts of British Columbia and the Atlantic provinces to rising sea levels.
For the first time, United Nations members have agreed on a unified treaty to protect biodiversity in the high seas -- representing a turning point for vast stretches of the planet where conservation has previously been hampered by a confusing patchwork of laws.
Clashes erupted briefly between police and a group of demonstrators in central Athens on Sunday on the fringes of a protest by thousands of students and railway workers over Greece's deadliest train crash in living memory.
Authorities in Ohio say there is no indication of any risk to public health from the derailment of a Norfolk Southern cargo train between Dayton and Columbus, the second derailment of a company train in the state in a month.
A massive fire raced through a crammed refugee camp for Rohingya Muslims in southern Bangladesh on Sunday, leaving thousands homeless, a fire official and the United Nations said.
Israeli Prime Minister Benjamin Netanyahu on Sunday said the remarks by a key Cabinet ally calling for a Palestinian town to be erased were inappropriate, after the United States demanded that he reject the statement.
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The Broadbent Institute is keeping TikTok as a sponsor during their upcoming conference, despite rising national security concerns from the government of Canada regarding the popular app.
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In yet another example of B.C.'s health-care system being at the breaking point, Fraser Health has ordered a review after a patient was left in a hallway overnight while bleeding heavily from an untreated miscarriage.
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Some teachers and professors across Canada are inviting ChatGPT into the classroom, amid debate about ethics, plagiarism and other potential pitfalls.
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The commercial plane with two aboard that went missing in a remote area of northern Ontario on Feb. 28 has been located just south of Chaucer Lake, Ont. by the Civil Air Search and Rescue Association aircraft at approximately 11:30 a.m. Saturday. There were no survivors.
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The United Nations is bracing for a further increase in the number of refugees this year, as last month's earthquake in Turkey and Syria adds to a series of crises that has the world looking to Canada for more help.
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Ontario residents dig out after a winter storm dropped up to 30 centimetres of snow on the ground.
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A massive fire raced through a crammed refugee camp for Rohingya Muslims in southern Bangladesh on Sunday, leaving thousands homeless, a fire official and the United Nations said.
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Clashes erupted briefly between police and a group of demonstrators in central Athens on Sunday on the fringes of a protest by thousands of students and railway workers over Greece's deadliest train crash in living memory.
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Authorities in Ohio say there is no indication of any risk to public health from the derailment of a Norfolk Southern cargo train between Dayton and Columbus, the second derailment of a company train in the state in a month.
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A Tennessee man on death row who was forced to act as his own lawyer is seeking a new trial, claiming multiple violations of his constitutional rights.
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Mourners filled a temple chamber for a final prayer session Sunday in northern Thailand for one of the 12 boys rescued from a flooded cave in 2018 who died at school in England last month.
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Larry Hogan, the former U.S. Republican governor of Maryland who positioned himself as one of his party's fiercest critics of Donald Trump, said Sunday he will not challenge the ex-president for the GOP's White House nomination in 2024.
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Former U.S. secretary of defence Leon Panetta says he believes there is still opportunity to mend the West's relationship with China, as relations with the superpower become increasingly adversarial.
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Morris Rosenberg — a former public servant who authored the report released this week on attempts to interfere in the 2021 federal election — says the option of a public inquiry should be 'on the table.'
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Indigenous RCMP commissioner an 'excellent idea,' but independent selection process underway: Trudeau
Responding to growing calls for the next RCMP commissioner to be an Indigenous person, Prime Minister Justin Trudeau has called it "an excellent Idea," but stopped short of committing to an appointment.
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In updated treatment guidelines issued last year, the World Professional Association for Transgender Health said evidence of later transition regret is scant, but that patients should be told about the possibility during psychological counseling.
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A new study from U.S. researchers has revealed a way to leverage artificial intelligence to detect Alzheimer's more easily.
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New survey results show that, despite the ending of most pandemic restrictions there have been small improvements to mental health but many Canadians remain very anxious and depressed.
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Five digital activists have created a website to help provide shelter to survivors of the earthquake in Syria and Turkiye that left millions homeless amid freezing winter temperatures.
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The Canadian lunar rover could soon help reveal the moon's far side. The country's first moon rover is set to put the Canadian Space Agency at the forefront of space exploration, helping in the global search for frozen water on the celestial body.
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Some teachers and professors across Canada are inviting ChatGPT into the classroom, amid debate about ethics, plagiarism and other potential pitfalls.
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A year after Will Smith smacked him on the Academy Awards stage, Chris Rock finally gave his rebuttal in a forceful stand-up special, streamed live on Netflix, in which the comedian bragged that he 'took that hit like Pacquiao.'
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'Creed III' punched above its weight at the domestic box office in its first weekend in theatres. The MGM release knocked 'Ant-Man and the Wasp: Quantumania' out of first place and far surpassed both industry expectations and the opening weekends of the first two movies in the franchise.
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A series of poems written in a concentration camp about romantic love, betrayal and hopeful dreams of faraway places is being brought to life in album form, sung in Czech by the author's granddaughter.
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Why are Canadian banks quick to charge more for borrowing, but slow to increase savings account rates?
While Canada's largest banks are charging more to lend money due to high interest rates, experts say they are failing to increase savings account rates in a similar way. Aimed at taming inflation, the Bank of Canada began implementing a series of interest rate hikes in March 2022.
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With tax season underway, a survey conducted by H&R Block Canada reveals that 44 per cent of Canadian gig workers are willing to risk the consequences of not claiming all their income.
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The Biden administration is close to tightening rules on some overseas investments by U.S. companies in an effort to limit China's ability to acquire technologies that could improve its military prowess, according to a U.S. official familiar with the deliberations.
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If young people are spending so much time on social media, it stands to reason that's a good place to reach them with news. Operators of the News Movement are betting their business on that hunch.
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Mamathi Vinoth would spend hours practising hula hooping after school every day to perfect her technique.
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A caregiver from Ontario said her 'body went numb' after checking her Lotto Max ticket, and discovering she won $60 million.
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Jin Young Ko won for the first time in a year at the HSBC Women's World Championship and hopes this signals a new start from a year of battling injuries that cost her the No. 1 ranking.
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Mikaela Shiffrin 's quest to tie Swedish great Ingemar Stenmark's record of 86 career World Cup victories now moves to his home country.
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The Canadian women's soccer team says despite the recently announced interim funding agreement with Canada Soccer, there is still 'a lot of work to be done' to achieve labour peace.
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Ford will increase production of six models this year, half of them electric, as the company and the auto industry start to rebound from sluggish U.S. sales in 2022.
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The adoption by European Union member countries of new carbon dioxide emission standards for cars and vans has been postponed amid opposition from Germany and conservative lawmakers, the presidency of the EU ministers' council said Friday.
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George Russell downplays the fact he beat Formula One great Lewis Hamilton in their first season at Mercedes and fully expects him to come charging back. | Epidemics & Outbreaks |
A new study found that states that decriminalized drugs did not see an increase in fatal overdoses, countering a narrative that’s taking hold as part of a wider backlash against progressive drug policies.
The study, conducted by researchers at the New York University Grossman School of Medicine and published in JAMA Psychiatry, looked at a year’s worth of overdose data in Oregon and Washington, which both decriminalized possession of drugs in 2021. It found no evidence linking an increase in overdose deaths to those decriminalization policies.
However, overdoses in those states didn’t decrease either; some harm reduction experts say that’s because drug decriminalization is just part of a larger strategy to curb deaths that also requires a safe and regulated supply of drugs.
The study, which was funded by the Centers for Disease Control and Prevention, comes as popularity for Oregon’s drug decriminalization policy is waning. Washington has already walked back its decriminalization measures and British Columbia, Canada, which also decriminalized drugs, is placing new restrictions on where people can use.
Oregon enacted Measure 110 in February 2021, meaning people found with small amounts of drugs will no longer face criminal penalties, but will pay a $100 or or complete a health screening. A February 2021 Washington Supreme Court decision, meanwhile, declared it unconstitutional to make drug possession a felony with the state later downgrading those offenses to misdemeanors.
While overdoses didn’t go up in those states because of decriminalization, they still went up. Oregon’s went from 18.7 per 100,000 people to 26.8 per 100,000 people while Washington went from 22 per 100,000 people to 28.1 per 100,000 people in 2020 and 2021, respectively. But the study compared the states’ increases with a control group made up of data from similar states that didn’t decriminalize drugs and found that the differences weren’t statistically significant.
Corey Davis, an assistant clinical professor at NYU Grossman School of Medicine and senior study author, said the increases in Oregon and Washington could potentially be explained by a few factors, including that both states had lower overdose rates to begin with, and that many drug users there consume stimulants as opposed to opioids.
“You can definitely overdose and die on cocaine or methamphetamine, but it's not as prevalent as overdosing and dying on opioids,” he said. But fentanyl, which initially was more prominent in the east, has now infiltrated the drug supply all over the country. “Fentanyl is just so cheap and available that people are starting to use fentanyl who didn't before.”
While the data challenges the notion that decriminalization is worsening the overdose crisis—and another study by Davis and his colleagues found it hasn’t worsened violent crime—the policy still isn’t popular.
In May, Washington passed a law walking back its reforms. A poll published in August about attitudes towards Measure 110 found that 56 percent of respondents supported completely repealing it, while 64 percent felt parts should be repealed.
Davis said he thought the study might show overdose rates decreasing because going to jail can increase the risk of an overdose. That’s because people’s tolerances for drugs are lower when they get out of jail.
However, he noted that a key part of Oregon’s plan—using cannabis tax money for addiction treatment and harm reduction—hadn’t been implemented when the study was taking place. That funding is still rolling out.
Davis said the contaminated drug supply is the main problem but discussion of having a safe supply of drugs in the U.S. is a “political non-starter.”
“If you can take those people who are getting something that is very dangerous and that oftentimes they don't want and replace it with some sort of regulated opioid, I mean, I don't know any serious people who would say that that probably wouldn't reduce overdose deaths,” he said.
Other state-level measures, such as increased access to naloxone or methadone for people with opioid-use disorder will have an impact, he added, but not enough to reverse the staggering number of deaths caused by fentanyl. | Health Policy |
Here is a simple moral proposition. No one in America, or anywhere in the world, should die or suffer unnecessarily because they cannot afford a prescription drug which, in many cases, costs a few cents or a few dollars to manufacture.
As Chairman of the US Senate Health, Education, Labor and Pensions Committee (Help) I’m going to do everything I can to develop a new approach to the development and manufacturing of prescription drugs that responds to medical need, rather than short-term shareholder profit. Given the power and greed of the pharmaceutical industry this is not an easy task, but it’s one that must be pursued.
The tragic reality is that, today, millions of people around the world are suffering, and dying, from preventable diseases because they can’t afford the outrageous prices charged by pharmaceutical companies. According to the World Health Organization (WHO), one third of humanity lacks access to essential medicines. For a staggering number of people around the world, this leads to what the WHO calls “a cascade of preventable misery and suffering.”
There are a number of reasons why this tragic reality continues to happen.
First, too often drug companies abuse patent monopolies to charge outrageous prices or otherwise keep lifesaving drugs out of reach for people around the world. For example, the Boston-based drug company Vertex is neither selling a transformative new treatment for cystic fibrosis in the developing world, nor allowing other local companies to produce it. Put simply, the company is not only refusing to bring a life-raft to people drowning with cystic fibrosis in poor countries, it is also blocking others from deploying their own life-rafts to people who need them to stay alive.
Second, far too often, the medicines that are desperately needed by millions of people in poor countries are not being produced by the pharmaceutical industry because the drug companies cannot make sufficient profits by doing so. In the US and other developed countries people often pay exorbitant prices for life-saving medicines. Poor people in developing countries can’t. They don’t have the money. The result: they die. Because the business model of the pharmaceutical industry values dollars gained over lives saved, there are not enough companies looking for transformative treatments, especially for diseases that afflict poor people.
Consider the case of tuberculosis (TB) – a disease that killed more than 1.3 million people in 2022, and is on the rise as a result of the Covid-19 pandemic. The TB vaccine still used today is more than a hundred years old, and only protects young children, even though adolescents and adults account for the majority of TB transmission. The testing of a promising new publicly-funded TB vaccine that could potentially save millions of lives was delayed after its corporate owner, GSK, decided to focus on more profitable vaccines.
The scientist who brought GSK the idea of the TB vaccine decades ago now acknowledges that Big Pharma cannot deliver for developing countries. “You get a big company to take it forward? Bullshit,” he told ProPublica. “That model is gone. It’s failed. It’s dead. We have to create a new one.”
Clearly, we must do better. The life of a millionaire in New York City is not worth more than the life of a person living in extreme poverty in South Sudan.
Fundamentally, we need to transform how we pay for the development of new prescription drugs. This starts with funding open-source research, so lifesaving information is shared, and scientists around the world can work together to research and manufacture their own breakthroughs. Patents should not stand in the way of public health.
If we can provide $886bn to the Pentagon for military spending, we can provide scientists with the money they need to develop cutting-edge cures that are accessible to everyone.
People should not die because of their income or where they were born. We know what it will take to save lives. Now we must have the courage to stand up to the pharmaceutical industry. Let’s do it.
Bernie Sanders is a US Senator, and chairman of the health education labor and pensions committee. He represents the state of Vermont, and is the longest-serving independent in the history of Congress | Drug Discoveries |
I’m not a fan of overeating. In fact, I think consistent overeating is one of the unhealthiest things a person can do because it places you in a state of constant energy excess. Excess means you can’t handle the food you’re taking in. It means your cells are literally full, your organs are overworked, and hormones aren’t functioning the way they’re supposed to function. Overeating is actually inflammatory, so if you’re doing it every single day you are chronically inflamed. And that’s not even mentioning the impact it has on obesity.
But we are humans—we feast. Whether it’s for a holiday like Thanksgiving or a birthday celebration or just because we feel like it, sometimes we like to eat a big meal. Sometimes we like to overeat.
How do we make it safer? How do we mitigate the negative effects of overeating and possibly even turn it into a positive input?
Let’s find out:
A hard workout
A hard workout prior to a large meal will improve nutrient partitioning by several mechanisms. First, by clearing out the glycogen in your muscle cells, you will increase insulin sensitivity and open up safe storage space for all the carbohydrates you’re about to eat. Hard exercise prior to eating increases something called insulin-independent glucose uptake, which means you don’t even need to increase insulin levels to store the glucose as glycogen. You can store the glucose while still preserving lipolysis, or the release of body fat for burning.
Hard exercise also upregulates muscle protein synthesis so that any protein you eat is preferentially directed to muscular hypertrophy and recovery. In short, a big workout before you eat allows you to consume more food without incurring the same metabolic consequences you would otherwise.
The most effective workout for these purposes will be a full body one that incorporates strength training and cardio or metabolic conditioning. Think a CrossFit workout, a combo of sprints and lifting, or circuit training.
Take berberine
Try berberine 30 minutes before the meal. Berberine is a powerful anti-hyperglycemic supplement that improves lipid numbers, metabolic function, and, when taken before a meal on an empty stomach, postprandial blood sugar. You will improve blood glucose levels if you take berberine before eating. Another helpful effect of berberine is mitochondrial uncoupling, which means it increases energy expenditure and “makes room” for all the incoming energy during a big meal by increasing metabolic rate.1
Eat vinegar
Eating vinegar 20 to 30 minutes prior to a large meal containing carbohydrates improves glucose tolerance and reduces the usual glucose response.2 This is actually part of the reason why vinegary salads are traditionally consumed before meals. It’s not just because they taste good—although that’s part of it—but because it preps your body for better glucose utilization.
Fast before
Eat lightly or not at all throughout the day leading up to your big meal—the best meals I’ve ever had have come at the tail end of a fast. It doesn’t have to be a full-day fast. It could just mean skipping breakfast and having a light lunch. And I wouldn’t recommend eating just one meal a day in perpetuity, as I think that can have negative long-term consequences for energy levels and metabolic flexibility. But if you’re about to eat a big meal and it’s a one-off, not eating in the hours leading up to it will help mitigate most of the negative effects of overconsumption while maximizing your enjoyment.
Prioritize protein
If you know you’re going to overeat, make sure to load up on protein. It’s Thanksgiving? Get plenty of turkey. Christmas dinner? Have your fill of lamb leg. Eat protein first, let fat come along for the ride, and then finish with carbs. Protein is the most satiating macronutrient, so starting with it means you’re less likely to overdo it on the rest of the food. Feasting is wonderful, but no one enjoys the feeling of overindulgence.
One study even found that overfeeding with low protein intake increased fat mass but not lean muscle, while overfeeding with a high protein intake increased the same amount of fat mass with extra lean muscle mass.3 No one wants to gain fat, but I’d argue that gaining muscle alongside the fat is better than gaining just body fat.
Eat gelatinous foods or collagen during the meal
Both collagen and gelatin are rich in glycine, an amino acid that’s been shown to reduce blood glucose levels.4 If you’re going to be eating a ton of carbs, far more than you usually do, including some gelatinous foods—like gravy, bone broth, skin, and connective tissue—or even just a few scoops of collagen will improve your glucose response to the meal. It will also offset the methionine load you’re getting from muscle meat.
Drink red wine with your meal
Red wine during a large meal has several health benefits, in addition to tasting great and improving the subjective enjoyment of your food.
It reduces the oxidation of your blood lipids and inflammatory gene expression that normally occurs after a big junk food meal.5,
It can reduce the rise in blood pressure that often occurs in overfeeding.6
It can reduce post-feast markers of oxidative stress.7
Early dinner
If you’re going to be eating a large amount of food, start the meal earlier than normal. Don’t have a giant dinner at 10 PM, then expect to fall right to sleep and get a great 8 hours. You need at least 3-4 hours after the meal to take your walks, digest your food, and get everything processed internally before trying to sleep. Everything digests better when you give yourself a few hours.
Drink coffee after
A cup of coffee or an espresso after the meal is a traditional way to boost digestion and settle your gut. Concerning coffee as a post-meal digestif—no, I wouldn’t tell someone with caffeine sensitivity to have an espresso after their meal, especially at night. If you know that coffee keeps you up, then don’t drink it then, or go with decaf (which works almost as well). But if you can enjoy a bit of coffee without it affecting your sleep, then after a big meal is the perfect time for it. The bitterness helps with digesting the food you’ve just consumed.
Go for a walk after
A 20 to 30-minute walk, or even just 10 minutes if that’s all you can spare, right after a meal aids digestion and reduces the spike in both blood glucose and blood fatty acids that normally occur after eating a giant meal.8 Personally, if I eat a big meal and sit around, I don’t feel great. I feel better if I go for a walk afterwards. That’s part of the appeal of the walkability of a place like Miami. When Carrie and I go out for dinner, we walk there and back, and that post-dinner stroll to our house is just right for triggering the beneficial effects on blood glucose levels, free fatty acids, and digestion.
There you have it: the ten things you can do before, during, and after a big meal to reduce the negative effects of overeating. Don’t make big meals a habit, but if you’re doing it for a special occasion, this is how to make it work for you rather than against you.
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 |
Researchers at the University of California San Diego have figured out a way to turn everyday earbuds into high-tech gadgets that can record electrical activity inside the brain. The 3D screen-printed, flexible sensors are not only able to detect electrophysiological activity coming from the brain but they can also harvest sweat. Yes, sweat.
More specifically, sweat lactate, which is an organic acid that the body produces during exercise and normal metabolic activity. Because the ear contains sweat glands and is anatomically adjacent to the brain, earbuds are an ideal tool to gather this kind of data.
You may be wondering why scientists are interested in collecting biometric info about brain activity at the intersection of human sweat. Together, EEG and sweat lactate data can be used to diagnose different types of seizures. There are more than 30 different types of recorded seizures, which are categorized differently according to the areas of the brain that are impacted during an event.
But even beyond diagnostics, these variables can be helpful if you want to get a better picture of personal performance during exercise. Additionally, these biometric data points can be used to monitor stress and focus levels.
And while in-ear sensing of biometric data is not a new innovation, the sensor technology is unique in that it can measure both brain activity and lactate. However, what’s more important is that the researchers believe, with more refinement and development, we will eventually see more wearables that use neuroimaging sensors like the one being made to collect health data on everyday devices. In a statement, UC San Diego bioengineering professor Gert Cauwenberghs said that, “Being able to measure the dynamics of both brain cognitive activity and body metabolic state in one in-ear integrated device,” can open up tremendous opportunities for everyday health monitoring.
Throughout the development of the sensor technology, the researchers had to grapple with some obstacles. They needed to make the sensors as small and thin as possible so that they could collect tiny sweat samples. They also had to integrate “components that can bend” to account for the irregular shape of the ear according to Ernesto De La Paz, a Ph.D. alumnus who co-authored the research.
One primary technical challenge was being able to fit the sensors in the ear, specifically in the tragus of the ear, which is an anatomically unique space situated in front of the ear canal that can vary from one individual to another. This led the researchers to create a “stamp-like stretchable sensor,” which can be easily tacked onto an earbud’s surface.
But in order to make sure that the sensors would actually have direct contact with the ear and accurately pick up readings, researchers opted for 3D printed, spring-loaded sensors that “hold contact but can adjust as earbuds move.” The biometric sensors also had to be covered with a hydrogel film that made sure they would amply collect sweat from a wearer.
Despite their capabilities and rosy future as a potential diagnostic aid, the 3D printed sensors really need a considerable amount of sweat in order to be useful for data analysis. But the researchers said down the line the sensors will be more precise, so hard workouts may not be necessary for meaningful sweat analysis. | Medical Innovations |
Khloe Kardashian has been keeping up with her comment section on social media.
In a gym selfie posted to Instagram Feb. 26, the Kardashians star—who underwent surgery to remove a tumor from her face last fall—was seen with a bandage on the right side of her jawline. After a user commented underneath her pic, "And what the heck is on your cheek," Khloe entered the chat to respond.
"A bandage," she wrote, adding, "I had a tumor removed from my face but I'm totally ok. Thank you for asking."
After reading another comment about the bandage, Khloe offered more details on her health journey. "I had a tumor removed from my face a few months ago so I wear this for healing and the prevention of my scar getting worse," she explained, per People. "All is great and healing wonderfully."
In October, the 38-year-old noted that she saw the "numerous stories" going around about the "ever-evolving bandage" on her face, sharing that it turned out to be more serious than what she initially presumed.
"After noticing a small bump on my face and assuming it was something as minor as a zit," she wrote alongside a photo of her bump shared to Instagram Stories at the time, "I decided to get it biopsied 7 months after realizing it was not budging."
Khloe went on to explain that she also got a second biopsy since the development "was incredibly rare for someone my age."
"A few days later I was told I need to have an immediate operation to remove a tumor from my face," she continued. "I called none other than Dr. Garth Fischer, a dear friend of my families and one of the best surgeons in Beverly Hills who I knew would take incredible care of my face."
As Khloe noted, she was already back on the mend and may be seen with a band aid from time to time moving forward.
"So, here we are...you'll continue to see my bandages and when I'm allowed, you'll probably see a scar (and an indention in my cheek from the tumor being removed)," she added, "but until then I hope you enjoy how fabulous these face bandages look." | Medical Innovations |
It's the cruel disorder people associate with memory issues in elderly people - but dementia can also strike dogs.
If your pet is more than seven years old and suffered a sudden shift in behavior, it could be a sign of Canine cognitive dysfunction (CCD).
Dog whisperer Lorna Winter said: ‘Dementia in dogs is not the same as in humans and there are a variety of dietary changes, medications and behavior therapies that can help. Always seek help from a professional first.
Winter, the co-founder of dog-training app Zigzag, added: 'Being a dog parent isn't always friendly cuddles and long walks, as just like humans, dogs go through different stages of life which come with specific challenges, new behaviors and changing moods.’
These are the warning signs to look out for:
Winter said: ‘All dogs stare into space at one point or another and you’ve probably thought to yourself, “What are they looking at?”
‘Dogs have different vision to us and are highly receptive to scent - so when they stare into nothing, it might be that they are trying to pay attention to a certain smell, which can look like they’re staring.
But with older dogs, staring into space can be a sign of CCD.
Winter said: ‘If you have an older dog, prolonged staring at nothing, or staring at the floor, could indicate CCD.
'As dogs get older, they tend to slow down, and cognitive and sensory decline can happen. They’re not trying to be naughty and ignore you - it’s just part of old age.’
Struggling with basic tasks they used to do with ease
If your senior dog is struggling with simple things that they used to be able to do, this could be a sign of dementia.
Winter said: ‘Think about a door that is slightly ajar, usually a dog might think to nudge it open with their nose or paw to get inside.
'However, a dog suffering from cognitive decline will likely end up just staring at the door because they are unable to think of the next step to get it open.
‘They might have been opening doors for years but cognitive decline means there is a lack of fuel going to your dog's brain and they might forget how to complete simple tasks like this.
‘Another classic is "forgetting" how to back out of corners.’
Suddenly disinterested in food - or forgetting to eat
When dogs experience dementia, they have feelings of anxiety and stress because they are less sure of their surroundings and the people around them, said Winter.
This can lead to a loss of interest in food, Winter said,
Winter said: ‘A dog with CCD might also forget to eat.
‘However, there are some examples of dogs with CCD eating more than usual because they have forgotten that they’ve already eaten.
'Either way, keeping a close eye on your senior dogs' eating habits is a good way to spot any signs that something might be wrong.’
In young dogs, barking at night can be a sign of anxiety, but in older animals (seven years old or more, depending on breed), being restless and barking at night can be a warning sign of dementia, Winter warned.
Winter said: ‘In a senior dog, becoming restless and barking at night could be a sign of age-related dementia.’
Going to the toilet indoors
Older dogs commonly ‘have accidents’ indoors if they are suffering from canine dementia, Winter said. | Disease Research |
Three mosquitoes collected near Sarasota, Florida, have tested positive for malaria amid an unusual cluster of locally acquired cases. It is the first time in two decades that US mosquitoes have tested positive for malaria in connection to US-based cases.Four cases have so far been confirmed in Florida, all in close geographic proximity, health officials reported on Monday. The Sarasota Herald-Tribune reported Wednesday that officials are investigating a possible fifth case.
With outbreak response efforts ongoing, officials have been trapping and testing local mosquitoes. In a statement to CBS News, Sarasota County Mosquito Management Services manager said the three positive insects were among more than a hundred sent to the Centers for Disease Control and Prevention for testing.
Meanwhile, efforts to stamp out the flare-up include door-to-door efforts to inform residents of the cases, as well as insecticide spraying from trucks and aircraft.
The mosquitoes that transmit the malaria parasite are of the Anopheles genus. There are multiple species of Anopheles mosquitoes in the US, which have been found in at least 32 states.
Low risk
In this case, the Anopheles species caught spreading the parasite is a type of nighttime biter—not typically active during the day or evenings, like some other Anopheles species. The species also tends to concentrate and breed around freshwater swamps. That's all according to Christopher Lesser, the director of Manatee County Mosquito Control District, who spoke with the Herald-Tribune. (Manatee County, just north of Sarasota, is also responding to the cases).
The cluster of locally acquired malaria cases around Sarasota—as well as an unrelated case in Texas—marks the first time the parasite is known to have spread in the US since 2003, when there was a cluster of cases in Palm Beach, Florida. In that outbreak, no captured mosquitoes were found to be positive for malaria.
However, an investigation around a cluster of locally acquired cases in Loudon County, Virginia, in 2002 turned up malaria-positive mosquitoes. It was the first time since 1957 that US mosquitoes linked to locally acquired cases had tested positive for a malaria parasite.
In a national health alert Monday, the CDC urged clinicians to look for malaria cases in people without travel-related risks, particularly in areas near the Florida and Texas cases. The clusters highlight the potential for reintroduction and reemergence in the US, given global travel and climate change. But, the CDC notes that, in general, the "risk of locally acquired malaria remains extremely low in the United States." | Epidemics & Outbreaks |
Matt Hancock was censored by the Cabinet Office over his concerns that the Covid-19 pandemic began with a lab leak in Wuhan, the Lockdown Files reveals.
The former health secretary was told to tone down claims in his book because the Government feared it would "cause problems" with China.
Mr Hancock wanted to say that the Chinese explanation - that the virus being discovered close to a government science lab in Wuhan was coincidental - "just doesn't fly".
But, in correspondence from late last year and leaked to the Telegraph, the Cabinet Office told him that the Government's position was that the original outbreak's location was "entirely coincidental" .
It is the first time that the British position has been categorically stated. Mr Hancock was warned that to differ from this narrative, which resembles China's version of events, risked "damaging national security".
In his book, Pandemic Diaries, Mr Hancock also wanted to write that "Global fear of the Chinese must not get in the way of a full investigation into what happened” but this too was watered down.
The disclosure comes just days before Rishi Sunak prepares to set out a new defence and security strategy that is expected to take a less aggressive tone to China than that proposed by his predecessor, Liz Truss.
The changes to the book were made by the Cabinet Office when Mr Hancock submitted his manuscript for review - a process all former ministers are expected to follow - last year. Once alterations were made, the book was signed off for publication by Simon Case, the Cabinet Secretary, on November 4 2022.
The assertion that the nature of the outbreak was "entirely coincidental" marks the first time that the British government has directly commented on the lab leak claims.
It is in contrast to the USA where the FBI and the Department for Energy have recently said that they believe that a lab leak theory is plausible.
In the draft of his Pandemic Diaries memoir, written with Isabel Oakeshott, Mr Hancock wrote “given how cagey the Chinese have been, I think we have to treat their official version of events – still the Wuhan thing – with considerable scepticism.
“Imagine there was an outbreak of a deadly new virus in Wiltshire and we shrugged off the fact that the outbreak ‘just so happened’ to be near a little place called Porton Down. We’d be laughed out of town."
However, officials at the Cabinet Office responded saying “this is highly sensitive and would cause problems if released”.
In a separate section he planned to write: "To me it seems pretty credible. It’s just too much of a coincidence that the pandemic started in the same city as the lab, which – by the way, is a full 40 minutes drive from the wet market originally linked to the outbreak. The only plausible alternative is that the virus was brought to Wuhan to be studied, and then escaped. The Chinese denials are a bit like us claiming that a random virus just happened to break out near a little place called Porton Down, perhaps because of some badgers. It just doesn’t fly."
The section was almost entirely removed at the behest of the Cabinet Office.
To explain proposed alterations, civil servants wrote that the reference to “Porton Down is damaging to national security”, referring to the laboratory linked to the Ministry of Defence.
They explained: “What is set up as a joke, is one of the attack lines Russia has used against us for the Novichok poisoning, as it is only a few miles from Porton Down to Salisbury (which is entirely coincidental – as, we believe, it is that the Wuhan lab is so close to where the first covid outbreak was recorded)”.
The comments appear in the final version of the book significantly watered down with references to Porton Down – the Government's scientific and military research centre – and "global fear of the Chinese" removed.
The comments about the origins of the coronavirus are among a number of instances where officials asked for criticism of China to be removed.
It is significant because they offer a glimpse as to the thinking of the British government over the Covid-19 outbreak.
Until now, the Government has not directly commented on theories about a possible lab leak.
Last week, Christopher Wray, the FBI director, said that the bureau believed Covid-19 most likely originated in a Chinese government-controlled lab.
However, US intelligence agencies maintain there is still no consensus on the origins of the Covid-19 virus, while China has rejected any suggestion that the virus might have leaked.
Last year, the former head of MI6 said that any evidence that a lab leak in Wuhan sparked the coronavirus pandemic has probably been destroyed.
Sir Richard Dearlove, who headed up the secret intelligence service between 1999 and 2004, warned that it would be difficult to prove that the Wuhan Institute of Virology was working on "gain of function" experiments to make a natural coronavirus more deadly to humans.
At a hearing in Washington this week, witness Jamie Metzl, a senior fellow at the Atlantic Council and a former State Department official, said: “There is no smoking gun proving a lab origin hypothesis, but the growing body of circumstantial evidence suggests a gun that, at the very least, is warm to the touch."
Next Monday, the integrated defence spending review update will be published, as Mr Sunak meets Joe Biden in the US for talks around the Aukus security pact between Australia, the UK and the United States, a No 10 spokesman said on Wednesday.
Last year, it was reported that Ms Truss was expected to formally term China a “threat” in the update, raising the possibility that Mr Sunak may criticise the country.
The Pandemic Diaries was published in December last year.
In autumn 2022, a draft of the book was given to the Cabinet Office by Mr Hancock for clearance. Under the Ministerial Code, former ministers intending to publish their memoirs are required to submit the draft manuscript in good time before publication to the Cabinet Secretary”.
Under the Radcliffe report, written in the 1970s which sets out categories of information that should be restricted in diaries and memoirs, former ministers are prohibited from “reveal[ing] anything that contravenes the requirements of national security” with other categories including Britain’s “relations with other nations”.
After receiving the manuscript, officials at the Cabinet Office suggested multiple changes, which were set out in a spreadsheet, along with new proposed wording.
The sheet includes a column for “rule triggered”, “feedback” and “recommended alteration”.
Civil servants highlight criticism of China and the World Health Organisation as areas to be amended. Other comments about Prince Charles, Donald Trump, Simon Case and Emmanuel Macron were also subject to recommended changes.
Mr Hancock had also wanted to reveal apparent praise he had been given by the then Prince of Wales for his handling of the pandemic but was told that it would "contradict the principle of confidential communication between Ministers and Members of the Royal Family".
He had also intended to reveal a private message from Mr Case in which the Cabinet Secretary described the Cabinet Office as "totally dysfunctional" but was told he could not as it was "damaging".
A civil servant also proposes that a section where the former health secretary describes a conversation with Dominic Raab be removed.
At the time, Mr Raab was foreign secretary and, according to the draft, had revealed that Germany was concerned that China might be able to produce a high number of vaccines and then use them as “a diplomatic weapon”.
The section did not appear in the final version of the book.
Civil servants also said they wanted Mr Hancock to change a section which described a meeting attended by Sir Jonathan Van Tam, the deputy chief medical officer during the pandemic.
The submitted version said that “JVT has been on a diplomatic tightrope at a global health security conference hosted by Taiwan. I tried to get hold of him first thing to discuss the latest on the vaccine programme but he was about to give a speech to a gathering of Asia Pacific health officials via Webex so couldn’t talk. He told me that Taiwanese representatives were trying to get him to criticise the WHO’s links to the Chinese, a temptation he resisted, given the ranks of hatchet faced Communist Party apparatchiks eyeballing him on the screen.
“Trying not to start WWIII,” he informed me breezily. | Epidemics & Outbreaks |
What if treating obesity could be as easy as popping an effective pill?
That's a notion that has long fueled hope for many of the more than 40% of Americans who are considered obese - and fueled criticism from those who advocate for wider weight acceptance.
Soon, the pill may be a reality.
may work as well as the popular injections when it comes to paring pounds and improving health, according to final results of two studies released Sunday night. The potent tablets also appear to work for people with diabetes, who notoriously struggle to lose weight.
Drugmaker Novo Nordisk plans to ask the U.S. Food and Drug Administration to approve the pills later this year.
"If you ask people a random question, 'Would you rather take a pill or an injection?' People overwhelmingly prefer a pill," said Dr. Daniel Bessesen, chief of endocrinology at Denver Health, who treats patients with obesity but wasn't involved in the new research.
That's assuming, Bessesen said, that both ways to take the medications are equally effective, available and affordable. "Those are the most important factors for people," he said.
There have been other weight-loss pills on the market, but none that achieve the substantial reductions seen with injected drugs like Wegovy. People with obesity will be "thrilled" to have an oral option that's as effective, said Dr. Katherine Saunders, clinical professor of medicine at Weill Cornell Health and co-founder of Intellihealth, a weight-loss center.
Novo Nordisk already sells Rybelsus, which is approved to treat diabetes and is an oral version of semaglutide, the same medication used in the diabetes drug Ozempic and Wegovy. It comes in doses up to 14 milligrams.
But results of two gold-standard trials released at the American Diabetes Association's annual meeting looked at how doses of oral semaglutide as high as 25 milligrams and 50 milligrams worked to reduce weight and improve blood sugar and other health markers.
A 16-month study of about 1,600 people who were overweight or obese and already being treated for Type 2 diabetes found the high-dose daily pills lowered blood sugar significantly better than the standard dose of Rybelsus. From a baseline weight of 212 pounds, the higher doses also resulted in weight loss of between 15 and 20 pounds, compared to about 10 pounds on the lower dose.
Another 16-month study of more than 660 adults who had obesity or were overweight with at least one related disease - but not diabetes - found the 50-milligram daily pill helped people lose an average of about 15% of their body weight, or about 35 pounds, versus about 6 pounds with a dummy pill, or placebo.
That's "notably consistent" with the weight loss spurred by weekly shots of the highest dose of Wegovy, the study authors said.
But there were side effects. About 80% of participants receiving any size dose of oral semaglutide experienced things like mild to moderate intestinal problems, such as nausea, constipation and diarrhea.
In the 50-milligram obesity trial, there was evidence of higher rates of benign tumors in people who took the drug versus a placebo. In addition, about 13% of those who took the drug had "altered skin sensation" such as tingling or extra sensitivity.
Medical experts predict the pills will be popular, especially among people who want to lose weight but are fearful of needles. Plus, tablets would be more portable than injection pens and they don't have to be stored in the refrigerator.
But the pills aren't necessarily a better option for the hundreds of thousands of people already taking injectable versions such as Ozempic or Wegovy, said Dr. Fatima Cody Stanford, an obesity medicine expert at Massachusetts General Hospital.
"I don't find significant hesitancy surrounding receiving an injection," she said. "A lot of people like the ease of taking a medication once a week."
In addition, she said, some patients may actually prefer shots to the new pills, which have to be taken 30 minutes before eating or drinking in the morning.
Paul Morer, 56, who works for a New Jersey hospital system, lost 85 pounds using Wegovy and hopes to lose 30 more. He said he would probably stick with the weekly injections, even if pills were available.
"I do it on Saturday morning. It's part of my routine," he said. "I don't even feel the needle. It's a non-issue."
Some critics also worry that a pill will also put pressure on people who are obese to use it, fueling social stigma against people who can't - or don't want to - lose weight, said Tigress Osborn, chair of the National Association to Advance Fat Acceptance.
"There is no escape from the narrative that your body is wrong and it should change," Osborn said.
Still, Novo Nordisk is banking on the popularity of a higher-dose pill to treat both diabetes and obesity. Sales of Rybelsus reached about $1.63 billion last year, more than double the 2021 figure.
Other companies are working on oral versions of drugs that work as well as Eli Lilly and Co.'s Mounjaro - an injectable diabetes drug expected to be approved for weight-loss soon. Lilly researchers reported promising mid-stage trial results for an oral pill called orforglipron to treat patients who are obese or overweight with and without diabetes.
Pfizer, too, has released mid-stage results for dangulgipron, an oral drug for diabetes taken twice daily with food.
Novo Nordisk officials said it's too early to say what the cost of the firm's high-dose oral pills would be or how the company plans to guarantee adequate manufacturing capacity to meet demand. Despite surging popularity, injectable doses of Wegovy will be in short supply until at least September, company officials said.
for more features. | Drug Discoveries |
Media releaseFrom: La Trobe University From: Flinders University
Hitting the gym or running track seems straight forward for some – but what are the barriers many women face in partaking in regular exercise, particularly after childbirth or older?
A study on survey data of more than 1200 Australian women by experts from La Trobe University, Flinders University, Victoria University and Melbourne University has identified four types of women with different levels of positive and negative body image.
These body image types have also been linked to different diet and exercise patterns – allowing future interventions, exercise programs and public health messages to be more tailored and targeted.
The Victorian researchers with Flinders University Associate Professor Ivanka Prichard, who leads a new Embrace body image research initiative with Australian of the Year Taryn Brumfitt and study co-author Dr Yali Zager, conducted the study to establish how a person’s body image can be linked to health behaviours.
Through analysing data from these women, average age of 41, using measures of body shame, body appreciation, and body mass index (BMI), the researchers identified four body image types: appreciative; medium shame; high shame and average. And that these different body image types could differentiate levels of dietary and exercise behaviour.
“These findings provide an important opportunity for public health intervention – with the four profiles being important to consider in the development of tailored health promotion or intervention programs,” says La Trobe University’s Dr Anita Raspovic, the first author in the new article in Body Image journal.
The researchers found that dietary restraint and exercise amount differed significantly according to a woman’s body image type: Women with high shame and low appreciation had the greatest eating concerns and lowest exercise. In contrast, low levels of eating concerns and healthy levels of exercise were evident among women with the Appreciative body image type.
While body appreciation is associated with more positive physical and mental health outcomes and body dissatisfaction is associated with disordered eating and exercise avoidance, “much is still unknown about the connection between these differing body image experiences," adds Dr Raspovic.
"It is critical that we develop deep understandings of the relationships between body image, behaviours, and health outcomes, to inform public health prevention and intervention efforts,” she says.
Study co-author, Flinders University's Associate Professor Prichard, says knowing about these body image types will help inform health and fitness professionals to tailor the way that they might work with different people.
“For instance, someone who is already body confident would benefit from a ‘light touch’ intervention that supports ongoing health behaviours and continues to encourage exercise for health, fitness and enjoyment.
“In contrast, those with high levels of body shame, which our research shows exercise less than other groups of women, will need more support to be active.
“These individuals would benefit from inclusive exercise spaces and communities that promote gratitude and appreciation for where someone's body is at and what it can do and a culture of non-judgement.”
She says these distinct body image types allow us to advocate for appreciating the body for what in order to promote positive health behaviours. They also tell us that body shame is not helpful in relation to health behaviour.
"This has important implications for public health messaging to encourage healthy and active lifestyles.”
Associate Professor Prichard adds: “We know that people who appreciate their bodies also engage in a greater range of health behaviours (e.g., healthier diets and physical activity), and that people who feel weight shame or stigma engage in less health behaviours and are more likely to gain weight over time.
“We also know that exercising for appearance or weight loss related reasons does not motivate exercise in the long term.
“Instead, if we want an active society, we need to help people find movement behaviours that they enjoy doing and that they are motivated to come back to again and again because it makes them feel good."
The article – Body image profiles combining body shame, body appreciation and body mass index differentiate dietary restraint and exercise amount in women (2023) by Anita Raspovic, Ivanka Prichard, Agus Salim (Melbourne University), Zali Yager (Victoria University) and Laura Hart (La Trobe and Melbourne University) – has been published in Body Image journal. DOI: 10.1016/j.bodyim.2023.05.007. | Women’s Health |
Australians heading to Sydney WorldPride who are eligible for mpox (previously monkeypox) vaccination are being encouraged to roll up their sleeves and get a jab ahead of the global LGBTIQ+ festival later this month.
Key points:
- Gay and bisexual men and other men who have sex with men are eligible for an mpox vaccine
- Australia has effectively eliminated the virus but it may be reintroduced during Sydney WorldPride, with thousands of international visitors expected
- Vaccination involves two doses given 28 days apart, but even one dose will offer "pretty decent protection"
More than 500,000 people, including thousands of international visitors, are expected to celebrate the 17-day event in Sydney, which includes the annual Sydney Gay and Lesbian Mardi Gras.
Globally, mpox cases have declined steeply since they peaked in August 2022, including in Australia, where no new cases have been recorded this year.
But ongoing, low-level transmission in other non-endemic countries has prompted health authorities to recommend festival attendees at risk of infection protect themselves by getting vaccinated.
"Over the last couple of months, we've seen an average of 50 cases a day globally, mainly in the US and South America," said Vincent Cornelisse, a sexual health physician and senior lecturer at the Kirby Institute.
"It's quite likely we'll see visitors from both of these places come to WorldPride, and there's a real possibility a few of these people might have undiagnosed mpox infections."
Mpox can affect anyone, but more than 95 per cent of cases in the recent global outbreak have been among gay and bisexual men, and other men who have sex with men.
Dr Cornelisse said it was unlikely Australia would see a large outbreak of mpox, but that it made sense for people to take precautions because of "how uncomfortable" an infection could be, as well as the potential for more serious complications.
In January, writing in an opinion piece in the Star Observer, federal Health Minister Mark Butler also urged eligible Australians — especially those from rural and regional areas — to make a vaccine appointment as soon as possible.
"We know uptake in country areas for the vaccines lags behind our big cities — and that many people living in rural and regional areas will travel to Sydney to celebrate WorldPride," Mr Butler wrote.
"So, I particularly encourage anyone in a country area who will be attending WorldPride and is not yet vaccinated to act now."
Mpox sexually transmitted in recent outbreak
Symptoms of mpox include a distinctive rash or skin lesions (bumps that turn into pimples, blisters or sores, and that may burst to form ulcers or scabs) as well as fever, headache, fatigue and swollen lymph nodes.
The virus spreads through close physical contact, including direct contact with body fluids or skin lesions.
In the past, mpox hasn't been considered a sexually transmitted infection (STI), but recent epidemiological data suggests sexual encounters are largely driving transmission.
"During this outbreak, mpox is sexually transmitted, particularly through close skin-to-skin contact," said Dr Cornelisse.
"There's possibly also a role for transmission through semen."
Transmission can also occur through contaminated clothing or bedding, and less commonly, through respiratory droplets during prolonged face-to-face contact.
While mpox illness is usually mild and most people recover within a few weeks, the virus can cause severe disease, particularly among people who are immunocompromised.
In Australia, vaccination is recommended for sexually active gay and bisexual men and other men who have sex with men, as well as sexual partners of these men, and sex workers.
There are two vaccines available that are effective against mpox. The preferred vaccine is given as two doses, 28 days apart, and is most effective two weeks after the second dose.
But with Sydney WorldPride just days away, Dr Cornelisse said even one dose will offer "a pretty decent amount of protection".
"There's also probably a lot of people who may have had their first dose several months ago who can still go and get their second dose. It doesn't matter if you're late."
While the best time for people to receive a vaccine is before they are exposed, vaccines can also be given after mpox exposure (ideally within four days) to reduce the risk of disease.
Vaccine willingness high but mpox concern has waned
So far, more than 50,000 mpox vaccine doses have been administered in Australia.
Social and behavioural scientist James MacGibbon, who recently undertook research with Dr Cornelisse to better understand Australians' attitudes and behaviours regarding mpox, said there was generally a good level of awareness among people at increased risk and that most appeared willing to get vaccinated.
"Among gay, bisexual and other men who have sex with men, there is a very high willingness to receive a vaccine," said Dr MacGibbon from UNSW's Centre for Social Research in Health.
However, the research also found people less concerned about mpox were less likely willing to receive a vaccine, he said.
"I think that's important to have in mind now because case numbers globally are a lot lower than they were last year, so some people may not perceive themselves to be at any risk, but [lower case numbers] doesn't mean there are low levels of mpox circulating."
At sexual health clinics in Sydney, concern about mpox has wavered in recent months, Dr Cornelisse said.
"It's entirely understandable given that we haven't seen any new cases in Australia since November, but as I always remind people … it hasn't gone away globally."
Prioritising safe sex at WorldPride
In addition to taking precautions around mpox, Sydney WorldPride attendees are also being encouraged to prioritise safe sex more generally, with STIs on the rise in NSW, including antimicrobial-resistant gonorrhoea and syphilis.
"Sexual health services in Sydney are fully prepared for an increased demand for services during WorldPride, and we're expecting that we'll probably see more gonorrhoea and more syphilis during that time," Dr Cornelisse said.
For that reason, it's important that people who take HIV prevention medication — commonly known as PrEP — ensure they have adequate supplies ahead of the festival, he said.
Dr Cornelisse added that COVID-19 had changed the way many people have sex — "in terms of the number of sexual partners they might have for fear of COVID exposure" — which had, in turn, changed the way people look after their sexual health.
"We know many people who were using PrEP prior to COVID stopped using it during COVID, and the worry is that some of those people may not have returned to using PrEP, and are now entering a few months of fun and frivolity where they may be exposed to HIV," he said.
"I would strongly encourage anyone who thinks they might have casual sexual contact during WorldPride to think about going either back onto PrEP or to start PrEP to ensure their HIV risk is managed appropriately."
Matthew Vaughan, director of HIV and sexual health at peak LGBTIQ+ body ACON, said it was also a good idea for people to get a sexual health check — usually provided for free at sexual health clinics — ahead of World Pride.
"That means if you've picked up any STIs unknowingly, you can get that detected and treated," he said.
He also urged festival attendees to be up to date with their COVID-19 vaccines, and to keep an eye on themselves — including monitoring for any symptoms of mpox or COVID — and the people around them.
"One of the great things about our community is the way we come together through moments like this — that great Australian sense of mateship, of looking out for one another.
"If you see someone that's not having a good time, make sure you take care of them and get help if needed." | Vaccine Development |
A few years ago, I found my boyfriend overdosed on the kitchen floor. I had handled the syringe he used because I found it in his stuff and then put it somewhere “safe” (I was sober a year myself but not thinking straight). The EMTs I called reached him before he could die. But what if they hadn’t? Would Greg Abbott say I was guilty of murder?
He just might. The Texas governor has pledged to sign a recently passed bill that would reclassify overdoses as “poisonings,” clearing the way for murder charges against anyone who provides a lethal dose—whether that provider was a friend, dealer, or person who happened to be in the same room. Still seeking top place in the cruelty contest, Florida passed a law allowing prosecutors to seek the death penalty for drug-induced homicide, or DIH, cases, again regardless of the supplier’s role. The Florida law also opens a new front in the criminalization of being around drugs: A nonfatal overdose could catch the supplier a second-degree felony.
The idea is not new. DIH (sometimes “drug delivery resulting in death”) has been available as a criminal charge since the first drug war. And that’s how we know how well it works. Historically, we know the approach is futile, and there’s even more overwhelming evidence of the active harm it can do (some studies have found it leads to more overdoses). Still, DIH laws are a fantastic way for politicians to pretend they’re doing something about the opioid epidemic, and so they have come into vogue again.
The idea is a retread at the federal level as well. There have been ways to indict people on DIH charges since the idea first came around almost 50 years ago. But that hasn’t stopped lawmakers—particularly Republican ones—from seizing the opportunity to make the most of doing the least that they can. In February, Marco Rubio, Josh Hawley, Ted Cruz (I don’t know why I even bother listing them; you know who they are), reintroduced legislation to treat distributing fentanyl that results in an overdose as a first-degree felony murder. As Rubio put it: “If the illicit sale of this drug results in death, then the seller should be charged with felony murder. That is a simple, commonsense step we can take right now to help turn the tide and protect our communities.”
I’ll grant him “simple” there, sure.
In practice, such laws look like this: Three Memphis teens overdosed in the parking lot of a high school, hours before graduation. One 17-year-old survived. She’s been charged with second-degree murder. In Texas, at least two counties appear to have taken Abbott’s endorsement of the coming state law as license to go ahead and use traditional murder statutes against teenagers for selling drugs to other teens. In California, the San Luis Obispo District Attorney’s website brags about their second arrest of this kind (though they seem to have stuck with charging adults) in the same press release that notes that street drugs these days frequently masquerade as pharmaceuticals and “there is no way to know who made them, where they came from, or what is in them.”
Those are all stories from last month.
Prosecutions of this kind appear to increase with the attention paid to, if not the actual scope of, the problem. We don’t really know, because no one keeps a true count. One organization did a tally of news stories about them, showing a steep increase, from 200 in 2007 to 700 in 2019, then an equally sharp decline over the last couple of years with just a couple of dozen reported in 2022. This might be a function of an actual decrease in use of the laws, or it’s a sign that the sort of people being charged literally don’t count.
Because obviously—we used to be on the same page here!—arresting your way out of a drug problem has never worked. Lord knows, if it worked, given the number of Americans arrested in this war, we would know that by now. But it doesn’t. You just wind up with more poor people, nonwhite people, and addicts in prison, which … ah, I see. That might be the point.
However, I’ve been in recovery long enough myself to know many people who sincerely believe, or want to believe, that drug-induced homicide laws might help. Sometimes they are blinded by structural racism or their own ideology to other solutions. But I’ve felt the helplessness and rage of losing someone to addiction. Having someone to blame for that pain is a temptation few can resist.
You hear this despair in the voices of some lawmakers. As tempting as it is to see pure cynicism in their motives, about a quarter of all Americans know a victim of the overdose epidemic, and statehouses are not immune. The Republican sponsor of a Utah DIH bill admitted, “This is maybe a little out of desperation.” In Colorado, the GOP sponsor acknowledged that the bill wasn’t even about making good policy. “This bill is all about trying anything,” he said, “I don’t know how we couldn’t do whatever we could, whether it works or not.”
Also in Colorado, Democratic state representative Marc Snyder echoed these thoughts on an even more personal level: “I have a family member in the throes of a fentanyl addiction. I’m somewhat of a desperate parent who is looking for any answers I can find. I’m willing to try anything.”
It’s easy to forget that parents of addicts and alcoholics have been saying some version of “I’ll do anything” for centuries, and yet here we are. The opioid crisis is a manifestation of one of the most formidable and oldest enemies humans have known. There are ambitious structural solutions, like blanket decriminalization (see: Portugal) and the elimination of prisons as Americans know them (see: Sweden). But there’s very little for lawmakers (or parents) to do on their own.
I don’t say this to discourage us from trying to combat the drug epidemic, just to distinguish this fight from the ones where people have a clearer path to some kind of progress. If politicians want to look like they’re doing something to address a family tragedy, there are other, equally urgent voices to listen to. This past legislative session, Texas parents cried out, “Address the gun problem! Protect our children!” and the state politicians got it backward, making guns more available and trying to legislate trans kids out of existence. (Some further evidence that Republicans prioritize punishment over aid: In Texas, a bill that would decriminalize fentanyl test strips—a huge step in preventing accidental overdoses—did not make it out of committee.)
For conservatives, there is a common thread through all these issues: They want to punish a specific kind of person (whether that’s drug users, trans people, or “bad guys with guns”) rather than be an ally to those harmed. They want to wage a war with an enemy they call evil, rather than do any good at all. | Epidemics & Outbreaks |
University of Colorado Anschutz Medical Campus researchers are part of an international team that has shown that the injection of a type of stem cell into the brains of patients living with progressive multiple sclerosis (MS) is safe, well tolerated and has a long-lasting effect that appears to protect the brain from further damage.
The study was published in Cell Stem Cell.
The collaborative study by researchers at CU Anschutz, the University of Cambridge and the University of Milano-Bicocca is a step toward developing an advanced cell therapy treatment for progressive MS, for which no treatments currently exist.
Over 2 million people live with MS, and while treatments exist that can reduce the severity and frequency of relapses, two-thirds of MS patients still transition into a debilitating secondary progressive phase of disease within 25-30 years of diagnosis, where disability grows steadily worse.
In MS, the body’s own immune system attacks and damages myelin, the protective sheath around nerve fibres, causing disruption to messages sent around the brain and spinal cord.
Programming ‘master cells’
Key immune cells involved in this process are macrophages (literally “big eaters”), which ordinarily attack and rid the body of unwanted intruders. A particular type of macrophage known as a microglial cell is found throughout the brain and spinal cord. In progressive forms of MS, they attack the central nervous system (CNS), causing chronic inflammation and damage to nerve cells.
Recent advances have raised expectations that stem cell therapies might help ameliorate this damage. These involve the transplantation of stem cells, the body’s “master cells”, which can be programmed to develop into almost any type of cell within the body.
Previous work from the Cambridge team has shown in mice that skin cells reprogrammed into brain stem cells, transplanted into the central nervous system, can help reduce inflammation and may be able to help repair damage caused by MS.
Together, the international team has completed a first-in-man, early-stage clinical trial that involved injecting neural stem cells directly into the brains of 15 patients with secondary MS recruited from two hospitals in Italy.
The stem cells were derived from cells taken from brain tissue from a single, miscarried foetal donor. From this single donor, the team says it would be possible to produce a virtually limitless supply of these stem cells – and in future it may be possible to derive these cells directly from the patient – helping overcome potential ethical and practical problems associated with the use of foetal tissue.
Substantial stability of the disease
The team followed the patients over 12 months, during which time they observed no treatment-related deaths or serious adverse events. While some side-effects were observed, all were either temporary or reversible.
All the patients showed high levels disability at the start of the trial – most required a wheelchair, for example – but during the 12-month follow-up period none showed any increase in disability or a worsening of symptoms. None of the patients reported symptoms that suggested a relapse and nor did their cognitive function worsen significantly during the study. Overall, the researchers say, this points to a substantial stability of the disease, without signs of progression, though the high levels of disability at the start of the trial make this difficult to confirm.
The researchers assessed a subgroup of patients for changes in the volume of brain tissue associated with disease progression. They found that the larger the dose of injected stem cells, the smaller the reduction in brain volume over time. They speculate that this may be because the stem cell transplant dampened inflammation.
The team also looked for signs that the stem cells were having a neuroprotective effect –protecting nerve cells from further damage. Their previous work showed how tweaking metabolism – how the body produces energy – can in turn reprogram microglia from “bad” to “good”.
‘Safe but also promising’
D’Alessandro
D’Alessandrolooked at how the brain's metabolism changes after the treatment. They measured changes in the fluid around the brain and in the blood over time and found certain signs that are linked to how the brain processes fatty acids. These signs were connected to how well the treatment works and how the disease develops. What’s more, the higher the dose of stem cells, the greater the levels of fatty acids, which also persisted over the 12-month period.
“We desperately need to develop new treatments for secondary progressive MS, and I am cautiously very excited about our findings, which are a step toward developing a cell therapy for treating MS,” Professor Stefano Pluchino from the University of Cambridge, who co-led the study, said.
“We recognize that our study has limitations – it was only a small study and there may have been confounding effects from the immunosuppressant drugs, for example – but the fact that our treatment was safe and that its effects lasted over the 12 months of the trial means that we can proceed to the next stage of clinical trials,” Pluchino added. | Medical Innovations |
Scientists 3D-print hair follicles in lab-grown skin
A team led by scientists at Rensselaer Polytechnic Institute has 3D-printed hair follicles in human skin tissue cultured in the lab. This marks the first time researchers have used the technology to generate hair follicles, which play an important role in skin healing and function.
The research, published in the journal Science Advances, has potential applications in regenerative medicine and drug testing, though engineering skin grafts that grow hair are still several years away.
"Our work is a proof-of-concept that hair follicle structures can be created in a highly precise, reproducible way using 3D-bioprinting. This kind of automated process is needed to make future biomanufacturing of skin possible," said Pankaj Karande, Ph.D., an associate professor of chemical and biological engineering and a member of Rensselaer's Shirley Ann Jackson, Ph.D. Center for Biotechnology and Interdisciplinary Studies, who led the study.
"The reconstruction of hair follicles using human-derived cells has historically been a challenge. Some studies have shown that if these cells are cultured in a three-dimensional environment, they can potentially originate new hair follicles or hair shafts, and our study builds on this work," Karande said.
When it comes to engineering human skin, hair may at first seem superfluous. However, hair follicles are quite important: They produce sweat, helping regulate body temperature, and they contain stem cells that help skin heal.
Hair follicles are also an entry point for topical drugs and cosmetics, making them an important part of dermatological testing. But today, initial safety testing is done on engineered skin tissues that lack hair follicles.
"Right now, contemporary skin models—the engineered structures that mimic human skin—are quite simple. Increasing their complexity by adding hair follicles would give us even more information about how skin interacts with topical products," said Carolina Catarino, Ph.D., first author of the study, who earned her doctorate at Rensselaer and is now a researcher developing new skin testing methods at Grupo Boticário, a cosmetics company in her home country of Brazil.
"Dr. Karande's lab is at the forefront of skin tissue engineering. This team has already successfully printed skin with working blood vessels, and this latest research is an exciting next step in developing and testing better treatments for burns and other skin conditions," said Deepak Vashishth, Ph.D., director of the Shirley Ann Jackson, Ph.D. Center for Biotechnology and Interdisciplinary Studies.
"Dr. Karande's work is a great example of advances being made by RPI researchers at the interface of engineering and life sciences with impact on human health," said Shekhar Garde, Ph.D., dean of Rensselaer's School of Engineering. "Bringing multichannel 3D printing to biological realm is opening exciting opportunities that would have been hard to imagine in the past."
The researchers created their follicle-bearing skin with 3D-printing techniques adapted for printing at the cellular level.
The scientists begin by allowing samples of skin and follicle cells to divide and multiply in the lab until there are enough printable cells. Next, the researchers mix each type of cell with proteins and other materials to create the "bio-ink" used by the printer. Using an extremely thin needle to deposit the bio-ink, the printer builds the skin layer by layer, while also creating channels for depositing the hair cells. Over time, the skin cells migrate to these channels surrounding the hair cells, mirroring the follicle structures present in real skin.
Right now, these tissues have a lifespan of two to three weeks, which is not enough time for hair shafts to develop. The research team's future work aims to extend that period, allowing the hair follicle to mature further and paving the way for their use in drug testing and skin grafts.
More information: Carolina Motter Catarino et al, Incorporation of hair follicles in 3D bioprinted models of human skin, Science Advances (2023). DOI: 10.1126/sciadv.adg0297
Provided by Rensselaer Polytechnic Institute | Medical Innovations |
A study published in Neuropsychopharmacology provides new insight into how the psychedelic drug LSD influences the way different brain regions communicate. The findings suggest that LSD disrupts the brain’s gatekeeping process, leading to increased information flow and altered perception.
Psychedelics have long been known to induce profound changes in perception, cognition, and consciousness. LSD provides a unique opportunity to study the brain and its functions. By investigating its effects, researchers can gain valuable insights into the neural processes that underlie perception, consciousness, and altered states of mind.
The authors behind the new study were particularly interested in identifying potential biomarkers that can predict the subjective effects induced by psychedelic drugs, which could be a valuable tool for both research and clinical purposes.
“I got interested in understanding the effects of LSD through a colleague and friend of mine who has been working on this topic for a long time. I myself usually work with patients with schizophrenia, who sometimes report hallucinations and a primary goal of my research is to understand why the patients have these and other experiences,” said study author Daniel Hauke, a postdoctoral research fellow at University College London.
“Speaking to my friend about the experiences that participants in his LSD studies report made it clear as day to me that everyone’s brain is able to generate these incredible, rich and sometimes scary experiences and how much of what we perceive as ‘reality’ is actually constructed by our brain. I wanted to understand this astonishing ability of our brain better in hope of learning something that might help me one day to explain to patients why they experience hallucinations.”
The study aimed to examine the neural mechanisms underlying the effects of LSD on the whole brain by employing computational modeling and machine learning. The researchers focused on two types of connectivity measures: functional connectivity and effective connectivity.
Functional connectivity measures the correlation between the activity of different brain regions, while effective connectivity estimates the directed influences between brain regions, taking into account the asymmetry of connections and the presence of self-inhibition within a region.
The study utilized data from two randomized, placebo-controlled, double-blind, cross-over trials involving a total of 45 healthy participants. The participants were administered either LSD or placebo in two separate experimental sessions, with at least a 7-day interval between sessions. Functional magnetic resonance imaging (fMRI) data were acquired during rest after the administration of LSD or placebo. The subjective effects of LSD were assessed using the 5 Dimensions of Altered States of Consciousness scale.
The researchers found evidence that LSD resulted in widespread changes in both functional connectivity and effective connectivity. Overall, LSD increased the strength of connections in many brain regions compared to placebo. However, there were also weaker connections in certain parts of the brain.
Hauke and his colleagues observed stronger functional connectivity between regions in the parietal, temporal, and inferior frontal areas of the brain. These regions support a wide range of cognitive processes and behaviors, including sensory processing, decision-making, language production, and memory.
Additionally, LSD was found to enhance connectivity in brain areas associated with thinking and cognitive functions. This included stronger connections between the inferior frontal gyrus and postcentral gyrus, which are involved in motor planning and sensory integration, as well as connections between the angular gyrus and inferior frontal gyrus, which are associated with language and semantic processing.
Hauke and his colleagues observed weaker functional connectivity between several regions in the occipital lobe, including the occipital pole, lingual gyrus, supracalcarine cortex, intracalcarine cortex, and fusiform gyrus. Weaker connections in these areas suggest that the interaction between these regions were reduced or less synchronized compared to when participants were in the placebo condition.
“I was surprised by the magnitude of the changes in connectivity in the brain under LSD,” Hauke told PsyPost. “Usually when we look at brain data – even when comparing the brains of patients with schizophrenia and healthy controls for example – the changes we see are much more subtle.”
The researchers found that changes in both functional connectivity and effective connectivity between specific brain regions, such as the angular gyrus and inferior frontal gyrus, as well as connections between occipital and cerebellar regions, were correlated with the overall subjective effects of LSD.
They trained a machine learning model to predict whether a person was under the influence of LSD or placebo based on their brain connectivity patterns, and the model performed well, indicating that brain connectivity could be used as a biomarker for drug effects.
Additionally, Hauke and his colleagues looked at how LSD affected inhibitory self-connections, which are related to the brain’s stability. They found that LSD increased inhibitory connections in some brain regions while reducing them in others. The study raises the possibility that LSD may disrupt the balance between excitation and inhibition in the brain, a factor that has been linked to psychosis and hallucinatory experiences.
Importantly, LSD increased the connectivity between various cortical regions and the thalamus, which is involved in regulating the flow of sensory information to the cortex. The findings support the thalamic gating hypothesis, which suggests that psychedelics like LSD reduce thalamic gating, allowing excessive information flow from the thalamus to other regions.
“Our findings suggest that LSD changes the connectivity in almost the entire brain,” Hauke told PsyPost. “Mostly it increases communication between brain areas that usually do not talk to each other much. One possible explanation that is also supported by our findings is that LSD affects a brain region called the thalamus.”
“The thalamus acts as a gatekeeper for the brain and LSD seems to open the gate to let more information pass the gatekeeper and reach other areas of the brain. Interestingly, we also found reduced communication between brain areas that are concerned with processing visual information, which we did not expect.”
“We don’t know yet what these changes mean and what the long-term consequences of them are,” Hauke explained. “We will try to get to the bottom of this by investigating how they relate to subjective experiences like hallucinations or synesthesia – the experience that one sense changes the perceptions in another sense, for example listening to music can change the things that people see under LSD.”
But the study, like all research, includes some caveats.
“One important limitation of our work is that LSD also leads to changes in blood flow in the brain, which we could not disentangle from changes in connectivity between brain regions,” Hauke explained. “In the future we will try to address this question by recording pulse and heart rate while participants are inside the scanner. It will also be important to investigate whether LSD results in long term changes in connectivity.”
The study, “The effect of lysergic acid diethylamide (LSD) on whole-brain functional and effective connectivity,” was authored by Peter Bedford, Daniel J. Hauke, Zheng Wang, Volker Roth, Monika Nagy-Huber, Friederike Holze, Laura Ley, Patrick Vizeli, Matthias E. Liechti, Stefan Borgwardt, Felix Müller, and Andreea O. Diaconescu. | Drug Discoveries |
Iranian President Ebrahim Raisi has blamed a wave of poisonings of hundreds of schoolgirls around the country on Tehran’s enemies.
The so-far unexplained poison attacks at more than 30 schools in at least four cities started in November in Iran’s Shia Muslim holy city of Qom, prompting some parents to take their children out of school.
Iran’s health minister said on Tuesday that hundreds of girls in different schools have been affected and some politicians have suggested they could have been targeted by religious groups opposed to girls’ education.
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Raisi, speaking to a crowd in southern Iran on Friday in a speech carried live on state television, blamed the poisoning on Iran’s enemies.
“This is a security project to cause chaos in the country whereby the enemy seeks to instil fear and insecurity among parents and students,” he said.
He did not say who those enemies were, although Iranian leaders habitually accuse the United States and Israel, among others, of acting against it.
Separately, a senior Iranian official said a fuel tanker found next to a school in a Tehran suburb and which had also been spotted in two other cities was probably involved in the poisonings.
Authorities seized the tanker and arrested its driver, said Reza Karimi Saleh, the deputy governor of the Pardis suburb.
Saleh is the first government official to report an arrest in connection with the wave of poisonings.
He said the same tanker had also been to Qom and Borujerd, in Lorestan Province in western Iran, where students have also suffered from poisoning. He did not elaborate.
“Guards at a parking lot where the fuel tanker was parked also suffered from poisoning,” Saleh said, referring to the Pardis site.
Calls for investigation
In Geneva, the United Nations human rights office on Friday called for a transparent investigation into the attacks.
“We’re very concerned about these allegations that girls are being deliberately targeted under what appear to be mysterious circumstances,” Ravina Shamdasani, spokesperson for the UN High Commissioner for Human Rights, told a briefing.
She said the findings of a government investigation should be made public and the perpetrators brought to justice.
Joining international calls, German foreign minister Annalena Baerbock said the reports were shocking and must be investigated fully.
“Girls must be able to go to school without fear,” Baerbock said on Twitter. “This is nothing less than their human right. All cases must be fully investigated.”
The US State Department spokesperson had on Wednesday called on Iran to investigate the cases of poisoning in schools.
Some Iranian politicians have suggested the schoolgirls could have been targeted by religious groups opposed to girls’ education.
Social media posts are replete with photos and videos of hospitalised girls. Some said they were nauseous and suffered heart palpitations. Others complained of headaches or heart palpitations. The posts could not be verified.
Schoolgirls have also taken part in the anti-government protests triggered by the death in custody of an Iranian-Kurdish woman last September. They have removed their mandatory hijabs in classrooms, torn up pictures of Supreme Leader Ali Hosseini Khamenei and called for his death.
In one online video last year, schoolgirls are seen waving their headscarves in the air and heckling a member of Iran’s paramilitary Basij force. | Epidemics & Outbreaks |
A measles outbreak in Ohio is raising concerns about the spread of the disease and how a decline in vaccination rates among children might be leading to additional outbreaks. Eighty-five cases have been reported in Ohio as of Friday, mainly in Columbus and other parts of Franklin County, according to Columbus Public Health. Most of these cases were in unvaccinated children. Hospitalization was required for 34 of those who were infected. It’s not the only recent measles outbreak in the country. Minnesota experienced 22 cases last year in the Twin Cities area. The outbreaks, which come amid a rise in anti-vaccine sentiment, are raising worries among health experts about whether lower vaccination rates will lead to further spread of diseases that can be safeguarded against by vaccines. “With any of the vaccine preventable illnesses, we always worry about when there’s not enough herd immunity,” says physician Susan Koletar, director of the Division of Infectious Diseases at The Ohio State Wexner Medical Center. Herd immunity occurs when enough people are immune through vaccination or natural infection to stop an illness from spreading. Measles is so contagious that immunization rates need to be at least 95 percent to eliminate the disease. The Ohio outbreak began in October 2022, with the bulk of cases occurring in mid-November to early December. These community cases are thought to be linked to one of four travel-related measles cases, says physician Mysheika W. Roberts, who is the health commissioner for Columbus. Although most of the cases are in unvaccinated children, six of the children had received their first of two doses of the combined measles, mumps and rubella (MMR) vaccine. Another twenty-four of the children were too young for any doses, according to the agency’s website. The U.S. was declared measles-free in 2000, but travelers periodically bring in infections. People who visit countries where measles is endemic, meaning there is regular transmission in the population, can return to their home communities and seed a local outbreak. “The mere fact that individuals who were not vaccinated, traveled to a measles endemic country and then were allowed to come back into the United States, where they likely instigated this outbreak is concerning to me as a public health professional,” says Roberts. One of the potential reasons these measles outbreaks may be happening is that vaccine coverage rates fell during the pandemic. The Centers for Disease Control and Prevention (CDC) report that vaccination rates among kindergarteners are high, but coverage for the 2021-2022 school year dropped to 93 percent compared to 95 percent for the 2019-2020 school year. The risk of contracting vaccine preventable diseases has been particularly heightened for children who are in low-income households or live in rural areas, as vaccine coverage decreased for those groups by 4 to 5 percent during the pandemic, according to the CDC. That drop in childhood vaccinations in part stems from disruptions during the pandemic, as well as financial and logistical hurdles, the CDC reported. But rising vaccine hesitancy and the anti-vaccine movement have also contributed, and are a major factor driving recent measles outbreaks. The U.S. saw its highest annual number of measles cases in recent history in 2019 with 1,274, most of which occurred in eight underimmunized communities, according to the CDC. “We are living in a generation where most of the people who have hesitancy about the vaccines never experienced any of those diseases,” says Koletar. “And they never experienced any of those diseases because of widespread immunization practices.” “I think many parents feel like since they don’t see measles in our community, that it is safe for them to not get their child vaccinated,” says Roberts. She attributes some of the vaccine hesitancy to the circulation of misinformation. A debunked theory linking the MMR vaccine to autism is one example. Baseless concern driven by that theory may lead some parents to delay MMR vaccination until right before their child enters school, which could mean the child gets their first dose when they are about 4 years old instead of 12 months old. The MMR vaccine has been around since the 1960s and is very, very effective, notes Roberts. “We didn’t get to eliminate measles without the MMR vaccine.” The politicization of vaccines during the COVID-19 pandemic has also fueled anti-vaccine attitudes, she says. “The anti-vaxx [and] the vaccine hesitant community has probably grown as a result of this pandemic and spilled over from the COVID-19 hesitancy to all vaccine hesitancy,” Roberts notes. Each family may be weighing their own personal risk and making decisions that way, says vaccine safety researcher Elyse Kharbanda. Willingness to get vaccinated may increase when transmission is high or there is recent memory of an outbreak, but once that goes away, vaccine acceptance may subside, she continues. Amid the dropping vaccination rates, Koletar is concerned that there could be an uptick in other vaccine preventable diseases, like tetanus, rubella and chickenpox. Rubella can be harder to diagnose than measles and may go undetected at times, according to Koletar. People in their late teens and adults who have neither had chickenpox nor been vaccinated against it can get really sick if they get chickenpox, she adds. “As a physician, those are frightening times, particularly if you have a young pregnant woman who gets chickenpox.” For now, the situation looks positive in Ohio. The most recent measles case was detected on Dec. 24, which means if there are no new cases through Feb. 4 the outbreak may be declared officially over. Looking ahead, there’s a need for more research into what interventions would help get more people in vaccine resistant communities to accept vaccines, according to Kharbanda. Interventions like alerts and letters are “effective at promoting vaccination to families who intend to vaccinate their children and just got busy and forgot,” Kharbanda tells The Hill. But “those types of simple interventions really don’t work with families and communities that are fearful and vaccine resistant,” she says. It takes time and good relationships with communities to understand what beliefs are perpetuating vaccine hesitancy and to gain trust, she adds. | Epidemics & Outbreaks |
Mpox no longer a global health emergency: WHO
The World Health Organization (WHO) has declared that mpox is no longer a global public health emergency as cases of the disease have fallen sharply in recent months.
Tedros Adhanom Ghebreyesus, the director general of WHO, said at a media briefing on Thursday that the agency’s emergency committee recommended to him the day before that the outbreak of mpox, which began last July, “no longer represents a public health emergency of international concern.”
“I have accepted that advice and am pleased to declare that mpox is no longer a global health emergency,” Tedros said.
He said the virus has caused more than 87,000 cases and 140 deaths in 111 countries that have been reported to WHO, but the agency has been encouraged by countries’ response to the virus. He said WHO has seen “steady progress” in controlling the disease’s spread based on lessons learned from experiences with HIV and working with the most vulnerable communities.
The virus quickly spread last year throughout the United States and other countries around the world in vulnerable populations, especially men who have sex with men. Health officials urged gay and bisexual men to take certain precautions to ensure they stay safe amid the outbreak.
The virus belongs to the same family of viruses that includes smallpox, allowing treatments and vaccines for smallpox, such as the Jynneos vaccine, to be used.
Health experts noted that the LGBTQ community was particularly positioned to be able to manage the outbreak because of its experience with the HIV and AIDS epidemic. A survey from the Centers for Disease Control and Prevention (CDC) found that half of men who have sex with men said they reduced their sexual activity because of the spread of mpox.
Tedros said almost 90 percent fewer mpox cases were reported in the past three months than the three preceding that.
“In particular, the work of community organizations, together with public health authorities, has been critical for informing people of the risks of mpox, encouraging and supporting behavior change, and advocating for access to tests, vaccines and treatments to be accessible to those most in need,” he said.
The WHO news came even as the CDC said it is investigating a new set of mpox cases in the Chicago area.
“A cluster of mpox cases have been reported in the Chicago area, which means the virus is still spreading, and we need to continue to be alert. More than 50% of cases in the cluster have been in people who have been previously vaccinated,” the CDC said Wednesday.
More than 30,000 cases were confirmed in the U.S.
Tedros said the end of the global public health emergency does not mean measures to counteract the disease can also end. He said the virus is continuing to affect communities in all regions of the world, especially in Africa.
He said countries should maintain their testing capabilities and continue to assess and quantify their needs to respond to the virus.
WHO’s announcement came less than a week after the agency downgraded COVID-19 to no longer declare it a global public health emergency.
“While the emergencies of mpox and COVID-19 are both over, the threat of resurgent waves remains for both. Both viruses continue to circulate and both continue to kill. And while two public health emergencies have ended in the past week, every day WHO continues to respond to 50+ emergencies,” Tedros said.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Epidemics & Outbreaks |
Few people would ever expect that the simple act of eating a poppy seed bagel could lead to the investigation of young mothers and their newborn babies over suspected opiate use, but that is exactly what two women in New Jersey say happened to them.
The pair of new mothers are alleging the hospitals in which they gave birth violated their rights after performing drug tests on them without their consent. The drug tests came back positive and led them to be reported for possible neglect or abuse just days after giving birth.
But both mothers believe poppy seed bagels they ate for breakfast, combined with the highly sensitive drug tests used by the hospitals, were the reason for false positive results. They have now sued the hospitals involved, in a move backed up by the American Civil Liberties Union (ACLU), which also says the tests were a gross violation of their privacy.
“I feel violated. This whole ordeal has been extremely stressful and has turned our lives upside down and now, because of what happened, I live in fear of medical tests and how they might be used against me as a mother,” said Kaitlin K, one of the mothers, in a statement. “I found out later that the lab used a testing threshold far, far lower than what the federal government uses.”
Although some in the medical community believe the idea that poppy seeds can result in a positive drug test is not possible, according to the United States Department of Agriculture (USDA), “it may be possible to exceed the morphine threshold by eating foods with poppy seeds and USDA can’t predict how long morphine or morphine metabolites from poppy seeds will stay in your system”.
Poppy seeds do not contain opium but can “become contaminated with opiates contained in the milky latex of the seed pod covering them” during harvesting, according to the University of Florida Health.
Earlier this year, even the US defense department issued a warning to service members before drug tests, urging them not to consume foods with poppy seeds because they risk testing positive for opium.
After the positive tests from the two mothers the hospitals involved – Hackensack University medical center and Virtua Voorhees hospital – reported both mothers to the state’s department of child protection and permanency (DCPP) for possible abuse or neglect.
One of the mothers, referred to as Kate L in the complaint filed by the ACLU, told the Guardian her newborn baby was held at the hospital in the neonatal intensive care unit (NICU) for longer than medically necessary.
“For the first four days [after the birth], we did not know that we were being investigated. The hospital wasn’t doing anything. They were just holding her. We questioned it a little bit, but I thought that they just had our best interests,” she said.
Kate said the hospital wanted to keep her baby for monitoring, but every test came back normal. That’s when mother’s intuition crept in.
“I knew she was fine. She was eating the way they wanted her to eat. She was being a normal newborn. Once we were discharged, and once I knew they were investigating us – that’s when we weren’t trusting the doctors any more. Because I already knew that they lied to us about the drug testing.”
She said she distinctly recalled one of the doctors in the unit telling her that they needed to feel “comfortable” before sending the baby home with her and her husband.
“It just really hurt me that they were just questioning my judgment and accusing me of something that I didn’t do,” Kate said.
Kate’s older son, a seven-year-old who was home at the time of the birth of his new sibling, was questioned by the state agency before Kate was allowed to return home. Even months after leaving the hospital, Kate said she was subjected to regular drug tests and visits from the DCPP. She called the ordeal “demeaning”.
“No one should be subjected to unnecessary and non-consensual drug tests. Our clients are sending a clear message to hospitals that these testing and reporting policies are unacceptable,” said ACLU-NJ lawyer Molly Linhorst.
The DCPP’s investigation into Kate and her husband concluded in November, but cases like these stay in the state’s system for at least three years.
“It’s just a lingering, painful thing I’m always thinking about,” Kate said. “I feel violated – our rights and our family. Giving birth should be one of the most like joyous events in your life, and everything that happened has completely destroyed that for me. Every time I think about [my baby] being born, this is what will be at the forefront of my mind.”
Elenore Wade, an assistant professor at Rutgers Law School, said that because both women weren’t told their urine was being tested for a drug test or explained the consequences of that, the hospitals are rightfully the target of this complaint.
“The lack of informed consent for the testing is partly what I see as the biggest issue here, especially because pregnant people are getting their urine tested routinely for protein levels,” she said.
Also at issue here is the the drug test performed by the hospital, which Wade said typically had a concentration level “15 times lower than the threshold that used to be used, and even more, proportionally lower than the threshold that the federal government now uses just because of all the false positives that come with these kinds of opiate tests”.
Wade added: “It kind of cuts against everything that we would want our own perinatal care experience to be, especially because it’s already a very stressful time for for people.” | Drug Discoveries |
This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255).
Summer is typically associated with carefree fun — but for some people, sunny days can spark sadness.
Seasonal affective disorder (SAD) — a condition that causes depressive symptoms and mood changes — is often linked to the dark winter months, but it can rear its head any time of year, according to experts.
Dr. Michael Groat, director of psychology for Silver Hill Hospital in Connecticut, spoke with Fox News Digital about why some people suffer from summer sadness.
There are two types of seasonal affective disorder, the doctor said.
"One is a winter pattern where the symptoms occur during the fall and winter months when there is less sunlight," he said.
"The other is a summer pattern, where the symptoms occur during the spring and summer months when it is lighter."
"Symptoms of either pattern usually last four to five months," he added.
Signs of summer sadness can include difficulty sleeping, a lack of energy, trouble concentrating and even suicidal despair, Groat said.
Individuals also can exhibit increased restlessness, weight loss and agitation.
Who is at risk?
Anyone can experience periods of sadness, but existing mental health conditions can raise the risk.
Twenty-five percent of people with bipolar disorder and 10%-20% of people with major depressive disorder also have seasonal affective disorder, according to Groat.
Women are more prone to the disorder than men, and it is most likely to begin in younger adults between the ages of 18 and 30.
"It is thought that the increased light found in the summer months affects the Circadian rhythm — the natural biological clock that regulates hormones, sleep and moods — of those who develop summertime SAD," Groat explained.
This could explain why people who live in areas with long winter nights (higher latitudes) and less sunlight are more likely to experience SAD, he added.
Preventing summer sadness
Although it may not always be preventable, there are steps one can take to lessen symptoms or keep sadness at bay, Groat said.
"These steps include healthy lifestyle habits such as routine exercise and movement, good nutrition and healthy sleep," he said.
"Sleep in particular is essential for helping maintain mood stability. Effective stress management is also important."
Dr. Maggie Tipton, senior director of psychological services at Caron Treatment Centers in Pennsylvania, also recommended limiting alcohol consumption.
"Alcohol consumption often increases during the summer, and the depressant quality of alcohol can exacerbate feelings of summer sadness," she told Fox News Digital.
"It’s a time when we need to be increasingly mindful of intake."
‘Consider taking a break from social media’
"If you find yourself increasing your scrolling on Instagram or Facebook, feeling jealous of others’ highlight reels or comparing your summer experiences to theirs — consider taking a break from social media," said Tipton.
"Be mindful and more thoughtful about your social media consumption and the times you are engaging," she added.
Even if it appears that everyone on your feed is having the time of their lives, the doctor noted that social media is a "highlight reel" of people’s lives, which can set "highly unrealistic expectations."
"Give yourself permission to do what makes you happy and what works for your lifestyle," she said.
"It’s OK to say no to a day by the pool if staying indoors is what you or your family really needs to reset and recharge so you can be your healthiest."
She also said, "The important thing is to figure out what you can do, regardless of season, that brings you happiness or contentment."
Diagnosis and treatment
Those who have persistent symptoms can see a psychiatrist or mental health professional for a diagnosis.
"If you’re feeling increased agitation, restlessness, changes in sleep patterns and/or a lack of appetite, these are signs you or a loved one may benefit from professional help," Tipton said.
The professional can review the symptoms, along with their duration, to determine a diagnosis, Groat added.
"If the symptoms continue past summer, the diagnosis might change to major depressive disorder or bipolar disorder," he said.
Summer SAD can be treated with psychotherapy, medication and lifestyle, the doctor said.
"Individual psychotherapy can provide support and address underlying thoughts and feelings related to the experience of depression," he said.
"Medication, such as antidepressants, can provide relief of symptoms as well."
Healthy lifestyle habits, such as adequate sleep, good nutrition, social support and stress management, also lay the foundation for ensuring well-being, experts say.
Seeking "moments of joy" also helps to boost mental health, said Tipton.
"Be creative and thoughtful with your summer plans, finding things that you can look forward to," she suggested.
"That may just mean having a favorite ice cream cone or taking in a summer concert, enjoying a picnic outside with your family or sitting outside to watch the sunset."
She added, "Little pieces of daily joy can often mean as much as an extended vacation away."
To read more pieces in Fox News Digital's "Be Well" series, click here. | Mental Health Treatments |
It is "ridiculous" that vapes are promoted to children, Rishi Sunak has said as he pledged to look at ways of strengthening marketing rules.
Speaking to ITV's This Morning, the prime minister said he didn't want his daughters "seduced by these things".
Earlier this week, a BBC investigation found vapes confiscated from school pupils contained high levels of lead, which could affect brain development.
It is illegal to sell vapes to under-18s.
NHS figures released last year found that while there was a fall in the number of school children taking drugs and smoking cigarettes, vape usage had risen to 9% among 11 to 15-year-olds in England - up from 6% in 2018.
In the same period, vaping among 15-year-old girls jumped from 10% to 21%.
A more recent study by Action on Smoking Health found that corner shops were "the main source of purchase and child awareness of instore promotion had grown significantly in the last year".
Vapes or e-cigarettes are generally considered to be safer than normal cigarettes because they do not contain harmful tobacco.
The government says vaping is "an important tool" to help adults give up smoking and contribute to its target of making smoking obsolete in England by 2030.
However, it also says children should not take up vaping and has launched a consultation seeking evidence on how the appearance and promotion of vapes may attract children.
Forty countries have banned vapes completely, while others have sought to make them less appealing to young people. Canada, for example, put restrictions on the types of vape flavours that can be sold.
Speaking to ITV's This Morning programme, Mr Sunak expressed concern about children, who are aged 12 and 10, taking up vaping.
"I have two young girls - that's why I worry about it."
He pointed to £3m of funding, announced last month, for a squad of trading standards officers to tackle shops illegally selling vapes to children.
He also said he wanted to look at "how can we strengthen the rules on how they are marketed, promoted - what do they look like".
He added: "It looks like they are targeted at kids which is ridiculous - I don't want my kids seduced by any of these things."
Labour has said it would ban vapes from being branded and advertised to appeal to children if it wins power.
The party has also promised to work with local councils and the NHS to ensure vapes "are being used as a stop smoking aide, rather than a new form of smoking". | Health Policy |
Nov. 13, 2023 -- What is the first thing that comes to mind when you think about the word âdiet?â For most people, diet means giving up enjoyable foods, regimented eating hours, and counting calories. Dig a bit deeper into the origins of the word and it becomes more palatable: The word "diet" comes from the Greek word "diata," which means a way of life or living.
For Ancient Greeks, diata meant visits to healing temples, saunas, meditation rooms, and most importantly, enjoyment of a variety of foods in a social atmosphere. This pattern of eating and living created a blueprint for what would eventually be coined the Mediterranean Diet, a holistic approach to life where the whole is much greater than the sum of its parts.Â
âI like to say that the Mediterranean Diet is a helpful and pleasurable lifestyle plan that allows you to eat a lot of what is good for you -- and enjoy a little bit of what isnât on occasion -- without giving anything up,â said Amy Riolo, an award-winning chef, television host, and author of 16 books. Riolo was named as ambassador of Italian cuisine in the U.S. and ambassador of Mediterranean cuisine in the world by the Italian news agency ANSA.Â
âThe diet is more than just about the food you eat,â added Pam Fullenweider, a registered dietitian who specializes in the Mediterranean Diet and a culinary nutritionist. âItâs the lifestyle components of daily exercise and social connectivity â enjoying meals with others â that makes it so unique.â
Lifestyle, With Benefits
For years, the Mediterranean Diet has taken first or second place in U.S. News & World Reportâs annual âBest Dietsâ rankings. There are reams of evidence supporting its value, with multiple studies demonstrating that when the primary pillars of the Mediterranean lifestyle â nutrition/eating, exercise/physical activity, and social connectivity are embraced â a wealth of benefits, including heart health, mental wellness, staving off cognitive decline, blood sugar control, and longevity can be realized.
Stefanos Kales, MD, a preventive medicine doctor and professor of medicine at Harvard Medical School in Boston, has been studying the lifestyle for decades. He also has a personal connection, explaining that his Greek grandmother was the bridge to the Mediterranean, especially Crete.
âWhen I grew up, I was fortunate that my grandmother, who was well into her 90s, spent a lot of time with us. She was always using olive oil, and would go out and pick what were basically weeds for any other American. But they were valuable greens for cleaning and preparation,â he said.Â
He noted that later when he was a student, the value of this connection to the past was reinforced time and again.
âGreat nutrition professors espoused that the best way to eat was by mimicking what your grandparents were telling you,â he said.
Kales said the Mediterranean lifestyle grew out of necessity. Olives, which are indigenous to the Mediterranean region, cannot be eaten raw, so people learned to cultivate and prepare them, including harvesting the ripe or semi-ripe fruit and pressing it into oil. The diet was plant-forward and relied on wild greens, fruits and vegetables in season, breads made of whole grains, and homemade wine. Meat and dairy were not regularly eaten. The lifestyle was agrarian, and people walked up to 10 km (6.2 miles) daily. They had adequate rest and took siestas in the afternoon.Â
The social aspect â breaking bread together â was and is essential.
âIncorporating the social aspect of eating, making sure that youâre eating not just to nourish your body but to nourish your soul so that you are not just enjoying the food, but eating and enjoying it with others, is key in the Mediterranean Diet,â said Rahaf Al Bochi, a registered dietitian, nutritionist, and owner of Olive Tree Nutrition, a virtual nutritional consulting practice. Al Bochi, who is also a spokesperson for the Academy of Nutrition and Dietetics, is very familiar with the Mediterranean lifestyle having grown up in the Middle East.Â
Studies about so-called Blue Zones, where where people consistently live past the age of 100, âtalk about the one day meal â the midday meal when everyoneâs together and how many psychological effects they reap from that,â said Riolo. In turn, the positive effects of socialization help âfuel the hormones of digestion and metabolism, and how we store fat.â
Getting Started
Unlike many âquick fixâ diets that include a specific list of foods or a specific meal plan to follow for a set period of time, the Mediterranean lifestyle is sustainable â namely because it emphasizes flavor, enjoyment, physical activity, and socializing.Â
âInstead of focusing on just weight as an outcome, it focuses on how food makes you feel, gives you energy, helps you feel more vibrant, and helps reduce your risk of chronic diseases,â said Al Bochi.Â
Key food categories include lots of vegetables, fruits, nuts, legumes, whole and unrefined grains, and olive oil; moderate intake of fish; little dairy, meats, and poultry; and a moderate amount of wine with meals. These categories are adaptable to oneâs cultural heritage and background, a point emphasized by both Al Bochi and Riolo. And the overall benefits of the Mediterranean lifestyle -- benefits that included a lower risk of dying from any cause and from cancer â reinforce that it is adaptable regardless of where one lives, according to a recent study co-authored by Kales.
Another important factor is that it is never too late to get started:
- Take a quick assessment of your plate and identify where the gaps are. âInstead of thinking about what foods you want to limit or avoid, which is usually the diet mentality that people fall into, think about what you can add,â she said. âIs it more fruits, more vegetables, more fiber-rich whole grains or beans and legumes?â
- Focus on the quality and freshness of the ingredients, and aim for whatâs in season, advised Riolo. Frozen fruits and vegetables might be the freshest and most affordable option and that is perfectly acceptable.Â
- Think about time and your own budget and compare them with your desired outcomes. Itâs helpful to decide when you will be able to prepare food. Socializing time can also involve cooking with others or inviting friends for dinner.
- Donât try to or change too many things at once, said Fullenweider; take it one step at a time. âMaybe it is as simple as adding chopped veggies to scrambled eggs or more greens to pasta,â she said.
- Consider the whole and not just the individual parts. To fully reap the health and nutrition benefits, the Mediterranean lifestyle also relies on physical activity with the emphasis on what is pleasurable, be it walking, gardening, dancing, swimming, etc., Riolo said.Â
- Avoid cherry picking. Drinking more red wine or adding olive oil to meals wonât result in the totality of the benefits.
- Finally, focus on flavor as much as nutrition. âI believe that the Mediterranean lifestyle is a love language,â Riolo said. âThereâs a thing in Italian that the food thatâs enjoyed more is better digested.â | Nutrition Research |
Millions suffer from pain due to lack of morphine distribution, WHO finds
The World Health Organization (WHO) said in a new report that morphine is not distributed equally around the world, leaving millions of people to suffer from pain.
“Leaving people in pain when effective medicines are available for pain management, especially in the context of end-of-life care, should be a cause of serious concern for policy-makers,” said Yukiko Nakatani, WHO assistant director general for medicines and health products, in a statement last month.
The report found that more than 80 percent of morphine available worldwide was distributed in the Americas, mostly in North America. The median estimated defined daily dose (DDD) of morphine for high-income countries was 125.9 DDD per million people per day, while it was 24.9 for upper-middle-income countries, 6.7 for lower-middle-income nations and 2.0 DDD in low-income countries.
Nakatani wrote in the report’s forward that opioid abuse and the lack of opioid access are becoming crises around the world. She wrote that “a lack of access to opioids such as morphine in many parts of the world means that millions of people continue to suffer preventable pain.”
The report found that 50 percent of those from low-income countries and 18 percent of those in lower-middle-income countries said that at least 8 in 10 people did not receive morphine despite showing medical need.
The authors wrote the disparity exists for several reasons, including the availability of the drug, the stigma around morphine and restrictive legislative policies relating to opioid use. The authors also warned of the dangers of drugs like morphine, which is an opioid, but said those concerns should not “undermine the benefits of opioid use when clinically indicated and when used safely by trained professionals.”
The authors also outlined a series of actions countries could take to mitigate the disparity in morphine, including making the drug more affordable, expanding access to the drug and establishing distribution centers.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Global Health |
- The Biden administration unveiled the first 10 prescription drugs that will be subject to price negotiations between manufacturers and Medicare.
- The announcement kicks off a controversial process under the Inflation Reduction Act that aims to make costly medications more affordable for older Americans.
The Biden administration on Tuesday unveiled the first 10 prescription drugs that will be subject to price negotiations between manufacturers and Medicare, kicking off a controversial process that aims to make costly medications more affordable for older Americans.
President Joe Biden's Inflation Reduction Act, which passed in a party-line vote last year, gave Medicare the power to directly hash out drug prices with manufacturers for the first time in the federal program's nearly 60-year history. The agreed-upon prices for the first round of drugs are scheduled to go into effect in 2026.
Here are the 10 drugs subject to the initial talks this year:
- Eliquis, made by Bristol-Myers Squibb, is used to prevent blood clotting to reduce the risk of stroke.
- Jardiance, made by Boehringer Ingelheim, is used to lower blood sugar for people type 2 diabetes.
- Xarelto, made by Johnson & Johnson, is used to prevent blood clotting to reduce the risk of stroke.
- Januvia, made by Merck, is used to lower blood sugar for people with type 2 diabetes.
- Farxiga, made by AstraZeneca, is used to treat type 2 diabetes.
- Entresto, made by Novartis, is used to treat certain types of heart failure.
- Enbrel, made by Amgen, is used to treat rheumatoid arthritis.
- Imbruvica, made by AbbVie, is used to treat different types of blood cancers.
- Stelara, made by Janssen, is used to treat Crohn's disease.
- Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill, insulins made by Novo Nordisk.
The Medicare negotiations are the centerpiece of the Biden administration's efforts to rein in the rising cost of medications in the U.S. Some Democrats in Congress and consumer advocates have long pushed for the change, as many seniors around the country struggle to afford care.
But the pharmaceutical industry views the process as a threat to its revenue growth, profits and drug innovation. Drugmakers like Merck and Johnson & Johnson and their supporters aim to derail the negotiations, filing at least eight lawsuits in recent months seeking to declare it unconstitutional.
The drugs listed Tuesday are among the top 50 with the highest spending for Medicare Part D, which covers prescription medications that seniors fill at retail pharmacies. That's based on data from June 1, 2022, to May 31, 2023, according to the Centers for Medicare and Medicaid Services, or CMS.
The drugs have been on the market for at least seven years without generic competitors, or 11 years in the case of biological products such as vaccines.
Medicare covers roughly 66 million people in the U.S., and 50.5 million patients are currently enrolled in Part D plans, according to health policy research organization KFF.
Drugmakers have to sign agreements to join the negotiations by Oct. 1. CMS will then make an initial price offer to manufacturers in February 2024, and those companies have a month to accept or make a counteroffer.
The negotiations will end in August 2024, with agreed-upon prices published on Sept. 1, 2024. The reduced prices won't go into effect until January 2026.
If a drugmaker declines to negotiate, it must either pay an excise tax of up to 95% of its medication's U.S. sales or pull all of its products from the Medicare and Medicaid markets.
The pharmaceutical industry contends that the penalty can be as high as 1,900% of a drug's daily revenues.
After the initial round of talks, CMS can negotiate prices for another 15 drugs for 2027 and an additional 15 in 2028. The number rises to 20 negotiated medications a year starting in 2029 and beyond.
"I think it's incredibly important to keep in mind that the negotiation process is cumulative," said Leigh Purvis, a prescription drug policy principal with AARP Public Policy Institute. "We could have as many as 60 drugs negotiated by 2029."
CMS will only select Medicare Part D drugs for the medicines covered by the first two years of negotiations. It will add more specialized drugs covered by Medicare Part B, which are typically administered by doctors, in 2028.
The drug price talks are expected to save Medicare an estimated $98.5 billion over a decade, according to the Congressional Budget Office.
Merck, Johnson & Johnson, Bristol-Myers Squibb and Astellas Pharma are among the companies suing to halt the negotiation process. The industry's biggest lobbying group, PhRMA, and the U.S. Chamber of Commerce have filed their own lawsuits.
The suits make similar and overlapping claims that Medicare negotiations are unconstitutional.
The companies argue that the talks would force drugmakers to sell their medicines at huge discounts, below market rates. They assert this violates the Fifth Amendment, which requires the government to pay reasonable compensation for private property taken for public use.
The suits also argue that the process violates drugmakers' free speech rights under the First Amendment, essentially forcing companies to agree that Medicare is negotiating a fair price.
They also contend that the talks violate the Eighth Amendment by levying an excessive fine if drugmakers refuse to engage in the process.
The suits are scattered in federal courts around the U.S. Legal experts say the pharmaceutical industry hopes to obtain conflicting rulings from federal appellate courts, which could fast-track the issue to the Supreme Court.
Some drugmakers have confirmed their intention to bring their legal battle to the nation's highest court.
"As we look forward, we're going to take this to the fullest, which means we'll take it through District Court and, if need be, into Circuit Court and ultimately to the Supreme Court," Merck CEO Robert Davis said during an earnings call earlier this month. "So, really that's the strategy."
Meanwhile, the Biden administration has vowed to fight the legal challenges.
Biden and his top health officials have embraced the lawsuits as evidence that they're making progress in the fight to cut drug prices.
"Big Pharma doesn't want this to happen, so they're suing us to block us from negotiating lower prices so they can pad their profits," the president said in a speech at the White House last month. "But we're going to see this through. We're going to keep standing up to Big Pharma." | Health Policy |
WEST ORANGE – As part of the Murphy Administration’s ongoing efforts to advance health care affordability on behalf of the residents of our state, Governor Phil Murphy today signed three bills he announced in partnership with legislative sponsors last year to help make prescription drugs more affordable for New Jerseyans. The three bills, which were signed alongside legislators and advocates, will work together to cap certain out-of-pocket costs, establish greater oversight of Pharmacy Benefit Managers, and promote transparency across the pharmaceutical supply chain.
“This is a huge step forward in our ongoing efforts to deliver much-needed relief to countless families throughout our state who are struggling to afford critical medications,” said Governor Murphy. “I am proud to sign nation-leading legislation that will make a real difference in the lives of New Jerseyans as we continue to work towards making prescription drugs and other health care services more affordable and accessible to everyone.”
Today’s bill package advances one of the most comprehensive prescription drug price transparency programs in the country to date. The legislation also makes New Jersey only the second state in the nation to cap out of pocket costs for asthma inhalers and EpiPens in addition to capping consumer costs for insulin.
The three bills the Governor signed today are:
With more than half of New Jersey residents concerned about the affordability of prescription drugs and one in four adults skipping or rationing their medications – an issue seen throughout the nation – the Office of Health Care Affordability and Transparency worked closely with legislative partners and other community stakeholders to advance this legislation for prescription drug affordability. Governor Murphy launched this office in 2020 to lead efforts across the Administration to make health care more affordable for residents and address the unsustainable rise in health care costs.
To further advance prescription affordability, the Governor also included funding in the Fiscal Year 2024 budget to expand eligibility for the Pharmaceutical Assistance for the Aged and Disabled (PAAD) program, which further cuts the costs of life-enhancing and life-saving prescription drugs for seniors and residents with disabilities. A companion bill signed on the same day as the budget, in addition to authorizing the eligibility expansion, will help get even more eligible New Jerseyans enrolled in both PAAD and the Senior Gold Prescription Discount program going forward.
The following legislators sponsored one or more of the three bills signed today – Senators Joseph Vitale and Troy Singleton and Assemblyman John McKeon, in addition to Senators Nellie Pou, Linda Greenstein, and Vin Gopal and Assembly Members Roy Freiman, Angela McKnight, Robert Karabinchak, Bill Moen, Gabriela Mosquera, Annette Quijano, Paul Moriarty, Joseph Danielsen, Daniel Benson, and Verlina Reynolds-Jackson.
“Far too many New Jerseyans have experienced the stress of affording the price of a medication, often cutting back on groceries, putting off bills, and even rationing or skipping doses. And unfortunately, prescription drug costs are just one factor pushing health care out of reach for many residents,” said Shabnam Salih, Director of the Governor’s Office of Health Care Affordability and Transparency. “My Office is working to lower costs across the health care system through a comprehensive affordability agenda. This package is a critical part of that work and a huge step forward that will have a real impact on New Jersey residents. It would not have been possible without the Governor’s leadership and the commitment of our partners throughout the Administration, in the Legislature, and in the community.”
“These reforms help to address the burdensome high cost of prescription drugs that consumers face across our state,” said New Jersey Department of Banking and Insurance Acting Commissioner Justin Zimmerman. “Through greater oversight and increased transparency of the factors that contribute to prescription drug pricing, the state can take meaningful steps to reduce patient costs. Additionally, the department will now require Pharmacy Benefits Managers to meet stringent standards for licensure to prevent practices that can drive up prescription drug costs. The enactment of these measures demonstrates Governor Murphy’s commitment to improving access to and affordability of health care for New Jersey residents.”
“The high cost of prescription medication jeopardizes the health and well-being of the most vulnerable among us: low-income families, the elderly, the uninsured, and people with disabilities,” said Attorney General Matthew J. Platkin. “I applaud Governor Murphy and the Legislature for taking these important first steps toward reining in the rising cost of prescription drugs in our state.”
“The Division of Consumer Affairs is dedicated to ensuring fairness and transparency in the market and we welcome the opportunity to shine a light on the high cost of prescription drugs,” said Cari Fais, Acting Director of the Division of Consumer Affairs. “Creating a system to collect, analyze, and report data on the entire process of drug pricing across the supply chain is critical to gaining greater insight and promoting accountability in the drug industry. New Jersey consumers deserve nothing less.”
“Across the nation, too many people are being forced to ration or go without critically needed and potentially life-saving prescription medications. I’m proud that in New Jersey we are working to make the prescription drug industry more transparent,” said Assembly Speaker Craig J. Coughlin. “The legislation being signed into law today will help us better understand how medications are priced, giving us the data necessary to respond and promote increased access to appropriate care as well as improve oversight and transparency of the entire pharmaceutical supply chain.”
“New Jersey's affordability crisis affects all of us – most especially those who rely on prescription drugs to live. Now more than ever, we must work to make life-saving medicine more accessible and affordable,” said Senator Singleton. “This package will address affordability and stimulate transparency and accountability within the pharmaceutical industry. Each and every day, someone skips a dose or cuts a pill in half just to save money. In the richest nation in the world, and one of the wealthiest states in America, this is unacceptable and simply unconscionable.”
“For far too long, consumers have been excluded from the drug pricing process and left to bear the brunt of prescription cost increases. This package will bring to light the inner workings and beneficiaries within the pharmaceutical industry and work to combat rising prices,” said Senator Vitale, Chair of the Senate Health Committee. “Inflated prescription drug prices without reasoning or accountability is unfair and irresponsible; these laws will ensure that pharmaceutical companies and manufacturers are open and honest with the consumers they serve.”
“Many consumers have struggled to afford necessary medicine,” said Assemblyman McKeon. “The legislation being signed into law will help us understand what’s behind the rise in drug prices and allow us to develop policies focused on affordability, while keeping those in the industry accountable for their actions.”
“Access to prescription medications can dramatically improve one’s quality of life, and in some cases they are difference between life and death,” said Assemblyman Freiman. “These new laws will help make prescription drugs more affordable and accessible for all New Jersey families. We must fight for the future health of our communities. Nobody should have to go without the medication they need to survive.”
“Currently, we are facing a severe affordability crisis throughout the nation, and the stunning increase in prescription drug prices continues to play a huge role. Consumers are kept in the dark about these price increases, which is neglectful of the impact these increases have on residents,” said Senator Pou. “These laws will help to keep consumers prepared and informed while holding pharmaceutical companies and manufacturers accountable.”
As prescription drug prices continue to skyrocket, approximately 30 million Americans are diagnosed with diabetes and are subjected to pay three times what people living overseas would pay for the same drug,” said Senator Greenstein. “This law is a major step forward in our efforts to mitigate the current drug affordability crisis, and will make insulin, asthma inhalers, and other critical treatments affordable for New Jersey residents.”
“Too many residents are forced to delay or all together forego taking a prescription due to the cost,” said Senator Gopal. “This legislation will regulate the behind-the-scene business practices of pharmacy benefits managers to be more transparent, require licenses, data and records reporting, and cost establishment modifications to help address the prescription drug affordability crisis facing our state.”
“AARP commends Governor Murphy and the NJ Legislature for enacting legislation today that will meaningfully respond to the skyrocketing costs of prescription medications,” said Crystal McDonald, AARP New Jersey Associate State Director of Advocacy. “High prescription drug prices hit older Americans particularly hard. More than two out of three NJ voters 50 plus are concerned they won’t be able to afford the medicines they need in the future. S1615 will give our State the data and tools to ensure transparency across the pharmaceutical supply chain and establish a Drug Affordability Council - responsible for actionable recommendations to lower drug costs. S1614 will cap the out-pocket-costs on insulin, asthma inhalers, and epi-pens for many insured New Jerseyans – keeping these life-saving drugs within financial reach of so many. We applaud Governor Murphy, Senator Singleton, Senator Vitale and Assemblyman McKeon for championing this legislation.”
“It’s been a long road, but we finally have a law that puts us on the path of making prescription drugs more affordable for New Jerseyans,” said New Jersey Citizen Action Healthcare Program Director Laura Waddell. “A Drug Affordability Council will help rein in prices at the pharmacy counter and ensure patients don't have to choose between paying for lifesaving medicines or for other essential needs. We thank Senator Singleton and Assemblyman McKeon for tirelessly championing this legislation, and applaud Governor Murphy and all our elected leaders who supported meaningful drug pricing reform. We also thank all our New Jersey for Affordable Drugs campaign partners and the countless grassroots advocates and activists whose work made this day possible. NJCA looks forward to continue working with both Governor Murphy and our Legislature throughout implementation.”
“GSPO is proud to have supported this critically-needed package of bills. Many of the new laws’ provisions are unparalleled and incredibly forward-thinking,” said Executive Director of Garden State Pharmacy Owners Brian Oliveira, PharmD. “The leadership demonstrated by the sponsors, co-sponsors, and Governor Murphy’s Office will assuredly benefit New Jersey’s patients and providers. We look forward to working closely with the Administration on implementation of the laws.”
“I am pleased to extend the New Jersey Pharmacists Association’s (NJPhA) sincere thanks to Governor Murphy, the bill sponsors, and co-sponsors for their hard work in bringing this extensive prescription drug transparency package to fruition,” said Rupal Mansukhani, Pharm.D - NJPhA President. “It will assist New Jersey pharmacies and pharmacists in providing the highest level of care to patients. These new laws are forward thinking with innovative provisions that protect patients, providers, and plan sponsors.”
“The American Diabetes Association celebrates New Jersey’s passage of critical legislation aimed at lessening the financial burden of insulin costs for people living with diabetes,” said Monica Billger, State Government Affairs Director for the American Diabetes Association. “While Congress passed a $35 cap for Medicare recipients last year, an affordability gap remained for many others with diabetes. New Jersey, along with 24 other states and the District of Columbia, are taking the lead to close the gap and improve affordability and access to life-saving insulin.”
“I applaud Gov. Murphy’s actions to lower the cost of prescription drugs for patients. The out-of-pocket caps on insulin, epi pens, and asthma inhalers will dramatically lower cost barriers to life-saving drugs for many families who depend on them,” said Center for American Progress’ Senior Vice President of Inclusive Growth, Emily Gee. “The state’s new measures to tighten oversight of pharmacy benefit managers (PBM) and shed light on pricing throughout the drug supply chain are crucial for improving competition and reducing drug costs for New Jersey residents.”
“Drug prices are outrageously high, and Americans are demanding action. Today, Governor Murphy is taking important steps to meet that demand by working to protect patients,” said Alex Lawson, Executive Director of Social Security Works. “These actions should be a model for governors across the country, as well as federal policymakers.”
"Nurses for America applauds Governor Murphy’s progressive and innovative package of bills to advance drug affordability and access in New Jersey," said Sherry Pomeroy PhD, RN, Faith Community Nurse. "As nurses we care for individuals, families & communities across the lifespan who struggle to afford medications critical to their overall health & well-being, such as insulin, asthma inhalers, and epinephrine pens. The ability to obtain and afford medications needed to treat a wide variety of health conditions is a basic health care right."
“We have known for years that insulins suffer from some of the greatest disconnects between the list prices and the real prices of those medicines, with much of the fluffed up costs paid by patients and employers being cannibalized by intermediaries within the drug channel, said Antonio Ciacca, CEO, 46brooklyn Research. "Within drug classes where these pricing distortions are most pronounced, it is a good thing for patients that they won’t have to continue to overpay for medicines in order to generate discounts that are pocketed by others.”
“PBMs are supposed to be working on behalf of patients and plan sponsors to make prescription drugs more affordable," continued Ciaacia. "However, due to a lack of transparency and significant conflicts of interest, PBMs often make our dysfunctional drug pricing system even worse. A 536/2841 is on the leading edge of these state PBM reforms, with a number of innovative approaches that attempt to curtail anti-competitive behavior and drug price manipulation. This seems like a very worthwhile effort to provide greater oversight and accountability to an important aspect of our healthcare delivery system.”
“You shouldn’t have to choose between paying the rent or getting a prescription filled — yet for many people, this is a reality,” shared Mona Shah, Senior Director of Policy and Strategy, Community Catalyst. “Important policy changes are necessary to create a more equitable health system, and we applaud Governor Murphy as well as our partners at NJ Citizen Action, for their meaningful work to make prescription drugs more affordable. This will give people, families, and communities the relief so clearly needed. At Community Catalyst, we won’t stop fighting until everyone has what they need to be healthy, and health is a right for all.” | Health Policy |
A coalition of leading public health organizations on Tuesday praised the administration’s response to the mpox outbreak but raised red flags about the nation’s continued “lack of readiness” to swiftly respond to health threats or emergencies.
In a letter to President Biden sent as the Department of Health and Human Services (HHS) public health emergency for the disease expires, the National Mpox Working Group outlined the administration’s successes and shortcomings in its handling of the mpox outbreak and offered recommendations to build a more robust public health system capable of responding to emergencies.
More than 30,000 cases of mpox — the disease formerly known as monkeypox — have been reported nationwide since May, when the first known case was cataloged in the U.S., according to the Centers for Disease Control and Prevention (CDC).
The National Mpox Working Group since its inception in June has worked to inform policy decisions made by the White House and Congress pertaining to the outbreak.
The working group in its Tuesday letter commended the Biden administration for bolstering interagency collaboration and communication to successfully contain the spread of mpox, but added that the message was sent primarily to “express our concern regarding the nation’s preparedness for future infectious disease outbreaks.”
“Mpox was the first national novel infectious disease to test many of the systems put in place during the COVID-19 pandemic, and it offers a roadmap to prepare for the next outbreak,” said the letter from the working group, a partnership of roughly two dozen public health, medical and LGBTQ advocacy organizations including AIDS United and the National Center for Lesbian Rights.
Among other preventative measures, the administration should prioritize public health interventions that resolve racial and geographic health inequities at the outset of emergencies, “rather than addressing them after they have already occurred or become entrenched.”
Multiple inquiries into the spread of mpox in the U.S. have found stark disparities in infection rates among Black and Hispanic Americans, who have accounted for a disproportionate share of cases relative to their share of the population.
A CDC report published earlier this month found that among mpox cases reported among cisgender women, Black and Hispanic women were disproportionately represented. Overall, the outbreak has overwhelmingly affected men who have sex with men.
The National Mpox Working Group on Tuesday also stressed the need for a federal financial support plan that includes increased investment in the nation’s public health system.
“Anything less sets a disturbing precedent for what we can expect in the next public health crisis,” the coalition wrote. More federal funding should also be diverted to community-based programs like local STI clinics — many of which burned through their own budgets to test, treat and vaccinate their communities against mpox, the letter said.
“Too many people suffered unnecessarily and the front-line organizations that responded to this outbreak exhausted their own limited funds to provide information, health care and support to their communities – only to see the White House reduce its critical needs request to Congress,” the groups wrote.
“This lack of support on behalf of America’s public health system undercut the very real needs of those in the field at a time when capacity and resources were stretched to the brink. We are disappointed that they did not get the timely, forceful, and tangible White House support they needed.” | Epidemics & Outbreaks |
A disabled man has had his benefits slashed after an Atos nurse lied about what he told her during an assessment about his pain and suicidal thoughts, and repeatedly under-stated how his health conditions affect his day-to-day life.
The nurse even claimed that Ian Littler, who lives with significant mental distress and long-term health conditions, said that all people were “scum” when he said no such thing during the telephone assessment.
As a result of the assessment report, he had his monthly personal independence payment (PIP) cut by nearly £340 a month.
It is the third time he has had to appeal after an inaccurate assessment report has resulted in his PIP being cut.
Atos has accepted the report was not fit for purpose – after listening to a recording he secretly made of the telephone assessment in April – and is investigating his complaint.
Littler, from Oldham, is calling for the nurse to be sacked and struck off from the nursing register, and he is seeking legal advice.
An Atos PIP client relations officer has told him: “The documentation of the information provided by you which can be heard within the recording, has not been documented accurately and there are inaccuracies in the report.”
It is just the latest case in which disabled people have proved that PIP assessors working for government contractors Atos and Capita have lied in their assessment reports.
The timing is particularly bad for Atos as it has so far failed to win a single contract to deliver PIP assessments and fitness for work tests for DWP over the next five-year period, and has been fighting through the courts to secure the last remaining contract (see separate story).
Among the errors in the assessment report, the nurse said Littler – who lives alone – would always take his medication, when he actually told her he could not take his anti-depressants unless someone was with him because of the risk that he would choke.
She also claimed he only expressed pain twice during the 40-minute assessment, even though he can repeatedly be heard groaning with pain.
The nurse wrote in her report that Littler “did not sound low in mood or anxious” and was “not anxious, agitated or tense” even though he told her: “I just don’t want to be here. I just want to go to sleep and not wake up.”
He also ended the assessment by becoming severely distressed and hanging up the phone after the nurse kept pushing him to explain why his GP was giving him monthly prescriptions when he had previously tried to take his own life.
Among the other lies in the report, the nurse described how he climbs the stairs in his house by holding one of the bannisters and a crutch when he told her that he climbs them on his backside.
And she said his tongue and eyes had swollen up just four times in seven years when he actually told her his dog had woken him up more than 130 times after sensing that his tongue was starting to swell.
Littler told Disability News Service that he felt “completely let down by Atos, the DWP and the whole assessment process in general”, which he said was “seriously flawed” and had increased his thoughts of self-harm.
He said: “After hearing horror stories for years about fraudulent Atos nurses and reports I’m shocked and stunned that they are still continuing to do these reports, and I feel that they should never be allowed to do these reports ever again or be awarded any future contracts.”
An Atos spokesperson said: “We have a robust complaints process for anyone dissatisfied with their consultation report.
“In this case, our investigation found the report did not meet our high standards and action was taken with the health professional involved in this regrettable incident.
“We have apologised and arranged for a new consultation with a different health professional.”
A DWP spokesperson said: “We support millions of people with disabilities every year and our top priority is that they receive a supportive, compassionate service.
“The department is clear that assessment providers should strive for 100 per cent accuracy and we want every report to reflect a high-quality functional assessment that the department can use to make benefit entitlement decisions.
“We have set performance guarantees and a threshold for unacceptable reports for providers, and, in this case, we welcome the decision by IAS* to rearrange the consultation for the individual in question.”
*Atos carries out assessments under the name Independent Assessment Services (IAS)
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Please consider making a voluntary financial contribution to support the work of DNS and allow it to continue producing independent, carefully-researched news stories that focus on the lives and rights of disabled people and their user-led organisations.
Please do not contribute if you cannot afford to do so, and please note that DNS is not a charity. It is run and owned by disabled journalist John Pring and has been from its launch in April 2009.
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Image source, Family handoutImage caption, Adam was diagnosed with Group B Strep infection and meningitis after spending weeks in intensive careThe health trust behind the worst maternity scandal in NHS history has accepted responsibility for a boy's brain injury.Adam Cheshire, 11, contracted a Group B Strep (GBS) infection following his birth at the Royal Shrewsbury Hospital in 2011.A High Court judge approved a payout from Shrewsbury and Telford Hospitals NHS Trust (SaTH) to provide special care for the rest of his life.The trust apologised for its failings.It accepted 80% of the responsibility for Adam's injury and agreed to make an interim payment to his family.His case was examined as part of senior midwife Donna Ockendon's investigation into SaTH which found catastrophic failures might have led to the deaths and life-changing injuries of hundreds of babies, as well as the deaths of nine mothers. Image source, Family handoutImage caption, The 11-year-old is now living with multiple severe health problemsAdam, from Newport, Shropshire, was born nearly 35 hours after his mother's waters broke in the afternoon of 24 March 2011.In the hours that followed, he began to show signs of early onset GBS including struggling to feed, crying and grunting.After weeks in intensive care, he was finally diagnosed with the infection and meningitis.Image source, Family handoutImage caption, Hours after being born at Shrewsbury Hospital, Adam began to show signs of Group B Strep infectionAdam is living with multiple conditions including hearing and visual impairments, autism, severe learning difficulties and behavioural problems so he relies on others to care for him.His mum, the Reverend Charlotte Cheshire, said she had expressed concerns about bright green discharge at one of her last antenatal appointments but no action was taken."From that point I just had a mother's instinct something wasn't right but I was reassured by the midwives so many times that everything was OK," the 45-year-old said."At no point in my pregnancy or in the hours after Adam was born was I told about Group B Strep."Image source, Family handoutImage caption, The High Court has approved a compensation payment to Adam's familyThe case was presented before the High Court which approved a liability agreement and an interim payment to compensate the family, although the amount is yet to be determined.Mrs Cheshire added: "While Adam is adorable and I am so thankful to have him in my life, it's difficult not to think how things could have turned out differently for him if he'd received the care he should have. "Adam will never live an independent life and will need lifelong care. While I'm devoted to him, I'm now raising a severely disabled son, which is extremely challenging and has changed the path of both our lives forever."My motivation is to make sure his needs are met and cared for, that is primary. Secondly, we're trying to prevent any other family going through what I have gone through."Image source, PA MediaImage caption, The "level of harm" Adam, 11, went through at birth was "life changing", his mum saidMs Ockenden examined maternity practices at SaTH over 20 years and concluded her investigation last year.It revealed at least 201 babies may have survived if they had received better maternity care, including 131 stillbirths and 70 neonatal deaths.Nine mothers died due to major or significant concerns about their care and at least 94 children suffered avoidable harm - including cerebral palsy and hypoxic brain injuries - due poor maternity care.Jane Plumb MBE, chief executive of the charity Group B Strep Support, said: "It's devastating Adam did not get the care he needed at the time and that the severe disabilities he now lives with as a result of group B Strep meningitis could have and should have been prevented. "The UK falls behind so many countries by not offering GBS testing to pregnant women and people and too often not even telling them about GBS. This needs to change. Families deserve better."A trust spokesperson for The Shrewsbury and Telford Hospital NHS Trust said: "We are very sorry for the failings in the care provided to this family."Image source, Irwin MitchellImage caption, Sara Burns of Irwin Mitchell, Charlotte Cheshire and Jane Plumb are now campaigning to improve maternity safetyFollow BBC West Midlands on Facebook, Twitter and Instagram. Send your story ideas to: [email protected] Internet LinksThe BBC is not responsible for the content of external sites. | Disease Research |
For the past few years I have suffered terrible pain in my feet. When I stand up, it feels as though I am standing barefoot on a pebble beach. My doctor diagnosed neuropathy which – I am told – stems from spinal canal stenosis, which squashes the nerves. The specialist said nothing can be done. Is that true?Neuropathy means there is damage to the nerves in the body. This can be caused by certain medications, chemotherapy and diseases such as diabetes. The nerves can also get crushed or damaged due to injuries.Spinal canal stenosis develops when the space inside the backbone is very small, meaning the spinal nerves get squashed.Nerves are responsible for all of our sensations including pain, touch and temperature. Damage to these nerves will cause numbness, pins and needles, burning and a specific type of pain called neuropathic pain. Today's reader is asking Dr Ellie if they can do anything to help the terrible pain in their feet after they were diagnosed with neuropathy caused by spinal canal stenosis (stock photo)Problems can be diagnosed using a nerve conduction study. These check if the nerves are working properly.When neuropathy develops because of a physical problem like spinal canal stenosis, it can be difficult to treat. One option would be to control the pain using specifically designed painkillers, such as gabapentin, pregabalin and duloxetine.Alternative forms of pain relief, such as acupuncture, may help, too, and walking, stretching or swimming may ease the pressure on the nerves, reducing pain. Physiotherapists can recommend specific exercises.Depending on the severity of the condition, a specialist may recommend surgery to decompress the spine and ease pressure on the nerves.My 78-year-old husband started having problems with going to the toilet earlier this year. The GP did a PSA test, which came back normal. But a second test showed a higher PSA level and a consultant then diagnosed early prostate cancer. Six months have passed and we've heard nothing. I am worried that the disease will spread. Are my fears rational?No patient should be waiting six months for follow-up cancer care. In fact, most people diagnosed with cancer will begin treatment within two months.A detailed cancer treatment plan should be outlined by oncologists and surgeons and sent, in writing, to the patient's GP. It is perfectly reasonable to ask for an appointment with the GP to talk about cancer treatment and understand what is going on.For some prostate cancers the treatment is active surveillance. This means avoiding treatment for a cancer that doesn't need it – sparing patients unnecessary side effects. A reader is concerned after her 78-year-old husband was diagnosed with prostate cancer and has had to wait six months for a follow-up appointment (stock photo)Prostate cancer can grow very slowly and, for some men, will cause no problems or symptoms. This is why monitoring the disease using scans, PSA tests and biopsies are sometimes the best options.If concerning test results come up, surgery or radiotherapy can be offered quickly.It is important that big gaps between appointments are explained properly to the patient so it would be worth talking through the letters you've had from the specialist team with the GP.If the plan is unclear, you can request to talk to the specialist and ask questions about your treatment. The Patient Advice and Liaison Service (PALS) is available in all hospitals, and offers support for patients.Another option would be to contact the charity Prostate Cancer UK on 0800 074 8383 – they have specialist nurses who offer advice.I've lately begun to notice that my fingers are very stiff. The first finger on my right hand is particularly bad, it keeps getting stuck. Last year I was diagnosed with osteopenia in my legs – could my new problem be related to this, or is it just arthritis?There are many different forms of arthritis. The type that people tend to get in old age is osteoarthritis. It causes the joints to become painful and stiff and happens as a result of wear and tear over time.Other types of arthritis include rheumatoid arthritis, gout and arthritis associated with psoriasis. More from Dr Ellie Cannon for The Mail on Sunday... DR ELLIE CANNON: Have blood pressure pills caused my recent spate of awful falls? 14/01/23 DR ELLIE CANNON: I quit smoking cigarettes three years ago but now I have emphysema... Will it get worse? 31/12/22 DR ELLIE CANNON: I have been told I have gallstones. So why am I not being treated? 17/12/22 DR ELLIE CANNON: My grandfather was hit by prostate cancer so should I get tested at age 63 and should I go private? 10/12/22 DR ELLIE CANNON: Should I try nappy ointment to soothe my itchy red skin? 03/12/22 DR ELLIE CANNON: I'm on pills to thin my blood, so is it risky to have a tooth out? 26/11/22 DR ELLIE CANNON: If lotions and pills won't ease my really itchy skin, what will? 19/11/22 DR ELLIE CANNON: Does my clotting condition mean I cannot go on HRT? 12/11/22 DR ELLIE CANNON: How can I avoid the big purple bruises all over my arms? 05/11/22 VIEW FULL ARCHIVE Of course, some joint problems are not arthritis at all.Osteopenia, which is when the bones get thinner but not enough to warrant a diagnosis of osteoporosis, can sometimes be related to arthritis.It isn't uncommon for the two conditions to develop at the same time, in the same person.If a finger feels like it's getting 'stuck', the cause may be a condition called trigger finger. This is in fact a problem with the tendons, rather than the joints.It makes the finger difficult to move when a tendon gets swollen and causes pain, stiffness and clicking. Patients usually find that their symptoms are worse in the morning.Trigger finger is more common in older people and seems to affect women more than men, as well as those with diabetes, rheumatoid arthritis or gout.GPs can spot both trigger finger and signs of arthritis during a simple examination.It might be worth having an X-ray or another scan of the joints, and investigating physiotherapy which can be useful for both these problems.Beware of menopause fear-mongering, Linda BarkerThe former Changing Rooms presenter Linda Barker is the latest celebrity to launch a menopause awareness campaign and monetise it. This one's called Changing Wombs – very clever – sponsored by feminine hygiene brand Essity.There was an accompanying video in which Linda, 61, told her 30-year-old daughter Jessica that the menopause hit her 'like a freight train', that she suffered sleeplessness and hot flushes for a decade and feared she would become 'invisible' in mid-life.Well, she certainly hasn't – and I'm sorry that she struggled. I hope she had support. Former Changing Rooms presenter Linda Barker (left), 61, told her 30-year-old daughter Jessica (right) that the menopause hit her 'like a freight train'The menopause isn't anything to hide or be ashamed of, and I welcome the new openness about it. But fear-mongering is not the way to garner awareness.The Royal College of Obstetricians and Gynaecologists says women's experience of the menopause can vary hugely.Each woman will have her own emotional and physical response to the changes.Young women also need to know that many of them will have an uncomplicated menopause that they'll barely notice, and they'll often feel liberated by not having to worry any longer about periods, cramps and mood swings.Videos to trust on Dr YouTubeI usually warn against using social media for health advice. But I have discovered YouTube can be surprisingly useful.I was invited to a YouTube event a few days ago which showcased its health content, and I was surprised by what I saw. 'I usually warn against using social media for health advice. But I have discovered YouTube can be surprisingly useful,' writes Dr Ellie CannonIt seems plenty of reliable organisations are publishing credible information on the video-sharing site – including the NHS, GP practices and leading specialist hospitals.Even some top doctors are sharing valuable stuff, and the videos are a lot more engaging than the leaflets you find in the GP's waiting room.But if you do dabble, keep an eye out for accounts given a big green tick by the online watchdog Patient Information Forum (PIF).The tick is its quality mark for credible healthcare information, and you can find a full list on its website at pifonline.org.uk. | Disease Research |
Archaeologists in Spain have unearthed a battered Roman-era skull that bears scars of violent trauma and may harbor signs of a brain tumor. However, not everyone is convinced that this battle-scarred man had a tumor, with one expert telling Live Science the findings are ambiguous.
The skull, discovered in 2019 during a caving expedition to the Sima de Marcenejas in northern Spain, dates to between A.D. 258 and 409 and belonged to a man who was likely between 30 and 40 years old when he died, possibly only decades before the fall of the Western Roman Empire.
The outside of the skull harbored three lesions, which formed before he died and were probably caused by one or more violent attacks. The other was on the inside and may have been the result of a common type of brain tumor called a meningioma, which would make it the first known case in an archaeological specimen found in the Iberian Peninsula.
"What is interesting about this finding is that it offers a window onto the health of past populations, and raises fundamental questions for us about the ability of individuals to survive these conditions, and their quality of life thereafter," lead author Daniel Rodríguez-Iglesias, an archaeologist at the Spanish National Research Center for Human Evolution (CENIEH), said in a statement.
The authors used micro-computed tomography (microCT) to build a 3D model of the inside and outside of the skull. The surface lesions ranged from 0.29 to 0.7 inch (0.7 to 1.8 centimeters) long and 0.04 to 0.59 inch (0.1 to 1.5 cm) wide. The lesions were on the top of the head, suggesting violent trauma rather than an accidental fall.
The inside lesion, however, could have been a meningioma, the authors hypothesized. They compared the lesion with a modern meningioma in a 42-year-old woman and found that the historical lesion was similar in location, size and shape. They ruled out causes such as metabolic or infectious disease because there was only one internal lesion and no signs of tissue thickening between the two layers of bone in the skull.
But not everyone is convinced that the internal lesion is a brain tumor.
"In contrast to the traumatic lesions on the ectocranial [outside] surface, which are quite clear, the lesion interpreted as caused by a possible meningioma is quite ambiguous," Christian Meyer, head of OsteoARC in Germany, who was not involved in the study, told Live Science in an email.
The authors acknowledged the uncertainty in their hypothesis. "The differential diagnosis of tumors remains one of the most challenging aspects of paleopathology," they wrote in the paper. Follow-up analysis could clear up the picture.
The findings were published July 28 in the journal Virtual Archaeology Review.
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Emily is a health news writer based in London, United Kingdom. She holds a bachelor's degree in biology from Durham University and a master's degree in clinical and therapeutic neuroscience from Oxford University. She has worked in science communication, medical writing and as a local news reporter while undertaking journalism training. In 2018, she was named one of MHP Communications' 30 journalists to watch under 30. ([email protected]) | Disease Research |
Don’t believe drug companies: 340B is a program worth saving
Its criticisms apply a familiar formula. They begin by presenting drug company-funded research as if it were not biased. Next, they use misleading statistics to accuse safety-net providers of abusing the program. After that, offer false concerns about wanting to protect medically underserved patients.
Then they go even further, blaming nonprofits for the 340B savings siphoned off by pharmacy benefit managers. They finish it all off by sprinkling in quotes from activists who have direct relationships with drug companies or organizations that have represented them. And voila, you have a smear with the veneer of legitimacy.
All of the drug industry’s criticisms and so-called 340B “reform proposals” culminate in one goal, which is to limit the number of prescriptions available at 340B prices. This would inevitably prioritize drugmaker balance sheets over the clinical outcomes of vulnerable Americans.
The AIDS Healthcare Foundation (AHF), where I am the national director of advocacy, is the nation’s largest nonprofit focusing on the health and well-being of people living with HIV. Currently, we have over 100,000 patients in care. As a federal grantee of the Ryan White HIV/AIDS Program, we use the 340B program just as Congress intended — to stretch scarce federal resources in a way that reaches more patients with more comprehensive services.
In many cases, AHF is our patients’ primary care provider. Contrary to claims made by 340B critics, we are not sitting on record-breaking profits. Unlike drug companies, we are not focused on turning a profit.
Even more importantly, unlike federal healthcare entitlement programs, AHF’s use of 340B does not cost American taxpayers a single dime.
Nonprofits like AHF reinvest the savings from 340B drug discount purchases into our healthcare mission. None of the margin achieved from the savings ends up in the pockets of corporate executives or in dividend checks to shareholders. And, without organizations like ours, medically underserved patients would be thrown onto Medicaid and Medicare rolls, actually burdening American taxpayers.
Nor is the program out of control. The Department of Health and Human Services regularly audits grantees, ensuring that 340B savings benefit patients.
A Berkeley Research Group study cited in the op-ed points the finger at grantees for runaway program growth. The author of the op-ed, however, fails to mention that Gilead Sciences paid for the study to bolster the drugmaker’s apparent goal, which is to dismantle 340B.
Research in the op-ed deploys a statistic about wholesale acquisition cost drug prices to exaggerate the size of 340B. Wholesale Acquisition Cost prices, set by drug companies, have no relevance to quantifying actual drug expenditures, let alone 340B drug prices.
Wholesale Acquisition Cost prices occur pre-rebate and prior to price negotiations between drugmakers and buyers — the pharmacy benefit managers, federal payers and commercial health insurers — in the prescription drug supply chain. These prices have as much relevance as sticker prices for new cars. Irrespective of insurance status, no patient pays retail drug prices. No private or public sector entity pays list prices either. Thus, it is misleading to claim grantees generate a 73 percent margin from 340B purchases.
Drugmakers voluntarily entered into an agreement that extends discount prices to 340B providers. Why? Was it out of beneficence and concern for low-income patients that could never afford their overpriced products? Hardly. In return, drug companies gain access to the much larger and more lucrative prescription Medicaid and Medicare drug markets.
Ignore public discourse about contract pharmacy agreements. The number of such arrangements is meaningless, since doctors do not prescribe more medicine because nonprofits and the patients they serve have more places to fill prescriptions. Yet drug companies aim to restrict contract pharmacy agreements because fewer sites translate to reduced access points for prescriptions at 340B prices.
The real fight over contract pharmacies is between drug manufacturers and pharmacy benefit managers. As for-profit healthcare industry combatants fight over prescription payments and reimbursements, the only casualties are underinsured and uninsured patients. Grantees without in-house pharmacies are forced to fill prescriptions at pharmacy benefit manager-preferred pharmacies, stealing 340B savings that Congress intended for safety-net providers.
Remember: The 340B Drug Pricing Program costs the American taxpayer nothing. Program funding comes from drug company profits.
Grantees such as AHF just want to care for vulnerable Americans without interference from drug companies and pharmacy benefit managers seeking 340B savings for themselves.
John Hassell serves as national director of advocacy at AIDS Healthcare Foundation.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Health Policy |
As the number of cannabis-friendly states across the U.S. has grown, so, too, has the drug's usage among American workers.
An annual analysis from Quest Diagnostics medical lab and testing company shows the percentage of general U.S. employees, who tested positive for cannabis in 2022 reached the highest level ever recorded by Quest, which began analyzing annual workplace drug testing data in 1988.
Of the more than 6 million urine tests Quest analyzed in 2022 for marijuana use in the general worker category — which excludes federally mandated, safety-sensitive workers such as pilots, truck drivers who undergo routine drug testing — 4.3% were positive, up from 3.9% in 2021. That marks the highest number of positive test results for marijuana ever recorded by Quest, which began analyzing annual workplace drug testing data in 1988. The number of general workers who tested positive for marijuana following an on-the-job accident in 2022 was 7.3%, compared with 6.7% in 2021 — the highest level in 25 years.
"This historic rise seems to correspond with sharp increases in positivity for marijuana in both pre-employment and post-accident drug tests, suggesting that changing societal attitudes about marijuana may be impacting workplace behaviors," Keith Ward, general manager and vice president for employer solutions at Quest Diagnostics, said in a statement.
More workers in federally mandated safety-sensitive jobs also tested positive for marijuana usage. Within this group, .98% tested positive for cannabis nationally, compared with 0.86% in 2021.
Increased legalization, increased use
"In the general U.S. workforce, states that have legalized recreational and medical marijuana use exhibit higher positivity rates than the national average. States that have not legalized marijuana appear to have positivity rates below the national averages," said Suhash Harwani, Ph.D, who is the senior director of science for employer solutions at Quest Diagnostics.
In states where recreational use of marijuana is legal, 5.7% of the general U.S. workforce tested positive for marijuana in 2022, versus the 4.3% national average that same year. Marijuana positivity among the general workforce in states where medical marijuana is legal was below the national average, at 3.9% in 2022.
Cannabis first became legal for recreational use at the state level in Washington and Colorado in 2012. Since then, 21 states and the District of Columbia have legalized recreational marijuana, the National Conference of State Legislatures reports. Medicinal cannabis is also currently legal in 38 U.S. states plus the District of Columbia.
The weed industry's massive push to ramp up its lobbying efforts over the past decade has powered the breakneck pace at which states have legalized cannabis. In 2022, the cannabis industry spent more than $5 million to fund its lobbying efforts in Washington D.C., up from just $35,000 in 2011, disclosures from OpenSecrets show.
Other drugs in the workplace
Despite a notable uptick in workers' marijuana use, overall drug use among all categories of U.S. employees was unchanged at 4.6% in 2022, Quest data shows. However, the 2021 and 2022 positivity rates are the highest since 2001. Amphetamine use rose one-fifth of a percentage point to 1.5% from 2021 to 2022, with the highest increase found among employees in the Education Services, at 2.1%.
Quest's testing does not differentiate between legally prescribed amphetamines, such as Adderall, and illicit formulations and illegal uses of that particular class of drugs.
"The increase in amphetamines positivity is also notable, given the addictive potential and health risks associated with this class of drugs," Ward said.
Drug-Screening Drop Off
In recent years, drug screening has become less popular among some American employers.
A Bureau of Labor Statistics survey of roughly 80,000 private-sector employers shows 16.1% of respondents reported testing their employees for drugs in 2021, down from 30% in 1996.
for more features. | Drug Discoveries |
Whether enjoyed in a latte, Americano, or even a martini, espresso coffee provides an ultra-concentrated jolt of caffeine. But it might do even more for one’s alertness over the long run, according to new research.
In vitro laboratory tests shows espresso compounds can inhibit tau protein aggregation, which is one of the processes believed to be involved in the onset of Alzheimer’s disease.
Although the exact mechanisms that cause dementia are still unclear, a protein called tau plays a significant role. In healthy people, tau proteins help stabilize structures in the brain, but when certain diseases develop, the proteins can clump together into fibrils.
Scientists believe the ‘tangles’ are one of the key causes of dementia – slowing thinking and memory skills.
Some researchers propose that preventing this aggregation could alleviate symptoms. So, Mariapina D’Onofrio and colleagues at Verona University in Italy—where they drink a lot of espresso—wanted to see if compounds in the coffee could prevent tau clumping in lab experiments.
The researchers pulled espresso shots from store-bought beans, then characterized their chemical makeup using nuclear magnetic resonance spectroscopy. They chose caffeine and trigonelline, both alkaloids, along with the flavonoid ‘genistein’ and ‘theobromine’—a compound also found in chocolate—to focus on in further experiments.
These molecules individually, along with the full espresso extract, were incubated alongside a shortened form of the tau protein for up to 40 hours. As the concentration of espresso extract, caffeine or genistein increased, fibrils were shorter and didn’t form larger sheets, with the complete extract showing the most dramatic results.
Shortened fibrils were found to be non-toxic to cells, and they did not act as “seeds” for further clumping.
In other experiments, the researchers observed that both caffeine and the espresso extract could bind pre-formed tau fibrils.
Italians knock back some 30 million espressos each day in little cups, and multiple studies in the last decade showed that the drink could have beneficial effects thanks to its antioxidants and plant chemicals which dampen inflammation.
Prof D’Onofrio said: “Coffee extracts contain a large variety of bioactive compounds exhibiting health-beneficial effects. We were able to identify the most abundant constituents.
“We have presented a large body of evidence that espresso coffee is a source of natural compounds showing beneficial properties in ameliorating tau-related pathologies.”
Although much more research is needed, the team, which published their results in the American Chemical Society’s Journal of Agricultural and Food Chemistry, says that their preliminary in vitro findings could pave the way toward designing bioactive compounds that could protect against neurodegenerative diseases, including Alzheimer’s.
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Having had one normal pregnancy, Emma Bailey assumed that her second experience of childbirth would progress relatively smoothly. But, at 34 weeks, she began to suffer sudden bursts of stabbing pain just underneath her ribcage.
“It was really excruciating pain,” she remembers. “I was admitted to hospital, but they sent me home, saying it was probably just anxiety. I then had to be readmitted the very next day because I was in agony.”
The pain she was experiencing is a known indication of one of the most serious forms of pre-eclampsia, a pregnancy complication that causes dangerously high blood pressure levels. In rare cases, it can initiate a liver and blood-clotting disorder called HELLP syndrome, which can be fatal to mother and baby.
Yet rather than initiating the only known form of treatment – delivering the baby as soon as possible – consultants at Broomfield hospital in Chelmsford, Essex, seemed to be unaware of the danger she was in.
“I was in hospital for four days, undergoing tests and seeing various consultants, all while being given strong pain relief for the rib pain, which no one could explain to me,” says Bailey. “By the time they acted, I was on the floor because my liver had ruptured and I was bleeding out. They rushed me in to do an emergency caesarean, but it wasn’t in time to save my daughter.”
Named Mia, she died two days later, while Bailey had to be placed in an induced coma, before enduring many weeks in intensive care while her liver healed.
“I survived but I very nearly didn’t,” she says. “It’s horrible to talk about, but I feel I need to raise awareness to stop this happening to other women.”
For while pre-eclampsia affects up to 6% of all pregnancies and causes approximately 500,000 foetal deaths and 70,000 maternal deaths worldwide each year, mostly in low- and middle-income nations, our understanding of why pre-eclampsia occurs, and how to treat it, is still rudimentary.
While routine blood pressure monitoring during pregnancy has helped reduce maternal deaths from pre-eclampsia in the UK, they still occur. According to the latest MBRRACE (Mothers and Babies: Reducing Risk Through Audit and Confidential Enquiries) report for 2019-21, produced by Oxford University’s national perinatal epidemiology unit, the number of women dying in childbirth, or in the six weeks after pregnancy, has risen by 15% in the UK in the past decade. Nine women died from pre-eclampsia during the three years covered by the report, all of which are likely to have been preventable deaths.
“The two major causes of death in pre-eclampsia are stroke and prolonged fitting,” says Ian Wilkinson, clinical pharmacologist and professor of therapeutics at Cambridge University. “What happens in pre-eclampsia is that blood pressure goes up but the capillaries become leaky, which leads to a bleed in the brain and a stroke. Or the brain becomes very irritated [inflamed] and women start to fit. But when you go through the cases where women have died, it’s often that they either haven’t realised that symptoms like a severe headache are a sign of an emergency, or the people looking after them haven’t monitored them as well as they should do.”
But deaths from pre-eclampsia are the tip of the iceberg when it comes to its overall impact. Women who experience the condition during pregnancy have a 20-fold greater risk of developing permanent high blood pressure compared with those who have no pregnancy complications at all. As a result, they have a two to threefold greater risk of a stroke or heart attack later in life.
Pre-eclampsia also appears to affect the biology of the developing baby such that those children are more likely to be born with congenital heart disease and kidney disorders and are at a greater risk of experiencing problems with blood pressure and related cardiovascular conditions throughout their lives.
But scientists are hoping that new studies will yield insights that can improve our ability to identify women most at risk and target treatments towards them.
Lack of awareness
The recommendation from the National Institute for Health and Care Excellence is that women perceived to be at high risk of pre-eclampsia should receive a daily 75-150mg dose of aspirin from 12 weeks of pregnancy until birth.
While this is not a cure, numerous studies have suggested aspirin can help by suppressing the production of various hormones thought to be involved in the development of the condition. However, it appears that many women who could benefit from aspirin treatment are not getting it.
“If it’s your first pregnancy and you’re over the age of 40, you’re meant to be on aspirin,” says Andrew Shennan, professor of obstetrics at King’s College London, who is based at St Thomas’ hospital. “That’s a lot of women, but worryingly there are many who will not get it, and it’s not even discussed with them. We looked back recently at our hospital, and only one in five of the women who should have received aspirin were getting it. So that’s a bit of a shocker and we probably need to do something about it.”
When it comes to assessing pre-eclampsia risk, the picture is complex, and Shennan suggests that there is still a lack of awareness among healthcare professionals regarding who is most likely to be vulnerable. Women with existing autoimmune conditions or diabetes, a body mass index greater than 35, a history of previous pregnancy complications or a family history of pre-eclampsia, and those expecting multiple babies are all more susceptible. Population studies in the UK have also shown that the condition disproportionally affects black women and those from Asian backgrounds.
Because pre-eclampsia is thought to be linked to poor blood vessel formation in the placenta, a new blood test, known as placental growth factor testing, is now available on the NHS. This is thought to be a reliable way of assessing which pregnant women have the condition, but many experts believe there is a need to intervene sooner.
At Addenbrooke’s hospital in Cambridge, Wilkinson and obstetric medicine registrar Bernadette Jenner are recruiting first-time mums-to-be for a new Wellcome-funded clinical trial called Poppy (preconception to post-partum study of cardiometabolic health in primigravid pregnancy). The aim is to follow the women before, during and after their pregnancy, and conduct repeated tests to assess their blood vessel and heart health.
The hope is that this will uncover new clues that can be used to more accurately pinpoint women with underlying vulnerabilities relating to placental health and long-term cardiovascular risk, making them more likely to develop pre-eclampsia. “I hope it will lead to a better way of predicting the women who develop pre-eclampsia,” says Jenner. “Then we can better target interventions towards them.”
The need for effective treatments
But while identifying at-risk women at an earlier stage will represent a step forward, outcomes will only truly improve if there are more therapies available to treat pre-eclampsia. Apart from low-dose aspirin, the only option available to doctors is to monitor the condition and, if necessary, deliver the baby prematurely, something that is associated with a large number of adverse health outcomes.
Babies born even a few weeks early are more likely to experience long-term social and emotional difficulties, while being born before 34 weeks can lead to complications such as cerebral palsy, visual and hearing problems, and reduced intelligence. “The fact that a baby needs to be born early to cure the problem is a big issue,” says Shennan. “Being born early has a major impact on the body.”
In the wake of the thalidomide scandal in the 1950s and 1960s, which resulted in more than 10,000 babies worldwide being born with severe defects, drug developers have largely shied away from developing novel treatments aimed at pregnant women. As a result, Wilkinson says that most clinical trials have focused on supplementation either with various vitamins and minerals or pills such as aspirin that have a very well-known safety profile.
Shireen Meher, a consultant in maternal foetal medicine at Birmingham Women’s and Children’s NHS foundation trust, is interested in whether high-dose calcium supplementation can help prevent pre-eclampsia or lessen its severity. She points to one review of eight clinical trials, involving a total of more than 10,000 women on low-calcium diets, which showed that a high dose of mineral supplementation reduced pre-eclampsia risk by about 36%. However, the quality of this data was considered relatively low because of significant variations in the underlying risk of pre-eclampsia in the women who participated in the trials, meaning that more evidence is needed.
“It’s thought that low calcium might raise blood pressure by triggering the release of some hormones in the blood such as the parathyroid hormone and renin,” says Meher. “The thinking is that giving calcium supplements might reduce this hormone release and prevent the constriction of blood vessels, which leads to hypertension.”
While existing data suggests that calcium supplementation is only beneficial for women who do not get adequate dietary calcium, Meher believes that more women in the UK could be deficient in the mineral than previously thought.
She is in the process of recruiting 7,756 pregnant women believed to have an elevated risk of pre-eclampsia as part of a Birmingham University trial called CaPE (calcium supplementation for prevention of pre-eclampsia in high-risk women). The aim is to see whether taking 2g calcium daily throughout pregnancy could lower their risk. “We’ve done a baseline survey with some of the women we’ve recruited so far and many of them don’t have adequate calcium in their diet,” she says, “If it works, calcium is a very attractive intervention – it’s cheap, easily available and as far as we know, there are no safety concerns.”
However, Shennan believes that there is also a need for more robust treatments to address some of the elements of the disease process, suggesting that the messenger RNA technology used in Covid-19 vaccines and emerging cancer therapies may have a role to play.
“Using this, you can perhaps suppress certain chemicals that are thought to be fundamental to the disease process,” he says. “These are blood markers which are measures of how the placenta is working, and there’s some suggestion that by suppressing them, you might be able to ameliorate the problem or at least extend the period before people get sick. It’s still in early phases but big organisations like the Gates Foundation are interested in this, a kind of infusion that would actually treat pre-eclampsia.”
For Bailey, the main hope is that more can be done to raise awareness within the healthcare system of how dangerous pre-eclampsia can be, particularly if the signs are not spotted and monitored early enough.
Along with her husband Grant, she sued Broomfield hospital after her experience and they settled out of court. She gave birth to a healthy daughter, Grace, in 2021.
“After Mia’s death, I had to wait for my liver to fully repair. And then, a year and a bit later, I fell pregnant again,” she says. “It was a nerve-racking nine months but we had a really good specialist this time at St Thomas’ hospital, who went through all the ways they were going to try and stop it happening, such as giving me aspirin throughout the pregnancy, and I had no complications, thankfully.
“So now we just want to raise awareness of the symptoms, to prevent other families losing their children.”
If you are planning your first pregnancy, you can find out more about the Poppy study here | Women’s Health |
Oct. 26, 2023 â Companies marketing expensive and unproven stem cell therapies are targeting patients with long COVID â an often debilitating condition that to date has no proven treatments, according to a report published today.
Researchers identified 38 direct-to-consumer businesses selling purported stem cell therapies to prevent and treat the virus â 36 of which also claim to treat post-COVID syndrome.Â
âThere's an important opportunity here for regulators to understand there are still quite a number of businesses making problematic advertising claims,â said Leigh Turner, PhD, the first author of a study on the issue and a bioethics professor at the University of California, Irvine Department of Health, Society, and Behavior. âI don't think this is going to go away anytime soon. It needs to be a high priority.â
Stem cells, sometimes called the bodyâs âmaster cells,â can generate new cell types â something no other cell in the body can do. And while they have the potential to repair and regenerate cells, these therapies have not been approved by regulatory bodies and are not backed by convincing safety and efficacy data.Â
The FDAÂ issued a warning in 2019Â against stem cell therapies to treat COVID-19.
Of the 60 clinics operated by these businesses, 24 are based in the U.S. and 22 are in Mexico, with other clinics in the Cayman Islands, Guatemala, Malaysia, Panama, the Philippines, Poland, Spain, Thailand, Ukraine, and the United Arab Emirates.
âIt was interesting to me the extent to which these were businesses operating in the U.S., not in far-flung places,â Turner said.
According to the report, clinics charge anywhere from $2,950 to $25,000 for stem cell products.
Many people with long COVID deal with symptoms such as brain fog, extreme fatigue, and severe headaches that linger for months or even years. One in 10 people with the virus will get post-COVID syndrome. The severity of the symptoms, and the lack of treatments, make patients particularly vulnerable to false claims, said Kristin Englund, MD, an infectious disease specialist who runs the Cleveland Clinicâs reCOVer clinic for long COVID patients.
Englund said several patients have asked about stem cell therapies, and she warns them that there could be potential side effects without much, if any, benefit. Companies often try to claim a medical benefit without scientific evidence and without being recognized by a regulatory agency, she said.
âWhen you work with this population, you see how desperate they can get to return to the lives they lived pre-COVID,â she said. âSome of the patients we're seeing, they've been going on 3 years with these symptoms. At this time, there is no single diagnosis, no single treatment, and that is tremendously frustrating for patients.â
Julia Moore Vogel, PhD, a computational biologist and researcher at Scripps Research, has seen this problem through both a patient and scientist lens. Before catching the virus in July 2020, the 38-year-old was a long-distance runner. Now, after dealing with long COVID for 3 years, she counts her steps so she doesn't get too tired.
And while she has tried potential low-risk therapies like supplements â which didn't work for her â she would not use stem cell therapies, given the lack of solid research.Â
âI of course remember, in school, stem cell therapies being something that was very much an area of interest,â she said. âI would just really need to see the data before I could feel confident about trying it.â
Though the National Institutes of Health has launched multiple clinical trials focused on treating long COVID, and the FDA has authorized several stem cell clinical trials for long COVID, there is still much to learn about post-viral syndromes in general, said Michael R. Jordan, MD, an infectious disease doctor at Tufts University in Medford, MA.
âThere are a number of observational cohort studies and clinical trials in progress to assess various treatments for long COVID,â he said. âBut what is important is there is no proven treatment at this point, and recommendations are for patients to work with licensed qualified and experienced health care providers for symptom management.â | Medical Innovations |
Two experts see major challenges facing the adoption of new obesity drugs.
Dr. Kavita Patel, a physician and NBC News medical contributor, believes fresh data from Novo Nordisk on Ozempic's ability to delay the progression of chronic kidney disease is among the strongest supporting evidence for secondary uses of the drug.
However, she considers data supporting the use of obesity drugs for other conditions including Alzheimer's and alcohol addiction as underdeveloped.
"Those trials … are nowhere near as robust as the data we have on [Novo Nordisk trial] FLOW, on sleep apnea, cardiovascular risks, on diabetes control — double-blind placebo, randomized controlled trials that are incredible," she told CNBC's "Fast Money" on Wednesday. "We have a long way to go for that. I've seen a lot of miracle drugs before."
Novo Nordisk halted FLOW on Tuesday. According to the company's press release, it happened more than a year after an interim analysis showed that Ozempic could treat chronic kidney disease in Type 2 diabetic patients.
As of Friday's close, Novo Nordisk is up 9.82% since its announcement. Its obesity drug maker competitor Eli Lilly is up 5.16% in the same period.
Patel believes efficacy is just one of the major hurdles the medication needs to clear before it can be approved for uses outside of diabetes management.
"We know this drug works really well in diabetics. But there are so many barriers to getting there —including cost, adherence, prescriber rate," said Patel, who also served as a White House Health Policy Director under President Obama.
Patients opting to use GLP-1 drugs — a group of medications initially designed to control diabetes — for weight management often must pay out-of-pocket.
"Right now, we are seeing active employers, entire states that are declining to cover on the weight loss indication," Patel said.
If the U.S. Food and Drug Administration approves Ozempic for use in Type 2 diabetics with chronic kidney disease, which Patel believes will happen, it could force the hand of insurance companies to expand their coverage of the drug.
"We'll see a final package of data that will just be so compelling, that it would be wrong not to cover this, because it should be superior to what we have available to us," she noted. "That is something that I think the insurance companies will have a difficult time [with]."
Mizuho Health Care Sector Strategist Jared Holz also expects challenges related to insurance coverage as more patients begin taking GLP-1 drugs, which could limit overall adoption.
"The payers, at some point, are going to be saying, 'We get it, but we cannot pay for these at this volume without seeing the benefit, which may be 10 years from now, 20 years from now, 30.' We have no idea when the offset is going to be," he also told CNBC's "Fast Money."
Holz also pointed out the divide emerging in the health care sector between Novo Nordisk, Eli Lilly and their pharmaceutical peers.
"We haven't seen this kind of valuation disconnect between the peer group, maybe in the history of the sector," he said.
The growth trend may not be sustainable for Novo Nordisk and Eli Lilly, based on current supply constraints that have left patients unable to secure dosages.
"The companies can't make enough, I don't think, to actually put out revenue that's going to appease investors, given where the stocks are trading," said Holz.
A Novo Nordisk spokesperson did not offer a comment due to the company's quiet period ahead of earnings. Eli Lilly did not immediately respond to a request for comment. | Drug Discoveries |
New analysis of pilot studies on night shift naps conducted from 2012 to 2018 revealed the ideal snoozing strategy that might help counteract drowsiness and fatigue during a 16-hour overnight duty. The findings can also benefit new parents.
Reanalysis of data showed that when staying up all night, scheduling two nap sessions -- a 90-minute one followed by a quick 30-minute shut-eye later -- is the optimal choice over a single 120-minute snooze in putting off drowsiness and fatigue. The study was published in the journal Scientific Reports.
"A 90-minute nap to maintain long-term performance and a 30-minute nap to maintain lower fatigue levels and fast reactions, as a strategic combination of naps, can be valuable for early morning work efficiency and safety," said study sole author Sanae Oriyama, a nursing science professor at Hiroshima University's Graduate School of Biomedical and Health Sciences.
Shift work is a norm in emergency sectors such as healthcare where round-the-clock access to services can be life-saving. And working double shifts on nontraditional hours isn't unheard of among medical professionals. However, night shift work is also known to increase the risk for sleep-related physical and mental health disorders and impair job performance.
During the daytime, our light-sensitive internal clock activates wakefulness. The opposite happens at nighttime when alertness dims as our biorhythm readies to switch off, elevating the likelihood of errors and accidents. In the medical field, this may inadvertently lead to serious harm to patients or to oneself. Naps are usually taken by shift workers to offset disruptions to the body clock.
In Japan, nurses are typically allowed to sleep up to two hours during 16-hour night shifts. Oriyama wanted to find out which napping schedule is the best in fighting off sleepiness and diminished cognitive function during such grueling work hours. And while at it, figure out how sleep quality factors in.
Single versus split naps
Oriyama reexamined past pilot studies she co-authored to compare alertness and cognitive performance after taking a nap and throughout a simulated 4 p.m. to 9 a.m. shift. The one-nap condition experiment was conducted in 2012, the two-nap in 2014, and the no-nap in 2018.
"I want to be able to combine multiple naps, depending on the type of work and time of day, and choose naps that are effective at reducing drowsiness, fatigue, and maintaining performance," she said.
She found that those who took a single 120-minute nap ending at midnight experienced worse drowsiness as soon as 4 a.m. and lasted until the end of the shift. However, participants who scheduled two naps -- the 90-minute one lasting until midnight and the 30-minute one ending at 3 a.m. -- staved off drowsiness until 6 a.m. Oriyama suggested adding an extra 30 minutes of shut-eye between 5-6 a.m. given that drowsiness might shoot up from 7-8 a.m.
As for fatigue, although all nap groups expressed significantly heightened levels of it from 4-9 a.m., the two-nap group experienced it at an intensity lower than the rest.
"During a night shift that, for example, lasts from 4 p.m. to 9 a.m. the next morning, a split nap of 90 minutes and 30 minutes, ending at 12 a.m. and 3 a.m., respectively, is thought to be more effective than a 120-minute monophasic nap ending at 12 a.m. when tasks requiring quick responses to maintain a high level of safety are scheduled between 2 a.m. and 9 a.m.," Oriyama said.
Finding the best nap length, timing
Both the single and split naps did not result in improved cognitive task performance. However, Oriyama noted that those who took longer to fall asleep during the 90-minute nap session showed poorer scores in the Uchida-Kraepelin test (UKT), a timed basic math exam meant to measure speed and accuracy in performing a task.
It takes 90 minutes to complete a full sleep cycle. And waking up before it is finished could exacerbate sleep inertia, the grogginess and disorientation felt upon first waking up. Similarly, the study found that if total sleep time is prolonged, fatigue and drowsiness could also increase.
Meanwhile, past research showed that a nap of 30 minutes or less could help boost vigilance, alertness, and energy levels.
The study also found that the timing of your nap plays a crucial role: the later you take it, the more potent it is in fending off sleepiness and exhaustion. However, delaying it too much could interfere with your focus as your sleep drive builds up.
"Hence, the ideal time for taking a nap and the ideal nap schedule during long night shifts need further elucidation," Oriyama said.
Beneficial for new parents, too
Oriyama said her findings could also be helpful to new parents.
"The results of this study can be applied not only to night shift workers but also to minimize sleep deprivation fatigue in mothers raising infants."
A total of 41 females in their 20s participated in the studies. Research participants were invited to a windowless and soundproofed laboratory for a 16-hour night shift simulation. The room temperature was kept at a comfortable 26 degrees Celsius and light intensity above work desks was set at 200 lux, the typical illuminance level in offices. All took the UKT each hour. Their hourly temperature, self-reported drowsiness and fatigue levels, heart rate, and blood pressure were also measured. After the tests, participants have free time to do anything they want on their desks like reading, drawing, or drinking water. During the scheduled nap time, they moved to a neighboring bedroom where they were allowed to darken the light according to their preference. Their sleep parameters were measured during this time.
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June 2, 2023 -- Anxiety, depression, and COVID-19 can be a bad combination for your brain -- and your long-term health.
Having anxiety and depression before a COVID infection increases the risk of developing long COVID, researchers have found.Â
Those with long COVID who develop anxiety and depression after an infection may have brain shrinkage in areas that regulate memory, emotion, and other functions as well as disruption of brain connectivity.Â
While many questions remain about these intertwined relationships, the associations arenât a complete surprise. Experts already know that depression and anxiety are associated with inflammation and immune dysfunction, perhaps helping to explain the link between these mental health conditions, the risk of long COVID, and the changes in the brain.
Brain changes accompanying a COVID infection have concerned researchers since earlier in the pandemic, when U.K. Biobank researchers found brain atrophy, loss of grey matter, and decline in cognition in those infected with COVID compared with those not infected.
Common Conditions
The ramifications of the research linking anxiety, depression and long COVID are far-reaching. According to the CDC, 12.5% of U.S. adults have regular feelings of anxiety (as well as nervousness and worry), and the latest Gallup Poll found that nearly 18% of adults currently have or are being treated for depression.Â
As of May 8, 10% of U.S. infected adults have long COVID, according to the CDC, and among U.S. adults ever infected, 27% have reported long COVID. Long COVID has been defined by the CDC as symptoms such as fatigue, brain fog, and cough that persist longer than 4 weeks and by the World Health Organization as symptoms persisting for 3 months or more.Â
Hereâs a roundup of what the research shows about mental health and long COVID risk â along with other research finding that paying attention to health habits may reduce that risk.Â
Pre-Existing Depression, Anxiety, and Long COVID Risk
A history of mental health issues -- including depression, anxiety, worry, perceived stress, and loneliness -- raises the risk of long COVID if infection occurs, Harvard researchers have found.
The researchers evaluated data from three large, ongoing studies including nearly 55,000 participants to determine the effects of high levels of psychological distress before a COVID infection.Â
âOur study was purely survey based,â said Siwen Wang, MD, the studyâs lead author and a research fellow at Harvardâs T.H. Chan School of Public Health at Harvard University.
At the start of the survey in April 2020, none of the participants reported a current or previous COVID infection. They answered surveys about psychological distress at the start of the study, at 6 monthly time points, then quarterly until November 2021.
Over the follow up, 3,193 people reported a positive COVID test and 43% of those, or 1,403, developed long COVID. That number may seem high, but 38% of the 55,000 were active health care workers. On the final questionnaire, they reported whether their symptoms persisted for 4 weeks or longer and thus had long COVID by the standard CDC definition.
Wangâs team then looked at the infected participantsâ psychological status. Anxiety raised the risk of long COVID by 42%, depression by 32%, worry about COVID by 37%, perceived stress, 46%, and loneliness, 32%.
COVID patients with a history of depression or anxiety are also more likely than others to report trouble with cognition in the weeks after a COVID infection and to develop brain fog and long COVID, UCLA researchers found. They evaluated 766 people with a confirmed COVID infection; 36% said their thinking was affected within 4 weeks of the infection. Those with anxiety and depression were more likely to report those difficulties.
Long COVID, Then Anxiety, Depression, Brain Changes
Even mild cases of COVID infection can lead to long COVID and brain changes in those who suffer anxiety or depression after the infection, according to Clarissa Yasuda, MD, PhD, assistant professor of neurology at the University of Campinas in Sao Paulo, Brazil. She has researched long COVIDâs effects on the brain, even as she is coping with being a long COVID patient.
In one of her studies, presented at the 2023 American Academy of Neurology meeting in April, she found brain changes in people with anxiety, depression, and COVID but not in those infected who did not have either mental health issue. She evaluated 254 people, median age 41, after about 82 days from their positive PCR test for COVID. Â Everyone completed a standard questionnaire for depression (the Beck Depression Inventory) and another for anxiety (the Beck Anxiety Inventory). She further divided them into two groups -- the 102 with symptoms and the 152 who had no symptoms of either depression or anxiety.Â
Brain scans showed those with COVID who also had anxiety and depression had shrinkage in the limbic area of the brain (which helps process emotion and memory), while those infected who didnât have anxiety or depression did not. The researchers then scanned the brains of 148 healthy people without COVID and found no shrinkage.
The atrophy, Yasuda said, âis not something you can see with your eyes. It was only detected with computer analysis. Visualization on an MRI is normal.â
The number of people in this study with mental health issues was surprisingly high, Yasuda said. âIt was intriguing for us that we noticed many individuals have both symptoms, anxiety and depression. We were not expecting it at that proportion.â
The researchers found a pattern of change not only in brain structure but in brain communication. They found those changes by using specialized software to analyze brain networks in some of the participants. Those with anxiety and depression had widespread functional changes in each of 12 networks tested. The participants without mental health symptoms showed changes in just 5 networks. These changes are enough to lead to problems with thinking skills and memory, Yasuda said.
Explaining the Links
Several ideas have been proposed to explain the link between psychological distress and long COVID risk, Wang said. âThe first and most mainstream mechanism for long COVID is chronic inflammation and immune dysregulation,â she said. âSeveral mental health conditions, such as anxiety and depression, are associated with inflammation and dysfunction and that might be the link between depression, anxiety, and long COVID.â
Another less mainstream hypothesis, she said, is that âthose with long COVID have more autoantibodies and they are more likely to have blood clotting issues. These have also been found in people with anxiety, depression, or other psychological distress.â
Other researchers are looking more broadly at how COVID infections affect the brain. When German researchers evaluated the brain and other body parts of 20 patients who died from non-COVID causes but had documented COVID infections, they found that 12 had accumulations of the SARS-CoV-2 spike protein in the brain tissue as well as the skull and meninges, the membranes that line the skull and spinal cord. Healthy controls did not.Â
The findings suggest the persistence of the spike protein may contribute to the long-term neurological symptoms of long COVID and may also lead to understanding of the molecular mechanisms as well as therapies for long COVID, the researchers said in their preprint report, which has not yet been peer-reviewed.Â
In another recent study, researchers from Hamburg, Germany, performed neuroimaging and neuropsychological assessments of 223 people who were not vaccinated and recovered from mild to moderate COVID infections, comparing them to 223 matched healthy controls who had the same testing. In those infected, they found alterations in the cerebral white matter but no worse cognitive function in the first year after recovering. They conclude that the infection triggers a prolonged neuroinflammatory response.Â
Can the brain changes reverse? âWe donât have an answer right now, but we are working on that,â Yasuda said. For now, she speculates about the return of brain volume: âI think for most it will. But I think we need to treat the symptoms. We canât disregard the symptoms of long COVID. People are suffering a lot, and this suffering is causing some brain damage.â
Lifestyle Habits and Risk of Long COVID
Meanwhile, healthy lifestyle habits in those infected can reduce the risk of long COVID, research by Wang and her colleagues found. They followed nearly 2,000 women with a positive COVID test over 19 months. Of these, 44%, or 871, developed long COVID. Compared with women who followed none of the healthy lifestyle habits evaluated, those with five to six of the habits had a 49% lower risk of long COVID.
The habits included: a healthy BMI (18.5 to 24.9), never smoking, at least 150 minutes weekly of moderate to vigorous physical activity, moderate alcohol intake (5-15 grams a day), high diet quality, and good sleep (7-9 hours nightly).
Long-Term SolutionsÂ
Yasuda hopes that mental health care â of those infected and those not â will be taken more seriously. In her commentary on her own long COVID experience, she wrote, in part: âI fear for the numerous survivors of COVID-19 who do not have access to medical attention for their post-COVID symptoms. ... The mental health system needs to become prepared to receive survivors with different neuropsychiatric symptoms, including anxiety and depression.â | Mental Health Treatments |
Conservative Rep. Dave Schweikert (R-AZ) has long wanted to tighten the U.S. government’s belt. But now, he has a novel idea on how to reduce the deficit: tightening the belts of Americans through Ozempic.
Schweikert wants to expand access to medications that have been shown to assist weight loss, with the rationale that these drugs like Ozempic, Wegovy, and Saxenda—known in the pharmaceutical world as “GLP-1 receptor agonists”—could improve health outcomes for Americans and therefore decrease long term health-care costs.
“Next year, one of the GLP-1s, the Ozempics, goes off-patent,” Schweikert said during a presentation to Four Peaks Young Republicans. “The price is gonna crash. What would happen if you took morbidly obese populations on Medicare, Medicaid, Indian Health Services, the VA and gave them access to it?”
“It’s not fat shaming; it’s actually fat loving,” Schweikert said. “We can love our brothers and sisters back to health.”
The drug with perhaps the most name recognition, Ozempic, took off on social media as influencers championed the drug as a weight-loss miracle. TikTok users have viewed the Ozempic hashtag 1.3 billion times. Similar drugs like Wegovy have also skyrocketed in popularity.
While social media users tout these drugs as weight-loss marvels, experts have warned that Ozempic’s side effects, which include malnutrition and gastrointestinal problems, aren’t as pleasant as Ozempic obsessives may present. Little is known about the long-term impact of the drug and other GLP-1s.
Ozempic was first developed and FDA-approved as a type 2 diabetes medication. Commercials for the medications used to tout that those taking the drug could experience some weight loss, and it didn’t take long for doctors to start prescribing Ozempic as an “off-label” weight loss medication. Another GLP-1, Wegovy, has the same active ingredient as Ozempic and was FDA-approved for chronic weight management for adults who are overweight.
Many private insurers do not cover drugs for weight loss, often making them prohibitively expensive. Medicare can cover medications for type 2 diabetes, but due to a 2003 law the program cannot cover drugs specifically used for weight loss.
Schweikert mentioned Ozempic by name during his presentation to Four Peaks Young Republicans but, during an interview last week, he emphasized to The Daily Beast that he sees the economic and health benefits of GLP-1 medications broadly.
“It’s more just the concept, what would happen if the most powerful thing you can do on U.S. debt—because debt’s out of control, we’re borrowing over $75,000 a second—is actually through health?” Schweikert asked.
(Schweikert, it should be noted, has had some budgeting problems of his own. His campaign committee agreed to a $125,000 fine for misusing donor money in February 2022.)
Schweikert’s proposal may sound goofy—particularly when there’s so little known about the long-term effects of these drugs—but there’s some wisdom in the idea that drugs like Ozempic could cut pounds and the national deficit. At least to some extent.
The Joint Economic Committee, of which Schweikert is the vice chair, released a report in July that addressed federal health-care spending and obesity. Committee economists project that between 2024 and 2033 government spending on obesity and obesity-related diseases will amount to $4.1 trillion.
“As I have long argued, demographics and disease are primary drivers of our debt,” Schweikert said in his portion of the report.
Expanding access to the GLP-1s, Schweikert told the Young Republicans, could bring “hundreds of millions of dollars of savings on the tax side.”
Schweikert isn’t the only person thinking about Ozempic’s downstream effects. Airlines recently noted that passengers losing weight would require planes to use less fuel, which in turn could save each airline tens of millions.
“It picks up productivity,” Schweikert said of these drugs during his presentation to the Four Peaks Young Republicans. “Populations can participate in the economy.”
But Schweikert, a lean House Freedom Caucus member who represents parts of Scottsdale and Fountain Hills, Arizona, may be overstating exactly how much these drugs could help Americans balance lower numbers on the scale—and the government balance the budget.
An October Congressional Budget Office article cast doubt on the idea that expanding Medicare coverage to GLP-1s for weight loss would bring down the national debt at the moment.
The budgetary effect of Medicare covering anti-obesity medications would depend on drug costs at the time. At current prices, which can come to over $1,000 a month, the CBO assessed that Medicare coverage of drugs like Ozempic for weight loss would “increase overall federal spending.”
The CBO acknowledged that greater use of the medications could improve patient health and reduce the use of other health-care products and services, which could, in turn, lower federal spending on other forms of health care. But the overall effect would depend on the cost of the medications.
“They're very expensive,” Josh Gordon, director of health policy at the Committee for a Responsible Federal Budget, said of these drugs. “I think it is true that Medicare negotiation over time could eventually come for these drugs and lower their prices.”
“But still, drugs in the United States tend to be pretty expensive,” Gordon continued. “They’re obviously developing newer forms of these drugs that might be more effective, lead to greater adherence, but that'll still cost money.”
Jonathan Watanabe, the director of the Center for Data-Driven Drugs Research and Policy at the University of California, Irvine, said studies are showing potential cardiovascular health benefits from these drugs for certain patients—and those benefits may reduce costly hospitalizations, strokes and stays in the intensive care unit.
“It still needs to be evaluated what that actually turns out in terms of dollars,” Watanabe said.
Schweikert said he and other lawmakers looking at the issue are continuing to research the economics of the proposal. He said specific policies are in drafting.
“A lot of what we’re trying to do is get the economics. Is our math correct?” he told The Daily Beast.
Two other lawmakers focused on increasing access to weight loss drugs—Reps. Brad Wenstrup (R-OH) and Raul Ruiz (D-CA), both of whom are doctors—introduced the Treat and Reduce Obesity Act in July. That bill would permit Medicare to cover FDA-approved weight loss drugs. In a statement, Wenstrup also pointed to the potential long-term taxpayer and health-care savings.
Ozempic and Wegovy have been cash cows for its manufacturer, Novo Nordisk. The Danish drugmaker giant spent $2.9 million lobbying the federal government on a range of issues in 2023, including obesity drug coverage and the Treat and Reduce Obesity Act.
Because Medicare does not cover weight loss medications, many people who could benefit from the drugs struggle to get access, according to Yuan Lu, assistant professor of cardiovascular medicine and chronic disease epidemiology at the Yale School of Medicine.
“When we looked at the national data on people with obesity, we found obesity to disproportionately affect minorities and people in low-income, low-socioeconomic-status communities,” said Lu. “If their insurance is not going to cover it, then there’s no way they can afford a medication.” | Drug Discoveries |
Danielle Busby is opening up about her struggles with an autoimmune disease.
The OutDaughtered star recently gave insight into her fight against the debilitating illness, sharing how it left her unable to do everyday activities.
"I used to not be able to get upstairs without feeling like I was gonna pass out," Danielle told Us Weekly in an interview published July 11. "That's just not a norm for me. I was always athletic and kind of fit and we've always taken care of ourselves. So for my body to go so down, it just was alarming."
The 39-year-old noted she experienced major changes in her body following the birth of her and husband Adam Busby's 8-year-old quintuplets: Ava, Olivia, Hazel, Riley and Parker.
"After I had [them], my body never kind of recovered because it was nonstop movement," said Danielle, who also shares daughter Blayke, 12, with her husband of 17 years. "I was living a life of adrenaline for years. So when my body started to slow down and they were in school and kindergarten—and well, first grade really—my body wasn't used to this. And so I went into this shock."
As for how her health journey is going so far, the reality star noted that her doctor treated her for fibromyalgia, due to her muscular tension and inflammation, as well as migraines. However, Danielle added that her exact condition is still in "discovery."
So, the family is taking things day by day, as Adam pointed out the unpredictability that goes along with his wife's illness.
"That's [the] thing with an autoimmune disorder," Adam told the outlet. "You don't know what it is and you don't know when it's gonna flare up and there's all these, like, unknowns. Like, one day she could be perfectly fine or … all of a sudden the next day she can hardly get out of bed."
While Danielle noted she hasn't experienced a migraine in "probably six months," she also explained that each day is paved with its own challenges.
"It's hard sometimes to even explain what I'm feeling or how my body is reacting to something even in the view of Adam because he's like, ‘You look fine, you [were] fine yesterday,'" she added. "It's annoying, it's frustrating and there's days where I didn't do anything extreme or off-set or something and [I] just will get up and I can't move my hands and my feet and so… it's an up and down journey." | Disease Research |
The Conservatives have defended accepting a donation from a firm accused of marketing vapes to children.
The £350,000 donation from Supreme 8 Limited was received in cash on 23 May.
Labour says vapes sold by the firm - such as Blue Razz Lemonade, Strawberry Mousse and Rainbow Burst - are clearly aimed at children. The legal age to purchase and use a vape is 18.
The Conservatives said they were not "anti-vaping" but the government was cracking down on underage sales.
Supreme 8 has been contacted for a comment.
Among the vaping products the company distributes for wholesale are Elf Bar, which has been criticised for marketing vapes to young people.
However, Elf Bar products do contain a warning indicating that "it is forbidden to sell this product to children".
Labour's Shadow Health Secretary Wes Streeting said: "We're sleepwalking into a new generation of children getting hooked on nicotine. Yet the Tories put lining their own pockets ahead of protecting children's health.
"Labour will come down like a ton of bricks on those peddling vapes to kids. We will ban the marketing and branding of vapes to children and give every child a healthy start to life."
Labour shadow children's minister Helen Hayes this week sought to introduce a law banning the marketing of vapes to children, telling MPs it is not necessary to use brightly-coloured branding to sell a smoking cessation product.
A Tory spokesperson said: "We are not anti-vaping. It is one of the most effective ways to help people quit and smoking and our government encourages this switch."
"However, this government is taking meaningful steps to tackle vendors who sell vapes to children.
"This includes setting up an Illicit Vape Enforcement Squad, closing loopholes on giving out sample vapes, and launching a review into fines for selling these products to under-18s."
One in five children (11-17 year olds) have tried vaping, figures from the 2023 Action on Smoking and Health survey of young vapers in England, Scotland and Wales suggest.
In May, Prime Minister Rishi Sunak said: "My daughters are 10 and 12, and I don't want the way vapes are marketed, promoted and sold to be attractive to them. That's why I am launching a new crackdown today to protect children."
Prof John Britton, honorary professor at the University of Nottingham, who previously advised the government on its plan to end smoking, said: "It's inconceivable to say that vaping is safe, it is a balance of risks.
"If you don't use nicotine in any shape or form, it is madness to start vaping."
Prof Britton anticipates that in 40 or 50 years' time, we will start to see people developing lung cancer, chronic bronchitis and other serious lung conditions as a result of their vaping.
The Department of Health and Social Care have said they have regulations in place to discourage underage vaping such as restricting sales of vapes to over 18s only, limiting nicotine content, refill bottle and tank sizes and through advertising restrictions. | Epidemics & Outbreaks |
Almost 300,000 women at higher risk of developing breast cancer are being given access to a drug that can halve their risk in a “major step forward” in the fight against the disease.
An estimated 289,000 women in England who are at moderate or high risk of breast cancer will from Tuesday be able to take the tablet to try to prevent it from developing, NHS bosses said.
The drug, anastrozole, is being made available to women who are in greater danger because they have been through menopause and have a major family history of Britain’s commonest form of cancer. It displays “remarkable” potential to reduce the number of people who go on to develop the disease, the head of the NHS said last night.
Every year, around 56,000 women in the UK are diagnosed with breast cancer – about 150 a day. While survival rates have improved, it still claims about 11,500 lives each year.
“It’s fantastic that this vital risk-reducing option could now help thousands of women and their families avoid the distress of a breast cancer diagnosis,” said Amanda Pritchard, NHSC England’s chief executive. The drug will be taken as a 1mg tablet once a day for five years.
The move to make anastrozole available to all eligible women represents a potential new frontier in the fight against Britain’s big killers because it is the first time that a drug which is already used to treat a condition has been “repurposed” to prevent the same disease from appearing.
Not everyone who elects to go on the medication will continue doing so for the full five-year course because of the side-effects involved, which include hot flushes, weakness, pain or stiffness in joints and arthritis. Skin rash, nausea, headaches, brittle bones and depression are also side-effects.
How many cases it prevents depends on how many women decide to use it. But even if just a quarter of the 289,000 newly eligible women decide to take the pill, it could prevent 2,000 of them from being diagnosed with the disease, NHS England said.
Post-menopausal women who have either seen relatives develop breast cancer at a younger age or several relatives develop it will be able to access the treatment. The NHS says that in the first instance they should visit their GP, who may refer them to a breast cancer or family history clinic.
Anastrozole is known as an aromatase inhibitor. It works by reducing the amount of the hormone oestrogen that a woman’s body makes by blocking the enzyme aromatase.
NHS England is able to offer the drug because the Medicines and Healthcare products Regulatory Agency has licensed it to be used as a preventative medicine.
“Allowing more women to live healthier lives, free of breast cancer, is truly remarkable, and we hope that licensing anastrozole for a new use today represents the first step to ensuring this risk-reducing option can be accessed by all who could benefit from it,” said Pritchard.
Experts in the disease hope the drug’s availability will prompt at-risk women to take it. “The extension of anastrozole’s licence to cover it being used as a risk-reducing treatment is a major step forward that will enable more eligible women with a significant family history of breast cancer to reduce their chances of developing the disease,” said Baroness Delyth Morgan, chief executive of the charity Breast Cancer Now.
Dr David Crosby, head of prevention and early detection at Cancer Research UK, said: “Approaches to help prevent breast cancer at high risk are badly needed, so this is a welcome announcement.
“We carried out some of the key work on developing these kinds of drugs, known as aromatose inhibitors, and 10 years ago our clinical trial showed that anastrozole could halve the risk of some women developing breast cancer, with minimal side-effects.”
Anastrozole is the first product of the pioneering Medicines Repurposing Programme, under which a consortium of key health bodies are examining the potential of existing drugs to be used for different purposes.
When that approach was adopted during the pandemic, it led to tocilizumab, an arthritis drug, and dexamethasone, a steroid, being deployed as treatments for Covid-19.
Meanwhile, women with vaginal bleeding who may have womb cancer could in future be spared having a potentially painful surgical biopsy thanks to a new test developed by a leading expert in women’s cancer.
The WID-qEC test, developed by Prof Martin Widschwendter of University College London, is more accurate than imaging at ruling out womb cancer. It could save 90% of women who are undergoing or have just been through the menopause from having a biopsy to diagnose the disease or rule it out, according to the results of research co-funded by the charity Eve Appeal and published in the Lancet Oncology.
The test will be commercially available in Austria and Switzerland from early 2024 and could become available in the UK soon afterwards, said Widschwendter.
Athena Lamnisos, the Eve Appeal’s chief executive, said many women who have a hysterectomy and biopsy when they are investigated for abnormal bleeding find it “extremely painful” and then face an “agonising” wait to get the result.
“Saving thousands of women from needing to go through the pain of tests and speeding up the wait before cancer being ruled out or diagnosed and starting treatment is very welcome progress,” she added. | Drug Discoveries |
Early risers could have a leg up on their health and well-being.
A recent study from Brigham and Women’s Hospital in Massachusetts revealed that "night owls" are at a higher risk of developing type 2 diabetes compared to morning people.
The research, published in the Annals of Internal Medicine on Sept. 12, found that night owls are 54% more likely to develop "unhealthy lifestyle habits."
As a result, people who prefer to stay up later at night and wake up later in the morning are also 19% more likely to develop diabetes.
The study researched the chronotypes — or the time of day people tend to gravitate toward — among 63,676 nurses ranging in age from 45 to 62.
Among all participants, 11% identified themselves as having a "definite evening" chronotype — while 35% said they had a "definite morning" chronotype.
The participants filled out a "Morningness-Eveningness Questionnaire" every two years from 2009 to 2017, according to the research.
The questionnaire measured lifestyle behaviors such as diet quality, physical activity, alcohol intake, body mass index (BMI), smoking and sleep duration.
None of the participants had a history of cancer, cardiovascular disease or diabetes at the start of the study.
"Incident diabetes cases" were self-reported and confirmed through an additional questionnaire.
Results showed that middle-aged nurses with an evening chronotype were more likely to report unhealthy behaviors leading to increased diabetes risk compared to morning chronotypes.
These unhealthy lifestyle habits included smoking, inadequate sleep, lack of physical activity and low-quality diet, according to a report from Medical News Today.
Before factoring in socioeconomic factors and lifestyle habits, people with an evening chronotype were at a whopping 72% higher risk of developing type 2 diabetes.
Board-certified emergency medicine physician Joe Whittington, M.D., was not involved in the new research but discussed the findings in an interview with Fox News Digital. He noted that the increased risk for evening chronotypes is "startling."
"But even more [startling] is the persistent 19% elevated risk after accounting for lifestyle factors," he said.
"This implicates inherent physiological or genetic traits tied to one's chronotype."
The California-based Whittington pointed out the "interesting nuance" discovered in this study: that diabetes risk is elevated among nurses who are working day shifts instead of those who are working night shifts.
"This raises the possibility that a mismatch between chronotype and work schedule amplifies type 2 diabetes risk," he said.
The doctor, who has nearly two million followers on TikTok, suggested that there may be a "few theories" to explain the significance of chronotype syncing.
"Chronotypes are entangled with the body's circadian rhythm, which governs critical physiological processes like hormone secretion," he said. "Any misalignment in these hormones can disrupt glucose metabolism."
He went on, "Adding another layer of complexity is the role of melatonin, commonly known as the sleep hormone, which has been shown to influence insulin secretion."
"Night owls with delayed melatonin secretion patterns may experience difficulties in glucose tolerance — thereby raising their diabetes risk."
Quality of sleep is a "major concern" for night owls, Whittington emphasized, especially when many people are expected to wake up early for work and other ongoing commitments.
"Poor sleep quality has been directly associated with insulin resistance, a well-established precursor to diabetes," he said.
"Not to mention, chronotype is partly genetically determined, raising the possibility that some individuals may be genetically predisposed to both evening preferences and diabetes."
"Emerging research also suggests that the gut microbiome, which plays a significant role in metabolism, has its own circadian rhythm that could be affected by disruptions in the sleep-wake cycle," the doctor added.
Although these findings may seem concerning for night owls, Whittington listed some measures people can take to reduce type 2 diabetes risk, including syncing up your schedule, focusing on sleep hygiene, exercising, managing stress and paying attention to diet.
"Aligning your work schedule with your natural circadian rhythm can offer significant health benefits," he said. "Focusing on sleep hygiene, such as maintaining a consistent sleep schedule and setting up a calming bedtime routine, can also prove beneficial."
"Exercise, particularly when done in the morning, can serve as a reset button for your internal clock while simultaneously enhancing insulin sensitivity," he noted. "A balanced diet rich in fiber, proteins and healthy fats can also go a long way toward stabilizing blood sugar levels."
"Stress management techniques like mindfulness and meditation can be effective in regulating the hormonal imbalance often seen in altered circadian rhythms," the doctor noted.
If lifestyle adjustments do not lead to improvements, Whittington said that "it may be advisable to consult a health care professional for a more targeted intervention." | Disease Research |
A damning report has found a "deeply worrying degree of dysfunctionality" at a Welsh health board.
The Audit Wales report identifies "clear and deep-seated fractures" among bosses at Betsi Cadwaladr health board in North Wales.
It said the health board needs to find a new CEO as a "matter of urgency" and pointed to ongoing and "long-standing concerns about the performance, quality and safety of a number of specific services".
The report added the board has a "long way to go" before its senior management can work effectively together and concluded the Welsh government would probably have to intervene.
The Welsh government acknowledges that the report raises "serious questions" about the board's management.
While the health board itself says it is "disappointing" that internal interventions have not led to improvements but that several actions are already in progress.
The auditor general found that challenging scrutiny from independent members of the health board in public meetings had "adversely affected working relationships" among the board's executive committee.
According to the report, this in turn has compromised the health board's ability to address the "significant challenges" it faces.
Read more:
Wales Air Ambulance bases to stay open until 'at least 2026'
Strikes back on in Wales after ambulance workers reject offer
The report added it is "unlikely" and "doubtful" that the situation will be resolved "without some form of intervention to establish a more unified Executive Team and wider board".
Mark Polin, chair of Betsi Cadwaladr University Health Board, said: "I can confirm the Board's commitment to taking the recommendations forward, and we will work collaboratively with Welsh Government and Audit Wales in doing so."
Mr Polin added that the health board was "aware of the majority of the issues raised" in the report.
"It is most disappointing that previous internal interventions have not resulted in necessary improvements in relation to an effective Board, which is what the patients and population of north Wales deserve in order to deliver and receive safe and effective services," he continued.
The Welsh Conservatives have called on the Welsh government to "urgently intervene" on the issues identified in the report.
A Welsh government spokesperson said: "This report raises serious concerns about the management and governance of Betsi Cadwaldr University Health Board.
"We are concerned about the performance of the board and we will be meeting with them to discuss those concerns.
"We will respond to the findings of this report shortly." | Health Policy |
Each year in the U.S., approximately 35 million children go trick-or-treating on Halloween — and studies show that each child can consume up to three cups of sugar while eating the candy they collect.
While no candy is beneficial for the teeth, some types are worse than others, according to Dr. Kevin Sands, a board-certified cosmetic dentist based in Beverly Hills, California.
Sands shared with Fox News Digital the Halloween candy that should be limited or avoided altogether.
Here are his tips.
5 types of Halloween candy to avoid
Hard candies
Jawbreakers and suckers can be particularly damaging to the teeth, Sands warned.
"These candies don't just pose a risk of chipping or cracking your teeth if bitten down on too hard, but their prolonged presence in your mouth provides bacteria with a long sugar feast," he said.
"This can potentially lead to cavities."
Sticky or gummy candies
Taffy and caramels can be especially troublesome, Sands said.
"Their sticky nature means they often get lodged in the nooks and crannies of the teeth, making them difficult to remove even after brushing," he said. "These sugar residues can promote bacteria growth and tooth decay."
Sour candies
Along with sour candies' appealing tang comes an alarming acidic punch, the dentist cautioned.
"Many sour candies have a pH level dangerously close to battery acid," Sands noted. "Continual exposure to such acidity can cause the enamel to break down, leading to sensitivity and other dental issues."
Sugar-free candies
It might seem that sugar-free candies are a tooth-friendly choice — but these often contain citric acid, which, despite the absence of sugar, can still wear down enamel, the dentist said.
Chewy candies
Chewy candies like nougat and toffee can stick to the teeth, providing a breeding ground for harmful bacteria.
"These bacteria can then produce acids that erode enamel and cause tooth decay," the dentist said.
7 less harmful candy options
For those who want to indulge without doing too much harm to the teeth, Sands recommended sticking to the following sweets.
Chocolate: When comparing candies, chocolate seems to be a slightly safer option. "It dissolves quickly and is less likely to get stuck on or between teeth," the dentist said. "In particular, dark chocolate, with its reduced sugar content and rich antioxidants, can be a more tooth-friendly treat."
Powdered candy: Powdered candies, such as pixie sticks, dissolve quickly in the mouth and don't stick to the teeth for an extended period, reducing the risk of tooth decay, said Sands.
Smarties: This type of candy quickly dissolves in the mouth, minimizing the time sugar is in contact with the teeth.
Yogurt-covered raisins: "While they contain sugar, yogurt-covered raisins are less sticky than caramel or toffee-based candies," Sands said.
Nuts: Nuts, such as almonds or peanuts, have minimal sugar content and are a better choice for dental health, Sands said.
Mini packs of popcorn: Plain or lightly salted popcorn can be a less sugary option compared to many other candies, according to the dentist.
Sugar-free gum: "Sugar-free gum can actually promote dental health by stimulating saliva production, which helps neutralize acids and cleanse the mouth," Sands said.
Tips for promoting children's dental hygiene
"Encourage children to consume treats in moderation and maintain good oral hygiene by brushing and flossing after consuming any type of candy," Sands recommended.
Additionally, providing alternatives like small toys or non-edible treats can be a great way to enjoy Halloween without compromising dental health, he added.
Below are the dentist’s most important tips for kids to maintain optimal dental health and hygiene.
Encourage regular brushing and flossing: Teach children to brush their teeth at least twice a day using fluoride toothpaste. Additionally, encourage flossing once a day to remove food particles and plaque between the teeth.
Use fluoride toothpaste: Choose a fluoride toothpaste that is age-appropriate for your child. Fluoride helps strengthen tooth enamel and prevent tooth decay.
Encourage water consumption: Water helps rinse the mouth and neutralize acids produced by bacteria in the mouth after eating candy or snacks.
Promote healthy snacks: Opt for healthier snack options like fruits, vegetables, cheese and nuts. These choices are not only nutritious but also less harmful to dental health.
Schedule regular dental check-ups: Dental professionals can detect early signs of issues and provide guidance on proper oral care.
"By following these recommendations and encouraging a healthy dental routine, you can help your child develop good oral hygiene habits that will benefit them throughout their lives," Sands said. | Nutrition Research |
A controversial new treatment for a condition called vitiligo that can restore pigment to the skin might soon be offered on the NHS, if UK experts approve it.
Some call ruxolitinib a miracle cream because it can return skin's natural colour and get rid of whitened patches.
But it carries some potentially serious side effects.
Others question whether vitiligo should be celebrated rather than masked or corrected.
Ruxolitinib (brand name Opzelura) must be prescribed by a doctor because the treatment requires monitoring.
It can affect the body's immune system, which might leave users more prone to infections such as coughs and colds, for example.
A stronger pill formulation of the same drug is already used to treat some cancers.
In trials of the cream for vitiligo, some users developed acne and redness affecting the area of skin where it was applied. But it was an effective treatment for nonsegmental vitiligo - the most common type - where patches or blotches of depigmentation appear on both sides of the body.
About half of those who used it twice a day experienced a significant improvement, and about one in six had almost a complete repigmentation within three months.
The list price for a tube is $2,000 (£1,660) in the US where it is already approved for use.
European regulators look set to recommend it, too, for people aged 12 and over.
What is vitiligo and what causes it?
Vitiligo is thought to be an autoimmune condition where the person's own body starts attacking cells in the skin that make protective pigment. This causes visible whitened patches or blotches that are prone to sun damage.
Vitiligo affects all races but is more noticeable in people with skin of colour. It is not infectious or contagious.
Experts say living with vitiligo can be psychologically devastating, causing anxiety, depression, low self-esteem and even suicidal thoughts.
Consultant dermatologist Dr Viktoria Eleftheriadou says some people with vitiligo may feel like they have lost their ethnic identity.
She said: "The risk of this can be higher among people of colour, as the condition is more noticeable in people with darker skin tones."
She says it would be good to offer people the choice of a treatment.
Winnie Harlow, one of the world's most recognisable models, has embraced having vitiligo rather than trying to hide her patches, although she has said she found living with it as a child "incredibly isolating".
"I vividly recall being in third grade and trying to befriend two girls who would run away from me because their mothers didn't want them to 'catch' what I had, as if I were contagious," she told Cosmopolitan magazine.
She describes her skin condition as one of her "greatest gifts".
"It has taught me, from the time I was a little girl, to use it as a megaphone: to be louder, prouder, and always fuelled by passion and love. It's helped me look beyond my own cover - and everyone else's, too."
Emma Rush, founder and chief executive of Vitiligo Support UK, says while it is great to see models raising public awareness, "there is a gap between the average model and the average person on the street".
She says many people find having vitiligo on your face can be particularly distressing. "My face is now covered with it. I don't recognise old pictures of myself from before I had it. It's like I was a different person.
"I can wear make-up to cover it but I can't just walk around unnoticed without it. It helps with that first encounter so people don't stare.
"When it starts on the face it is often around the mouth and eyes and those are the parts that people look at. It can be catastrophic experience in a society that is focused on appearances.
"Having a condition that can turn your skin white is not just impacting your skin colour, either. When your appearance changes, it can come with a whole raft of assumptions about where you come from and who you are.
"Some people say they feel like they have lost a depth of their identity or had something taken away from them by the disease."
She says having it as a new treatment option would be "an absolute godsend".
Teacher Joti Gata-Aura was diagnosed with vitiligo in her early 20s. At that time, she says, she would have been willing to try almost anything to remedy it.
"I battled with it for a very, very long time. I was constantly searching for treatments," she said.
"I hadn't accepted the skin I was in."
"I'm Indian. I have brown skin - I'm not a fair-skinned Asian person. So when I had vitiligo I stood out and I covered up my skin for many, many years.
"I hid my skin so much."
Now aged 45, her outlook has changed and she campaigns about body positivity and mentors young people to help them with self-confidence.
"I've done so much work on being happy in the skin you are in and being confident in who you are."
She says identity is still a big issue. "My identity was stripped when I lost my pigment.
"It's taken so long for me to accept this white skin.
"It does, for me, add the extra layer of having to... not justify myself, but explain who I am, and that can sometimes be quite difficult, especially now that my skin is whiter than some of my English friends. That's difficult because I am proud of my background and culture."
She said people needed to make their own choices about living with vitiligo.
"It might not be a disability, it might not be an illness, but people psychologically have been ripped apart because of this condition and I think it is so important that while I'm in a good place right now, I wasn't in a good place when I was diagnosed.
"People are going through what I went through 20 years ago. This could be light at the end of the tunnel for many people."
Current treatments for vitiligo that result in a return of patients' natural skin colour are limited and have variable effectiveness, which means that if one treatment worked well for one patient it might not work for another at all, says the British Association of Dermatologists.
The most commonly used ones - phototherapy, tacrolimus and topical corticosteroids - can all have their downsides. For example, there are side effects associated with the long-term use of strong topical steroids, and phototherapy sessions usually require repeat trips to hospital for several months.
Ruxolitinib would need to be approved by the drug regulator, the MHRA, to be sold or prescribed in the UK. The advisory body NICE is planning to assess its merits and risks and whether the cost can be justified for the NHS to provide to patients. | Medical Innovations |
Seven in 10 people in the UK believe charges for NHS care will creep in over the next decade, ending the health service’s record of being free at the point of use, polling has found.
One of the NHS’s key founding principles from 1948 is in peril, 71% of the public believe, according to the survey carried out for the Health Foundation ahead of the service’s 75th birthday this week.
Despite almost three in four people saying the NHS in its current free form is “crucial”, 51% say they expect to pay for some services within the next decade, while 13% think most services will need to be paid for upfront and 7% anticipate charges for all services.
Tim Gardner, an assistant director of policy at the Health Foundation, said the thinktank interpreted the findings as an “expression of concern that what the public values the most about the NHS – affordable care provided free at point of use – may be under threat”.
He said: “The durability of the principle that the health service would provide care based on need not ability to pay has been regularly questioned throughout its history, especially at times when the service is under great pressure.”
There had been growing calls for radical changes, such as charging for GP appointments and A&E visits, added Gardner.
Politicians such as Rishi Sunak, the prime minister, Liz Truss, his predecessor in No 10, and the former chancellor and health secretary Sajid Javid have all backed one or both of those ideas as potential ways of raising more money for the NHS and reducing demand. Critics dismissed them as “zombie” ideas that were impractical and would not help.
The Health Foundation survey of 2,540 over-16s, conducted by Ipsos, was carried out at a time of huge pressure on the NHS owing to the backlog in waiting lists and staff shortages, and as junior doctor and consultant strikes loom this month.
On Sunday Amanda Pritchard, the chief executive of NHS England, urged the government and health unions to settle their dispute as soon as possible, saying patients would “pay the price” for the unprecedented scale of the action. She said strikes must not become “business as usual” for the NHS.
Separate polling from Ipsos shows that most Britons support healthcare workers in their wave of strikes over pay and conditions this year despite the worsening disruption, with backing for junior doctors at about 56% in June.
Wes Streeting, the shadow health secretary, said there was “no doubt that having run down the NHS over 13 years, many Conservatives will now use their failure to argue that its founding principles must be abandoned” by making the case for charging. He said Labour would “never let this happen”.
“The future of the NHS will be on the ballot at the next election,” he said. “It was Labour who created the NHS and made sure it was there for us when we need it, delivering the shortest waiting times and highest patient satisfaction in history.
“It will fall to the next Labour government to rescue the NHS from the biggest crisis in its history, and breathe new life into the service so it is still there for us in the next 75 years.”
Daisy Cooper, the deputy Liberal Democrat leader and party health spokesperson, said the Lib Dems would “set out our plans to ensure that we have an NHS fit for the 21st century that remains free at the point of use” before the next election.
“Waiting lists, staff sick days and social care demand are all soaring and only getting worse under this out-of-touch Conservative government,” she said.
The Tory peer James Bethell, who was a health minister at the height of the Covid pandemic, said the situation with waiting lists was already so bad that it constituted “rationing”, but he said he did not think charging for services was a good idea.
He said: “People might be thinking the pressures in the NHS makes charging inevitable but that doesn’t mean it’s either a good idea or that it’s popular. I haven’t seen any evidence that charging will improve outcomes.”
He argued for “a new contract between the government and the public that is not just a one-way promise for free access but is more of a partnership around healthy living”.
“That requires leadership from government to create an environment where ordinary people can make realistic healthy choices and are supported to fight disease,” he said.
“Instead too many of us are constantly battling against junk food, mouldy homes, dirty air, toxic workplaces and addictive algorithms that drive us to porn, casinos and depression, and losing the battle with huge costs in health, care, benefits and productivity.”
With the NHS struggling, the Health Foundation survey shows people appear to have little faith in politicians’ promises to keep the NHS free, even though they would overwhelmingly like to see its current model continue.
According to the survey, the NHS ranks highest as people’s first choice when asked what makes them most proud to be British – compared with democracy, culture and history – at 54% of those surveyed.
The data also revealed the public are pessimistic about the NHS’s ability to meet key future challenges, with 77% believing the NHS is not ready for the increasing health demands of an ageing population.
It found some degree of split along political lines, with 66% of people intending to vote Conservative more likely to expect user charges for some services compared with 51% of Labour voters.
A senior Tory source said: “The NHS is our most treasured national institution and we are fully committed to its founding principle of healthcare for all, free at the point of delivery.
“As we celebrate its 75th anniversary this week, we have backed the NHS’s long-term workforce plan with an extra £2.4bn of investment to cut waiting lists and put the service on a secure footing long into the future.
“For the NHS to carry on caring for us all for the next 75 years and beyond, we need a strong economy, and the biggest threat to that is Labour’s plan for a £28bn annual spending splurge fuelled by uncontrolled borrowing.”
About 80% of those surveyed think the NHS needs an increase in funding, compared with 17% who think it should operate within its current budget, with some degree of support for a dedicated NHS tax (31%), an increase in national insurance (22%) or an increase in income tax (21%).
The NHS in England is due to receive only a 1.2% increase to its budget this year – a third of its historical average of 3.6% – despite long waiting times, growing patient dissatisfaction and increasing alarm that it is “broken” and unable to provide urgent care quickly. | Health Policy |
Media releaseFrom: Frontiers
Our favourite bittersweet symphonies may help us deal better with physical pain
Researchers found that listening to our preferred music reduces pain intensity and unpleasantness, knowledge which could optimize music-based pain therapies
Even before it was found to reduce pain and anxiety in modern times, music has been used for centuries to relieve pain. Now, researchers in Canada have investigated which aspects of listening to music can lead to a decreased pain perception. They found that participants’ perception of pain intensity and unpleasantness was reduced when they listened to their favorite music compared to pre-selected relaxing music, which is commonly used in clinical settings. In addition, bittersweet music – unlike other emotionally loaded music – was found to additionally reduce pain unpleasantness.
Research has shown that music might be a drug-free way to lower humans’ pain perception. This decreased sensitivity to pain – also known as hypoalgesia – can occur when pain stimuli are disrupted between their point of input and where they are recognized as pain by the conscious mind. In a new study, researchers in Canada have examined what type of music helps to dampen pain perception.
“In our study, we show that favorite music chosen by study participants has a much larger effect on acute thermal pain reduction than unfamiliar relaxing music” said Darius Valevicius, a doctoral student at the Université de Montréal. The research was carried out at the Roy Pain Lab at McGill University and published in Frontiers in Pain Research. “We also found that emotional responses play a very strong role in predicting whether music will have an effect on pain.”
Everybody hurts (but less so when listening to favorite music)
To test which kind of music was most effective for reducing pain, participants received moderately painful thermal stimuli to the inner forearm, resulting in a sensation similar to a hot teacup being held against the skin. These stimuli were paired with music excerpts, each lasting approximately seven minutes.
Compared to control tracks or silence, listening to their favorite music strongly reduced pain intensity and unpleasantness in participants. Unfamiliar relaxing tracks did not have the same effect. “In addition, we used scrambled music, which mimics music in every way except its meaningful structure, and can therefore conclude that it is probably not just distraction or the presence of a sound stimulus that is causing the hypoalgesia,” Valevicius explained.
The researchers also examined if musical themes could modulate the pain-decreasing effects of favorite music. To do that, they interviewed participants about their emotional responses to their favorite music and assigned themes: energizing/activating, happy/cheerful, calming/relaxing, and moving/bittersweet. They discovered that different emotional themes differed in their ability to reduce pain.
“We found that reports of moving or bittersweet emotional experiences seem to result in lower ratings of pain unpleasantness, which was driven by more intense enjoyment of the music and more musical chills,” Valevicius said. Although it is not yet entirely understood what musical chills are, they seem to indicate a neurophysiological process that is effective at blocking pain signals. In some people, chills can manifest as a tingling sensation, shivers, or goosebumps.
Something for the pain
The researchers also pointed to limitations of their study, one of which is concerned with how long participants listen to music samples. For example, listening to relaxing music for longer might have stronger effects than the shorter tracks the participants listened to in this study. Questions which also need to be addressed in further research include if listening to favorite music is also effective with other, non-thermal pain stimuli, such as mechanical stimulation or chronic pain, the researchers said.
“Especially when it comes to the emotion themes in favorite music like moving/bittersweet, we are exploring new dimensions of the psychology of music listening that have not been well-studied, especially in the context of pain relief. As a result, the data we have available is limited, although the preliminary results are fairly strong,” Valevicius concluded. | Medical Innovations |
Published June 13, 2022 11:18AM Updated 2:21PM article A customer walks by a Starbucks Coffee store on June 10, 2020 in Corte Madera, California. (Justin Sullivan/Getty Images) WASHINGTON - After opening their bathrooms to the general public, Starbucks CEO Howard Schultz reportedly said store restrooms may have to close again. CNN first reported on June 10 that Schultz said at a New York Times DealBook conference in Washington, D.C. that the company may reverse its open bathroom policy due to a growing mental health problem for employees and patrons. The policy is making it a challenge for store associates to manage its stores, Schultz reportedly said. "We have to harden our stores and provide safety for our people," Schultz told the New York Times. "I don’t know if we can keep our bathrooms open." A Starbucks spokesperson told FOX Televisions Stations Monday that there were no changes to the bathroom policy to share at this time. RELATED: Starbucks opens bathrooms to all visitors after controversy The coffee giant made their bathrooms available to the public in 2018 after two Black men waiting for their friend to arrive were denied use of a Starbuck’s restroom in Philadelphia. A video circulated showing the two men being arrested by police, who were called by a Starbucks employee. Officials said police officers were told the men had asked to use the store's restroom but were denied because they hadn't bought anything and they refused to leave. Starbucks CEO Kevin Johnson said the arrests should not have happened and the company said he met with the two men. Starbucks also said the employee who called police no longer works at the store, but declined to give further details. RELATED: Starbucks to close all stores for racial-bias education on May 29 The men who were arrested reached a $1 settlement with the city of Philadelphia, and city officials pledged $200,000 for a program that would benefit young entrepreneurs. The incident sparked nationwide protests and it lead Starbucks to close more than 8,000 U.S. stores for several hours to conduct racial-bias training for its nearly 175,000 workers. FOX 9 Minneapolis and FOX 29 Philadelphia contributed to this story. This story was reported from Washington, D.C. | Mental Health Treatments |
Surgeons at NYU Langone Health have completed the world’s first whole eye transplant, a groundbreaking advancement many thought was impossible.
The patient, Aaron James, 46, a military veteran from Hot Spring Village, Arkansas, cannot see out of the transplanted eye, but he considers the operation a success nonetheless.
“You’ve got to start somewhere, and hopefully this will get the ball rolling on future surgeries,” James said in an interview.
In 2021, James survived what should have been a fatal electric shock while he was working as a high-voltage lineman. His face accidentally touched a live wire, causing devastating injuries, including the loss of his left eye, his nose and his lips. Only bone was left in his left cheek and his chin. Much of his left arm was also stripped to the bone.
The operation, which took place in May, lasted 21 hours and required the expertise of more than 140 surgeons, nurses and other health care professionals. In addition to the eye transplant, James also received a partial face transplant, which remains an incredibly rare procedure, with fewer than 50 face transplants having been performed worldwide since the first one in 2005.
The donated face and eye came from a single donor. The eye had never been removed from the donor’s socket, and the surrounding tissue and the optical nerve remained intact.
Still, transplanting the new eye was laborious. Blood vessels surrounding the eye are extremely small, making it a challenge to attach enough for adequate blood flow. Reattaching the optic nerve is another challenge. As part of the operation, the surgeons also injected adult stem cells into James’ optic nerve — another first — to prompt the nerve to create healthy new cells.
Five months after James’ surgery, there is healthy blood flow to the retina, the part of the back of the eye that converts light into the electric signals the brain converts into images — a major sign of vitality.
“Although there is no sight, we’ve crossed a barrier that many didn’t think was possible,” said Dr. Eduardo Rodriguez, the director of the Face Transplant Program at NYU Langone in New York City, who led the surgery. “Nothing like this has ever been attempted. There isn’t even any science published in the literature that could indicate what could be the result of such a transplant.”
The eye also has normal pressure, and it is not painful.
Infection around the brain was another major complication James was able to avoid in the crucial months after the transplant.
“That is an absolutely remarkable accomplishment in itself,” said Dr. Joseph Rizzo, the director of the neuro-ophthalmology service at Mass Eye and Ear at Mass General Brigham and a professor of ophthalmology at Harvard Medical School in Boston.
More than sight
Rizzo said he believes a whole eye transplant that restores vision is still “beyond our capabilities at the moment.”
“For one to have sight at the level you’d be able to do something functional, it would require the reconnection of a fair number of nerve cells,” he said. “But the complexity is not just whether some nerve cells can regrow.”
Roughly 1.2 million nerve fibers connect each eye to the brain, and those nerves are not connected in a random fashion. “Point A has to connect to point A,” Rizzo said.
During brain development, a complex system of interactions forms specific pathways that connect points on the retina to points on the brain, he said. The adult brain does not have these same systems, at least not in a robust way.
“The public should not be imagining that vision will be restored at this point, but from a scientific standpoint, even if they were able to get a small number of nerve cells to grow back to the brain, that would be a groundbreaking accomplishment,” Rizzo said, noting that full vision restoration, if ever possible, is still likely to be a long way from reality.
Rodriguez said that restoring sight in James’ left eye through a whole eye transplant was a moon shot from the get-go but that performing the surgery provided other benefits, as well.
“Even if the eyelids were closed, it would give a better aesthetic than eye sockets that don’t have anything in it,” Rodriguez said.
James, who has had many operations since the accident, including one to remove his damaged left eye because of pain, said the face and whole eye transplant has been “life-changing” for him.
“I can go out and I’m really not stared at anymore. I just look like a normal person walking down the street,” he said.
Before the face and eye transplant, James could not taste because of the loss of his nose. He also could not eat solid food.
“I just had a little hole in my mouth. My wife had to cook soups and puree them in a blender, and I had to drink them through a straw. That’s the only thing I could eat,” James said.
James said he’s extremely grateful to the donor and the donor’s family.
“Somebody had to pass away to make this happen, and the donor and the donor’s family, I can’t imagine having to make a decision like they had to do, and it’s something I think about every day,” James said. “I really want them to know that I’m grateful and I thank them every single day.”
Rodriguez will continue to monitor signs of vitality in James’ eye in the coming years.
“You can give a person a little bit of hope and push science forward,” Rodriguez said. “It may open up a new chapter they may not have thought was possible.” | Medical Innovations |
On Dec. 7, 2021, more than a dozen surgeons convened a meeting at their hospital, HCA Florida Bayonet Point in Hudson, Florida. Their concerns about patient safety at the 290-bed acute care facility owned by HCA Healthcare Inc. had been intensifying for months and the doctors had requested the meeting to push management to address their complaints.
Unsanitary surgical instruments, inadequate monitoring of ICU patients, an overflowing emergency department, anesthesiology errors that resulted in patients waking up while in surgery — all were allegations ripe for discussion.
The meeting soon took an extraordinary turn, four doctors who attended told NBC News. With a hospital administration official on hand to hear the answers, the group was asked two questions. Is the hospital providing a safe environment in which to perform surgery? “No,” everyone in the group answered, according to the four doctors. Is it a dangerous place to practice? “Yes,” came the unanimous reply.
For more on this story, tune in to NBC Nightly News with Lester Holt tonight at 6:30 p.m. ET/5:30 p.m. CT or check your local listings.
The hospital administrator promised to address the doctors’ issues, attendees told NBC News. But more than a year later, little has changed, they said. A spokeswoman for the hospital declined to comment on the meeting.
HCA Healthcare Inc., owner of Bayonet Point, is America’s largest hospital company, operating 182 hospitals and 125 surgery centers across the nation and in the U.K. HCA is highly profitable — last year it earned $5.6 billion — and its stock is an investor favorite.
But HCA’s laser focus on profits can put its patients at risk as it cuts costs and corners, say seven of the company’s doctors in California, Florida, Texas and Virginia, some of whom reached out to NBC News after our report last month about HCA. Nurses in five states concur. Most of HCA Florida’s that have been rated by the federal agency responsible for Medicare and Medicaid currently rank below average, and state regulators have raised issues about patient care at Bayonet Point at least twice in the past two years.
Four physicians at Bayonet Point shared recent experiences for this article; three requested anonymity to discuss the hospital because they said they feared retaliation by HCA.
All four doctors said the quality of care at the facility has declined significantly since 2021, when HCA cut staff and began hiring contract workers. They said that the number of so-called sentinel events — patient safety incidents that result in death, permanent or severe temporary harm — have risen. In January 2022, there were 18 “near misses” among patients about to undergo surgery, said Dr. George Giannakopoulos, 65, a neurosurgeon and the hospital’s chief of staff at the time. One such “near miss” occurred, he said, when the wrong side of a patient was prepped for surgery — anesthetizing a left hip that should have been the right.
Even as Bayonet Point celebrates the opening of a new $85 million tower with 102 additional beds, recent photos of the existing facility provided by doctors show ceiling leaks in a recovery room, oxygen equipment held together with tape, bloody and backed-up sinks, wires dangling from a hole in the wall and cockroaches in the operating room.
Regina Temple is chief executive officer of Bayonet Point. She declined an interview request by NBC News to discuss the doctors’ allegations. The hospital’s spokeswoman provided a statement that did not answer many of the questions posed by NBC News, including those about allegations of rising “sentinel events” at the hospital, the 18 “near misses” in the OR in a month, the decaying infrastructure or pests.
In her statement, the spokeswoman said: “As a learning hospital, we are continually looking for ways to improve patient safety and quality of care. We apply those learnings, including reports by both federal and state regulators, to ensure best practices for quality care are in place. HCA Florida Bayonet Point Hospital is appropriately staffed to ensure the safe care of our patients. We rely on feedback from our physicians, and when issues are validated we take necessary action.”
NBC News also asked for an interview with Samuel N. Hazen, HCA Healthcare’s chief executive officer. He declined but a spokesman for the company said in a statement that HCA Healthcare has more physicians — 45,000 — practicing at its facilities than ever. “We are able to attract physicians in part due to the systems we have in place to continually improve quality,” he said, adding that HCA’s most recent physician engagement survey showed “results at all-time highs, including their confidence in our quality initiatives. Our approach to ensuring high-quality care is rooted in our belief of always doing what is right for our patients.”
Complaint surveys filed by Florida’s Agency for Health Care Administration over the past two years buttress the physicians’ concerns about the hospital, however. Last September, for example, nurse-to-patient staffing ratios fell short at Bayonet Point, agency documents show, with one staff member telling government investigators that “she does not feel safe with the number of patients per nurse.”
In April 2021, AHCA determined that Bayonet Point had “failed to enforce the emergency department policy and procedures to protect the health and safety of all patients in the hospital’s ED.” AHCA said, for example, that staffers whose sole job was to watch electronic monitors for changes in patients’ vital signs were also acting as unit secretaries, “answering phones, transferring calls, taking written messages, and being distracted by other tasks that involved them not looking at the monitors for long periods of time.”
The hospital’s spokeswoman confirmed in her statement that the surveys completed by AHCA had “identified issues, and we worked with AHCA to resolve those issues successfully.”
Last November, officials from AHCA communicated with the hospital, two Bayonet Point doctors told NBC News, warning that the facility might stop receiving Medicare and Medicaid reimbursements if it did not correct its deficiencies. AHCA did not respond to requests for information about the interaction. Asked about this incident and its past deficiencies, the hospital spokeswoman did not respond except to say: “Today, our hospital is in good standing with all regulatory and accrediting bodies, including AHCA.”
On its hospital comparison website, the federal Centers for Medicare and Medicaid Services (CMS), which administers health care for more than 60 million Americans, assigns Bayonet Point an overall one-star rating out of five, the lowest star ranking assigned by the government.
“The CMS ratings are based on 2017-2019 data and we have since improved our performance,” the hospital’s spokeswoman said.
Waking up during brain surgery
Florida, with its elderly population, is a big market for HCA, which has 49 hospitals there — the largest number of any state, according to its website.
The CMS quality comparison website rates 37 of HCA’s Florida hospitals on its five-star system. Fully 70% of them are rated below average, at one or two stars. None of the HCA Florida hospitals currently have a five-star rating.
Neurosurgeon George Giannakopoulos, a 29-year veteran at Bayonet Point and the hospital’s chief of staff for the past eight years, said he has grown increasingly disturbed —and vocal — about unsafe and unsanitary conditions at the hospital. He said he’s had criticisms over the years about how the hospital was run but that problems really accelerated in 2021.
“I put patients first,” Giannakopoulos told NBC News. “I don’t care how far I have to go.”
But choosing to speak out seems to have put a target on his back, documents and interviews with fellow doctors indicate. Following his criticisms of the hospital and repeated pleas for improvements, its leadership took a remarkable step in January.
Though Giannakopoulos’s peers resoundingly re-elected him as Bayonet Point’s chief of staff for two more years last fall, the hospital’s board later rejected the election, documents show. In a move the doctors called unprecedented, the board installed another physician in the position. Meanwhile, the board accepted the election results for two additional officers — vice chief of staff and secretary.
After the doctors objected to the move, a lawyer for the hospital’s board sent a letter to Giannakopoulos saying it had voted “not to approve” the election. “If Dr. Giannakopoulos attempts to attend meetings of the Medical Executive Committee, the Board of Trustees, or other Medical Staff Committees,” the letter continued, “he will be prevented from doing so by security and, if necessary, he will be escorted off the hospital’s property.”
Dr. Christine Behan, a family medicine physician and contract employee of the hospital, chairs its board. She said the board’s invalidation of the election was “in the best interest of the hospital and its patients.” She cited “repeated instances of inappropriate and unprofessional behavior, including threatening, yelling at, and berating staff, physicians and hospital administrators,” by Giannakopoulos. “The board concluded that he could not work cooperatively and collegially with hospital administration and the board,” she said.
Giannakopoulos disputed Behan’s account. “All those charges were manufactured by the hospital administration to keep me from being chief of staff because I was calling them out on patient care,” he said. The three other doctors interviewed by NBC News said they also believed this to be the case.
Bayonet Point’s new chief of staff is Dr. Rami Akel, a cardiologist who is also director of HCA Florida Bayonet Point’s Cardiology Fellowship Program. NBC News asked if Akel receives additional compensation for that position; the hospital spokeswoman did not respond. Akel did not return a phone call seeking comment.
Patient risks really began to mount in 2021, doctors at Bayonet Point say, when the hospital slashed its anesthesiology staff — going from 15 providers to one — and began hiring contract employees affiliated with HCA’s Physician Services Group, an in-house staffing unit. The new employees were not as dedicated or talented as the staff they’d replaced, Giannakopoulos and other surgeons said, and terrifying errors began to occur. In one incident, Giannakopoulos said he had just begun a brain surgery procedure, placing the patient’s head on sharp instruments known as “pins” for support, when the patient woke up and tried to get off the operating table.
“Those pins were about two centimeters away from the eye,” Giannakopoulos said. “So, you can imagine that could have been tragic.”
The Bayonet Point spokeswoman did not respond to questions about this incident or the doctors’ anesthesiology concerns.
Last October, almost a year after the extraordinary meeting at which the surgeons characterized the hospital as unsafe, Giannakopoulos sent a letter to Bayonet Point management. In it he detailed significant deficiencies he and his fellow physicians had observed at the hospital.
“At the request of the medical staff by unanimous vote, I have been asked to contact you and appraise you of the dire and dangerous conditions at our hospital,” began the letter, which was reviewed by NBC News. In it he told of alleged deficiencies in the emergency department, the ICU, nurse staffing, and anesthesia, “leading to at least a couple deaths,” he wrote.
Hazen, chief executive officer of HCA Healthcare, was copied on the letter along with other executives. Giannakopoulos said he received no responses at all about its contents.
A few weeks after sending the letter, Giannakopoulos was re-elected chief of staff, the four doctors told us. By January, however, the board ruled he was out.
Reduced surgery hours
On an early evening in February 2022, a patient arrived at Bayonet Point’s emergency department with a ruptured aneurysm, Giannakopoulos said. Surgery to coil the aneurysm was scheduled for early the next morning, he said, and staff was instructed to monitor the patient closely overnight.
Next morning, when it came time for the procedure, the patient was comatose, Giannakopoulos said. In the patient’s file, he said, there were no nurse’s notes detailing the monitoring that had been called for during the overnight hours. The patient later died.
“It was obvious what had happened,” Giannakopoulos said. “Nobody had seen the patient from 7 p.m. to 7 a.m.”
Asked about this incident, the Bayonet spokeswoman did not respond.
All seven of the HCA doctors interviewed by NBC News for this article said they believe the company’s hospitals are managed to maximize growth in financial metrics and shareholder returns and that patient care suffers as a result. The new $85 million building at Bayonet Point is an example, the doctors there say. Increasing admissions by adding 102 new beds seems more important than repairing broken equipment in the existing building, eradicating pests in the operating room, or hiring staff in the emergency department, they said.
The Bayonet spokeswoman said the hospital is building the new tower “to meet the community’s needs for rehabilitation services, expanded medical and surgical services, and critical care. In the past three years we have invested an additional $123 million to improve and upgrade many areas of the hospital. Specifically, we renovated and expanded our ER and updated our Post-Anesthesia Care Unit, Preoperative/Holding Area, and Central Sterile Processing Unit. Additionally, we made upgrades to the cafeteria and common areas, invested in new equipment and general maintenance, including repairing minor roof damage.”
Bayonet Point hospital is currently rated "A" for patient safety by Leapfrog Group, an organization that ranks hospitals and describes itself as a health care watchdog.
Leapfrog also rated Bayonet Point "A" in November 2021, a month after the group of concerned surgeons had unanimously characterized the hospital as unsafe, Leapfrog’s website shows. “Receiving the ‘A’ grade validates our commitment to safety,” Bayonet Point’s CEO Temple said in a hospital press release.
Responding to questions from NBC News about the rating amid the Bayonet Point doctors’ grave concerns, Leah Binder, Leapfrog’s chief executive, said hospitals earn grades based on 30 measures of safety that come primarily from the federal government.
“An ‘A’ grade means this hospital did better than a ‘B’- graded hospital — it does not mean they are perfectly safe,” she said. “What this story raises is we need better ways for patients and clinicians to report problems with safety to a federal entity that can use that data and follow up and do investigations.”
HCA has some associations with Leapfrog. An HCA physician is one of 17 hospital members of Leapfrog’s Hospital Advisory Committee and another HCA employee is on one of Leapfrog’s 12 “expert panels.” HCA Healthcare is also member of Leapfrog’s 18-entity “Partners Advisory Committee” for which HCA pays $35,000 in annual dues.
Binder said HCA’s involvement on Leapfrog committees or panels gives it no influence on ratings.
Last year, the National Labor Relations Board accused Bayonet Point of engaging in anti-union activity against its employees, as reported by the Tampa Bay Times. The federal agency, which protects workers’ rights to organize, concluded that hospital officials had questioned Bayonet Point workers about their union activity and threatened to fire them.
The hospital settled with the agency last November, documents show, agreeing to post notices detailing workers’ rights to unionize and saying that management would not threaten them with termination or “create the impression that we are engaging in surveillance of your union activities or other protected concerted activities.”
In a statement, Bayonet Point said it “respects the rights of our caregivers and, while we reject any allegation of wrongdoing, we agreed to post the flyer informing our colleagues of their rights.”
Meanwhile, in addition to rejecting Giannakopoulos’ election last fall as chief of staff at Bayonet Point, the hospital has reduced his surgery hours — a measure of retaliation for speaking out, he believes. The hospital spokeswoman did not respond to a question about reducing the neurosurgeon’s surgery hours.
Giannakopoulos continues to work at the hospital, a place he calls home after nearly three decades.
“I will survive,” he said. “What really bothers me the most — I care about what’s going to happen to Bayonet Point and the patients that are there. To drive Bayonet Point down to the ground because of money, because of profits ahead of patient care, it is not acceptable.” | Health Policy |
For the past 12 weeks, the first thing I do when I wake up is roll over, grab my $349 carb vape, head to the couch, and begin my morning measurement. I suck in a deep breath through this thing for four seconds, hold my breath for 10 seconds, and then breathe out for six seconds. A few seconds later, the Lumen app on my phone tells me whether I’m burning fat, carbs, or a mix of both. Once that’s done, it then spits out a customized plan for what I should eat that day.
In the crudest terms, Lumen is a metabolism breathalyzer and digital nutritionist rolled into one. The pitch is that you can learn how efficiently your body switches between burning fats and carbs. Armed with that data, you can theoretically take a more informed approach to losing weight, enhancing your athletic performance, or improving your overall metabolic health. It sounds too good to be true for one device to do all three. These are three issues that pretty much anyone would love to fix, and the numbers prove it. Diet culture alone is a $71 billion industry, while the fitness industrial complex is worth $30 billion.
I first reviewed this thing three years ago, but I decided to revisit the device a few months ago after Lumen reached out to say the product had undergone some major updates. That, and I’d just royally botched the New York City Half Marathon. I know now that race wasn’t meant to be, but at the time, I was convinced I’d done something wrong. Maybe I’d fueled incorrectly in the weeks leading up to the race. I don’t like leaving things unexplored, and I’d already signed up for a 10K — why not take the Lumen for a spin and see if using it could help me run a better race?
What’s new, how it works, and science
A lot has changed since I reviewed the first-gen Lumen, but some things are exactly the same. Like the design. Lumen sent me its second-gen device, and I legitimately can’t tell the difference. When I asked Lumen, they said the only change lies in some of the internal components.
The device is small enough to fit in my hand, with a discreet power button on the bottom half. When you turn it on, a purple LED circle lights up. (It turns red when the battery is low and green while charging.) There’s a magnetic cap for the mouthpiece to keep it clean, and you get a dock for charging. I said this in my first review, but while the dock is theoretically great for your nightstand, there’s no point in putting it there. Nightstand real estate is precious, and a single charge lasts weeks. Since setup, I’ve only had to charge this thing twice.
Most of the changes are in the Lumen app. It’s a lot slicker than it was three years ago, there are a lot more educational videos about nutrition, wellness, and fitness, and the food database for macro logging is more robust (though still not as good as Lose It or MyFitnessPal). You can even order premade meals through the Metabolic Meals service in the app.
But the most significant change is you only need to take one breath per measurement. With the original, you had to take three breaths to get your morning Lumen score. Since you have to wait at least a minute between each breath, the morning measurement used to take two or three minutes at best. And if you screwed one up, it was a total drag. It’s a lot less painful and time-consuming now, even if you have to redo a measurement.
You can take as many measurements as you like during the day, but the most important one is the one you take in the morning before eating or drinking any food. Lumen also recommends you take a measurement 30 minutes before and after eating and workouts, as well as a final measurement before bed. Ain’t nobody got time to take 10 measurements a day every day, but so long as you take your morning measurement, you can get a customized nutrition plan.
When you breathe into the device, it’s basically looking for how much carbon dioxide is in your breath. That’s then compared to gold-standard Respiratory Exchange Ratio (RER) tests. In the app, you get a score of 1-5. If you get a 1 or 2, you’re mostly burning fat. A 3 is a more even mix of both, and a 4 or 5 means you’re burning mostly carbs. After four weeks, you’ll get a Lumen Flex score, which gauges how well you switch between both fuel sources. As to why you should care... it boils down to optimization. For weight loss and body recomposition, maximizing the time you spend in fat burn is ideal. For athletic performance, carbs are faster at providing your body energy, and you want to make sure your muscles have enough glycogen to power your activities.
My goal was to improve my running performance and build some muscle, so I chose Lumen’s performance track. You can, however, choose weight loss or general metabolic health tracks as well.
April: a carb-filled learning curve
My mom said no meal is complete without a bowl of rice, and I stand here today as an unapologetic carb lover. Also, anyone who’s ever tried to run a long-distance race without carbs knows that bonking sucks. Coming off a half marathon straight into my birthday month probably explains why for the first three weeks, my morning Lumen scores almost exclusively alternated between 3s and 4s. And truthfully, I didn’t put a lot of effort into reducing my carb intake because a birthday month without lots of cake and good food is a travesty.
Even so, the Lumen app did not shame me — as many fitness-related apps and wearables are wont to do. Instead, it peppered me with factoids and short videos with educational tips on nutrition, mental health, and how to properly use the Lumen. I was pleasantly surprised to find Lumen includes a comprehensive guide to portion sizes, macronutrients, and recipe suggestions. The majority of the recipes cater to a Western palate, but spending some time going through the app’s educational materials should give you the building blocks to navigate all sorts of cuisines.
While exploring the Lumen app, I was relieved to see the overall focus was on making slow, steady changes to your lifestyle rather than quick results. Tips included alternatives to the scale in measuring progress, ways to add to your diet instead of restricting, and suggested methods for building a sustainable exercise habit. I much prefer this approach to restrictive diets and an emphasis on calorie deficits. Not only is it more forgiving when life gets in the way, but it’s less reliant on motivation and willpower.
That said, I don’t recommend using Lumen for people struggling with or newly recovering from disordered eating without consulting a healthcare professional. Although Lumen takes thought and care into how this information is presented, I could see how someone could misuse Lumen to perpetuate disordered eating or obsess over measurements.
Truthfully, I didn’t see much, if any, progress in my training during April. My times were slow, I was easily fatigued, and my calves were perpetually screaming. A few weeks in, I had a check-in with a Lumen nutritionist to discuss a game plan and ways to improve. (This 1-on-1 guidance isn’t explicitly available to Lumen customers, though you can easily message support with questions from the app, and Lumen has a Facebook Group.) Most of the discussion reaffirmed what I already knew — eat the bulk of your carbs earlier in the day, whole grains are a good carb source, and there is always room for birthday cake. But I did learn a few good tips for sneaking extra protein into my meals — like swapping regular pasta for protein pasta — and that, for my lifestyle, I ought to try early morning workouts.
Looking back, April was more about getting the hang of this whole Lumen thing. Some changes — like eating dinner before 11PM — took me weeks to do sustainably. Before making tweaks to my diet, I had to understand my current diet. By week five, I started seeing minor improvements in my morning scores. All this to say, Lumen is not a system that delivers quick results — nor does it claim to. It takes four weeks of consistent use to get a Lumen Flex score! That’s annoying in a world that runs on instant gratification, but it’s at least honest.
May: meal logging is a pain
By May, I didn’t really think too hard about my morning measurement. I became a little breath-checking robot. It helped that I could double-tag my morning measurements. It’s subtle, but being able to tag my morning measurement as a pre-workout reading, too, helped get me into my running shoes and out the door. You can also tag measurements as pre-breakfast and post-fasting. That let me start focusing on following Lumen’s daily nutrition plans.
Since I chose the athletic performance track, the app gave an ambitious protein goal of 120g per day and a moderate fat goal. Carb goals fluctuated day to day. Some days were low-carb days; others were medium-carb days. Others yet were high-carb “boost” days. It’s effectively guided carb-cycling. I did my best to stick to the plans, but it wasn’t what I’d call easy.
For starters, 120g of daily protein is a lot. I normally average around 50-70g and don’t eat a lot of meat. I started drinking daily protein shakes to get most of the way to 120g but rarely achieved it. On the plus side, I’ve also now got a small database in my brain of protein-rich snacks and toppings that I can add to meals to get an extra boost. I also didn’t succeed at having low-carb days. I tried, but keeping my carbs to 75g was too difficult for me, noted carb lover. The app adds 15-30g to the total if you exercise for at least 30-40 minutes, but even that was tough.
And while tracking meals was easier than when I first reviewed Lumen, it’s still tedious. You can scan barcodes now, but newer or international products don’t always show up. In those instances, you have to manually enter them, and that’s a different kind of tedious if you have to do it multiple times per day. I’m not a math whiz, and the last thing I want to do is convert serving sizes on nutrition labels to what I actually ate, only to find the app tracks servings in a totally different unit of measurement. It was much easier to link Lumen up to HealthKit (or Google Fit for Android users) and then log meals in the Lose It app, which lets you import recipes from food blogs, scan barcodes, and has a larger user-generated database. The meals themselves don’t show up, but the daily macros do — and that’s the most important part.
I’ll cop to being terrible at meal logging. For me, it makes eating feel like a chore, and it’s by far my least favorite part of using Lumen. That said, it’s kinda imperative that you do it to get the most benefit.
Out of curiosity, I ordered some Metabolic Meals through the app. There are lots of options to choose from, all of which have been vetted by Lumen’s head of nutrition. You do have to order by 10AM ET on Wednesdays if you want meals the next week. Otherwise, you’ll have to wait 10 to 14 days, which was what ended up happening to me.
There are pros and cons. On the one hand, it’s so convenient. Boom, there’s a meal in the fridge that I can pop into the microwave and easily log by scanning the barcode. It took the guesswork out of what I should eat and ensured I wouldn’t order takeout if I didn’t feel like cooking. If you don’t finish all the meals within a certain week, then you can stick them in the freezer. Plus, there’s no subscription, so you’re not obligated to order every week or month like you are with services like Blue Apron or Green Chef. Taste-wise, they were fine, but — not to toot my own horn — I’m a better cook.
The main con is it can be expensive. Lumen gave me a code for 14 meals, but each meal costs somewhere between $10-$15, with the bulk at around $12-13. The minimum is eight meals per order, so on average, you’re going to spend at least $100. If you order eight lunches and dinners for the month? Then it makes sense, and you’re probably saving money that you would’ve spent on takeout. It gets way more expensive if you’re ordering this for two meals a day, seven days a week.
I will never ever like meal logging, but I won’t lie: I got results from doing it. Nothing major. My run times improved ever so slightly, I had more energy while running, my weight remained stable, and I was consistently waking up early. My Lumen Flex score shot up, and most days, I woke up with a score of 1 or 2. I had another follow-up with Lumen’s nutritionist ahead of my race, and basically, I was doing all the right things. The improvements were modest, but I’m also someone who was already doing most of what Lumen advises.
June: race day results
I was proud of myself for sticking to it for all of May, but I fell slightly off track in the two weeks before my race on June 17th and after. Life happens, and circumstances beyond my control impacted my sleep, which in turn impacted my training, which in turn made me less inclined to diligently track my macros. My Lumen scores started creeping up to 3s and 4s, my Flex score dropped, and I even forgot to take my measurements for a three-day stretch.
Even though I started backsliding, I still did the bare minimum with Lumen 90 percent of the time. Aside from those three days, I still took readings every morning and before / after workouts and threw macro logging to the wind. I didn’t notice that much of a change in performance, and this was a lot easier than tracking every meal. I was essentially treading water, but I felt spry enough on practice long runs that it was a tradeoff I felt fine making.
Going into the 10K, I decided not to have a time goal. The only goal was to enjoy the run as much as I could and, hopefully, feel good. I did amazing for the first half of the race before losing most of my steam at mile 5. And although I didn’t have a strong finish, had it not been for a terribly timed bathroom break at mile 4, I would’ve PR’ed. Was it a clear-cut win? No. But it was measurable progress; I accomplished what I set out to do and went home feeling good.
For the tortoises, not the hares
The TL;DR of this whole story is that I tried Lumen and improved a tiny bit after months of worsening performance. Were I to continue using Lumen, I imagine I’d keep improving bit by bit until I hit a plateau. At that point, I’d try something new and eventually break that plateau. Then, the cycle would repeat until I’m six feet under. Whether it’s worth the investment depends on how patient you are.
Since I last reviewed this device, Lumen’s switched to a subscription model. It’s $249 for a three-month plan, $299 for a six-month plan, and $349 for a yearlong plan. That’s roughly $83 a month for the three-month plan, $50 a month for the six-month plan, and $30 a month for the yearlong plan. The hardware comes “free,” and you get a 30-day money-back guarantee. I don’t love subscriptions, but they are par for the course in fitness and, increasingly, life.
If you want quick, dramatic results, I don’t think Lumen is a good fit. Unless you’re just starting out on your health journey, your gains will probably be modest. But let’s say you are an absolute beginner. In that case, Lumen is an excellent educational tool, and picking one of the shorter plans is enough to build a good foundation. For everyone else, it’s a matter of whether you believe that slow and steady wins the race. I do, and so for me, it was worth it. | Nutrition Research |
Weight influences how and when bodies burn energy, new research indicates.
An Oregon Health & Science University study published in the journal Obesity found people who have a healthy weight use more energy during the day, when most people are active and eat, while those who have obesity spend more energy during the night, when most people sleep. The study also found that during the day, those with obesity have higher levels of the hormone insulin — a sign that the body is working harder to use glucose, an energy-packed sugar.
“It was surprising to learn how dramatically the timing of when our bodies burn energy differed in those with obesity,” said the study’s first author, Andrew McHill, Ph.D., an assistant professor in the OHSU School of Nursing and the Oregon Institute of Occupational Health Sciences at OHSU. “However, we’re not sure why. Burning less energy during the day could contribute to being obese, or it could be the result of obesity.”
Schedules and when people sleep, eat and exercise can also affect health, by either complementing or going against the body’s natural, daily rhythms. Every 24 hours, people experience numerous changes that are triggered by the human body’s internal clock. These changes normally occur at certain times of the day in order to best serve the body’s needs at any given hour.
McHill and the study’s senior author, Steven A. Shea, Ph.D., director of the Oregon Institute of Occupational Health Sciences at OHSU, focus their research on how circadian rhythms and sleep impact the human body. McHill leads the OHSU Sleep, Chronobiology and Health Laboratory.
While previous research has suggested circadian rhythm misalignment affects energy metabolism and glucose regulation, those studies have largely involved participants who have a healthy weight. To explore this further, McHill, Shea and colleagues organized a study that included people of different body sizes.
A total of 30 people volunteered to participate in the study, which involved participants staying at a specially designed circadian research lab for six days. The study followed a rigorous circadian research protocol involving a schedule designed to have participants be awake and sleep at different times throughout each day.
After each period of sleep, volunteers were awakened to eat and participate in a variety of tests for the remaining time of each day. One test had participants exercise while wearing a mask that was connected to a machine called an indirect calorimeter, which measures exhaled carbon dioxide and helps estimate energy usage. Blood samples were also collected to measure glucose levels in response to an identical meal provided during each day.
Next, the research team plans to explore eating habits and hunger in people who are obese, as well as those who have a healthy weight. That new study will also follow up on a 2013 study, led by Shea, that found circadian clocks naturally increase food cravings at night.
This research was supported by National Institutes of Health (grants HL125893, HL156948, HL146992, HL155681, HL131308, HL163232, TR002370, HL151745, HD109477, TR000128, TR002369) and by the Oregon Institute of Occupational Health Sciences, which receives support from the State of Oregon.
This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
REFERENCE: Andrew W. McHill, Saurabh S. Thosar, Nicole P. Bowles, Matthew P. Butler, Omar Ordaz-Johnson, Jonathan S. Emens, Jonathan Q. Purnell, Melanie Gillingham, Steven A. Shea, Obesity alters the circadian profiles of energy metabolism and glucose regulation in humans, Obesity, Nov. 15, 2023, DOI: 10.1002/oby.23940, https://onlinelibrary.wiley.com/doi/full/10.1002/oby.23940. | Nutrition Research |
A UCLA-led team may have found the key to stimulating human brown adipose tissue into combating obesity
A UCLA-led team of researchers has found nerve pathways that supply brown adipose tissue (BAT), a type of tissue that releases chemical energy from fat metabolism as heat – a finding that could pave the way toward using it to treat obesity and related metabolic conditions.
The researchers have for the first time detailed this nerve supply and provided examples of how manipulating it can change BAT activity, marking a first step toward understanding how to use it therapeutically, said senior author Dr. Preethi Srikanthan, professor of medicine in the division of endocrinology, diabetes & metabolism, and the director of the Neural Control of Metabolism Center at the David Geffen School of Medicine at UCLA. The largest deposits of BAT are in the neck.
“We know from previous literature that the sympathetic nerve system is the main ‘on switch’ for BAT activity,” Srikanthan said. “However, the sympathetic nervous system is also responsible for many other stimulatory effects on organs such as the heart and gut. Finding a way to increase activity of BAT alone has been challenging, so finding out the path these sympathetic nerves take to BAT will allow us to explore ways of using nerves to provide a very specific stimulus to activate BAT.”
The paper is published in the peer-reviewed PLOS ONE.
The researchers dissected the necks of eight cadavers to trace the distribution of sympathetic nerve branches in the fat pad above the clavicle. They found nerve branches in all the dissections from the third and fourth cervical nerves to BAT. Further, they demonstrated that BAT activity had changed in clinical cases where neck pathology, such as an increase in BAT temperature following removal of a tumor, had effected a change in the nerves.
”There is a need to find long-term solutions for obesity, and while we are lucky to have effective drugs such as Wegovy and Mounjaro, people need to take them long term for weight loss,” Srikanthan said.
The researchers hope to use the knowledge gleaned from this study to find a way to coax BAT into producing a constant source of fat-burning heat.
“There is literature suggesting -- and we are doing another study to confirm it -- that these drugs act by stimulating BAT,” she said. “By identifying the nerve pathways supplying BAT we hope to explore methods of chronically stimulating nerves to BAT and hopefully achieving similar therapeutic outcomes of weight loss.”
Study limitations include the small number of cadavers dissected and the high age of the donated cadavers, which have a smaller amount of BAT compared to younger bodies.
Study co-authors are Dr. Shumpei Mori, Ryan Beyer, Dr. Breno Bernardes de Souza, Julie Sorg, Dr. Harold Sacks, Dr. Michael Fishbein, Dr. Grace Chang, Dr. Warwick Peacock, Dr. Maie St. John, Dr. Olujimi Ajijola, and Dr. Kalyanam Shivkumar of UCLA; Dr. Donald Hoover of East Tennessee State University, and Dr. James Law and Dr. Michael Symonds of University of Nottingham, UK.
The study was funded by the National Institutes of Health (OT2OD023848). | Nutrition Research |
Sarah Ferguson is continuing to recover following her single mastectomy.
"It's really just extraordinary to come to terms with a new you," she said on the July 5 episode of her and Sarah Thomson's podcast Tea Talks with the Duchess and Sarah, which was recorded about a week after the procedure. "It's extraordinary. You just cannot be complacent with yourself or life or just how lucky you are."
As Ferguson recalled, she had gone in for a routine mammogram and the doctor detected a "shadow." She said she then went to the NHS' Royal Free Hospital in London, where she "had contrast put in my arm" and they could further see the shadow. She later underwent surgery at King Edward VII's Hospital.
"From the drive from the Royal Free over to the VII, I sort of looked up mastectomy," the duchess remembered. "And then pathology came back a few days later and then, of course, your mind's already gone racing in every direction. And then [I] get a text saying, 'We think it's mastectomy.' Then your mind plays more tricks. And then you go and meet the reconstructive surgeon and you suddenly think, 'OK, we can do this.'"
Ferguson said the surgery lasted eight hours. A spokesperson for the 63-year-old told Sky News on June 25 that the procedure had "taken place successfully" and that the "prognosis is good."
And the duchess is continuing to urge others to get checked.
"We must make people realize, it's not OK. But if you're going to get it, then catch it quick," she shared on her podcast. "Do the screening, catch it quick and go and say I can do this….It's not bravery. It's not courage. It's about understanding that you're not going to feel as you did for a bit. So don't try and be a superhero. Take many steps, have the cup of tea, trust people. Very important not to be complacent with every single thing now."
"I think it's scary for any family member out there," she said. "You really start looking at your own demise. It's a wake-up call, and then you think, 'How am I going to deal with this?'"
However, Ferguson considers herself lucky.
It "didn't go into my lymph nodes, and I don't have to have chemo or radiation or Tamoxifen," she said, later adding. "My job is to get out there strong, healthy and keep spreading the word." | Women’s Health |
Over the last decade of diagnosing countless young patients with new psychotic disorders, one striking result has stuck out for New York City psychiatrist Dr. Ryan Sultan.
“Of all the people I’ve diagnosed with a psychotic disorder,” he said, “I can’t think of a single one who wasn’t also positive for cannabis.”
Sultan, an assistant professor of clinical psychiatry at Columbia Irving Medical Center, is one of many experts raising serious concerns about the increasing marijuana use by adolescents and young adults.
And the evidence is growing of marijuana’s association with psychiatric disorders such as depression, bipolar disorder and schizophrenia, especially in young men.
New research published this month, involving millions of people worldwide over decades, is adding to worries that heavy use of high-potency cannabis and legalization of recreational weed in many U.S. states could exacerbate the nation's mental health crisis in young adults.
“There is a big sense of urgency not just because more people are smoking marijuana, but because more people are using it in ways that are harmful, with higher and higher concentration of THC,” Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), said in an interview.
One of the studies, from researchers in Denmark in collaboration with the U.S. National Institutes of Health, found evidence of an association between cannabis use disorder and schizophrenia. The finding was most striking in young men ages 21-30, but was also seen in women of the same age.
The paper, published in the journal Psychological Medicine, looked at data from almost 7 million men and women in Denmark over the course of a few decades to look for a link between schizophrenia and cannabis use disorder.
The magnitude of the connection between cannabis and schizophrenia for young men surprised study author Volkow, who was expecting the number to be closer to 10%.
“This is worrisome,” she said.
Whether recreational cannabis laws contribute to underage consumption is unclear, but Volkow has made addressing cannabis use among teenagers one of NIDA’s top priorities. Daily marijuana use among young adults has risen to record highs, with more than 1 in 10 of young adults ages 19-30 now reporting daily use, and almost half reporting use within the last year, according to the agency's most recent data.
Another study, led by Sultan and Columbia researchers published earlier this month, found that teenagers who use cannabis only recreationally are two to four times more likely to develop psychiatric disorders, including depression and suicidality, than teenagers who don’t use cannabis at all.
Because research to date has been observational and doesn’t directly prove cause and effect, the connection between marijuana and psychiatric disorders is controversial. It’s unclear whether people who already have or are developing psychiatric conditions are more likely to turn to cannabis as a way to self-medicate or whether cannabis use triggers mental problems.
Volkow is optimistic that a large ongoing study on adolescent brain development at the National Institutes of Health can help answer this question.
Sultan acknowledged the limitations of the evidence. “It’s sort of this circular feedback where they’re kind of just feeding off each other,” he said.
Dr. Deepak D’Souza, a psychiatrist at Yale University who has been studying cannabis for 20 years, insists there are too many lines of evidence to ignore.
“We may be grossly underestimating the potential risks associated with cannabis,” he said.
Given increasing legalization and rising potency in cannabis products, D’Souza has never been more worried about the mental health effects of cannabis use among youth.
“This is a massive concern,” he said. “We have been woefully inept in educating the public and influencing policy.”
Is legalization affecting rates of marijuana use?
Early data suggests that in young adults ages 18-25, legalization is leading to higher rates of cannabis use, particularly in Oregon and Washington, according to an analysis published earlier this month in the journal Substance Abuse.
The research, led by researchers from McMaster University in Canada, found the evidence in other age groups a little less clear, and more research is needed to understand how legalization is affecting rates of cannabis use.
In areas where marijuana becomes legal and easier to access, Volkow’s concern is the ease with which products can be mixed, leading to a high total dose of marijuana consumed.
One of the biggest issues, she says, is the lack of regulation on the concentration of THC in products.
Marijuana consumed decades ago had concentrations of THC, the main psychoactive ingredient, of 2 to 3%, but cannabis products today can have THC levels as high as 90%.
“That’s not even the case for alcohol as you cannot put more than a certain percent alcohol into liquor,” she said. “The same thing with tobacco cigarettes, you regulate how much nicotine they have. Here, we have no regulation.”
THC potency is significant, Volkow said, because cannabis is more likely to be linked to psychosis with higher doses consumed.
What age is the most vulnerable?
Research has shown that the human brain is the last organ to fully develop and doesn’t finish until the mid-to-late 20s. That makes adolescents and young adults particularly vulnerable to the effects of cannabis as their brains continue to mature.
“Really, the ideal time to consider using weed — if you’re going to use it — is 26 or later,” Sultan said.
People who wait until at least age 26 are much less likely to become addicted or develop mental disorders, said Dr. Sharon Levy, a pediatrician and addiction specialist at Boston Children’s Hospital.
“The greatest risks are clearly in the adolescent and young adult age range,” she said.
However, people with a family history of a psychotic disorder shouldn’t use cannabis at all, Sultan cautioned
What does cannabis do to the brain?
Although scientists are still learning about the effects of marijuana on developing brains, studies so far suggest marijuana use in teenagers may affect functions such as attention, memory and learning, multiple studies have found.
“It’s somehow interfering with the connections that we use in our brain to distinguish between what’s going on in our heads and what’s going on outside of our heads,” Levy said in reference to the psychotic symptoms that can happen.
D’Souza added that cannabis use can have serious impacts on the developing brain because of its effects on the endocannabinoid system, a complex signaling system in the brain that marijuana targets.
“Endocannabinoid systems play an important role in sculpting the brain during adolescence, which is when schizophrenia usually manifests itself,” he said.
Disturbing that system with cannabis use could have “far reaching complex implications on brain development.” | Mental Health Treatments |
Cough syrup made with codeine could be made prescription-only following concerns it is addictive and can lead to serious health problems.
Most people get coughs when they have caught a cold - and over the counter medicines like syrups are used as a suppressant.
Codeine linctus is an oral solution or syrup with the active ingredient codeine phosphate and is used to stop a dry cough.
The Medicines and Healthcare products Regulatory Agency (MHRA) said it has received 116 reports of recreational drug abuse, dependence and/or withdrawal as a result of codeine medicines, including codeine linctus, since 2018.
There were also 277 serious and fatal adverse reactions to medicines containing codeine in 2021 and 243 in 2022 - and there have already been 95 cases so far this year.
As a result, the UK medicines safety regulator has launched a consultation on the reclassification of codeine linctus to a prescription-only medicine.
Dr Alison Cave, MHRA chief safety officer, said: "Codeine linctus is an effective medicine, but as it is an opioid, its misuse and abuse can have major health consequences.
"Every response received will help us to develop a broader view on whether codeine linctus should be restricted to prescription-only status.
"We want to hear from members of the public, health professionals and others who would be affected by this potential change so we can make a properly considered decision for the benefit of patients, carers, and healthcare professionals across the UK."
Pharmacists have welcomed the move, saying there is "insufficient robust evidence for the benefits of codeine linctus in treating coughs safely and appropriately".
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Professor Claire Anderson, president of the Royal Pharmaceutical Society, said: "We welcome the MHRA consulting in this area, to understand the impact of this potential change on pharmacists, pharmacy teams and the public.
"Medicines should maximise benefits to patient health with minimum risk. We believe there is insufficient robust evidence for the benefits of codeine linctus in treating coughs safely and appropriately. We also have significant concerns about its misuse and addictive potential, as well as the risk of overdose.
"There are many non-codeine based products available for the treatment of dry cough. With studies showing up to 60% of people are genetically predisposed to opioid dependence, the role of codeine linctus in treating what is ultimately a self-limiting condition is questionable."
The consultation will run for four weeks until 15 August. | Drug Discoveries |
The tally of COVID-19 cases linked to a conference of disease detectives hosted by the Centers for Disease Control and Prevention in April has reached at least 181, the agency reported.Roughly 1,800 gathered in person for this year's annual Epidemic Intelligence Service (EIS) Conference, which was held on April 24 to 27 in a hotel conference facility in Atlanta where the CDC's headquarters are located. It was the first time the 70-year-old conference had in-person attendees since 2019. The CDC agency estimates an additional 400 attended virtually this year.
By the last day of the event, a number of in-person attendees had reported testing positive for COVID-19, causing conference organizers to warn attendees and make changes to reduce the chance of further spread. That reportedly included canceling an in-person training and offering to extend the hotel stays of sick attendees who needed to isolate.
But in the days that followed, the CDC received reports of more cases, and it teamed up with the Georgia Department of Public Health to carry out a rapid assessment. As of May 2, the agency had tallied 35 cases linked to the conference.
The rapid assessment team surveyed attendees from May 5 to 12, and 1,443 conference attendees responded to the survey. Of those who responded, some attended the conference virtually, but the CDC said over 80 percent attended in person.
Overall, 181 or (13 percent of the total survey takers) reported testing positive for COVID-19, and 52 percent of the COVID-positive responders indicated it was their first known bout of COVID-19. Nearly all of the survey takers, 1,435 (99.4 percent), reported having received at least one COVID-19 vaccine. But 70 percent of the survey takers reported going unmasked during the gathering. The CDC notes that the conference occurred when transmission levels were low, during which the CDC does not recommend wearing masks.
The agency highlighted that none of the infected conference attendees were hospitalized, though 49 respondents (27 percent) reported taking antiviral medications for their infection.
"[T]he findings of this rapid assessment support previous data that demonstrate that COVID-19 vaccines, antiviral treatments, and immunity from previous infection continue to provide people with protection against serious illness," the agency wrote. "CDC continues to recommend that everyone ages six months and older stay up to date with all COVID-19 vaccines, including receiving an updated vaccine."
Still, according to an advisory seen by The Washington Post, the CDC is warning attendees of an upcoming conference the agency is holding at the same hotel venue in June about the outbreak at the event in April. The CDC is encouraging attendees of the June event to wear their "own high-quality masks and, if possible, also carry COVID-19 rapid tests with them." Spokesperson Kristen Nordlund said that the agency will also have masks on hand. | Epidemics & Outbreaks |
In brief
- Researchers at ETH Zurich and the University Hospital Zurich play ultra-brief tones to stimulate the brain during deep sleep.
- This stimulation improves cardiac output and relaxation of the left ventricle.
- Such technology to improve cardiovascular function could be relevant both in disease treatment and competitive sports.
Sleep is a vital aspect of human life, with deep sleep being particularly crucial for overall health. The brain recovers during this sleep stage, and the rest of the body seems to regenerate then as well.
Recently, researchers at ETH Zurich and the University of Zurich have shown that increased deep sleep is of particular benefit to the cardiovascular system: targeted stimulation with brief tones during deep sleep causes the heart – in particular the left ventricle – to contract and relax more vigorously. As a result, it pumps blood into the circulatory system and draws it out again more efficiently. The left ventricle supplies most organs, the extremities, and the brain with oxygen-rich arterial blood.
When the heart contracts, the left ventricle is squeezed and wrung out like a wet sponge. The more immediate and more powerful this wringing action, the more blood enters the circulation and the less remains in the heart. This increases blood flow, which has a positive effect on the cardiovascular system.
An interdisciplinary team of heart specialists led by Christian Schmied, Senior Consultant for Cardiology at the University Hospital Zurich, used echocardiography (cardiac ultrasound examinations) to demonstrate that the left ventricle undergoes more intense deformation after nocturnal stimulation. This is the first time anyone has shown that an increase in brain waves during deep sleep (slow waves) improves cardiac function. The corresponding study was recently published in the . European Heart Journal
'We clearly saw that both the heart’s pumping force and its relaxation were greater after nights with stimulation compared to nights without stimulation.'Christian Schmied
“We were expecting that stimulation with tones during deep sleep would impact the cardiovascular system. But the fact that this effect was so clearly measurable after just one night of stimulation surprised us,” explains project leader and sleep expert Caroline Lustenberger, SNSF Ambizione Fellow at the Neural Control of Movement Lab at ETH Zurich.
Heart specialist Schmied is also delighted: “We clearly saw that both the heart’s pumping force and its relaxation were greater after nights with stimulation compared to nights without stimulation.” Both factors are an excellent measure of cardiovascular system function.
Stimulation with pink noise
The study involved 18 healthy men aged 30 to 57, who spent three non-consecutive nights in the sleep laboratory. On two nights, the researchers stimulated the subjects with sounds; on one night, they did not.
While the subjects slept, the scientists continuously measured their brain activity, blood pressure and heart activity. They coupled their measurements to a computer system that analysed the incoming data.
As soon as the readings indicated that the subject had fallen into deep sleep, the computer played a series of very brief tones at certain frequencies, called pink noise, which sound like static. Ten seconds of such tones were followed by 10 seconds of silence, and then the same procedure could be repeated. A feedback mechanism ensured that the noise was played at the right time and – depending on the brain wave pattern – stopped again.
This experimental setup allowed the researchers to directly monitor whether the sound simulation enhanced deep sleep and whether it influenced the subjects’ heart rate and blood pressure. “During stimulation, we clearly see an increase in slow waves, as well as a response from the cardiovascular system that is reminiscent of cardiovascular pulsation,” says lead author Stephanie Huwiler, describing the direct effects during sleep.
The next morning, the heart specialists examined the subjects’ cardiac function using echocardiography (ultrasound).
Significant results despite small group
“Despite the relatively small group of subjects, the results are significant. We were also able to reproduce the results on two separate nights, which in statistical terms makes them very strong,” Lustenberger says.
'The treatment of cardiovascular diseases may be enhanced with this or similar stimulation methods.'Caroline Lustenberger
A small group size is typical for laboratory sleep studies, she adds, because they require a lot of resources. In addition, the researchers deliberately selected only men. This is because they are more homogeneous as a group of subjects than women in a comparable age bracket, whose menstrual cycle or menopause has a major effect on their sleep. “When all you’ve got to work with is one night a week for three weeks, the effects of the menstrual cycle will play a role in women. These effects might have masked the stimulation effect in this sort of initial study,” Lustenberger explains.
She emphasizes, however, that future studies should definitely include women, as gender differences in sleep and cardiovascular health are becoming increasingly apparent and have profound implications for primary healthcare.
Practical future benefits
This study is of great interest not only to cardiologists but to athletes as well. “Especially in preventive medicine, but also in competitive sport, this kind of deep sleep stimulation system might enable improved cardiac function in the future – and possibly ensure faster and better recovery after intense workouts,” says Huwiler, who presented the initial results of the study at the Zurich Symposium for Sports Cardiology in March 2023. Lustenberger adds: “The treatment of cardiovascular diseases may be enhanced with this or similar stimulation methods. However, it’s crucial to first investigate whether patients can benefit from this kind of deep sleep stimulation method as well.”
The researchers are now looking for further, more powerful stimulation methods to positively impact the cardiovascular system. To this end, Huwiler is applying to Innosuisse for a Bridge Proof of Concept grant and for an ETH Pioneer Fellowship grant. In addition, she is in the process of setting up a start-up called EARDREAM together with Lustenberger, Simon Baur, and Rafael Polanía to further develop the findings and transfer them into practice.
The SleepLoop project
This project has been carried out as part of the flagship project that was launched in 2017 by the SleepLoop research network. SleepLoop was initiated by researchers at the Interdisciplinary Centre for Sleep Medicine at University Children’s Hospital Zurich and the Department of Neurology at University Hospital Zurich. A total of 16 research groups from ETH Zurich, the University of Zurich and Ulm University are involved in it. University Medicine Zurich | Medical Innovations |
Image source, Getty ImagesMore than 650,000 deaths were registered in the UK in 2022 - 9% more than 2019. This represents one of the largest excess death levels outside the pandemic in 50 years.Though far below peak pandemic levels, it has prompted questions about why more people are still dying than normal.Data indicates pandemic effects on health and NHS pressures are among the leading explanations. Is it Covid?Covid is still killing people, but is involved in fewer deaths now than at the start of the pandemic. Roughly 38,000 deaths involved Covid in 2022 compared with more than 95,000 in 2020.We are still seeing more deaths overall than would be expected based on recent history. The difference in 2022 - compared with 2020 and 2021 - is that Covid deaths were one of several factors, rather than the main explanation for this excess. So what else might be going on?The crisis in healthcareA number of doctors are blaming the wider crisis in the NHS.At the start of 2022, death rates were looking like they'd returned to pre-pandemic levels. It wasn't until June that excess deaths really started to rise - just as the number of people waiting for hours on trolleys in English hospitals hit levels normally seen in winter.On 1 January 2023, the president of the Royal College of Emergency Medicine suggested the crisis in urgent care could be causing "300-500 deaths a week". It is not a figure recognised by NHS England, but it's roughly what you get if you multiply the number of people waiting long periods in A&E with the extra risk of dying estimated to come with those long waits (of between five and 12 hours).It is possible to debate the precise numbers, but it's not controversial to say that your chances are worse if you wait longer for treatment, be that waiting for an ambulance to get to you, being stuck in an ambulance outside a hospital or in A&E.And we are seeing record waits in each of those areas. In November, for example, it took 48 minutes on average for an ambulance in England to respond to a suspected heart attack or stroke, compared to a target of 18 minutes. Lasting effect of pandemicSome of the excess may be people whose deaths were hastened by the after-effects of a Covid infection. A number of studies have found people are more likely to have heart problems and strokes in the weeks and months after catching Covid, and some of these may not end up being linked to the virus when the death is registered. As well as the impact on the heart of the virus itself, some of this may be contributed to by the fact many people didn't come in for screenings and non-urgent treatment during the peak of the pandemic, storing up trouble for the future. We can see that the number of people starting treatment for blood pressure or with statins - which can help prevent future heart attacks - plunged during the pandemic and, a year later still hadn't recovered. No evidence of vaccine effectThe rise in cardiac problems has been pointed to by some online as evidence that Covid vaccines are driving the rise in deaths, but this conclusion is not supported by the data. One type of Covid vaccine has been linked to a small rise in cases of heart inflammation and scarring (pericarditis and myocarditis). But this particular vaccine side-effect was mainly seen in boys and young men, while the excess deaths are highest in older men - aged 50 or more.And these cases are too rare - and mostly not fatal - to account for the excess in deaths.Finally, figures up to June 2022 looking at deaths from all causes show unvaccinated people were more likely to die than vaccinated people. While this data on its own can't tell us it's the vaccine protecting people from dying - there are too many complicating factors - if vaccines were driving excess deaths we would expect this to be the other way around. | Epidemics & Outbreaks |
Patients with rheumatic conditions who shielded during the pandemic feel "left behind", according to new research.
The University of the West of England (UWE) in Bristol conducted a study with patients about their experiences of shielding during the pandemic and how it continued to affect them.
Researchers interviewed 15 rheumatology patients from the Bristol area.
Pamela Richards, who suffers with arthritis, said the pandemic has been "a massive blow" to the way she lives.
At the height of the pandemic, four million people in the UK were advised to shield.
"I have never experienced anything like shielding, it heightened a sense of anxiety in me," said Ms Richards.
"How do I get food? I cannot leave the house. How can I see friends? I was not allowed to."
Ms Richards, who shielded for nearly two years during the pandemic, said that life has not returned to normal, despite no longer being advised to shield.
"It is a new normal, which is about being on high alert and managing risk every day," she said.
"A lot of people are now able to go back to every day business without care, but there is still some of us that are wary about doing really normal things."
The research group had a mix of rheumatic conditions including rheumatoid arthritis, psoriatic arthritis, lupus, Sjogren's and ANCA Vasculitis.
Many of the participants helping with the research, funded by the Bath Institute for Rheumatic Diseases, also spoke about a lack of self confidence due to the mental impact.
Researcher Christine Silverthorne said: "Many are still dealing with lasting physical and mental effects both from the experience of shielding and as a consequence of delays to their healthcare and treatment.
"By raising awareness of our findings about the needs of rheumatology patients, we hope to enable patients to receive the support they need and find their new normal," she added.
"People with conditions such as rheumatoid arthritis are often overlooked."
A spokesperson for the Department for Health and Social Care said: "The welfare of the most vulnerable people remains a priority as we live with Covid.
"We continue to prioritise access to vaccines, treatments and free lateral flow tests for this group.
"The NHS website also has resources for mental health support and patients are advised to contact their local GPs for more personalised health advice." | Epidemics & Outbreaks |
An A-level student has told how she was bombarded by disgusting comments from older men after plucking up the courage to speak out about her rare diagnosis.
Elsie Slaats, from Norwich, found out that she had MRKH - a congenital malformation characterised by the failure of the uterus and vaginal canal to develop - when she was 16 and had not started her period.
Since her diagnosis, she has been undergoing dilation treatment, which involves inserting an instrument into the vagina to lengthen it and make sexual activity more comfortable.
The 18-year-old has bravely shared her journey to her 33,700 followers on TikTok but now has to deal with men, who are often much older than she is, sexualising her condition and asking her if she's "tight".
However, she refuses to let the vile comments stop her from raising awareness about the condition.
Elsie, who goes by the handle @mrkhwithels, said: "As a young girl, these kinds of comments were off-putting; especially when I was trying to create content to raise awareness.
"Luckily, I'm quite level-headed and I don't let comments get to me.
"I am very proud of succeeding with my dilatation therapy. It was difficult for me to remain consistent as it wasn't the most comfortable or pleasant process, but I found ways of relaxing to make it easier.
"I'm also proud of how I've dealt with this diagnosis and the impact I’ve had on girls in similar situations to me.
"I've met so many great people through my TikTok, and on my bad days, reading the positive messages and comments that I receive makes me feel so much better.
"It reminds me why I started the account in the first place."
Elsie went to the GP after growing concerned over her lack of period and the fact that she felt she "hadn't developed in the way that most girls had".
After doing some research, she initially suspected that she had an imperforate hymen - a condition where a hymen without an opening obstructs the vagina.
But further tests, including scans and an MRI, revealed that she had MRKH which, unlike an imperforate hymen, is incurable.
Elsie said: "This was an emotional time for 16-year-old me, leaving me feeling unsure about the future and how my life would now be affected.
"The prospect of having MRKH was quite a shock to both me and my mum.
"Going about my daily routine carrying such heavy emotions around was challenging for me, but the support of my close friends and family was crucial at that time.
"It can make relationships difficult, but not because anyone has ever discriminated against me for my condition. It's more due to my insecurities.
"Sometimes I worry that I can't give people the same as other girls can.
"It can be hard for me to feel 100% confident in myself and I'll fall into the trap of comparing myself to others which can strain my relationships if it comes across as jealousy or distrust in a partner."
Despite the challenges she faces, Elsie has not given up hope of having a family of her own one day.
"As a young woman, coming to terms with not being able to get pregnant was very difficult for me," Elsie said.
"The way I fight these feelings is by remembering the support around me, as well as thanking my body for the things it can do for me.
"MRKH doesn’t affect my ovaries, meaning my egg cells can be extracted in order for a surrogate mother to carry a child for me.
"Although this is different to how I originally planned my life to go, I feel grateful that I could still have a child which is biologically mine.
"Researching surrogacy and adoption is something important for me, but given that I’m still so young, I feel as though I should enjoy these years of my life and worry about the logistics of having children later on."
Elsie is also determined to continue with her advocacy and raise awareness for MRKH.
She said: "I wish MRKH was more talked about in general. Although there is a strong, tight-knit community of MRKHers who support one another, the wider public isn't as educated.
"It tends to be assumed that every girl has a period, every girl will go on to have a family, etc, which isn't actually the case.
"MRKH will always be a big part of my life and will change many aspects of it.
"But I am still a woman, and I hope anyone else diagnosed with this or something similar can come to this conclusion." | Disease Research |
Health inequality across England is growing as some regions are "left further behind" in the drive to cut NHS waiting lists.
There is a 29% difference in the number of people waiting in the most and least affected regions, a new analysis of the NHS by the firm Lane Clark & Peacock (LCP) has found.
In 2021, the company found an estimated 7.8 million people were likely waiting for care on the NHS in England - a figure higher than the official number of 5.8 million at the time because of people who had yet to come forward for treatment.
The official number of people needing treatment will likely peak at more than 7.3 million in April, LCP has now found.
But it has again warned the true number could be much higher.
The concerning analysis comes as tens of thousands of junior doctors launch a three-day strike in a dispute over pay and conditions, and despite the government's Elective Recovery Plan, which is intended to cut waiting lists.
Progress has been made, with waits of more than two years reduced to two patients per 100,000 nationally, while waits of 18 months and above are also down from their peak.
Read more:
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Hundreds of community pharmacies could close
NHS waits are also differing significantly, depending on where you live in England.
In November 2021, the regions with the most and fewest people on the waiting list after adjusting for population size were the North West (11,199 per 100,000 people) and the North East (8,941 per 100,000 people).
This means there were 25% more people on the waiting list in the most affected region compared to the least affected.
One year on, rather than bridging the gap, geographical inequalities in waiting lists appear to be more pronounced.
The East of England has the most people waiting for elective care at 12,918 per 100,000 people, while the South East has the least, at 10,022 per 100,000 people.
The South East has also seen 18-month waits reduced by 51% compared to the Midlands, which has seen only a 20% reduction so far.
Orthopaedics and gynaecology face the most challenges
Specialist areas, such as orthopaedics and gynaecology, have seen the most challenging wait times.
The LCP analysis shows that orthopaedics is the clinical speciality with the largest population-adjusted waiting lists, with 1,386 per 100,000 people in November 2022, an increase of 60% since March 2020.
Despite improvements over the previous year in those waiting longer than 52 weeks for care, 59,000 patients have been waiting more than a year for orthopaedic treatment.
Meanwhile, as of November 2022, gynaecological waiting lists have increased by almost 100% since the beginning of COVID-19, growing from 489 per 100,000 people across England in March 2020 to 963 per 100,000.
If the NHS achieves its targets, the official waiting list is expected to peak in April, at 7.3 million.
But there are warnings it could reach 7.9 million, with the peak instead coming in July, if the targets for increasing capacity are missed.
Yet the true number of patients requiring care may be even higher.
Some patients are counted as 'hidden need' in the analysis - meaning people who may not have joined elective waiting lists during the pandemic, either due to fear of contracting COVID-19 or due to challenges in securing appointments.
The reality is, according to LCP, that as many as 13.1 million people could be waiting for NHS care, with a prediction this could peak at 15.5 million in 2023.
This problem is also not equally distributed across England.
Of the areas with the greatest unmet need (which means the waiting list, plus the hidden need), four of the top six are clustered together across the North West and Midlands.
These are NHS Black Country (the second most unmet need per 100,000), NHS Cheshire and Merseyside (fourth), NHS Staffordshire and Stoke-onTrent (fifth) and NHS Greater Manchester (sixth).
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This disparity could also become a political problem.
Of the 42 English seats the Conservatives won from Labour in the 2019 general election, 12 of these (29%) are found within the North West/Midlands cluster, with high amounts of hidden need.
Robert King, an associate consultant at LCP, said: "In the context of patients with increasingly complex, chronic conditions, coupled with ongoing financial and workforce pressures, the NHS needs to find innovative ways to strengthen capacity and address inequities.
"Alongside this, it is clear that the East of England, Midlands and areas in the North West are being left further behind, and policymakers can help move the needle by proportionately targeting resources and support to areas with the greatest need." | Health Policy |
An announcement from MIT News: One promising approach to treating Type 1 diabetes is implanting pancreatic islet cells that can produce insulin when needed, which can free patients from giving themselves frequent insulin injections. However, one major obstacle to this approach is that once the cells are implanted, they eventually run out of oxygen and stop producing insulin.
To overcome that hurdle, MIT engineers have designed a new implantable device that not only carries hundreds of thousands of insulin-producing islet cells, but also has its own on-board oxygen factory, which generates oxygen by splitting water vapor found in the body. The researchers showed that when implanted into diabetic mice, this device could keep the mice's blood glucose levels stable for at least a month. The researchers now hope to create a larger version of the device, about the size of a stick of chewing gum, that could eventually be tested in people with Type 1 diabetes.
"You can think of this as a living medical device that is made from human cells that secrete insulin, along with an electronic life support-system," says Daniel Anderson, a professor in MIT's Department of Chemical Engineering, a member of MIT's Koch Institute for Integrative Cancer Research and Institute for Medical Engineering and Science, and the senior author of the study.
While the researchers' main focus is on diabetes treatment, they say that this kind of device could also be adapted to treat other diseases that require repeated delivery of therapeutic proteins.
Thanks to Slashdot reader schwit1 for sharing the news.
To overcome that hurdle, MIT engineers have designed a new implantable device that not only carries hundreds of thousands of insulin-producing islet cells, but also has its own on-board oxygen factory, which generates oxygen by splitting water vapor found in the body. The researchers showed that when implanted into diabetic mice, this device could keep the mice's blood glucose levels stable for at least a month. The researchers now hope to create a larger version of the device, about the size of a stick of chewing gum, that could eventually be tested in people with Type 1 diabetes.
"You can think of this as a living medical device that is made from human cells that secrete insulin, along with an electronic life support-system," says Daniel Anderson, a professor in MIT's Department of Chemical Engineering, a member of MIT's Koch Institute for Integrative Cancer Research and Institute for Medical Engineering and Science, and the senior author of the study.
While the researchers' main focus is on diabetes treatment, they say that this kind of device could also be adapted to treat other diseases that require repeated delivery of therapeutic proteins.
Thanks to Slashdot reader schwit1 for sharing the news. | Medical Innovations |
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So, the ball's in your court. Remember the potential waiting to be unlocked and the difference you can feel with the right nutrition. It's time to make the move, grab the system, and welcome the vibrant version of you. Ready to dive in? The door to wellness is wide open, just waiting for you to step through! Click here to learn more. | Nutrition Research |
A team of researchers at the University of Massachusetts Amherst has shown how a single, small strand of microRNA, known as let-7, governs the ability of T-cells to recognize and remember tumor cells.
This cellular memory is the basis for how vaccines work. Boosting cellular memory to recognize tumors could help improve cancer therapies.
The research, supported by the National Institutes of Health and published recently in Nature Communications, suggests a new strategy for the next generation of cancer-fighting immunotherapies.
“Imagine that the human body is a fortress,” says Leonid Pobezinsky, associate professor of veterinary and animal sciences at UMass Amherst and the paper’s senior author, along with a research assistant professor Elena Pobezinskaya.
Our bodies have T-cells, which are white blood cells that specialize in fighting both pathogens, think of the common cold, and altered cells of the organism itself, like tumor cells. Most of the time, the T-cells are “naïve”—mustered out of duty and resting. But when they recognize foreign antigens after bumping into them, they suddenly wake up, turn into killer T-cells and attack whatever the pathogen may be, from the sniffles to COVID, or even cancer.
After the killer T-cells have won their battle, most of them die.
“But,” says Pobezinsky, “somehow a few survive, transform into memory cells and form an elite task force called the ‘memory pool’—they remember what that particular antigen looked like, so that they can be on the lookout for the next time it invades the body.”
This is one of the mechanisms behind how vaccines work: infect the body with a weakened dose of a pathogen—say, the chicken pox virus—and the memory cells will remember what that virus looks like, turn into killer T-cells, annihilate the virally infected cells and then transform back into memory cells, waiting for the next time the chicken pox virus shows up.
But it’s never been clearly understood just how T-cells form their memories.
Cancerous tumor cells work by tricking the killer T-cells, turning them off before they can attack and create a memory pool, leaving the cancer to metastasize unchecked.
“What we’ve discovered,” says Pobezinsky, “is that a tiny piece of miRNA, let-7, which has been handed down the evolutionary tree since the dawn of animal life, is highly expressed in memory cells, and that the more let-7 a cell has, the less chance that it will be tricked by cancerous tumor cells, and the greater chance it has of turning into a memory cell.”
If the memory cell isn’t tricked by the cancer, then it can fight and, crucially, remember what that cancerous cell looks like.
“Memory cells can live for a very long time,” adds Pobezinskaya. “They possess stem-cell-like features and can live for 70 years.”
“We are very excited, not only about the fundamental insights this research has provided, but also the translational impact it could have on next generation immunotherapies,” says lead author Alexandria Wells, a postdoctoral fellow at the Cancer Research Institute who completed the work at UMass Amherst.
“In particular, understanding how let-7 is regulated during treatment to enhance the memories and capabilities of our own immune systems is a promising avenue for further research.”
SHARE the Cancer Research to Bring Hope to Social Media… | Disease Research |
Trays of cookies and tins of assorted popcorn at work. Holiday parties laden with sugary desserts. Family gatherings with tables overloaded with turkey or ham, all kinds of potatoes, and buttery rolls. Thereâs no way around it: The weeks between Thanksgiving and New Yearâs pose all kinds of challenges for anyone trying to maintain a healthy weight.
Actually, studies show that most adults donât gain as much weight as you might think during the holidays.Â
The average weight gain during this time period is anywhere from 0.8 pounds to just under 2 pounds, according to a research review published in the Journal of Obesity.
Where that can start to become a problem is when that extra pound or two sticks around after the holidays, and is on repeat year after year. A pound every December can turn into 10 pounds in a decade.Â
âStudies have also found that people who are already overweight and obese gain more weight than those who are at a healthy weight, and when considering average weight gain over a year, holiday weight is the major contributor to annual excess weight gain,â says Vanessa King, MS, a registered dietitian nutritionist and spokesperson for the Academy of Nutrition and Dietetics.Â
So how can you continue to enjoy your holiday traditions, including the ones involving food, without feeling guilty or putting on unhealthy weight?Â
âWhatâs important is our mindset,â King says. âWe donât want our goal of healthy eating to mask disordered eating habits, such as cutting out food groups or feeling shame around weight gain.âÂ
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âLife is short and we need to enjoy it,â says Grace Derocha, MBA, a registered dietitian and  Academy of Nutrition and Dietetics spokesperson. âFood is more than fuel and calories, especially during this time of year. Itâs tradition, itâs memories, itâs culture, itâs social connection, itâs family, itâs love. Rather than viewing holiday eating through a lens of denial and saying âNo,â I suggest focusing on being present to enjoy what youâre doing, including what you are eating, while trying to make the best choices you can.â
Top Tips for Healthy Holiday Eating, From Dietitians
Donât skip meals. If you know you have a big dinner event with lots of tempting food coming up, it might seem like a good idea to skip lunch and âmake more roomâ for the eveningâs treats. Donât do it! âThat throws your body into starvation mode,â Derocha says. âYour hunger and satisfaction cues are thrown off, and your body holds onto the calories. You want to teach your body to be its best self, and skipping meals is not the way to do that.â
Practice mindfulness at parties and family dinners. âIf you stay in the kitchen or near the buffet table, it can be easy to keep taking bites or serving seconds,â King says. âMove your chats out of the kitchen and away from the table. If mealtime is over and food is still on the table, package up the leftovers right away to freeze or send home.â
Heed your bodyâs hunger cues. âHaving that understanding of âAm I hungry, or am I satisfied?â is a big part of the battle,â Derocha says. âYou can enjoy a sampling of the buffet table, but that doesnât mean that you have to eat the entire tray of cheesy potatoes. Listen when your body tells you itâs had enough.â
Choose healthier options whenever you can. That doesnât mean skipping the pumpkin pie or the buttery mashed potatoes if you love them. But aim for most of your meal to be healthy. âThink of choosing vegetables and more raw, grilled, and baked versions of dishes and less of the gravy and heavy sauces,â King says. âOpt for leaner meats and proteins that are broiled, baked, and grilled vs. fried or breaded.â
Make allowances for favorites. Are there foods that you know are your family traditions, or the âonce a yearâ specialties that you donât have very often? âYou should get to enjoy that without guilt or shame or fear of weight gain,â Derocha says.
Bring snacks when you travel. Traveling can disrupt healthy eating, with temptations to grab nutritionally disastrous (and expensive!) snacks in airports and at highway rest stops.
Get enough sleep. âThis can be particularly challenging during the holidays, but less sleep means less energy, and that means that we are more likely to turn to more comforting and less nutrient-dense foods,â King says.
Move your body. When itâs cold outside and days are shorter, the urge to hibernate can be strong. âYou donât have to go to your workout class like you normally do, but even little things like extra laps if youâre doing holiday shopping at the mall, or going for an outdoor walk after a heavy lunch, can be helpful,â Derocha says. âWalking outside when itâs crisp and cold can feel nice. Nature is also a de-stressor, and stress can contribute to weight gain.â
Think long-term. Being mindful about holiday eating can help keep any short-term weight gain under control, but remember to keep things in perspective. âWhen it comes to our weight or anything around our health, we can overestimate whatâs going to happen in a short period of 6 weeks and underestimate the power of committing to a long-term healthy lifestyle,â King says. | Nutrition Research |
Cases of tuberculosis (TB) — an illness that kills more people than any other infectious disease — rose in the U.S. during 2022, per the Centers for Disease Control and Prevention (CDC). And some doctors are concerned that limitations of testing at the border could be partly to blame for the surge.
In 2021, the disease infected nearly 11 million people and caused 1.6 million deaths worldwide, according to the World Health Organization (WHO).
Tuberculosis is a highly contagious disease caused by a bacterial infection. It primarily affects the lungs, but can also affect the brain, kidneys and spine.
Required testing may have limitations: CDC
The CDC states that all refugees ages two and older must be tested for tuberculosis before entering the U.S.
"By law, refugees diagnosed with an inadmissible condition are not permitted to depart for the United States until the condition has been treated," the agency states on its website.
The CDC uses its Electronic Disease Notification (EDN) system to notify federal, state and local health departments of any immigrants and refugees who are found to have medical conditions that require follow-up.
There are limitations to that process, however.
"By design, the EDN system only collects information for the approximately 10% of immigrants who have an overseas medical classification," explained Neha Sood, health communication specialist for the CDC in Atlanta, Georgia, in a statement to Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor.
"Human error likely caused some losses, resulting in possible underestimates of immigrants with medical classifications."
"Thus, DHS [Department of Homeland Security] data were used to approximate the immigrant denominators."
There is also some degree of human error that comes into play, Sood added.
"Because data transfer for immigrants during the study period primarily relied on staff at ports of entry to correctly review, retain and route paper forms for each immigrant with a medical classification, human error likely caused some losses, resulting in possible underestimates of immigrants with medical classifications," she said.
While health departments are "encouraged and provided incentives" to share the results of immigrants’ testing with the CDC, Sood said there is always the chance of "underreporting."
She added, "The proportion of immigrants, refugees and eligible others who completed a post-arrival examination might be higher than indicated in this report."
Although the CDC has "comprehensive surveillance systems" to track communicable diseases within the U.S., the agency does not track diseases by immigration status, Sood explained.
Linda Yancey, M.D., a specialist in infectious disease who is affiliated with Memorial Hermann Health System in Houston, Texas, said she regularly sees people who have screened positive for the disease and need treatment to prevent developing symptomatic illness.
"Tuberculosis is quite common in Texas, especially in the big cities," she told Fox News Digital. "Houston is an international port of entry, so we get people from TB-endemic areas coming here frequently."
Most of the imported tuberculosis cases seen at Memorial Hermann are among people coming from Africa and the Indian subcontinent, Yancey said.
"People can be exposed to TB years before they become contagious."
"This is why immigrants coming into the U.S. are screened at the time of entry," she said.
"People can be exposed to TB years before they become contagious," she went on. "By doing early screening, we are able to treat people long before they develop severe pneumonia."
Immigrants who have positive screenings are given three to four months of pills to protect their TB from developing into an illness, Yancey said.
In a 2022 study by the University of Texas, researchers analyzed patterns in tuberculosis patients who had been diagnosed when crossing into the U.S. from the Mexican state of Tamaulipas, which serves as a "migration waypoint."
The study, which was published in the Journal of Immigrant and Minority Health, found that an average of 30% of immigrants screened positive for tuberculosis over an eight-year period.
Immigrants with tuberculosis may be less likely to get successful treatment due to various factors, the study authors also wrote in a discussion of their findings.
The barriers to treatment that were cited included mobile living conditions, economic constraints, fear of deportation and the policy of the host country to provide free TB therapies.
Drug-resistant tuberculosis poses treatment challenge
Another concern is the type of TB that potentially could be coming into the U.S.
James Hodges, M.D., an internist in Waco, Texas, is concerned that immigrants are bringing in a drug-resistant strain of the disease.
"Immigrants who are positive for tuberculosis are more likely to have a drug-resistant type."
"I have found that immigrants who are positive for TB are more likely to have a drug-resistant type," he told Siegel.
"This is likely due to the over-the-counter meds and antibiotics that are available in Mexico and other central and South American countries — these patients have incompletely treated coughs on their own," Hodges continued.
"This is becoming more common with the last two years of an open border."
Tuberculosis treatments need to be "specialized, complex regimens," Dr. Siegel explained. "Here in the U.S., we use INH, Rifampin, PZA, Ethambutol and others. If you use an over-the-counter antibiotic that only partially treats TB, resistance is more likely to emerge."
Facts about tuberculosis symptoms, diagnosis and treatment
Exposure to tuberculosis is very common, but only about 20% to 30% of people who are exposed to it become infected, according to Mount Sinai.
Most new infections occur when bacteria enter the air after the infected person coughs or sneezes, and is then breathed in by someone else.
A majority of people who get the infection will have no symptoms and are not contagious, which is known as "latent tuberculosis."
Those who have "active infections" develop the disease, experience symptoms and can potentially spread it to others.
During the first stage of TB, most people don’t experience any symptoms, though some may have a mild fever, cough and/or fatigue.
Patients who develop an active infection — either immediately after the primary infection or after months or years of a latent infection — may experience coughing (sometimes with blood or mucus), chest pain, pain when breathing or coughing, fever, chills, weight loss, night sweats, loss of appetite and/or fatigue, according to the Mayo Clinic’s website.
Some people may develop extrapulmonary tuberculosis, which is when the infection spreads from the lungs to affect other parts of the body.
"If you have tuberculosis and you’re treated, your outlook is good if you’ve followed directions and taken your medications for as long as you should and in the way you were told."
There is currently no vaccine for TB available in the U.S.
Diagnosis can be made via a skin test or a blood test.
For those who have positive screenings, additional tests — including chest X-rays, CT scans and lab analysis of lung fluid — can determine the extent of the infection and the impact on the lungs, according to the Cleveland Clinic website.
There are multiple treatments available for both latent and active tuberculosis, Yancey said.
"For latent disease, we treat with drugs like rifampin, rifapentine and isoniazid," she said. "People only need to take the pills for three to four months."
For active disease, additional pill options include pyrazinamide, ethambutol, moxifloxicin and linezolid, Yancey said.
There is also an injectable option called amikacin.
"Because we have so many different options to treat TB, drug shortages are very seldom an issue," Yancey said. "If one drug is in short supply, we have multiple effective alternative regimens."
Medications are typically taken for a period of at least six to nine months.
If left untreated, the disease can be fatal.
"If you have tuberculosis and you’re treated, your outlook is good if you’ve followed directions and taken your medications for as long as you should and in the way you were told," the Cleveland Clinic’s website indicates.
People who experience chest pain, severe headache, seizures, confusion, difficulty breathing, bloody mucus or blood in the urine or stool should seek emergency medical care right away, per the Mayo Clinic. | Epidemics & Outbreaks |
An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to pain medicine. In 16.6 days, it estimated, she would be ready to leave her nursing home.
On the 17th day, her Medicare Advantage insurer, Security Health Plan, followed the algorithm and cut off payment for her care, concluding she was ready to return to the apartment where she lived alone. Meanwhile, medical notes in June 2019 showed Walter’s pain was maxing out the scales and that she could not dress herself, go to the bathroom, or even push a walker without help.
It would take more than a year for a federal judge to conclude the insurer’s decision was “at best, speculative” and that Walter was owed thousands of dollars for more than three weeks of treatment. While she fought the denial, she had to spend down her life savings and enroll in Medicaid just to progress to the point of putting on her shoes, her arm still in a sling.
Health insurance companies have rejected medical claims for as long as they’ve been around. But a STAT investigation found artificial intelligence is now driving their denials to new heights in Medicare Advantage, the taxpayer-funded alternative to traditional Medicare that covers more than 31 million people.
Behind the scenes, insurers are using unregulated predictive algorithms, under the guise of scientific rigor, to pinpoint the precise moment when they can plausibly cut off payment for an older patient’s treatment. The denials that follow are setting off heated disputes between doctors and insurers, often delaying treatment of seriously ill patients who are neither aware of the algorithms, nor able to question their calculations.
Older people who spent their lives paying into Medicare, and are now facing amputation, fast-spreading cancers, and other devastating diagnoses, are left to either pay for their care themselves or get by without it. If they disagree, they can file an appeal, and spend months trying to recover their costs, even if they don’t recover from their illnesses.
“We take patients who are going to die of their diseases within a three-month period of time, and we force them into a denial and appeals process that lasts up to 2.5 years,” Chris Comfort, chief operating officer of Calvary Hospital, a palliative and hospice facility in the Bronx, N.Y., said of Medicare Advantage. “So what happens is the appeal outlasts the beneficiary.”
The algorithms sit at the beginning of the process, promising to deliver personalized care and better outcomes. But patient advocates said in many cases they do the exact opposite — spitting out recommendations that fail to adjust for a patient’s individual circumstances and conflict with basic rules on what Medicare plans must cover.
“While the firms say [the algorithm] is suggestive, it ends up being a hard-and-fast rule that the plan or the care management firms really try to follow,” said David Lipschutz, associate director of the Center for Medicare Advocacy, a nonprofit group that has reviewed such denials for more than two years in its work with Medicare patients. “There’s no deviation from it, no accounting for changes in condition, no accounting for situations in which a person could use more care.”
Medicare Advantage has become highly profitable for insurers as more patients over 65 and people with disabilities flock to plans that offer lower premiums and prescription drug coverage, but give insurers more latitude to deny and restrict services.
Over the last decade, a new industry has formed around these plans to predict how many hours of therapy patients will need, which types of doctors they might see, and exactly when they will be able to leave a hospital or nursing home. The predictions have become so integral to Medicare Advantage that insurers themselves have started acquiring the makers of the most widely used tools. Elevance, Cigna, and CVS Health, which owns insurance giant Aetna, have all purchased these capabilities in recent years. One of the biggest and most controversial companies behind these models, NaviHealth, is now owned by UnitedHealth Group.
It was NaviHealth’s algorithm that suggested Walter could be discharged after a short stay. Its predictions about her recovery were referenced repeatedly in NaviHealth’s assessments of whether she met coverage requirements. Two days before her payment denial was issued, a medical director from NaviHealth again cited the algorithm’s estimated length of stay prediction — 16.6 days — in asserting that Walter no longer met Medicare’s coverage criteria because she had sufficiently recovered, according to records obtained by STAT.
Her insurer, Security Health Plan, which had contracted with NaviHealth to manage nursing home care, declined to respond to STAT’s questions about its handling of Walter’s case, saying that doing so would violate the health privacy law known as HIPAA.
Walter died shortly before Christmas last year.
NaviHealth did not respond directly to STAT’s questions about the use of its algorithm. But a spokesperson for the company said in a statement that its coverage decisions are based on Medicare criteria and the patient’s insurance plan. “The NaviHealth predict tool is not used to make coverage determinations,” the statement said. “The tool is used as a guide to help us inform providers, families and other caregivers about what sort of assistance and care the patient may need both in the facility and after returning home.”
As the influence of these predictive tools has spread, a recent examination by federal inspectors of denials made in 2019 found that private insurers repeatedly strayed beyond Medicare’s detailed set of rules. Instead, they were using internally developed criteria to delay or deny care.
But the precise role the algorithms play in these decisions has remained opaque.
STAT’s investigation revealed these tools are becoming increasingly influential in decisions about patient care and coverage. The investigation is based on a review of hundreds of pages of federal records, court filings, and confidential corporate documents, as well as interviews with physicians, insurance executives, policy experts, lawyers, patient advocates, and family members of Medicare Advantage beneficiaries.
It found that, for all of AI’s power to crunch data, insurers with huge financial interests are leveraging it to help make life-altering decisions with little independent oversight. AI models used by physicians to detect diseases such as cancer, or suggest the most effective treatment, are evaluated by the Food and Drug Administration. But tools used by insurers in deciding whether those treatments should be paid for are not subjected to the same scrutiny, even though they also influence the care of the nation’s sickest patients.
In interviews, doctors, medical directors, and hospital administrators described increasingly frequent Medicare Advantage payment denials for care routinely covered in traditional Medicare. Many said their attempts to get explanations are met with blank stares and refusals to share more information. The black box of the AI has become a blanket excuse for denials.
“They say, ‘That’s proprietary,’” said Amanda Ford, who facilitates access to rehabilitation services for patients following inpatient stays at Lowell General Hospital in Massachusetts. “It’s always that canned response: ‘The patient can be managed in a lower level of care.’”
Brian Moore, a physician and advocate for patients denied access to care at North Carolina-based Atrium Health, recalled visiting a stroke patient who was blocked from moving to a rehabilitation hospital for 10 days. “He was sitting there trying to feed himself. He was like, ‘I just never thought when I signed up for Medicare Advantage that I wouldn’t be able to get the care I need,’” he said. “He was drooling and crying.”
The cost of caring for older patients recovering from serious illnesses and injuries, known as post-acute care, has long created friction between insurers and providers. For decades, facilities like nursing homes racked up hefty profit margins by keeping patients as long as possible — sometimes billing Medicare for care that wasn’t necessary or even delivered. Many experts argue those patients are often better served at home.
The enactment of the Affordable Care Act in 2010 created an opportunity for reform. Instead of paying for care after the fact, policy experts proposed flipping the payment paradigm on its head: Providers would be paid a lump sum upfront, incentivizing them to use fewer resources to deliver better outcomes.
At the time, most Republicans in Congress were wringing their hands over the new law and its subsidies to help low- and middle-income Americans pay for health insurance. Tom Scully, the former head of the Centers for Medicare and Medicaid Services under George W. Bush, shared those concerns. But he also saw something else: a potential billion-dollar business.
Scully drew up plans for NaviHealth just as the new law was taking effect. Its payment reforms aligned perfectly with the Medicare Advantage program he had played a pivotal role in creating during the Bush administration.
Scully knew how those insurance plans worked. He also knew they were taking a financial beating in post-acute care.
“Look, I love the nursing home guys, but there were a lot of patients coming out of hospitals spending 20 days in a nursing home in MA,” because that’s what Medicare’s rules allowed, Scully said on a podcast in 2020. “It was just like Pavlov’s bell.”
As a well-connected partner at the private equity firm Welsh, Carson, Anderson & Stowe, Scully heard of a small shop called SeniorMetrix that was working on this type of post-acute data and analytics. The firm quickly won him over. “They had an algorithm,” Scully said on the podcast. “I saw it and said, ‘This is it.’”
He wrote a $6 million check to buy the company, which he rebranded to NaviHealth. Scully then raised $25 million from wealthy friends and companies, including the health system Ascension and the rehabilitation hospital chain Select Medical, and coaxed another $25 million from Welsh Carson.
NaviHealth started making its sales pitch to Medicare Advantage plans: Let us manage every piece of your members’ care for the first 60 to 90 days after they are discharged from the hospital, and we’ll all share in any savings.
The sweetener was the technology. One of the company’s core products is an algorithm called nH Predict. It uses details such as a person’s diagnosis, age, living situation, and physical function to find similar individuals in a database of 6 million patients it compiled over years of working with providers. It then generates an assessment of the patient’s mobility and cognitive capacity, along with a down-to-the-minute prediction of their medical needs, estimated length of stay, and target discharge date.
In a six-page report, the algorithm boils down patients, and their unknowable journey through health care, into a tidy series of numbers and graphs.
The product was a revelation to insurers, giving them a way to mathematically track patients’ progress and hold providers accountable for meeting therapy goals. By summer 2015, NaviHealth was managing post-acute care for more than 2 million people whose insurance plans had contracted with the company. It was also working with 75 hospitals and clinics seeking to more carefully manage contracts in which they shared financial responsibility for holding down costs. At the time, spending on post-acute care accounted for $200 billion annually.
That same year, Scully sold NaviHealth to the conglomerate Cardinal Health for $410 million — roughly eight times the investment. In 2018, another private equity firm, Clayton, Dubilier & Rice, upped the ante and paid $1.3 billion to take over NaviHealth. Then in 2020, UnitedHealth — the largest Medicare Advantage insurer in the country — decided to make the hot commodity its own, buying NaviHealth in a deal valued at $2.5 billion.
In an interview with STAT, Scully said the concept behind NaviHealth is “totally correct,” because it roots out wasteful spending. And he did not believe the algorithms restricted necessary care. But when presented with reporting that showed NaviHealth was at the center of voluminous denials and overturned appeals, Scully said he wasn’t in a position to comment on what may have changed since he sold his stake.
“The NaviHealth decision tool as I knew it — again, this is eight years ago — has a place and is valuable. If [it] overdoes it and is inappropriately denying care and sending people to the wrong site of service, then they’re foolish, and they’re only hurting themselves reputationally,” Scully said. “I have no idea what United’s doing.”
Providers told STAT that as NaviHealth was changing hands and enriching its investors, they started noticing an increase in denials under its contracts — that the pendulum had now swung too far in the other direction in an effort to prevent overbilling and make sure patients weren’t getting unnecessary services.
Patients with stroke complications whose symptoms were so severe they needed care from multiple specialists were getting blocked from stays in rehabilitation hospitals. Amputees were denied access to care meant to help them recover from surgeries and learn to live without their limbs. And efforts to reverse what seemed to be bad decisions were going nowhere. Atrium Health’s Moore, who leads a team that specializes in reviewing medical necessity criteria, started taking a deeper look at the denials.
“It was eye-opening,” he said. “The variation in medical determinations, the misapplication of Medicare coverage criteria — it just didn’t feel like there [were] very good quality controls.”
He and many other providers began pushing back. Between 2020 and 2022, the number of appeals filed to contest Medicare Advantage denials shot up 58%, with nearly 150,000 requests to review a denial filed in 2022, according to a federal database.
The database fails to capture countless patients who are unable to push back when insurers deny access to services, and only reflects a portion of the appeals even filed. It mostly tracks disputes over prior authorization, a process in which providers must seek insurers’ advance approval of the services they recommend for patients.
In comments to federal regulators and interviews with STAT, many providers described rigid criteria applied by NaviHealth, which exercises prior authorization on behalf of the nation’s largest Medicare Advantage insurers, including its sister company UnitedHealthcare as well as Humana and several Blue Cross Blue Shield plans.
“NaviHealth will not approve [skilled nursing] if you ambulate at least 50 feet. Nevermind that you may live alon(e) or have poor balance,” wrote Christina Zitting, a case management director for a community hospital in San Angelo, Texas. She added: “MA plans are a disgrace to the Medicare program, and I encourage anyone signing up..to avoid these plans because they do NOT have the patients best interest in mind. They are here to make a profit. Period.”
Federal records show most denials for skilled nursing care are eventually overturned, either by the plan itself or an independent body that adjudicates Medicare appeals.
But even patients who win authorization for nursing home care must reckon with algorithms that insurers and care managers like NaviHealth use to help decide how long they are entitled to stay. Under traditional Medicare, patients who have a three-day hospital stay are typically entitled to up to 100 days in a nursing home.
With the use of the algorithms, however, Medicare Advantage insurers are cutting off payment in a fraction of that time.
“It happens in almost all these cases,” said Christine Huberty, a lawyer in Wisconsin who provides free legal assistance to Medicare beneficiaries. She said Medicare Advantage patients she represents rarely stay in a nursing home more than 14 days before they start receiving payment denials.
“But [the algorithm’s report] is never communicated with clients,” said Huberty, who often only finds the report after filing a legal complaint. “That’s all run secretly.” NaviHealth said the findings of the algorithm, if not the report itself, are routinely shared with doctors and patients to help guide care.
A director at one post-acute facility said denials from UnitedHealthcare and NaviHealth are now the norm for many of their patients, even if they are clearly sicker than what the algorithm projects.
“They are looking at our patients in terms of their statistics. They’re not looking at the patients that we see.”
Medical director of a post-acute care facility
“They are looking at our patients in terms of their statistics. They’re not looking at the patients that we see,” said the director, who asked not to be named to avoid jeopardizing relationships with Medicare Advantage plans.
And when insurers deluge providers with denials, “they’re hoping that their endurance is greater than ours,” the director said.
NaviHealth has not published any scientific studies assessing the real-world performance of its nH Predict algorithm. And to the extent it tests its performance internally, those results are not shared publicly.
Additionally, regulators do not monitor these algorithms for fairness or accuracy, but the industry-wide blowback has forced the government to consider acting. Federal Medicare officials proposed new rules in December that say Medicare Advantage insurers can’t deny coverage “based on internal, proprietary, or external clinical criteria not found in traditional Medicare coverage policies.” Insurers also would have to create a “utilization management committee” that reviews their practices every year.
But even these proposals would still allow insurance companies to “create internal coverage criteria,” as long as they are “based on current evidence in widely used treatment guidelines or clinical literature that is made publicly available.”
Major lobbying groups for health insurance companies — America’s Health Insurance Plans, the Better Medicare Alliance, and the Alliance of Community Health Plans — did not make anyone available for interviews. Instead, the groups referred to comments they sent to Medicare supporting some, but not all, of these government proposals. AHIP, for example, urged Medicare “to not adopt policies that would place limits on plan flexibility to manage post-acute care.” Final regulations are due this spring.
If concerns about the algorithms have begun to surface in legal filings and public letters to Medicare, they remain almost entirely out of sight for patients like Dolores Millam, who fell and broke her leg on a summer day in 2020.
After surgery, she began her stay in a Wisconsin nursing home on Aug. 3. Like many older patients, Millam arrived with a complicated medical history, including coronary artery disease, diabetes, high blood pressure, and chronic pain, according to court records. Her doctor had ordered that she stay off her leg for at least six weeks.
Nevertheless, an algorithm used by her insurer, UnitedHealthcare, predicted she would only need to stay for 15 days, until about Aug. 18, according to records obtained by STAT.
Just a couple days after that date, Millam received notice that payment for her care had been terminated. It was 4 p.m. on a Friday.
“I must have made — I’m not kidding — 100 phone calls just to figure out where she could go [and] why this was happening,” said Millam’s daughter, Holly Hennessy, who also received the notice.
She said she couldn’t fathom UnitedHealthcare’s conclusion that her mother — unable to move or even go to the bathroom on her own — no longer met Medicare coverage requirements.
“You try to call and reason with somebody and get explanations, and you’re talking to somebody in the Philippines,” Hennessy said. “It’s simply a process thing to them. It has nothing to do with care.” UnitedHealthcare declined to discuss its handling of Millam’s care, asserting that doing so would violate federal privacy rules.
When she received the denial, Millam could not put weight on her left leg and was being moved with a Hoyer lift, a large, freestanding harness used to transport patients who can’t use their legs. She also required 24-hour care to help with dressing, eating, and other basic tasks, according to court records.
In a note filed after payment was denied, a speech therapist wrote, “Pt. is not yet safe to live independently. She will need assistance with medication administration and supervision with ADLS [activities of daily living] due to memory deficits making her unsafe.”
Hennessy said she had no choice but to keep her mother in the nursing home, Evansville Manor, and hope the payment denial would get overturned. By then, the bills were quickly piling up.
Medicare rules call for a five-stage appeal process. The first appeal goes directly to the insurer. If denied, the patient can ask an outside entity known as a “quality improvement organization” to reconsider.
Hennessy and her mother were denied at both levels, forcing them to consider an appeal to a federal judge, a process that takes months and requires filling out reams of paperwork. Somewhere in her blitz of phone calls, Hennessy heard about the Greater Wisconsin Agency on Aging Resources, which agreed to take up her case.
In late October, Millam returned home from the nursing home after a nearly three-month recovery. The bill was almost $40,000. A few days later, her appeal came before a judge.
Hennessy, who was driving to Florida at the time, recalls pulling over for the hearing, which was held via Zoom.
The judge only asked a handful of questions of the family and representatives from the nursing home. If there was any participation from UnitedHealthcare, its opinions were not mentioned in the official record. Court documents only reference a finding from the quality improvement organization, Livanta, which had asserted that Hennessy’s mother had no “medical issues to support the need for daily skilled nursing care” when the payment denial was issued in early August.
The final ruling, issued on Nov. 25, found instead that it was the insurer that hadn’t given any good reason to deny care for a patient who was still “a safety risk.” The judge said her treatment should be paid for in full.
In the months afterward, Hennessy herself crossed the age threshold into Medicare eligibility. She said a friend who sold Medicare Advantage plans had always expected to get her business when she turned 65.
“I just told him, ‘I can’t do it. I’ve lived this nightmare,’” Hennessy recalled. The conversation ended their friendship, until the neighbor called back a couple years later following a struggle with his own Medicare Advantage insurer over a knee replacement.
“He called me to apologize for having gotten so bent out of shape,” Hennessy said. “I’ve still got friends who say, ‘Oh, I’ve got UnitedHealthcare Advantage, and it’s wonderful.’”
“Well, it is,” she said. “Until you need the big stuff.’”
This story is part of a series examining the use of artificial intelligence in health care and practices for exchanging and analyzing patient data. It is supported with funding from the Gordon and Betty Moore Foundation.
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More people than ever before are accessing fertility treatment in the UK, according to new figures, but more people than ever before are also paying for it.
The Human Fertilisation & Embryology Authority (HFEA) says that there was a 9% increase in the number of IVF cycles between 2019 and 2021.
But at the same time, the number provided on the NHS shrank by 10%.
For patients aged 18 to 34, 63% of IVF procedures are now privately funded, compared to 52% in 2019.
There are a number of reasons for this shift towards private treatment, but several experts pointed towards NHS waiting times.
Dr Catherine Hill, CEO of Fertility Network UK said: "Typically a couple would be trying for two years to conceive before going to see their GP. The GP would send them for tests, and some of these tests can take - in some parts of the country - up to two years.
"And that's before you get referred to the fertility clinic where there can sometimes be additional delays. And time is of the essence when it comes to fertility treatment."
There has also been a shift in the type of family accessing treatment.
Clinics treated 44% more single patients and 33% more patients in same-sex female couples in 2021 than they did in 2019.
The criteria for accessing NHS fertility treatment varies depending on where you live, and under current rules, very few single and same-sex patients qualify for NHS funding.
In most areas, they must prove they have tried several rounds of artificial insemination without success, and entirely at their own cost.
Read more:
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'A huge barrier, huge challenges, and I faced both'
Libby King is a gay, single woman who decided to have fertility treatment in 2020.
Her struggle to access the treatment she needed led her to set up the LGBT+ support group BourneThisWay in her local town of Eastbourne.
Ms King said: "To be eligible for IVF, we have to have tries of IUI (Intrauterine insemination), I think it's three to six tries, and we have to prove that we've tried IUI treatment before we're considered for IVF, which costs thousands of pounds again, so there's a huge barrier, huge challenges, and I faced both, being both a solo parent and a gay woman.
"It was a struggle. When people start paying for IVF, it's tens of thousands of pounds, whereas heterosexual couples get three cycles free, after they've been trying to conceive for a few years."
Other striking data from the HFEA shows that there has been a dramatic rise in the number of women freezing their eggs.
There was a 64% rise in egg freezing and storage between 2019 and 2021.
Some experts have said the COVID pandemic had a big impact on the number of women wanting to freeze their eggs in the hope of preserving their fertility. | Women’s Health |
People who get influenza could be six times more susceptible to having a heart attack in the days following a flu diagnosis, a new study from the Netherlands has found.
The study’s conclusions were scheduled to be presented on April 18 at the European Congress of Clinical Microbiology & Infectious Diseases in Copenhagen, Denmark, as reported by Medscape.
The lead researcher, Dr. Annemarijn de Boer with the Julius Center for Life Sciences and Primary Care at the University Medical Center Utrecht, analyzed test results from 16 labs in the Netherlands, as well as medical and death records.
Of 26,221 cases of influenza between the years 2008 and 2019, 401 people experienced at least one heart attack within a year of the diagnosis, the report said.
Additionally, people had a 6.16 times higher likelihood of having a heart attack in the week after getting the flu compared to the year before or after, the researchers found.
However, when excluding the deaths that occurred outside the hospital, the increased risk was 2.42 times instead of 6.16.
This is likely because most flu testing in the Netherlands is performed in the hospital, which means patients are more likely to have severe illness, according to de Boer.
Similar findings came from a 2018 Canadian study led by Dr. Jeffrey C. Kwong from the Dalla Lana School of Public Health in Toronto, Ontario.
Researchers found that participants were 6.05 times more likely to have a heart attack in the week after diagnosis.
Inflammation heightens risk, doctors say
Board-certified cardiologist Dr. Mary Greene with Manhattan Cardiology in New York City was not involved in the study, but reviewed the findings.
"While the methodology of this particular Dutch study did not yield as much robust data, the study certainly echoes previous studies that have come to similar conclusions," Greene told Fox News Digital.
"Seemingly common colds can turn into serious medical issues."
"I do agree that a flu diagnosis can increase the odds of heart attack in a select group of patients, especially those with underlying heart disease," she added.
The increase in heart attacks among patients diagnosed with influenza, said Greene, largely stems from the inflammatory process and the environment that is created within the body when someone is fighting off the flu or other viral illnesses.
"Such inflammation in the body can make cholesterol plaques more vulnerable to rupture and blood more likely to clot, which is the underlying mechanism of both myocardial infarction (heart attack) and ischemic stroke," she said.
Study had limitations
Dr. Craig Bober, a family medicine physician at Inspira Medical Group Primary Care Mantua in Sewell, New Jersey, who was also not involved in the Dutch research, noted a key limitation of the study.
"It is important to note that the study was not designed to reflect the generalized population, as it looked at only those tested in hospital settings — these patients tend to be the sickest and usually elderly," he told Fox News Digital in an email.
"However, the study certainly emphasizes the dangers of seemingly benign virus-mediated infections."
Fox News Digital reached out to the study author for comment.
Prevention, early awareness are key
To help minimize the risk of heart attacks, all people should have a cardiovascular screening starting at age 40, or earlier if there is a history of early heart disease in the family, said Greene of New York City.
"I also recommend that all patients with underlying coronary artery disease, history of stents, history of heart attack and history of heart failure have their annual flu shot," she said.
"Cardiovascular patients see a larger benefit from influenza vaccination in terms of protection against a heart attack should they become infected with the influenza virus."
These findings should serve as a reminder that seemingly common colds can turn into serious medical issues, Bober of New Jersey said.
"Anyone with concerning chest pain or shortness of breath — especially those with high-risk medical conditions such as underlying heart disease, lung conditions, diabetes or kidney disease — should seek medical attention sooner rather than later," he added. | Epidemics & Outbreaks |
The number of pharmacies in England has fallen by 160 over the last two years, BBC analysis shows.
There are now 11,026 community chemists, according to data from NHS Business Services Authority - the lowest number since 2015.
Rising operational costs, staff shortages and reduced government financial support have been blamed.
This is despite rising patient demand, and plans for pharmacists to provide more services to ease pressure on GPs.
Pharmacists are warning that many more local businesses could close, without help.
Online services are available, but many rely on a local chemist for advice and to pick up prescriptions.
On Tuesday, the government will publish a primary care access plan designed to improve and extend availability of consultations by GPs. Ministers have also announced £240m for practices to replace old phones with more modern call systems and online tools to make it easier for patients to get in contact.
Part of the primary care plan is expected to include an expanded role for pharmacists, but there are concerns about their feasibility.
Many pharmacists feel they have been taken for granted and expected to offer more services, even though their real-terms funding has fallen. They estimate there has been a 30% cut in government funding over the last seven years, after taking account of inflation.
Sanjeev Panesar owns Pan Pharmacy in Birmingham. The business was set up by his parents, and has just celebrated its 40th anniversary, but he fears services might have to be cut back, and staff numbers may also have to be reviewed.
"Things are in serious jeopardy. It's our worst year ever, where we've made a loss. We have to make some really tough calls and decisions now," he said.
Mr Panesar says he would love to support the government by helping the NHS and GP services, but said it is not possible with current financial constraints.
The workload has grown steadily, with more patients, some frustrated over lack of GP access, coming in for consultations and advice. That comes on top of the core function of dispensing medicines and treatments, while there is increasing demand for home delivery of medication.
Janet Morrison, chief executive of the Pharmaceutical Services Negotiating Committee, hopes the new plan will address long-standing problems in the sector.
"What everyone learnt during the pandemic was one of the two places that will stay open was the pharmacy - lots more people come in for advice and support that we're not paid to provide. What we've been saying to ministers is we're part of the solution because we can provide access."
Scotland scheme 'more patient-focused'
Pharmacists in England look to Scotland, where a scheme called Pharmacy First includes a contract between the sector and the Scottish government setting out what services are expected, with payment for every consultation.
These cover minor ailments and illnesses, some of which might once have been dealt with at GP practices. In England there is a less formal arrangement, with some consultations by pharmacists not remunerated. There is also more prescribing of medicines by pharmacists in Scotland.
George Romanes, who owns a chain of local pharmacies in the Scottish borders, believes the new structure works better than the arrangements south of the border.
"I used to have an English pharmacy but I sold it, and all the outlets we have now are in Scotland. I think the Scottish contract is much more patient-focused," he said.
"The fact you can come in and see a pharmacist there and then as it were, rather than needing an appointment, is very beneficial for patients, they like to get a problem sorted as quick as they can."
A Department of Health and Social Care spokesperson said an extra £100m was invested in the sector last September.
"We are supporting pharmacies to provide a range of clinical services and we are increasing the services pharmacists - who are degree-qualified medical health professionals - can provide to their community, including managing oral contraception," they said.
Mr Panesar called for political leaders, including Prime Minister Rishi Sunak, whose mother ran a pharmacy, to visit local pharmacies to see first-hand the pressures they face.
"I'd love him to come and see what we do, how patients feel about what we offer and actually, that this is serious, and that the sector is crumbling, and is going to fall down like a stack of dominoes, if there's not intervention urgently." | Health Policy |
The New South Wales health minister, Ryan Park, has vowed to improve the care available to transgender children and review gender research after a media report highlighted issues many people face trying to get help.
Park said on Tuesday it was “extremely disappointing” and “concerning” to hear people had struggled to access healthcare and that doctors had felt unable to speak up.
“We’re not enabling people to access this level of healthcare as frequently as they need it,” the minister told ABC radio.
ABC’s Four Corners program on Monday night reported three new patients had been seen at the gender clinic at Westmead children’s hospital this year compared with 88 new patients in 2022.
Park has since spoken with the secretary of the health department and the deputy secretary about the issues raised in the program, including staffing.
He said a new framework to guide clinicians on care would be established along with a new care hub for south-west Sydney. Two new advisory bodies will help ensure best practice, the minister said.
The ABC alleged a number of staff had left the Westmead service following the publication of research initiated in 2013 that was being “weaponised by anti-trans activists and proponents of alternative forms of gender care”.
The Sax Institute, an independent organisation that seeks to use evidence to improve health policies, has since been charged with examining that research, Park said.
The minister said the institute would “look at that research and ensure that we are at best practice”. He vowed to make changes to ensure clinicians were able to speak up when they had concerns.
“There’s always going to be robust debate,” Park said. “But we also need to make sure that when people on the front line feel as though things are not working, we need to make sure those things are in place.”
The ABC reported the research covered links to family trauma, “rapid-onset gender dysphoria” and “the concept of ‘desisters’ which often refers to someone who no longer identifies as trans”.
Park apologised for the death of 14-year-old boy Noah O’Brien who took his own life in January while awaiting specialised gender-affirming treatment.
Four Corners reported his death followed a referral for – but not provision of – specialist gender support at Westmead children’s hospital.
“That is a very very sad situation and my heart goes out to the family,” Park said on Tueday. “I am very sorry they have had a system that let them down.”
A spokesperson for the Sydney Children’s Hospitals Network said all care at Westmead was “based on the best available medical evidence and is in line with international best practice”.
“SCHN expresses our sincere condolences to Noah’s family,” the spokesperson said. “Due to patient privacy and confidentiality, SCHN is unable to provide further information about his specific care.”
The spokesperson said the research project and papers published had been reviewed and found to meet their requirements.
“SCHN is committed to providing transparency in communicating the results of research undertaken by the network and is informed by research in ensuring evidence-based care for children, young people and their families.”
In Australia, the crisis support service Lifeline is 13 11 14. In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email [email protected] or [email protected]. In the US, the National Suicide Prevention Lifeline is at 988 or chat for support. You can also text HOME to 741741 to connect with a crisis text line counselor. Other international helplines can be found at befrienders.org | Mental Health Treatments |
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