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Scotland should pilot the use of drug consumption rooms, a committee of MPs has recommended.
Efforts to run similar facilities in Glasgow have so far been blocked by the Home Office.
However, the Home Affairs Committee said the power to introduce them should be devolved if the UK government would not back a pilot jointly funded with Holyrood.
The Home Office said it would not consider the recommendation.
A spokesperson said the UK government's focus was on tackling the supply of drugs, and on treatment.
Drug consumption rooms are facilities where people can inject drugs under supervision.
According to studies, they can reduce overdose deaths, public injecting and drug-related litter, while a range of bodies and health experts - including the Royal College of Physicians of Edinburgh - have backed previous Scottish proposals.
Figures released last week showed that Scotland's drug deaths fell to their lowest level in five years, however it was still the worst rate in the UK and the rest of Europe.
In its latest report, the Home Affairs Committee said an evidence base for consumption rooms in the UK was needed and recommended a pilot in Glasgow.
It said: "We recommend that the government support the piloting of safe consumption facilities in areas across the UK where there is deemed to be a need by local government and stakeholders.
"In particular, we recommend the government support a pilot in Glasgow by creating a legislative pathway under the Misuse of Drugs Act 1971 that enables such a facility to operate legally."
MPs said the UK government must work with the Scottish government and local partners to establish and operate the pilot - and that it must be evaluated to establish a reliable evidence base on the use of such facilities.
They added: "We repeat the recommendation made by the Scottish Affairs Committee in 2019 that, if the UK government is unwilling to support this, the power to establish a pilot be devolved to the Scottish government."
However, the UK government insisted "there is no safe way to take illegal drugs" and said it had no plans to consider the recommendation.
A Home Office spokesperson said: "Our 10-year Drugs Strategy set out ambitious plans, backed with a record £3bn funding over three years to tackle the supply of illicit drugs through relentless policing action and building a world-class system of treatment and recovery to turn people's lives around and prevent crime."
Speaking to BBC's Good Morning Scotland programme, the Scottish government's drugs and alcohol policy minister, Elena Whitham, welcomed the committee's findings.
"We have long called for agreement from the UK government to allow us to do this, whether to support us in establishing a pilot or through devolving the necessary powers to allow us to do so," she said.
The report also recommended that the Home Office and Department of Health and Social Care (DHSC) establish a national drug-checking service in England to enable people to submit drug samples by post anonymously.
The MPs said a UK-wide drug-checking service would be the most effective approach.
They also called for on-site drug-checking services at temporary events like music festivals and within the night-time economy.
They said the Home Office should establish a dedicated licensing scheme for drug checking at such events before the start of the summer 2024 festival season.
The committee said it was "disappointed" that the Home Office had "repeatedly refused" to publish a 2016 report by the ACMD - a body which it said seeks to provide scientific, evidence-based recommendations to support the development of evidence-based drug policy.
Calling for the report to be handed over - at least on a confidential basis to the committee - the MPs said withholding it "contravenes established practice and undermines the ACMD's transparency".
'Learn from successes'
In 2020, activist Peter Krykant set up his own so-called "safe consumption van" in Glasgow without official funding or permission from authorities.
He was helped by Glasgow MSP Paul Sweeney.
Experts from three universities studied the use of Mr Krykant's injecting van and found nearly 900 injections were supervised and nine potential overdoses were prevented.
Dame Diana Johnson, who chaired the Home Affairs Committee, called on the UK government to learn from the successes of local schemes.
She said: "Simply attempting to remove drugs from people's live hasn't worked. They need the right support to let them deal with addiction, but also psychosocial support and interventions that deal with the underlying trauma that may have led them to drugs in the first place.
"Over the course of the inquiry, we have seen a number of positive, locally-developed schemes make a real difference to those suffering from addiction and the wider communities.
"The government should learn from the success as it develops best practice that can be implemented nationwide." | Drug Discoveries |
Jae* injured her shoulder when she did an unfamiliar move in a reformer Pilates class in Central Victoria.
She has been doing Pilates for seven years and is an instructor in Melbourne.
She had never done a move with a jump board before.
"I did my first jump and I slid off and fell off the reformer," Jae said.
"I scraped my arm and injured my shoulder.
"I was in shock.
"I wasn't the only one who fell — there were a few clients who expressed concerns to the instructor that they couldn't stabilise themselves."
Jae does not want to use her real name for privacy reasons, but is concerned studios are letting instructors with little experience teach classes.
"You are trusting your body in someone's hands," she said.
"Anyone can open a studio and you do not know if the instructors are properly qualified.
"People can do a weekend course and become an instructor, and that's really concerning."
'Such a grey area'
According to AusPlay – an ongoing national telephone survey by the Australian Sports Commission – Pilates is the fifth most common exercise for adults.
AusPlay found the number of adults doing Pilates rose by 145,037 between 2021 and 2022.
Pilates teacher and studio owner Stacey Smith is worried the number of studios opening up in regional Victoria could mean a rise in underqualified teachers.
"Anyone with a certificate 3 in fitness can come in and teach," she said.
"I disagree with that — I think you need to do a certificate 4, minimum, in reformer and mat Pilates.
"It's such a grey area — you get injured clients, pre and postnatal clients.
"You need to know a bit about anatomy, physiology, the way the reformer works and what modifications you can give."
Calls for regulation
Pilates is an unregulated industry, meaning anyone can open up a studio and teach classes.
For an instructor to be recognised by a professional association such as the Pilates Australasian Alliance (PAA) or Australian Pilates Method Association, you must hold a qualification from an organisation that is nationally recognised organisation.
The PAA is advocating for regulations to be introduced to mandate minimum training and qualifications before people can teach Pilates.
"There is a risk of injury in Pilates," president Robyn Rix said.
"We are working with a moving platform and springs, so a clear understanding of the risks and how to mitigate them has to be covered through comprehensive training.
"Would you go to a hairdresser who's done a weekend course? You're putting your whole body in someone's hands."
Ms Rix is concerned the lack of regulation and mandatory training is enabling dangerous moves to be performed.
Broken bones reported
The PAA has received two reports of people breaking bones at reformer Pilates classes.
"Over the last year I've heard so many reports of injuries in Pilates studios," Ms Rix said.
"Someone broke their arm and someone broke their leg and actually needed surgery on their leg."
The alliance recommends people check the Pilates studio uses instructors who have either done government accredited training or are a member of the organisation before going to a class.
"We expect courses to be at least 500 hours," Ms Rix said.
"We also check they're up to date with insurance and first aid.
"We are calling for [the Australian Health Practitioner Regulation Agency — AHPRA] or the Australian Physiotherapy Association to set standards for Pilates training for physiotherapists.
"We are even seeing osteopaths and chiropractors teaching Pilates with minimal training."
An AHPRA spokesperson said Pilates was not a registered health profession and decisions about which health professions were regulated were the federal health minister's to make.
"Practitioners registered in the professions of physiotherapy, osteopathy and chiropractic have particular knowledge and skills in the diagnosis and treatment of musculoskeletal conditions, using a range of therapies that may include exercise-based intervention," the spokesperson said.
'Fell in love with it'
In Bendigo there are more places to practice Pilates than there are pizza shops, but that was not the case when Ms Smith opened her Pilates studio two years ago.
She first tried the form of exercise eight years ago after a life-altering injury.
"I fell at an indoor trampoline centre and fractured my vertebrae," Ms Smith said.
"I was two millimetres away from becoming paraplegic."
After spinal surgery she was in a brace for seven months and had to learn how to walk again.
"Before the injury, I was doing marathons and high-intensity exercise," Ms Smith said.
"The physio got me on a reformer machine and I remember after the first time thinking, 'This is amazing.'
"I fell in love with it."
Health professionals say one of the reasons reformer Pilates is rising in popularity is because it is low-impact.
Physiotherapists often recommend it for people recovering from an injury.
'Fitter and stronger'
Di Parker, 72, started reformer classes a year ago when her gym started offering them.
She hadn't done reformer Pilates before, but had done mat Pilates years ago.
"When I first saw it I thought, 'Oh that looks easy, I can do that,'" Ms Parker said.
"But some of it is really challenging — I thought I was pretty fit, I felt fit and I do a lot of physical exercise.
"But this has taken me to a whole new level."
Ms Parker now goes to four classes a week.
Most of the people in her classes are female.
"I hope it's not just a fad," she said.
"I feel fitter and stronger, my balance is also better." | Health Policy |
Colorado retailers have sold more than $15 billion worth of legal marijuana products since the state’s first adult-use retailers opened in 2014—and that has generated more than $2.5 billion in cannabis tax revenue to support public programs and services—state officials have announced.
As of August, Colorado has seen $15,028,995,376 in total legal cannabis sales. In 2023 alone so far, marijuana sales have amounted to $1,052,517,913.
The tax revenue from the last nine years of legalization stands at $2,554,160,551 as of September, the Colorado Department of Revenue (CDOR) said in a press release on Wednesday.
A spokesperson for Gov. Jared Polis (D) told Marijuana Moment that under the governor’s “pro-freedom plans, we have seen Colorado’s marijuana industry grow stronger, create more jobs and support our thriving economy across the state.”
“Governor Polis is glad to see Colorado’s cannabis industry thrive, generate tax revenue for local governments and school construction and is hopeful that these sales will responsibly get higher and higher and surpass $15 billion,” he said.
Colorado was the first state to launch recreational marijuana sales following voters’ approval of a legalization initiative at the ballot in 2012. Annual sales peaked in 2021, when they reached about $2.2 billion, but they’ve since declined and largely leveled out in the past two years.
An analysis from the state’s nonpartisan Legislative Council Staff (LCS) that was released in August also showed that Colorado generated more tax revenue from marijuana than alcohol or cigarettes during the last fiscal year, with $280 million in cannabis tax dollars going toward a variety of government programs and services like K–12 education and health care.
The U.S. Census Bureau has started keeping tabs on state cannabis sales and tax revenue data, even as the plant continues to be federally prohibited. And a new Census report shows that Colorado is one of five states that have consistently seen cannabis revenue make up at least one percent of all state income over the past two years.
In Colorado, those marijuana tax dollars are funding a variety of services, including substance misuse treatment, early childhood literacy, youth mentorship and bullying prevention, law enforcement training, affordable housing, research and illicit market interdiction.
As CDOR explained in the new press release, the tax revenue comes from several sources: the state’s 2.9 percent sales tax on cannabis, a 15 percent tax on retail marijuana products sold in stores and a 15 percent retail excise tax applied to wholesale sales and transfers, as well as fee revenue from cannabis business license and application fees.
Polis has been a longstanding champion of legalization, and he’s worked to build on the existing industry while also pushing for federal reform.
He recently applauded President Joe Biden after his administration’s top health agency recommended rescheduling marijuana—but he says the initial move must be followed with more action to address cannabis banking, immigration, criminal justice reform and federal enforcement concerns.
While marijuana sales in Colorado have dipped in recent years, other more new state markets have widely seen record-breaking sales numbers this year.
In Illinois, for example, officials recently touted the industry’s “unprecedented growth” in fiscal year 2023, with regulated stores selling more than $1.5 billion in marijuana products. In September, stores in the state sold more individual cannabis products than during any prior month.
Connecticut, meanwhile, tallied more than $25 million in total sales in September, besting a record set the previous month.
Licensed retailers in Maryland, sold a record amount of adult-use cannabis products in September although medical marijuana sales fell.
August was also a record-setting month in Rhode Island, which sold its highest amount of cannabis for the fourth consecutive month, notching $9.7 in monthly receipts.
Purchases of adult-use cannabis in August also broke a record ($23.7 million) in Montana, state officials reported, although medical marijuana sales were at their lowest ($5.0 million) since recreational markets opened early last year.
In Maine, too, marijuana sales reached a record high in August, with nearly $22 million worth of purchases, according to recent data from the state Office of Cannabis Policy (OCP).
Early last month, Massachusetts officials reported that retailers have now sold more than $5 billion in adult-use marijuana since the state’s recreational market launched five years ago. Sales reached $139.3 million in August alone, with the year-to-date total at $1.05 billion within the first eight months of 2023.
Michigan marijuana sales also reached another record high in July, with nearly $277 million worth of cannabis sold.
In Missouri, meanwhile, retailers have been selling about $4 million worth of marijuana per day on average since the state’s adult-use market opened up in February—and the state saw a record $121.2 million in cannabis purchases in June.
Back in Colorado, the governor has also called on lawmakers to take steps to allow him to issue mass pardons for people with prior psychedelics convictions after he signed legislation to implement regulations for substances like psilocybin and ayahuasca in May.
He’s further approved legislation that will bolster marijuana-related protections for working professionals in the state—effectively codifying an executive order he issued last year.
Photo courtesy of WeedPornDaily. | Drug Discoveries |
During pandemic, proponents of ‘doing your own research’ believed more COVID misinformation
As the virus that caused the COVID-19 pandemic first began to spread around the planet, it brought along a new vocabulary. Unfamiliar phrases like “flatten the curve,” “COVID pod” and “essential worker” infected regular conversation. But another — “do your own research” — was already well-known to Sedona Chinn, who studies misinformation and health communications.
“We had heard the phrase a lot before,” prior to the pandemic, says Chinn, a University of Wisconsin–Madison professor of Life Sciences Communication who began researching the idea in 2019 with University of Michigan communications professor Ariel Hasell. It was “coming from a lot of online, anti-vaccine rhetoric.”
Both researchers knew people who were willing to “occasionally do weird, unproven stuff, typically around health,” Chinn says. “It’s not like they reject doctors and medical expertise, but they think their opinion can be equally valid if they do their own research.”
Then the calendar turned over to 2020, and “do your own research” had simultaneous moments in both discourse (especially online) related to the complicated and often confusing global public health emergency and in the relatively chaotic national politics in the United States.
The phrase’s use grew quickly, Chinn says, “popularized by Q-Anon and other conspiratorial groups, in more extreme and more dangerous ways. Now, we’re following what seem more like connections to certain political views than calls for more and better scientific research.”
According to a new study Chinn and Hasell published recently in the Harvard Kennedy School’s Misinformation Review, people who were supportive of the phrase “doing your own research” were more likely to be distrustful of scientists and more likely to believe misinformation about COVID-19. Even when controlling for the type of media they consumed, the DYOR fans among the researchers’ panel of about 1,000 survey respondents grew more distrustful and more ill-informed about COVID-19 even as news of successful vaccine trials emerged.
“We measured their trust in science and COVID beliefs in December 2020 and again in March 2021,” Chinn says. “We wouldn’t normally expect this to change too much, especially over such a brief period. But for people who felt positively about ‘doing your own research,’ we did see that their distrust in scientific institutions and misperceptions about the pandemic grew.”
What may be most fascinating to Chinn is that telling someone to “do your own research” is generally excellent advice.
“There’s a lot of research showing that people who do more information seeking about politics are more civically engaged and people who do more information seeking about their health conditions have better treatment outcomes,” she says. “So, it is objectively good to do your own research.”
Those good outcomes are hard to square with the correlation between DYOR and COVID misinformation, but the phrase does not necessarily have a benign history. “Do your own research” gained initial popularity as a slogan of Milton William Cooper. In the 1990s, Cooper wrote a book and hosted a radio show about his theories of a vast global conspiracy tying together UFOs, the Kennedy assassination and the AIDS epidemic, among other subjects.
“DYOR messages can promote skepticism in the guise of being informed and independent,” Chinn says. “(People believe) you should ‘do your own research’ because maybe you can’t trust what they’re telling you. And so, you need some alternative research or alternative information to balance out (what you believe are) potentially untrustworthy institutional sources of knowledge.”
Chinn is expanding on the initial study’s findings with new work analyzing the content of social media posts that call for readers to “do your own research,” examining whether people who support “DYOR” actually do engage in their own research, and studying how suggestions to “do your own research” may affect people’s beliefs and behavior.
“As we dig further, we’re finding that ‘do your own research’ is really not associated with much information seeking,” Chinn says. “And it begins to look more like an expression of an anti-establishment world view than an interest in finding more or better evidence on any given topic.” | Epidemics & Outbreaks |
For several years, researchers have been successfully using chimeric antigen receptor (CAR) T cells to target specific antigens found on blood cells as a cure for patients with leukemia and lymphoma. But solid tumors, like breast and colon cancers, have proven to be more difficult to home in on. Solid tumors contain a mix of cells that display different antigens on their surface-often shared with healthy cells in the body. Thus, identifying a consistent and safe target has impeded the success of most CAR-T cell therapy for solid tumors at the first phase of development.
Breakthrough approach to fighting cancer
Synthetic biologists at Columbia Engineering report today a new approach to attacking tumors. They have engineered tumor-colonizing bacteria (probiotics) to produce synthetic targets in tumors that direct CAR-T cells to destroy the newly highlighted cancer cells.
"Our probiotic platform enables CAR-T cells to attack a broad range of tumor types," said Tal Danino, associate professor of biomedical engineering, who led the study published today by Science. "Traditional CAR-T therapies have relied on targeting natural tumor antigens. This is the first example of pairing engineered T cells with engineered bacteria to deliver synthetic antigens safely, systemically, and effectively to solid tumors. This could have a significant impact on the treatment of many cancers."
Painting targets on solid tumors
Danino's lab has essentially created a universal CAR-T cell that attacks a universal antigen, by programming the tumor-seeking bacteria to paint solid tumors with a synthetic marker that the CAR-T cells can recognize. The researchers expect that, with further refinements, this platform will enable the treatment of any solid tumor type without the need to identify a specific tumor antigen -- thus bypassing the need to generate a custom CAR-T cell product for each cancer type and each patient.
Engineering "living medicines"
This probiotic-guided CAR-T cell (ProCAR) platform is the first time that scientists have not only successfully combined engineered probiotics with CAR-T cells, but have also demonstrated the first evidence of CARs responding to synthetic antigens produced directly within the tumor.
"Combining the advantages of tumor-homing bacteria and CAR-T cells provides a new strategy for tumor recognition, and this builds the foundation for engineered communities of living therapies," said the study's co-lead author Rosa Vincent, a PhD student working in Danino's lab. "We chose to bridge the individual limitations of these two cell therapies by combining the best features of each -- using bacteria to place the targets, and T cells to destroy the malignant cells."
Safe and effective platform
The platform has proven to be safe and effective across multiple models of human and mouse cancers in both immunocompromised and immune-healthy mice. In fact, the study shows that human T cells in particular benefit so much from the presence of immunostimulatory bacteria within the tumor that their tumor-killing functions are further enhanced.
"Overall, our ProCAR platform represents a new strategy for enhancing the effectiveness of CAR-T cell therapy in solid tumors," said Danino, who is also affiliated with the Herbert Irving Comprehensive Cancer Center and Data Science Institute. "While we're still in the research phase, it could open up new avenues for cancer therapy."
Next steps in an ongoing collaboration
This work was done as part of an ongoing collaboration with the laboratory of Nicholas Arpaia, assistant professor of microbiology and immunology at Columbia's Vagelos College of Physicians and Surgeons. The team has previously developed bacteria that deliver immunotherapy payloads together. The researchers are continuing to refine their work and hope to begin clinical trials to fully assess the platform's safety and efficacy in human patients.
Story Source:
Materials provided by Columbia University School of Engineering and Applied Science. Original written by Holly Evarts. Note: Content may be edited for style and length.
Journal Reference:
Cite This Page: | Medical Innovations |
LAKE GROVE, Suffolk County (WABC) -- As members of the ABC family, we are celebrating the 10th anniversary of our friend Robin Roberts returning to GMA after getting a bone marrow transplant.
It saved her life. And it can save the lives of others-- if they find a match.
Learn more about how to become a donor through the Be The Match registry.
A family on Long Island with two young children facing a rare disease that could require a bone marrow transplant in the future is using their story to raise awareness about the importance of joining the registry.
A visit with the Superina family here in Lake Grove can't help but melt your heart.
Four of the sweetest young daughters, each, with their own personality that would make any parent want to freeze these moments in time.
"They have so much energy, so much life," Mom Lisa Superina said. "And we just want them to stay that way forever."
But for Lisa and Graig's two youngest daughters, Kayla and Nora that is especially true.
"I know I take more pictures than I do of my other girl," Lisa said. "I just do it because there's always that fear, of what could happen."
Two-year-old Nora and 4-year-old Kayla both have a rare, inherited disorder called Shwachman-Diamond Syndrome or SDS.
It can cause bone marrow failure and puts them at higher risk for blood cancers.
"I think the risk of leukemia...I mean, we think about that and we live with that every day," Lisa said.
Their two older sisters, Emma and Maria, are carriers of the disorder, like their parents and no one in their family is a match, should the girls need a bone marrow transplant down the road
Lisa is constantly checking the registry.
About 70% of patients who need a transplant, don't have a donor from their family who fully matches making the bone marrow transplant registry that much more important for patients searching for a donor.
"They currently have zero matches in the registry,' Lisa said.
Depending on a person's ethnic background, the likelihood of finding a match can be even harder.
"It's scary because we just don't know if and when they'll ever need something," Graig said. "And if anyone would be available to donate."
The Superinas's journey is like so many others highlighting the importance of bone marrow donation.
Interestingly they never even knew Kayla had SDS until after her younger sister was born. Kayla had been asymptomatic up to that point but not little Nora.
"She had elevated liver enzymes," Lisa said. "She was a failure to thrive."
Her mother pushed fiercely for genetic testing and the family is so grateful she did.
"It was a blessing for our other daughter that we would have never known until maybe it was too late," Graig said.
Right now the family is thriving and raising awareness about the importance of registering as a donor.
Lisa and Graig are confident that they'll learn to face whatever challenges lie ahead.
'It's hard you just want your kids to be happy," Lisa said. "And you want them to have a normal, healthy life."
Robin Roberts has made it her mission to raise awareness about the Be The Match bone marrow registry after she received a life-saving transplant in 2012.
Now you could be the match for a patient in need of a donor.
Watch the ""One Match, Second Chance" special on Eyewitness News This Morning and Good Morning America Tuesday , February 21 to learn more about Robin's story and meet some of the people getting swabbed to help those in need of a match.
Learn more about how to become a donor through the Be The Match registry. | Disease Research |
The concept of austerity featured prominently in the first round of hearings of the UK’s COVID inquiry, which has recently come to a close. Notably, former chancellor George Osborne claimed that austerity had a “positive” effect on the UK’s ability to withstand the pandemic.
Our reading of the evidence is that the austerity policies initiated after 2010 weakened the UK, allowing COVID to do more damage than it otherwise might have.
Osborne’s claim was based on the argument that, without austerity policies to “repair the UK’s public finances” following the economic recession of 2008 to 2009, “Britain would have been more exposed” to the pandemic.
Austerity measures seek to reduce government deficits, usually through a mix of public spending cuts and increased taxation. While there’s continued disagreement about whether these measures really help the economy, the evidence is clear that austerity in the UK has been bad for health.
Osborne’s 2010 austerity budget cut billions from public and welfare spending. One recent analysis estimated that austerity policies pursued between 2010 and 2019 were associated with £540 billion less public spending.
Research suggests that the “spending gap” attributed to austerity – reductions in health and social care expenditure – was 13.64% between 2010 and 2015, which may have led to 33,888 extra deaths in the same period.
Austerity acts at every point on the pathways that lead to disease and premature death. Most obviously, austerity measures make people poorer. The poorer a person is the more likely they are to suffer ill health and die younger.
Austerity measures can also make people’s lives more precarious in that they can no longer be confident that they will have income, employment, shelter or even food.
For example, cuts to welfare have been followed by large increases in food bank use over recent years. The Trussell Trust reports that the number of people receiving emergency food parcels from their food banks in the UK increased from roughly 25,000 in 2008-2009 to nearly 2 million in 2019-2020, and this number grew further by 2022-2023.
Food insecurity is associated with poor physical health and obesity, for example due to increased consumption of processed foods, which can be cheaper, or under-nutrition, through decreased access to healthy foods.
The austerity policies pursued by Osborne and his successors also left the UK vulnerable to COVID in a number of specific ways.
We know groups that were already disadvantaged were hit hardest by the pandemic. They were more likely to get COVID and, if they became infected, to become severely ill and die.
The reasons are not difficult to discern. When a novel virus enters a population that has no previous immunity, its spread is determined, almost entirely, by the nature and intensity of interactions between people.
Even before the British government decided, belatedly, to lock down, those who could were already restricting their interactions with others. Many began working from home, becoming familiar with new ways of interacting with colleagues online. But for many others, this was simply not possible.
All of this created ideal conditions for the virus to spread within families and across places of employment, such as care homes.
These problems might have been ameliorated if strong welfare protections had been in place, but they weren’t. For almost a decade, governments had been chipping away at social support systems, with people who were old or disabled especially hard hit. By the mid-2010s, life expectancy at older ages had begun declining.
As a result of austerity measures, social care spending, which rose between 2001 and 2010, started falling between 2010 and 2015 (taking inflation into account). This meant the resilience of the social care system was significantly weakened going into the pandemic.
Older people’s plight was exacerbated by the abysmal state of the housing stock, with the least efficient heat retention in Europe.
Funding cuts to local authorities have contributed to cold homes, less energy-efficient housing, and greater fuel poverty, which in turn negatively affect health. Older people are more likely to be vulnerable to the cold, including in poorly insulated homes, because they’re more likely to have existing medical conditions.
Then there was the NHS. Owing partly to the spending gap mentioned earlier, investment in health infrastructure, from diagnostic scanners to IT infrastructure, had almost dried up. Facilities were literally falling apart.
Cuts to medical and nursing training have been a major factor in the chronic staff shortages we now see, with places often filled by locum or agency staff. These staff are not only more expensive but often unfamiliar with their working environment.
Preparing for the next crisis
Any argument that austerity placed the country’s economy on a sounder footing than would otherwise have been the case, making it better rather than worse prepared when the pandemic came, is misguided.
Leaving aside the questionable economics, this is akin to arguing that a ship’s captain should skimp on lifeboats so that he can send the cabin boy out to buy some when the ship is about to hit the iceberg.
Austerity policies shred the safety nets that those most economically vulnerable would otherwise depend on. Then, when people fall ill, these measures weaken the ability of health services to care for them.
The COVID pandemic will not be the last. One of the best things we can do to prepare for future pandemics is to avoid a return to austerity. | Epidemics & Outbreaks |
The medicine in the diabetes drug Mounjaro helped people with obesity or who are overweight lose at least a quarter of their body weight, or about 27 kilograms (60 pounds) on average, when combined with intensive diet and exercise, a new study shows.
By comparison, a group of people who also dieted and exercised, but then received dummy shots, lost weight initially but then regained some, researchers reported Sunday in the journal Nature Medicine.
"This study says that if you lose weight before you start the drug, you can then add a lot more weight loss after," said Dr. Thomas Wadden, a University of Pennsylvania obesity researcher and psychology professor who led the study.
The results, which were also presented Sunday at a medical conference, confirm that the drug made by Eli Lilly & Company has the potential to be one of the most powerful medical treatments for obesity to date, outside experts said.
"Any way you slice it, it's a quarter of your total body weight," said Dr. Caroline Apovian, who treats obesity at Brigham and Women's Hospital and wasn't involved in the study.
The injected drug, tirzepatide, was approved in the U.S. in May 2022 to treat diabetes. Sold as Mounjaro, it has been used "off-label" to treat obesity, joining a frenzy of demand for diabetes and weight-loss medications including Ozempic and Wegovy, made by Novo Nordisk.
All the drugs, which carry retail price tags of $900 a month or more, have been in shortage for months.
Tirzepatide targets two hormones that kick in after people eat to regulate appetite and the feeling of fullness communicated between the gut and the brain. Semaglutide, the drug used in Ozempic and Wegovy, targets one of those hormones.
The new study, which was funded by Eli Lilly, enrolled about 800 people who had obesity or were overweight with a weight-related health complication — but not diabetes. On average, study participants weighed about 109.5 kilograms (241 pounds) to start and had a body-mass index — a common measure of obesity — of about 38.
After three months of intensive diet and exercise, more than 200 participants left the trial, either because they failed to lose enough weight or for other reasons. The remaining nearly 600 people were randomized to receive tirzepatide or a placebo via weekly injections for about 16 months. Nearly 500 people completed the study.
Participants in both groups lost about 7% of their body weight, or almost 8 kilograms, ( 17 pounds) during the diet-and-exercise phase. Those who received the drug went on to lose an additional 18.4% of initial body weight, or about 20 kilograms (44 pounds) more, on average. Those who received the dummy shots regained about 2.5% of their initial weight, or 2.7 kilograms 6 pounds).
Overall, about 88% of those taking tirzepatide lost 5% or more of their body weight during the trial, compared with almost 17% of those taking placebo. Nearly 29% of those taking the drug lost at least a quarter of their body weight, compared with just over 1% of those taking placebo.
That's higher than the results for semaglutide and similar to the results seen with bariatric surgery, said Apovian.
"We're doing a medical gastric bypass," she said.
Side effects including nausea, diarrhea and constipation were reported more frequently in people taking the drug than those taking the placebo. They were mostly mild to moderate and occurred primarily as the dose of the drug was escalated, the study found. More than 10% of those taking the drug discontinued the study because of side effects, compared with about 2% of those on placebo.
Lilly is expected to publish the results soon of another study that the firm says shows similar high rates of weight loss. The U.S. Food and Drug Administration has granted the company a fast-track review of the drug to treat obesity, which Eli Lilly may sell under a different brand name. A decision is expected by the end of the year. | Drug Discoveries |
Migraine sufferers have been offered fresh hope after research discovered potential new ways of treating the debilitating headaches.
Around one in five women, one in 16 men, and one in 11 children have regular migraines – with attacks three times more prevalent in women.
Now, an international study of the genetics of migraine has provided new insights into the biology behind the attacks.
Scientists say it will enable detection of rare variants protecting against migraine, opening an avenue for the potential development of new drugs to treat the problem.
An international team of researchers, led by deCODE Genetics in Iceland, analyzed genetic data from more than 1.3 million participants of which 80,000 had migraine.
The scientists focused on detecting sequence variants associated with the two main subtypes of migraine: migraine with aura, often referred to as “classical migraine”, and migraine without aura.
The results highlight several genes that affect one of the migraine subtypes over the other—pointing to new biological pathways that could be targeted for therapeutic developments.
Although recent advances have been made in studies of the genetics and underlying biology of migraine and new treatments recently developed that are effective for many migraine sufferers, they do not work for all types of migraine.
The study, published today in the journal Nature Genetics, discovered associations with 44 variants, 12 of which are new.
Importantly, a rare variant pointing to the KCNK5 gene, confers large protection against severe migraine and brain aneurysms—either identifying a common pathway between the two diseases or suggesting that some cases of early brain aneurysms may be misclassified as migraine.
“Four novel migraine-with-aura associations were revealed and 13 variants associated primarily with migraine without aura,” explained Professor Kari Stefansson. “Of particular interest were three rare variants with large effects pointing to distinct pathologies underlying different types of migraine.
“Thus, a rare frameshift variant in the PRRT2 gene confers a large risk of migraine with aura and with another brain disease, epilepsy, but not of migraine without aura.”
In SCN11A, a gene known to play a key role in pain sensation, the scientists detected several rare loss-of-function variants associated with protection effects against migraine, while a common missense variant in the same gene is associated with modest risk of migraine.
“What makes our study unique is that it includes large datasets from sequenced individuals enabling detection of rare variants protecting against migraine, potentially opening an avenue for development of novel drug targets,” said the Professor, and CEO of deCODE genetics.
(Contributing writer: Stephen Beech/SWNS)
SEND THIS DISCOVERY to Migraine Sufferers By Sharing on Social Media… | Disease Research |
Editor’s Note: A version of this story appeared in CNN’s Meanwhile in China newsletter, a three-times-a-week update exploring what you need to know about the country’s rise and how it impacts the world. Sign up here.
The US Department of Energy’s assessment that Covid-19 most likely emerged due to a laboratory accident in China has reignited fierce debate and attention on the question of how the pandemic began.
But the “low confidence” determination, made in a newly updated classified report, has raised more questions than answers, as the department has publicly provided no new evidence to back the claim. It’s also generated fierce pushback from China.
“We urge the US to respect science and facts, stop politicizing this issue, stop its intelligence-led, politics-driven origins-tracing,” a Chinese Foreign Ministry spokesperson said on Wednesday.
The Department of Energy assessment is part of a broader US effort in which intelligence agencies were asked by President Joe Biden in 2021 to examine the origins of the coronavirus, which was first detected in the Chinese city of Wuhan.
That overall assessment from the intelligence community was inconclusive, and then, as now, there has yet to be a decisive link established between the virus and a specific animal or other route – as China continues to stonewall international investigations into the origins of the virus.
Four agencies and the National Intelligence Council assessed with low confidence that the virus likely jumped from animals to humans through natural exposure, while one assessed with moderate confidence that the pandemic was the result of a laboratory-related accident. Three other intelligence community elements were unable to coalesce around either explanation without additional information, according to a declassified version of the 2021 report.
The majority of agencies remain undecided or lean toward the virus having a natural origin – a hypothesis also widely favored by scientists with expertize in the field. But the change from the US Department of Energy has now deepened the split in the intelligence community, especially as the director of the FBI this week commented publicly for the first time on his agency’s similar determination made with “medium confidence.”
Intelligence agencies can make assessments with either low, medium or high confidence. A low confidence assessment generally means the information obtained is not reliable enough, or is too fragmented to make a more definitive judgment.
And while the assessment and new commentary has pulled the theory back into the spotlight, neither agency has released evidence or information backing their determinations. That raises crucial questions about their basis – and shines the spotlight back on gaping, outstanding unknowns and need for further research.
New evidence?
Scientists largely believe the virus most likely emerged from a natural spillover from an infected animal to people, as many viruses before it, though they widely acknowledge the need for more research of all options. Many have also questioned the lack of data released to substantiate the latest claim.
Virologist Thea Fischer, who in 2021 traveled to Wuhan as part of a World Health Organization (WHO) origins probe and remains a part of ongoing WHO tracing efforts, said it was “very important” that any new assessments related to the origin of the virus are documented by evidence.
“(These are) strong accusations against a public research laboratory in China and can’t stand alone without substantial evidence,” said Fischer, a professor at the University of Copenhagen.
“Hopefully they will share with the WHO soon so the evidence can be known and assessed by international health experts just as all other evidence concerning the pandemic origin.”
A senior US intelligence official told the Wall Street Journal, which first reported the new Department of Energy assessment, that the update to the assessment was conducted in light of new intelligence, further study of academic literature and in consultation with experts outside government.
The idea that the virus could have emerged from a lab accident became more prominent as a spotlight was turned on coronavirus research being done at local facilities, such as the Wuhan Institute of Virology. It was further enhanced amid a failure to find a “smoking gun” showing which animal could have passed the virus to people at Wuhan’s Huanan Seafood Wholesale Market – the location linked to a number of early known cases amid limitations to follow-up research.
Some experts who have been closely involved in examining existing information, however, are skeptical of the new assessment giving the theory more weight.
“Given that so much of the data we have points to a spillover event occurring at the Huanan market in late 2019 I doubt there’s anything very significant in it or new information that would change our current understanding,” said David Robertson, a professor in the University of Glasgow’s School of Infection and Immunity, who was involved in recent research with findings that supported the natural origin theory.
He noted that locations of early human cases centered on the market, positive environmental samples, and confirmation that live animals susceptible to the virus were for sale there are among evidence supporting the natural origins theory – while there’s no data supporting a lab leak.
“The extent of this evidence continually gets lost (in media discussion) … when in fact we know a lot about what happened, and arguably more than other outbreaks,” he said.
China’s response
Efforts to understand how the pandemic started have been further complicated by China’s lack of transparency – especially as the origin question spiraled into another point of bitter contention within rising US-China tensions of recent years.
Beijing has blocked robust, long-term international field investigations and refused to allow a laboratory audit, which could bring clarity, and been reticent to share details and data around domestic research to uncover the cause. However, it repeatedly maintains that it has been transparent and cooperative with the WHO.
Chinese officials carefully controlled the single WHO-backed investigation it did allow on the ground in 2021, citing disease control measures to restrict visiting experts to their hotel rooms for half their trip and to prevent them from sharing meals with their Chinese counterparts – cutting off an opportunity for more informal information sharing.
Citing data protection, Beijing has also declined to allow its own investigatory measures, like testing stored blood samples from Wuhan or combing through hospital data for potential “patient zeros,” to be verified by researchers outside the country.
China has fiercely denied that the virus emerged from a lab accident, and has repeatedly tried to assert it could have arrived in the country for the initial outbreak from elsewhere – including a US laboratory, without offering any evidence supporting the claim.
But a top WHO official as recently as last month publicly called for “more cooperation and collaboration with our colleagues in China to advance studies that need to take place in China”– including studies of markets and farms that could have been involved.
“These studies need to be conducted in China and we need cooperation from our colleagues there to advance our understandings,” WHO technical lead for Covid-19 Maria Van Kerkhove said at a media briefing.
When asked about the Department of Energy assessment by CNN, a WHO representative said the organization and its origins tracing advisory body “will keep examining all available scientific evidence that would help us advance the knowledge on the origin of SARS CoV 2 and we call on China and the scientific community to undertake necessary studies in that direction.”
“Until we have more evidence all hypotheses are still on the table,” the representative said.
CNN’s Hannah Rabinowitz, Jeremy Herb and Natasha Bertrand contributed reporting. | Epidemics & Outbreaks |
For years, Victoria Grande just assumed she was permanently bloated.
So, imagine her shock when she was told a tumour covered in hair was actually to blame for her looking '20 weeks pregnant'.
The 11cm-mass had been silently growing inside her since she was a baby, doctors claimed.
But Miss Grande's nightmare didn't end when surgeons removed the growth, which turned out to be cancerous and also contain skin.
Doctors allegedly discovered another 100 tumours had spawned inside the 29-year-old, from Charlotte in North Carolina.
Miss Grande claims she was diagnosed with 'growing teratoma syndrome', a poorly-understood phenomenon occurring in patients with tumours of the same name.
Such tumours — usually spotted in the ovaries or testicles — can also contain teeth, muscle and bone.
Some patients can develop the even rarer GTS. This complication, doctors state in medical journals, occurs either during or after chemotherapy.
Experts say chemotherapy cures the malignant cells but that they can remain there and grow into benign tumours.
But Miss Grande had only undergone surgery to remove the original growth.
The bartender said: 'They told me it was likely wrapping around my ovary and cutting off my blood supply.
'They said it would keep growing unless I had surgery to get it out.'
Describing the teratoma's effects on her appearance, she added: 'It was like I was 20 weeks pregnant inside my body.'
Her tumour was spotted in April 2022, following a trip to the emergency department because of crippling abdominal aches that left her 'bent over in pain'.
Before her diagnosis, Miss Grande had endured on-off stomach pains for a decade — but they were usually dismissed as constipation.
She said of her tumour: 'They told me it had hair and skin. It was crazy to me. It had been growing for 28 years but so slowly it was hard to detect.'
Doctors classified it as a cystic teratoma — just one type of germ-cell tumour.
They are so rare there are no reliable figures.
Experts say the cause of teratomas is not completely understood but have suggested they come from germ cells turning into different cells.
Miss Grande underwent surgery a week after her diagnosis and follow-up tests revealed it was cancerous.
She claimed surgeons then took another look at her and found the tumours, before diagnosing her with GTS.
A 10-hour operation saw some of the tumours removed, as well as pieces of her lung, right fallopian tube, her right ovary, gallbladder and appendix - which all showed signs of cancer
Miss Grande then started six rounds of chemotherapy in July, which she completed in October.
She has now been told there is no evidence of the disease.
Ovarian germ cell tumours can spread around the body, just like other cancers. | Disease Research |
Mounting demand for Novo Nordisk-made Ozempic and Wegovy has fueled a rise in illegal sales of the weight-loss drugs in Denmark, where the pharmaceutical company is based, the Danish Medicines Agency reported.
The agency said in a statement issued Tuesday that authorities know of 26 websites illicitly selling what they claim to be Ozempic and Wegovy.
The drugs, which were initially prescribed as once-weekly shots to treat Type 2 diabetes but have since gained immense mainstream popularity for its “miraculous” weight-loss effects.
“There are no surprises or new trends that we were not already aware of. As a result of the great demand and media attention, we had unfortunately expected an increased illegal supply of the semaglutide preparations Ozempic and Wegovy,” Danish Medicines Agency head Jeanna Majland said in the statement, which was earlier reported on by Bloomberg.
America’s Food and Drug Administration has also reportedly launched an investigation into so-called “faux-zempic” after health authorities were tipped off to numerous fraudulent schemes of counterfeit Ozempic trafficking in the US.
In addition, the European Medicines Agency last month issued a warning against counterfeit Ozempic pens, which the organization said boasted labels in German “falsely labeled as diabetes medicine Ozempic” with 1 milligram of semaglutide for injection.
Both Ozempic and Wegovy are semaglutide injections, a type of strong medication that mimics the actions of the GLP-1 hormone, which the pancreas releases after eating that makes people feel full.
Since the Ozempic and Wegovy craze took effect, their appetite-suppressing benefits have taken both Hollywood and non-celebrities by storm so much so that even Walmart said the medications were causing shoppers to pare back on groceries.
Customers haven’t seemed to mind the series of bizarre side effects that have emerged, including “Ozempic butt” where users are claiming that their derrières have flattened along with their tummies.
Users later warned of “Ozempic finger,” where finger and wrist sizes were rapidly shrinking too, causing women to fear that their engagement rings would fall off.
The latest — and much more serious — side effect saw patients reporting that the medicines triggered thoughts of suicide and self-harm.
Representatives for Novo Nordisk did not immediately respond to The Post’s request for comment.
Last month, the pharma giant overtook French luxury empire LVMH as Europe’s most valuable company.
Novo Nordisk saw its market capitalization surge to $424.7 billion during Sept. 1 trading in London — beating out the luxury retail conglomerate owned by the family of Bernard Arnault.
The same day, LVMH — which has been Europe’s most valuable company for two-and-a-half years and includes brands Louis Vuitton, Dior, and Sephora — had a market cap of $420.1 billion, according to Refinitiv data cited by the Reuters news agency.
As of Wednesday, the Danish multinational company’s market value has dropped to $333 billion. | Drug Discoveries |
Many NHS staff "cried" when describing their working environment to the health safety watchdog, an interim report has revealed.
Healthcare Safety Investigation Branch (HSIB) investigated staff wellbeing across urgent and emergency care systems and its impact on patient safety.
During conversations, it "saw, felt and heard the significant distress" staff were experiencing.
Many NHS staff cried or displayed other extreme emotions when describing working conditions, their personal feelings about decisions they or others had to make in relation to patient care, and the burden of moral distress, the report outlined.
"How many people are we going to kill today?" was found to be a common worry among emergency ambulance dispatchers due to their "frustration and sadness" at not being able to send ambulances to patients in need.
The watchdog heard of occasions in which more than 100 category 2 calls - made for emergencies such as a stroke, that needed to be responded to in an average time of 18 minutes - were left waiting, with no available ambulances to respond to patients
Staff handling 999 calls reported receiving multiple calls from patients waiting for an ambulance, and hearing patients deteriorating without being able to do more than offer telephone advice.
Emergency department staff reported moral distress when they could not do right by all their patients, such as when deciding which of the unwell patients in a queue of ambulances to take in for treatment.
Read more:
This is where - and why - there are long waits for emergency care
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Staff told investigators that, even after work, they found it difficult to switch off from work and interact with friends and families, with those living alone speaking of "isolation and despair."
Staff reported feeling exhausted, a reduced ability to process information, lack of time for emotional repair and support, and reduced resources to support their emotional wellbeing.
On the advice that reflective practice - in which staff are given a protected time to come together and talk about their work's emotional impact - could be beneficial, staff told investigators that such opportunities to speak openly and safely would be "incredibly helpful" and "cathartic".
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NHS England told investigators that it believes there is a link between staff wellbeing and patient safety, and their teams and partners are working on a patient and staff safety plan.
"A culture in which staff are valued, well supported and engaged in their work leads to safe, high-quality care," it said, adding that this means "both psychological safety and physical safety."
Lead investigator Neil Alexander said: "We recognise that until there is a whole system response to the challenges in urgent care, staff will continue to face issues."
He added that in the short term, however, reflective practice and expert support are important. | Stress and Wellness |
Alcohol is the most common addictive substance in the world. Every year in the U.S. excessive alcohol use costs $249 billion and causes approximately 88,000 deaths, as well as various chronic diseases and social issues. Alcohol use disorder, a highly prevalent, chronic, relapsing disorder, affects more than 14 million people in the U.S. alone, in addition to being severely under-treated, with only three modestly effective pharmacological therapies available.
Chronic exposure to alcohol has been shown to produce profound neuroadaptations in specific brain regions, including the recruitment of key stress neurotransmitters, ultimately causing changes in the body that sustain excessive drinking. The area of the brain known as the “bed nucleus of the stria terminalis” (BNST) is critically involved in the behavioral response to stress as well as in chronic, pathological alcohol use.
Researchers from Boston University Chobanian & Avedisian School of Medicine have identified that a peptide called pituitary adenylate cyclase activating polypeptide (PACAP), is involved in heavy alcohol drinking. In addition, they have discovered that this peptide acts in the BNST area.
Using an established experimental model for heavy, intermittent alcohol drinking, the researchers observed that during withdrawal this model showed increased levels of the stress neuropeptide PACAP selectively in the BNST, compared to the control model.
Interestingly, a similar increase was also observed in the levels of another stress neuropeptide closely related to PACAP, the calcitonin gene-related peptide, or CGRP. Both peptides have been implicated in stress as well as pain sensitivity, but their role in alcohol addiction is less established.
The researchers then used a virus in a transgenic model to block the neural pathways containing PACAP that specifically arrive to the BNST. “We found that inhibiting PACAP to the BNST dramatically reduced heavy ethanol drinking,” explained co-corresponding author Valentina Sabino, PhD, co-director of the school’s Laboratory of Addictive Disorders as well as professor of pharmacology, physiology & biophysics.
According to the researchers, these results provide evidence that this protein mediates the addictive properties of alcohol. “We found a key player, PACAP, driving heavy alcohol drinking, which can be targeted for the development of novel pharmacological therapies,” added co-corresponding author Pietro Cottone, PhD, associate professor of pharmacology, physiology & biophysics and co-director of the Laboratory of Addictive Disorders.
These findings appear online in the journal eNeuro. | Disease Research |
Covid vaccines should be made available for people to buy privately in Britain, leading scientists have urged, amid concerns over a new wave of the virus which could worsen in autumn and winter.
Unlike flu jabs, which individuals or employers can buy for about £15 from high street pharmacies, Covid jabs are only available on the NHS in the UK.
This month the UK government announced that the Covid autumn booster programme would cover a smaller pool of the population than earlier vaccination drives. The age limit has been raised from 50 to 65 and above, with some younger vulnerable groups also eligible.
Prof Adam Finn, of the University of Bristol, a member of the UK’s Joint Committee on Vaccination and Immunisation (JCVI), said Covid jabs should be available commercially. Some employers might want to offer the vaccines to their staff, he added.
Speaking in a personal capacity, Finn said: “I think it will be a good idea for vaccines to be made available to those that want them on the private market. I don’t really see any reason why that shouldn’t be happening.”
Pharmaceutical companies are not prohibited from taking Covid jabs to the private market, according to the Department of Health (DHSC).
A DHSC spokesperson said: “Private sales of Covid vaccines is the same as other private healthcare, such as private sales of the seasonal flu vaccine – it is for manufacturers and private healthcare providers to decide and agree on.”
Pharmaceutical companies suggested they were tied into UK government contracts, though industry data suggested they were open to offering the jabs for commercial sale.
Reports suggest that private jabs could be offered as soon as this autumn in the US. In March Moderna told Reuters that it expected to price its Covid vaccine at about $130 [£102], while Pfizer last year suggested $110 to $130 per dose.
Darius Hughes, the UK general manager for Moderna, said: “Moderna will continue to work with UKHSA to ensure we have met all orders to support the 2023-24 NHS programme for recommended groups as per the JCVI advice, and we remain open to exploring the possibility and viability of providing Covid-19 vaccines to healthcare providers for private sales.”
Lawrence Young, a virologist at the University of Warwick, said private access to vaccines was fraught with difficulties, particularly in relation to equity of access, and Covid vaccines could be unaffordable for many. But there was precedent, he said.
“We accept every year that those who are not at high risk of serious complications can access a private flu jab, so why should the Covid jab be any different?
“While the Covid jab may not offer much protection against infection for the vast majority of people, it will help in preventing spread of the virus. Covid vaccination will also protect against the development of long Covid.”
Prof Danny Altmann, an immunologist at Imperial College London, said: “JCVI have done their calculation in favour of a very limited vaccine offer for the elderly and immunosuppressed, leaving the bulk of the population way out from their last dose and poorly protected.”
Prof Stephen Griffin, of the University of Leeds, said the current policy, which appears to rely on infections to boost immunity in the general population instead of vaccines, put people at risk of illness, including long Covid.
“Whilst private provision is therefore less than ideal, it would at least improve the unfortunate position the UK finds itself in today,” he said. “Perhaps, with subsidy for those unable to afford them, this might reduce the impact of the predicted autumn and winter Covid waves.”
However, Prof Sir Andrew Pollard, of the University of Oxford, said the eligibility criteria for the new booster campaign made sense.
“The science is clear that from the NHS perspective, Covid-19 is no longer a problem for the healthy and young in the population and it makes sense to focus vaccine policy on older adults, especially the frail, and those with underlying health conditions,” he said.
Philippa Harvey, the director of the Covid Vaccine Unit at UKHSA, said: “The Covid-19 vaccination programme continues to target those at higher risk of serious illness in line with JCVI advice, as those groups are most likely to benefit from booster vaccination at this time.
“The Covid-19 vaccine is not currently available to buy privately in the UK but there is no blanket restriction on private sales of licensed vaccines.” | Vaccine Development |
NEW YORK -- In 2022, doctors recorded the first confirmed case of tick-borne encephalitis virus acquired in the United Kingdom.
It began with a bike ride.
A 50-year-old man was mountain biking in the North Yorkshire Moors, a national park in England known for its vast expanses of woodland and purple heather. At some point on his ride, at least one black-legged tick burrowed into his skin. Five days later, the mountain biker developed symptoms commonly associated with a viral infection — fatigue, muscle pain, fever.
At first, he seemed to be on the mend, but about a week later, he started to lose coordination. An MRI scan revealed he had developed encephalitis, or swelling of the brain. He had been infected with tick-borne encephalitis, or TBE, a potentially deadly disease that experts say is spreading into new regions due in large part to global warming.
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EDITOR’S NOTE: This story is part of a collaboration between The Associated Press and Grist exploring the intersection of climate change and infectious diseases.
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For the past 30 years, the U.K. has become roughly 1 degree Celsius warmer (1.8 degrees Fahrenheit) on average compared to the historical norm. Studies have shown that several tick-borne illnesses are becoming more prevalent because of climate change. Public health officials are particularly concerned about TBE, which is deadlier than more well-known tick diseases such as Lyme, due to the way it has quickly jumped from country to country.
Gábor Földvári, an expert at the Center for Ecological Research in Hungary, said the effects of climate change on TBE are unmistakable.
“It’s a really common problem which was absent 20 or 30 years ago,” he added.
Ticks can’t survive more than a couple of days in temperatures below zero, but they’re able to persevere in very warm conditions as long as there’s enough humidity in the environment. As Earth warms on average and winters become milder, ticks are becoming active earlier in the year. Climate change affects ticks at every stage of their life cycle — egg, six-legged larva, eight-legged nymph, and adult — by extending the length of time ticks actively feed on humans and animals. Even a fraction of a degree of global warming creates more opportunity for ticks to breed and spread disease.
“The number of overwintering ticks is increasing and in spring there is high activity of ticks,” said Gerhard Dobler, a doctor who works at the German Center for Infection Research. “This may increase the contact between infected ticks and humans and cause more disease.”
Since the virus was first discovered in the 1930s, it has mainly been found in Europe and parts of Asia, including Siberia and the northern regions of China. The same type of tick carries the disease in these areas, but the virus subtype — of which there are several — varies by region. In places where the virus is endemic, tick bites are the leading cause of encephalitis, though the virus can also be acquired by consuming raw milk from tick-infected cattle. TBE has not been found in the United States, though a few Americans have contracted the virus while traveling in Europe.
According to the World Health Organization, there are between 10,000 and 12,000 cases of the disease in Europe and northern Asia each year. The total number of cases worldwide is likely an undercount, as case counts are unreliable in countries where the population has low awareness of the disease and local health departments are not required to report cases to the government. But experts say there has been a clear uptick since the 1990s, especially in countries where the disease used to be uncommon.
“We see an increasing trend of human cases,” Dobler said, citing rising cases in Austria, Germany, Estonia, Latvia, and other European countries.
TBE is not always life-threatening. On average, about 10 percent of infections develop into the severe form of the illness, which often requires hospitalization. Once severe symptoms develop, however, there is no cure for the disease. The death rate among those who develop severe symptoms ranges from 1 to 35 percent, depending on the virus subtype, with the far-eastern subtype being the deadliest. In Europe, for example, 16 deaths were recorded in 2020 out of roughly 3,700 confirmed cases.
Up to half of survivors of severe TBE have lingering neurological problems, such as sleeplessness and aggressiveness. Many infected people are asymptomatic or only develop mild symptoms, Dobler said, so the true caseload could be up to 10 times higher in some regions than reports estimate.
While there are two TBE vaccines in circulation, vaccine uptake is low in regions where the virus is new. Neither vaccine covers all of the three most prevalent sub-types, and a 2020 study called for development of a new vaccine that offers higher protection against the virus. In Austria, for example, the TBE vaccine rate is near 85 percent, Dobler said, and yet the number of human cases continues to trend upward — a sign, in his opinion, of climate change’s influence on the disease.
In central and northern Europe, where for the past decade average annual temperatures have been roughly 2 degrees Celsius above pre industrial times (3.6 degrees Fahrenheit), documented cases of the virus have been rising in recent decades — evidence, some experts say, that rising global temperatures are conducive to more active ticks. The parasitic arachnids are also noted to be moving further north and higher in altitude as formerly inhospitable terrain warms to their preferred temperature range. Northern parts of Russia are a prime example of where TBE-infected ticks have moved north. Some previously tick-free mountains in Germany, Bavaria, and Austria are reporting a 20-fold increase in cases over the past 10 years.
The virus’s growing shadow across Europe, Asia, and now parts of the United Kingdom throws the dangers of tick-borne disease into sharp relief. The U.K. bicyclist who was the first domestically acquired case of the disease survived his bout with TBE, but the episode serves as a warning to the region: though the virus is still rare, it may not stay that way for long.
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Associated Press climate and environmental coverage receives support from several private foundations. See more about AP’s climate initiative here. The AP is solely responsible for all content. | Epidemics & Outbreaks |
Image source, Getty ImagesReducing an antidepressant dose should be done in stages, with help from a medical professional, according to the National Institute for Health and Care Excellence (NICE).It says this helps manage withdrawal symptoms that can occur from the drugs.NICE has published new information that sets out how mental health care can be improved in England and Wales. A committee of experts says community care services should work with patients to agree a treatment plan.This includes assessing whether it is right for them to come off their medication and over what time period withdrawal should take place.Another suggestion is that extra attention should be paid to adults from minority ethnic backgrounds who have depression.It comes after NHS Digital data from 2021 showed that 11.9% of people from black and Asian backgrounds completed a course of treatment for depression compared with 79.9% of people from a white family background. The suggestion is that mental health services should be delivered in a way that is culturally appropriate and that language barriers are also removed. According to the NHS, antidepressant prescriptions reached an all-time high in 2022, with 8.3 million people taking them in England. Statistics also show about one in six adults aged 16 or over in the UK experienced some form of depression in the summer of 2021, with the rate remaining higher than before the coronavirus pandemic and lockdowns. 'No one-size fits all approach'The recommendations are in addition to pre-existing ones on managing depression in adults, which were last updated in November 2021.NICE suggested then that people with mild depression should be offered behavioural therapy or group exercise before medication is discussed.Dr Paul Chrisp, who is in charge of NICE guidelines, said: "In many cases, people experience withdrawal symptoms, and the length of time it takes them to safely come off these drugs can vary, which is why our committee's useful and useable statement for a staged withdrawal over time from these drugs is to be welcomed.If you are affected by any of the issues in this article you can find details of organisations that can help via the BBC Action Line."But it should be stressed there is no one-size fits all approach to coming off antidepressants," he added. In response to the proposals, Prof Allan Young from the Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience said: "It makes complete sense that the guidelines for treating depression in adults - which were published in June last year- are followed. "Whether it can be delivered given the current state of the NHS is another question."'It was like a constant hangover times five'Image source, John JuniorImage caption, John took himself off antidepressants during lockdownJohn Junior, 34, started taking antidepressants in 2017 after being diagnosed with depression and generalised anxiety disorder.Gradually building up his dosage of sertraline, he says the drug "really did help" curb suicidal thoughts he had been having.However, he found the side effects unbearable."I suffered from palpitations, which is a horrible side effect, and I was getting all sorts of headaches, migraines, more severe anxiety and stuff, even high blood pressure as well," he told the BBC."And then I'd be prescribed more medications to try and mask the other side effects I was experiencing."It got to the point where I thought I was going to be fully dependent on antidepressants," he says.During the coronavirus lockdown, he decided to come off the medication, but could not get through to his doctor."The phone was always engaged - which made it really difficult."I was experiencing more and more side effects and it just wasn't working for me, my body reached its limit and I just knew I had to come off of them."He says going "cold turkey" caused "sickness, headaches, raw anxiety, sweats and sleepless nights" and likened it to a "constant hangover times five". John says he is coping well since coming off antidepressants and uses the gym and meditation to keep his mental health in check. He welcomes the new NICE guidance and says: "I think having an individual plan would be a great idea because it would give people that structure. And having that communication and reassurance from medical professionals would be great." Stephen Buckley from the mental health charity Mind, says: "Medication helps some people, but it isn't always right for others."If you're taking medication for your mental health, you might reach a point where you want to stop taking it. "We strongly suggest talking to your doctor or mental health team if you are thinking of withdrawing from your medication, you want to change medication, or you are experiencing withdrawal symptoms, so that you can be supported to come off or change your medication safely over time." If you are affected by any of the issues in this article you can find details of organisations that can help via the BBC Action Line. | Mental Health Treatments |
An illustration of Neisseria gonorrhoeae bacteria.Illustration: Shutterstock (Shutterstock)Super gonorrhea has infected people in the United States for the first known time. This week, Massachusetts public health officials announced the discovery of two gonorrhea cases appearing to display increased resistance to all known antibiotic classes that can be used against it. These cases were thankfully still curable, but it’s the latest reminder that this common sexually transmitted infection is becoming a more serious threat.OffEnglishGonorrhea, caused by the namesake bacteria Neisseria gonorrhoeae, is the second most commonly reported STI in the U.S., with 677,769 cases documented in 2020. Many infected people don’t experience illness, but initial symptoms can include a discolored discharge from the genitals, painful or burning urination, and rectal bleeding if caught from anal sex. When gonorrhea is left untreated, it raises the risk of more serious complications, like damage to the reproductive tract in women and swollen testicles in men, both of which can lead to infertility. And when it’s passed down from mother to child, the infection can be fatal or cause blindness in newborns.While gonorrhea was once easily treatable with a simple pill of penicillin or other antibiotics, the bacteria has steadily learned to resist almost every drug put in its path. These days, only one or two antibiotics taken at the same time (depending on the region) are considered reliably effective against gonorrhea and are recommended as front-line treatments. But in recent years, doctors have seen cases of gonorrhea where it’s started to evade even these drugs. These extensively hardy, or pan-resistant, infections have been documented in parts of Europe and Asia to date, but at least two similar cases have now been identified in Massachusetts.According to the state health department, the strain of gonorrhea isolated from one case clearly showed resistance or a reduced response to five classes of antibiotics, while the strain pulled from the second case was genetically close enough that it would likely have similar resistance. A common genetic marker seen in these cases was previously identified in a case reported in Nevada, but that strain still responded normally to at least one class of antibiotics. As far as health officials know, these are the first documented gonorrhea cases to show increased resistance to all of the drug classes known to treat it ever identified in the U.S.“The discovery of this strain of gonorrhea is a serious public health concern which DPH, the CDC, and other health departments have been vigilant about detecting in the US,” said Public Health Commissioner Margret Cooke, in a statement from the agency.G/O Media may get a commissionUp to $100 creditSamsung ReserveReserve the next gen Samsung deviceAll you need to do is sign up with your email and boom: credit for your preorder on a new Samsung device.Growing rates of resistance to the antibiotic azithromycin led the U.S. to stop recommending it for gonorrhea in late 2020. Now, only the drug ceftriaxone—taken as an injection—is considered a frontline option in the country, and at a higher dose than before. Luckily, despite the reduced response to ceftriaxone, both cases were successfully cleared after patients took these higher doses.These cases are likely only a warning of what’s to come. Some of the important genetic markers seen in this novel strain have been spotted in pan-resistant cases from Europe and Asia, which shows that these mutations are continuing to spread around the world. Gonorrhea rates in general have increased year after year in the U.S. And perhaps most worryingly, no clear connection between the two Massachusetts cases has been found, indicating that these strains may already be circulating past the point where they could be easily contained.There are ongoing efforts to develop vaccines and novel antibiotics against gonorrhea, but it may take years before any of these come to fruition, if any do. So it’s only become more important to take precautions against contracting and spreading these STIs in the first place. Health officials are now alerting doctors and testing labs in Massachusetts to look out for and report any similar cases.“We urge all sexually active people to be regularly tested for sexually transmitted infections and to consider reducing the number of their sexual partners and increasing their use of condoms when having sex. Clinicians are advised to review the clinical alert and assist with our expanded surveillance efforts,” said Cooke. | Disease Research |
Women suffering from debilitating pain are putting off going to the doctor because they are worried their symptoms will be dismissed or think the pain is normal.
Helen McLaughlin was told her symptoms were "just a UTI" - despite experiencing pain so bad she was in and out of hospital and struggling to walk, work, and put a seatbelt on.
She is one of about 1.5 million women and people assigned female at birth living with endometriosis in the UK.
Endometriosis is a condition where cells similar to the ones lining the womb grow outside the uterus.
They react to the menstrual cycle, building up and then breaking down and bleeding, but the blood has no way to escape.
Endometriosis can cause chronic pelvic pain, painful bowel movements, pain when urinating and having sex, fatigue and difficulty getting pregnant.
Despite the severity of the symptoms, 75% of women say they would not go to a doctor if they were suffering from them, a new survey by Endometriosis UK has found.
Among those who wouldn’t see a doctor, 24% said it was because they considered painful periods to be a normal part of life, while 23% said they would think it was "not serious enough to bother a doctor with".
More than a fifth said they would worry doctors might not take their symptoms seriously.
Ms McLaughlin, 38, is a support group leader for Endometriosis UK and told Sky News many women with the condition are subject to "medical gaslighting".
Asked what women get told when they present with symptoms, she rattles off a list: "It’s IBS, you’re overreacting, it’s all in your head, all women have heavy periods, 'just get pregnant, it’ll cure you'."
The last one is particularly insensitive, she said, because of the link between endometriosis and infertility.
It’s "really, really draining" advocating for yourself when doctors are dismissive, Ms McLaughlin said: "You're already exhausted, in pain, confused, lost - you’re doubting yourself."
Read more:
Bindi Irwin was told endometriosis 'simply something you deal with as a woman'
'Endometriosis diagnosis came after years of agony'
For her, the first inkling it was endometriosis didn’t come from a gynaecologist, but a stranger.
She was in hospital when she got a text from a friend asking if she’d heard of the condition: "There's a woman at work that's got it and she said you might have it too," she said.
Ms McLaughlin recommends people who think they might have endometriosis keep a pain and symptom diary to show to a doctor and familiarise themselves with the NICE guidelines on endometriosis.
Despite the poor experiences some endometriosis sufferers have had or fear in the health system, she urged people not to delay seeing their doctor.
"If it’s impacting your normal day-to-day life and paracetamol or ibuprofen aren't quite cutting it, then I would definitely go to the GP," she said.
"You know your body better than anyone. So if your gut is telling you that something's not quite right, then you should definitely push on." | Women’s Health |
Cases of norovirus are spreading across the United States and are higher than usual at this point in this season, according to data from the Centers for Disease Control and Prevention.
As of Feb. 9, more than 15% of weekly tests for norovirus are coming back positive, the highest seen since mid-March 2022. Additionally, 225 outbreaks have been recorded between Aug. 1, 2022 and Jan. 2, 2023, compared to 172 at this point last year, CDC data shows.
Norovirus has also been linked to outbreaks at two schools: an elementary school in Las Vegas and a preschool-grade 8 school in Livonia, Michigan -- 20 miles west of Detroit.
"It tends to occur in outbreaks, like it is not something that's kind of always there. at a low level," Dr. Adam Ratner, director of pediatric infectious diseases at NYU Langone Hassenfeld Children's Hospital, told ABC News. "It's something where you see outbreaks in all sorts of different kinds of, close communities -- a school daycare center -- we see norovirus outbreaks on cruise ships or in nursing homes."
Here's what you need to know about norovirus and how to best protect yourself from contracting it.
What is norovirus?
Norovirus is a highly contagious virus that is the most common cause of viral gastroenteritis, which is an inflammation of the inside lining of the gastrointestinal tract.
Although it's often referred to as the "stomach bug" or "stomach flu," norovirus illness is not related to influenza.
In fact, it is the leading cause of foodborne illness in the United States, causing 58% of foodborne illnesses each year, according to the CDC.
The most common symptoms are nausea, vomiting, stomach pain and diarrhea. However, patients can also experience fever, headaches and body aches.
"They're probably a lot of people when they get infected that have very, very mild symptoms or no symptoms," Dr. John Segreti, a hospital epidemiologist at Rush University Medical Center in Chicago, told ABC News.
According to the federal health agency, every year the virus causes between 19 and 21 million illnesses, 109,000 hospitalizations and 900 deaths.
How is norovirus spread?
"One of the distinguishing features of norovirus is that it is highly contagious and transmissible, so just a few virus particles can cause someone to be sick," Dr. Soniya Gandhi, an infectious diseases specialist at Cedars-Sinai Medical Center in Los Angeles, told ABC News.
This means a person can become infected by having direct contact with someone who is infected and sharing food or utensils with them; touching surfaces or objects contaminated with norovirus and then touching your face or mouth; or consuming contaminated foods or liquids.
For the latter, this includes fruits and vegetables washed in contaminated water or shellfish, like oysters, harvested from contaminated water.
Typically, an infected person will develop symptoms between 12 to 48 hours after being infected. However, norovirus typically resolves quickly and, in most health adults it will only last one to three days, according to the CDC.
Is there a test for norovirus?
Dr. Karen Krueger, an assistant professor of medicine and infectious diseases at Northwestern University, told ABC News that often people don't even to be tested for norovirus.
However, for those who are tested, it's not with a nasal swab or throat swab as is done with other viruses.
"We don't even necessarily test everybody who's affected since the symptoms are usually short lived, but in an outbreak setting, we really do want to be aware of what's going on and what strains are circulating out there to gain more information," she said. "So, in those situations, we generally perform the test by looking at genetic material norovirus in the stool, so it'd be the patient providing a stool sample."
How to treat norovirus
There is no specific treatment or antiviral for norovirus, so this means the treatment plan is managing symptoms.
Doctors say to make sure you're staying hydrated and to drink liquids that replenish electrolytes, which can be depleted through diarrhea and vomiting.
If you have a fever that causes discomfort, you can take anti-fever medication such as ibuprofen or acetaminophen.
Although symptoms will result in a few days for most people, certain groups are at high risk for severe dehydration including those under age 1, the elderly and the immunocompromised.
What to eat when you have norovirus
Similar to any illness that causes vomiting or diarrhea, doctors recommend eating bland food if you have norovirus such as bananas, dry toast, crackers and rice for about 24 to 48 hours.
Avoid eating foods or drinking liquids that might upset the stomach including spicy food, alcohol, caffeine and dairy products such as milk and cheese.
Segreti, however, said patients shouldn't force themselves to eat if they don't feel well.
"You shouldn't force yourself to eat," he said. "You should try to force yourself to drink fluids to maintain your hydration. And if you can't, seek medical help."
What is the difference between norovirus and food poisoning?
Norovirus is one form of food poisoning, the large umbrella term the describes being sick after eating or drinking.
Food poisoning can be caused by ingesting several types of germs including salmonella, campylobacter, E. coli and listeria.
Additionally, while norovirus symptoms can take up to 48 hours to appear, food poisoning symptoms typically occur between six and 12 hours later.
'The other piece with norovirus to recognize is that even after an individual recovers, and is feeling better, or they can shed norovirus in their stool for weeks subsequently," Gandhi said. "And so, I think that also contributes to its transmissibility and is a distinguishing feature from kind of the run-of-the-mill food poisoning."
Difference between norovirus, rotavirus and astrovirus
There's not much difference when it comes to norovirus, rotavirus and astrovirus.
Clinically, their symptoms are the same and you can't tell the difference between them unless you run a test.
However, rotavirus and astrovirus are more common in children and norovirus is more common in adults.
"The major difference among the three is that we now vaccinate against rotavirus," Ratner said. "So, rotavirus used to be super, super common, and it's much less common now in the U.S. because we routinely vaccinate children."
How to prevent norovirus
The experts say the best way to prevent getting norovirus is to wash your hands with warm soap and water for 20 seconds.
Norovirus has a lipid envelope -- a shell that protects it and helps it evade recognition by the immune system -- making alcohol-based sanitizers less protective.
"Norovirus actually has a pretty tough protective shell," said Gandhi. "So, alcohol doesn't deactivate the virus as well and is not as effective as handwashing, eliminating norovirus from your hands. So that is the number one tool we have."
The CDC says to makes sure you're washing your hands after you use the toilet or change diapers as well as when you're eating, preparing or handling food.
To prevent contamination from food, make sure fruits and vegetables are washed and that shellfish is cooked to at least an internal temperature of 145F.
Lastly, clean and disinfect food preparation surfaces and any area where someone vomited or had diarrhea.
"And then for individuals who do get sick, it's really important to isolate yourself until you've been feeling better for 48 hours," Krueger said. | Epidemics & Outbreaks |
UK becomes 1st country to approve gene therapy treatment for sickle cell, thalassemia
Britain’s medicines regulator has authorized the world’s first gene therapy treatment for sickle cell disease, in a move that could offer relief to thousands of people with the crippling disease in the U.K. In a statement on Thursday, the Medicines and...
LONDON -- Britain's medicines regulator has authorized the world's first gene therapy treatment for sickle cell disease, in a move that could offer relief to thousands of people with the crippling disease in the U.K.
In a statement on Thursday, the Medicines and Healthcare Regulatory Agency said it approved Casgevy, the first medicine licensed using the gene editing tool CRISPR, which won its makers a Nobel prize in 2020.
The agency approved the treatment for patients with sickle cell disease and thalassemia who are 12 years old and over. Casgevy is made by Vertex Pharmaceuticals (Europe) Ltd. and CRISPR Therapeutics. To date, bone marrow transplants, an extremely arduous procedure that come with very unpleasant side effects, have been the only long-lasting treatment.
“The future of life changing cures resides in CRISPR based (gene-editing) technology,” said Dr. Helen O'Neill of University College London.
“The use of the word ‘cure’ in relation to sickle cell disease or thalassemia has, up until now, been incompatible,” she said in a statement, calling the MHRA's approval of gene therapy “a positive moment in history.”
Both sickle cell disease and thalassemia are caused by mistakes in the genes that carry hemoglobin, the protein in red blood cells that carry oxygen.
In people with sickle cell — which is particularly common in people with African or Caribbean backgrounds — a genetic mutation causes the cells to become crescent-shaped, which can block blood flow and cause excruciating pain, organ damage, stroke and other problems.
In people with thalassemia, the genetic mutation can cause severe anemia and patients typically require blood transfusions every few weeks, and injections and medicines for their entire life. Thalassemia predominantly affects people of South Asian, Southeast Asian and Middle Eastern heritage.
The new medicine, Casgevy, works by targeting the problematic gene in a patient's bone marrow stem cells so that the body can make properly functioning hemoglobin. Doctors take stem cells from the patient's bone marrow and use genetic editing techniques in a laboratory to fix the gene. The cells are then infused back into the patient for a permanent treatment.
Britain's regulator said its decision to authorize the gene therapy for sickle cell disease was based on a study done on 29 patients, of whom 28 reported having no severe pain problems for at least one year after being treated. In the study for thalassemia, 39 out of 42 patients who got the therapy did not need a red blood cell transfusion for at least a year afterwards.
Gene therapy treatments typically cost thousands of dollars and experts have previously raised concerns that they could remain out of reach for the people most in need of treatment. Vertex Pharmaceuticals said they had not yet established a price for the treatment in Britain and were working with health authorities “to secure reimbursement and access for eligible patients as quickly as possible.”
Medicines and treatments in Britain must be recommended by a government watchdog before they are made freely available to patients in the national health care system.
Casgevy is currently being reviewed by the U.S. Food and Drug Administration; the agency is expected to make a decision early next month, before considering another sickle cell gene therapy.
Millions of people around the world, including about 100,000 in the U.S., have sickle cell disease. It occurs more often among people from places where malaria is or was common, like Africa and India, and is also more common in certain ethnic groups, such as people of African, Middle Eastern and Indian descent. Scientists believe being a carrier of the sickle cell trait helps protect against severe malaria.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content. | Medical Innovations |
10 ways kids appear to be acting naughty but actually aren't
Many of kids' so-called 'bad' behaviors are actually normal developmental acts of growing up.
When we recognize kids' unwelcome behaviors as reactions to environmental conditions, developmental phases, or our own actions, we can respond proactively, and with compassion.
Here are 10 ways kids may seem like they're acting "naughty" but really aren't. And what parents can do to help.
1. They can't control their impulses.
Ever say to your kid, "Don't throw that!" and they throw it anyway?
Research suggests the brain regions involved in self-control are immature at birth and don't fully mature until the end of adolescence, which explains why developing self-control is a "long, slow process."
A recent survey revealed many parents assume children can do things at earlier ages than child-development experts know to be true. For example, 56% of parents felt that children under the age of 3 should be able to resist the desire to do something forbidden whereas most children don't master this skill until age 3 and a half or 4.
What parents can do: Reminding ourselves that kids can't always manage impulses (because their brains aren't fully developed) can inspire gentler reactions to their behavior.
2. They experience overstimulation.
We take our kids to Target, the park, and their sister's play in a single morning and inevitably see meltdowns, hyperactivity, or outright resistance. Jam-packed schedules, overstimulation, and exhaustion are hallmarks of modern family life.
Research suggests that 28% of Americans "always feel rushed" and 45% report having "no excess time." Kim John Payne, author of "Simplicity Parenting," argues that children experience a "cumulative stress reaction" from too much enrichment, activity, choice, and toys. He asserts that kids need tons of "down time" to balance their "up time."
What parents can do: When we build in plenty of quiet time, playtime, and rest time, children's behavior often improves dramatically.
3. Kids' physical needs affect their mood.
Ever been "hangry" or completely out of patience because you didn't get enough sleep? Little kids are affected tenfold by such "core conditions" of being tired, hungry, thirsty, over-sugared, or sick.
Kids' ability to manage emotions and behavior is greatly diminished when they're tired. Many parents also notice a sharp change in children's behavior about an hour before meals, if they woke up in the night, or if they are coming down with an illness.
What parents can do: Kids can't always communicate or "help themselves" to a snack, a Tylenol, water, or a nap like adults can. Help them through routines and prep for when that schedule might get thrown off.
Image via iStock.
4. They can't tame their expression of big feelings.
As adults, we've been taught to tame and hide our big emotions, often by stuffing them, displacing them, or distracting from them. Kids can't do that yet.
What parents can do: Early-childhood educator Janet Lansbury has a great phrase for when kids display powerful feelings such as screaming, yelling, or crying. She suggests that parents "let feelings be" by not reacting or punishing kids when they express powerful emotions. (Psst: "Jane the Virgin" actor Justin Baldoni has some tips on parenting through his daughter's grocery store meltdown.)
5. Kids have a developmental need for tons of movement.
"Sit still!" "Stop chasing your brother around the table!" "Stop sword fighting with those pieces of cardboard!" "Stop jumping off the couch!"
Kids have a developmental need for tons of movement. The need to spend time outside, ride bikes and scooters, do rough-and-tumble play, crawl under things, swing from things, jump off things, and race around things.
What parents can do: Instead of calling a child "bad" when they're acting energetic, it may be better to organize a quick trip to the playground or a stroll around the block.
6. They're defiant.
Every 40- and 50-degree day resulted in an argument at one family's home. A first-grader insisted that it was warm enough to wear shorts while mom said the temperature called for pants. Erik Erikson's model posits that toddlers try to do things for themselves and that preschoolers take initiative and carry out their own plans.
What parents can do: Even though it's annoying when a child picks your tomatoes while they're still green, cuts their own hair, or makes a fort with eight freshly-washed sheets, they're doing exactly what they are supposed to be doing — trying to carry out their own plans, make their own decisions, and become their own little independent people. Understanding this and letting them try is key.
7. Sometimes even their best traits can trip them up.
It happens to all of us — our biggest strengths often reflect our weaknesses. Maybe we're incredibly focused, but can't transition very easily. Maybe we're intuitive and sensitive but take on other people's negative moods like a sponge.
Kids are similar: They may be driven in school but have difficulty coping when they mess up (e.g., yelling when they make a mistake). They may be cautious and safe but resistant to new activities (e.g., refusing to go to baseball practice). They may live in the moment but aren't that organized (e.g., letting their bedroom floor become covered with toys).
What parents can do: Recognizing when a child's unwelcome behaviors are really the flip side of their strengths — just like ours — can help us react with more understanding.
Image via iStock.
8. Kids have a fierce need for play.
Your kid paints her face with yogurt, wants you to chase her and "catch her" when you're trying to brush her teeth, or puts on daddy's shoes instead of her own when you're racing out the door. Some of kids' seemingly "bad" behaviors are what John Gottman calls "bids" for you to play with them.
Kids love to be silly and goofy. They delight in the connection that comes from shared laughter and love the elements of novelty, surprise, and excitement.
What parents can do: Play often takes extra time and therefore gets in the way of parents' own timelines and agendas, which may look like resistance and naughtiness even when it's not. When parents build lots of playtime into the day, kids don't need to beg for it so hard when you're trying to get them out the door.
9. They are hyperaware and react to parents' moods.
Multiple research studies on emotional contagion have found that it only takes milliseconds for emotions like enthusiasm and joy, as well as sadness, fear, and anger, to pass from person to person, and this often occurs without either person realizing it. Kids especially pick up on their parents' moods. If we are stressed, distracted, down, or always on the verge of frustrated, kids emulate these moods. When we are peaceful and grounded, kids model off that instead.
What parents can do: Check in with yourself before getting frustrated with your child for feeling what they're feeling. Their behavior could be modeled after your own tone and emotion.
10. They struggle to respond to inconsistent limits.
At one baseball game, you buy your kid M&Ms. At the next, you say, "No, it'll ruin your dinner," and your kid screams and whines. One night you read your kids five books, but the next you insist you only have time to read one, and they beg for more. One night you ask your child, "What do you want for dinner?" and the next night you say, "We're having lasagna, you can't have anything different," and your kids protest the incongruence.
When parents are inconsistent with limits, it naturally sets off kids' frustration and invites whining, crying, or yelling.
What parents can do: Just like adults, kids want (and need) to know what to expect. Any effort toward being 100% consistent with boundaries, limits, and routines will seriously improve children's behavior.
This story first appeared on Psychology Today and is reprinted here with permission. | Mental Health Treatments |
Your hands are probably heavier than you think, a new study suggests. In a series of experiments, researchers showed that people consistently underestimated the weight of their hands. The findings might one day help us better design prosthetics that feel more comfortable for their users to wear, the authors say.
The study was led by psychologists from the University of London in the UK. The team was inspired by research findings that amputees will commonly complain about the weight of their new prosthetic limbs, despite these limbs often weighing less than the genuine article. Stroke patients who experience partial paralysis will also sometimes report that their limbs feel heavier afterward—a change that might be caused by higher levels of fatigue post-stroke.
To better understand this phenomenon, the team decided to recruit groups of healthy adults for two separate experiments.
In the first experiment, the team had 20 volunteers sit in a chair with armrests and fixed screens that blocked them from seeing their hands. Each volunteer’s left hand was first left to dangle off the edge of the chair while the rest of the arm was supported by a cushion. Then the volunteers were made to carry differently sized bags of rice hooked onto a wristband on their left arm while their left hand was supported by another cushion (in effect, replacing the weight of the hand with the rice bags). With each new weight attached, the volunteers were asked to judge whether the rice bag was heavier or lighter than their hand.
People were good at telling apart light and heavy weights, the researchers found. But the volunteers also systematically underestimated the weight of their own hands—by an average of 49%. Since the typical adult hand is around 400 grams (just under 0.9 pounds), this would amount to people thinking that their hands instead weighed about 200 grams.
In the second experiment, the team had another group try the same task with an added twist. This time, the volunteers were first asked to use a dynamometer (a device that measures hand grip strength) for ten minutes in order to tire them out. As before, the volunteers underestimated the weight of their hands, but only by 29% on average. The findings were published Monday in the journal Current Biology.
The results are based on a small sample size, so more research will be needed to confirm the team’s observations. But they do provide some of the first experimental support for the idea that we experience the weight of our body parts differently than we do for objects that aren’t attached to us.
The researchers aren’t quite sure why this happens, but they have their theories. Not sensing the weight of our limbs might allow us to be more precise in judging the weight of things we’re carrying in those limbs, for instance. Simply not feeling the burden of our body all the time might also make us more willing and able to stay active. On the flip side, if fatigue can literally make our hands and other body parts feel heavier than before, as the team’s findings suggest, then that sensation might provide us with an added incentive to take a break.
“By making actions feel effortless, weight underestimation may encourage activity. Conversely, the reappearance of body weight with fatigue may produce the opposite effect,” the researchers wrote.
There have long been efforts to create more real-seeming prosthetics, including those that try to incorporate some level of sensory feedback for their users. And some research has already suggested that these improved prosthetics will also get to feel lighter as a result as well, the authors note. | Medical Innovations |
NHS maternity services are getting worse, with inspectors finding growing numbers ‘inadequate’ for safety - as pressure grows for the government to call a national public inquiry.
Overall, the Care Quality Commission found 49% of maternity services were inadequate or required improvement - up from 39% last year.
Meanwhile, on safety specifically, the figure had shot up from 54% last year to 65% this year.
Richard Stanton and Rhiannon Davies, who lost their daughter Kate in 2009 due to failures at Shrewsbury and Telford Hospital Trust, accused the NHS of a "missed opportunity" to make urgent improvements to care recommended by independent midwife Donna Ockenden in her report more than 18 months ago.
“It’s incredibly frustrating beyond words really,” Richard told ITV News Central.
“We know that many hospitals are acting on her recommendations, but somehow we just don’t see care improving in maternity.
“Here we are with a raft of recommendations, some of them very basic, and yet maternity services seem to be sliding backwards.”
At the time, the Shropshire review, with more than 1,400 cases of poor care resulting in hundreds of babies and mothers dying or being left seriously injured, was thought to be the biggest scandal in NHS history.
It came after a similar one in 2015, which found the preventable deaths of 11 babies and one mother at Morecambe Bay; and was followed later in 2022 by another review which found 45 preventable baby deaths at East Kent.
Richard and Rhiannon, alongside fellow campaigners Kayleigh and Colin Griffiths and backed by other bereaved families, have called for a national public inquiry.
“At the moment we’ve got a jigsaw, with bits and pieces here and there,” Richard said.
“It’s only at national level that we can understand the entire picture,” Rhiannon added.
“There are socio-economic and deprivation concerns, ethnicity concerns.
"Until we can dig into every single area of what is actually going wrong instead of putting a sticking plaster here and there, we’re not going to understand the full picture and we’re not going to get significant, deep change.”
The report from the CQC follows a debate in the House of Commons yesterday, led by North Shropshire MP Helen Morgan.
“Each time a scandal emerges, we promise ourselves that it will be the last time. But tragically, so far, that has not been the case. It does seem that far from being a localised issue, maternity services have been experiencing a crisis nationally,” she warned.
“Too often, harm continues to occur as a result of care that isn’t in line with nationally agreed standards. Listening to the voices and experiences of families must be at the heart of policy. But most importantly, we must ensure that staffing levels are safe so that no one leaves the hospital with empty arms and a broken heart where that could have been avoided.”
The Stanton-Davies and Griffiths families sent letters calling for a national public inquiry directly to Health Secretary Steve Barclay, who has yet to respond.
“The silence,” Rhiannon said, “has been deafening.”
In response, the Department of Health and Social Care issued the same response it has given each time it has been approached by ITV News Central about this story.
It said: “Every parent deserves to feel confident in the care they and their baby receive. These findings in Leicester are concerning and so we welcome the Care Quality Commission’s commitment to monitoring those trusts that are not providing an adequate standard, to ensure improvements are made.
“Nationally, we have invested £165 million a year since 2021 to grow the maternity workforce and improve neonatal services and we are promoting careers in midwifery by increasing training places by up to 3,650 over the past four years.
“The Care Quality Commission is also currently inspecting all NHS acute hospital maternity services that have not been inspected and rated since April 2021.”
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It's the middle of the day and you just can't seem to get out of first gear. And it's not the first timeWhatâs making you feel so wiped out? There is a long list of possible reasons, and many of them are things that you can influence. Check out these common culprits for fatigue and get some pep back in your step.
Does Your Lifestyle Need a Tweak?
Everyday habits can make a big difference.
"With my patients, I talk about the three pillars of health: sleep, diet, and exercise," says Theodore Friedman, MD, PhD, chair of medicine at the Charles R. Drew University of Medicine and Science in Los Angeles. "If you aren't getting good sleep, it's hard to eat well, and it's hard to exercise. And the same is true the other way around. They're all related."
So try not to short-change yourself on shut-eye. Adults need 7 to 9 hours of sleep. Eat a balanced diet of fruits, veggies, and lean protein, and get a regular dose of physical activity.
If you've checked all those boxes and you still drag through your days, it might be time to check possible medical causes of fatigue.
Anemia
Iron acts like a train car that transports oxygen in your blood. "People with low iron don't have enough cars on their train," Friedman says. "They're tired, they get dizzy when they stand up, they get brain fog, they get heart palpitations."
Your doctor can check you for anemia with a simple blood test.
Diabetes
Doctors don't know exactly why it makes people so tired. One likely reason is that your body uses lots of energy to deal with your frequent changes in blood sugar levels.
Problems With Your Thyroid
It's a small, butterfly-shaped gland that sits in your neck. It makes a hormone that helps control how you use energy. When your thyroid gland is out of whack, you're out of whack.
"People with an underactive thyroid are going to feel tired," Friedman says. "Their cells aren't working well, they're sluggish, and their reflexes are slow."
Heart Disease
Extreme tiredness is a common symptom of congestive heart failure, which happens when it doesn't pump as well as it should. If you have it, your fatigue usually gets worse when you exercise. You might also have swelling in your arms or legs and shortness of breath.
Sleep Apnea
This disorder keeps you from getting enough oxygen when you sleep, which means you won't get real rest during the night.
"The brain notices you're not getting rid of your CO2, and it wakes up really briefly in an alarmed state," says Lisa Shives, MD, director of the Sleep Medicine Center at the University of California, San Diego School of Medicine. You don't even realize it, which makes it hard to figure out why you're so sleepy during the day.
"You don't get into REM -- the sleep that makes you feel best," Shives says.
A device called a continuous positive airway pressure (CPAP) machine can help keep your airways open for a solid night's sleep.
Menopause
If you're a woman who's going through menopause, you may find it hard to get good sleep. Your hormones change a lot at this time, which give you night sweats and hot flashes. That can keep you up at night and leave you dragging during the day.
Depression
It robs your brain of the chemicals it needs to work at its best. One of those is serotonin, which helps regulate your internal body clock.
Depression can lower your energy levels and make you feel tired during the day. You may also find it hard to fall asleep at night, or you might wake up earlier than you want in the morning.
Talk to you doctor if you think you're depressed. Talk therapy and medicine can help. | Stress and Wellness |
Auckland surgeons are now being required to consider a patient’s ethnicity alongside other factors when deciding who should get an operation first.
Several surgeons say they are upset by the policy, which was introduced in Auckland in February and gave priority to Māori and Pacific Island patients - on the grounds that they have historically had unequal access to healthcare.
Listen live: David Seymour at 7.05am, Te Whatu Ora Auckland Interim District Lead Dr Mike Shepherd at 7.30am
Health officials stress that ethnicity is just one of five factors considered in deciding when a person gets surgery, and that it is an important step in addressing poor health outcomes within Māori and Pacific populations.
Te Whatu Ora - Health New Zealand has introduced an Equity Adjustor Score, which aims to reduce inequity in the system by using an algorithm to prioritise patients according to clinical priority, time spent on the waitlist, geographic location (isolated areas), ethnicity, and deprivation level.
In the ethnicity category, Māori and Pasifika are top of the list, while European New Zealanders and other ethnicities, like Indian and Chinese, are lower-ranked.
Some surgeons, who spoke on the condition of anonymity, said the new scoring tool was medically indefensible. They said patients should be prioritised on how sick they were, how urgently they needed treatment, and how long they had been waiting for it - not on their ethnicity.
One of the surgeons said he was “disgusted” by the new ranking system.
“It’s ethically challenging to treat anyone based on race, it’s their medical condition that must establish the urgency of the treatment,” the surgeon said.
“There’s no place for elitism in medicine and the medical fraternity in this country is disturbed by these developments.”
A document on the equity adjustor which was leaked to Newstalk ZB shows two Māori patients, both aged 62 and who have been waiting more than a year, ranked above others on the list. A 36-year-old Middle Eastern patient who has been waiting almost two years has a much lower priority ranking.
An email by Te Whatu Ora business support manager Daniel Hayes in April said: “Hi team, Heads up. This is going to be the new criteria for outsourcing your patients going forward. Just putting this on your radar now so that you can begin to line up patients accordingly. Over 200 days for Māori and Pacific patients. Over 250 days for all other patients.”
When contacted by ZB, Hayes said he would not comment until he had verified who he was speaking to. He did not return further requests for comment.
Health Minister Ayesha Verrall said when it came to prioritising healthcare, there were important reasons why ethnicity was a factor.
She pointed to the Government-commissioned, independent review of the health system in 2018, which found the system did not serve everyone well and produced unequal outcomes, particularly for vulnerable populations.
“The reformed health system seeks to address inequities for Māori and Pacific people who historically have a lower life expectancy and poor health outcomes,” Verrall said.
Sir Collin Tukuitonga, a leading expert in Pasifika health, said Māori and Pasifika patients could be moved to the front of surgical lines due to the inequalities in the previous stages of the health system, such as the referral process.
“Māori and Pacific people tend to linger on the referral list... and inevitably, I think people will say that there’s also an institutional bias, possibly a racism that doesn’t put them where they need to be in order to get the surgery,” Tukuitonga said.
“The referral pathways are not that straightforward.”
Tukuitonga specifically used the example of bariatric surgery, which helps to aid those with morbid obesity, which he said was “much more” prevalent in Māori and Pacific communities than in Pākehā. He said this could be another reason why these patients are being brought forward in the waiting times.
“For most of the surgical interventions, Māori and the Pacific people don’t get to get the rates of interventions that might be warranted given their conditions,” Tukuitonga said.
He added: “In other words, it’s not acceptable to have a group in the population where obesity is a major problem and yet they’re not getting the physical intervention that they require.”
Te Whatu Ora interim lead for Te Toka Tumai (the former Auckland District Health Board) Dr Mike Shepherd said the causes of health inequity were complex and required a sophisticated solution to reduce inequitable outcomes that already existed.
“It’s important to note that ethnicity is not the only element considered in the scoring system,” Shepherd said.
He said the equity adjuster waitlist score helps reduce barriers and inequities in the healthcare system, to ensure that people have equitable outcomes, regardless of their ethnicity, socio-economic circumstances or where they live.
“These adjustments are based on evidence which shows these groups often have inequitable health outcomes, which often begin at the start of their healthcare journey. Early analysis shows the tool is effective at helping to eliminate the existing inequities.”
Shepherd said the tool was rolled out in Auckland in February and, due to positive evidence that it is helping to eliminate inequities in the healthcare system, it is now being rolled out across the other northern region districts.
Before the Health New Zealand reforms came into force last year, around half of the then District Health Boards had considered or committed to prioritising Māori and Pacific patients for some elective surgeries.
A number of studies and reports show Māori and Pacific people are less likely to be referred or accepted for treatment in the first place, and once in the system generally get less treatment. The Auckland District Health Board’s own data show Māori and Pacific patients take longer after referral to have a procedure confirmed.
Barry Soper is Newstalk ZB’s senior political correspondent. He was ZB’s political editor for many years after first joining the station and the press gallery in 1980.
Jason Walls is Newstalk ZB’s political editor. He was previously deputy political editor and chief political reporter for the station. | Health Policy |
Ministers have rejected pleas from the NHS for an emergency £1bn bailout to cover the rising cost of the strikes that have badly disrupted services this year.
On Wednesday, NHS England will announce that it is handing £800m to health service trusts to help them pay bills incurred by industrial action and prepare for the winter ahead.
However, none of the £800m is new money from either the Treasury or the Department of Health and Social Care, the Guardian understands, despite the NHS’s repeated requests for at least £1bn of extra funding.
The government’s decision to rebuff those demands will come as a major disappointment to NHS chiefs. They believed that months of talks with ministers and officials would lead to the service receiving an unscheduled boost of at least £1bn of genuinely new money.
The news is also a blow for Steve Barclay, the health secretary. He has been lobbying the Treasury to find the £1bn that NHS bosses had made clear was the least that hospitals needed to help them cope with the extra costs strikes have imposed, such as paying staff to cover for colleagues on days of industrial action.
Of the £800m that will be announced, £600m has come from NHS England repurposing money earmarked for several improvement initiatives while the other £200m is money that Barclay announced in September to help the NHS navigate its traditional winter crisis.
There was cautious optimism in the NHS that Jeremy Hunt, the chancellor, was sympathetic to its request for in-year financial aid, given his deep understanding of the pressures it is under based on his six-year stint as the health secretary from 2012 to 2018.
Hunt and Rishi Sunak could now face claims that they have denied the NHS money it sorely needs to instead put it towards tax cuts before next year’s general election.
The government is thought to have £13bn-£15bn of “fiscal headroom” – money it can chose how to spend before polling day. One senior NHS figure said: “A lot of Tory MPs would see giving the NHS £1bn extra as not a good use of that money, especially as so many of them see the NHS as a bottomless pit of money anyway, and particularly as so many of them want Hunt to be able to announce personal tax cuts.”
NHS England will announce that it will be distributing £800m of extra cash to its 42 integrated care systems (ICSes) – regional groupings of trusts – many of which are on track to end the 2023/24 financial year in debt, with some potentially facing an overspend of more then £100m. Rising drug prices have added to their running costs, on top of spending on strikes.
Julian Kelly, NHS England’s deputy chief executive and finance chief, made clear at its board meeting on 5 October that staff walkouts had cost the service £1.1bn by the end of July alone – and that it needed the government to cover that cost.
In a briefing to the board he wrote that: “ICSes’ financial positions continue to be impacted by the ongoing industrial action, which is driving additional expenditure as well as impacting on efficiency delivery.
“Without further support for costs of industrial action there is significant risk that many systems will overspend this year. To the end of July we have estimated a cost impact of –£550m and described lost activity [cancelled operations] valued at a further –£500m.”
Matthew Taylor, the chief executive of the NHS Confederation, which represents trusts, gave a clear insight into the NHS’s expectations last Saturday. He told the Financial Times that trusts needed the unexpected £1bn gap in their finances to be “plugged without delay”.
In a warning of potential cuts to services unless the money was forthcoming, he added that: “if it cannot be compensated in full, the NHS will need to understand from the government how it intends to adjust expectations on what its services will deliver with the resources available.” | Health Policy |
In return, the government wants to end to all strike action.
The government has made a formal pay offer to NHS workers following several weeks of “intense” negotiations with health unions.
Under the deal, NHS workers in England would receive a 2% non-consolidated pay rise and a so-called “Covid-recovery bonus” for the current financial year, plus a rise of 5% for most workers in 2023/24.
If the deal is agreed upon, the government wants an end to all industrial action for the duration of the agreement.
A “one-off” payment.
A one-off non-consolidated award payment would be made to all staff.
It will not contribute towards your ongoing annual salary but would be subject to deductions such as tax, national insurance (NI) and student loan contributions.
The payment will be calculated based on your base salary and will not include any overtime, or unsociable hours enhancements. For NHS workers who are part-time, the payment will be pro-rata.
It is not yet clear when this payment would be made.
The pay rise.
The lowest-paid NHS workers would see the biggest rise with a consolidated increase of 10.4%, with all other NHS workers receiving a flat rate of 5%.
It would be implemented from April 2023 and backdated if the deal is agreed upon after this date.
The government has also committed to implementing a number of other non-pay changes.
The NHS Long Term Workforce Plan will be published, which according to the Health Secretary will “ensure the NHS can recruit and retain the staff it needs in the future” and investigate safe staffing rules.
A new pay spine will be created exclusively for all nursing staff, taking into account their skills and experience, with the intention of it coming into force for 2024/25.
They also pledged to address nursing career progression, violence and aggression at work, and make the NHS pay review body process more streamlined. | Health Policy |
The government has announced £250m in funding to provide an extra 5,000 NHS hospital beds in England this winter.
Ministers say 900 new beds should be ready by January, with the remainder to follow soon after, boosting capacity and helping lower record waiting lists.
The increase will mean nearly 100,000 permanent beds on wards and in A&E, available at the busiest time of the year - a 5% rise on current levels.
NHS Providers said the extra capacity was needed "before winter begins".
Miriam Deakin, director of policy and strategy at NHS Providers, said trusts would welcome the support but cautioned any new beds would need to be staffed.
She added that, since winter is the busiest time of the year for urgent and emergency care, trust leaders would be concerned that the promised extra capacity is only expected to be in place by January.
"For the best results, trusts would need these new beds before winter begins," she said.
Pat Cullen, from the Royal College of Nursing, added: "The elephant in the room is who will staff these additional beds? Nursing staff are already spread too thinly over too many patients."
Co-ordinated follow-up care
The government money will also fund services where people can be treated without requiring a hospital stay.
Funding will be focused on developing or expanding urgent treatment centres and same-day emergency care services, where patients can be seen quickly without the necessity of being admitted to hospital.
NHS England is also preparing to make it easier to discharge hospital patients when they are medically-fit to leave, through the rollout of so-called "care traffic control centres".
These bring together the NHS community, housing and charity teams to help co-ordinate support for those patients who require continuing care once they are discharged from hospital.
The aim is that plans for a prompt and efficient discharge can be drawn up shortly after patients are first admitted to hospital, thanks to better co-ordination among teams regarding follow-up care.
Alongside these measures, there will be at least 10,000 'virtual' hospital beds available by autumn, allowing some patients to be monitored in their home.
It comes after new data from NHS England revealed waiting lists had reached a record 7.6 million at the end of June.
'Longer-term challenges'
Prime Minister Rishi Sunak said the planning for winter had started "earlier than ever before" and that the public could be reassured the NHS would be given the resources it needs.
"These 900 new beds will mean more people can be treated quickly, speeding up flow through hospitals and reducing frustratingly long waits for treatment," he said.
Health Secretary Steve Barclay said: "We know that winter is a difficult time, so we're working to get ahead of pressures whilst also creating a sustainable NHS fit for the future."
NHS chief executive Amanda Pritchard said: "Winter is always a busy time for the NHS and so it is right that we put robust plans in place as early as possible to boost capacity and help front-line staff to prepare for additional pressure.
"Our winter plans, which build on the progress already made on our urgent and emergency care recovery plan, aim to reduce waiting times for patients, and to transform services with an expansion of same-day care and virtual wards, helping patients to be cared for in their own home where possible."
But certain longer-term issues have yet to be addressed, warned Ms Deakin from NHS Providers.
"Underlying issues, including workforce shortages, a lack of investment in capital and the desperate need for social care reform will ultimately hinder progress unless also addressed," she said.
"It will also be important to understand where new beds are being created, and where beds are being freed up by better means of meeting patients' needs - through care at home or same-day emergency care, for example.
"Steps like this are promising, but the only way to recover urgent and emergency care - and to put the NHS on a sustainable footing - is for the government to tackle the longer-term challenges in health and care," she said. | Health Policy |
Roundworms need a good night’s sleep to maintain the memories associated with particular smells, a study suggests.
When trained to avoid a sweet scent, Caenorhabditis elegans (C. elegans) nematodes can still remember to do so after 16 hours, as long as their post-training nap is uninterrupted. But disturbing their sleep prevents crucial changes to their nervous system that are involved in forming long-lasting memories.
The findings, published in Cell on 2 June1, pave the way for scientists to delve more into the processes that occur at the cellular and molecular level during sleep.
“This brings cellular resolution to a question that’s ancient”, namely what is the purpose of sleep and how is it linked to memory, says study co-author Noelle L’Etoile, a cell biologist at the University of California, San Francisco.
Eating in their sleep
L’Etoile and her colleagues wanted to investigate whether this also applied to C. elegans. Studying sleep in such a simple organism “might help us to really understand the underlying mechanism”, says Hanna Zwaka, a neuroscientist at Harvard University in Cambridge, Massachusetts. “We know their individual synapses, and that’s something that we don't have in other animals.”
The research came with an unusual challenge, says L’Etoile: defining when the one-millimetre-long worms are in fact asleep. With no limbs or clear-cut sleep stages to observe, distinguishing a sleeping C. elegans from one that is awake is a tricky task.
The researchers used video-based imaging tools to observe hundreds of worms and look for telltale features of sleep such as reduced movement, stereotypical postures and seeming to ‘wake up’ when exposed to a flashing blue light.
While napping, “the little worms become straight with just a little crook where their head is”, says L’Etoile. Although they tend not to move around, the worms can’t resist sleep eating. “Their feeding is reduced, but it’s not zero,” she says.
Controlled connections
Memories are thought to reside in synapses — the junctions between neurons. Part of the process of consolidating memories involves reducing the number of synapses during sleep, which is thought to balance connections between neurons in the brain and keep them within an appropriate range.
With only 302 neurons, C. elegans has one of the most streamlined nervous systems of any organism, says L’Etoile, and scientists have mapped its entire connectome — the web of all of the neurons and their connecting synapses. This makes the species ideal for studying the changes in synapses that happen during sleep.
To put the worms’ memory to the test, the researchers trained them to ignore the sweet scent of the compound butanone, which they normally find attractive. The team did this by associating the smell with the removal of food.
The worms detect the odour of butanone using a neuron called AWC, which connects to a pair of neurons called AIY. Using an imaging tool called GRASP to elicit green fluorescence at synapses, the authors showed that training the worms to avoid the odour caused a reduction in the number of AWC–AIY synapses in their nervous system.
The worms also tended to rest after the training. To test whether this post-training nap is required to maintain odour memory, the researchers disrupted the worms’ sleep by either gently shaking them every 15 minutes, or removing food.
The worms that enjoyed uninterrupted sleep immediately after the odour training did not react to the smell of butanone after 16 hours. But the ones deprived of sleep in the first 1–2 hours after training showed more-intense synaptic connections than did those with undisturbed sleep, and didn’t remember to stay away from butanone after 16 hours.
“When the odour becomes a solidified memory, it requires sleep,” says L’Etoile. The results suggest that the worms have a critical sleep window of 1–2 hours after training, during which they solidify their memories. When the worms’ sleep was disrupted 2–6 hours post-training, it did not have the same effect on memory retention.
For David Raizen, a neuroscientist at the University of Pennsylvania in Philadelphia, the next step will be to study the biochemical mechanisms though which sleep behaviour induces these changes in the number and strength of synapses. | Disease Research |
The Biden administration on Tuesday unveiled the first 10 prescription drugs that will be subject to price negotiations with Medicare, marking a milestone for Democrats in their yearslong push to lower rising health care costs.
The list includes Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara and Fiasp/NovoLog insulin products.
President Joe Biden, in remarks at the White House, said the medications are "drugs to treat everything from heart failure, blood clots, diabetes, kidney disease, arthritis, blood cancers, Crohn's disease and so much more."
"Today is the start of a new deal for patients where Big Pharma doesn't just get a blank check at your expense and the expense of the American people," he said. "On my watch, health care should be a right not a privilege in this country."
The impact won't be immediately felt, however, as the negotiations will occur this year and next, with the new prices becoming effective in 2026.
The Medicare Drug Price Negotiation Program is a result of the Inflation Reduction Act, one of Biden's key legislative victories. It allows the government to directly broker with drug manufacturers for the first time in the history of the program, which provides health insurance coverage to 65 million people, including 57 million seniors.
Biden marked the occasion with an event in the East Room, where he and Vice President Kamala Harris were joined by Steven Hadfield, a Medicare beneficiary who recounted his experience working multiple jobs to afford medications for his chronic conditions.
"You've been through one hell of an ordeal," Biden told Hadfield. "Your story is a familiar one to too many Americans. Instead of using all your energy to fight disease, you're fighting insurance or drug companies for medicines that literally keep you alive."
Medicare enrollees taking the 10 drugs selected for negotiation paid a total of $3.4 billion in out-of-pocket costs for the medications in 2022, according to the Department of Health and Human Services.
Biden said the negotiations will help lower costs for 9 million Americans. By September 2024, he said, HHS will publish the negotiated prices that will go into effect by January 2026.
Under the Inflation Reduction Act, the federal government can select up to 15 more drugs for negotiation in 2027, another 15 drugs for 2028 and up to 20 more drugs each year after.
President Biden, in a nod to his 2024 reelection message, said taking on Big Pharma is part of his "Bidenomics" vision of building the economy from the middle out and bottom up.
"We're going to see this through," he said. "We're going to keep standing up to Big Pharma and we're not going to back down."
Biden's campaign also took a victory lap, stating several presidents have tried to take on the industry but "President Biden finally got it done."
"Elections have consequences," campaign manager Julie Chavez Rodriguez said in a statement, in which she also hit Republicans for opposing the Inflation Reduction Act. Biden, too, criticized "MAGA Republicans" who opposed the Inflation Reduction Act and some now trying to repeal it.
The drug industry, in response to the announcement, hit back on the program. Several pharmaceutical companies have sued the administration in an attempt to derail the price negotiations.
"Giving a single government agency the power to arbitrarily set the price of medicines with little accountability, oversight or input from patients and their doctors will have significant negative consequences long after this administration is gone," Pharmaceutical Research and Manufacturers of America (PhRMA) President Stephen J. Ubl said in a statement.
-ABC's Justin Gomez, Anne Flaherty, Karen Travers and Fritz Farrow contributed to this report. | Health Policy |
A drug-resistant and potentially deadly fungus has been spreading rapidly through U.S. health care facilities, a new government study finds.
The fungus, a type of yeast called Candida auris, or C. auris, can cause severe illness in people with weakened immune systems. The number of people diagnosed with infections — as well as the number of those who were found through screening to be carrying C. auris — has been rising at an alarming rate since it was first reported in the U.S., researchers from the Centers for Disease Control and Prevention reported Monday.
The increases, “especially in the most recent years, are really concerning to us,” the study’s lead author, Dr. Meghan Lyman, chief medical officer in the CDC’s Mycotic Diseases Branch, said in an interview. “We’ve seen increases not just in areas of ongoing transmission, but also in new areas.”
The CDC's new warning, published in the Annals of Internal Medicine, comes as Mississippi is fighting a growing outbreak of the fungus. Since November, at least 12 people have been infected with C. auris with four "potentially associated deaths," according to the state's health department, Tammy Yates, spokesperson for Mississippi State Department of Health said in an email.
There has been ongoing transmission at two long-term care facilities, although cases have been identified at several other facilities in the state.
Fungus found on the skin and throughout the body
"Unfortunately, multi-drug resistant organisms such as C. auris have become more prevalent among our highest risk individuals, such as residents in long-term care facilities," said Yates.
The fungus can be found on the skin and throughout the body, according to the CDC. It's not a threat to healthy people, but about one-third of people who become sick with C. auris die.
In the CDC report, researchers analyzed state and local health department data on people sickened by the fungus from 2016 through Dec. 31, 2021, as well as those who were “colonized,” meaning they were not ill but were carrying it on their bodies with the potential of transmitting it to others who might be more vulnerable to it.
The number of infections increased by 59%, to 756, from 2019 to 2020 and then by an additional 95%, to 1,471, in 2021.
The researchers also found that the incidence of people not infected with the fungus but colonized by it increased by 21% in 2020, compared to 2019, and by 209% in 2021, with an increase to 4,041 in 2021 compared to 1,310 in 2020.
C. auris has now been detected in more than half of U.S. states, the new study found.
Most concerning was the increasing numbers of fungus samples resistant to the common treatments for it. Lyman hopes the paper will put C. auris on health care providers’ radar and spur facilities to practice “good infection control.”
The new findings are “worrisome,” said Dr. Waleed Javaid, an epidemiologist and an infectious disease expert and director of infection prevention and control at Mount Sinai Downtown in New York.
“But we don’t want people who watched 'The Last of Us' to think we’re all going to die,” Javaid said. “This is an infection that occurs in extremely ill individuals who are usually sick with a lot of other issues.”
Even if C. auris moves beyond health care facilities and into communities, it’s unlikely to become a problem for healthy people who do not have invasive medical devices, such as catheters, inserted into their blood vessels, Javaid said.
'Extreme ability to survive on surfaces'
The main problem is preventing the fungus from spreading to patients in hospital intensive care units, Javaid said. Unfortunately C. auris can colonize not only people who come in contact with the fungus, but also patient rooms.
“By its nature it has an extreme ability to survive on surfaces,” he said. “It can colonize walls, cables, bedding, chairs. We clean everything with bleach and UV light.”
While the fungus was first identified in 2009 in Asia, scientists have determined that C. auris first appeared around the world about a decade earlier, after they re-examined older data and discovered instances where C. auris had been mistakenly identified as a different fungus, Dr. Graham Snyder, medical director of infection prevention at University of Pittsburgh Medical Center, said in an interview.
“It’s the pattern we’ve observed with these types of pathogens,” he said. “Often they start out extremely rare, then they emerge in more and more places and become widespread.”
It's important to stop the pathogen so it doesn’t spread beyond hospitals and long-term facilities like the drug-resistant bacteria MRSA did, Snyder said.
“It’s not unusual to see MRSA in the community now,” Snyder said. “Will that happen with C. auris? I don’t know. That’s partly why the CDC is raising the alarm.” | Epidemics & Outbreaks |
Researchers report December 5 in the journal Neuron that mice display behavior that resembles self-recognition when they see themselves in the mirror. When the researchers marked the foreheads of black-furred mice with a spot of white ink, the mice spent more time grooming their heads in front of the mirror -- presumably to try and wash away the ink spot. However, the mice only showed this self-recognition-like behavior if they were already accustomed to mirrors, if they had socialized with other mice who looked like them, and if the ink spot was relatively large.
The team identified a subset of neurons in the hippocampus that are involved in developing and storing this visual self-image, providing a first glimpse of the neural mechanisms behind self-recognition, something that was previously a black box in neurobehavioral research.
"To form episodic memory, for example, of events in our daily life, brains form and store information about where, what, when, and who, and the most important component is self-information or status," says neuroscientist and senior author Takashi Kitamura of University of Texas Southwestern Medical Center. "Researchers usually examine how the brain encodes or recognizes others, but the self-information aspect is unclear."
The researchers used a mirror test to investigate whether mice could detect a change in their own appearance -- in this case, a dollop of ink on their foreheads. Because the ink also provided a tactile stimulus, the researchers tested the black-furred mice with both black and white ink. Though the mirror test was originally developed to test consciousness in different species, the authors note that their experiments only show that mice can detect a change in their own appearance, but this does not necessarily mean that they are "self-aware."
They found that mice could indeed detect changes to their appearance, but only under certain conditions. Mice who were familiar with mirrors spent significantly more time grooming their heads (but not other parts of their bodies) in front of the mirror when they were marked with dollops of white ink that were 0.6 cm2 or 2 cm2. However, the mice did not engage in increased head grooming when the ink was black -- the same color as their fur -- or when the ink mark was small (0.2 cm2), even if the ink was white, and mice who were not habituated to mirrors before the ink test did not display increased head grooming in any scenario.
"The mice required significant external sensory cues to pass the mirror test -- we have to put a lot of ink on their heads, and then the tactile stimulus coming from the ink somehow enables the animal to detect the ink on their heads via a mirror reflection," says first author Jun Yokose of University of Texas Southwestern Medical Center. "Chimps and humans don't need any of that extra sensory stimulus."
Using gene expression mapping, the researchers identified a subset of neurons in the ventral hippocampus that were activated when the mice "recognized" themselves in the mirror. When the researchers selectively rendered these neurons non-functional, the mice no longer displayed the mirror-and-ink-induced grooming behavior. A subset of these self-responding neurons also became activated when the mice observed other mice of the same strain (and therefore similar physical appearance and fur color), but not when they observed a different strain of mouse that had white fur.
Because previous studies in chimpanzees have suggested that social experience is required for mirror self-recognition, the researchers also tested mice who had been socially isolated after weaning. These socially isolated mice did not display increased head grooming behavior during the ink test, and neither did black-furred mice that were reared alongside white-furred mice. The gene expression analysis also showed that socially isolated mice did not develop self-responding neuron activity in the hippocampus, and neither did the black-furred mice that were reared by white-furred mice, suggesting that mice need to have social experiences alongside other similar-looking mice in order to develop the neural circuits required for self-recognition.
"A subset of these self-responding neurons was also reactivated when we exposed the mice to other individuals of the same strain," says Kitamura. "This is consistent with previous human literature that showed that some hippocampal cells fire not only when the person is looking at themselves, but also when they look at familiar people like a parent."
Next, the researchers plan to try to disentangle the importance of visual and tactile stimuli to test whether mice can recognize changes in their reflection in the absence of a tactile stimulus -- perhaps by using technology similar to the filters on social media apps that allow people to give themselves puppy-dog faces or bunny ears. They also plan to study other brain regions that might be involved in self-recognition and to investigate how the different regions communicate and integrate information.
"Now that we have this mouse model, we can manipulate or monitor neural activity to comprehensively investigate the neural circuit mechanisms behind how self-recognition-like behavior is induced in mice," says Yokose.
This research was supported by the Endowed Scholar Program, the Brain & Behavior Research Foundation, the Daiichi Sankyo Foundation of Life Science, and Uehara Memorial Foundation.
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Dementia poses an “enormous threat” to healthcare systems and the general public in England and Wales, experts have warned, as data suggests 1.7 million people will have the condition by 2040.
It is already known to be among the most serious health and social care threats and a new analysis shows the total number affected could be 42% higher than previously estimated.
The research was published in the Lancet public health journal. It said the “burden on health and social care might be considerably larger than currently forecast”. Led by University College London (UCL), the study updated previous work suggesting cases would reach 1.2 million people in 2040.
“Dementia incidence followed a nonlinear trend in England and Wales with a declining trend from 2002 to 2008 and an increased trend from 2008 to 2016,” the researchers wrote.
“If the upward incidence trend continues, along with population ageing, the number of people with dementia in England and Wales is projected to increase to 1.7 million in 2040.”
The rate decreased by 29% between 2002 and 2008 but grew by a quarter between 2008 and 2016, according to the study.
“Not only will this have a devastating effect on the lives of those involved but it will also put a considerably larger burden on health and social care than current forecasts predict,” said Dr Yuntao Chen, of the UCL Institute of Epidemiology and Health Care. “Continued monitoring of the incidence trend will be crucial in shaping social care policy.”
Although an increase in dementia cases has often been put down to an ageing population, the researchers found the rate of people developing dementia in older age groups was also rising.
Prof Eric Brunner, also of UCL, said: “Our research has exposed that dementia is likely to be a more urgent policy problem than previously recognised – even if the current trend continues for just a few years.
“We have found that not only is the ageing population a major driver of the trend in England and Wales but also the number of people developing dementia within older age groups is increasing.
“We don’t know how long this pattern will continue but the UK needs to be prepared so we can ensure that everyone affected, whatever their financial circumstances, is able to access the help and support that they need.”
James White, of the Alzheimer’s Society, said dementia was “the biggest health and social care issue of our time”. The study was a stark reminder that, without action, “the individual and economic devastation caused by dementia shows no sign of stopping”.
Hilary Evans, chief executive at Alzheimer’s Research UK, said the research exposed “the enormous threat dementia poses” to the public and the healthcare system.
“With more people expected to be living with dementia in the future, healthcare decision-makers need to wake up and put steps in place to radically improve how the condition is diagnosed and invest in capacity to do so,” she added.
Some scientists expressed scepticism, however.
Prof David Curtis, of the UCL Genetics Institute, who was not involved with the study, said: “The claim that dementia cases could be 42% higher than previously estimated by 2040 depends entirely on assuming that rates will continue to rise by 2.8% every year. I really don’t see why this should be the case.
“It is true that dementia is a huge public health problem with terrible consequences, but I do not think this study can tell us much about how many cases we may be seeing in 2040.”
Prof Tom Dening, professor of dementia research at the University of Nottingham, also not involved with the study, said: “This is an important paper and hopefully will remind everybody that we cannot be complacent about dementia.”
Prof Dag Aarsland, professor of old age psychiatry at King’s College London, said the research underlined how dementia was among “the most important societal challenges that we face”.
He added: “Despite recent positive findings suggesting that the incidence of new dementia was declining, this well-designed study, one of the first reporting more recent trends up to 2016, shows that this initial decline has reversed and the incidence is again increasing. This trend is particularly strong among people with low education.
“While the causes for these changes are yet unknown, these findings … should be a call to society and researchers to intensify the work to find methods to prevent dementia. This is possible but requires a huge increased effort.”
While researchers hunt for new treatments, Evans, of Alzheimer’s Research UK, said ministers must ensure they take action so the burden of increased dementia risk “does not unfairly weigh” on the most deprived communities.
“We want people to know the steps they can take to reduce their own risk of developing dementia, such as keeping a healthy heart, staying connected and staying sharp,” she added.
The Department of Health and Social Care said it was committed to improving diagnosis rates, widening access to new treatments with more funding for research efforts and expanding the country’s social care capacity. | Disease Research |
Oct. 16, 2023 â The incident happened years ago, but MaKenna Schmidt, 18, of Otsego, MN, can still recall it in detail. âWe were on the bus and this girl said, âYou look pregnant,â â Schmidt remembered. âI was like 8.â
âI was really upset about it. It definitely sticks with me.â She can easily recall other hurtful comments, including a classmate telling her she was fat and another pointing out her stomach was big. âIn gym class, weâd have to run the mile. I was always the last. I was very embarrassed.â
Since then, Schmidt has gotten medical help, learned how to eat healthier, and has lost weight. Sheâs now down 30 pounds, and still trying to lose excess weight.Â
Today, many other children and teens are likely facing insults similar to those Schmidt remembers. Obesity affects about 14.7 million children and teens, nearly 20% of that age population, according to the CDC. (Children whose weight is at the 95th percentile, compared to other U.S. children of the same age and sex, are classified as obese.) In the U.S., national childhood obesity rates rose from the 1970s into the early 2000s, according to the State of Childhood Obesity, and while the rates have grown more slowly since then, childhood obesity is still a serious public health concern.
While medical experts have viewed the issue as an epidemic and a crisis for years, some are now saying itâs time to focus even more attention on the situation, and to do so earlier rather than later.
- In an opinion piece published recently in the journal Pediatrics, three obesity medicine experts suggest that the U.S. should strongly consider the pros and cons of declaring childhood obesity a public health emergency.Â
- Earlier this year, the American Academy of Pediatrics issued its first-ever comprehensive guidelines for the evaluation and treatment of children and teens with obesity. It says pediatricians should not follow a âwatchful waitingâ course, but step in earlier, using options such as newly approved obesity medications when needed. It also stresses that family-based treatment  is what works best.
Obese Children, Obese Adults
Letting children with obesity âgrow out of itâ will likely not work, research shows. In one review of published studies including more than 200,000 people, obese children and adolescents were about five times more likely to be obese as adults than those who werenât obese as children and teens.Â
Stepping in more quickly and more intensely, experts said, could save children from a lifetime of obesity, in turn reducing the chances of obesity-related risks such as high blood pressure, high cholesterol, type 2 diabetes, coronary heart disease, stroke, sleep apnea, and osteoporosis.
Childhood Obesity as a Public Health Emergency
Declaring childhood obesity as a public health emergency has not been suggested before, to his knowledge, said Eric Bomberg, MD, an assistant professor of pediatrics at the University of Minnesota and associate director for research informatics at the universityâs Center for Pediatric Obesity Medicine. He co-authored the Pediatrics opinion piece. He emphasized that he is, for now, suggesting that experts look at the pros and cons of the idea before moving forward.
Under the Public Health Service Act, the secretary of the U.S. Department of Health and Human Services can declare a public health emergency if a disease or disorder warrants it. âThere are definitely arguments for and against,â Bomberg said. âWe do know this disease is rampant.â
Among arguments in favor:
- Public health emergencies have been declared for diseases affecting far fewer people, such as the opioid addiction epidemic.
- Emergency declarations have helped in the past for many diseases, including COVID-19.
Among arguments against:
- Resources would be necessary and may divert from other efforts such as opioid addiction.
- Calling the obesity epidemic an emergency might stigmatize weight more.
- The public may view another public health emergency as âone too many,â and not pay much attention.
Bombergâs bottom line: âI think it should be considered,â but declaring it a public emergency without first suggesting what to do about it and thinking it through thoroughly would not be helpful. âI think it needs further study,â he said.
As the idea gets discussed more, the new guidelines from the American Academy of Pediatrics âhave absolutely moved things in the right direction,â Bomberg said.Â
Academy Guidelines: 'Watchful Waiting' Discouraged
These first comprehensive guidelines highlight evidence that obesity treatment is safe and works well, urging pediatricians to act sooner rather than later.
âThere is no evidence that âwatchful waitingâ or delayed treatment is appropriate for children with obesity,â Sandra Hassink, MD, a guideline co-author and vice chair of the academyâs Clinical Practice Guideline Subcommittee on Obesity, said in a news release.
Doctors should consider prescribing weight loss medications, such as semaglutide (Wegovy), to those ages 12 and above with obesity, taking into account weight, risks, and benefits, to supplement lifestyle treatments, the guidelines say.
The suggestion to opt for weight loss drugs didnât sit well with some doctors, Bomberg said. But Schmidt, the college freshman who remembers being insulted about her weight, said they have worked for her.
Sheâs on semaglutide now, and she credits it with helping her lose 30 pounds. At her highest weight, she said, she was at 223 pounds. Now at 190, she is moving from being classified as obese to overweight.Â
Bomberg recalled another patient who had followed diet and exercise plans without enough success, then added an obesity medication. He lost more than 50 pounds in about 3 months. âWhen I saw him yesterday, his mother was literally crying,â he said.
Family-Centered Approach
Taking a family-centered approach to weight loss, long recommended, is still important, according to the guidelines. One such program that includes family is the Healthy Weight Clinic at Children's Hospital Los Angeles, which evaluates children as young as 2.
The approach is compassionate. âWe want parents to know that it is not their fault that their child is living in a larger body,â said Alaina Vidmar, MD, a pediatric endocrinologist and obesity medicine specialist who is medical director of the Healthy Weight Clinic. âThis is a medical condition, and we are here to support them and provide their child all the tools they need to live a long and healthy life.â
âWe provide tips around nutrition, and we really approach food as medicine,â she said. Advice on activities, obesity medications, and referrals to obesity surgery are also part of the program, Vidmar said. âWe have to remember there is no cure for pediatric obesity. The goal of treatment is not the number on the scale or the size of the body. The goal is to help these young people live long, healthy lives and prevent life-limiting complications.â
The nutrition tips are often needed by working parents, who find that getting a healthy dinner on the table nightly can seem impossible. Schmidt said she grew up with her sister and their mother, a single parent, and their grandmother often cared for them.
Schedules were busy. âWeâd often eat fast food for dinner or have my grandmother make something easy and cheap.â Both her mother and grandmother struggled with weight issues, she said, and now her younger sister does. Now that sheâs in college, Schmidt said, she has more control over food choices and has learned how to choose healthier options.
Experts Weigh In
Neither the American Academy of Pediatrics nor the Obesity Society has a stand on whether childhood obesity should be declared a public health emergency.
The main goal, for now, âis to stimulate conversation about pediatric obesity and to frame it in a way people arenât used to,â said Aaron Kelly, PhD, co-chair of the Obesity Societyâs Pediatric Obesity Treatment Task Force, a professor of pediatrics, and co-director of the University of Minnesota Center for Pediatric Obesity Medicine. There must be more awareness and conversation, he said.
Lifelong Effort
After educating herself on obesity as a medical condition, Schmidt said she knows her efforts for weight control have to be ongoing. âI feel like itâs a work in progress,â she said of her weight loss, âbut I am definitely getting to a better spot.â
Her resolve is obvious. âI am always going to have to work on it,â she said. | Nutrition Research |
Smartphones may be able to detect how drunk a person is based on changes in their voice, according to a new study.
Researchers used sensors in smartphones to record a person's voice before and after drinking.
They then put the recordings through a digital program to isolate and measure certain aspects, like frequency and pitch.
When checked against breath alcohol results, they found that the model they developed was able to predict a person's level of intoxication with 98% accuracy.
Experts say the results of the small study could be used to develop ways to help prevent alcohol-related injuries and deaths in the future.
The research was led by Brian Suffoletto, an associate professor of emergency medicine at Stanford University in the US.
He said the accuracy of the findings of his research "genuinely took me by surprise".
"Imagine if we had a tool capable of passively sampling data from an individual as they went about their daily routines and survey for changes that could indicate a drinking episode to know when they need help," he said.
Professor Suffoletto said larger studies were needed to confirm the validity of the findings, which have been published in the Journal of Studies on Alcohol and Drugs.
The study involved 18 adults aged 21 and above, who were randomly given a series of tongue twisters to read out loud.
A smartphone was used to record their voices before drinking, and each hour up to seven hours after drinking.
The researchers also measured each person's breath alcohol levels at the beginning of the study and every 30 minutes for up to seven hours.
Read more from Sky News:
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Using digital programs, the researchers were able to isolate the speaker's voices and analyse measures such as frequency and pitch in one-second increments.
According to Prof Suffoletto, other behaviours such as gait and texting could be combined with voice pattern sensors to gauge intoxication levels.
He said: "Timing is paramount when targeting the optimal moment for receptivity and the relevance of real-time support.
"For instance, as someone initiates drinking, a reminder of their consumption limits can be impactful.
"However, once they're significantly intoxicated, the efficacy of such interventions diminishes." | Medical Innovations |
Image source, Helen Mary Inages Image caption, Lora and Neil Fachie welcomed baby Fraser into their family in OctoberParalympic cycling gold medallist Lora Fachie has opened up about the struggle to breastfeed her baby that led her to feel like a failure. Lora, who has a visual impairment, was a gold medal winner at the Paralympic Games in Tokyo in 2021. Before her baby was born in October, Lora said she desperately wanted to give him "the best start in life".But in a social media post she told of her "grief" about giving up when baby Fraser stopped gaining weight. Lora told BBC Radio Scotland's Drivetime programme she wanted to tell her story of why she switched to formula feeding, to help other new mothers feeling pressure in the situation. Lora wrote on Twitter: "Breastfeeding was something I dreamed about when discovering I was pregnant. "I couldn't wait to do it, especially knowing that it was the best for my baby and I desperately wanted to give them the best start in life. I knew it would be difficult, but I relish the challenge."Lora said she was now coming to terms with feeling like she had failed, after a late diagnosed tongue tie in her baby's mouth led to a lack of milk being produced. Unfortunately, this week our breastfeeding journey came to an end. I never quite envisaged how difficult it would be, and how emotionally draining these past 12 weeks have been. I’ve desperately tried everything to make Breast Feeding work, but it just wasn’t meant to be— Lora Fachie MBE (@loraturnham) January 25, 2023
The BBC is not responsible for the content of external sites.View original tweet on Twitter"We went to a lactation consultant who tried to tried to help me increase my supply and she did actually listen to me," Lora told BBC Scotland. "Finally I felt justified because whenever I said to someone I don't think I've got enough milk for him people would go 'don't be silly'. "I genuinely didn't have enough. He couldn't suck - he wasn't getting milk and my then body wasn't being told to produce more milk."She added: "It just ended up being a bit of frustrating mess,"'I'm not good at quitting'Lora's partner Neil, the Scottish Paralympic gold medal-winning cyclist who was awarded an OBE alongside her last year, said it had been a "challenging few weeks". Lora added: "It was like going through a grieving process because you want to breastfeed, but for one reason or another you can't.Image source, Helen Mary Inages Image caption, Lora said baby Fraser was happy and interacting more"It kind of makes me feel like that if you can't breastfeed you're not one of these one of these amazing mums, you're not inspirational. But it's not true."Part of what I struggle with is, to do what I do with cycling and to win gold medals, you have to be resilient and determined and I guess that's where I have struggled. I'm not very good at quitting." 'A lot of women feel that sadness'Sarah Edwards from the Breastfeeding Network said about 70% of mums in Scotland start breastfeeding but less than 50% are still feeding when their baby is six to eight weeks. "The overall across the UK the statistic is about eight out of ten people say they stop feeding before they wanted to," she said. "A lot of women unfortunately feel that sadness, the trauma and the grief of stopping before they wanted to."Image source, Neil FachieImage caption, Fraser was born with a tongue tie which affected his ability to feedShe said help in Scotland was not evenly spread and can be "difficult to find". "Scotland could be a much more breastfeeding-friendly country than it is. Women are being failed by the lack of easily accessible support and information for them to succeed with whatever breastfeeding would look like for them." She said support for mothers could come from midwives, health visitors and specialist infant feeding teams, peer support groups and breastfeeding helplines. "Even if you have fed for a couple of days, or a couple of hours, there is still a success in that," Ms Edwards added. | Women’s Health |
Union contracts covering 22,000 healthcare workers at HCA, the largest hospital corporation in the US, are expiring in the coming months at 30 hospitals in five states as healthcare workers push the company to address chronic understaffing they say burns out workers and jeopardizes patient safety.
A study published in January 2023 by Service Employees International Union (SEIU) found staffing ratios at HCA Hospitals in 2020 were significantly lower than state averages in 19 of 20 states where HCA operates facilities and 30% lower than national averages.
Workers contacted by the Guardian said the corporation had the money to fix staffing issues. HCA spent $8bn on stock buybacks and reported a profit of about $7bn in 2021 and $5.6 bn in 2022, while many HCA workers are paid less than $15 an hour. From 2011 to 2021, HCA paid out $4.9bn in dividends to shareholders and spent $26.9bn on stock buybacks.
In Las Vegas, Nevada, Jody Domineck, a pediatric nurse for 18 years, said among 4,700 members across the three hospitals in town, the primary issues facing healthcare workers are the lack of safe staffing and resources required to take care of patients.
“Working short-staffed means that one kid is having trouble breathing and one kid is in excruciating pain, and I have to decide where to go because there’s only one of me, which means somebody waits,” Domineck said. “It means that I’ve had to walk away from a mom that’s worried about her kid because I have to go check on the other patients because there’s not enough people to do both. It means that at the end of the day, I sit in my car and I cry because I did everything and I know it wasn’t enough for all of them, that our patients deserve more.”
She said the understaffing has driven high turnover and it puts workers’ nursing licenses at risk because of the heightened risk of missing something or making a mistake because each nurse is responsible for too many patients.
“It’s a huge burden and at some point, people can’t tolerate that anymore, they can’t survive under that, so we’ve lost a lot of bedside nurses,” added Domineck. “We’ve seen that HCA made billions in profits last year. We would really like to see them invest that to improve patient care, improve staffing ratios and improve the working conditions for the staff.”
In a survey conducted by SEIU in January 2022 of 1,500 nurses in HCA hospitals, 89% agreed short staffing is compromising patient care at their hospitals. Among HCA workers surveyed in Florida, 47% reported wanting to leave their job due to burnout.
Penny Caesar, a unit secretary at HCA Florida Westside Hospital in Plantation, Florida, since 2008, described chronic understaffing at her hospital, low and stagnant wages and high turnover that have deteriorated working conditions and patient care.
“The patients complain. They’re waiting 30 minutes to go to the bathroom -now they need their own bed changed. That they’ve been waiting over 30 minutes for pain meds. The weekends are the worst. They’re really understaffed on the weekends,” said Caesar. “I love my job and all my nurses love their job, but we’ve been burned out. We really get burnt out.”
She argued patient-to-nurse ratios are high to the point where workers can’t take breaks because there is no coverage, that many nurses have left through the Covid-19 pandemic because they can make more money working as travel nurses, and that the hospital hasn’t made efforts to resolve staffing issues and if workers complain, they get disciplined with write-ups.
“We’re so understaffed because the nurses are so overworked. They want to keep calling us heroes and the families of patients ask: ‘Why are they calling you heroes and they’re not giving us the proper staff?’” said Caesar. “They see it, we don’t have to tell them.”
Bella Panchal, a speech pathologist at HCA-owned Riverside Community Hospital in Riverside, California, since 2018, also claimed her hospital suffers from chronic understaffing and the constant burnout and turnover it induces, especially given the traumatic conditions many nurses worked under during the Covid-19 pandemic. Her hospital lost three workers to Covid-19, and many nurses had to take on the burden of holding patients’ hands as they passed away in hospitals, without family members being able to sit by their side due to Covid-19 lockdown protocols.
“It was horrifying for the nurses,” Panchal said. “A lot of the nurses have PTSD.”
Due to the chronic understaffing, Panchal claimed the workplace culture at the hospital is one where workers often have to skip breaks and work past their scheduled shift unpaid.
“We almost never take a break. If I were to take a break, I wouldn’t have finished my work,” said Panchal. “Unfortunately, with HCA, they want you to work every other weekend, so there’s very little work and life balance and you’re running ragged when you are working, so it’s very stressful.”
She argued HCA needs to invest in improving workplace cultures and conditions and hiring workers as staff rather than on a per diem basis.
“They have the money, they can do it,” added Panchal.
HCA did not respond to multiple requests for comment on this story. | Health Policy |
Researchers have known that a lack of quality sleep can increase a person's risk of diabetes. What has remained a mystery, however, is why.
Now, new findings from a team of sleep scientists at the University of California, Berkeley, are closer to an answer. The researchers have uncovered a potential mechanism in humans that explains how and why deep-sleep brain waves at night are able to regulate the body's sensitivity to insulin, which in turn improves blood sugar control the next day.
"These synchronized brain waves act like a finger that flicks the first domino to start an associated chain reaction from the brain, down to the heart, and then out to alter the body's regulation of blood sugar," said Matthew Walker, a UC Berkeley professor of neuroscience and psychology and senior author of the new study. "In particular, the combination of two brain waves, called sleep spindles and slow waves, predict an increase in the body's sensitivity to the hormone called insulin, which consequentially and beneficially lowers blood glucose levels."
The researchers say this is an exciting advance because sleep is a modifiable lifestyle factor that could now be used as part of a therapeutic and painless adjunct treatment for those with high blood sugar or Type 2 diabetes.
Scientists also noted an additional benefit besides the potential new mechanistic pathway.
"Beyond revealing a new mechanism, our results also show that these deep-sleep brain waves could be used as a sensitive marker of someone's next-day blood sugar levels, more so than traditional sleep metrics," said Vyoma D. Shah, a researcher at Walker's Center for Human Sleep Science and co-author of the study. "Adding to the therapeutic relevance of this new discovery, the findings also suggest a novel, non-invasive tool -- deep-sleep brain waves -- for mapping and predicting someone's blood sugar control."
The team's findings were published today in the journal Cell Reports Medicine.
For years, researchers have studied how the coupling of non-rapid eye movement sleep spindles and deep, slow brain waves corresponded to an entirely different function -- that of learning and memory. Indeed, the same team of UC Berkeley researchers previously found that deep-sleep brain waves improved the ability of the hippocampus -- the part of the brain associated with learning -- to retain information.
But this new research builds on a 2021 rodent study and reveals a novel and previously unrecognized role for these combined brain waves in humans when it comes to the critical bodily function of blood sugar management.
The UC Berkeley researchers first examined sleep data in a group of 600 individuals. They found that this particular coupled set of deep-sleep brain waves predicted next-day glucose control, even after controlling for other factors such as age, gender and the duration and quality of sleep.
"This particular coupling of deep-sleep brain waves was more predictive of glucose than an individual's sleep duration or sleep efficiency," said Raphael Vallat, a UC Berkeley postdoctoral fellow and co-author of the study. "That indicates there is something uniquely special about the electrophysiological quality and coordinated ballet of these brain oscillations during deep sleep."
Next, the team then set out to explore the descending pathway that might explain the connection between these deep-sleep brain waves sending a signal down into the body, ultimately predicting the regulation of blood glucose.
The findings from the team reveal an unfolding set of steps that could help explain how and why these deep-sleep brain waves are related to superior blood sugar control. First, they found that stronger and more frequent coupling of the deep-sleep brain waves predicted a switch in the body's nervous system state into the more quiescent and calming branch, called the parasympathetic nervous system. They measured that change in the body and the shift to this low-stress state using heart rate variability as a proxy.
Next, the team turned its attention to the final step of blood sugar balance.
The researchers further discovered that this deep sleep switch to the calming branch of the nervous system further predicted an increased sensitivity of the body to the glucose-regulating hormone called insulin, which instructs cells to absorb glucose from the bloodstream, preventing a deleterious blood sugar spike.
That's particularly important for people trying to back away from hyperglycemia and Type 2 diabetes.
"In the electrical static of sleep at night, there is a series of connected associations, such that deep-sleep brain waves telegraph a recalibration and calming of your nervous system the following day," Walker said. "This rather marvelous associated soothing effect on your nervous system is then associated with a reboot of your body's sensitivity to insulin, resulting in a more effective control of blood sugar the next day."
The researchers subsequently replicated the same effects by examining a separate group of 1,900 participants.
"Once we replicated the findings in a different cohort, I think we actually started to feel more confident in the results ourselves," Walker said. "But I'll wait for others to replicate it before I truly start believing, such is my British skepticism."
The scientists said the research is particularly exciting given the potential clinical significance years down the line. Diabetes treatments already on the market can sometimes be difficult for patients to adhere to. The same is true of the recommended lifestyle changes, including different eating habits and regular exercise.
Sleep, however, is a largely painless experience for most people.
And while sleep is not going to be the single magic bullet, the prospect of new technologies that can safely alter brain waves during deep sleep that this new research has uncovered may help people better manage their blood sugar. That, the research team said, is reason for hope.
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Intermittent fasting is safe, effective for those with Type 2 diabetes
Time-restricted eating, also known as intermittent fasting, can help people with Type 2 diabetes lose weight and control their blood sugar levels, according to a new study published in JAMA Network Open from researchers at the University of Illinois Chicago.
Participants who ate only during an eight-hour window between noon and 8 p.m. each day actually lost more weight over six months than participants who were instructed to reduce their calorie intake by 25%. Both groups had similar reductions in long-term blood sugar levels, as measured by a test of hemoglobin A1C, which shows blood sugar levels over the past three months.
The study was conducted at UIC and enrolled 75 participants into three groups: those who followed the time-restricted eating rules, those who reduced calories and a control group. Participants’ weight, waist circumference, blood sugar levels and other health indicators were measured over the course of six months.
Senior author Krista Varady said that participants in the time-restricted eating group had an easier time following the regime than those in the calorie-reducing group. The researchers believe this is partly because patients with diabetes are generally told to cut back on calories by their doctors as a first line of defense, so many of these participants likely had already tried — and struggled with — that form of dieting. And while the participants in the time-restricted eating group were not instructed to reduce their calorie intake, they ended up doing so by eating within a fixed window.
“Our study shows that time-restricted eating might be an effective alternative to traditional dieting for people who can’t do the traditional diet or are burned out on it,” said Varady, a professor of kinesiology and nutrition. “For many people trying to lose weight, counting time is easier than counting calories.”
There were no serious adverse events reported during the six-month study. Occurrences of hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) did not differ between the diet groups and control groups.
Today, 1 in 10 U.S. residents has diabetes, and that number is expected to rise to 1 in 3 by 2050 if current trends continue, the researchers explain. Finding more options for controlling weight and blood sugar levels for these patients, therefore, is crucial.
Just over half the participants in the study were Black and another 40% were Hispanic. This is notable as diabetes is particularly prevalent among those groups, so having studies that document the success of time-restricted eating for them is particularly useful, the researchers said.
The study was small and should be followed up by larger ones, said Varady, who is also a member of the University of Illinois Cancer Center. While it acts as a proof of concept to show that time-restricted eating is safe for those with Type 2 diabetes, Varady said people with diabetes should consult their doctors before starting this sort of diet.
The other current and former UIC authors on the paper are Vasiliki Pavlou, Sofia Cienfuegos, Shuhao Lin, Mark Ezpeleta, Kathleen Ready, Sarah Corapi, Jackie Wu, Jason Lopez, Kelsey Gabel, Lisa Tussing-Humphreys, Vanessa Oddo, Julienne Sanchez and Dr. Terry Unterman. Other authors are from Northwestern University, the University of Minnesota, Minneapolis, and the University of Southern California. | Nutrition Research |
A woman who died during an operation for a buttock enlargement in Turkey was not given enough information to make a safe decision about the procedure, a coroner has concluded.
Melissa Kerr, 31, from Gorleston, Norfolk, died at the private Medicana Haznedar Hospital in Istanbul, in 2019.
Coroner Jaqueline Lake said she would be writing a report for the health secretary to try and prevent further deaths from this "risky" procedure.
The hospital has been asked to comment.
Ms Kerr had gone abroad to have what is commonly referred to as a Brazilian butt-lift or BBL, the Norwich inquest heard.
In a statement Ms Kerr's family said they were devastated.
"We hope in the future individuals give proper consideration before travelling to Turkey for cosmetic tourism," it said in a prepared statement.
The Norwich inquest was told Ms Kerr, a psychological well-being practitioner at mental health charity Mind, was "self-conscious" about her appearance.
The inquest was told Brazilian butt-lift operations carried the highest risk of all cosmetic surgery procedures.
The UK has an agreed moratorium on carrying out such operations due to the dangers involved, an expert plastic surgeon Simon Whitey said in a report for the inquest.
Mr Withey said if the risk of the procedure had been explained to Ms Kerr before she had financially committed to the procedure she would not "in all probability" have gone through with it.
On 19 November, 2019, a day after arriving in Turkey and paying £3,200 in cash, she underwent a "limited" pre-operation assessment before surgery.
Fat was harvested using a liposuction process from her jowls, thighs and abdomen and inserted into her posterior.
It was during the re-injection of the fat, deep into her buttock muscle tissue, that Ms Kerr suffered a fatal clot that had travelled to her lungs.
The inquest was told that if material was injected too deep into muscle tissue there was a risk of it travelling to other areas of the body.
Ms Kerr had been in theatre for more than three hours when efforts were made to resuscitate her, documents from the Turkish hospital said. She died a short time afterwards.
Ms Kerr had no known health conditions according to her UK GP and she had undergone a breast augmentation 10 years previously, without any issues.
Recording a narrative conclusion the coroner said Ms Kerr died after cosmetic surgery.
She recorded her cause of death as a pulmonary thromboembolism and fat thromboembolism.
Referring to her report for the secretary of state Ms Lake said: she was "concerned patients are not being made aware of the risks or the mortality rate associated with such surgery."
She added, while the UK government had no control over what happens in other countries,"the danger to citizens who continue to travel abroad for such procedures continues... and I'm of the view future deaths can be prevented by way of better information." | Medical Innovations |
The parents of twin brothers who were among Lucy Letby's 13 victims have told the BBC the nurse is a "hateful human being" who has taken "everything" from them. Letby murdered one of their baby boys, and tried to kill the other twin the following day.
Letby has been found guilty of murdering seven babies, and trying to kill six others, at the Countess of Chester Hospital. There were six more attempted murder charges. She was found not guilty of two and the jury was undecided on the remaining four.
To protect the identities of the babies and their parents, the twins are referred to as Baby E and Baby F.
"We were actually told we would never have our own children," the babies' mother says, speaking to BBC Panorama. She found out she was having twins on Valentine's Day, in 2015, after several failed IVF attempts.
It had not been the plan to have the babies at the Countess of Chester Hospital, where Letby worked. It wasn't their nearest hospital, but when the time came that was where there was space.
The twins were born prematurely, in the summer of 2015, and despite them needing specialist care in the neonatal unit, their father remembers the joy he felt as a new dad.
"There was just a sheer elation and happiness that I'd never felt before, or since," he says now.
Warning: This article contains details some readers may find upsetting
After the birth, the babies' mother would come down from the maternity ward where she was recovering from a Caesarean section to drop off breast milk.
Her babies, who lay side-by-side in incubators, were doing well and the family was waiting to be transferred to a hospital closer to home. But as she approached their room one evening, she could hear intense crying that sounded like screaming.
"I've never heard anything like it since," the mother says. "I was like, 'What's the matter with him?'"
"It was a sound that should not come from a tiny baby," she said while giving evidence at Letby's trial, in November.
Walking into the room she discovered it was one of her babies - Baby E - making the noise. He had blood around his mouth. Rushing to comfort him, she gently put her hand on his tummy to give him a reassuring sign that she was there.
She'd been taught this in hospital - and normally it worked. But the baby continued screaming and she could feel her panic rising.
Letby was the only other person in the room. The child's mother remembers she wasn't near her baby and didn't look at him while she was in there.
"You know when it feels like somebody wants to look busy, but they're not actually doing anything?" she says now.
She asked Letby what was wrong with her son. The nurse told her the baby's feeding tube must have been rubbing the back of his throat. She said she had already called a registrar, who would be there soon.
Letby, an experienced nurse who the mother trusted, told her not to worry, to go back to her ward and that she'd be contacted if there was a problem. "She has this really calm demeanour about her," the mother told the BBC. "She's very softly spoken."
Baby serial killer Lucy Letby
The parents had struck up a rapport with Letby - they were all on first name terms. They'd shared their story with the neonatal staff; their journey to starting a family, and the obstacles they'd faced. Letby had told them about her life. She was happy being single, she told them, and was hoping to buy a house.
When the baby's condition deteriorated later on, his mother rushed back to the unit, where she watched through the glass as medics crowded around his incubator, attempting to resuscitate her son.
She remembers Letby was there but didn't make eye contact with them.
By the time the baby's father arrived, a priest had been called, and the parents were taken to be with their child. "We were told to talk to him, and hold his hand," says the mother, "and then he was christened."
Eventually, the consultant told them there was nothing more that could be done. "She said: 'It's no good. We want him to die in your arms rather than being worked on'," she says through tears.
"And they passed him to us, and he died."
The parents remember Letby looking visibly upset. The nurse then took control of the situation.
"She bathed him and then she dressed him in a little woollen gown and gave him back to us," says the mother, "and we held him for a little bit longer."
Doctors decided the cause of Baby E's death was a bowel condition, and that his premature birth was a factor. The death wasn't initially considered suspicious, so no post-mortem examination was carried out.
In court, the mother said she had been "totally surprised" when Letby presented her and her husband with a memory box containing a lock of the baby's hair and his hand and footprints. Letby had also taken photos of him, without their knowledge, and presented those to the parents too.
The mother said the nurse had given both twins a cuddly toy and later showed her a photo of her surviving baby, Baby F, holding his twin brother's teddy.
"She said: 'He rolled over and hugged his bear - I thought it was so amazing I took a picture for you,'" the mother remembers Letby saying.
At the time, this anecdote was comforting to the parents. But soon they realised new born babies can't roll over - their neck and arm muscles aren't strong enough - and it became one of many disturbing things they now view very differently.
During the trial, medical experts concluded that Baby E had not died as a result of his premature birth or a bowel condition, as previously thought.
His cause of death was internal bleeding and an injection of air into his bloodstream.
He was the fourth of seven babies murdered by Lucy Letby between June 2015 and June 2016. She attempted to murder another six infants - including Baby E's twin brother, Baby F, who suddenly deteriorated and became critically ill within 24-hours of his sibling's death.
Having just lost one child, the parents did not want to leave the side of their surviving baby. They were told his heart rate had become dangerously high.
"I said to my husband: 'Please, not again, we - we can't do this again, this can't be happening.'" She remained by his cot all night.
Medics managed to save Baby F and the parents were told their son had an infection. It was only two years later that they learned that his intravenous feedbag had been poisoned with insulin.
They say their child, who is now seven years old, was badly harmed by Letby and has been left with severe learning difficulties and "a lot of complex needs". "There's a consequence," his mother says, "and he's living with it."
Letby has "taken everything from us - absolutely everything," she says. "I think she's a hateful human being."
In 2018, when Letby was first arrested, Baby E and F's parents found it difficult to believe that she was the suspect. "Never in a million years did I think it would be someone that we felt we had a connection with," says the mother now.
"She had everything going for her, and then starts killing babies. What happened?" she asks. "It's something that we'll never know."
In court, the couple discovered the nurse had repeatedly searched their names on Facebook - including on Christmas Day.
Letby maintained she was simply checking how Baby F was doing - the baby whose heart she'd deliberately sent soaring with dangerous amounts of insulin, and whose twin brother she had killed just 24 hours before.
The babies' mother now believes Letby should spend the rest of her life behind bars. "What she's done has changed the course of our life forever."
If you, or someone you know, have been affected by the issues raised here, there are details of organisations that may be able to offer support on the BBC Action Line. | Epidemics & Outbreaks |
Progress being made on tackling the hospital waiting backlog will be put at risk by next week's junior doctors' strike, NHS bosses are warning.
NHS England medical director Prof Sir Stephen Powis said there had been huge achievements over the winter.
But he said it was inevitable the 72-hour walkout in England, which starts on Monday, would have an impact.
It comes as the annual NHS staff survey shows a falling number happy to recommend the care at their service.
The poll found 63% would be happy to see a friend or relative treated - down by five percentage points in the past year and 11 over two years.
Meanwhile, latest performance data shows NHS emergency services are continuing to miss their targets, although the situation is not getting worse.
The figures for February show just under 72% of A&E patients were seen in four hours.
Ambulance response time for immediately life-threatening category one cases was eight minutes, 30 seconds, while for category two emergency calls, including heart attacks and strokes, it was just over 32 minutes. In December, this rose to more than 90 minutes.
Dr Tim Cooksley, president of the Society for Acute Medicine, said despite the situation not getting worse it still presented a "damning" picture, and warned it was "increasingly causing harm to patients".
Performance in cancer care did deteriorate, however, with just 54% of patients starting treatment within two months following an urgent referral by a GP - that is the worst on record.
There was more positive news for routine treatments, such as knee and hip replacements.
While the total number on the waiting list remained at 7.2 million, there has been progress on tackling long waits.
At the end of December there were nearly 55,000 people waiting more than 18 months, but by late February that had dropped to below 33,000.
Sir Stephen said this was a "huge achievement" especially given it has been winter, which is the busiest time of year for emergency care.
"The NHS will not stop in its efforts to bring down 18-month waits, but it is inevitable the upcoming junior doctors' strikes will have a significant impact."
The walkout by junior doctors, who represent 40% of the medical workforce, begins at 06:30 GMT on Monday and will involve both emergency and planned care.
Consultants are being brought in to provide cover. | Health Policy |
White House launches national response plan for combatting ‘tranq’ drug deaths
The Biden administration is rolling out a national response plan to deal with the threat of fentanyl combined with xylazine.
Xylazine, also known as “tranq,” is an easily accessible veterinary drug approved for use in animals as a sedative and pain reliever. But it is also being used by drug dealers as a low-cost cutting agent in drugs like fentanyl, possibly as a way to extend a user’s high.
Officials said the ultimate goal of the plan announced Tuesday is to reduce the number of xylazine drug poisoning deaths by 15 percent in at least three of four U.S. census regions by 2025.
The plan involves six “pillars of action,” including testing, data collection, prevention, supply reduction, scheduling and research.
“We need more testing to get a national picture of the threat,” Rahul Gupta, director of the Office of National Drug Control Policy (ONDCP) told reporters during a press briefing.
Gupta said testing for xylazine was ongoing in community and law enforcement settings, but it wasn’t enough. He said the administration will work to develop new tests, and also make xylazine test strips available for the first time.
Xylazine test strips are available for purchase, Gupta said, and the administration wants to ensure they get into the communities that need them.
He called on Congress to fund the White House budget request for emerging threats “in order to ensure that we are getting more resources out for prevention treatment, as well as harm reduction measures to people as quickly as possible.”
The White House also said it will consider whether to schedule xylazine as a controlled substance, and work to disrupt the supply of xylazine.
Gupta said the White House doesn’t want to disrupt the veterinarian industry, so if it does schedule xylazine as a controlled substance, it will need to balance protecting public health while making sure there remains a legitimate supply.
Veterinarians use drug products containing xylazine, but it is not safe for use in people and may cause serious and life-threatening side effects. It can cause people to stop breathing, and causes serious skin lesions when it is injected.
“As a physician, I’ve never seen wounds this bad at this scale,” Gupta said. “Right now, the medical community knows how xylazine adulterated with fentanyl affects individuals, but there is not a single agreed upon framework for treating them.”
Xylazine is spreading quickly, and federal agencies are sounding the alarm. The drug has been detected in nearly every state.
Data from the Centers for Disease Control and Prevention showed that between January 2019 and June 2022, the monthly percentage of overdose deaths from fentanyl combined with xylazine increased by 276 percent.
The White House in April declared xylazine-laced fentanyl an official emerging drug threat to the nation, and the national response plan is required as part of the designation.
“If we thought fentanyl was dangerous, fentanyl combined with xylazine is even deadlier,” Gupta said.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Drug Discoveries |
What happens in the human brain when we learn from positive and negative experiences? To help answer that question and better understand decision-making and human behavior, scientists are studying dopamine.
Dopamine is a neurotransmitter produced in the brain that serves as a chemical messenger, facilitating communication between nerve cells in the brain and the body. It is involved in functions such as movement, cognition and learning. While dopamine is most known for its association with positive emotions, scientists are also exploring its role in negative experiences.
Now, a new study from researchers at Wake Forest University School of Medicine shows that dopamine release in the human brain plays a crucial role in encoding both reward and punishment prediction errors. This means that dopamine is involved in the process of learning from both positive and negative experiences, allowing the brain to adjust and adapt its behavior based on the outcomes of these experiences.
The study was published today in Science Advances.
"Previously, research has shown that dopamine plays an important role in how animals learn from 'rewarding' (and possibly 'punishing') experiences. But, little work has been done to directly assess what dopamine does on fast timescales in the human brain," said Kenneth T. Kishida, Ph.D., associate professor of physiology and pharmacology and neurosurgery at Wake Forest University School of Medicine. "This is the first study in humans to examine how dopamine encodes rewards and punishments and whether dopamine reflects an 'optimal' teaching signal that is used in today's most advanced artificial intelligence research."
For the study, researchers on Kishida's team utilized fast-scan cyclic voltammetry, an electrochemical technique, paired with machine learning, to detect and measure dopamine levels in real-time (i.e., 10 measurements per second). However, this method is challenging and can only be performed during invasive procedures such as deep-brain stimulation (DBS) brain surgery. DBS is commonly employed to treat conditions such as Parkinson's disease, essential tremor, obsessive-compulsive disorder and epilepsy.
Kishida's team collaborated with Atrium Health Wake Forest Baptist neurosurgeons Stephen B. Tatter, M.D., and Adrian W. Laxton, M.D., who are also both faculty members in the Department of Neurosurgery at Wake Forest University School of Medicine, to insert a carbon fiber microelectrode deep into the brain of three participants at Atrium Health Wake Forest Baptist Medical Center who were scheduled to receive DBS to treat essential tremor.
While the participants were awake in the operating room, they played a simple computer game. As they played the game, dopamine measurements were taken in the striatum, a part of the brain that is important for cognition, decision-making, and coordinated movements.
During the game, participants' choices were either rewarded or punished with real monetary gains or losses. The game was divided into three stages in which participants learned from positive or negative feedback to make choices that maximized rewards and minimized penalties. Dopamine levels were measured continuously, once every 100 milliseconds, throughout each of the three stages of the game.
"We found that dopamine not only plays a role in signaling both positive and negative experiences in the brain, but it seems to do so in a way that is optimal when trying to learn from those outcomes. What was also interesting, is that it seems like there may be independent pathways in the brain that separately engage the dopamine system for rewarding versus punishing experiences. Our results reveal a surprising result that these two pathways may encode rewarding and punishing experiences on slightly shifted timescales separated by only 200 to 400 milliseconds in time," Kishida said.
Kishida believes that this level of understanding may lead to a better understanding of how the dopamine system is affected in humans with psychiatric and neurological disorders. Kishida said additional research is needed to understand how dopamine signaling is altered in psychiatric and neurological disorders.
"Traditionally, dopamine is often referred to as 'the pleasure neurotransmitter,"' Kishida said. "However, our work provides evidence that this is not the way to think about dopamine. Instead, dopamine is a crucial part of a sophisticated system that teaches our brain and guides our behavior. That dopamine is also involved in teaching our brain about punishing experiences is an important discovery and may provide new directions in research to help us better understand the mechanisms underlying depression, addiction, and related psychiatric and neurological disorders."
This study was supported by grants from the National Institutes of Health: R01MH121099, R01DA048096, R01MH124115, P50DA006634, 5KL2TR001420, F31DA053174, T32DA041349 and F30DA053176.
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Intermittent fasting performed as well as calorie-counting for helping people with Type 2 diabetes manage weight and blood sugar.
lacaosa/Getty Images
Intermittent fasting performed as well as calorie-counting for helping people with Type 2 diabetes manage weight and blood sugar.
lacaosa/Getty Images
Intermittent fasting is enjoying a moment in American households — by some accounts nearing the popularity of calorie counting and plant-based diets.
The appeal?
Research suggests that simply having less time to eat can lead people to cut down on how much they ultimately consume, without the rigmarole of watching each calorie.
Now, new research bolsters the case that intermittent fasting — specifically limiting when you eat to a given window of time during the day — can be a safe and effective strategy for managing Type 2 diabetes.
The study, published on Friday in JAMA Open, finds people with Type 2 diabetes can successfully shed weight and manage their blood sugar by eating only within an 8-hour window each day.
"I think this is pretty exciting data," says Dr. Joanne Bruno, an endocrinologist at NYU Langone Health who wasn't involved in the trial.
While it's still an emerging field, a growing number of clinical trials have shown time-restricted eating can improve metabolic health and deliver weight loss. But few of these studies have focused specifically on Type 2 diabetes.
The findings add evidence that time-restricted eating has potential for helping those with high blood pressure, elevated blood sugar and other problems affecting cardiovascular and metabolic health, says Dr. Pam Taub, a cardiologist at the University of California San Diego.
"I think you get the most bang for the buck with this type of population," says Taub, who also has published studies on time-restricted eating.
An easier alternative
The study, based at the University of Illinois Chicago, ran for six months and included 75 adults with Type 2 diabetes.
The study authors say it's the first randomized controlled trial directly comparing time-restricted eating to counting calories in patients with Type 2 diabetes, looking at effects on body weight and A1C, a test that shows blood sugar levels over the past three months.
Overall, the study found that time-restricted eating led to about the same improvements as calorie-counting in A1C levels. Both groups had a drop of over 0.7% from baseline over the course of six months.
Given that most medications used for diabetes will reduce that number by about 1%, Bruno says this represents a "significant change and can have meaningful clinical benefits."
The difference in weight loss was the most remarkable result.
Those who only ate between 12 p.m. and 8 p.m. ended up losing nearly double the amount of weight as those who counted their calories.
"I was surprised," says Krista Varady, a professor of nutrition at the University of Illinois and the study's lead author. She notes her previous studies have shown the same amount of weight loss as calorie counting, not more.
"They didn't need to count calories or carbs or anything like that," she says, "They ended up reducing their calorie intake just by eating in that 8-hour window."
The study included three arms: the controls who made no changes to their diet, those who were instructed to count calories and reduce their intake by about 25%, and the time-restricted eating group.
On average, those who kept their eating to an 8-hour window shed about 10 pounds and lost more fat than the calorie counting group, which dropped a total of about 6 pounds.
Varady says they picked the noon to 8 p.m. window because observational studies show that's when most people who do intermittent fasting prefer to eat.
"They really found time-restricted eating to be a nice, refreshing alternative," she says.
Many study participants said in interviews they had spent years being advised to count calories and were disillusioned with the approach, says Varady.
Benefits go beyond weight-loss
Despite being the largest clinical trial to date on Type 2 diabetes, it's still considered "fairly small," but it was well-performed, says Benjamin Horne, an epidemiologist at the Intermountain Heart Institute in Salt Lake City and an adjunct professor at Stanford University.
"I would say it's the best study in that population to date, so I think we can be confident that there are potential benefits," he says.
Indeed, Varady and her co-authors acknowledge it needs to be followed up with larger trials and caution that the findings on weight loss shouldn't be interpreted as proving that time-restricted eating is better.
"It's not a one diet fits all approach," she says. "We're just showing that time-restricted eating is another option."
Horne points out some of the study's strengths. It included a diverse patient pool: A majority of the participants were Black and about a third were Hispanic. And those who did the time restricted eating had good adherence, sticking to the 8-hour window on average about six out of seven days a week.
Finally while the weight-loss groups did meet with dietitians regularly, the study offered a practice that people can replicate even if they're not in a clinical trial.
"It's very easy to do a fasting regimen," he says, "You don't need a prescription to do it. It doesn't cost anything."
In an era of blockbuster weight-loss and diabetes drugs, Taub says the study adds to the evidence that this lifestyle intervention can also help.
"It's not one or the other," says Taub, "One of the things that I strive for with my patients with Type 2 diabetes is how do I minimize the pharmacotherapy and maximize the lifestyle?"
In fact, Taub's work has shown that for people with metabolic syndrome, a 10-hour eating window not only improves their ability to manage blood sugar, but also reduces other metrics like blood pressure and cholesterol.
A study on shift workers has found that intermittent fasting, even if it's done late in the evening, can still confer benefits. "It's about giving your body that fasting period, that metabolic rest," she says.
What research suggests, she says, is that time-restricted eating can offer metabolic benefits above and beyond what'd you'd expect simply from losing a given amount of weight.
For those with Type 2 diabetes though, Taub and Bruno say patients should not take up intermittent fasting without medical supervision.
For example, in the JAMA Open study, some participants needed to have their medications adjusted depending on their blood sugar test.
Bruno says concerns about hypoglycemia from fasting appears to be one reason there haven't been more studies on people with Type 2 diabetes till now.
While there are still lingering safety questions that need to be studied, especially for those taking insulin, she says overall it does seem to be safe and effective.
And increasingly it's a tool that she offers her patients.
"Many do feel liberated in some ways by this dietary strategy," she says. "I'm hopeful that time-restricted feeding will get its due."
Carmel Wroth edited this story. | Nutrition Research |
Prince Harry credited the use of psychedelic drugs with helping him deal with the 'grief' and 'trauma' he felt after the tragic death of his mom, Princess Diana.The Duke of Sussex, 38, spoke out about his past drug use during an explosive new sit down interview with 60 Minutes, which aired on Sunday, and he called psychedelics like ayahuasca and magic mushrooms his 'medicine' after the huge 'loss' of his mother in 1997.While Harry was only 12 when Diana tragically died in a car accident, he admitted in his upcoming book, Spare, that he struggled to come to grips with her sudden passing.Now he has shared more details about his mother's death with 60 Minutes host Anderson Cooper, explaining that he only cried once over his mother's death - when her coffin was put in the ground - and that he was plagued with guilt over feeling like he was not being emotional enough over her passing for years. Prince Harry admitted to using psychedelic drugs to deal with the 'grief' and 'trauma' he felt after the tragic death of his mom, Princess Diana The Duke of Sussex, 38, spoke out about his past drug use during an interview with 60 Minutes, and he called the drugs his 'medicine' after the huge 'loss' of his mother in 1997 While Harry (seen at her funeral) was only 12 when Diana died in a car accident, he admitted in his upcoming book, Spare, that he struggled to come to grips with her sudden passing Now, Harry (seen with Diana in 1987) admitted he only cried once over his mother's death - and said he was plagued with guilt over feeling like he was not being emotional enough But the former royal said using psychedelics when he got older ultimately 'cleared away the idea' that he needed be sad to prove he 'missed' his mom. What is ayahuasca? According to Healthline, ayahuasca is a plant-based psychedelic made from the leaves of the Psychotria viridis shrub along with the stalks of the Banisteriopsis caapi vine.'This drink was used for spiritual and religious purposes by ancient Amazonian tribes and is still used as a sacred beverage by some religious communities in Brazil and North America, including the Santo Daime,' it explained. 'The main ingredients of Ayahuasca - Banisteriopsis caapi and Psychotria viridis -both have hallucinogenic properties.'When combined, these two plants form a powerful psychedelic brew that affects the central nervous system, leading to an altered state of consciousness that can include hallucinations, out-of-body experiences, and euphoria.' 'I would never recommend people to do this recreationally,' he said during the one-hour tell-all interview. 'But doing it with the right people if you are suffering from a huge amount of loss, grief or trauma, then these things have a way of working as a medicine.'For me, they cleared the windscreen, the windshield, the misery of loss. They cleared away this idea that I had in my head that ... I needed to cry to prove to my mother that I missed her. When in fact, all she wanted was for me to be happy.'Harry explained during the sit down that he believes he didn't cry over Diana's death because he had 'refused to accept that she was gone.' He added that there was a huge 'weight on his chest' that he 'felt for so many years' over not shedding more tears - and that he even tried watching videos of her to bring forth his emotions. 'I was constantly trying to find a way to cry, even sitting on my sofa and going over as many memories as I could muster up about my mum,' he added. 'And sometimes I watched videos online.'In his memoir, Spare, which released in Spain last week and will premiere worldwide on January 10, Harry explained that he sought help from a therapist seven years ago, and that he ultimately decided to try psychedelics to help him come to terms with the pain from losing his mother - and he wrote that they allowed him to see 'the truth' and 'redefine' reality.He explained that the drugs also helped him to discover 'another reality,' and even after they wore off, he said he saw a world that was 'twice as beautiful.' He recalled one time that he took magic mushrooms at a party in 2016 and began to hallucinate that a garbage can was talking to him. But the former royal (seen in 10`6) said using psychedelics seven years ago ultimately 'cleared away the idea' that he needed be sad to prove he 'missed' his mom 'I would never recommend people to do this recreationally,' Harry (seen in 2004) said. 'But if you are suffering from a huge amount of loss, grief or trauma, these things have a way of working as a medicine' 'They cleared away this idea that I had that ... I needed to cry to prove to my mother that I missed her,' Harry (seen in 2012) said. 'When in fact, all she wanted was for me to be happy''Beside the toilet was a round silver bin, the kind with a foot pedal to open the lid. I stared at the bin. It stared back. Then it became... a head,' he wrote, according to The Sun.'I stepped on the pedal and the head opened its mouth. A huge open grin. I laughed, turned away, took a p**s. 'Now the loo became a head too. The bowl was its gaping maw, the hinges of the seat were its piercing silver eyes. It said, "Aaah."'Elsewhere in his memoir, Harry also admitted to also smoking cannabis and using cocaine as a teen, and claimed he was once dragged into an office and questioned by a member of the Royal Household staff over the potential use of illegal drugs. He said the grilling took place during the Queen's Golden Jubilee in 2002, when he was 17, after a journalist asked Buckingham Palace about his illicit habits. 'Of course I had been doing cocaine around this time,' he said. 'At someone’s country house during a hunting weekend, I’d been offered a line, and I’d done a few more since.'It wasn’t much fun, and it didn’t make me particularly happy, as it seemed to make everyone around me.'But it did make me feel different, and that was the main goal. Feel. Different. I was a deeply unhappy 17-year-old willing to try almost anything that would alter the status quo. That was what I told myself anyway.' Harry (left) explained during the sit down interview with Anderson Cooper (right) that he believes he didn't cry over Diana's death because he had 'refused to accept that she was gone' Elsewhere in his memoir, Harry (seen in 2002, at age 17) admitted to using cocaine during his teen years, stating that he did drugs because he wanted to 'feel different' Harry (seen in 2009) said cocaine 'wasn’t much fun,' and described himself as a 'deeply unhappy 17-year-old willing to try almost anything that would alter the status quo' Harry previously opened up about using a bizarre therapy method known as EMDR - which uses hand taps and eye movements - to 'process bad memories' According to Healthline, ayahuasca - a plant-based South American drug that's usually brewed into a tea - is made from the leaves of the Psychotria viridis shrub along with the stalks of the Banisteriopsis caapi vine. Celebrities who have confessed to using ayahuasca Aaron RodgersChelsea HandlerWill Smith Megan FoxLindsay LohanStingPenn BadgleyMiley CyrusPaul SimonTori AmonsRicki LakeRobin QuiversJosh RadnorTerrance HowardChris RobinsonMichelle RodriguezJames ScottSusan SarandonWilliam BurroughsBren LeeRon WhiteJim Carrey 'This drink was used for spiritual and religious purposes by ancient Amazonian tribes and is still used as a sacred beverage by some religious communities in Brazil and North America, including the Santo Daime,' it explained. 'The main ingredients of ayahuasca - Banisteriopsis caapi and Psychotria viridis -both have hallucinogenic properties.'When combined, these two plants form a powerful psychedelic brew that affects the central nervous system, leading to an altered state of consciousness that can include hallucinations, out-of-body experiences, and euphoria.'Other celebrities who have admitted to using the drug include Aaron Rodgers, Julia Fox, Chelsea Handler, Will Smith, Megan Fox, Lindsay Lohan, Miley Cyrus, and Susan Sarandon, among others. As for magic mushrooms, they include an ingredient called psilocybin - a hallucinogenic chemical that can cause feelings of euphoria and sensory distortion, according to Medical News Today.Harry previously opened up about using a bizarre therapy method known as EMDR - which uses hand taps and eye movements - to 'process bad memories.'The principle of EMDR, which stands for Eye Movement Desensitisation and Reprocessing, is that the mind can heal from trauma by using external stimuli to help the brain process the traumatic experience and facilitate healing. It has a host of other celebrity fans, including Mel B and Jameela Jamil.During a segment with psychotherapist Sanja Oakley on Apple TV+ in May 2021, called The Me You Can't See, Harry demonstrated the process by closing his eyes and tapping his chest.'EMDR is always something that I've wanted to try and that was one of the varieties of different forms of healing or curing that I was willing to experiment with,' he told Oprah about it.'And I never would have been open to that had I not put in the work and the therapy that I've done over the years.' | Mental Health Treatments |
Drugmakers around the globe are bracing for a major shakeup in how one of their largest customers does business. On Sept. 1, Medicare will target its first 10 drugs for historic price negotiations. The medications are sure to be among the country's costliest and will likely include common treatments for cancer and diabetes.
The negotiations could save the federal government nearly $100 billion by 2031 and slash some prices Medicare pays by half. They are also the subject of multiple lawsuits by major drugmakers including Merck and Johnson & Johnson.
The power to negotiate prices directly with drug companies is one Medicare has never before had in its 58-year history. Exercising that power requires the government to grapple with a difficult question: What makes a drug price fair?
Whatever approach the agency takes to answering that question could have major ripple effects on both the affordability and availability of prescription drugs — now and for decades to come.
Medicare can push back and signal its priorities to drugmakers
Although this unprecedented negotiation process presents several tricky decisions for Medicare, experts said the need to keep finding better treatments for dire diseases looms largest.
"This chronic tension between trying to make sure that we keep health care affordable and that we reward good clinical innovation — that's a huge tradeoff hanging over this entire enterprise," said Steve Pearson, founder and president of the Institute for Clinical and Economic Review.
While Medicare is motivated to lower the roughly $150 billion it spends each year on medications and help the nearly 1 in 4 older Americans who struggle to afford prescriptions, the agency is also aware that profits from these products help make future blockbusters possible. "Ultimately," said Medicare director Meena Seshamani, "the goal of negotiation is to improve affordability and drive innovation for the cures that people need."
By cutting prices for certain drugs more than others, Medicare has an opportunity to signal to industry the types of major innovation the agency values, such as drugs that address unmet needs or that attack diseases in novel ways. Government health agencies in some other countries, including England and France, have long paid companies less for copycat drugs that offer fewer clinical improvements over existing therapies.
While the private companies who manage Medicare prescription drug plans do already wring some discounts from drugmakers, their bargaining power is limited and their incentives do not always align with the government's.
With this new authority, Medicare can begin to push back far more firmly and directly on some of the prices that the agency sees as unjustly high.
"This negotiation process really turns the tables," said Ben Rome, a physician at Brigham and Women's Hospital and researcher at Harvard Medical School.
Is there an alternative medication, and how much does it cost?
The first phase of the process turns on this central question: How much more or less money is the drug under negotiation worth, compared to other available treatments for the same condition?
To draw those comparisons the government is assembling a team of dozens of experts including pharmacists, economists and data scientists. Among its leaders is Daniel Heider, who recently came to the Centers for Medicare & Medicaid Services from a senior position at Bristol Myers Squibb, one of the drugmakers suing to stop negotiations.
First, the team must determine what makes a drug strictly comparable. "In some cases that's going to be very easy," Rome said. "But in many cases, Medicare is going to struggle with how broadly or narrowly to define the alternative therapies."
Take Eliquis, for example — many experts expect the $561-a-month drug that prevents and treats unwanted blood clots to be among the first 10 drugs selected for negotiation. Eliquis is typically prescribed to patients who have a common heart condition called atrial fibrillation or who have developed blood clots deep in their veins.
The treatment has three close competitors that work in similar ways and have sticker prices well over $100 a month. A fourth, much-older treatment option, known as warfarin, runs less than $10 monthly.
The clinical data suggests that Eliquis is often more effective than warfarin at preventing strokes, carries fewer side effects and is more convenient for patients. Some leading medical associations discourage doctors from using warfarin for certain patients. All this raises the question of whether it should be included in Medicare's analysis if the agency targets Eliquis for negotiation.
Rome and others argue that drugs like warfarin can provide a helpful baseline. "When there is an older alternative available, [Medicare] absolutely needs to compare the new drug to it — to get a sense of how much benefit the new product really adds," Rome said.
In 2021, Medicare spent $12 billion total on Eliquis and paid 42 times more, on average, per dose of the drug than it did for warfarin (not including confidential discounts given by drugmakers).
Warfarin's low price could, in theory, provide more cover for Medicare to demand a deeper discount on Eliquis. The risk, pharmaceutical executives warn, is that if the government price goes too low it could dampen the industry's future enthusiasm for developing safer, better versions of older therapies.
Other countries have recipes for price negotiation, but Medicare is crafting its own
In addition to collecting clinical data, Medicare must also consider several other factors that Congress outlined in the Inflation Reduction Act — such as drug production costs and how much the manufacturer benefited from federally funded research.
Anton Avanceña, a health policy researcher at the University of Texas, said the agency should consider less obvious but important societal factors, such as how certain drugs affect people's well-being, like treatments for depression and other psychological problems.
"These are things we know patients value and they need to be considered alongside health outcomes," Avanceña said. Medicare has said it plans to hold patient-focused listening sessions and incorporate concerns shared by the public in its drug price analysis.
The agency then must distill down its mountain of evidence into a single price — its opening offer at the negotiating table.
Most other countries that have done similar negotiating work for years have relied on relatively formulaic, often quantitative processes to help assess a drug's value relative to its therapeutic benefits. To date, Medicare has declined to borrow much from other countries' stricter cookbooks.
"What Medicare has started out with sounds a little bit more like you take a pinch of this, a pinch of that and you throw it in a blender," said Steve Pearson of ICER.
The agency has said it plans to take a more qualitative approach, which could vary by drug. "You have to maintain flexibility to be able to consider the nuances between different drugs," Medicare's Seshamani told Tradeoffs. "We absolutely plan on using data and analyses as part of the process. Where we come to the qualitative is in how you then bring all of those data points together."
While Pearson agreed with Seshamani that flexibility would be crucial for Medicare, especially in its early negotiations, drug manufacturers warned that the approach could be more vulnerable to shifts in politics and create instability across the industry.
"Investing in these drugs is risky," said Lauren Neves, deputy vice president at PhRMA, the sector trade group. "Companies need to be able to predict how much the government is going to pay for these medicines." PhRMA jointly filed a lawsuit in June asserting that Medicare's new power is unconstitutional.
A more replicable negotiation process could benefit private health insurance plans, too, noted Ben Rome, as well as the patients they cover, who also struggle to afford prescriptions.
A lack of trust on both sides threatens to derail negotiations
Industry watchers are uncertain whether either side will engage in a good faith negotiation after Medicare has made its initial price offer. Drugmakers have one chance to formally counter.
Some policy experts worry that the companies will default to countering with as high a price as they can get under the law — regardless of whether the data justifies that high price.
Others worry Medicare will force a race to the bottom on prices, especially since the first negotiations will take place in 2024 — an election year — when it may be politically advantageous to appear tough on the drug industry.
"My concern is that there's just going to be an across the board hatchet taken to prices," said University of Southern California health economist Darius Lakdawalla. "There absolutely are going to be drugs that don't have demonstrated value and that should have deeper price cuts — but that nuance is really important."
If negotiation goes off the rails, whether due to legal threats or a lack of trust, Americans stand to lose more than just the nearly $100 billion in promised savings, Steve Pearson said. They would also lose a long overdue opportunity to reckon in a more public way with the limits of the country's finite health care resources — and the difficult choices the country faces in deciding how to spend those dollars.
"This process may not live up to everyone's expectations," Pearson said, but it offers a rare chance "to make these kinds of tradeoffs more transparent, more explicit and more open to input from all different participants, so that we can get the balance right going forward."
This story comes from the health policy podcast Tradeoffs, whose coverage of health care costs is supported, in part, by Arnold Ventures and West Health. Dan Gorenstein is Tradeoffs' executive editor, and Leslie Walker is a senior reporter/producer for the show, where a version of this story first appeared. | Health Policy |
If you or your child has eczema, youâre probably no stranger to the itchiness, inflammation, and rash-like symptoms it can bring on. You can get eczema anywhere on your body. Exactly where depends partly on how old you are, says Kalyani Marathe, MD, a pediatric dermatologist and director of the Division of Dermatology at Cincinnati Childrenâs Hospital.
Infants tend to get eczema on their:
- Face
- Backs of the arms or legs
- Back
- Chest
- Belly
Older children and teens tend to get symptoms in creases or on places where they sweat, like their:
- Neck
- The insides of elbows
- On the backs of knees
- Sometimes, on hands or feet
Adults are more likely to get eczema on their hands, Marathe says, perhaps because they wash their hands and do the dishes more. Itâs also common for symptoms to show up on the:
- Feet
- Neck
- Inside creases
Adults are less likely to get facial and scalp eczema, Marathe says.
Using Medication on Hard-to-Treat Spots
The amount and type of treatment thatâs right for you or your child also depends on where the eczema is, Marathe says. Some areas are harder to treat than others.
Treatment can be trickier when eczema flares up on parts of your body with thinner skin, like your lips, the areas around your eyes, and your groin.
Steroids, the most common treatment, can thin out your skin if you overuse them, which could lead to bruising and tearing, says Steve Daveluy MD, an associate professor and program director at Wayne State Dermatology in Michigan. Accidentally getting steroids in your eyes can also raise your chances for a temporary type of glaucoma, which could affect your vision, he says.
Still, you can safely use low-strength (weaker) steroids on your face and groin, Daveluy says. You just have to be careful. Work with your dermatologist to make sure youâre using the right strength for the right amount of time, and call them right away if you have side effects.
Your dermatologist might also recommend nonsteroid drugs, like ones called topical calcineurin inhibitors. âTheyâre great because they donât have the same side effects as steroids -- they donât thin the skin, thereâs no risk of glaucoma -- so theyâre super-safe to use on the face and on the genitals,â Daveluy says. The only possible drawbacks, he says, are that they can sting a bit at first, and getting your insurance to cover them might be a hurdle. Nonsteroid medications also include crisaborole (Eucrisa) ointment, ruxolitinib (Opzelura) cream, and abrocitinib (Cibinqo) or upadacitinib (Rinvoq) pills.
Home Remedies for Hard-to-Treat Spots
Want to try home remedies to ease your symptoms? The kinds that might help also depend partly on where the eczema shows up. (Note: Talk to your doctor before you try home remedies on a baby.)
Wet wraps, which can help medicines work better, work well on body parts where the skin is thicker, like the legs, feet, hands, wrists, and forearms, Marathe says. To make a wet wrap:
- Put on your medication.
- Cover your affected body part with plastic wrap for 30 minutes.
- Take off the wrap and moisturize your skin.Â
You can do the same thing with store-bought tubular dressings. The only difference is that you soak them in warm water and wring them out, so theyâre damp when you put them on, Marathe says.
If your small child has eczema, you can do something similar if they wear long-sleeved pajamas at night: Soak the PJs in warm water, then put them in the dryer for a few seconds so theyâre damp but warm. âSometimes kids will sleep in them, so [parents] put dry pajamas on top of that,â Marathe says. âSome kids really like that because it has a bit of a cooling sensation, but for other kids itâs too cold for them, so they donât really like it.â
A couple of whole-body home remedies can also help. âDiluted bleach baths are great for people of all ages, and we recommend them for kids as well,â Marathe says. You can get the benefits from swimming in a chlorinated pool, or by making a bleach bath at home. Use a quarter-cup of plain bleach -- not concentrated -- for half of a tub of water, or half a cup for a full tub of water, she says. Whether you go swimming in a pool or take a bleach bath, itâs important to shower or to rinse off right afterward. If the chlorine dries on your skin, itâs likely to make you itchier, Marathe says.
Other ways to ease the itch in tough-to-treat areas include:
Moisturize. To keep your skin from getting dry, inflamed, and irritated, your daily moisturizer is a must, Daveluy says. Choose one with no fragrance, which can irritate the skin. The most important thing is to find one that you like and that youâll use at least once a day, he says. âMost people need it more than once a day.â
Cool off. Instead of scratching or rubbing a lot, which can damage skin, ease the itch with an ice pack or a bag of frozen peas. âIce actually soothes itch really well, because the same nerves that feel itch feel cold,â he says. You can also put your moisturizing cream in the refrigerator.
Make a soothing mask. âYou can make a facial mask out of rice paper, like the kind they use to make spring rolls or fresh rolls,â Daveluy says. âYou basically cut eye holes and a mouth hole ⦠and then you get it wet [with water]. You can put that on to soothe the skin, because it has some natural moisturizing effects in it from the starch in the rice. Some people even wear it to bed.â You may want to cut the rice paper in two before you wet it, because it can be hard to handle.
Try massage. If your childâs face itches at night, massage some moisturizer into their skin before bedtime, Daveluy says. âTheyâve done some studies that found massage can be soothing for kids with eczema and help them fall asleep. And it can actually help improve the eczema, probably by helping it calm down a little.â
Shop safely. Talk to your dermatologist before you use over-the-counter products for your groin, especially for womenâs genitals. Many of these products have a lot of ingredients that can irritate eczema, Daveluy says. | Disease Research |
Analyzing Black Market Sales of the Second-Line ADHD Medication Atomoxetine
Abstract:
1. Introduction
2. Results
3. Discussion
4. Methods
4.1. Data Source
4.2. Procedures
4.3. Analysis
5. Strengths and Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Roe, S.A.; DeSalve, D.S.; Piper, B.J. Analyzing Black Market Sales of the Second-Line ADHD Medication Atomoxetine. Pharmacoepidemiology 2023, 2, 320-327. https://doi.org/10.3390/pharma2040027
Roe SA, DeSalve DS, Piper BJ. Analyzing Black Market Sales of the Second-Line ADHD Medication Atomoxetine. Pharmacoepidemiology. 2023; 2(4):320-327. https://doi.org/10.3390/pharma2040027Chicago/Turabian Style
Roe, Sophie A., Dayna S. DeSalve, and Brian J. Piper. 2023. "Analyzing Black Market Sales of the Second-Line ADHD Medication Atomoxetine" Pharmacoepidemiology 2, no. 4: 320-327. https://doi.org/10.3390/pharma2040027 | Drug Discoveries |
Your mother's smile as you say your first word or the smell of the candles on your second birthday cake are memories many people would love to hold onto. But almost nobody can recall memories from very early childhood — a phenomenon known as infantile amnesia.
So why do we tend to forget these very early memories? It's not because we don't retain information as young children. Rather, it's likely because at that age our brains don't yet function in a way that bundles information into the complex neural patterns that we know as memories.
Until sometime between the ages 2 and 4, however, children usually lack "episodic memory" — memory regarding the details of a specific event. Such memories are stored in several parts of the brain's surface, or "cortex." For example, memory of sound is processed in the auditory cortexes on the sides of the brain, while visual memory is managed by the visual cortex at the back. A region of the brain called the hippocampus ties all the scattered pieces together.
"If you think of your cortex as a flower bed, there are flowers all across the top of your head," Patricia Bauer, a professor of psychology at Emory University told Live Science. "The hippocampus, tucked very neatly in the middle of your brain, is responsible for pulling those all together and tying them in a bouquet." The memory is the bouquet — the neural pattern of linkages between the parts of the brain where a memory is stored.
Kids may fail to record specific episodes until the 2-to-4 age range because that's when the hippocampus starts tying fragments of information together, Nora Newcombe, a professor of psychology at Temple University in Philadelphia told Live Science.
Newcombe said that, for children younger than that age range, episodic memory may be unnecessarily complex at a time when a child is just learning how the world works.
"I think the primary goal of the first two years is to acquire semantic knowledge and from that point of view, episodic memory might actually be a distraction," Newcombe said.
However, another theory suggests that we actually store these early memories as kids but struggle to recall them as adults. For example, a 2023 study, published in the journal Science Advances, found that "forgotten" childhood memories could be reinstated in adult mice by stimulating neural pathways that are relevant to specific memories with light.
The authors of the study first set out to explore developmental factors that could influence infantile amnesia. They found that mice with characteristics of the neurodevelopmental condition autism spectrum disorder (ASD) were able to recall memories from their pup days.
Autism has many causes, but it has been previously linked to the over-activation of the mother's immune system during pregnancy. So, to make mice with ASD, the researchers stimulated the immune system of female mice during pregnancy.
This immune activation helped prevent the loss of early memories in these offspring by influencing the size and plasticity of specialist memory cells in their brains. When these cells were optically stimulated in adult mice without autism, forgotten memories could be restored.
"These new findings suggest that immune activation during pregnancy results in an altered brain state that alters our innate, yet reversible 'forgetting switches' that determine whether the forgetting of infant memories will occur," study co-author, Tomás Ryan, an associate professor of biochemistry at Trinity College Dublin in Ireland, said in a statement.
While the research is in mice and has yet to be studied in humans, it "holds significant implications for enhancing our comprehension of memory and forgetting across child development, as well as overall cognitive flexibility in the context of autism," Ryan said.
Editor's note: Originally published on Feb. 7, 2011 and updated on Nov. 27, 2023 to include the new study about autism.
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Elfbar: Top vape firm drops sweet flavours over appeal to kids
The UK's leading vape brand Elfbar and its sister brand Lost Mary say they will drop dessert and soft drink flavours, which have been criticised for appealing to children.
Elfbar called for a new licencing regime similar to ones for cigarettes and alcohol.
Elfbar and Lost Mary make up more than half of the UK's disposable vape sales, according to data firm NielsenIQ.
The government consultation on new rules for vapes closes on 6 December.
The dazzling range of flavours have helped to turn disposable vapes into a market worth billions of pounds in a few short years, with Elfbar and Lost Mary taking the lion's share. They're both owned by the Chinese firm Shenzhen iMiracle Technology.
Elfbar has already dropped Bubble Gum, Cotton Candy, and Rainbow Candy flavours, with more expected to follow. Gummy Bear has been renamed Gummy, but even that will soon be dropped.
These will take some time to filter through the supply chain, so it may take a while for the changes to become apparent on the shelves, a spokesman said.
The company also called for tighter restrictions on vape sales, including a licencing regime for retailers, and rules requiring them to display vapes behind the counter.
"The introduction of such a regime would mitigate children's access to vapes and make it easier for the authorities to better regulate the sale of vaping devices. Furthermore, we believe it would help combat the growing illicit vape market and drive increased rates of vape recycling," an Elfbar spokesman said.
As many as one third of the UK's vapes don't meet UK legal requirements, such as limits on nicotine strength and tank capacity.
On Monday the third-largest seller, London-based tobacco company BAT, also called for a licencing regime.
Elfbar argues against the introduction of a new tax on vapes similar to that charged on tobacco. It argued that a new tax would encourage former smokers to switch to illegal vapes, or return to cigarettes.
Hazel Cheeseman, deputy chief executive of the anti-smoking charity Action on Smoking and Health (ASH) said: "It is no surprise that Elf Bar have failed to strike this balance in their recommendations with a series of half measures that will fail to adequately protect children".
She added that an extra tax on vapes "is particularly important to addressing the illicit market, something they say they care about, as it will enable far greater control of products at the border."
In a survey this year, ASH found that 50% of 11 to 17-year-olds who had tried vapes had tried an Elfbar, and 25% had tried Lost Mary.
The second most popular vape seller in the UK, SKE - which makes Crystal Bar - did not return our request for comment on the consultation. In August it defended the use of sweet flavours. "You've got to consider that many Gummy Bears are sold to adults," its communications director Serge Davies told the BBC.
Councils have called for an outright ban on disposable vapes, saying that as well as appealing to children, they cause a litter problem and a fire hazard.
Elfbar and Lost Mary sold over £900m worth of vapes in twelve months, more than 160 million units, according to NielsenIQ. Their numbers only capture around half the market, as they don't include many vape shops, online retailers and convenience stores. So the true figure could be double that.
The consultation on e-cigarette regulations ends on 6 December, and legislation in England, Scotland and Wales is expected “as soon as possible” afterwards. | Health Policy |
High turnover and the hiring of so-called traveling nurses at Jacobi Medical Center is likely costing the city tens of millions of dollars a year in additional costs, according to sources inside the New York State Nurses Union, which represents staff at the hospital.
Their claim is based on internal hospital staffing data that shows from between November 2022 to January 2023, Jacobi employed a total of 146 so-called traveling or “agency” nurses, who aren’t technically permanent members of the hospital staff.
The agency nurses can earn substantially more in annual salary than regular staff nurses, according to Kristle Simms-Murphy, who’s worked as a nurse practitioner at Jacobi for 16 years.
“It’s a slap in the face,” she said. “We train these agency nurses, and they come on and make more than what we earn.”
The data, which NYSNA shared with the Daily News amid contract negotiations with the city’s public Health + Hospitals network, also suggests the city is spending millions more on traveling nurses than it would on staff nurses at its other public hospitals. When applied to the city’s 10 other hospitals, that spending could translate into hundreds of millions of dollars in additional costs.
“A conservative estimate is that the city is spending $18.5 million to $24.2 million per year on traveler/agency nurses just for Jacobi Hospital,” NYSNA spokeswoman Kristi Barnes told The News.
Barnes, who cited fragmented city data as well as data published in a hospital trade publication last year, noted that Health + Hospitals has not yet given NYSNA a full and official accounting of how much it spends on traveling nurses, but said that on average they make two to three times more than nurses who are on staff permanently.
She noted that the union’s estimates are based on all the data currently available to it and said they are “conservative.”
The city’s Health + Hospitals network is now engaged in on-again, off-again contract negotiations with NYSNA. The union presented a full proposal to H+H on March 7, and in a subsequent negotiation, on March 14, the city broke off talks halfway through the day, Barnes said. The next negotiation is set for April 4.
The talks come two months after members of the union went on strike at two private hospitals in the city — Mount Sinai in Manhattan and Montefiore Medical Center in the Bronx. The walk outs ultimately led to contracts, but shook the city’s health care infrastructure and proved that NYSNA was willing to go to the mattresses for its workers.
The main bones of contention with H+H are likely to be pay parity between nurses at public hospitals compared to their private counterparts, as well as nurse staffing levels, which the union contends are too low.
Members of NYSNA are expected to testify to the City Council on Tuesday about the city’s hospitals budget.
An H+H spokesperson did not immediately respond to questions.
“Nurses stand on the frontlines of our health care system, and we all were witness to their heroic actions during the peak of the COVID-19 pandemic. We are incredibly grateful for the hard work, dedication, and sacrifice our highly-skilled nurses make every day and we welcome new opportunities to strengthen our partnership with NYSNA and the nurses who are so essential,” said Kate Smart, a spokeswoman for Mayor Adams.
“The city meets regularly with NYSNA and has multiple calendared meetings on the books in the coming weeks as we work toward finalizing a new contract.”
Staff nurses at public hospitals are leaving at an alarming rate as well, according to Simms-Murphy and Barnes — thanks to the higher pay they can take home from private hospitals in the city.
“Health + Hospitals is paying for that training but losing their investment,” said Simms-Murphy. “We’re not able to retain nurses.”
Citing internal hospital data, she said that last year about 250 nurses resigned from Jacobi, and that of those only about 70 were people who retired. Many of the others who left did so because they could demand a better salary elsewhere, she said.
“They tell me they can’t afford to work here,” Simms-Murphy said. “It means that continuing care is lacking. It means that staff doesn’t know our patients. They don’t know the ins and outs of the hospital.” | Health Policy |
Researchers have claimed a major step forward in the field of organ transplantation after a monkey survived for more than two years with a genetically engineered pig kidney.
The work is the latest to emerge from the US biotech company eGenesis and Harvard Medical School, where scientists see genetically altered pigs as a potential solution to the global shortage of donors for patients with organ failure.
Dr Michael Curtis, the chief executive of eGenesis, said the “extraordinary milestone” provided hope for the approach and “may pave the way for better outcomes for countless individuals in need of lifesaving organ transplants”.
Scientists have spent decades working out whether animal organs could ever work properly and safely in humans without them being rejected by the patient’s immune system, but the challenges have proved immense.
For the latest trial, researchers used a gene-editing tool called Crispr to alter genes in Yucatan miniature pigs before transplanting their kidneys into macaques. The modifications altered genes to prevent organ rejection and remove pig viruses that could potentially be activated in recipients.
Writing in the journal Nature, the scientists describe how 21 monkeys fared after their kidneys were removed and a single genetically modified pig kidney was implanted. Monkeys typically survived only 24 days when the kidneys were edited to disable three genes that trigger immune rejection. But when the scientists added seven human genes that reduce blood clotting, inflammation and other immune reactions, the monkeys survived seven times longer, typically for 176 days.
When combined with treatment to suppress the immune system, the researchers report that one monkey survived for more than two years – 758 days – with the transplanted organ.
Curtis said the long-term survival of at least some of the monkeys had put eGenesis on course to satisfy the US Food and Drug Administration requirement to see at least 12 months’ survival in animals before the team can launch a clinical trial in humans.
“We are well on our way there,” Curtis said. “There simply aren’t enough kidneys to go around. In our opinion it’s the only near-term viable solution.”
The team uses Yucatan miniature pigs as donors because at maturity their kidneys are roughly the same size of those in the adult human. In the monkey trial, the kidneys were transplanted at two to three months when the organs were much smaller.
Prof Tatsuo Kawai, an author on the study at Harvard Medical School, said the scientists expected the modified pig organs to perform better in humans than monkeys because “they are a better match”.
Two humans have so far received pig heart transplants. The first, David Bennett, died two months after surgery in 2022. The second, 58-year-old Lawrence Faucette, who had end-stage heart disease, received a new heart on 20 September this year and is in recovery.
Prof Muhammad Mohiuddin, at the University of Maryland School of Medicine, who was involved in the pioneering heart transplants, said genetically modified pig organs should move into human trials.
“It is time for clinical translation of this vital technology, which has the potential to save lives that would otherwise be lost to the shortage of human organs,” he wrote in an accompanying editorial.
“There is still much to be learned from non-human primate preclinical models. But it will be clinical trials, enrolling people who have been excluded from all other hope of treatment, that will truly further our understanding of this remarkable procedure, and help to realise the potential of this technology.”
Prof Dusko Ilic, at King’s College London, called the work a “groundbreaking achievement”, but said: “There is still a long way to go before this strategy could be used in clinical trials.” | Medical Innovations |
Five-month-old boy battles blood cancer after medics missed crucial diagnosis - blaming symptoms on chest infection
- Basildon University Hospital said symptoms were a reaction to a chest infection
- Two weeks later five-month-old Fred Turpin was rushed to A&E with leukaemia
A five-month-old boy is fighting for his life with blood cancer after doctors missed his diagnosis and said his symptoms were down to a chest infection.
Fred Turp was rushed to Basildon University Hospital, Essex, on December 27 last year after he developed a 'cough and a cold' and was 'struggling to breathe'.
But doctors soon discovered Fred had an abnormal white blood cell count of 50,000, ten times the average, and urgently referred him to children's specialists Great Ormond Street Hospital (GOSH), London, with suspected acute myeloid leukaemia.
It was only the next day when doctors changed their mind on the advice of GOSH and told his mother Amy Nunnery, 24, his cancer symptoms were probably just a 'strange reaction' to his chest infection.
Fred Turp's mother Amy Nunnery, 24, was told by Basildon University Hospital his cancer symptoms were probably just a 'strange reaction' to his chest infection
Two weeks later he was rushed to A&E and is now battling acute myeloid leukaemia at Great Ormond Street Hospital, London
After a feeling of 'huge relief', Fred's mother and his father Brennan Turp, 25, were given a phone number to book a follow-up blood test two weeks after he was discharged on January 1, 2023.
But the family ran into more problems after trying for a week and a half to call the hospital and 'not a single person answered' - while Fred's health got noticeably worse.
Miss Nunnery said he wasn't 'eating or sleeping' and was showing symptoms of a 'viral infection' with a 'mild temperature' and a rash that looked like 'pin-prick bruises' on his leg.
What is acute myeloid leukaemia?
Leukaemia is cancer of the white blood cells.
Acute leukaemia means it progresses quickly and aggressively and usually requires urgent treatment.
It is classified according to the type of white blood cells affected.
The two main types of white blood cells are:
- Monocytes and granulocytes, which come from myeloid stem cells
- Lymphocytes, which come from lymphoid stem cells
The symptoms of AML usually develop over a few weeks and become worse over time.
Symptoms can include:
- Looking pale or 'washed out'
- Feeling tired or weak
- Breathlessness
- Frequent infections
- Unusual and frequent bruising or bleeding, such as bleeding gums or nosebleeds
- Losing weight without trying to
She said her 'motherly instincts' told her something was wrong and the doctors must have missed something, so Fred was rushed back to Basildon University Hospital A&E on January 24.
It was only then that doctors found his white blood cells had more than tripled to 170,000 and realised he had acute myeloid leukaemia, urgently referring him to GOSH.
Miss Nunnery told MailOnline: 'When we arrived at A&E they initially said it was a viral infection and prescribed a throat spray.
'It was only when his blood tests came back they knew it was leukaemia. It really gave us a false sense of hope.
'We felt confident he didn't have leukaemia as the doctors at Basildon surely wouldn't have sent us home with cancer as still a risk.
'We just feel incredibly let down. If we had been able to book the blood test then we may have been able to catch this slightly earlier and given Fred a better start to his treatment.'
He arrived at GOSH the same evening where he was finally diagnosed with cancer after being given an emergency lumbar puncture because he was 'so unwell'.
Miss Nunnery added: 'It's just so unfair. We had a harder time believing doctors because they said he didn't have leukaemia in December.
'To see him so unwell as parents is the worst thing in the world.'
Fred's family set up a GoFundMe page to raise money to help cover the costs of travel, accommodation and any other bills while they stay at GOSH for his course of chemotherapy and recovery - you can donate to it here.
He completed his first round of chemotherapy last week after 11 days in hospital and is expected to stay longer for recovery.
Miss Nunnery wrote on Instagram: 'He has absolutely smashed it and considering the place we were in 11 days ago, I can't believe the difference in him.
'Despite his little body being pumped full of all sorts, he looks better, is more himself and is also happier than ever.
'All of his blood work has been stable and he hasn't required any more oxygen.
I know the next few weeks are going to be challenging but we will just take each day as it comes and continue to pray that this first round has worked and he goes into remission.'
Dr David Walker, Chief Medical Officer at Mid and South Essex NHS Foundation Trust, told MailOnline: 'We offer our full support to the family at this distressing time.
'We followed the correct procedure. Any suspected leukaemia in a child is always referred to a paediatric specialist hospital for review.
'The Trust was advised by the specialist team that this was unlikely to be leukaemia and in line with advice, we asked the family to return for review.
'We are sorry that the family had difficulty contacting our blood test line on the phone.
'We have now put systems in place to ensure families are able to book urgent blood tests.'
Amy Nunnery, 24, pictured with Fred last year before he was diagnosed with acute myeloid leukaemia
Brennan Turp (left), 25, pictured with his partner Miss Nunnery and Fred last Christmas, two days before he was taken to Basildon University Hospital, Essex | Disease Research |
'Little to no difference': Massive mask meta-study undermines remaining COVID mandates
Researchers in "gold standard" collaboration struggle to find benefit from surgical over no masks, or N95 respirators over surgical. Findings buoy warnings by PPE expert that even "perfect rate of capture" by N95s can't stop COVID transmission.
The Facts Inside Our Reporter’s Notebook
Links
- Cochrane Database of Systematic Reviews
- Reuters reported
- recommending masking in areas with "high" transmission levels
- Daily Mail
- denied its "temporary masking protocol"
- public letter against the policy
- brief summary of the study population and findings
- prior review from November 2020
- The Danish study had trouble finding a major journal
- wearing surgical masks had no statistically significant effect
- no effect for surgical masks under age 50
- only 20 infections between control and treatment groups
- Cochrane itself had a spat with Instagram
- does not accept "commercial or conflicted funding
- CDC only recommended two years into the pandemic
- Michael Osterholm tried to discredit one of the studies
- warned colleges nearly two years ago
- lengthy and somewhat technical essay
- fact sheet on N95s
- N95 maker Honeywell sets the minimum at 0.3 microns
- January study in Elsevier journal Environmental Research
- National Institute of Allergy and Infectious Diseases research letter
- Brownian motion
Other Media
An international research collaboration that reviewed several dozen rigorous studies of "physical interventions" against influenza and COVID-19 through last year failed to find even a modest effect on infection or illness rates from masks of all qualities.
Published in the peer-reviewed Cochrane Database of Systematic Reviews, run by the British evidence-based medicine charity Cochrane, the study raises new doubts about ongoing mask mandates and public health recommendations worldwide.
The CDC is still recommending masking in areas with "high" transmission levels — fewer than 4% of U.S. counties — as well as indoor masking to protect high-risk contacts in "medium" counties (27%).
Masks are still required in educational institutions in Democratic strongholds such as New York, New Jersey, Massachusetts, Pennsylvania, Washington and California, according to the Daily Mail. Boston Public Schools denied its "temporary masking protocol" in early January was a "mandate," following a public letter against the policy by student Enrique Abud Evereteze.
South Korea is still requiring masks on public transport and in medical facilities after dropping COVID mandates in most indoor settings, including gyms, Monday, Reuters reported.
The researchers for the Cochrane study are affiliated with a geographically disparate range of institutions in the U.K., Canada, Australia, Italy and Saudi Arabia. Half are affiliated with the Institute for Evidence-Based Healthcare at Australia's Bond University. The corresponding author is the University of Calgary's John Conly.
Unlisted author Carl Heneghan, director of the Centre for Evidence-Based Medicine at the University of Oxford, gave a brief summary of the study population and findings on Twitter.
The team added 11 new randomized controlled trials and "cluster-RCTs," which randomize groups of subjects rather than individuals, to its prior review from November 2020, for a total of 78 studies. The additions included COVID pandemic trials: two from Mexico and one each from England, Norway, Denmark and Bangladesh, the latter two well known internationally.
The Danish study had trouble finding a major journal willing to publish its controversial findings that wearing surgical masks had no statistically significant effect on infection rates, even among those who claimed to wear them "exactly as instructed."
Mainstream media overlooked red flags in the Bangladeshi mask study, which found no effect for surgical masks under age 50 and a difference of only 20 infections between control and treatment groups among 342,000 adults.
Cochrane itself had a spat with Instagram in November 2021 over sharing purported COVID misinformation, even though the group does not accept "commercial or conflicted funding" and its funding partners include the U.S. National Institutes of Health and U.K. National Institute for Health and Care Research.
The updated Cochrane review included 10 cluster RCTs in the "community" and two with healthcare workers totalling about 290,000 participants, comparing the effect of surgical versus no masks.
They measured risk ratios, which below 1 means the intervention improved the outcome and above 1 worsened it. The closer to 1, the less effect it had.
In the community, mask-wearing "probably makes little to no difference" in either influenza-like or COVID-like illness (0.95) or "laboratory-confirmed" infections of either virus (1.01). While the confirmed-infections finding had a much wider confidence interval, the team called both these results "moderate-certainty evidence."
Researchers had more trouble determining the effect of respirators such as N95s — which the CDC only recommended two years into the pandemic — versus surgical masks. Five studies (four healthcare and one household), with a total of 16,000 participants, found a risk ratio of 0.70 for "clinical respiratory illness" but deemed it "very low-certainty evidence," with a wide confidence interval. The RR was 0.82 for influenza-like illness, deemed "low-certainty" with a smaller confidence interval.
They were more confident in results for respirators versus surgical masks on lab-confirmed influenza: RR of 1.10 among the 8,400 participants in those trials, and no difference when the household trial was excluded.
Former White House COVID adviser Michael Osterholm tried to discredit one of the studies in the respiratory-surgical review, led by researchers at Canada's McMaster University, when it was published in December in the Annals of Internal Medicine.
An expert on personal protective equipment and regulatory compliance, who warned colleges nearly two years ago their mask mandates violated disability integration law, told Just the News she has reviewed many of the RCTs the Cochrane team studied.
Megan Mansell said she expects to keep seeing "unreasonable responses when a decent RCT is published." She cited her interactions with critics of the McMaster study, whose "primary complaint is that the individuals weren’t monitored for N95 compliance 24/7, which is both outside of the terms of safe wear for the apparatus and wholly unreasonable."
Mansell wrote a lengthy and somewhat technical essay last week explaining why even "a perfect rate of capture" by N95s still provides "plentiful enough potential exposure" for infection, based on "severity of illness, immune response of a given individual, and progress in the course of illness."
While the Department of Health and Human Services' fact sheet on N95s says they "can" filter particles under 0.3 microns, which can include SARS-CoV-2, Mansell said they aren't rated to capture matter below that threshold.
The sheet also warns N95s can't filter gases and vapors, which include aerosolized COVID, and N95 maker Honeywell sets the minimum at 0.3 microns as well, she said.
"More than 90% percent of exhaled particulates have been shown to fall under 0.3 µm," Mansell's essay says, citing a January study in Elsevier journal Environmental Research. Such small matter can stay aloft for "hours, even days, depending on air exchange rates within the given space," she wrote, citing a National Institute of Allergy and Infectious Diseases research letter to the New England Journal of Medicine.
The claim that N95s actually filter better under that threshold depends on a misunderstanding of Brownian motion, which "only occurs when there is essentially no velocity," such as between breathing in and out, Mansell said. | Epidemics & Outbreaks |
Mia was just 10 years old when she and her family knew she needed mental health support.
But their attempts to access help were met with delays and denials that lead to such a severe deterioration in her condition it nearly cost Mia her life.
"I wasn't deemed sick enough, I was told it was fine and there was nothing wrong with me", Mia explains. "I was telling them, 'this is not normal', and they didn't listen."
But Mia was struggling. Her mental health was worsening and would eventually reach crisis point.
"By the time I was 12 I was self-harming. I felt like some days I couldn't cope with the day but I was still performing well academically and that, when you're a kid in this country, that is how they mark your wellbeing."
It was when Mia turned 15 that help eventually came but only after she suffered a breakdown. She was arrested for false imprisonment and criminal damage after an attack on her teacher, and eventually admitted to a psychiatric unit.
Mia believes earlier intervention would have prevented her deterioration into crisis.
"I would have killed myself. I would have. Mental health care is lifesaving, just as lifesaving as cardiac care, just as lifesaving as diabetes care. You cannot live a healthy, happy life if you are mentally unwell, without support."
Mia's story about her struggle to access the right mental health care at the right time exposes a system in crisis. Children and young adults across the country are being forced to endure long waits for specialist care and demand continues to grow.
NHS England estimates a quarter of all 17 to 19-year-olds now have a probable mental health disorder compared to one in 10 just six years ago.
David Barker and his team at Youth Talk offer free confidential counselling for 13 to 25-year-olds.
But they are overrun with record numbers of children and young people in need of help.
The charity has doubled its capacity - but even this is not enough.
Mr Barker told Sky News: "Before the pandemic there was a crisis of young people struggling with their mental health, the pandemic has compounded all of that, hugely, and as a result of that we're seeing a long tail of the COVID pandemic in terms of mental health and particularly young people."
Community health services are also struggling. A survey of NHS Providers found that children are now waiting an average of 91 weeks for an autism spectrum disorder assessment and between 72 and 207 weeks for an ADHD assessment.
Read more:
Seasonal affective disorder - or SAD - isn't just 'winter blues'
Student mental health problems almost tripled in recent years - study
Jenna Hughes had to wait three years for a diagnosis for her eldest child Amelia.
Her youngest, Imogen, has already been waiting for a year. Caring for Amelia and Imogen without any extra help is having an impact on everyone in the family.
"I've struggled with my mental health," Jenna says. "Because of the level of care my children need. That's hard on my family. The NHS is overrun but it puts so much pressure on families, and strain and stress."
Demand is only expected to increase.
And if there is no urgent action, healthcare providers like the Hertfordshire Community NHS Trust predict that by next year their community waiting lists for children and young people will have more than doubled since the pandemic.
Its chief executive Elliot Howard-Jones said the biggest challenge for his trust in responding to the growing crisis was finding the right staff.
"It's absolutely not where we want to be, we want to have much shorter waiting times for children, it significantly affects their life chances and their educational attainment if we don't see them quickly.
"The biggest challenge in terms of community services is not the vision for what we want to do which is clearly to support people at home and to help children develop as best as they can, it's getting the staff and growing the service quickly enough to be able to respond."
Mia is 21 now. She is in the final year of a wild animal biology degree at the Royal Veterinary College after passing her A levels with top grades.
But the outcome could have been very different and for the many thousands of children still struggling it will be unless the crisis in children's mental health is addressed urgently. | Mental Health Treatments |
More than half of people have no faith they would receive timely treatment on the NHS if they were diagnosed with cancer, a poll has suggested.
The poll, by Savanta for the Liberal Democrats, also showed people are ignoring moles they think are cancerous and even attempting to remove lumps themselves because they think it will take too long to see a GP.
Liberal Democrat leader Sir Ed Davey said the results show the Conservatives have "broken people's faith" in local services.
Politics Live: Prisons 'weeks or days' away from being full
Savanta asked 2,185 people how confident they were that they would be seen within a two-month timeframe if they were referred to a specialist for suspected cancer.
Some 40% said they were confident they would, but 52% were not confident and around 9% did not know.
People were also asked which of the following, if any, they had done because they thought it would take too long to be seen by a GP.
Some 21% said they had called NHS 111, 13% had ignored a lump or suspicious mole completely, 11% had self-diagnosed a lump or mole using the internet and 8% had gone straight to A and E with a lump or mole they thought could be cancerous.
Some 8% paid for private treatment to inspect a lump or mole and 7% had attempted to remove a mole on themselves or someone else.
Sir Ed said: "It's shocking to see how badly people's faith in their local health services has been broken by this Conservative government - to the extent that people are now putting their own health at risk by ignoring possible cancer symptoms.
"Early diagnosis and treatment of cancer is vital for improving someone's survival, but these statistics show that some people have lost confidence that they will get it."
Read More:
RCN calls for 'culture change' to make Labour's NHS overtime plan work
Most people 'can't identify' the lesser-known symptoms of breast cancer
Sir Ed has promised to introduce a guarantee for cancer patients to begin treatment within two months if his party holds the balance of power after the next general election.
He has previously shared how he lost both parents at a young age to cancer.
The Lib Dems are looking to make major gains at the next election and have around 80 "blue-wall" seats in their sights where they came second to the Tories in 2019.
They have been focusing on the NHS as part of plans to woo Conservatives in the rural heartlands.
Prime Minister Rishi Sunak has made slashing waiting lists one of his five key priorities for government.
But the number of people in England waiting to start routine hospital treatment has continued to hit a record high.
An estimated 7.75 million people were waiting to start treatment at the end of August, the latest figures show, up from 7.68 million in July.
The data showed all cancer waiting time targets were missed. | Health Policy |
There is something insidious that's been lurking on my TikTok For You Page for the past few months. Every dozen or so videos, I'm fed one about self-improvement. And I’m not talking about getting more sleep — but biohacking your very existence to preserve your health and improve every aspect of your life.
Much of this biohacking discourse is led by a man named Andrew Huberman who, against my most ardent attempts, didn't respond to a request for an interview. Huberman seems to be, by all accounts, a very smart person. He's a neuroscientist and tenured professor in the Department of Neurobiology at Stanford School of Medicine and has studied brain development, brain function, and neural plasticity. He's been lauded with hella awards as a McKnight Foundation and Pew Foundation Fellow. He is also a podcaster and a partner of the sports and nutrition company Momentous, with which he offers branded dietary supplements. It's unclear just how successfully he's sold Momentous, but a bundle of five bottles will cost you nearly $200.
On his podcast, he discusses his strict daily routine. He starts his day with yoga Nidra, exposure to sunlight for at least five to ten minutes, and a cold shower, then waits two hours before drinking coffee. He doesn't smoke or drink. He follows an intermittent fasting regimen, weight trains for 45 minutes to an hour every other day, takes a long list of daily supplements, microdoses with testosterone, and, at night, drinks a sleep cocktail of magnesium threonate and apigenin. He seems to be a very healthy man. He is also probably pretty rich, which inarguably improves the quality of his life. There is an undeniable monetary benefit from telling people how you live when it is deeply rooted in science and then selling them supplements.
Huberman has a significant group of loyal fans on social media, some of whom have taken on the loving moniker of Huberman Husbands, a title created by Sierra Campbell, a TikTok creator who bonded with her husband over biohacking and Andrew Huberman's podcast.
“I don’t know which is worse, having an Almond Mom or a Huberman Husband,” Campbell said in a tongue-in-cheek video. “But the case for the Huberman Husband being worse is not only do I have to live with him my whole life, but I’m also going to live forever.”
While Huberman Husbands have taken over a large swath of the biohacking-obsessed, he isn't the only person who talks about self-optimization. For the most part, Huberman's most devoted fans seem…pretty normal.
"I see the humor in the trend," Heather Mao, a TikTok creator who runs two gyms and follows Huberman's advice, told Mashable. "I see the ridiculousness in the whole Huberman Husband trend, and I see how people go extreme with it."
But, she says, she likes it because it's a lot of information that's backed by research and you can take what works for you and leave the rest. And many of the biohacking tips Huberman shares are free.
"We have a cold tub in our basement, and that absolutely was not free," Mao said. "But other things like morning sunlight, some of the things that'll help with your sleep, they're low cost and they're not gonna add a ton of extra time onto what I'm currently doing."
That's a trend with a lot of self-optimization online. Eating well, exercising, journaling, and meditation, for instance, are self-optimization or biohacking tips as old as time, and they're all not particularly time-consuming or expensive and are proven to be beneficial for you.
Both Mao and Campbell told Mashable that they don't take any of this too seriously. They try the recommendations out and review them with their friends — and use it as a way to connect.
"It's more fun when it's accessible to everybody and not super individualistic," Campbell told Mashable.
Yet, the solutions Huberman finds are centered around the individual — not community-based.
I want to be clear that there isn't anything wrong with trying to make yourself better, healthier, or happier. But investigating why we feel the need to optimize ourselves to cope with a system of political and social injustices that make life harder for us without actually questioning the injustices of that very system is not only unhelpful, but it's counterproductive. The people who hold the most power have a great deal of interest in us focusing on bettering ourselves instead of bettering our communities.
For instance, starting your day with exposure to sunlight is an excellent way to help regulate dopamine levels. But it isn't possible for many people who work even a 9-to-5 in certain parts of the U.S. — and certainly isn't possible for people who work odd hours. Instead of fighting for a more equitable work system in the U.S. that allows communities of people to wake up at a reasonable hour and go to bed at one, too, we're just biohacking ourselves. The long list of supplements many biohackers live by can be hundreds of dollars a month — and could instead be replaced by nutrients found in food if so many people didn't already live in food deserts. Wealth inequality is as bad today as it was during the Gilded Age — and focusing on ourselves instead of our communities is doing a disservice not only to the most vulnerable but also to us.
In A Companion to Marx's Capital, a book by David Harvey, he points out that time is a social construct molded to the work week, and trends that center the self and self-optimization, particularly to be more productive throughout the day, are maximizing your potential as a worker and consumer under capitalism more than anything else.
Not all biohacking is centered on productivity, thankfully, but it certainly isn't centered on community, either. In a video essay on YouTube, Alice Cappelle points out that much of self-help and self-optimization can — and should — be centered on community instead of the self because that's what got us to this point of feeling so much lack to begin with.
"What if getting angry was self-help? What if talking about social injustices was true self-help?" she posited. "In the past year, I've realized that I've become a better, happier human being by actually decentering my attention from my internal struggles and focusing instead on bigger causes, on other people's social injustices… And that, for me, that's what self-help truly is."
I can't help but agree. | Stress and Wellness |
The care watchdog is investigating possible safeguarding failures at an NHS trust after a documentary uncovered figures showing there were 24 alleged rapes and 18 alleged sexual offences in just three years at one of its mental health hospitals.
The Care Quality Commission (CQC) told Disability News Service (DNS) yesterday that it had suspended the trust’s ratings for wards for people with learning difficulties and autistic people while it carried out checks, following the documentary’s revelations.
The figures were secured by the team behind Locked Away: Our Autism Scandal, a film for Channel 4’s Dispatches, which revealed the poor and inappropriate treatment and abuse experienced by autistic people in mental health units.
None of the alleged rapes at Littlebrook Hospital in Dartford, Kent, led to a prosecution, with allegations of 12 rapes and 15 further sexual offences dropped because of “evidential difficulties” and investigations into 12 other alleged rapes and two sexual offences failing to identify a suspect.
The hospital is run by Kent and Medway NHS and Social Care Partnership Trust.
The only disciplinary action taken related to just one of the alleged sexual offences, and saw an agency nurse removed from duty by the trust and reported to the police and their employer.
A trust spokesperson said it did not recognise the Kent Police figures, that none of the reports resulted in criminal action, and that it was working with Kent Police to understand the data.
It was unable to say how many different patients made complaints of rape and sexual assault in the three-year period, for data protection reasons.
It had failed to comment on the CQC’s actions by noon today (Thursday).
But a CQC spokesperson told DNS yesterday: “Inspectors are reviewing information in relation to care at the hospital, to decide whether we need to take further action to ensure people are safe.
“Additionally, we have today (28 March) visited the secure inpatient services for people with learning disability and autism as part of a focused inspection to ensure people are being given the best care possible.”
CQC had responded after DNS pointed out that the watchdog had raised concerns about safeguarding and the high number of agency staff at Littlebrook in 2016, when it was rated as “requires improvement” for safeguarding.
There was also an unannounced inspection in June 2021 after concerns were passed to CQC “about the safety and quality of the services” – during that inspection, the trust was unable to show inspectors that the agency staff working on the day of the inspection had completed their inductions.
A CQC spokesperson said: “Safe staffing and staff induction form part of our key lines of enquiry and engagement with the trust. We will report on these as soon as we are able.”
CQC said its inspectors were now reviewing information about care at Littlebrook “to decide whether we need to take further action to ensure people are safe”.
It also visited the trust’s secure inpatient services for autistic people and people with learning difficulties as part of a “focused inspection” on Tuesday (28 March) to “ensure people are being given the best care possible”.
Dispatches was told how one young autistic woman had been kept in long-term segregation for her entire stay at Littlebrook, although not in a unit for autistic people or people with learning difficulties.
She was kept locked in a room with a mattress on the floor for 551 days.
Her mother told Dispatches that this was “effectively solitary confinement”.
But she said her daughter had also revealed that she had been taken to areas in the hospital where there were no cameras, where she was sexually assaulted and raped.
Her daughter, who also has an eating disorder, was later moved to a psychiatric hospital 320 miles from her home in a specialist unit in Northumberland, and “deteriorated in almost every possible way” while she was there.
She was then taken to a ward in a general hospital where she was refusing to eat and was being surgically fed through a tube.
The documentary was written, filmed and directed by Richard Butchins, a disabled writer, journalist and presenter, who also made The Truth About Disability Benefits, the award-winning Dispatches exposé of links between the Department for Work and Pensions and the deaths of benefit claimants.
Butchins, who talks in the film about being autistic and his fears about having to ask for mental health treatment himself, told DNS: “While it is gratifying to see action taken in response to my film, it should not take the spotlight of publicity to improve the care for disabled people in vulnerable situations, and it is concerning to see places deemed not to provide safe and caring environments left open to admissions.
“Often the source of any problem is seen as the fault of the patient – rather than one of the toxic dynamic of the care system.”
A Kent Police spokesperson said: “Between 1 January 2020 and 1 January 2023 a total of 24 rapes and 18 other sexual offences allegedly committed at Littlebrook Hospital, Dartford, were reported to Kent Police.
“Each have since concluded with the evidential test for prosecution not being met or no suspect being identified, with one resulting in further action being taken by another body or agency.”
Detective superintendent Mark Weller, of Kent Police’s protecting vulnerable people command, said: “Tackling rape and other sexual offences, including those committed against women and girls, is a top priority for Kent Police.
“Such offences are among the most serious we deal with and we carry out a full and thorough investigation into every incident reported to us based on the information available.
“We also work very closely with the Crown Prosecution Service to bring offenders before the courts when there is sufficient evidence to do so.
“Protecting vulnerable people, including those suffering through mental ill health, is of the utmost importance, and we record and investigate every incident reported to us to a consistently high standard.
“Victims’ welfare is at the heart of everything we do, and we take steps to support and safeguard them in partnership with independent sexual violence advisors and other support agencies, even when it is not possible to pursue a criminal prosecution.”
A CQC spokesperson said: “Sexual offences are a matter for the police in the first instance.
“However, we take reports of sexual offences seriously and review them all, and raise these issues directly with the trust.
“We do this alongside involvement from police and local authority safeguarding teams’ own investigations and monitor any actions and outcomes taken by the trust to ensure people are kept safe.
“We speak regularly with the trust to monitor the care it provides and to ensure they are taking the right steps to address any areas for improvement.
“Each and every person is entitled to safe, high-quality care and we remain fully committed to using all of the powers available to us to make sure action is taken against services that are not providing this.”
Kent and Medway NHS and Social Care Partnership Trust said new safeguarding policies and procedures were introduced following the 2016 CQC report, including more regular and strict supervision of staff, and new incident reporting systems, while it claimed that all staff, including agency staff, undertake mandatory safeguarding training.
It said that very few allegations made against its staff were substantiated and none of the reports made to the police had resulted in prosecutions.
The trust’s chief executive, Helen Greatorex, said: “We take the safety of our service users, their loved ones and our staff extremely seriously and do not tolerate any form of sexual harassment or misconduct.
“As a safety focused organisation we encourage the reporting of all incidents so that appropriate action can be taken.
“This can include involving the police, putting safeguarding arrangements in place to protect those involved and supporting service users and staff.
“Whilst none of the reports made to the police resulted in criminal action, we can confirm that between 2020-2023 we took immediate action against one individual, an agency nurse.
“We removed them from duty and reported them to both the police and their employer.
“The specialist national services for people with autism are not where we all want them to be.
“The purpose of in-patient mental health services is to care for people experiencing severe mental illnesses.
“Autistic people need specialised settings that cater to their needs which are often not met in acute psychiatric settings.
“We have stepped in to help individuals with autism when there is nowhere else for them to go and have been transparent and clear about our concerns in doing so.
“We remain committed to contributing to the work being done across our region and nationally to create much better options for autistic people who need a period of inpatient care.” | Mental Health Treatments |
Aug. 15, 2023 â A new poll out this month showed that 45% of U.S. adults are interested in taking a prescription medication for weight loss. Thatâs good news, according to doctors who are on the front lines of the nationâs obesity epidemic, because it may mean that views about obesity as personal failure or the result of a lack of willpower are finally changing.
The new class of drugs, whose roster includes names like Wegovy and Ozempic, can help people lose up to 15% of their body weight.Â
âCertainly 45% of U.S. adults would meet the criteria for using anti-obesity medication, but I am a bit surprised that the number [in the poll] was that high,â said Judith Korner, MD, PhD, a professor of medicine and director at the Weight Control Center at Columbia University Irving Medical Center in New York City. âHistorically, there really has been quite a bit of reluctance for most people in terms of wanting to take medication for weight loss.â
The new poll results could be a sign that more and more, the conditions of obesity and being overweight are being viewed as diseases. Reducing stigma is a critical step in creating a pathway for people to seek treatment.
The poll from the health policy think tank KFF showed that among people who had ever been told by a doctor that they were overweight or obese, 67% said they would be very or somewhat interested in trying a safe and effective prescription weight loss drug. Being overweight or obese is determined using a combination of a personâs weight and height that results in a score called body mass index, or BMI.
For those among the 45% of people interested in new weight loss treatment options, just making an appointment to meet with a medical professional about weight loss will likely first require overcoming unhelpful internal self-talk.
Last week, Jamy Ard, MD, met with a woman to discuss weight loss options. She told him she believed weight loss was a matter of willpower and that she should be able to tackle the challenge on her own. She ended up declining treatment.
âThatâs internalizing the message that itâs somehow your fault,â said Ard, who co-directs the Weight Management Center at Atrium Health Wake Forest Baptist in Winston-Salem, NC. âEverything that we know is that itâs really not totally within your control, and there are a lot of external factors that impact what your body weight is at any given point in time. Thatâs a real barrier for people to overcome is, âI should be able to figure this out on my own.ââ
âYou Donât Have to Feel Like You Are Stuckâ
Along with finding a helpful inner voice, people who are ready to seek care will need to set aside perhaps painful memories of how theyâve been treated based on their weight, particularly within the same health care settings that are supposed to help them.Â
The negative inner voice is called âinternal stigma,â and it stems from the ideas that are planted there by society and the health care system itself through experiences called âexternal stigma,â Korner explained.
Primary care providers are able to treat obesity and overweight, and thatâs a great place to start, Ard said, but itâs also perfectly fine to seek care from a specialist or through telehealth options.
âThere are people who know how to do it well, who make people feel cared for and heard,â said Ard, who is also a professor of epidemiology and prevention at Wake Forest University School of Medicine. âFind someone who can work with you â even if it is at a distance using remote options or telehealth. You donât have to feel like you are stuck if your experiences locally have not been ideal.â
One way to find a provider experienced in treating obesity is to use the lookup tool on the website for the American Board of Obesity Medicine, of which Korner is chair of the board of directors.
A sign that it may be time to look for someone experienced in treating obesity is that when weight is discussed, people are simply told to adjust their diet and to exercise, Korner said.
âItâs sort of like telling a person with an ulcer, âYou have a lot of stress in your life. Go home and donât get so stressed and your ulcer will get better.â That doesnât work,â she said.
For people who live in rural areas and donât have nearby access to specialists, Ard said more telehealth specialty options are coming online. Earlier this year, Weight Watchers acquired the telehealth platform Sequence as part of its goal to offer prescription weight loss options. The effort now has 37,000 clinical subscribers, along with 4.1 million traditional Weight Watchers subscribers, according to the transcript of the companyâs second-quarter call with investors.
Before your first visit, itâs important to check what your insurance plan will cover.
âThen, I think the other thing that I would suggest people do is really think about what other changes â from a lifestyle standpoint â they want to take,â Ard said. âUse of a medication does not take away the need to still engage in a healthy lifestyle program, and that includes physical activity, healthy diet, and proper sleep.âÂ
He noted that some people may be what is known as a âlifestyle responderâ and not need medication. Others, particularly those who have severe obesity with major health risks, might need multiple treatments.
And finally, itâs also important to be open-minded while keeping in perspective that obesity is a disease. Just like taking a blood pressure medication, weight loss drugs might have to be taken long-term, and maybe even for life.
âItâs like any other medication. If you donât take it, it wonât work,â Ard said. âWeâre not giving a cure for obesity. Weâre giving a treatment for obesity.â | Drug Discoveries |
Protein-like polymers illuminate the path to macular degeneration treatment
In the latest stride toward combating neovascular age-related macular degeneration (nAMD), a team led by Professor Nathan Gianneschi from the International Institute for Nanotechnology at Northwestern University has unveiled a novel approach that could transform patients' lives worldwide.
Their research, published in Science Advances, introduces Thrombospondin-1 mimetic protein-like polymers (TSP1 PLPs) as a potential game-changer in the fight against this leading cause of blindness.
Understanding the challenge: Neovascular age-related macular degeneration (nAMD)
Before delving into the innovation of Gianneschi and his team, it's crucial to comprehend the gravity of nAMD. This condition is the primary cause of blindness in developed nations, leaving millions grappling with deteriorating eyesight and a diminished quality of life. While effective for many, current treatments fall short for a significant portion of patients, highlighting the urgent need for alternative therapies.
"Some years ago, we were made aware of the fact that some patients do not respond to current therapeutics in conversations with Profs. Jeremy Lavine and Greg Schwartz in Ophthalmology at Northwestern, Feinberg School of Medicine. We formed a multidisciplinary team to tackle the problem by mimicking a protein with our polymer technology, hypothesized to play a key role in the necessary pathway," said Gianneschi.
Enter TSP1 proteomimetic polymers: A ray of hope
Gianneschi and his colleagues have invented proteomimetic polymers, synthetic compounds engineered to mimic the behavior of natural proteins, as a potential solution. Their study centers around Thrombospondin-1 (TSP1), a protein known for inhibiting angiogenesis and forming new blood vessels. In nAMD, abnormal angiogenesis contributes to vision loss. By designing TSP1 PLPs, the researchers aimed to harness the power of this natural anti-angiogenic agent in a groundbreaking manner.
Their nano-size scale sets TSP1 PLPs apart, making them incredibly efficient at targeting specific cellular processes, much like an antibody, but manmade. By binding with CD36, a key player in angiogenesis regulation, these proteomimetic polymers interfere with the abnormal blood vessel formation characteristic of nAMD. Their diminutive size enables them to navigate the intricate ocular environment.
"Our polymers, act to engage the key receptor in a multivalent manner. This is similar to how we grab things with our entire hand instead of with one finger. It means we can hold on tight. The PLPs do this, but at cellular receptors at the back of the eye," said Gianneschi.
Moreover, these nano marvels demonstrate remarkable selectivity, stability, and longevity within the eye, ensuring a sustained therapeutic effect. Their nano-scale dimensions enhance their biological interactions and pave the way for minimally invasive delivery methods, promising improved patient comfort and outcomes.
Gianneschi and his team's work highlights the transformative potential of nanotechnology in medicine. By leveraging the principles of nanoscience, researchers are not only unraveling the complexities of biological systems but also engineering solutions that were once relegated to the realm of science fiction. Gianneschi's TSP1 PLPs represent a testament to the remarkable progress made in the field, offering a glimpse into a future where nanoscale innovations redefine the landscape of medical treatments.
More information: Wonmin Choi et al, Thrombospondin-1 proteomimetic polymers exhibit anti-angiogenic activity in a neovascular age-related macular degeneration mouse model, Science Advances (2023). DOI: 10.1126/sciadv.adi8534
Journal information: Science Advances
Provided by Northwestern University | Drug Discoveries |
BALTIMORE -- A Maryland man has died after receiving the world's second genetically-modified pig-heart transplant, the University of Maryland Medical Center said Tuesday.
Lawrence Faucette, 58, was a U.S. Navy veteran from Frederick, Maryland. He was dying from heart failure and ineligible for a traditional heart transplant when UMMC doctors offered the highly experimental surgery.
Faucetete told WJZ that his decision to participate in the experimental surgery was rooted in his love for his family.
"I will fight tooth and nail for every breath I can take so I can stay with them longer, but realistically this is still an early-stage learning process and I have to be ready to accept any outcome we end up with," he said.
"We mourn the loss of Mr. Faucette, a remarkable patient, scientist, Navy veteran, and family man who just wanted a little more time to spend with his loving wife, sons, and family," Bartley Griffith, the Cardiothoracic surgeon who performed the transplant on Faucette said.
Faucette received the transplant on September 20, meaning he survived for nearly six weeks after the procedure.
Earlier this month, UMMC said Faucette wasfrom the surgery, doing physical therapy, and working on regaining his ability to walk.
"Mr. Faucette had made significant progress after his surgery, engaging in physical therapy, spending time with family members, and playing cards with his wife, Ann. In recent days, his heart began to show initial signs of rejection – the most significant challenge with traditional transplants involving human organs as well," UMMC said. "Despite the medical team's greatest efforts, Mr. Faucette ultimately succumbed on October 30."
Related Coverage:
UMMC surgeons performedof a heart from a genetically altered pig into another dying man last year.
before that heart failed, for reasons that aren't completely clear, although later were found inside the organ.
Lessons from that first experiment led to changes before this second try, including better virus testing.
for more features. | Medical Innovations |
Meet the doctor working to change the CDC
As the newly appointed chief medical officer at the nation’s top public health agency, Debra Houry says her job is to make sure the Centers for Disease Control and Prevention (CDC) is ready to respond quickly to the next pandemic.
Houry was named to her position as part of CDC Director Rochelle Walensky’s massive agency reset aimed at correcting mistakes and regaining the public’s trust after the COVID-19 and mpox responses.
“COVID certainly showed where we could improve, but I think the agency itself has just been changing too. And so we needed to look to where we can really be more proactive and flexible and respond to the public,” Houry, who is based in the CDC’s Atlanta headquarters, said in a recent interview from D.C.
The CDC has been under intense criticism from Republicans, Democrats and the general public for a delayed and inconsistent response to the pandemic, and the changes are meant to make the agency more nimble.
A new culture at the CDC
Walensky came on as director in January 2021 after long saying the agency needed to move faster and communicate better. In April, she called for an in-depth review of the agency, and the initial public announcements came in August.
“My goal is a new, public health action-oriented culture at CDC that emphasizes accountability, collaboration, communication and timeliness,” she said in an August statement.
Houry said moving quickly is a challenge for a government organization as large as the CDC with many long-tenured career officials, but it’s a way to try to ensure success.
“With change management, the longer you do it, the more people have angst, concern,” she said.
Houry, who comes from a background in emergency medicine, is part of a new leadership team that reports directly to Walensky, including the former director of Maine CDC Nirav Shah, who is taking over as principal deputy director.
That direct line, Houry said, is important, because it helps the agency deputies make sure all the various divisions are talking with each other. Houry said she wants to knock down the “artificial separations” between divisions so that there’s much more communication and collaboration.
“I think when there’s more layers, it’s easier to … hide is not the right word, it’s like it’s easier to stay in your silo. And when those layers are removed, the silos don’t exist,” Houry said.
Houry has been at CDC since 2014, serving first as director of the National Center for Injury Prevention and then most recently as acting principal deputy director. Prior to her time at CDC, she was a professor in the Department of Emergency Medicine at Emory University School of Medicine.
Prioritizing action and outreach
Houry said she knows CDC has a reputation for being an academic-focused agency. One of the main criticisms it faces is that it is too focused on data analysis at the expense of action.
Experts have said the agency was too slow to recognize the extent of the coronavirus’s spread in the early days of the pandemic and continuously issued confusing and often contradictory guidance about masks and quarantines. The initial tests to detect the virus were also flawed, and rollout of vaccines was seen as sluggish.
CDC has also struggled with how to communicate to a pandemic-weary and politically divided public, some of which is skeptical of health officials more broadly.
Walensky’s plan aims to fix that, and Houry is helping to lead the charge to make CDC much more response-ready.
One of the main changes is to make deployments a normal part of an emergency response.
During the earliest days of the COVID-19 pandemic, the agency needed to reassign people, and it was done on a volunteer basis for just a couple months at a time.
Houry said the short rotations led to too much turnover, so there was a need to not only make deployment longer but also mandatory.
“I think it became clear that we needed to have a bigger bench for responders, but we also had other priorities and other issues that we had to make sure we were covering … across the agency,” Houry said.
“But it became very clear, both under the prior administration and the current administration, that we needed to have longer rotations. The goal is to have the majority of the agency ready to deploy on a response and not for one to two months but for six months at a time minimum,” she added
The initial phase of the reorganization wrapped up at the end of February, and Houry said she understands that Congress wants to see progress.
“People want to make sure that moving boxes is not all that we’re doing. And I agree, because if it’s just a reorganization, you know … that doesn’t solve things. It’s like, how do you change the culture? How do you change processes?” Houry said.
Houry said Walensky is also pushing to get more flexibility from congressional appropriators.
“We have not received significant increases for a lot of our core work,” Houry said.
The CDC’s nearly $11 billion budget is also too specific, she said.
“I think we have 150 budget lines. And so that makes it hard to be nimble. If we had fewer budget lines with more flexibility, we could be more nimble,” Houry said.
Improving staff morale
She said the lines are targeting specific diseases and can’t be shifted. But if instead of a budget line on Lyme disease, a line on malaria, it could be combined into an all-encompassing tropical disease unit.
Another concern is agency morale. CDC employees have been enormous strain since 2020, and Houry said she hopes the reorganization can take some of the pressure off.
“Our staff are awesome. You know, they’ve worked hard for the past few years, even pre COVID but they truly are 24/7,” Houry said.
She thinks morale is improving.
“I think staff are feeling, they certainly are still tired because you know, we have several different responses going on. But they’re able to be part of these changes. And for many of them, it’s exciting. We’re looking at, how do we do our science differently?” Houry said. “People are inspired. So I think it’s an exciting time for the agency and it’s time for us to really innovate.” | Health Policy |
Matt Hancock said he feared that the warning systems designed to spot potential problems with the Covid vaccine were “shonky”, The Telegraph can disclose.
WhatsApp messages sent during the pandemic show the former health secretary told one of the Government’s most senior scientific advisers that he was worried its “pharmacovigilance” – schemes for recording adverse reactions and whether medicines and medical products are working properly – were inadequate.
The exchange between Mr Hancock and Sir Chris Whitty, the Chief Medical Officer, occurred on Jan 9, 2021, a month after the vaccine rollout began.
Mr Hancock asked Sir Chris: “How strong is our pharmocovigilence system to check events post-rollout? I was told we were doing it but I worry that the details will be shonky.”
Sir Chris replied: “Reasonable but needs to get better. There will be cases.”
The UK has a medicines regulator, which runs a system to monitor side-effects of all medicines and medical devices, including Covid vaccines.
Medics and patients who suspect someone has suffered an adverse reaction can make a “yellow card” report to the Medicines and Healthcare products Regulatory Authority (MHRA), with experts then analysing the information to see whether action needs to be taken.
Scientific studies also monitored whether the jabs were effective.
The disclosure of Mr Hancock’s comments comes after the Telegraph revealed that the Oxford-AstraZeneca Covid vaccine has been branded “defective” in a multi-million pound landmark legal action that will suggest claims over its efficacy were “vastly overstated”.
Independent studies, including work by Airfinity, show the AstraZeneca vaccine was incredibly effective in tackling the pandemic, saving more than six million lives globally in the first year of the rollout.
Last year, the World Health Organisation said the vaccine was “safe and effective for all individuals aged 18 and above” and that the adverse effect that has prompted the legal action was “very rare”.
However, the comments about the systems used to monitor vaccinations may fuel concerns that the MHRA, the regulator responsible for monitoring the safety of drugs, may have been slow to respond to evidence of rare side-effects.
Relatives of those who died or were harmed told The Telegraph they were shocked by Mr Hancock’s comment.
Kam Miller, whose husband Neil died after having the AstraZeneca jab, said: “It’s very concerning that he could describe the system in that way at that point in the pandemic – and when so much was at stake.”
A spokesman for Mr Hancock said: “Multiple reports from deeply credible institutions have found that the science, rollout and pharmacovigilance of the UK vaccine rollout was exceptional. To imply otherwise is debunked nonsense.”
The MHRA’s “yellow card” scheme is a similar system to those in place in other countries but, unlike in some of those nations, is voluntary.
Experts have repeatedly raised fears about the potential for under-reporting, and the MHRA has said that in 2018 only an estimated 10 percent of serious side-effects were logged.
The regulator has said this data should not be seen as an indicator of the reporting rate for Covid vaccinations, and that there was high public awareness of the “yellow card” scheme at the time of the rollout.
A spokesman for the regulator said it had “put in place a comprehensive Covid-19 vaccine surveillance strategy”.
The spokesman added: “This proactive and continuous monitoring strategy was based on a wide range of information sources from the UK and internationally, with a dedicated team of scientists continually reviewing information to look for safety issues or any unexpected, rare events.
“When a link between a Covid-19 vaccine and a safety concern was identified, the MHRA took action, working closely with the wider UK health system and communicating to healthcare professionals and the wider public.”
Describing the WhatsApp exchange about pharmacovigilance in his book, Pandemic Diaries, Mr Hancock said there were two parts to the system, “one to register all adverse events to check they’re not worryingly regular and another to check if anyone gets Covid afterwards”.
In the WhatsApp messages, the then health secretary went on to ask Sir Chris who he should talk to about improving the systems.
“Who is best to talk to to improve the operationalisation of it?” he wrote, with Sir Chris rersponding: “JVT and Susan Hopkins leading,” in reference to Prof Sir Jonathan Van Tam, his deputy at the time, and Prof Hopkins, who was then chief medical adviser to Test and Trace.
On a separate occasion, Lord Bethell also raised apparent concerns. In a WhatsApp message sent on Jan 5, 2021, when he was life sciences minister, he wrote: “Pharomocovigilence. This is normally done by the company. Obviously in this case we have a massive interest.
“PHE [Public Health England] have sent a sub which uses Siren and other existing studies to maintain surveillance. I thought it was massively undercooked and have asked for a maximalist alternative. Waiting for that.”
The Siren study was put in place shortly after the pandemic began and regularly tested around 45,000 healthcare workers to evaluate their immune response to Covid, and reinfection after catching the virus or being vaccinated.
Drug manufacturers are obliged to submit data showing side-effects, and in some cases efficacy as well. However, the UK always collects additional data.
An MHRA spokesman said: “The public’s safety is our top priority, and we are committed to getting the right advice to people at the right time. Throughout the pandemic, the MHRA authorised the Covid-19 vaccines following a rigorous review of their safety, quality and efficacy.”
A spokesman for the Department of Health and Social Care said the Government had delivered “a world-leading vaccine rollout which protected millions of lives across the nation”.
The UK Health Security Agency, which replaced PHE, said the “primary responsibility for vaccine safety” lies with the MHRA. A spokesman said: “MHRA led the work on monitoring safety, PHE provided data and used its existing capabilities and clinical networks where necessary to help inform that assessment.”
Sir Chris and Lord Bethell did not respond to requests for comment. | Vaccine Development |
I lost my sight giving birth to my second baby - after pregnancy triggered a rare condition
- Amie Bridson, 36, had never had problems with her sight before falling pregnant for a second time with her son, Oscar, now three
- On Boxing Day in 2019, she woke up and found her vision had gone completely
- Read more: Pregnant Jessie J is 'filming a documentary exploring her career relaunch, miscarriage and love life' - as she prepares to welcome her first child
A mother-of-two has revealed how pregnancy triggered a 'terrifying' rare sight condition - which made her lose her vision.
Amie Bridson, 36, from Chester, had enjoyed a happy Christmas in 2019, when she woke up on Boxing Day to find her vision had completely gone.
She was sent to hospital by her opticians and while her sight returned after three days, undergoing a C-section while giving birth unleashed the condition again.
Amie spent the first weeks of her newborn's life with distorted vision and now, three years later, she still has issues with her sight.
Amie said: 'Doctors told me I'd developed this unexplained medical condition which predominantly impacts my sight. I've had to deal with it ever since.'
Amie Bridson, 36, had never had problems with her sight before falling pregnant with her second child, now three
Amie went to sleep on Christmas Day in 2019 completely fine. But the next morning she woke up blind. The mum-of-two recalls desperately rubbing her eyes and splashing them with water in the hope her vision would return.
She spent the whole of Boxing Day unable to see, before making an emergency appointment with the opticians the next day.
It was there that Amie was informed if she didn't go to hospital within the next few hours she'd be blind forever.
Amie, a business manager, said: 'The whole of Boxing Day I couldn't see a thing. So we went to the opticians the first thing the next morning. They told me the optic nerve in the back of my eye was severely swollen, and the intercranial pressure was causing sight loss.
Pictured after baby Oscar was born in 2020; a C-section triggered distorted vision caused by Idiopathic Intercranial Hypertension (IIH), which lasted several weeks
Amie must now live with Idiopathic Intercranial Hypertension (IIH), which causes pressure headaches and balance issues
Doctors believe the rare condition could have resulted from Amie's increased hormones during pregnancy - but they can't say for sure
What is Idiopathic Intracranial hypertension (IIH)
Idiopathic Intracranial hypertension (IIH) is a rare condition affecting about one or two in every 100,000 people, most of them women, but men and children can also be affected.
The space around the brain is filled with water like fluid known as cerebrospinal fluid (CSF). IIH is a neurological condition in which there is too much CSF present, which causes pressure around the brain.
This causes headaches, swelling of the optic nerves (papillodema) and can result in loss of vision or blindness.
Common symptoms of IIH are:
- Severe headache
- Loss of field of vision and rarely of central vision
- Transient blurred vision
- Double vision
- Photophobia (light sensitivity)
- Pulsatile tinnitus (‘whooshing noise’ in the ears in time with the pulse)
Source: NHS
She adds: 'But they didn't know why - all they knew was I needed to go to hospital immediately, so they rung me an ambulance. And it's their initial diagnosis which ultimately saved my sight.'
Amie underwent multiple scans and a lumber puncture at hospital.
The tests confirmed the high pressure in her skull from excess cerebrospinal fluid.
And she was diagnosed with Idiopathic Intercranial Hypertension (IIH). Doctors believe this could have resulted from Amie's increased hormones during pregnancy - but they can't say for sure.
She regained her vision three days later after surgeons regulated the pressure in her skull. But her C-section in April 2020 triggered the condition again and Amie's vison became bent and distorted for weeks.
Three years later she is still battling the effects of her IIH diagnosis. Son Oscar, now three, was born without any other complications. She said: 'I was told I needed a C-section as the pushing that comes with regular birth would exert too much pressure on my brain.
'But during the operation I felt my vision going again and suddenly everything I was looking at was at a right angle.
'We were unable to leave the ward as it was the height of covid, and the heat was unbearable as they had no air conditioning on to try and stop the spread of covid.
'It was the most horrific experience of my life, and my sight stayed like that for two weeks after.
The doctors were able to release the pressure again and I was eventually discharged, but the effects of IIH are permanent.
'It's like living with a brain tumour without actually having a tumour, and at the moment there's no cure.
When an episode occurs, Amie has to 'wait it out' for her vision to go back to normal
'The constant symptoms are a loud drumming and pulsing in the ear, pressure headaches, fullness in the head, neck ache, and balance issues.
'I've returned to hospital twice since when it's felt like my vision was going again, but was told both times to just wait it out.
'IIH effects less than two percent of the population, and I want to share my story to raise awareness, and support others suffering from this life-changing condition.' | Women’s Health |
A dad-of-two has told of how a dodgy curry gave him food poisoning which led to him becoming paralysed and almost dying.
David Miller, 43, tucked into his normal chicken Bhuna curry order from his favourite Indian takeaway in London, where he used to live.
But he was quickly struck down with severe food poisoning which then developed an auto-immune disorder that caused him to lose the use of his limbs.
David stopped being able to breathe properly and couldn't walk or see clearly.
The web contractor, now based in Welbourn, Lincolnshire, initially suffered from a painful stomach bug thought to be brought on by the food poisoning, which lasted two months.
A tingling sensation in his hands and feet some two months later developed into near-full paralysis where he couldn't roll over in bed, needed a wheelchair to get around and spent two and a half months in hospital.
He was diagnosed with Guillain-Barre syndrome, caused when the immune system is low.
He first fell ill in 2016 but has only now chosen to speak about his miraculous six-year recovery from the illness.
His recovery had been successful enough that he was now preparing to run a marathon - his first after the incident.
David, who before his illness was a keen cyclist, said: "It was pretty scary. Obviously we didn't go back to that restaurant again.
"It was a steep decline - I went from having tingling and pins and needles in my hands and feet to needing a wheelchair to get into hospital a week later.
"Some people die from this syndrome. It works its way from the extremities through your core and can stop your breathing.
"Imagine looking at your body and trying to make it move and it doesn't."
David suspected that it all stemmed from the food poisoning he thinks he caught from the chicken curry.
This lasted a week and led to David suffering from painful gastroenteritis for two months.
The food poisoning and following painful stomach bug meant his immune system was compromised.
He was just back at work in December having moved house from London to Lincoln that same month, when over Christmas the numbness and tingling started.
A week later he was diagnosed with Guillain-Barr syndrome, a rare and serious condition which can lead to life-long problems.
It happens when a weakened immune system starts to attack its own nerve cells, damaging them.
David was admitted to hospital in early January 2017 and put into intensive care after his breathing became compromised.
The father of two daughters, Elise, now seven, and Eva, three, said: "I was worried about my breathing, I could tell I wasn't breathing strongly.
"I was never fully paralysed, I still had some movement in my hips but not enough to even roll over in bed with."
He remembered not even being able to watch football properly, as the nerve damage had affected his eyes and ability to focus them.
His wife Kirsty was at home with their 18-month-old baby girl Elise, who didn't recognise him in the hospital bed.
David said: "I remember my wife putting her on me when I was lying in bed. Elise very clearly didn't want to be there. It was upsetting, certainly odd."
When David was released from hospital two and a half months later he was still using crutches and walking sticks to move around and installed grab rails around their new house.
He said: "It does make you think about food and the knock-on effect. It was a year of my life that it affected. My eating habits haven't really changed, but it does make you think."
He has since made a full recovery with no sign of any lasting side effects and is using his returned physical abilities to run the London marathon this April.
He said: "It makes you think a little bit more about life and focus on the now.
"I've been doing that more recently. I've taken more time off work and being ill was definitely a contributing factor in that.
"With the marathon I'm raising money for the John Muir Trust.
"I've been worrying about the future more recently and the money raised will go to protecting our forests." | Disease Research |
Individuals who use pornography solitarily and keep it secret from their partners tend to experience lower daily relationship satisfaction and intimacy, according to new research published in The Journal of Sex Research. However, when solitary pornography use is known by the partner, it isn’t significantly related the user’s relationship satisfaction, and may even be associated with increased intimacy over time.
For many couples, discussions about pornography use can be a sensitive and sometimes avoided topic. Prior research has shown mixed results regarding the effects of pornography on relationships. Some studies have suggested that it may lead to decreased intimacy or relationship dissatisfaction, while others have found no significant associations.
The researchers were motivated to understand how the secrecy surrounding solitary pornography use might influence relationship quality. While previous studies often focused on general pornography use within couples, this study delved into the nuanced differences between known and unknown pornography use. By examining these distinctions, the researchers aimed to provide a clearer picture of how this behavior affects relationships.
“Pornography use is a frequent sexual activity, including for individuals in a romantic relationship,” explained study author Marie-Pier Vaillancourt-Morel, an associate professor at the Université du Québec à Trois-Rivières and director of the Sexual and Intimate Life Research Lab.
“Even if we now have some good cross-sectional, daily, and longitudinal studies on the effect of pornography use on romantic relationship, results are still quite mixed. We thought about in which context pornography use could affect romantic relationship and the secrecy surrounding partners’ pornography use strikes us as a potential interesting context to explore.”
“Indeed, a person’s solitary pornography use may not always be known by their partner. Is it better to tell your partner about your pornography use or is it something personal that should not be disclosed? This is the main question we wanted to answer.”
The researchers conducted a comprehensive study involving 217 couples. These couples were recruited through online advertisements, email lists, and flyers distributed in Canadian cities between March 2017 and June 2018.
To be eligible for participation, both partners had to be at least 18 years old, cohabiting for a minimum of 12 months, and sexually active at least once a month for the past three months. Couples were disqualified if one partner was pregnant or breastfeeding, unable to understand either French or English, or reported that a severe mental/physical illness was interfering with their sexuality.
The study involved collecting data through daily diaries and longitudinal measures at three time points over a year. These measures allowed researchers to capture both daily fluctuations and long-term trends in relationship satisfaction and intimacy.
A significant proportion of participants reported only unknown solitary pornography use during the study period, indicating that many individuals do not disclose this behavior to their partners. The researchers also observed that many individuals exhibited substantial variation in whether their use was known or unknown by their partner, suggesting that disclosure often changes from day to day.
“In our sample among participants who used pornography during the 35 days of our daily diaries, 54% of women’s pornography use and 64% of men’s and non-binary individuals’ pornography use was unknown by their partner,” Vaillancourt-Morel told PsyPost. “Thus, most pornography use is not disclosed to a romantic partner, which was surprising as past studies showed that most women and men think their partners are honest and tell them about their pornography use.”
The researchers found that on days when individuals reported solitary pornography use unknown to their partner, they experienced lower relationship satisfaction and intimacy. This suggests that keeping this behavior a secret may negatively affect daily relationship quality. However, when individuals reported using pornography alone, and this behavior was known to their partner, it was unrelated to their own relationship satisfaction and intimacy.
When examining long-term associations, unknown solitary pornography use was linked to lower initial relationship satisfaction but did not significantly affect changes in satisfaction and intimacy over one year. Known solitary pornography use, on the other hand, was associated with increased intimacy over the same period.
The researchers also uncovered some partner effects. On days when men reported known solitary pornography use, their partners also reported lower intimacy levels on the same day. Furthermore, higher frequency of known solitary pornography use by individuals was related to a decrease in their partner’s intimacy over one year.
“Even when considering partner knowledge of solitary pornography, findings are still quite complex, but an important take away message is that on a day a person reported solitary pornography use that was unknown by their partner, they reported lower relationship satisfaction and intimacy,” Vaillancourt-Morel told PsyPost. “Thus, not telling their romantic partner about their pornography use was related to lower romantic relationship functioning, which suggest that it would be better to find a way to talk about each partner’s pornography use.”
While this study sheds light on the intricate dynamics of pornography use within relationships, it’s essential to acknowledge its limitations. The research relied on self-report measures, which may be subject to biases and social desirability. Additionally, the sample may not be fully representative of the general population, as it consisted of individuals who volunteered for sex research.
“Our findings talk about associations on the same day and over one year and are not about problematic pornography use (e.g., excessive use),” Vaillancourt-Morel explained. “There are still many unanswered questions to identify in which context pornography use may have negative effects on romantic relationships in order to help couples navigate their pornography use in a healthy way.”
“We also want to know more about how couples discuss their pornography and how the quality of communication about pornography use could help understand in which context pornography use may have negative effects on romantic relationships.”
Nonetheless, this study offers valuable insights for couples and therapists. It emphasizes the importance of open and honest communication between partners about pornography use. Establishing clear boundaries and expectations can help protect against potential negative effects, especially when solitary use is kept a secret.
“Each couple should decide if pornography use is acceptable within their romantic relationship and whether they want to talk about their pornography use,” Vaillancourt-Morel said.
“We are currently recruiting couples for an international study that examines similarities and differences in sexual interests among couples,” she added. “If you are in a romantic relationship of at least 6 months and at least 18 years of age or older, check bit.ly/tipurq. Compensation is offered for participating in the study!”
The study, “Partner Knowledge of Solitary Pornography Use: Daily and Longitudinal Associations with Relationship Quality“, was authored by Marie-Pier Vaillancourt-Morel, Natalie O. Rosen, Beáta Bőthe, and Sophie Bergeron. | Mental Health Treatments |
Tyler Baltierra talks to PEOPLE about how ketamine therapy has improved his mental health
Tyler Baltierra is getting candid about ketamine therapy on the new season of The Teen Mom: The Next Chapter.
Baltierra invites viewers to follow his journey as he undergoes the legal psychedelic treatments — paired with therapy sessions — to unlock repressed memories and help him work through childhood trauma.
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Baltierra opened up to PEOPLE about his decision to go public with his journey, and how he hopes to normalize conversations surrounding mental health.
How did you decide to get ketamine therapy?
TB: I’ve done so much normal CBT — Cognitive Behavioral Therapy — and it worked really well for me for many years. But I felt like I wanted to do something a little bit deeper, something a little more intense. Once I heard about ketamine and its benefits and the studies about how it's really helping a lot of people with PTSD and anxiety and depression, I wanted to do more research about it.
Once I did the research, I was kinda hooked! I wanted to do it because there are certain things that happen to you that are traumatic and you talk about it so much that you almost get used to explaining your trauma and explaining why you feel from it. For me, I did so much talking that I didn’t get to actually dive deep into it with my normal talk therapy. I kinda skimmed by it. That’s the main reason why I really want to take this opportunity to do something a little different.
Is ketamine therapy what you thought it would be like?
TB: It definitely was not how I thought it would be because I’ve used different psychedelics recreationally. It was a lot more sedative for me and it also brought up a lot of stuff I just didn’t think it would. It wasn’t what I expected — it was way more intense. It was definitely a crazy, wild experience. When you go through trauma, your brain goes through a lot of automatic repair and sometimes it does it too well so I was like alright, this really unlocked all of that for me. It helped me get down to the core of my trauma and better understand how it affected me as an adult.
Can you walk me through a typical session?
TB: It all depends on where you go which is why before you just dive into this, you need to do research about the facility and the doctors who will monitor you while you are doing it. You should meet with several, do a quick little intro and find out how the process works, because every therapist does it in a different way. For me, I really wanted something that was very spiritually-driven, so I wanted to go somewhere that really embodied this. We meditate, we center ourselves, we listen to calm music.
For me, it’s all about the environment. I found this place in California I really liked. When you first go in there, you’re like this feels a little weird. There are two different ways you can do it. You can do it through IV or an injection. I did the injection. It starts out really kinda light but it gets heavy very fast. You are blindfolded and they put this weighted blanket on you. You feel really not connected to your body if that makes sense, so you kinda don’t have your other senses working, you’re just literally in your own head. It’s pretty intense. I had music going that was calming to me, breathing is super important. It’s a ride.
What are your thoughts on the negative connotation of ketamine?
TB: My opinion is it should be used in therapeutic situations. I think there’s a lot of untapped potential in psychedelics when it comes to therapy and using it to process trauma, so if it was up to me, psychedelics would be legal. Unfortunately, when I Googled it, ketamine was the only thing that was actually legal in my state. I really believe it to be medicine.
I feel like it needs to be explored more because the effects of it are amazing. People should really do their own research but also talk to their doctor because a lot of doctors are now understanding the benefits that it has. And they will be really open and honest with you, so people should look at it a little deeper and with an open mind.
What were your reactions from your family and friends? Especially knowing it was going to be broadcasted on TV?
TB: To be honest, the first initial reaction was you’re doing horse tranquilizer?! Once I explained it to everybody, they were all like woah! I didn’t realize it could be used like that. They were all pretty shocked about it at first but they all really supported me, especially getting back from doing it and telling them how it went.
Are you open with your children about how this ketamine therapy has helped you?
TB: We haven’t talked about ketamine specifically but just the other day, Novalee asked where [my wife] Cate was and I said she was in a therapy appointment. And she was like oh ok good I’m glad she is in therapy. So our kids know about therapy. We’ve talked about how no emotion is a bad emotion, no emotion is wrong. It’s just a matter of how you process it and therapy allows you to do that. We have been very open with all of the kids, but mainly Novalee because she’s at the age of actually understanding a little bit. We tell her that we’ve used therapy in the past. We are also really big advocates of sometimes mom and dad need help too just like you need help. Just because we’re parents and grownups to you, doesn’t mean that we don't need help too sometimes. So I think it’s important to keep raising our kids with that kind of message so they don’t feel shameful about coming forward when they’re older.
Do you think ketamine treatment has been the most helpful for you?
TB: This definitely was the best thing for me. I wouldn’t have been able to do this ten years ago I don’t think, so I definitely needed the normal therapy that I had before to get me in the right mental space and an awareness level where I could actually handle what was being brought up during the ketamine sessions. My suggestion for people even thinking about it is to really spend some time with a normal therapist or a ketamine specialist who will be able to tell you if you are ready to dive deeper and go into this. A lot of times, they’ll actually have you do four weeks of work beforehand to see if you are ready for it. So, it definitely was the most enlightening and eye opening for me as far as therapy goes.
What do you hope people take away from watching you go through this experience?
TB: The reason why I decided to share my experience with MTV is because this is part of my story. I feel like it’s pretty vital to show people that there are other options out there. So for me, it was like, let’s advocate for mental health, let’s stop the stigma that something is wrong with you or you are irreparable, that you’re a psycho or crazy. The suicide rate for men is so high compared to women, that it’s a problem. I really wanted to put it out there because I need other guys out there to know that you don’t have to tough it out and just grind through it and all the other things people tell you to do. You are a human being with emotions. I just wanted to educate people that there are other options out there. The more information I could put out about it, the better.
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Read the original article on People. | Mental Health Treatments |
- The CDC urged those at highest risk of mpox to get vaccinated.
- The CDC's call for those at risk to get up-to-date on their vaccines comes after a cluster of at least 21 mpox cases was reported in the Chicago area this month.
- Many of the people who caught mpox in the Chicago cluster were fully vaccinated against the virus, raising questions about whether immunity from the shots might wane off over time.
- New studies from the CDC and New England Journal of medicine estimated that two vaccine doses are 66% to 88% effective at preventing mpox.
The Centers for Disease Control and Prevention on Thursday urged gay men and other individuals at high risk from mpox to get fully vaccinated to prevent a summer resurgence of the virus.
The CDC's call for those at risk to get up to date on their vaccines comes after a cluster of at least 21 mpox cases was reported in the Chicago area this month.
Many of the people who caught mpox in the Chicago cluster were fully vaccinated against the virus, raising questions about whether immunity from the shots might wane over time.
The patients in the Chicago cluster all have mild symptoms, according Demetre Daskalakis, deputy head of the White house mpox task force.
Daskalakis said no vaccine is perfect but people who have received two doses have a much lower risk of catching and spreading the disease.
Three new reports released by the CDC and the New England Journal of Medicine Thursday demonstrated that two shots of the Jynneos vaccine provide more protection than a single dose.
The CDC estimated in one study that a single dose of the vaccine is 75% effective at preventing mpox, while two doses were about 86% effective. The New York State Department of Health found similar results in a second study, with one dose 68% effective and two doses about 88% effective.
But the New England Journal of Medicine study found that one dose was just 36% effective at preventing mpox, while two doses were 66% effective.
Though the estimates of mpox vaccine effectiveness vary, Daskalakis said the message is clear: "One dose is good, two doses are better."
"Now is the time to get vaccinated," Daskalakis told reporters on a call Thursday. "If you didn't get your first dose — get it. If you didn't get your second dose – get that," he said.
The effectiveness of the vaccine was largely the same regardless of whether the shots were administered through subcutaneous or intradermal injection or a mix of the two, according to the CDC.
A subcutaneous injection is administered under the skin, while an intradermal shot is injected between the layers of the skin. The intradermal shots use less vaccine substance, which allows public health authorities to stretch the vaccine supply.
Less than a quarter of the 1.7 million people at highest risk from mpox – primarily gay, bisexual and other men who have sex with men – have received two doses of the vaccine.
Daskalakis said most new cases of mpox continue to be reported among men who have sex with men.
Dr. Christopher Braden, the CDC's mpox incident manager, said health authorities are conducting studies to determine whether immunity after vaccination might wane off over time.
Braden said waning immunity is only one possible explanation for why an unexpected number of people in the Chicago cluster caught mpox despite being fully vaccinated against the virus.
He said the CDC is also studying whether the virus may have evolved over time to overcome immunity. It's also possible that the vaccine the patients in the Chicago cluster received were compromised in some way or weren't administered properly, he said.
This is a developing story. Please check back for updates. | Vaccine Development |
HELENA, Mont. — Connie MacDonald works for the State Department at the U.S. consulate in Jeddah, Saudi Arabia. It’s a dream job, and she loved living abroad with her two sons.
But earlier this year, MacDonald said, her 8-year-old son started to become aggressive. At first the family thought it was ADHD. Her son was indeed eventually diagnosed with attention-deficit/hyperactivity disorder — as well as disruptive mood dysregulation disorder, which makes it difficult for her son to control his emotions, particularly anger.
“He was hurting me. He was threatening to kill his brother. One of the last straws was they had four people at school holding him down for almost an hour trying to calm him down,” she said.
The American International School of Jeddah told her that her son couldn’t come back. His behavior was so severe that MacDonald started to look for residential treatment back in the U.S.
She found Intermountain Residential in Montana. Children in the Intermountain program learn to build healthy relationships through intense behavioral therapy over the course of up to 18 months.
Intermountain Residential is one of the only facilities in the U.S. that serves young children with emotional dysregulation, like her son.
MacDonald remembers crying hysterically when she dropped him off in June, but tears gave way to hope as his violent outbursts decreased over the weeks and months afterward.
“Now when we have our weekly calls, it’s very normal. It’s like talking to your child again. It’s wonderful,” she said.
Intermountain is one of about a dozen programs in the nation that provide long-term behavioral health treatment for kids under 10, according to the National Association of Therapeutic Schools and Programs. It’s one of the only options for kids as young as 4.
Intermountain is tucked away in a quiet neighborhood in Helena and has been treating children for over 100 years. The children Intermountain treats have emotional disorders, behavioral issues stemming from mental illness or trauma, and other issues. They struggle with self-harm, severe depression, or violent outbursts that can lead to attacking other people or animals. Most families that come to Intermountain have tried medication, outpatient therapy, or even short-term residential treatment, all without success.
Long-term treatment programs like the one Intermountain offers are often a last resort for families.
It can take months before kids with severe mental and behavioral health issues feel safe enough to open up to Intermountain staff, said Meegan Bryce, who manages the residential program. Some kids have been traumatized or abused while adults were supposed to be caring for them, she said. Living through that can leave them deeply scared of or resistant to adult interaction, even once they’re living in a safe environment. Bryce said that Intermountain staff have to gain a patient’s trust before working to figure out the root cause of the child’s behavior. It takes time before they can make an effective long-term treatment plan based on intensive behavioral therapy and building healthy relationships.
Intermountain parents and staff were shocked when the facility announced suddenly this summer that it would close its doors this fall, blaming staffing shortages.
Some parents threatened to sue. A law firm representing them argued in a September letter to Intermountain’s board that it has a contractual responsibility to finish treating children who remain at its residential facility.
Intermountain then reversed course, saying it would downsize in an attempt to keep the program open. But spokesperson Erin Benedict said it’s no guarantee Intermountain can keep its doors open long-term. Intermountain plans to decrease its capacity from 32 beds to eight.
Megan Stokes, until recently executive director of NATSAP, thinks staffing shortages are not the full story of Intermountain’s troubles.
“We are seeing a lot of long-term facilities moving to what they call the short-term, intensive outpatient. You’re able to get insurance money easier,” she explained. Stokes said she knows of 11 long-term programs for kids 14 and younger that have shifted to offering only shorter stays, of 30 to 90 days.
Short-term programs are cheaper and insurance companies will pay for them more quickly, Stokes said. Over the course of a year, short-term programs can treat more patients than long-term residential facilities. That can make them more lucrative to run.
But those programs aren’t likely to help kids who might have to leave Intermountain. In fact, short-term programs could cause them harm.
“The problem is if that kid bombs out of that shorter-term stay, or they do well and maybe six months down the road they don’t have the tools in their toolkit to continue that, and now you’re labeled as treatment-resistant, when that kid wasn’t treatment-resistant,” Stokes said.
Kids labeled treatment-resistant can then be rejected from other short-term programs.
For now, parents of kids at Intermountain are looking for other treatment options because of the uncertainty over whether Intermountain will remain open. Parents told NPR and KFF Health News they’ve had to sign up for waitlists that can take a year or longer to clear for the few programs that take kids 10 and younger. That’s if they can find facilities that would accept their kids at all.
Stacy Ballard hasn’t been able to find a facility willing to treat her 10-year-old adoptive son with reactive attachment disorder who is currently at Intermountain. The condition can make it hard for kids to form an attachment with their family. Ballard said her son can be extremely violent.
“He was walking around our house at night thinking about killing all of us, and he said it was almost nightly that he was doing that,” Ballard explained.
Facilities that treat children his age generally won’t treat kids with a reactive attachment disorder diagnosis, which often is associated with severe emotional and behavioral problems.
MacDonald also can’t find another facility that could be a backup option for her son. He was supposed to complete 14 more months of treatment at Intermountain.
She said she can’t gamble on keeping her son at Intermountain because of the uncertainty over whether it will remain open.
So, she’s getting ready to leave Jeddah and fly back to the U.S., taking a leave of absence from her job.
“I’ll take him to my family’s place in South Carolina until I can find another place for him,” she said. | Mental Health Treatments |
MDMA Approved for Schizophrenia Clinical Trial by FDA
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The U.S. Food and Drug Administration (FDA) has approved the use of 3,4-methylenedioxymethamphetamine – better known as MDMA – for use in a small clinical trial conducted by the University of California, Los Angeles (UCLA). The tolerability of the MDMA investigational medical product (IMP), produced by Canadian biotech PharmAla, will be assessed in a small number of patients with schizophrenia.
Targeting difficult-to-treat schizophrenia symptoms
Schizophrenia is characterized by hallucinations, delusions and disorganized thinking, as well as asocial symptoms such as losing interest in everyday activities, lack of interest in personal hygiene and avoidance of people. Antipsychotic medications treat many of the symptoms of schizophrenia, although there are no treatments for asociality.
Research suggests that MDMA, known for its pro-social effects, could potentially tackle these asocial symptoms. The drug increases motivation for social engagement and can produce feelings of empathy and closeness among healthy volunteers – this is thought to be in part due to its effects on oxytocin, the “love hormone”.
Interest in psychedelic compounds such as psilocybin, ketamine and MDMA has been increasing, with many drawn by their potential for the treatment of psychiatric disorders such as post-traumatic stress disorder (PTSD), major depressive disorder (MDD) and schizophrenia.
In 2021, a Phase 3 clinical trial from the non-profit Multidisciplinary Association for Psychedelic Studies (MAPS) showed that participants with PTSD who received both MDMA treatment and psychotherapy were twice as likely to recover compared to those who received a placebo and psychotherapy.
This is yet another in a string of trials to evaluate the potential therapeutic efficacy of MDMA after its designation by the FDA as a “breakthrough therapy” in 2017. Now, the green light from the FDA for PharmAla’s clinical-grade MDMA IMP marks its first approval for trial use in the United States and will be evaluated in patients with schizophrenia.
Approved for use in clinical trial
According to clinicaltrials.gov, the trial (NCT05770375) has been approved to assess the tolerability of the IMP, known as LaNeo™ MDMA, in 40 mg capsules. The open-label study is estimated to enroll a small number of participants – 20 patients with schizophrenia – and has an estimated completion date of March 2026.
The investigators plan to administer to the participants 3 separate ascending doses of 40 mg, 80 mg and 120 mg MDMA. The tolerability of these doses will be measured by clinician-rated psychotic symptoms 24 hours after dosing using the PANSS scale (positive and negative syndromic scale for schizophrenia) to measure disorganized speech, delusions and hallucinations on a scale from 1 to 7 based on their severity. This will help to select a maximum well-tolerated dose for use in future studies.
The study’s findings have the potential to lay the groundwork for additional studies of MDMA and other psychedelic compounds for difficult-to-treat symptoms in schizophrenia.
“We found that the FDA scrutinized our materials and processes in a rigorous but fair fashion,” said Nicholas Kadysh, founder and CEO of PharmAla. “As with all of our clients, we worked hard to support UCLA researchers in their application to [the FDA]. We hope that they are pleased with the results, and look forward to providing them with their IMP as soon as [the Drug Enforcement Administration (DEA)] and Health Canada issue the relevant permits.”
“While we’ve had great success with many regulators around the world, it’s still a major milestone to receive a stamp of approval from [the FDA] for our investigational drugs,” said Dr. Harpreet Kaur, vice president of research at PharmAla. “As with any IMP supplier, there are always questions about chemistry, manufacturing and control – even for well-known molecules. We believe that this announcement should confirm that our IMP conforms to the high levels of quality and documentation that one of the pre-eminent regulators in the world requires.”
This article is a rework of a press release issued by PharmAla Biotech. Material has been edited for length and content. | Drug Discoveries |
The common cold can leave you with a stuffy nose, sore throat and phlegmy cough, but along with these main symptoms, you may also struggle to hear properly.
So why does your sense of hearing falter when you have a cold or another respiratory infection?
The answer lies in the Eustachian tube, a narrow canal that connects your ear with the back of your nose, Dr. John Fornadley, a Pennsylvania-based ear, nose and throat specialist and a clinical associate professor of surgery at Penn State, told Live Science by email.
The hollow Eustachian tube is typically closed, but it opens when we swallow or yawn, according to Stanford Medicine. It helps to drain excess mucus made by the lining of the middle ear into the nose and throat, and it's also critical to our sense of hearing.
Related: How long do cold symptoms last?
"Our eardrums vibrate in response to sound, and they transmit this vibration to the inner ear," Fornadley said. "To do this effectively, the eardrum, like the musical instrument drum, requires air behind the drum to have the same air pressure as air on the outside of the eardrum for normal vibration." The Eustachian tube connects the space behind the eardrum, known as the middle ear, to the nose in order to equalize the air pressure in the middle ear with that of the outside world, he explained.
When there is a significant difference in air pressure, the Eustachian tube opens rapidly — this is the sensation often referred to as "popping" the ears. And if the tube doesn't pop open on its own, you can force it to by pinching your nose and then blowing air into the ear.
"We are more aware of the ears popping when traveling by air, or going up a mountain quickly in a vehicle," Fornadley said. "The process of opening the Eustachian tube remains important, just more subtle, when living at sea level."
When cold or other respiratory viruses infect you, they trigger an immune response. To combat the infection, the nose and sinuses rapidly increase their production of mucus and swell as the tissues become inflamed, creating the sensation of a stuffy nose. This extra fluid can then spread to the ear through the Eustachian tube and blunt the vibration of the eardrum as a result.
"For this reason, nasal congestion will temporarily decrease hearing," Fornadley said.
In addition, the resulting buildup of mucus in the Eustachian tube can sometimes cause a middle-ear infection, worsening the hearing problems. This common complication of colds is particularly prevalent in babies and toddlers. An estimated 5 in 6 children will get at least one ear infection by their third birthday, according to the National Institute of Deafness and Other Communication Disorders. Compared with those of adults, children's Eustachian tubes are smaller and more horizontal, rather than set on a steep angle, making it more difficult for them to drain fluids out of the ear.
Middle-ear infections can temporarily decrease the perceived volume of sounds by up to 40 decibels, producing a similar sensation to wearing a pair of ear plugs, according to a 2022 review published in the journal Cureus. Recurring or untreated infections of the middle ear can eventually cause a perforation of the eardrum and, in the most severe cases, permanent hearing loss, the review notes.
But thankfully, the mild hearing loss that people experience during a cold usually goes away on its own once the illness resolves.
This article is for informational purposes only and is not meant to offer medical advice.
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Anna Gora is a health writer at Live Science, having previously worked across Coach, Fit&Well, T3, TechRadar and Tom's Guide. She is a certified personal trainer, nutritionist and health coach with nearly 10 years of professional experience. Anna holds a Bachelor's degree in Nutrition from the Warsaw University of Life Sciences, a Master’s degree in Nutrition, Physical Activity & Public Health from the University of Bristol, as well as various health coaching certificates. She is passionate about empowering people to live a healthy lifestyle and promoting the benefits of a plant-based diet. | Disease Research |
"Girl dinners," a TikTok trend sweeping social media this summer, might sound like a fun night out with friends — but it’s actually a potentially dangerous food practice that’s sparking concern among doctors and nutritionists.
Using the hashtag #GirlDinners, some Gen Z women are sharing photos of what they’re having for dinner, with many of the "meals" coming up drastically short in terms of calorie count or nutritional benefit.
Some of the more substantial "girl dinners" follow a charcuterie theme, including a spread of nuts, cheeses, olives, sliced meats and breads or crackers.
Others, however, are far more limited.
Some "girl dinners" recently posted to TikTok include plain hamburger buns, M&Ms poured into custard, a jar of peanut butter and deep-fried pickles wrapped in cheese. One poster even shared a can of Coke Zero as her "dinner."
While some of these options may have been shared in a joking manner, some experts are concerned the trend could influence some girls and women to adopt unhealthy or disordered eating habits.
"While it may have started out as quirky or strange food combinations, recent examples of the ‘girl dinner’ trend online have been showing minimally nutritious or nonexistent ‘meals,’" said Tanya Freirich, a registered dietitian nutritionist in Charlotte, North Carolina, in an interview with Fox News Digital.
"Unfortunately, it seems like the wonderful and health-promoting focus on body positivity in our media and society has been replaced with an unhealthy obsession with ‘thinner is better’ in recent years," added Freirich, who practices as The Lupus Dietitian.
Experts are concerned that promoting limited-calorie or nutrient-deficient dinner choices could lead some women down a path to disordered eating — particularly if they already have an unhealthy relationship with food.
"Anorexia, an eating disorder that involves extreme restriction of food, is a mental health disorder associated with five-to-six times the risk of death in comparison to the general population," Freirich warned.
"It is not a laughing matter or a joke that should be spread on social media."
"There's nothing wrong with making use of a seemingly random collection of ingredients in the pantry — but a diet soda or cup of ice does not make a meal."
"Glorifying and spotlighting disordered eating habits as acceptable may only contribute to the normalization of those habits," she added.
Lindsay Allen, registered dietitian nutritionist and owner at Back in Balance Nutrition, LLC, in Tampa Bay, Florida, said these trends are "painful to see."
She told Fox News Digital, "Young women are especially prone to the negative effects because they are still developing and they need extra nutrition."
"Vitamins, minerals, fatty acids and protein, among other things, are the key building blocks we need for robust health and achieving the best version of ourselves," she added.
"It's time to normalize eating real food."
So what should a healthy "girl dinner" or "woman dinner" look like?
Freirich recommends a balanced meal with 50% of the plate filled with vegetables, 25% consisting of a source of protein (beans, lentils, chicken, fish, eggs, etc.) and 25% carbohydrates (rice, potatoes, pasta, etc.).
"If you've had a history of dieting, it can be hard to check in with your body's hunger cues rather than diet ‘rules,’ but ideally, you should eat when you're hungry and stop when you're satiated," she said.
"There's nothing wrong with making use of a seemingly random collection of ingredients in the pantry, but a diet soda or cup of ice does not make a meal," Freirich added.
"Nourishing yourself with food is a form of self-care and love." | Nutrition Research |
Detransitoner Chloe Cole made a desperate plea for Congress to act against gender treatments and surgeries, testifying on her 19th birthday Thursday that, "My childhood was ruined."
"What message do I want to bring to American teenagers and their families? I didn't need to be lied to. I needed compassion. I needed to be loved. I need to be getting therapy to help me work through my issues. Not affirmed to my delusion that by transforming into a boy, it would solve all my problems," Cole said in her opening statement before a House Judiciary subcommittee hearing slated to discuss the "dangers and due process violations of 'gender-affirming care'."
"We need to stop telling 12-year-olds that they were born wrong, that they are right to reject their own bodies and feel uncomfortable with their own skin. We need to stop telling children that puberty is an option. That they can choose what kind of puberty they will go through just they can choose what clothes to wear or music to listen to," she continued. "Puberty is a rite of passage to adulthood, not a disease to be mitigated. Today, I should be at home with my family, celebrating my 19th birthday, and instead I'm making a desperate plea to my representatives learn the lessons from other medical scandals like the opioid crisis to recognize that doctors are human too. And sometimes they are wrong."
"My childhood was ruined, along with thousands of detransitioners that I know through our networks. This needs to stop. You alone can stop it. Enough children have already been victimized by this barbaric pseudoscience. Please let me be your final warning," she said.
Cole, who had a double mastectomy at age 15, described to lawmakers how discomfort with the changes of puberty, being intimidated by new male attention and looking up to her brothers ultimately resulted in her coming out as transgender in a letter placed on the dining room table at just age 12. Her parents responded by seeking help from medical professionals.
"This proved to be a mistake. It immediately sent our entire family down a path of ideologically motivated and coercion," Cole said. "The gender specialist I was taken to, taken to see told my parents that I needed to be put on puberty blocking drugs right away. They asked my parents a simple question ‘Would you rather have a dead daughter or a living transgender son?’ The choice was enough for my parents to let their guard down. And in retrospect, I can't blame them. This is the moment that we all became victims of so-called gender-affirming care."
Cole said that she was diagnosed with gender dysphoria and fast-tracked onto puberty blockers and testosterone, of which she received her first injection of at age 13.
"It's caused permanent changes to my body. My voice will forever be deeper, my jawline sharper, my nose longer," she said. "My bone structure permanently masculinized. My Adam's apple more prominent. My fertility unknown. I look in the mirror sometimes, and I feel like a monster."
Cole described how "menopausal hot flashes made focusing on school impossible" and said she still gets "joint pains and weird pops in my back, but there were far worse when I was on the blockers." Of the double mastectomy, she described how she still struggles to this day with sexual dysfunction and has massive scars across her chest.
She said the skin grafts doctors took of her nipples "are weeping fluid today, and they were grafted into a more masculine positioning."
"I was cancer free, of course. I was perfectly healthy. There was nothing wrong with my still developing body or my breasts. Other than that, as an insecure teenage girl, I felt awkward about. After my breasts were taken away from me, the tissue was incinerated before I was able to legally drive," Cole said. "I had a huge part of my future womanhood taken from me. I will never be able to breastfeed. I struggle to look at myself in the mirror at times."
"When my specialist first told my parents that they could have a dead daughter or a live transgender son, I wasn't suicidal. I was a happy child who struggled because she was different," Cole testified. "However, at 16, after my surgery, I did become suicidal. I'm doing better now. But my parents almost got the dead daughter promised to them by my doctors. My doctors had almost created the very nightmare they said they were trying to avoid."
In an emotional moment later in the hearing, Rep. Chip Roy, R-Texas, gave Cole an opportunity to respond to the testimony of the other witnesses. Cole chose to address that of Myriam Reynolds, who testified about what she perceived as benefits of "gender-affirming care" for her now 18-year-old transgender son.
"I understood that Mrs. Reynolds is scared for her child. And I just want to set the record straight that I don’t hate her, I don’t think anybody in this room hates her. In fact, I see my own mother and my own father in her," Cole said, beginning to choke up. "And that clearly, she really loves her child, and she’s been doing the best with what she’s been given. And unfortunately, it’s not much. And for that, I’m sorry. I mean I think every parent deserves the utmost grace and guidance with how to help their child."
"That being said, I don’t wish for a child to have a same result as I did. I don’t wish for anybody to regret transition and de-transition because it’s incredibly difficult. It comes with its own difficulties, and it’s not easy. And I hope that her child gets to have a happy and fulfilling adulthood." | Mental Health Treatments |
An official with the Biden Administration tells us it’s their belief that marijuana will be moved to schedule III prior to the 2024 election.
In a letter sent recently to the Drug Enforcement Agency (DEA), the Department of Health officially requested that marijuana to be reclassified as a Schedule III drug under the Controlled Substances Act, allowing it to be used for medical purposes (other schedule III drugs include codeine and testosterone). The letter comes in response to an executive order issued last year by President Biden asking Health and Human Services Secretary Xavier Becerra and Attorney General Merrick Garland to initiate a review process to consider marijuana rescheduling.
Currently marijuana is classified as a Schedule I drug, putting it alongside hard drugs such as heroin and LSD and indicating that it has “no known medical benefit”. This makes it illegal for all purposes under all circumstances.
The Biden Administration official, who asked to remain anonymous but who’s credentials we were able to independently verify, says that it’s the Administration’s belief that the entire process of rescheduling marijuana will be completed prior to the November, 2024 election.
“Yes, that’s what we are anticipating and hoping for.” The official says this move will “show the world that we’re serious about marijuana reform.”
According to two separate polls released earlier this year, 64% of adults in the United States support marijuana being legalized for recreational use. | Drug Discoveries |
The Tacoma-Pierce County Health Department in Washington has obtained multiple court orders requiring a Tacoma resident to get treatment for her active tuberculosis, officials told NBC News on Friday.
The woman has thus far refused to isolate or take the necessary medications, according to Nigel Turner, the department's division director of Communicable Disease Control.
"The court order is in place ordering isolation and quarantine," Turner said. "We’re working with her on assessing the compliance with that."
The News Tribune, a local news outlet, reported on Friday that over the past year, the health department has repeatedly sought and been granted court orders compelling the woman to isolate and get treated for tuberculosis. According to the Tribune, legal petitions from the department said the patient had not abided by previous orders, and had at one point started but discontinued medication. The health department confirmed the Tribune's reporting to NBC News.
A judge issued the latest order on Jan. 20, granting the department the authority to test, treat and detain the woman, starting next week.
The department announced Monday that it was monitoring the case and said at the time that it was working with the woman’s family to persuade her to accept treatment.
The department declined to offer information about why the woman has refused treatment.
Under Washington state law, public health officials have the legal authority to seek a court order when a person’s refusal to take medication poses a threat to the public.
Tuberculosis can rise to that level because it can be deadly if left untreated, and infectious people risk spreading the disease further. The bacteria that causes tuberculosis can spread through the air when a person with an active case coughs, sneezes or speaks.
The treatment process can take three to nine months, according to the Centers for Disease Control and Prevention. People who discontinue medications before treatment is complete can also develop antibiotic resistance.
When it comes to taking legal action, Turner said, "it’s very reluctantly that we do that because obviously we’re balancing people’s civil liberties against protecting the health of the public."
In the past 20 years, the department said, it has had to enlist the help of law enforcement to detain three people who refused tuberculosis treatment until they were no longer infectious. Turner said the department typically exhausts other measures before seeking a court order, such as enlisting family members, medical providers or infectious disease experts to reason with a patient.
Treatment for tuberculosis generally consists of antibiotics taken daily or weekly for a period of months. People with infectious tuberculosis must be isolated during that time, until they’re no longer capable of spreading the disease to others. The vast majority of cases can be cured with medication, according to the World Health Organization.
Turner said the length of treatment or possibility of side effects from the antibiotics may deter some people from accepting medication. People who don’t have reliable access to food or housing may also be reluctant to follow isolation guidelines, he said, so the health department may provide them with those resources.
In regards to the current patient, he said, the department is "really looking for every opportunity for them to comply with and work with us to resolve this as soon as we can."
The Tribune reported that a January legal filing from the health department said the woman had previously gone to the emergency room following a car crash but had not disclosed her tuberculosis diagnosis to staff. Chest X-rays taken during the visit showed the disease's progression, the petition said, according to the Tribune. The Tacoma health department confirmed the report to NBC News.
Symptoms of active tuberculosis include a bad cough that lasts three weeks or longer, chest pain or coughing up blood or phlegm, according to the CDC.
Nationally, the number of tuberculosis cases has declined steadily since 1992, according to the CDC. The U.S. recorded around 7,900 active cases in 2021. Tuberculosis vaccines are not widely administered in the U.S. because the disease is not prevalent and the shots are not highly effective in adults.
But some people live with latent tuberculosis infections, meaning the bacteria is inactive and the host isn’t contagious and doesn’t have symptoms. The CDC estimates this affects up to 13 million people in the U.S. Around 5% to 10% of those latent cases, if left untreated, will develop into active disease at some point in people's lives. | Epidemics & Outbreaks |
- Blockbuster weight loss drugs are priced significantly higher in the U.S. than in other large, high-income countries, according to a new analysis.
- The analysis from KFF, a health policy organization, comes as many U.S. health insurers balk at the extreme cost of weight loss drugs and drop the medications from their plans.
- Novo Nordisk's Ozempic and Wegovy are listed for roughly $1,000 in the U.S., but just hundreds of dollars in Germany, for example.
The report from KFF, a health policy organization, comes as many U.S. health insurers balk at the extreme cost of weight loss drugs and drop the medications from their plans.
At roughly $1,000 per month on average — for medications that are typically taken over a long period of time — the drugs are straining insurers' budgets. But many of the 100 million American adults who are obese can't afford to pay out of pocket for the treatments, called GLP-1 agonists.
KFF compared list prices – the price a drugmaker sets before insurance or any discounts – available through website searches.
It found a 30-day supply of Novo Nordisk's diabetes drug Ozempic, which is used off-label for weight loss, has a list price of $936 in the U.S. That's five times as expensive as the $168 list price in Japan.
The list prices are even lower in other countries: Ozempic is priced at $103 in Germany, $96 in Sweden and $83 in France.
Novo Nordisk's Wegovy, which has the same active ingredient as Ozempic and is approved for weight loss, has a list price of more than $1,300 in the U.S. Meanwhile, Wegovy's list price is just $328 in Germany.
Eli Lilly's diabetes drug Mounjaro, which is also used off-label for weight loss, has a list price of $1,023 in the U.S. but just $319 in Japan and $444 in the Netherlands.
Representatives for Novo Nordisk and Eli Lilly weren't immediately available to comment on the report Thursday.
These list prices and the patchy insurance coverage of weight loss drugs in the U.S. undoubtedly impact accessibility. But a KFF survey released earlier this month suggests that they also affect patients' overall interest in the medications.
The survey found that nearly half of U.S. adults are generally interested in taking a prescription weight loss drug, but that interest drops to 16% if the medication isn't covered by insurance.
Around 80% of adults in the survey said insurance companies should cover the cost of weight loss drugs for adults who are overweight or obese, while half said insurers should cover the cost for anyone who wants to use them to lose weight.
New trial data released by Novo Nordisk last week could potentially put more pressure on U.S. insurers to cover weight loss drugs.
The Danish company's trial found that Wegovy slashed the risk of serious heart problems and heart-related death by 20% in overweight or obese patients with established cardiovascular disease.
The results suggest that Wegovy and, likely, other obesity drugs have significant health benefits beyond shedding unwanted pounds. But organizations representing insurers have told CNBC that more data is needed before they could qualify for broader coverage. | Drug Discoveries |
Most microbes perish when exposed to common cleaning products, but the residue from those disinfectants may be driving deadly bacteria to become resistant to antibiotics, a lab study suggests.
Biocides, which include disinfectants and antiseptics, are chemicals that are widely used in households, hospitals and manufacturing to kill disease-causing microorganisms such as bacteria. However, there are rising concerns that their widespread use may be spurring antibiotic resistance by pressuring bacteria to evolve in ways that make them less vulnerable to the drugs.
In the new study, published Monday (Oct. 9) in the journal Nature Microbiology, scientists focused on one species of multidrug-resistant bacteria called Acinetobacter baumannii, which sickens thousands of patients in U.S. hospitals each year. The researchers revealed that low levels of several common biocides — for example, those that would be left over on surfaces and that are hard to remove from the environment — can push the germ to gain tolerance to antibiotics. Specifically, A. baumannii grows resistant to antibiotics that target the inside of bacterial cells, preventing them from making new DNA or proteins.
"Our finding suggests that biocides at low concentration can compromise antibiotic potency and lead to the development of antibiotic resistance," Liping Li, lead study author and research fellow at Macquarie University in Sydney, told Live Science in an email. "We propose that further investigation and survey about the side effects of residual biocides in real world scenarios are necessary to warrant that we are using these precious chemicals wisely and safely," he added.
A. baumannii normally live in soil and water. It is an opportunistic pathogen, meaning that it doesn't usually harm healthy people but may seize the opportunity to attack those with weakened immune systems or to enter hospitalized patients' bodies via open wounds. A. baumannii can cause serious diseases — including pneumonia, bloodstream infections, and the nervous-system infection meningitis — and various strains have developed resistance to multiple antibiotics.
The authors of the new study introduced mutations into the genome of A. baumannii to determine which genes would help the bacteria survive when treated with 10 biocides. By exposing the mutant bacteria to different cleaners, they identified several of these survival genes; some coded for proteins in the wall that surrounds bacterial cells, and others coded for proteins inside the cells, including proteins involved in metabolism or respiration, the process by which cells make fuel.
According to the team's experiments, one key way these biocides kill bacteria is by disrupting the electrical activity across their cell membranes; this hampers the cells' ability to make fuel. But if the concentration of biocide isn't high enough, this won't kill the bacteria — instead, it makes it stronger, they found.
Indeed, in seven of the 10 biocides tested, low levels of the products were enough to disrupt this membrane activity but not kill the bacteria. What's more, this low-level exposure made it so antibiotics that targeted the insides of cells couldn't infiltrate the bacteria as easily. Two particularly bad offenders appeared to be the biocides, chlorhexidine and benzalkonium.
Antibiotics that target the cell envelope were not affected and could still kill the microbe. The authors hypothesized that this is because the inside-targeting antibiotics were less likely to be imported, likely because this process requires energy from the cell, which would make them less potent against A. baumannii.
The study was conducted only in lab dishes, not in a real-world setting like a hospital. However, the authors noted that this suggests it may be time to talk about "biocide stewardship." So-called antibiotic stewardship is a critical effort to stop the misuse of antibiotics and thus limit the pressure that normally pushes bacteria toward resistance. The authors think biocide stewardship may also be necessary.
The "principal concern" of biocide stewardship would be to figure out how to reduce the amount of residual biocide in the environment after cleaning, to prevent bacteria from being exposed to too-low concentrations of the cleaners and thus stop them from gaining resistance, the authors wrote.
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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 |
It’s just over two years since the first Pfizer Covid jabs reached Britons’ arms, with the goal of quickly preventing deaths and halting further strain on the NHS. Now, the US pharmaceutical giant hopes once again to play a part in protecting the health service, at a time when staff are striking, waiting lists in England stand at more than 7 million, and the organisation is at breaking point.
Pfizer’s president in the UK, Susan Rienow, is lobbying to switch the focus towards early-stage illness to prevent people being hospitalised. “We have a once-in-a-generation opportunity coming out of the pandemic to try to break the cycle of ill health that holds back the economy, the NHS and the health of the population. The key to that is prevention,” she says. “We don’t have enough hospital beds for all the patients who need them.”
Rienow hopes Pfizer can help move the system from one “prioritised on end-stage disease and significant ill health to a place where we’re actually preventing people from getting sick”.
To this end, she is attempting to tackle “the silent pandemic”: antimicrobial resistance . For years, scientists have bemoaned public apathy about bacteria and fungi that develop an ability to defeat drugs designed to kill them. The World Health Organization estimated that 1.27 million people died due to this resistance in 2019, and this figure is expected to hit 10 million by 2050. “If you’re in a situation where you don’t have working antibiotics, you almost go back to sort of a medieval dark ages,” says Rienow.
The American executive, a Pfizer lifer with two decades at the company under her belt, has made the resistance threat a priority since taking charge last February.
We meet at the firm’s UK headquarters in Surrey, a complex designed to look like a hand from the air. The “palm” is a spacious grassed area where rabbits appear and the occasional deer has been known to leap the fence. Mist covers the tranquil scene – it’s hard to believe this company was at the centre of the global Covid fightback and all its associated controversies. There’s no sign of white lab coats (the firm’s scientists are in Kent) and the offices are sparsely populated, with endless rows of empty desks a reminder of the pandemic’s remote-working legacy.
Pre-Covid, Pfizer’s public profile in the UK largely extended to its landmark erectile dysfunction pill, Viagra, and a failed £69bn tilt at buying AstraZeneca in 2014. Fast forward six years, and both companies were racing to develop a Covid vaccine – Pfizer teaming with BioNTech and choosing not to take US government support, but to make a profit. Astra, meanwhile, partnered with Oxford University and pledged to simply cover its costs during the crisis.
To date, Pfizer has shipped 4.4bn vaccine doses to 181 countries. The firm invested $2bn (£1.6bn) in research and development before regulatory approval, so without a guaranteed return. But it has since raked in $75bn in vaccine sales (and $18.9bn from its Covid pill Paxlovid), triggering accusations of profiteering. Its stock has risen more than 60% since March 2020, to value it at $248bn.
Is Rienow comfortable that Pfizer didn’t profiteer from a horrific global crisis? “Very comfortable. The scale of [our] intervention has never been seen before. It was $2bn when you don’t know if you have any revenues at all.” She says executives had a “moral clarity around the importance of what we were trying to do”.
The firm remains in the crosshairs: last month its chief executive, Albert Bourla, was interrogated as he walked through snow in Davos over Pfizer’s vaccine venture.
Then, recently, users making false claims that Covid-19 vaccines caused spasms went viral on social media with the tagline “thanks Pfizer”. Are the anti-vaxxers frustrating? “It is important that if people have questions about the vaccine that they aren’t dismissed. They should speak to their doctor or look for credible sources … and not just take what they see on social media at face value,” Rienow says. “We’ve tried very hard during the pandemic to be as transparent as possible.”
Rienow, whose father was a heart surgeon, was born one of seven siblings in North Carolina and moved around the US before starting her career consulting in Boston for companies including Pfizer. Before long, she moved in-house at its New York HQ and then to Belgium, Japan, Australia, South Korea and the UK, where she landed in 2015.
She first led Pfizer’s critical care division, and then took on its vaccines business just before the pandemic. She is guarded at times, declining to answer questions on whether the NHS should offer an annual Covid booster programme, on perceptions of big pharma, or on how much she is paid. (Her boss, Bourla, received $24m in 2021, a 15% bump). A senior pharma industry executive describes her as “thoughtful, pragmatic and authoritative”.
Her plan to get to grips with antimicrobial resistance includes a new funding method agreed with government which sees Pfizer paid an annual subscription for antibiotics rather than by volume used in the health service. This will encourage research and development of new drugs and reduce the incentive to overuse some existing ones. “It de-links volume from revenue and thinks about the value of the antibiotics in terms of what it does for society and reducing resistance,” she says.
During his leadership campaign last summer, Rishi Sunak set out a vision of the UK as a life sciences superpower. More recently, Kate Bingham, the former chair of the UK Vaccine Taskforce, and GlaxoSmithKline chief Emma Walmsley have raised concerns about Britain’s ability to remain a force in research and big pharma.
Rienow shares their concerns, noting that the UK is falling down industry league tables for manufacturing and research investment, while clinical trials are taking longer than expected. She advocates a return to pandemic tactics, when regulatory hurdles for new treatments were cleared faster through parallel approval processes. But overall, she is hopeful. “The idea of positioning the UK globally as a life sciences superpower is something that we’re quite excited about”.
CV
Age 43
Family Married with a teenage son.
Education BA in History, Boston University; MBA, Stern School of Business, New York University.
Pay Undisclosed.
Last holiday A long weekend in Sardinia.
Best advice she’s been given “Seek progress not perfection; manage your energy not your time.”
Phrase she overuses “This has changed the longer I’ve been in the UK – it’s now ‘Super!’ but it was ‘Awesome!’ before I moved here.”
Biggest career mistake “Not a mistake exactly but I’m always looking to find solutions where there seemingly aren’t any, which means that I don’t always succeed – but usually even in failure there are things to learn that make you better next time.”
How she relaxes Gardening and walking the dog. | Disease Research |
Register now for FREE unlimited access to Reuters.comBANGKOK, June 9 (Reuters) - (This Jun. 9 story corrects first paragraph to show smoking in public risks breaking the law - not that smoking is not allowed - and removes comment in 11th paragraph for clarity)Thailand legalised the growing of marijuana and its consumption in food and drinks on Thursday, the first Asian country to do so, with the aim of boosting its agriculture and tourism sectors but smoking pot in public can still violate public health laws.Shoppers queued up at outlets selling cannabis-infused drinks, sweets and other items as advocates of the plant welcomed the reform in a country that has long had a reputation for strict anti-drug laws.Register now for FREE unlimited access to Reuters.comAmong those at the front of the queue at one Bangkok shop was Rittipong Dachkul, 24, waiting since Wednesday evening to buy his first ever legal marijuana."I took a bus here after I got off work," Rittipong told Reuters."We're now able to find it easily, we don’t have to worry about the source, but I have no idea about the quality," he said, referring to the strength of the products on offer.Thailand, which has a tradition of using cannabis to relieve pain and fatigue, legalised medicinal marijuana in 2018.The government, banking on the plant as a cash crop, plans to give away a million plants to encourage farmers to take up its cultivation."After COVID, the economy going down the drain, we really do need this," said Chokwan Kitty Chopaka, who owns a shop selling cannabis gum sweets.But authorities aim to head off an explosion of recreational use by limiting the strength of the products on offer.A Highland Cafe's staff holds up a piece of cannabis at the Highland Cafe on the first day of removing it from the narcotics list under Thai law in Bangkok, Thailand, June 9, 2022. REUTERS/Athit PerawongmethaThe possession and sale of cannabis extracts containing more than 0.2% of its psychoactive ingredient, tetrahydrocannabinol (THC), is not allowed.Those who break the law can still face jail and fines.De-listing cannabis as a narcotic comes as parliament debates a draft cannabis bill, meaning some confusion in the meantime over how it can be legally used.GROWERS' APPCannabis growers have to register on a government app called PlookGanja, or grow ganja, another nickname for the spikey-leafed plant. Nearly 100,000 people have signed up to the app, said health ministry official Paisan Dankhum.Some were concerned about quality control among the many new cultivators."It will be hard to control the level of THC and other contaminants in their products and that could be dangerous for consumers,” Suphamet Hetrakul, co-founder of the Teera Group, which grows cannabis for medical use.The health ministry said it has approved 1,181 products including cosmetics and food, containing cannabis extracts and it expects that the industry will earn as much as 15 billion baht ($435.16 million) by 2026.Big business is jumping in.Agro-industrial conglomerate Charoen Pokphand Foods Pcl (CPF.BK) and energy firm Gunkul Engineering (GUNKUL.BK) have teamed up to produce food and drinks infused with the extract.Register now for FREE unlimited access to Reuters.comAdditional reporting by Panarat Thepgumpanat and Artorn Pookasook; Editing by Kanupriya Kapoor and Robert BirselOur Standards: The Thomson Reuters Trust Principles. | Global Health |
A new approach to helping people with depression is becoming more and more popular. "Social Prescribing" sees GPs sending patients on trips to places like allotments rather than pharmacies. Healthcare professionals say it works, and reduces pressure on GPs and A&E too.
Craig Denton, from Gateshead, has struggled with depression and loneliness for years.
"It's like a sense of darkness that covers you, and you can't escape," he said.
He is one of more than eight million adults in England now taking antidepressants. But, in the North East, a new approach to helping people with depression is growing.
"Social prescribing" is part of a plan by health and council bosses to tackle what Gateshead's director of public health described as "really shocking" health outcomes in the region.
It has seen Craig enjoy a day out at an allotment run by his GP's surgery where he has dug and cleared, but also chatted with other people, and not been alone.
"Instead of just sitting down in your house, where you can just dwell on things, you can use this as a distraction, meet knew people," he said.
Julie Bray, from Oxford Terrace and Rawling Road Medical Group in Gateshead, was one of the first NHS social prescribers in the country and said she was "really passionate" about it.
"It blows my mind - just to see the difference in some of the patients that we've worked with," she said.
"They build their confidence up, it reduces GP appointments, it reduces A&E appointments, and it just makes them connect with the community and be resilient."
The North East has among the highest rates of drug-related deaths, heart disease, liver disease and suicide in England.
Rates of child poverty are double the England average in some areas with poverty underpinning much of the ill health.
Social prescribing is only one part of a plan by the NHS, local councils, and community groups to make improvements by 2030.
Alice Wiseman, Gateshead director of public health, said a report in 2020 showed that, while life expectancy across the UK had stalled, it had started getting shorter for those in the bottom 10% income bracket in the North East.
"Nine of all 13 areas within this plan have a healthy life expectancy of less than 60 years," she said.
"People aren't even reaching retirement age without having a life-limiting illness.
"It is really shocking."
Linda Robinson, who runs events to help people like Craig from the same Gateshead surgery, said people went to their doctors "because they feel ill, they feel as if they don't fit in".
They want medicine "to help them feel better" but the required medicine is often "not chemical, it's social" when the issue is depression and loneliness.
What is needed is "forming friendships and feeling as if they've valued, as if they're worth something", she said.
"And miraculously their illness goes away. They don't feel depressed. They don't feel isolated anymore." | Mental Health Treatments |
A new combination of treatments safely decreased growth of pancreatic cancer in mice by preventing cancer cells from scavenging for fuel, a new study finds.
Led by researchers at NYU Grossman School of Medicine, its Department of Radiation Oncology, and the Perlmutter Cancer Center, the work builds on prior discoveries at NYU Langone Health that revealed how pancreatic cancer cells, to avert starvation and keep growing, find alternate fuel sources. Oxygen, blood sugar, and other resources normally supplied by the bloodstream become scarce as the increasing density of fast-growing pancreatic tumors cuts off their own blood supply. In this environment, the ability to switch fuels contributes to the deadliness of pancreatic cancers.
Published online October 9 in Nature Cancer, the new study involves a drug designed to prevent pancreatic ductal adenocarcinoma (PDAC) cells from one such switch. PDAC cells use the enzyme glutaminase to convert the amino acid glutamate into glutamine, which can be burned for fuel to sustain rapid tumor growth. Drugs designed to block glutaminase, however, have been shown to cause cancer cells to switch to still other scavenging pathways.
For this reason, the field next looked at experimental treatments like DRP-104, designed by Dracen Pharmaceuticals, a new “prodrug” form of the compound 6-Diazo-5-oxo-L-norleucine (DON) that is preferentially activated within tumors to overcome toxicity issues seen with an older version of DON. DON was designed to starve cancer cells by mimicking glutamine, so that unlike glutaminase blockers it broadly inhibits all metabolic pathways that use glutamine. Currently in clinical trials against non-small cell lung cancer, DRP-104 cannot be burned as fuel, but clings to the same enzymes as glutamine.
In the current study, DRP-104 treatment alone decreased PDAC growth in mouse models of pancreatic cancer. Importantly, the current team also found that PDAC cells pushed into metabolic crisis by DRP-104 increase signaling through a protein called extracellular signal-regulated kinase (ERK) to make up for their loss of glutamine metabolism. When the team combined DRP-104 with an existing drug that blocks the ERK signaling pathway, trametinib, it further improved survival in pancreatic cancer mouse models compared to DRP-104 treatment alone.
“Despite a decade of advances in understanding how cancer cells switch fuel sources, we have not yet effectively translated this into clinically relevant therapies,” says corresponding study author Alec Kimmelman, MD, PhD, the Anita Steckler and Joseph Steckler Chair of the Department of Radiation Oncology. “Broad antagonism of metabolic pathways with glutamine analogs may provide another mode of attack against these highly resistant tumor cells. The fact that such drugs are already being tested in the clinic makes us hopeful that we may finally see patient outcomes improve, if this approach proves to be effective in clinical trials.”
Moving forward, the research team will seek to understand how glutamine antagonism impacts other adaptive nutrient-scavenging mechanisms in pancreatic cancers and whether these could be targeted as well. The success of such approaches will depend on careful balancing of improved therapeutic efficacy and toxicity from the potential effects on normal tissues, Dr. Kimmelman adds.
Along with Dr. Kimmelman, authors from Perlmutter Cancer Center and the Department of Radiation Oncology were Joel Encarnación-Rosado; Albert Sohn; Douglas Biancur; Elaine Y. Lin, PhD; Victoria Osorio-Vasquez; and Diana González-Baerga. Additional authors from Perlmutter Cancer Center were Ende Zhao and Diane M. Simeone, MD. Other authors of the study were Tori Rodrick and Drew R. Jones, PhD, from the Division of Advanced Research Technologies at NYU Grossman School of Medicine; Seth Parker, PhD, from the Department of Biochemistry and Molecular Biology at University of British Columbia in Vancouver; and Yumi Yokoyama, PhD, and Robert Wild, PhD, from Dracen Pharmaceuticals, of San Diego.
Funding for the study came from Perlmutter Cancer Center support grant P30CA016087 and National Cancer Institute grants P01A1080192, P01CA117969, R35CA232124, P30CA016087-38, and 1R01CA251726-01A1; as well as from the Lustgarten Foundation, Stand Up to Cancer, and the Howard Hughes Medical Gilliam Fellowships.
Dr. Kimmelman has financial interests in Vescor Therapeutics, is on the scientific advisory board of Rafael/Cornerstone Pharmaceuticals and OncoRev, and has been a consultant for Deciphera and AbbVie. These relationships are being managed according with the policies of NYU Langone Health. Dr. Yokoyama and Dr. Wild are employees of, and have ownership in, Dracen Pharmaceuticals, the maker of DRP-104.
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For many people, treating depression isn't as simple as popping a pill. For about half of people with depression, the first medication they try isn't the right fit. Even an antidepressant that works to relieve symptoms could cause unpleasant side effects like drowsiness, nausea, weight gain, or problems with your sex drive.
You might need to change drugs or change doses -- maybe more than once. Your doctor could have you try a combination of medications. If you're not already doing talk therapy, they may suggest you add it to the mix. Therapy and antidepressants work about equally well to relieve depression symptoms.
Your doctor needs to monitor this process closely. It takes time and patience. And patience isn't easy when you're still having depression symptoms or dealing with medication side effects. But it pays off when you and your doctor zero in on the treatment that's right for you.
How to Find the Right Antidepressant for You
Choosing an antidepressant is more nuanced than you might think.
"Everyone is unique," says Michelle Riba, MD, clinical professor of psychiatry at the University of Michigan. "Just picking a medication off the shelf won't do it. ⦠You have to do a really good evaluation and medical examination and look at the medical history."
Before prescribing one, your doctor will ask a lot of questions. One might be what antidepressants you or other family members with depression have taken before, and how well they worked. The answer could predict how you'll respond to the same drug or drugs.Â
They'll also consider other medical and mental health conditions (bipolar disorder, PTSD, anxiety) you may have. For example, your doctor might avoid selective serotonin reuptake inhibitors (SSRIs) if you have a bleeding disorder. This type of antidepressant slightly increases your risk for bleeding.
"And if you've got bipolar disorder, you shouldn't take an antidepressant by itself," says Michael E. Thase, MD, chief of the Mood and Anxiety Section and professor of psychiatry at the Perelman School of Medicine of the University of Pennsylvania. "You'd want to take a mood stabilizer first."
Your doctor will also consider any other medications you're taking, to avoid interactions. If you're pregnant or breastfeeding, they'll avoid drugs that arenât safe for you.
Learn as You Go
When you start on a new antidepressant, your doctor will check in at regular intervals to ask how you feel and whether you have any side effects. "You're learning as you're going," Thase says.
You may need to take a new drug for up to 6 weeks to give it enough time to work. Side effects often go away over time, too.
If your symptoms are a little better but still there, your doctor might bump up the dose. Or they might put you on a different antidepressant in the same class, to see if it's a better match.
But if a particular drug didn't help or caused annoying side effects, your doctor will likely switch you to a different type. Your response to the previous medication helps your doctor choose which one you get next. "If you had too many stomach side effects with an SSRI, your next choice of medicine would not be an SSRI," Thase says.
Sometimes, adding another type of medication to the antidepressant helps it work better. Another option is to add a newer antipsychotic drug to the mix. The upside is that the antipsychotics work quickly -- within a week or two. The downside is that they can cause more side effects than SSRIs or serotonin and norepinephrine reuptake inhibitors (SNRIs), Thase says.
Treating depression isn't much different than treating a medical condition like high blood pressure. Not only might you need to try different medications and dosages, you also may need to make changes to your lifestyle to see an improvement.
"With high blood pressure you have to change your diet, exercise, and stop eating salt. You try medication and you may have to increase or change it. It takes time," Riba says.
Research shows that these lifestyle changes may help people with depression:
Could a Genetic Test Match You to the Right Antidepressant?
Your genes offer important clues to help your doctor narrow down the search for the right antidepressant.
New genetic tests use a sample of DNA from your blood or saliva to predict how your body might respond to a certain type of drug. These tests can't tell you which antidepressant will definitely work for you. But they can give your doctor an idea of how your body processes certain drugs, or if a certain type of antidepressant might cause side effects for you.
But the tests can be expensive, costing up to $2,000. Some insurance companies will pay for genetic tests, but may want you to try a few antidepressants first. Most people donât get this testing unless they're having trouble finding an effective treatment, Thase says.
Stick With It
You've got a 50-50 chance of finding the right antidepressant on the first try, Thase says. If that one doesn't work, there's about a 40% chance of getting it right the second time. Each time you switch to a new med, your odds of success drop slightly.
When you're dealing with depression symptoms even after getting treatment, you may be tempted to stop the medication completely. But there are benefits to sticking with it. About 9 out of 10 people who stay on their depression treatment for a year eventually do feel better, Thase says.
Each time a medication doesn't work, your doctor will dig into the reasons why.
"Sometimes there's a point at which you have to go back and ask, 'Is this the right diagnosis? Are we missing something?'" Riba says.
If your depression is stubborn, it may be time to rethink your treatment plan. Your doctor could try a different type of treatment, such as transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), or ketamine.
In TMS, doctors use an electromagnet to stimulate nerve cells in certain areas of your brain. These regions of your brain are thought to have less activity when you have depression. Scientists aren't sure exactly how TMS works, but it can ease depression symptoms.
ECT is a procedure in which a doctor sends low-voltage electric currents through your brain, causing a brief seizure. This causes brain changes that relieve symptoms for some people. Ketamine is an anesthetic, once known as a club drug, that doctors can prescribe for treatment-resistant depression.
"The most important thing is to collaborate and be open and willing to learn from your experiences," Thase says. "Your chances of being on the good side of the 50-50 really do go up."
Once you get on the right medicine and dose, follow your doctor's directions for taking it. And stay on it for as long as your doctor recommends. Depression is a chronic condition, and it can come back if you stop treatment too soon. | Mental Health Treatments |
Facts matter: Sign up for the free Mother Jones Daily newsletter. Support our nonprofit reporting. Subscribe to our print magazine.Patients entering the bright third-floor offices of Houston Women’s Reproductive Services used to follow the familiar steps for a routine medical appointment: check in, get your blood pressure taken, have other vitals examined. But for the past nine months, the typical rhythms and protocols have been completely upended. These days, patients seeking abortion care are rushed straight to an ultrasound—lab work comes later. They are often overcome with palpable anxiety. “Our patients are absolutely panicked when they come in. They are nervous wrecks, they are trembling with fear,” says administrator and founder Kathy Kleinfeld. “It’s heartbreaking. So we try to get them the answers they need right away.”
The answer they need immediately is if they are within the narrow six-week mark and can qualify for an abortion in Texas under a draconian law, Senate Bill 8, that bans abortion care in the state once embryonic cardiac activity is detected. “We are all holding our breath during every sonogram,” says Kleinfeld.
The small staff of four full-time employees is also consumed with urgency and anxiety; if abortion care takes place past the strict timeframe, that could mean costly and destructive career-ending lawsuits. There are some who are within the window and can obtain abortion care at the clinic. They usually “burst into tears” of relief, says Kleinfeld, though they still have to wait 24 hours following the ultrasound, as mandated by another 2011 state law. But then, there are the more than 300 in-person patients—and thousands of callers—who the clinic has been forced to turn away since the ban took effect. These are the people, Kleinfeld says, who feel “devastated” and “deeply shocked.” Some end up confused and dazed, burdened with processing how and even if they can secure the resources and manage the logistics required to make the trek out of state. How is it possible to get child care, time off work, and money for transportation and lodging? Providers and advocates resoundingly stress it is low-income Texans and people of color who have been disproportionately affected by the severe law and who are most likely to carry unwanted pregnancies to term.
As a result, Texas clinics have been transformed into what are essentially somber travel agencies. Since September of last year, when SB 8 took effect, an average of nearly 1,400 Texans traveled out of state for abortion care each month, a figure nearly equivalent to the number that traveled every year between 2017 and 2019, according to the Texas Policy Evaluation Project. Some are forced to travel hundreds, even thousands, of miles for an abortion, causing a “domino effect” by delaying care for others at health clinics across the country, according to the Guttmacher Institute.
Kleinfeld now refers to her clinic staff as “navigators,” as they are tasked with shepherding distraught patients to medical care far from home—helping them find transportation, lodging, and even meals. “We are like de facto travel agents because of this law,” she says. “Our secondary—and even primary—jobs now are to truly be navigators.”
One of these navigators can’t believe how her work has changed—and feels shock at history repeating itself. As a college student at the University of Texas at Austin 50 years ago, she helped guide people in Texas to abortion access prior to Roe. “It’s absolutely scary watching this happen again,” says Kitty, who asked to be identified only by her first name. She hears the same “desperation, sadness, and anger” as she did when she was assisting abortion-seeking Texans in the late ’60s and early ’70s. “It’s unbelievable.”
It is also a harbinger of what is to come across the country if, as expected, the Supreme Court guts the landmark 1973 ruling in the coming weeks, which would be followed by 26 states certainly or likely banning abortion care. “All the adjustments we’ve had to make,” Kleinfeld explains, “are unfortunately a preview of what clinics in other states may soon need to do.” Living under what was the nation’s most restrictive abortion law for most of the past year, Texas clinics have been forced to adapt and transform their practices, or face SB 8’s punitive consequences. Erroneously dubbed a “heartbeat” bill by anti-abortion advocates, the law offers no exceptions for rape or incest and is, in effect, a near-total ban as it cuts off abortion care before most people are even aware they are pregnant. Its novel private enforcement mechanism empowers any individual—including anti-abortion vigilantes with no connection to the patient—to sue abortion providers or anyone who “aids or abet” care for damages of at least $10,000, effectively chilling clinic operations. The law has already inflicted irreparable harm in a state that’s home to 10 percent of the country’s reproductive-age population.
While medication abortion and telehealth may seem like an ideal solution for abortion-seeking Texans, particularly those who cannot travel, state lawmakers added major barriers to that option as well. Senate Bill 4, which took effect in December, bars the mail delivery of abortion medication and shortens when a patient can take that medication from 10 weeks to seven weeks of pregnancy, despite the fact that the Food and Drug Administration lifted federal mail restrictions and approved use for up to 10 weeks; SB 4 instead requires doctors to give the pills in-person. Providers who violate the law could be saddled with a state felony, a $10,000 fine, and up to two years in prison. Kleinfeld says requests to travel out of state for telehealth services are rare. (Of course, some Texans have not let SB 4 prevent them from accessing self-managed abortion online, turning to channels outside the US health care system; after SB 8, Austria-based provider Aid Access saw a sharp rise in Texans requesting abortion pills.) So over the past few months, Kleinfeld and her team have become experts on, as she puts it, the “complex web” of abortion hurdles in surrounding Southern states and beyond. She has memorized a list of restrictions, which she expertly rattles off: If a patient wants care in Arkansas, they’ll need to make two trips to the clinic and wait 72 hours between the ultrasound and the procedure; New Mexico doesn’t have a waiting period; in Louisiana, they must wait 24 hours and make two clinic visits, and so on. When we speak in mid-May, Kleinfeld tells me she needs to be vigilant about shifting laws—particularly in Oklahoma, where nearly half of displaced Texas patients were getting abortion care. At the time, a six-week ban, modeled after Texas’, was in effect in Oklahoma, drastically narrowing a crucial pipeline for abortion-seeking Texans and forcing Kleinfeld to further redirect patients. In the weeks since, a total ban has also been put in place there, dealing a final blow to that line of care. “It’s been so important to know the laws in other states as we try to arm patients with the most accurate information to navigate access,” she says.
One strategy for implementing the most effective “travel agency” has been to strengthen lines of communication with abortion funds and out-of-state providers. Clinic staff sometimes texts other clinic staff directly on their personal cellphones to ask how long patients will need to wait for the next appointment; other times they juggle a number of different Slacks and listservs (“There are so many,” remarks Kleinfeld) among providers across the nation. Collectively, they all feel an unprecedented sense of solidarity in their mission to connect patients to care.
“It’s never been more imperative to network with outside clinics and abortion funds,” Kleinfeld explains. “That’s certainly been a big change, we now need to be in constant communication.”
Whole Woman’s Health, which operates four clinics in Texas and five in other states, has made a similar pivot. Its Texas clinics have seen approximately 50 percent fewer patients since SB 8 took effect and a rise in those seeking care outside the state. So Amy Hagstrom Miller, the organization’s president and founder, has hired new staff solely focused on helping patients get appointments across state lines. They call this new travel assistance service the “Abortion Wayfinder” program, which seeks to streamline and facilitate a sometimes complicated process. By networking with other abortion support groups, Whole Woman Health’s staff members make appointments in other states on behalf of displaced Texas patients, including at its own Virginia and Minnesota sites. If needed, Whole Woman’s Health will dip into its own abortion fund, Stigma Relief, and coordinate with national and local abortion funds to provide financial support to cover the procedure, as well as travel and other logistics. Over the past few months, the program has helped 60 low-income patients, with $1,000 each.
Nonetheless, even with assistance, the financial burdens of travel and managing the logistics aren’t always easy for patients, especially those who are already struggling economically. Some don’t have credit cards, for instance, which makes booking hotels and flights more difficult; others have never taken an Uber before or boarded an airplane. One patient, says Hagstrom Miller, refused a flight to Alexandria, Virginia, as she had never flown before and couldn’t leave her children behind. Instead, she made the 26-hour drive from the border city of McAllen, with her whole family in tow. (These stressors are far from unique: Nearly 60 percent of those who have abortions are already parents, and of that number, a third have at least two children, according to the Guttmacher Institute.) Other providers note the difficulty in travel for undocumented residents navigating access amid in-state Border Patrol checkpoints. Minors confront other complications; some hotels, for instance, require guests to be at least 21 years old.
So what may seem like a straightforward journey from one place to another often becomes fraught with unexpected difficulties and challenges, particularly for already vulnerable Texans. Hagstrom Miller explains that the need for the program was obvious to those who worked there, but the challenge was creating an infrastructure to support all of its various elements. “One thing has been very clear,” Hagstrom Miller adds. “When patients decide they want abortion care, they are very determined to be unpregnant.”
For transportation that doesn’t involve air travel, they are working to devise scalable ride-sharing programs with other groups. They also manage a database that keeps track of which airlines have the most reliable schedules and service and the team has developed relationships with hotels that specifically don’t stigmatize against abortion and even with sandwich shops in other states to help patients obtain meals—unusual roles they never thought they’d fill.
“I think we will see that some clinics will remain open without providing direct [abortion] services but will be there to support patients and do everything possible to help them get access to care in other states,” says Elizabeth Nash, who tracks state reproductive health policy at the Guttmacher Institute. “Texas clinics have already started figuring this out…It’s a real testament to the perseverance of these clinics.” Working hand in hand with the clinics are abortion funds, which have long been on the frontlines of connecting low-income patients with access. They too have seen their operations change as they face unprecedented demand. Fund Texas Choice offers financial assistance to patients for transportation to clinics and has functioned as a de facto state travel agency since it started in the wake of House Bill 2, which shuttered half of Texas’ clinics and gave way to several “abortion deserts” in the massive state. (Although the multi-part state law was overturned by the Supreme Court in 2016, most of the defunct clinics have been unable to recover and reopen their doors, underscoring HB 2’s lasting impact.) These efforts have only grown under SB 8. Before the law took effect, less than half of the 40 clients Fund Texas Choice served a month required out-of-state travel; today, 99 percent of the now 100 clients it serves monthly do, involving on average more than 1,300 miles roundtrip. As surrounding states continue to restrict abortion care, Fund Texas Choice program manager Sahra Harvin worries about how the increase in distance will in turn hike the average cost per client, especially amid rising gas and airfare prices. While the group was able to assist every caller before SB 8, call volume has jumped sixfold, and even after adding new staff, they are still unable to meet demand.
“We don’t need to imagine a post-Roe environment. We know firsthand what it looks like,” says Harvin. “We’ve seen how there are not enough hours in the day to help everyone that calls us, and that demand will likely rise. It should not be up to funds and practical support organizations to ensure the people of this state access essential health care—we are just filling the gap where the state has failed.”
Similarly, Texas Equal Access Fund, which operates in the state’s north, went from supporting a quarter of its callers in traveling out of state to almost 90 percent. The majority of clients seeking help from the Lilith Fund, which serves central and south Texas, are also now going out of state, which has led the group to increase the amount spent per client from an average of $348 in 2020 to $587 in the months since SB 8 took effect.
This is further hurting the most vulnerable Texans, including Black, Indigenous, and other people of color, people with disabilities, people in rural areas, young people, and undocumented people, who constitute most of these funds’ callers. Indeed, more than 70 percent of TEA’s callers are BIPOC, with Black women making up the majority of its client base. Most lack health insurance and, due to federal Medicaid rules and a Texas law that prohibits public and private insurance covering abortion, they must pay out of pocket.
“Abortion bans are systemic discrimination and racism in action—and the impact of SB 8 and other abortion restrictions have been extremely harmful to our most marginalized communities,” says Kamyon Conner, TEA’s executive director. “The added cost and logistics to go to another state make getting an abortion very hard for people who don’t have access to paid time off or are unable to take any time off to get care. We worry that people will just go without the care they need.”
Anti-abortion laws are “blatant misogyny and white supremacy in action,” echoes Lilith Fund executive director Amanda Beatriz Williams. With the future sustainability (and job security) of Texas clinics up in the air—especially independent providers, which face a greater threat of closure—investing in building clinics elsewhere may turn out to be the most strategic path forward for the post-Roe world.
Some providers are already eyeing expansion in “safe haven” states that are working to enshrine abortion rights and even expand abortion access. In her office, Hagstrom Miller keeps a map of the US that outlines which states will likely protect abortion access if Roe is struck down. While she’s had it up since 2019, today it’s become indispensable. She uses it to explore where she might open a new clinic next; her team is currently evaluating cities in Illinois and North Carolina as possible options. After SB 8 went into effect, Whole Woman’s Health opened a new clinic in Minnesota, which is expected to be a safe-haven state; it’s situated near the Minneapolis–St. Paul airport for easier access for out-of-state patients. Today, some 30 percent of that clinic’s clients come from Texas, a figure that is expected to rise “drastically,” she says. But Nash from the Guttmacher Institute stresses that not even people who live in those safe haven states are immune from the damaging policies of abortion-hostile states, since patient displacement is causing a ripple effect across clinics in all regions. “Despite what’s been happening in Texas, and now Oklahoma, it hasn’t seemed to quite penetrate into the public consciousness,” says Nash. “Some of that is because abortion is very stigmatized and some of that is because people don’t think these laws will affect them. But, in fact, what we are seeing is that what happens in one state causes disruption across the country. Providers from California to Maryland are seeing the effects of high patient volume, delayed wait times, and capacity shortages.”
While all the changes that Texas abortion clinics have been required to make have been exhausting, one of the most difficult and emotionally taxing parts has been turning away more and more patients while adhering to a law that directly contradicts their values and principles as compassionate medical providers. Beyond acting as travel agents, clinic directors say staff have become informal trauma counselors, as they interact daily with angry, terrified, confused, and desperate patients, some of whom are forced to continue pregnancies against their will in a state that has a tattered social safety and family planning net. In many cases, there is nothing staff can do for them other than to “listen, hold their hands, and dry their tears,” says Hagstrom Miller.
“You will feel immense guilt and grief as you are forced to carry out the state’s will against your own conscience,” she says, offering advice for other abortion providers. “The psychological and emotional impact this will have on you will be traumatic. But please remember, it is not your fault. There is no way to fully prepare other than to make time and space for the sadness.”
Kleinfeld says that in order to continue the work even while turning hundreds of clients away, she and her team try to focus on the individual victories—the patients who are able to get care within the narrow sliver of time still allotted by law. When we speak again in early June, she shares the story of a young woman who called her Houston clinic panicked since she believed she was eight-weeks pregnant and thus past the legal limit in Texas. Kleinfeld advised her to come in for an ultrasound anyway; it turned out the patient had miscalculated the date of her last period and was only five-weeks pregnant and able to receive abortion care at her hometown clinic.
“She was over the moon,” says Kleinfeld. “She was so relieved and so happy that she didn’t need to travel out of state…When a patient comes in and is actually within the legal limit, it’s like, ‘Hallelujah!’ Those moments help keep us going.” | Women’s Health |
FDA Approves Lilly's Zepbound™ (tirzepatide) for Chronic Weight Management, a Powerful New Option for the Treatment of Obesity or Overweight with Weight-Related Medical Problems
Adults taking Zepbound in a clinical trial lost on average 48 lb. at the highest dose
Zepbound is the first and only approved treatment activating two incretin hormone receptors, GIP and GLP-1, to tackle an underlying cause of excess weight
"Obesity is a chronic disease that can result in serious health complications, including heart disease, stroke and diabetes. Despite our knowledge of obesity as a treatable, chronic disease, people living with obesity still face many challenges in their health and weight management journey," said Joe Nadglowski, president and chief executive officer of the
The approval was based on results from the phase 3 SURMOUNT-1 and SURMOUNT-2 trials. In SURMOUNT-1, a study in 2,539 adults with obesity, or excess weight and weight-related medical problems not including diabetes, people taking Zepbound as an adjunct to diet and exercise experienced substantial weight loss compared with placebo at 72 weeks. At the highest dose (15 mg), people taking Zepbound lost on average 48 lb., while at the lowest dose (5 mg), people lost on average 34 lb. (compared to 7 lb. on placebo).
Additionally, 1 in 3 patients taking Zepbound at the highest dose lost over 58 lb. (25% of body weight), compared to 1.5% on placebo, according to data not controlled for type 1 error. The average starting weight was 231 lb.
While not approved to treat these conditions, in a clinical trial, people who dieted, exercised and took Zepbound for the treatment of obesity or overweight with weight-related medical problems observed changes in cholesterol and reductions in blood pressure and waist size.
"Unfortunately, despite scientific evidence to the contrary, obesity is often seen as a lifestyle choice – something that people should manage themselves," said Dr.
Zepbound use may be associated with gastrointestinal adverse reactions, sometimes severe. The most commonly reported adverse events (observed in ≥ 5% of clinical trial participants) were nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, injection-site reactions, fatigue, hypersensitivity reactions, eructation, hair loss and gastroesophageal reflux disease.1 In studies, most nausea, diarrhea and vomiting occurred when people increased their dose – but the effects generally decreased over time. In studies, gastrointestinal side effects were more common in people taking Zepbound than people taking placebo, and people taking Zepbound were more likely than those on placebo to stop treatment because of these side effects. The label for Zepbound includes a Boxed Warning regarding thyroid C-cell tumors. Zepbound is contraindicated in patients with a personal or family history of medullary thyroid carcinoma, in patients with Multiple Endocrine Neoplasia syndrome type 2, and in patients with known serious hypersensitivity to tirzepatide or any of the excipients in Zepbound. See Important Safety Information below and full Prescribing Information and Medication Guide.
"Far too many hurdles continue to prevent people living with obesity from accessing obesity treatments that could lead to significant weight loss," said
Zepbound is expected to be available in the
- People who are commercially insured with coverage for Zepbound may be eligible to pay as low as
$25for a 1-month or 3-month prescription.
- People who are commercially insured without coverage for Zepbound may be eligible to pay as low as
$550for a 1-month prescription of Zepbound, approximately 50% lower than the list price.
People may begin using the savings card program in the days following product availability at
Tirzepatide is also under regulatory review for weight management in
Click here to view the Zepbound product image.
Click here to view the Zepbound logo.
About the SURMOUNT clinical trial program
The SURMOUNT phase 3 global clinical development program for tirzepatide in chronic weight management began in late 2019 and has enrolled more than 5,000 people with obesity or overweight across six registration studies, four of which are global studies. SURMOUNT-1 and SURMOUNT-2 were submitted to the FDA and demonstrated tirzepatide significantly reduced body weight compared with placebo in people living with obesity or overweight, with or without type 2 diabetes.
About Zepbound™ (tirzepatide) injection1
Zepbound™ (tirzepatide) injection is FDA-approved as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with obesity (BMI ≥ 30 kg/m2), or overweight (BMI ≥ 27 kg/m2) with at least one weight-related comorbid condition. Zepbound is the first and only FDA-approved obesity treatment that activates both GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) hormone receptors.
INDICATION AND SAFETY SUMMARY WITH WARNINGS
Zepbound™ (ZEHP-bownd) is an injectable prescription medicine that may help adults with obesity, or with excess weight (overweight) who also have weight-related medical problems, lose weight and keep it off. It should be used with a reduced-calorie diet and increased physical activity.
- Zepbound contains tirzepatide and should not be used with other tirzepatide-containing products or any GLP-1 receptor agonist medicines. It is not known if Zepbound is safe and effective when taken with other prescription, over-the-counter, or herbal weight loss products. It is not known if Zepbound can be used in people who have had pancreatitis. It is not known if Zepbound is safe and effective for use in children under 18 years of age.
Warnings - Zepbound may cause tumors in the thyroid, including thyroid cancer. Watch for possible symptoms, such as a lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath. If you have any of these symptoms, tell your healthcare provider.
- Do not use Zepbound if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC).
- Do not use Zepbound if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
- Do not use Zepbound if you have had a serious allergic reaction to tirzepatide or any of the ingredients in Zepbound.
Zepbound may cause serious side effects, including:
Severe stomach problems. Stomach problems, sometimes severe, have been reported in people who use Zepbound. Tell your healthcare provider if you have stomach problems that are severe or will not go away.
Kidney problems (kidney failure). Diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems. It is important for you to drink fluids to help reduce your chance of dehydration.
Gallbladder problems. Gallbladder problems have happened in some people who use Zepbound. Tell your healthcare provider right away if you get symptoms of gallbladder problems, which may include pain in your upper stomach (abdomen), fever, yellowing of skin or eyes (jaundice), or clay-colored stools.
Inflammation of the pancreas (pancreatitis). Stop using Zepbound and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back.
Serious allergic reactions. Stop using Zepbound and get medical help right away if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, or very rapid heartbeat.
Low blood sugar (hypoglycemia). Your risk for getting low blood sugar may be higher if you use Zepbound with medicines that can cause low blood sugar, such as a sulfonylurea or insulin. Signs and symptoms of low blood sugar may include dizziness or light-headedness, sweating, confusion or drowsiness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, mood changes, hunger, weakness or feeling jittery.
Changes in vision in patients with type 2 diabetes. Tell your healthcare provider if you have changes in vision during treatment with Zepbound.
Depression or thoughts of suicide. You should pay attention to changes in your mood, behaviors, feelings or thoughts. Call your healthcare provider right away if you have any mental changes that are new, worse, or worry you.
Common side effects
The most common side effects of Zepbound include nausea, diarrhea, vomiting, constipation, stomach (abdominal) pain, indigestion, injection site reactions, feeling tired, allergic reactions, belching, hair loss, and heartburn. These are not all the possible side effects of Zepbound. Talk to your healthcare provider about any side effect that bothers you or doesn't go away.
Tell your healthcare provider if you have any side effects. You can report side effects at 1-800-FDA-1088 or www.fda.gov/medwatch.
Before using Zepbound
- Your healthcare provider should show you how to use Zepbound before you use it for the first time.
- Tell your healthcare provider if you are taking medicines to treat diabetes including insulin or sulfonylureas which could increase your risk of low blood sugar. Talk to your healthcare provider about low blood sugar levels and how to manage them.
- If you take birth control pills by mouth, talk to your healthcare provider before you use Zepbound. Birth control pills may not work as well while using Zepbound. Your healthcare provider may recommend another type of birth control for 4 weeks after you start Zepbound and for 4 weeks after each increase in your dose of Zepbound.
Review these questions with your healthcare provider:
❑ Do you have other medical conditions, including problems with your pancreas or kidneys, or severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems digesting food?
❑ Do you take diabetes medicines, such as insulin or sulfonylureas?
❑ Do you have a history of diabetic retinopathy?
❑ Do you take any other prescription medicines or over-the-counter drugs, vitamins, or herbal supplements?
❑ Are you pregnant, plan to become pregnant, breastfeeding, or plan to breastfeed? Zepbound may harm your unborn baby. Tell your healthcare provider if you become pregnant while using Zepbound. It is not known if Zepbound passes into your breast milk You should talk with your healthcare provider about the best way to feed your baby while using Zepbound.
- Pregnancy Exposure Registry: There will be a pregnancy exposure registry for women who have taken Zepbound during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry, or you may contact
Lillyat 1-800-LillyRx (1-800-545-5979).
How to take
- Read the Instructions for Use that come with Zepbound.
- Use Zepbound exactly as your healthcare provider says.
- Zepbound is injected under the skin (subcutaneously) of your stomach (abdomen), thigh, or upper arm.
- Use Zepbound 1 time each week, at any time of the day.
- Change (rotate) your injection site with each weekly injection. Do not use the same site for each injection.
- If you take too much Zepbound, call your healthcare provider, seek medical advice promptly, or contact a Poison Center expert right away at 1‑800‑222‑1222.
Learn more
Zepbound is a prescription medicine. For more information, call 1-800-LillyRx (1-800-545-5979) or go to www.zepbound.lilly.com.
This summary provides basic information about Zepbound but does not include all information known about this medicine. Read the information that comes with your prescription each time your prescription is filled. This information does not take the place of talking with your healthcare provider. Be sure to talk to your healthcare provider about Zepbound and how to take it. Your healthcare provider is the best person to help you decide if Zepbound is right for you.
ZP CON CBS 08NOV2023
Zepbound™ and its delivery device base are registered trademarks owned or licensed by
About
This press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about Zepbound (tirzepatide) as a potential treatment for adults with obesity or overweight and the timeline for additional regulatory submissions, future readouts, supply and commercialization of Zepbound, presentations, and other milestones relating to Zepbound and reflects
References
- Zepbound. Prescribing Information. Lilly
USA, LLC.
PP-ZP-US-0076 11/2023 ©Lilly
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Refer to:
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Jessica Thompson; [email protected], 317-433-7100 (Media)
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Joe Fletcher; [email protected], 317-296-2884 (Investors)
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SOURCE | Drug Discoveries |
NHS Tayside has been criticised over its handling of disgraced surgeon Sam Eljamel in a new report.
The internal due diligence review criticised health board management for putting the doctor under indirect supervision in June 2013 rather than suspending him.
It follows years of revelations about Prof Eljamel.
The surgeon harmed dozens of patients but was allowed to continue operating until he was suspended in late 2013.
Some of his patients were left with life-changing injuries.
He was employed as a surgeon by NHS Tayside for 18 years and later became the head of the neurosurgery department in Ninewells Hospital in Dundee.
NHS Tayside has claimed it became aware of concerns around the surgeon in June 2013, but an NHS whistleblower told the BBC the health board knew as early as 2009 that there were serious concerns.
He is now working as a surgeon in Libya.
The due diligence report found missed opportunities for senior management to intervene and protect patients.
Despite a rising number of complaints, it said NHS Tayside failed to put in place adequate restrictions and monitoring of Prof Eljamel.
The surgeon was allowed to operate on 111 patients unsupervised despite being under clinical supervision after senior management were made aware of serious complaints.
It said that patients who were operated on during this time will receive a letter of apology from the health board.
The review said: "It was clear that he was not being truthful with his patients about procedures and he did not share mistakes with colleagues for learning and reflection."
Some of Prof Eljamel's patients have previously called for a full public inquiry into the case, as have MSPs from the Scottish Conservatives, Labour and Liberal Democrats.
'Risk of patient safety'
A complaint made in December 2012 triggered a Significant Clinical Event Analysis (SCEA) which found issues with Prof Eljamel's clinical practice.
The SCEA, as well as two further complaints, escalated the problem to medical management.
Prof Eljamel was interviewed by his clinical lead and clinical director, and it was concluded that he had "reflected and altered his practice significantly".
The review added: "There was no plan put in place to performance manage Prof Eljamel as a result of the meeting."
A second meeting was held 17 days later after further complaints emerged against the surgeon.
It was agreed an external review would be conducted by the Royal College of Surgeons (RCS) and he was placed under clinical supervision with restrictions on his practice the following day.
He also stopped his private clinical practice.
However the NHS Tayside report said there was "inadequate senior input which resulted in inadequate assessment of risk and consideration of patient safety."
It found that there was also no direct supervision of the surgeon's clinical practice, including surgery.
Prof Eljamel operated on 111 patients during his indirect supervision, with nine submitting complaints and two raising legal claims.
The report said: "These patients were placed at potential risk of harm due to the inadequacy of the supervision arrangements."
The RCS interim letter sent to the medical director in October 2013 stated that "there were signals of a poor doctor i.e. poor communication, poor behaviours and complaints".
The final RCS report was submitted on 6 December and Prof Eljamel was suspended four days later.
An internal investigation was later dropped after the surgeon resigned in May 2014.
He removed himself from the GMC register in 2015.
The NHS Tayside report found a total of 98 complaints in documents held by the health board between 1995 until 30 June 2023.
However complaints made before 2012 are no longer available due to system changes and the report acknowledged that there may have been more.
The review found that the majority of complaints held - 84 - were received after Eljamel was suspended in December 2013, but they were related to surgical treatment from 1996 onwards.
And 20 legal claims were made against NHS Tayside around Prof Eljamel's surgical practice which took place from 1995 to March 2023, with the first claim made in February 2013.
Communication with patients impacted by Prof Eljamel was of "variable quality, fragmented and generally poor and there has been no central coordination to ensure a truly person-centred approach."
While there were "multiple systems" for identifying concerns around a clinician, the report said that "some of these systems were in their infancy and some were reliant on self-reporting of clinical outcomes."
Nine recommendations were made, including ensuring patient outcomes are collected and analysed to improve care.
The report said NHS Tayside had improved the governance, complaint and alert systems since Prof Eljamel resigned in 2013.
Health board apologises
NHS Tayside executive medical director Dr Pamela Johnston said the report concluded action taken on recommendations from the Scottish government review in 2022.
"We recognise that many former patients remain understandably very upset and unhappy with what has happened," she said.
"NHS Tayside apologises to former patients of the surgeon and remains committed to do whatever is required to support the independent commission which is being set up by Scottish government to respond to patients' ongoing concerns."
She urged any former patients with concerns to get in touch with the Patient Liaison Response Team.
Conservative MSP Liz Smith, Labour's Michael Marra and Liberal Democrat Willie Rennie urged the first minister and health secretary to carry out a full public investigation of the case.
Ms Smith said: "It is blatantly obvious that when a series of very serious allegations were made against Eljamel, he should have been suspended not put under casual observation when he could do more damage to patients.
"We know from what whistle-blowers told us earlier this year that those who worked with Sam Eljamel knew about the serious concerns, as did managers, yet they allowed him to continue practising in theatre."
Mr Marra said the admission had been "wrung from NHS Tayside like blood from a stone".
Mr Rennie added: "Without trust in the cabinet secretary and his process there is no other option but a public inquiry." | Medical Innovations |
A new study from UNSW Sydney shows that teenagers with OCD experience deficits in decision making and behavioural control. This is linked to abnormal activity in an area of the brain called the orbitofrontal cortex (OFC). The research is published this week in Biological Psychiatry Global Open Science.
“OCD is highly prevalent, affecting more than 750,000 Australians. People with OCD get stuck in loops of unwanted thoughts and behaviours,” says first author Dr Iain Perkes, Senior Lecturer at UNSW Medicine & Health and child and adolescent psychiatrist in Sydney Children’s Hospitals Network.
The researchers aimed to better understand the biological basis of OCD, which could lead to the development of new treatments. They focused on adolescents in the study, which is important given that OCD typically develops in childhood or adolescence.
“These repetitive actions, obsessions and compulsions aren’t completely under the control of someone with OCD. Otherwise, they would simply choose not to do them,” Dr Perkes says.
“So, there was good reason to think that those decision-making mechanisms in the brain go awry in the case of OCD.”
From animals to humans
Prof. Balleine, who is the senior author of this paper, leads the UNSW Decision Neuroscience Lab. The lab has conducted an extensive research program involving behavioural experiments in rats. This is combined with studies of the brain to understand which areas of the brain activate, and how they communicate, to contribute to decision making.
Through collaboration with clinical researchers like Dr Perkes, this research can now be translated to humans.
Studying decision making
The study involved 21 healthy adolescents and 20 adolescents with OCD. Participants were completed decision-making tasks to gain small food rewards. They did these tasks inside a magnetic resonance imaging (MRI) scanner, which showed blood flow in their brains associated with brain activity.
Participants were tested in terms of their ability to make decisions based on environmental cues, in exchange for food rewards. For example, in one of the activities they played a computer game where they learned to tilt a vending machine in different directions, which corresponded to different snacks.
“We make decisions every day based on environmental cues – for example, stop signals and go signals that we see at traffic lights. These cues allow us to predict the circumstances around us,” Dr Perkes says.
Before one of the decision-making tasks, the ‘value’ of the food rewards was reduced; the participants were shown a video of insects crawling over the food, making it less desirable.
“We wanted to see how changing the value of the reward would change the choice of action for healthy young people, versus young people with OCD,” Dr Perkes says.
OCD changes cognition
Compared to the control group, adolescents with OCD struggled to make choices and control their behaviour to gain food rewards. In addition, when the value of the food rewards was reduced, this had little influence on their behaviour during the tasks.
“People with OCD experience difficulties using reward signals to guide their choices in an adaptive way. Those behavioural difficulties are associated with changes in the brain,” Dr Perkes says.
The MRI scans showed different patterns of activity in the brain for adolescents with OCD, compared to healthy adolescents. The differences were particularly strong in the OFC, a region of the brain responsible for decision-making, behavioural control and other cognitive functions.
In participants with OCD, specific areas of the OFC were hyperactive and others were hypoactive during the two decision-making tasks. These findings are consistent with previous research in rats, providing evidence of the specific OFC areas responsible for these psychological functions.
The researchers also found that for adolescents with OCD, hyperactivity of the OFC during the experiments was linked to the severity of OCD symptoms. This further supports the connection between decision-making performance and the disorder.
“This is strong evidence that these mechanisms have a core role in the development of OCD,” Dr Perkes says.
Reducing OCD stigma
This study provides more support for the biological basis for OCD. According to Dr Perkes, people with OCD are sometimes invalidated by others when they struggle with unwanted thoughts and behaviours.
“As we understand the biological reality and underpinnings of mental health conditions like OCD, it helps to reduce stigma,” Dr Perkes says.
“It shifts the dialogue from ‘Just pull your socks up, work harder’ to ‘There are changes in the brain, that’s a real health condition.’”
A better understanding of the root causes and important brain regions for OCD also takes us further towards developing better treatments. For example, these findings could contribute to more targeted transcranial magnetic stimulation, which is sometimes used to target nerve cells in the brain to treat OCD. Also, knowledge about OCD decision-making processes could lead to more tailored behavioural therapies.
“We know that for one third of people living with OCD, they don’t respond to first-line treatments,” Dr Perkes says.
“There is a real need to continue discovering new and better treatment paradigms.” | Mental Health Treatments |
Financial jobs may often be lucrative — but some of them could make you seem boring and even incompetent to the people around you, according to a new study.Researchers from the University of Essex in Colchester, England, asked more than 500 people across five different experiments about the careers and hobbies they considered the most "boring" — and what characteristics they associated with people who did those jobs. The study was published in the Personality and Social Psychology Bulletin earlier this month.Finance was overwhelmingly tagged as the world's most boring industry, with finance-associated positions occupying four of the top five slots on the "most boring" list. The people occupying those "boring" jobs were also not seen as competent, according to the report, which surprised at least one of the study's authors."I would have thought that accountants would be seen as boring, but effective and the perfect person to do a good job on your tax return," Wijnand Van Tilburg, a study co-author and senior lecturer in the university's psychology department, said in a statement last week.Tilburg said that stereotypically "boring people" are generally disliked, and often avoided by the people around them — largely due to unfair preconceived notions.Your perceptions of people can certainly change over time, but folks dubbed as "boring" don't often get a chance to prove the stereotypes wrong, Tilburg said. "The very fact that people choose to avoid them can lead to social ostracization and increase loneliness, leading to a really negative impact on their lives," he said.Tilburg said he launched the study to explore stigmas around boredom, and how it can impact the way humans perceive each other: "The irony is studying boredom is actually very interesting and has many real-life impacts."Here are the results of the study, including top-five lists for most boring jobs, most exciting jobs and most boring hobbies:Top 5 most boring jobsData analysisAccountingTax/insurance workCleaningBankingTop 5 most exciting jobsPerforming artsScienceJournalismHealth professionalTeachingTop 5 most boring hobbiesSleepingReligionWatching televisionObserving animalsMathSome of those "boring" jobs do tend to pay more than some of the "most exciting" ones. According to compensation software and data company Payscale, the average salary for a data analyst is around $62,754 per year. That's approximately $10,000 per year more than the average salary of someone in performing arts — roughly $52,522, according to Glassdoor.And while "sleeping" ranked as the single most boring hobby anyone could have, getting regular amounts of high-quality sleep is essential to your productivity, health and mental sharpness, according to research.Don't miss:Want to be more charismatic? Ask yourself this simple question, researchers suggestHolding an early-career managerial position can lead to better heart health, according to epidemiology | Mental Health Treatments |
Story at a glance
- Health experts worry about the physical toll remote work might have on some people.
- Their main concern is that remote work promotes a more sedentary lifestyle, which can contribute to blood clots, cardiovascular disease and diabetes.
- Remote work can also lead to increased eyestrain and make it easier for workers to engage in bad habits like continuous snacking, smoking or drinking.
The explosion of remote work in recent years may come with a physical toll.
Three years after the arrival of COVID-19 triggered a mass exodus from offices, about 22 million Americans were still working fully remotely as of March 2023, according to Pew Research Center data.
The shift to remote work has been life-changing for many working adults, like those who have disabilities or are caregivers to family members, and surveys show Americans as a whole love working from home.
A more sedentary lifestyle can lead to blood clots, long-term health issues.
When it comes to the physical toll of remote work, health experts are most concerned about teleworkers’ lack of movement during the day.
The world has been struggling with a physical inactivity crisis for years. In 2008, about 31 percent of people 15 years or older and older were “insufficiently physically active,” according to World Health Organization data.
And that crisis appears to have been exacerbated by COVID-related lockdowns and potentially worsened by remote work, according to Ross Arena, a professor of physical therapy at the University of Illinois, Chicago.
“One of the big questions is are we going to bounce back? Or are we going to become the new even worse normal where the world is moving even less,” said Arena.
The average remote worker just takes 16 steps from their bed to their workstation, according to a 2022 survey from Upright, an app that promotes good back health. And multiple studies show such workers are physically less active than their office-going counterparts.
That same survey also found that 54 percent of remote and hybrid workers believe that their movement during the workday has shrunk by 50 percent or more over the past year.
One 2021 analysis from Standford University found that between 2007 and 2016 the average time American adult spent sitting increased from 5.5 to 6.4 hours a day. By April 2020, 40 percent of U.S. adults sat more than eight hours a day.
One worry associated with a mainly sedentary lifestyle is blood clots. Sitting for too long can increase a person’s chance of developing a blood clot like deep vein thrombosis, or a clot that forms in veins deep in the body, which can then travel up to the lungs and cause a pulmonary embolism, or a blockage of blood flow. A pulmonary embolism can in turn stop oxygen from entering the bloodstream, damaging organs, and can quickly become life-threatening.
Anyone at any age is at risk of developing a blood clot, according to the U.S. Centers for Disease Control and Prevention (CDC), but there are risk factors that increase someone’s odds of developing one.
Older adults and those with people with clotting disorders are the most at risk of developing a blood clot due to inactivity, according to the CDC. A recent surgery, hospitalization or pregnancy, cancer and some types of cancer treatments can also be risk factors.
To avoid blood clots, health experts encourage remote workers to stay hydrated and to get up from their desks and move around every two to three hours.
“It’s the same rationale as encouraging individuals at risk for clotting to get up and walk on long flights and drinking water,” said Carnethon.
Not only can little movement lead to more immediate risks like blood clots, but it can contribute to long-term health issues as well.
Unless remote workers make a conscious effort to exercise, being sedentary throughout the day puts workers at risk of putting on weight, and increasing insulin resistance, raising their odds of developing cardiovascular disease and diabetes, according to Arena.
Physical activity has also been linked to improving bone and musculoskeletal health and reducing the risk of developing dementia, according to the CDC.
About 3.2 million deaths a year are the result of physical inactivity, according to the World Health Organization.
Excess screen time can worsen eyesight, cause migraines
More than half of remote workers reported experiencing an increase in eyestrain during the first year of the pandemic, according to a survey of 2,000 at-home and hybrid workers.
This could be linked to the extra number of hours remote workers spend staring at screens compared to their office-going counterparts.
One survey from All About Vision found that a person working from home spends an average of 13 hours a day looking at a screen a day, be it their laptop, phone or television — over two hours more than what the average on-site worker spends staring at a screen.
The same survey found that 68 percent of remote workers reported new eye or vision problems since they started working from home.
Those complaints of worsening eyesight make sense, according to Mercedes Carnethon, vice president of preventative medicine at Northwestern Feinberg School of Medicine.
“If I’m working remotely and I’m spending five hours a day in meetings, that’s five hours of blue light exposure,” she said. “If I had been working in an office and meeting with people in person, I would have a need to adjust my vision to see things further away and closer which helps to, I think, keep the eyes healthy.”
Carnethon added that people who look at screens for long periods of time are less likely to blink as frequently compared to people not starting at a screen. This habit can contribute to dry eyes, which, if left untreated, can turn into a chronic problem.
“It’s a significant quality of life issue,” said Carnethon. “And if you end up with eyestrain or vision changes that are sped up due to staring at screens…headaches and other uncomfortable downsides are very real.”
Other painful side effects associated with staring at screens too long are double vision, blurred vision and neck pain.
Working from home can make it easier to pick up — or indulge — bad habits
Working from home can make it easier for some people to continuously snack throughout the day, which can lead to unwanted weight gain, according to Carnethon.
It can also make it easier for some people to indulge in habits like smoking and drinking too much.
For people working in an office, opportunities to smoke are limited, and commutes often prevent people from having after-work drinks the moment the workday ends.
“When you are working from home without that sense of accountability, you could potentially see someone just sitting at their desk smoking while they work,” she said. “Or pour that drink at 5 o’clock because they don’t have to drive home.”
One out of five U.S. workers admitted to having used alcohol, marijuana or another recreational drug while working remotely in 2021, according to a national survey that year from Sierra Tuscon, a mental health treatment center in Arizona.
Out of those who used, 73 percent said that if their employer forced them to return to the office they would “miss the opportunity to use marijuana, alcohol, and other recreational drugs during their workday.”
In addition, 22 percent of those who used said they have participated in a virtual work call while under the influence of alcohol, cannabis or another recreational drug.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Stress and Wellness |
Patients who have been waiting more than 40 weeks for treatment in England will be offered the option of getting seen in another part of the country.
About 400,000 will be contacted in the coming weeks and asked whether they would be willing to travel and how far.
Patients already have a right to ask for treatment elsewhere.
But NHS England believes that by proactively contacting the longest waiters they will help unlock some of the worst bottlenecks in the system.
Only those who do not have an appointment already scheduled within the next eight weeks will receive the offer via text, email or letter.
The 400,000 figure represents about 5% of the total number waiting for treatment.
If a patient is happy to travel, the treatment could either be in an NHS or private sector hospital.
Those on low incomes will be entitled to some financial support to enable them to travel for treatment.
Patients will retain their place on the waiting list at their local hospital while other options are explored.
NHS England chief executive Amanda Pritchard said it was "absolutely right" to make the most of available capacity across the country to reduce backlogs.
Waits for treatment can vary greatly, with some hospitals able to treat patients three times more quickly than others for common orthopaedic procedures such as hip and knee operations.
Health Secretary Steve Barclay said empowering people to exercise choice would help "tackle waiting lists and improve access to care".
Louise Ansari, of the patient watchdog Healthwatch England, welcomed the move, saying long waits were having a devastating impact on both the physical and mental health of people.
But she said it needed to be backed by more financial support.
"People have also told us that they would welcome the opportunity to travel to receive care more quickly, as long as any additional costs incurred would be covered."
She said if people did not receive the support they needed to travel, the move risked widening inequalities.
Saffron Cordery, deputy chief executive of NHS Providers, which represents hospitals, said patient choice should not be seen as a "magic bullet".
"Long waiting times are a symptom of years of severe workforce shortages and underinvestment in the NHS," she added. | Health Policy |
- The order by the U.S. 5th Circuit Court of Appeals is almost certain to be appealed to the Supreme Court.
- Mifepristone, used in combination with another drug called misoprostol, is the most common method to terminate a pregnancy in the U.S..
A federal appeals court on Wednesday imposed restrictions on the abortion pill mifepristone, though the ruling will not have an immediate impact.
The ruling by the U.S. 5th Circuit Court of Appeals is paused from taking effect until the Supreme Court makes a decision about the case. The high court imposed the pause in April upon request from the Biden administration after lower courts ruled against the pill.
The appeals court Wednesday ruled that the several decisions the Food and Drug Administration took to make the abortion pill more broadly available to women were illegal.
If the Supreme Court upholds Wednesday's ruling, women would no longer be able to obtain the abortion pill by mail. Patients would have to receive a prescription from a doctor and have three follow-up appointments in person. The restrictions would also shorten the time period when women can take the pill to 49 days into their pregnancy, down from 70 days.
"In loosening mifepristone's safety restrictions, FDA failed to address several important concerns about whether the drug would be safe for the women who use it," Judge Jennifer Walker Elrod wrote in the majority opinion Wednesday. "It failed to consider the cumulative effect of removing several important safeguards at the same time."
The appeals court left the Food and Drug Administration's underlying 2000 approval of mifepristone and its 2019 authorization of a generic form of the drug in place.
In a dissenting opinion, Judge James Ho argued that the appeals court should have also rolled back the FDA's original approval of mifepristone, an action that would remove the medication from the U.S. market.
Mifepristone, used in combination with another drug called misoprostol, is the most common method to terminate a pregnancy in the U.S.
The court battle over mifepristone comes more than a year after the Supreme Court abolished federal abortion rights by overturning the landmark 1973 Roe v. Wade ruling.
The three-judge panel at the 5th Circuit heard oral arguments in May from the FDA, mifepristone distributor Danco Laboratories, and a group of anti-abortion doctors called the Alliance for Hippocratic Medicine.
The appeals court judges were all appointed by Republican presidents. Elrod was appointed by George W. Bush. Ho and Judge Cory Wilson were appointed by Donald Trump.
The FDA and Danco argued during oral arguments in May that the lawsuit seeking to pull mifepristone from the U.S. market is unprecedented, has no basis in science and will jeopardize women's health.
The panel of judges pushed back hard on those arguments.
The judges questioned whether allowing women to receive mifepristone by mail without having to see a doctor would result in more patients seeking emergency care. Ho pushed back on the FDA and Danco's characterization of the case as unprecedented.
"I don't understand this theme — the FDA can do no wrong. That is basically the narrative you all are putting forth — nobody should ever question the FDA," Ho said during the hearing.
"We are allowed to look at the FDA just like we are allowed to look at any agency, that's the role of the courts," Ho said. | Drug Discoveries |
If you looked into most of the violence in this country, you would likely find that drugs were at the bottom of it. And the lawless maiming and killing of road users by dangerous drivers is definitely a form of criminal violence.
What a contrast it is to the carefully promoted image of marijuana as a 'harmless high' to see the tangled metal, flames and life-ruining carnage of a road accident – and to realise that has very probably been brought about by the use of this substance.
Drug-driving is at least comparable to the knife crime that is such a terrifying problem in London and other cities. And as Rebecca Camber reports, the amount of drug-driving has now surpassed the amount of drink-driving in this country.
After almost 60 years of pretending that drugs were not really a problem, and only concerned puritan old fogeys, we find that these substances ruin and end lives.
Yet even then, the enforcement of a law against this menace is inadequate, with dangerous criminals being caught and then let off because it is a bit difficult to proceed against them.
Actually there is a much wider problem with drugs. In almost all cases of highly publicised terrorist violence, here and abroad, the culprits have been found to be users of mind-altering drugs.
This does not mean that marijuana turns people into terrorists (though in some cases it surely does). It means that in the few cases where the media spotlight is turned on the culprit's life, there is a striking link between violence and long-term drug use.
The ceaselessly updated website 'Attacker Smoked Cannabis' records scores of hideous violent crimes in which allegedly peaceful marijuana has been a feature.
But – in a country far too used to such crime – such events are these days only reported locally.
Yes, alcohol is also a dangerous drug and, given the impossibility of banning it after thousands of years of legality, we should try a lot harder to control it as we did until the 1980s.
But the astonishing thing is that illegal drugs, which – on paper – attract heavy prison sentences, should be doing so much damage, while we do so little about them.
By far the best way of making our roads safer would be to do as they do in Japan and South Korea, and prosecute and punish the possession of illegal drugs. That would stop this problem at its source.
The police of this country long ago decided it was not worth their while to do much about the huge and growing use of dangerous, illegal drugs.
They achieved this by simply ignoring the laws they are paid to enforce. They then pretended that crime was falling, when in fact they had just stopped paying attention to it.
The policy started with marijuana, a highly dangerous drug whose use is linked with severe mental illness, but which years of skilful PR falsely portrayed as 'soft'.
Then it moved on to the bogeyman drugs such as cocaine and heroin, and all the rest of these idiotic poisons. We pay the price of this police arrogance every day.
I am sorry if this upsets you. I too would much prefer to respect and admire the police.
But here's the proof: in February 1994, the former head of Scotland Yard's legendary Flying Squad, John O'Connor, wrote a newspaper article in which he admitted the stark truth: 'Cannabis has been a decriminalised drug for some time now.
'Although still illegal, somebody found by police in possession of a small amount for their own use will probably just get away with a caution these days.'
Please note again, this was in 1994. A few years later, after yet another elite 'report' into the drug laws (all these reports want to soften the law) this arrangement was formalised across England and Wales.
Chief police officers, without troubling to consult Parliament, invented their own 'Cannabis Warning', a non-punishment, not even centrally recorded, which would be applied to most cases of marijuana possession.
Not long after that, they more or less totally gave up doing anything at all, and large parts of urban Britain now reek of dope, especially in the summer months.
Are you surprised, in the light of this, that so many people drive while drugged? In 2012, in a carefully researched book, The War We Never Fought, I explained that this was a long one-way process, dating to the 1960s.
The police are not totally to blame. Politicians, civil servants, judges and magistrates have all worked together to undermine the law of the land. They do not believe drugs are really bad.
But if we want them to enforce the laws then the people of this country must reject and reverse the long liberal campaign to soften the drug laws, and make our political leaders act to ensure that the drug problem is stifled at its source – the irresponsible individuals who buy and take these poisons. | Drug Discoveries |
World June 15, 2022 / 11:52 AM / CBS/AFP A group of scientists say that history has been blaming the wrong rodent for bringing the deadly epidemic to Europe Scientists rethink source of bubonic plague in Europe 00:45 A deadly pandemic with mysterious origins: It might sound like a modern headline, but scientists have spent centuries debating the source of the Black Death that devastated the medieval world.Not anymore, according to researchers who say they have pinpointed the source of the plague to a region of Kyrgyzstan, after analyzing DNA from remains at an ancient burial site."We managed to actually put to rest all those centuries-old controversies about the origins of the Black Death," said Philip Slavin, a historian and part of the team whose work was published Wednesday in the journal Nature. The Black Death was the initial wave of a nearly 500-year pandemic. In just eight years, from 1346 to 1353, it killed up to 60% of the population of Europe, the Middle East and Africa, according to estimates. Ancient DNA traces origin of Black Death https://t.co/NNd656FmhG— nature (@Nature) June 15, 2022 Slavin, an associate professor at the University of Stirling in Scotland who has "always been fascinated with the Black Death," found an intriguing clue in an 1890 work describing an ancient burial site in what is now northern Kyrgyzstan. It reported a spike in burials in 1338-39 and that several tombstones described people having "died of pestilence.""When you have one or two years with excess mortality it means that something funny was going on there," Slavin told reporters."But it wasn't just any year — 1338 and 1339 was just seven or eight years before the Black Death," he said.It was a lead, but nothing more without determining what killed the people at the site. For that, Slavin teamed up with specialists who examine ancient DNA.They extracted DNA from the teeth of seven people buried at the site, explained Maria Spyrou, a researcher at the University of Tuebingen and author of the study.Because teeth contain many blood vessels, they give researchers "high chances of detecting blood-borne pathogens that may have caused the deaths of the individuals," Spyrou told AFP.Once extracted and sequenced, the DNA was compared against a database of thousands of microbial genomes."One of the hits that we were able to get... was a hit for Yersinia pestis," more commonly known as plague, said Spyrou.The DNA also displayed "characteristic damage patterns," she added, showing that "what we were dealing with was an infection that the ancient individual carried at the time of their death."The start of the Black Death has been linked to a so-called "Big Bang" event, when existing strains of the plague, which is carried by fleas on rodents, suddenly diversified. Scientists thought it might have happened as early as the 10th century but had not been able to pinpoint a date.The research team painstakingly reconstructed the Y. pestis genome from their samples and found the strain at the burial site pre-dated the diversification.And rodents living in the region now were also found to be carrying the same ancient strain, helping the team conclude the "Big Bang" must have happened somewhere in the area in a short window before the Black Death. A 2009 file photo of the Black Death burial trench under excavation between the concrete foundations of the Royal Mint, East Smithfield, London. Getty Images The research has some unavoidable limitations, including a small sample size, according to Michael Knapp, an associate professor at New Zealand's University of Otago who was not involved in the study."Data from far more individuals, times and regions... would really help clarify what the data presented here really means," said Knapp.But he acknowledged it could be difficult to find additional samples, and praised the research as nonetheless "really valuable."Sally Wasef, a paleogeneticist at Queensland University of Technology, said the work offered hope for untangling other ancient scientific mysteries. "The study has shown how robust microbial ancient DNA recovery could help reveal evidence to solve long-lasting debates," she told AFP.According to the World Health Organization, a total of 3,248 cases were reported worldwide between 2010 and 2015, resulting in 584 deaths. The Democratic Republic of the Congo, Madagascar and Peru were the most affected countries. The plague was first introduced to the U.S. in 1900 from steamships carrying infected rats. The last urban outbreak of rat-associated plague in the U.S. was in Los Angeles between 1924 and 1925. According to the U.S. Centers for Disease Control and Prevention, people typically get bubonic or septicemic plague after they are bitten by a flea that is carrying the bacterium. Humans may also contract the disease when handling an animal that is infected. In: Pandemic Thanks for reading CBS NEWS. Create your free account or log in for more features. Please enter email address to continue Please enter valid email address to continue | Disease Research |
Eamonn Holmes departed Wembley Stadium in his wheelchair after his beloved Manchester United defeated Newcastle in the League Cup final on Sunday.
The presenter, 63, who is battling chronic back pain, was pushed by his devoted son Declan, 34, and appeared in high spirits despite his recent health woes.
He cut a casual figure in a navy sports jacket which he layered over dark trousers, completing the look with comfy trainers.
The former This Morning host, who has also undergone back surgery for help relieve the symptoms, wore his silver locks in a relaxed style and carried a crutch in his right hand.
Beaming Eamonn gave a wave to fans as he entered the venue and even stopped to chat with a star-stuck security guard.
As well as Declan, Eamonn shares Rebecca, 31, and Niall, 29, with his ex-wife Gabrielle.
He split from Gabrielle, after ten years of marriage in 1996, as the pressure of commuting to London to present GMTV from their home in Belfast took its toll.
Eamonn married co-host and wife Ruth in 2010, they share son Jack, 20.
It comes after Eamonn reunited with pal and former S Club & star Jo O'Meara for lunch, after she recommended a surgeon to operate on his injured back.
The singer, 43, had herself struggled with chronic pain which led her to spend eight days in hospital and unable to work, after a failed surgery to remove a disc from her back.
Jo took to Instagram to share a snap with Eamonn earlier this month after they met up to discuss their recent problems, joking that it was 'lovely to moan about their backs' together.
The GB New host previously credited Jo with recommending a surgeon who was able to help with his back problems, after being left in excruciating pain following a fall at his home.
He went under the knife in September to alleviate the pain, but continues to struggle with 'an issue with his left leg,' for which he is undergoing physiotherapy.
Jo shared a picture of herself with her arm round Eamonn, who appeared to be seated outdoors.
She wrote: 'So lovely catching up with this one today @eamonnholmes it was lovely to see you and chat (and moan) about our backs, but always a giggle close by ! #gettogether #friends #recovery #lunch.'
In an interview with The Daily Mail last month, Eamonn revealed that Jo contacted him on social media with the name of a German surgeon after he struggled with chronic back pain.
A scan revealed three protruding discs. 'I still thought it would go away, but it didn't. The knock-on effect was that I lost a lot of use in my right leg,' he says.
'I got epidural injections, which helped to a degree, but didn't cure the problem. I started using a stick, so life was already becoming more curtailed.'
Things took a turn for the worse when, last May, he flew to Belfast to host an event in honour of close friend, broadcasting legend Gloria Hunniford, and ended up in A&E at the city's Royal Victoria Hospital, after his spinal problems caused bladder and bowel issues.
Eamonn was immediately admitted for emergency surgery, only for the operation to be postponed at the last minute.
'The surgeon was standing over me, all masked up and ready to operate, but then decided it was too complicated.
'The spine and all the nerves that lead off it affect so many other things, which he felt needed to be addressed first. I was crushed,' he recalls. 'I had been in severe pain for a year, and I desperately hoped this might be the answer.'
Instead, he spent nine days being monitored in hospital before returning to England - to a full work schedule, culminating in live coverage of the death of the Queen in September.
'By now my left leg wasn't working well either,' he says. 'I had to rely heavily on Isabel, who was bearing my weight, getting me round. It was horrendous.'
He mentioned his troubles in passing on social media and was contacted by Jo.
'She got in touch to say she had the same disc problems I did and had just had surgery with a German surgeon,' he said. 'I asked if she could pass on his details, because by now I was desperate.'
After contacting the surgeon, Eamonn went under the knife in late September. 'It went well — the doctor tidied things up, and generally the pain has gone, which is brilliant,' he said. | Medical Innovations |
Humza Yousaf has denied deleting Whatsapp messages relating to the Covid-19 pandemic.
The Scottish government has been accused of failing to hand over data to the UK Covid Inquiry.
Senior government figures during the pandemic, including former first minister Nicola Sturgeon, have been accused of wiping messages or using an auto-delete function.
Mr Yousaf said it was "certainly not true" that he had removed messages.
He said his government would "fully" comply with both the UK and Scottish Covid inquiries.
"I have kept and retained all of the WhatsApp messages and I am more than happy to hand them over to the Covid inquiry," the first minister told BBC Scotland News.
"Government business isn't routinely done over WhatsApp and of course where any decisions were made they were appropriately recorded within our message management system.
"If the Covid inquiry wants more information, needs more information, then I expect every minister, past and present, every government official or clinical adviser to comply."
Mr Yousaf - who served as health secretary from May 2021 before becoming first minister in March 2023 - said government figures were not told to delete messages and that his administration had provided about 13,000 documents to the inquiries.
He said the government had recently asked the UK Covid Inquiry for a legal order to release messages to "make sure we are operating within the bounds of the law".
Ms Sturgeon announced in May 2020 that there would be a Scottish Covid inquiry in addition to the UK probe. This was confirmed in August 2021.
It has been reported by the Sunday Mail that the former first minister manually deleted messages relating to the pandemic.
Her spokesperson said she was co-operating with both the Scottish and UK inquiries.
The Scottish inquiry issued a "do not destroy" order at the beginning of August 2022, meaning it could be an offence for witnesses to have deleted Covid-related messages after that date.
Mr Yousaf told MSPs in June "any material that is asked for - WhatsApp messages, emails, Signal messages, Telegram messages or whatever - will absolutely be handed over to the Covid inquiries and handed over to them in full".
Deletion fears
Jamie Dawson KC, counsel to the UK inquiry, said 70 Scottish government figures were asked for their WhatsApp messages, but "very few appear to have been retained".
He said this was "surprising" and that the "process of recovery had gone more slowly than expected".
There were at least 137 WhatsApp groups being used across the Scottish government and its agencies during Covid.
The Scottish government told the inquiry in recent weeks that it needed a formal order under section 21 of the Inquiries Act 2005 to disclose all of the information due to data privacy concerns.
Mr Yousaf said this had not yet been received.
On Thursday, The Times reported that national clinical director Jason Leitch deleted messages every day during the pandemic.
The Scottish Daily Mail also reported that chief medical officer Prof Sir Gregor Smith used an auto-delete function on Whatsapp messages during the crisis. That function was launched by WhatsApp in November 2020, eight months after the pandemic was declared.
Prof Leitch and Prof Smith have been asked to comment.
Green minister Lorna Slater, who was appointed in August 2021, told BBC Scotland's Sunday Show she did not use Whatsapp for government business and did not have a government-issue phone.
Deputy First Minister Shona Robison is expected to make a statement on the issue in the Scottish Parliament, possibly as early as Tuesday.
Scottish Labour health spokesperson Jackie Baillie accused Mr Yousaf of misleading parliament over the electronic messages and said he should give the statement to MSPs since he served as health secretary during the crisis.
"The withholding of evidence like this is disrespectful and insulting to bereaved families who lost loved ones to Covid because they were promised answers by government and it looks like information is being deliberately withheld," she told BBC Radio's Good Morning Scotland.
The Scottish Conservatives have said that ministers must "come clean" over whether they deleted messages relevant to the UK Covid Inquiry. | Epidemics & Outbreaks |
Let’s prevent the feds from jeopardizing veteran addiction recovery
During my time in uniform, I observed firsthand servicemembers and veterans who returned from service with injuries and chronic pain. Unfortunately, due to these issues many have become dependent on dangerous opioids for relief and sadly, many will wind up as another of the 80,000 opioid overdose deaths per year in the United States.
One of the tools and resources many veterans have used to quit their opioid dependence, manage pain, improve mood and focus, and get their lives back on track has been through controlled use of a pure, unadulterated kratom product. For many, it is literally a miracle solution keeping them from a downward spiral of addiction and destruction.
But today, the recovery of millions of veterans is threatened by an overreaching federal government. Three times in the last decade, the U.S. Food and Drug Administration (FDA) has attempted to force kratom into Schedule 1 of the Controlled Substances Act, a drastic action that would essentially criminalize the use of the supplement nationwide and harm countless Americans who have benefited from kratom for decades. The FDA, which has a long-standing bias against any supplement that is not a pharmaceutical that can profit Big Pharma and their own budget, has pushed for kratom to be labelled a Controlled Substance by misstating the science, ignoring kratom’s long history of safe use, and falsely claiming kratom has the same effects as classic opioids.
I am introducing a bill in the House to beat back this threat to criminalize the millions of Americans who have used kratom to get off dangerous opioids and improve their lives. The Federal Clarity for Kratom Consumers Act would protect the supplement from federal overreach and reclassification as a dangerous drug, while ensuring the safety of the product to provide consumers with a properly manufactured supplement they can rely on.
In their relentless campaign to get kratom reclassified as a dangerous drug, the FDA has relied on three fallacious and thoroughly debunked objections to its widespread use: that kratom is unsafe, that it is highly addictive, and that it has no approved medical use. Even former HHS Assistant Secretary for Health Brett Giroir felt compelled to call out the FDA for relying on “disappointingly poor evidence and data and a failure to consider the overall public health” in coming to such a baseless conclusion. It is rare for a top-ranking HHS official to criticize the FDA for biased, shoddy work, but in this case the unsupported conclusions were so egregious that Giroir felt it necessary to publicly criticize them. Likewise, current HHS Secretary Xavier Becerra acknowledged substantial “knowledge gaps” regarding kratom and that “kratom-involved overdose deaths have occurred after use of adulterated kratom products or taking kratom with other substances.”
These claims about deaths associated with kratom have been reviewed by experts and found to be entirely without basis in fact. Kratom simply does not cause the respiratory suppression that is associated with overdose death. Additionally, the FDA is completely mistaken in asserting that kratom is dangerously addictive. The data shows relatively low abuse potential as compared to morphine-like opioids, stimulants, and other drugs of abuse. While kratom has not been approved for medical use, the same is true for tens of thousands of foods, dietary ingredients, botanical supplements, and dietary supplements currently available to U.S. consumers, many of which are regularly used to self-medicate by consumers to maintain their health and well-being.
Singling out kratom for criminalization would be an egregious abuse, particularly given this supplement’s proven utility as a way of lessening the use of dangerous opioids responsible for an epidemic of death and addiction.
The Federal Clarity for Kratom Consumers Act is a good first step to protect Americans from overreaching federal government regulators, the same ones who looked the other way during the opioid epidemic.
Jack Bergman is a retired Marine Corps lieutenant general and currently represents Michigan’s 1st District.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Drug Discoveries |
With hospitals in China reportedly overwhelmed by a surge of mysterious childhood pneumonia cases — and as outbreaks begin to crop up in areas of the U.S. — experts are weighing in on possible causes and recommendations.
Dr. Sarah Park, medical director of medical affairs at Karius, a California biotech company, was formerly with the Centers for Disease Control and Prevention (CDC) as an epidemic intelligence service officer.
She told Fox News Digital that the surge in respiratory illnesses, including cases of pneumonia, is primarily attributed to common pathogens like Mycoplasma pneumoniae, respiratory syncytial virus (RSV), adenoviruses and influenza virus.
"There is no indication of a novel virus causing these illnesses," said Park.
She's contributed to combating diseases such as bacterial respiratory diseases, West Nile Virus and SARS.
The condition has been described as "white lung syndrome," which is a reference to the appearance of the chest scans that show "diffusely damaged lungs" related to severe cases of pneumonia, Park noted.
What factors are causing the outbreak?
The increase in respiratory illnesses is believed to be due to a combination of factors.
Respiratory illnesses typically surge in the colder months, but this has been compounded by a post-pandemic effect, according to experts.
"This is the first winter without strict COVID-19 measures, and that has likely led to increased exposure and susceptibility to common respiratory infections," Park said.
"Prolonged lockdowns and other COVID-19 containment measures have limited people's exposure to common pathogens, potentially reducing population immunity levels."
While Park called the outbreaks "concerning," she said there is "no current indication that it represents a novel pathogen or a threat on the scale of a new pandemic."
She added, "Most of the reported pathogens are well-known and typically manageable."
Where are the outbreaks occurring?
In China, ProMED, the global digital disease surveillance system, reported that the country’s hospitals — primarily in Beijing — have become "overwhelmed with sick children" as a result of the pneumonia outbreak.
The Netherlands has also seen a surge. During the week of Nov. 13-19, there were 103 pneumonia cases for every 100,000 children between the ages of 5 and 14, according to the Netherlands Institute for Health Services Research (NIVEL).
Some areas in the U.S. have also reported outbreaks or upticks in cases, including the states of Ohio and Massachusetts.
"Similar patterns of increased respiratory illnesses have been observed in other countries, including the U.S., after the lifting of COVID-19 restrictions," Park told Fox News Digital.
"Prolonged lockdowns and other COVID-19 containment measures have limited people's exposure to common pathogens, potentially reducing population immunity levels."
"However, the specific mix of pathogens and the severity of outbreaks can vary based on local factors such as population immunity and health care infrastructure."
How is childhood pneumonia treated?
Pneumonia, or "white lung syndrome," is usually treated with a course of antibiotics.
There is some concern about antibiotic resistance, particularly in the case of Mycoplasma pneumoniae infections, Park noted.
"Overuse or misuse of antibiotics can lead to strains that are harder to treat, emphasizing the need for responsible antibiotic prescribing and usage," she said.
In managing the childhood pneumonia outbreaks, Park emphasized the importance of "timely and transparent communication" between countries and international health organizations like the World Health Organization (WHO).
"This exchange of information is critical for global surveillance and response to infectious diseases," she said.
The ongoing mental and physical impacts of the COVID-19 pandemic and associated restrictions may also play a role in the current health landscape, the expert said.
"As the global community continues to navigate the aftermath of the COVID-19 pandemic, this situation is a reminder of the need for continued vigilance against respiratory illnesses," she said.
"This includes ongoing research, health care system preparedness, and public health measures." | Epidemics & Outbreaks |
Humans have an attuned sense of touch that connects us to our surroundings, and now, scientists think they've discovered a previously unknown way that we use this sense.
A new study has revealed that cells within the outer layer of our hair follicles, the tiny tubes in our skin that surround hair fibers, can detect touch. In response, these cells release chemicals called neurotransmitters that activate nearby sensory neurons, which relay information about our surroundings to the brain. It was previously thought that touch detectors were found only in nerve endings in the skin and near hair follicles — not actually within the follicles themselves.
The findings, published Oct. 27 in the journal Science Advances, were drawn from isolated cells and have yet to be proven in living organisms. However, if confirmed, they may expand the repertoire of known ways that humans sense touch, including via the activation of sensory neurons in the skin that detect both touch and the movement of hair.
"The mechanism we have presented is not better, or more sensitive than direct activation of sensory neurons, which is how we usually process touch," co-senior study author Claire Higgins, a tissue regeneration researcher at Imperial College London, told Live Science in an email.
"So, we are intrigued to discover what the hair follicle adds to the process of touch sensation and why it has this role," she said.
Related: The five (and more) human senses
In the new study, the researchers analyzed the gene activity of more than 40,000 cells isolated from human hair follicles and skin. They did this by looking at RNA molecules, which relay instructions for building proteins from the cell's DNA to its protein construction sites. They found that the hair follicle cells contained three times as many touch-sensitive receptors as the skin cells.
In a separate test, applying tension to human hair follicle cells that had been grown in the lab alongside sensory neurons led to the activation of the latter.
In another experiment, the authors discovered that hair follicle cells activated the nearby neurons by releasing the neurotransmitters serotonin and histamine, which also triggers inflammation. The skin cells also released histamine in response to touch, but not serotonin, and the authors are curious whether both the skin cells' and hair follicles' activation could be linked to skin diseases such as eczema. The skin condition is thought to be exacerbated by histamine-producing immune cells called mast cells, but perhaps these two types of touch detectors also play a role.
"Our work is the first to show that skin cells can also release histamine," Higgins said. "While the levels released are much lower than that released by mast cells, it still suggests a mechanism for skin cells in this disorder," she said.
This research is still in its early days, but as serotonin and histamine can influence each other's production and release in many parts of the body, this could represent a new therapeutic avenue.
"We don't know if this relationship is mirrored in the skin, but if it is, we can explore ways of modulating serotonin as a way to regulate histamine release," she said.
Ever wonder why some people build muscle more easily than others or why freckles come out in the sun? Send us your questions about how the human body works to [email protected] with the subject line "Health Desk Q," and you may see your question answered on the website!
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Emily is a health news writer based in London, United Kingdom. She holds a bachelor's degree in biology from Durham University and a master's degree in clinical and therapeutic neuroscience from Oxford University. She has worked in science communication, medical writing and as a local news reporter while undertaking journalism training. In 2018, she was named one of MHP Communications' 30 journalists to watch under 30. ([email protected]) | Medical Innovations |
An Apple Store employee shows the Series 5 Apple Watch during the preview of the redesigned and reimagined Apple Fifth Avenue store in New York, U.S., September 19, 2019. REUTERS/Brendan McDermid/File PhotoRegister now for FREE unlimited access to Reuters.comJune 13 (Reuters) - San Francisco-based startup Rune Labs on Monday said it received clearance from the U.S. Food and Drug Administration to use the Apple Watch to monitor tremors and other common symptoms in patients with Parkinson’s disease.The Rune Labs software uses motion sensors built into the Apple Watch, which can already be used to detect when a person falls. Rune Labs Chief Executive Brian Pepin said in an interview that Apple Watch data will be combined with data from other sources, including a Medtronic Inc (MDT.N) implant that can measure brain signals.Rune Labs' goal is for doctors to use the combined data to decide whether and how to fine-tune the patients' treatment. At present, Pepin said, most doctors have to gather data on a patient's movements by observing them during a short clinical visit, which is not ideal because Parkinson's symptoms can vary widely over time.Register now for FREE unlimited access to Reuters.comUsing the Apple Watch, Rune Labs' StrivePD software platform will provide doctors a continuous stream of observations over long stretches, Pepin said."When you think about the process of getting someone to their optimal therapy or combination of drugs or devices, or even whether or not a patient might be a good fit for a certain clinical trial, it's a very hard decision to make when you only have a little context," Pepin said.The Rune Labs FDA clearance is the first prominent use of software tools that Apple released for measuring movement disorders in 2018.Last year, a group of scientists at Apple published a study in the journal Science Translational Medicine showing the device was effective at monitoring Parkinson's symptoms. After contacting Apple about the tools, Pepin said, "it took about eight minutes for the team lead to get back to me and say, 'Hey, perfect, let's explore this.'"Apple has partnered with a range of other companies to use the Apple Watch as a health monitoring device, including a deal with Johnson & Johnson (JNJ.N) to study whether it can be used to help lower stroke risk.Register now for FREE unlimited access to Reuters.comReporting by Stephen Nellis in San Francisco; editing by Diane Craft and Bill BerkrotOur Standards: The Thomson Reuters Trust Principles. | Medical Innovations |
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