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The day-to-day demands of work can pose many challenges when you have arthritis. Thatâs true whether you work at a desk job or a job that requires lifting and bending. Fortunately, a few simple principles can help most people get through the day without undue pain. Ergonomically designed chairs, desks, and specific equipment can also help take the strain off painful joints. Here are eight tips from arthritis experts.
1. Take Breaks From Repetitive Motions
Whether you work at a computer or on a construction site, chances are your job requires some repetitive motions. âRepetitive movements can cause repetitive stress injuries, which can exacerbate arthritis pain,â says Andrew Lui, PT, assistant clinical professor of physical therapy and rehabilitation at the University of California, San Francisco, where he counsels people with arthritis and other joint pain. âWhenever possible, take frequent breaks if you have to do work that involves repetitive movements."
2. Use Good Arthritis Body Mechanics
Whether you do a lot of moving at work or sit or stand in one position, your joints are less likely to act up if you keep them in what physical therapists call a neutral position. For knees, for example, the neutral position is slightly bent -- the position they are in when you sit in a chair with your feet extended forward a little.
For wrists, neutral position places your hand and forearm in a straight line, so the nerves passing through your wrist arenât pinched. The neutral position for your neck when youâre working at a desk is with your head held straight. âWhatever kind of work you do, pay attention to the position your body is in,â says Lui. âTry to eliminate unnecessary strain by finding the most comfortable position.â
3. Stay Mobile With Osteoarthritis
Staying in any one position for too long also puts stress on your joints. âAs much as possible, try to change positions frequently during your working day,â says Kimberly Topp, PhD, professor and chair of the department of physical therapy and rehabilitation services at UC-San Francisco.
If youâre on your feet a lot at work, take frequent breaks to sit. Another strategy that may help: placing one foot on a footstool while youâre standing, in order to change your knee position and relieve strain on your back. (Be sure to alternate between your right and left foot.) If your job involves working with your hands, such as typing or carpentry, alternate tasks frequently so that you change your body position. If your job involves sitting, take breaks to stand up, stretch, and walk around. Desk chairs that allow you to adjust positions can also help prevent unnecessary strain on joints.
4. Lift Wisely and Save Your Joints
âIf your job involves lifting objects, be sure to bend your knees when lifting,â says Kate Lorig, RN, DrPH, professor emeritus at Stanford University School of Medicine and author of The Arthritis Helpbook. âThis puts less strain on your back. Hold objects close to your body in order to reduce the load on your arms and wrists.â Store heavy items in locations that minimize the amount of lifting you have to do. When possible, ask co-workers to help if your arthritis is acting up.
5. Minimize Joint Pain and Strain
âBy using a little advance planning, you can avoid unnecessary strain on troublesome joints,â says Lorig. If you have to climb stairs for something, for instance, think about anything else you might need to bring up or down. That way you can minimize the number of trips you have to take.
6. Use Arthritis-Friendly Wheels
The wheel was a terrific invention. So use it. Folding metal carts, wheeled tea carts, utility carts, and wheeled briefcases or suitcases are great ways to move items from place to place without having to carry them. If youâre buying a cart, try out several models to find the one that feels best to you. Ideally, folding carts should be sturdy but light, with a handle that feels comfortable in your hands.
7. Try Arthritis Assistive Devices
Today, many kinds of tools and gadgets are available in designs made to minimize the strain on joints, especially fingers and hands. Examples include:
- Ergonomic computer keyboards. Designed so that your hands and wrists are aligned to minimize pinching of the nerves in your wrist, these keyboards have been shown to reduce pressure within the carpal tunnel, which carries the nerves that control the hand. Some ergonomic keyboards are adjustable, allowing you to find the position thatâs most comfortable for you.
- Doorknob extenders. These clever devices eliminate the need for closing your hand around the knob -- something that can be painful if you have arthritis in your hands or fingers.
- Book holders. If your work involves consulting books or manuals, desktop book holders are a great way to minimize strain on your hands. Another new option is eBook readers, which are typically much lighter than books and can be propped up in stands on your desk.
- Pencil grips. If you use a pencil at work, buy a pencil grip, which wraps around the shaft of the pencil, creating a much wider grip. Some pens come with built-in grips.
- Ergonomically designed implements. Many tools, from scissors to screwdrivers, come in varieties designed to minimize joint pain. Because no two people with arthritis are exactly alike, itâs wise to try out several models in order to choose the one thatâs best for you.
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8. Reduce Stress and Ease Joint Pain
âThe issue for people with arthritis is managing pain, and pain comes from many sources,â says Lorig. âStress, depression, and fatigue can also increase pain.â So in addition to finding practical strategies and tools to minimize joint strain, itâs important to find ways to relieve stress and maintain a practical outlook.
Learning a few specific relaxation techniques, such as progressive relaxation or meditation, can help. Taking a little time each day for exercise has also been shown to help ease stress and depression. âExercise has the added benefit of strengthening joint muscles and improving flexibility,â says Lorig. That, in turn, may help ease arthritis pain. | Stress and Wellness |
Many Swifties are experiencing a post-concert "blank space."
Fans of international pop star Taylor Swift have reported a lack of memory after attending Eras Tour concerts — with some saying they're even forgetting chunks of her performance.
Experts at Hackensack Meridian Health in New Jersey researched why concertgoers are experiencing blackouts after their big night out.
Dr. Nathan Carroll, associate chief resident psychiatrist at Hackensack Meridian Jersey Shore University Medical Center, linked the memory loss after concerts to a neurological condition called transient global amnesia (TGA).
TGA is a "rare phenomenon impacting memory," the researcher told Fox News Digital.
"Individuals who experience TGA will attend an event (like a concert, wedding or festival) and later report undeniable gaps in their memory," he said.
This type of memory loss is different from normal forgetfulness, Carroll said.
"For example, during the event, it may look like you’re acting normally and answering questions — but later, you may not recall some of your conversations," he said.
"Unlike other amnesias, memory loss is very limited, only lasting about a day, and people don’t forget [autobiographical] information."
TGA can develop due to elevated blood pressure, strenuous physical activity and emotional excitement, which Carroll said are all "theorized to temporarily impair the functioning of the memory center of our brain, the hippocampus."
"What’s interesting is that the concertgoers are only recognizing the memory loss post-event," he said.
"Thanks to social media, there’s constant communication and sharing of experiences online, which allows us to notice patterns that we may have otherwise missed."
"They actually experience TGA during the event but don’t realize it at the time."
The researchers’ findings suggest that certain risk factors may make Eras Tour concertgoers more susceptible to TGA.
These include lack of sleep, poor hydration, anticipation and pre-existing anxiety or depression, Carroll said.
Environmental risk factors include the intensity of the concert, engagement with the music, crowd-induced excitement and a sense of surprise throughout the event.
Fellow researcher Dr. Soha Salman, attending psychiatrist at Hackensack Jersey Shore University Medical Center, said Taylor Swift isn’t the only pop star who's causing this impact.
"Because there’s been such an outpouring of reports of this amnesia from the concert, it seems as though it's specific to Taylor Swift, when that’s not actually the case," she told Fox News Digital.
"There are similar reports from concert-goers who attended Beyoncé’s ‘Renaissance’ tour this summer, as well as reports from Harry Styles’ concerts," Salman said.
"Thanks to social media, there’s constant communication and sharing of experiences online, which allows us to notice patterns that we may have otherwise missed."
But, Salman suggested, it’s understandable that so many Swifties experience this overwhelming phenomenon, as many attendees undergo intense nostalgia due to the Eras Tour's throwback structure.
"The emotional connection to her music may be one of the reasons fans are experiencing this memory loss," she said.
Salman also mentioned that a sense of bonding at Taylor Swift’s concerts releases adrenaline and cortisol — both hormones involved in the brain’s memory-making process.
"The connection between heightened emotional states and the release of these hormones is one of the things we are researching further," she said.
This type of amnesia doesn’t only happen after a concert, but can occur after any "physically exerting or emotionally arousing event," said Salman.
"We did find in our research that there were reports of people experiencing similar amnesia after attending sporting events and weddings," the doctor said.
There are no lingering effects or neurological deficits with the condition, Carroll added, which "helps distinguish TGA from more serious health issues that can cause memory loss, such as a stroke."
"Still, it is best to have a doctor check you out with any notable memory loss," he said.
A person experiencing TGA will show no signs of distress and will "act, talk and behave normally," Carroll noted.
It is only "a short time later, when questioned about the event, [that] the person with TGA realizes they have memory gaps," he said.
"These memory gaps typically go away in about a day."
TGA is much more common in adults than younger people – typically older than the average age of a "Swiftie," according to Carroll.
A clinical diagnosis is made based on an exam and symptom screening, he said, though some imaging, such as an MRI, can help confirm the diagnosis if warranted.
While there are no specific methods of preventing TGA, Salman recommended getting enough sleep and staying hydrated before a big event.
"Another proposed mechanism of TGA is elevated blood pressure and the release of stress hormones," she said. "By being mindful and taking deep breaths throughout the concert, especially during periods of heightened excitement, you can reduce the release of stress hormones."
Research has revealed that cell phone use also has an impact on memory, so Salman recommended limiting screen time during an event.
"By simultaneously trying to use your phone and watch the concert, you may overtax your working memory and affect your ability to store those specific memories," she said.
"Studies have also found that when we are recording something with our smartphones, we are relying on them to remember for us," Salman added. "This could lead to poorer recall of the event later." | Disease Research |
Greg Nash Secretary of Health and Human Services Xavier Becerra answers questions during a Subcommittee on Labor, Health and Human Services, Education, and Related Agencies to discuss the President’s FY 2023 budget for the Department of Health and Human Services on Thursday, March 31, 2022. Health and Human Services (HHS) Secretary Xavier Becerra tested positive for COVID-19 on Monday, the agency announced, the second time he has been infected in less than a month. “This morning in Sacramento, U.S. Health and Human Services Secretary Xavier Becerra tested positive for COVID-19 after taking an antigen test. He is fully vaccinated and boosted against COVID-19, and is experiencing mild symptoms. He will continue to perform his duties as HHS Secretary, working in isolation,” HHS spokeswoman Sarah Lovenheim said in a statement. Becerra previously tested positive for COVID-19 on May 18 while traveling in Berlin ahead of the Group of Seven meetings for health ministers. Last week, Becerra was in Los Angeles to participate in the Summit of the Americas with President Biden and Vice President Harris. HHS said Becerra is not considered a close contact of either. Biden so far has avoided having a known case of the virus, but the White House has acknowledged it is possible he will be infected as well. The administration argues that tools such as vaccines, booster shots and treatments now exist that make the virus much more manageable. Becerra is not the only official who tested positive following the summit. Canadian Prime Minister Justin Trudeau on Monday revealed he also tested positive for COVID-19 for the second time this year. Reinfection is quickly becoming the primary driver of new cases in the United States, showing that immunity from previous infections is no longer able to provide the same level of protection against emerging variants and subvariants. Infectious disease experts think a typical SARS-CoV-2 infection will likely become less dangerous over time, but the full implications and severity of multiple infections are still not clear. Tags Biden COVID-19 Harris HHS Joe Biden Kamala Harris Xavier Becerra Xavier Becerra | Epidemics & Outbreaks |
Health inequalities are causing 33,000 avoidable cases of cancer in the UK every year, a damning analysis suggests.
Ministers have promised for years to tackle differences in health outcomes as part of their declared mission to level up the country. But their long-promised white paper on health inequalities has been ditched and the junk food advertising ban on TV and the web has been delayed until October 2025.
Spending on public health grants has also been reduced by about a fifth since 2015, amounting to real-terms cuts of almost £800m. This has meant cuts to vital schemes that promote better health and reduce the risk of cancer, including reducing smoking and losing weight.
An analysis by Cancer Research UK, seen by the Guardian, estimates there are 33,000 extra cases of cancer in the UK each year associated with deprivation. These could be avoided if health inequalities were tackled, the charity says.
Dr Ian Walker, the executive director of policy and information at Cancer Research UK (CRUK), said there was clearly a “real issue” with fairness. He added: “It should not, in this day and age, be that your likelihood and outcome of a cancer diagnosis is significantly impacted by where you live, how much money you’ve got, what your background is. It really shouldn’t. There’s a real injustice to this. It’s a really important problem that we’re trying to help move in the right direction.”
Lung cancer is the leading cause of the extra cases linked to deprivation, largely because smoking is much more common in more deprived areas. People in routine and manual occupations in England are about 2.5 times more likely to smoke than people in managerial and professional occupations, CRUK said. There are nearly twice as many cancer cases caused by smoking in the poorest areas than in the wealthiest in England.
People living in more deprived areas are also more likely to be overweight or obese, which is the second biggest preventable risk factor for cancer after smoking.
CRUK developed the analysis using the indices of multiple deprivation model, which is based on geographical area. Excess cases were estimated by comparing the number of cases that actually occurred in deprived areas with the number of cases there would be if everyone had the same incidence rates as people in the least deprived parts of the country.
It estimated that there are 33,000 extra cases of cancer in the UK each year linked with deprivation. Nearly one in 10 (9.1%) cancer cases were associated with deprivation, the charity’s analysis found.
Health inequalities owing to deprivation mean that, on average, more than 90 people in the UK are diagnosed with an avoidable cancer every day.
“If everybody in the country had the same outcomes, then they’re avoidable,” said Walker. “If we didn’t have inequalities across risk factors, if we didn’t have inequalities across signs and symptoms awareness, if we didn’t have inequalities across access to primary and secondary healthcare, then they’re avoidable.”
He added: “It’s a fairly significant picture and something we need the government and the health system to start addressing.”
Data suggests people from the most deprived communities are less aware of cancer symptoms and also report more barriers to seeking help – the most common being getting an appointment at a time that works for them. Because of these obstacles, people may find it difficult to seek help or put off doing so until the disease reaches a crisis point.
People from more deprived areas are not only more likely to get cancer, they are more likely to be diagnosed at a late stage for certain cancer types and have trouble accessing cancer services. They are also more likely to die from the disease.
Walker said he was disappointed that the government chose to launch a major conditions strategy last year, rather than having a standalone cancer strategy. “Whilst that is still an important process … we are concerned that that probably won’t go far enough in terms of turning the tide for [cancer] survival and certainly in terms of addressing these inequalities,” he said.
The government said it was committed to levelling up the health of the nation so that everyone could live longer, healthier lives.
A Department of Health and Social Care spokesperson added: “We are tackling the causes of preventable cancers, announcing a £40m pilot to give eligible patients access to effective obesity drugs and providing £70m of additional new funding for local authority stop smoking services. We are also expanding cancer screening programmes and asking more people to come forward for checks.
“Our major conditions strategy will also set out further plans to tackle the main causes of ill-health, including cancer.” | Health Policy |
In the U.S., someone has a stroke every 40 seconds and dies from it every three minutes and 14 seconds, according to the Centers for Disease Control and Prevention. When it comes to stroke, experts echo the fact that time is brain. Faster treatment translates to better outcomes, and certain treatments, like the clot-busting drug tPA, have a strict time window for administration.
“The quicker that we can get the patient to treatment, the quicker we can have a good outcome,” said Dustin LeBlanc, M.D., director of Prehospital Medicine and associate chief medical officer for Emergency Management at the Medical University of South Carolina (MUSC). “But the big step in between – that is diagnostic studies.”
To accelerate diagnostic studies, a team of MUSC researchers, including LeBlanc, partnered with Charleston County Emergency Medical Services (EMS) to equip an ambulance with a portable MRI. The team was led by Donna Roberts, M.D., professor in the Department of Radiology and Radiological Sciences at MUSC and the deputy chief scientist for the International Space Station National Lab, and included Jillian Harvey, Ph.D., a professor in the College of Health Professions. Their findings, reported in the October issue of the Journal of Stroke and Cerebrovascular Diseases, showcased the potential of the MRI-equipped ambulance.
An earlier trial in collaboration with Georgetown County EMS laid the foundation for this human trial by showing that images could be obtained in a moving ambulance on a standardized calibration model.
The project received funding from MUSC’s Blue Sky Award program, aimed at supporting high-risk research that tackles major medical and scientific challenges.
How the device could improve stroke care
Roberts thinks the new technology could be a game-changer for stroke care decision-making.
“If you're somebody who could just receive tPA, you might go to a local hospital, while those who need to have advanced procedures, such as interventional neuroradiology, would go to a different hospital,” she said. “The imaging provided by the portable MRI scanner in the ambulance could help make that decision.”
Harvey thinks that it will also speed up stroke response times.
“If we can get that information in transit and the decision process going before they even arrive at the hospital, then we can shorten the time to care and treatment,” she said.
Harvey is working with Kit Simpson, DrPh, also a professor in the College of Health Professions, to analyze state stroke data to see where MRI-equipped ambulances are most needed.
“The real benefit may come in rural areas where patients may be hours or further away from an MRI,” said Harvey.
For LeBlanc, it’s all about how cutting-edge technology can transform and improve patient care.
“If you think about where defibrillators were 50 years ago, they were hundreds of pounds, and it really took out-of-the-box thinking to imagine they could be portable. And now, they're public access points,” he said. “The MRI-equipped ambulance is just another example of technology helping us to develop ways to make things faster, lighter, smaller, more portable and to get it to the patient as quickly as possible.”
Ambulances equipped with CT scanners, known as mobile stroke units, are already used by some medical centers. However, they have limitations, including radiation exposure. The portable MRI has no radiation risk, and because it has a much lower magnetic field than traditional MRI, safety concerns regarding metal near the system are minimized, allowing operation of other medical or electrical equipment. Traditional MRI imaging can also identify stroke patients without a clear stroke timeline. Further research will determine if portable MRIs can achieve the same.
Taking the MRI-equipped ambulance for a trial run
The research team worked with Charleston County EMS to secure a portable MRI in one of its ambulances and capture imaging while driving slowly around a parking lot, which had been blocked off with the help of MUSC Facilities. During the trial run, the research team obtained imaging of a healthy volunteer. Diagnostic-quality images were obtained and successfully transmitted to hospital radiologists for review.
“This was really a team sport, with all aspects of MUSC and Charleston County EMS coming together for the mission of research,” said LeBlanc.
The road ahead
Despite these early promising results, more work needs to be done to see if diagnostic-quality images can be obtained when the ambulance is traveling at full speed. The team is also working with the Clemson School of Engineering to optimize the ergonomic fit of the MRI in the ambulance. With further technological advancements and clinical studies, MRI-equipped ambulances could become a game-changer in the field of emergency medicine, ensuring that stroke patients receive the best care possible, even before they reach the hospital.
“Ultimately, we need to stop thinking about telling patients to come to us,” said Roberts. “Instead, we need to be thinking about how we can take medicine to the patient.”
# # #
About MUSC
Founded in 1824 in Charleston, MUSC is the state’s only comprehensive academic health system, with a unique mission to preserve and optimize human life in South Carolina through education, research and patient care. Each year, MUSC educates more than 3,200 students in six colleges – Dental Medicine, Graduate Studies, Health Professions, Medicine, Nursing and Pharmacy – and trains more than 900 residents and fellows in its health system. MUSC brought in more than $298 million in research funds in fiscal year 2022, leading the state overall in research funding. MUSC also leads the state in federal and National Institutes of Health funding, with more than $220 million. For information on academic programs, visit musc.edu.
As the health care system of the Medical University of South Carolina, MUSC Health is dedicated to delivering the highest-quality and safest patient care while educating and training generations of outstanding health care providers and leaders to serve the people of South Carolina and beyond. Patient care is provided at 16 hospitals (includes owned and equity stake), with approximately 2,700 beds and four additional hospital locations in development; more than 350 telehealth sites and connectivity to patients’ homes; and nearly 750 care locations situated in all regions of South Carolina. In 2022, for the eighth consecutive year, U.S. News & World Report named MUSC Health University Medical Center in Charleston the No. 1 hospital in South Carolina. To learn more about clinical patient services, visit muschealth.org.
MUSC has a total enterprise annual operating budget of $5.1 billion. The nearly 26,000 MUSC family members include world-class faculty, physicians, specialty providers, scientists, students, affiliates and care team members who deliver groundbreaking education, research, and patient care.
Journal
Journal of Stroke and Cerebrovascular Diseases
Subject of Research
People
Article Title
Mobile point-of-care MRI demonstration of a normal volunteer in a telemedicine-equipped ambulance.
Article Publication Date
12-Aug-2023 | Medical Innovations |
Q&A: New lymphedema-on-chip platform holds promise
In a new PNAS study co-authored by Boston University biomedical engineer Dr. Chris Chen, researchers say they're getting closer to understanding the mysteries of lymphedema—a condition characterized by the buildup of fluid in the body due to a malfunctioning lymphatic system. Until now, the reasons behind this disorder have remained elusive.
As part of the study, the research team created a tiny 3D cell culture model that mimics the function of lymphatic vessels. They used this model to explore how certain inflammatory substances in our bodies, called cytokines, affect the lymphatic system. Surprisingly, these cytokines didn't weaken the connections between lymphatic cells, as expected.
Instead, they made them tighter, causing problems with fluid drainage out of tissues. But here's the exciting part: the researchers also found a way to counteract these effects. By targeting a protein called ROCK2, the team managed to reverse lymphedema in mice. Dr. Chen, director of BU's Biological Design Center, shares how this discovery opens up new possibilities for treating the condition and future applications for other diseases.
What is the primary goal of this research study?
The goal of this work was to develop a platform to study how lymphatic vessels drain fluid that accumulates in tissues, and then use it to see if we could understand why lymphatic drainage is reduced when they experience injury-induced inflammation, leading to lymphedema (edema, or swelling of tissues, caused by lymphatic dysfunction). Ultimately, we discovered a pathway that causes this to happen, and showed that lymphedema can be improved by inhibiting that pathway first in our device and then in mice.
What is lymphedema and why is it important to study it?
Lymphedema is a debilitating chronic condition that impacts millions of people, where fluid that naturally and continuously leaks into tissues from blood vessels, is not being drained sufficiently by the lymphatics. It can be painful and significantly increases the rates of infection of the affected tissue or organ. In the US, one of the more common causes of lymphedema is following surgeries or radiation such as for treating gynecologic or breast cancer.
What did the researchers discover about lymphatic vessels during injury?
Using the lymphatic-on-chip device, we found that inflammatory cues commonly release during injury can cause the vessels to decrease fluid drainage. Examining how this happens, we discovered that cells tighten their cell-cell junctions, which closes the space between them and prevents fluid from passing through. They appear to form these tight junctions using a receptor known as JAM-A, and inhibiting ROCK2 prevents this, allowing drainage to continue.
What are the potential future applications of this research beyond lymphedema treatment?
Going forward, we are hoping to understand what other changes occur in the lymphatics following injury, and more generally understand how to restore their function. Fluid drainage is important not only for lymphatics, but in many more general cases where tissues retain fluid (edema), such as pulmonary edema from COVID-19 infection.
How might this study contribute to bridging the gap between laboratory research and real-world medical applications?
We hope that these organ-on-chip models engineered to mimic human pathologies continue to help provide a new way to study and ultimately cure human diseases.
Who are the key research collaborators?
Dr. Hong Chen and Dr. Diane Bielenberg both contributed to the work. They are professors at the Boston Children's Hospital and Harvard Medical School, and experts in lymphatic vascular biology. Dr. Esak Lee led the study as a postdoctoral fellow in my group and is now an assistant professor at Cornell University.
More information: Esak Lee et al, A 3D biomimetic model of lymphatics reveals cell–cell junction tightening and lymphedema via a cytokine-induced ROCK2/JAM-A complex, Proceedings of the National Academy of Sciences (2023). DOI: 10.1073/pnas.2308941120
Provided by Boston University | Medical Innovations |
Claims have been made alleging former health secretary Matt Hancock rejected expert advice to mandate Covid tests for all people going into care homes at the start of the pandemic.
WhatsApp messages leaked to the Daily Telegraph newspaper suggest Mr Hancock was told in April 2020 that there should be "testing of all going into care homes". Government guidance later mandated tests only for those leaving hospital for care homes.
When it comes to Covid, in retrospect, there is always the temptation to see things in black and white.
If we had followed option A, it would have stopped option B occurring, runs the simple theory.
But when considering these issues, it is essential to also ask whether A could have actually been done at that point and, if it could, what trade-offs might there have had to be?
And then, a judgement has to be taken on whether option A would actually have stopped option B happening anyway.
The current news story is a classic example: a seemingly simple claim that does not, in fact, have a straightforward conclusion.
As chief medical officer Prof Sir Chris Whitty made clear in his December review on the pandemic, the problem the UK faced at that early stage was that there were not enough Covid tests available.
By mid-April only around 20,000 tests a day were being undertaken. Testing had to be strictly rationed. It was being used to test only those people with symptoms, and then only those in vulnerable settings, such as hospitals or care homes, or key workers.
A member of the public in the general community, even one who had symptoms, could simply not access a test.
The decision to test care home residents whether they displayed symptoms or not (and therefore to include asymptomatic testing) marked a break from current thinking at the time.
With limited testing available, the decision taken was that, initially, asymptomatic testing would only apply to those people admitted directly from hospital. They were deemed to carry the highest risk of being infected, since they were coming from a place where sick people with Covid were being cared for.
Even if the test results showed no Covid, isolation was still recommended given it can take time for symptoms to develop.
In the absence of available testing for people admitted to a care home from the community, isolation was also recommended. Eventually they too were tested, with testing capacity expanding rapidly in the weeks that followed.
But for that wider testing to be done any earlier, it must be assumed, would have meant tests not being available for another key group.
However, this does not mean there are no questions to answer on this issue.
Why did the UK have such a small diagnostic testing capacity in the first place?
Should the government have used the small labs available so more testing could have been done in those early days? It ruled out this strategy in favour of developing a network of large Lighthouse labs to ensure quality control and integrated end-to-end systems for ordering, sending off and obtaining results.
What it does show is that, when it comes to Covid, there are very few issues where the solution is as simple as it might first appear. | Epidemics & Outbreaks |
Florida has become the latest state to ban tianeptine, an unapproved drug that’s been dubbed “gas station heroin” because it causes opioid-like withdrawal in some users and is available at gas stations and convenience stores.
Attorney General Ashley Moody announced an emergency ban on tianeptine last Thursday, making it a Schedule I drug, meaning it’s a felony to possess, sell, and use in the state.
“We filed an emergency rule to outlaw tianeptine, an extremely dangerous chemical being sold at gas stations, convenience stores and smoke shops in our state. Tianeptine is linked to five deaths nationwide. And so far this year, Florida’s Poison Control Center has fielded 15 calls about exposure to this drug,” Moody said in a video statement released Sept. 21.
Commonly sold under brand names like Zaza, Tianaa, and Pegasus, or in powder form online, tianeptine acts on a person’s opioid receptors and is not approved for medical use by the Food and Drug Administration. But it’s not a federally scheduled drug.
Tianeptine is regulated and used as a tricyclic antidepressant in over 60 countries, but the versions sold in the U.S. are not regulated, and users have reported becoming quickly addicted to it and going into severe withdrawal after a few hours. Withdrawal symptoms include nausea, chills, sleeplessness, restless legs, and extreme anxiety.
Alabama, Tennessee, Minnesota, Georgia, Oklahoma, Michigan, Indiana, Kentucky, Ohio, and Mississippi have already banned tianeptine.
While Florida’s ban is temporary, Moody said she’ll work to make it permanent in Florida’s next legislative session.
In March, VICE News traveled to Jacksonville to spend time with Kristin and Jason, a couple who used to use painkillers and had become severely addicted to tianeptine in the last few years. Jason made daily two-hour round trips on foot to local smoke shops to purchase the drug. At the time, Kristin, a mother of five, said she feared that if the drug were to be banned she would start using opioids again.
“I want them to ban them and get them gone but I don’t because it could affect me deeply,” Kristin previously told VICE News. “I don't know if I could even live through withdrawal from it.”
“The highly addictive nature, severe withdrawal symptoms, and unregulated volume, potency, and purity of this ‘gas station heroin’ can lead users to become dependent or back to opioids and other illicit drugs,” reads Florida’s emergency ban.
In September, VICE News spoke to a man who was detoxing off tianeptine at home based on a protocol he found on Reddit, where many tianeptine users support each other. The man ended up in hospital but managed to stop using the drug.
He said he thinks the state bans will either force people into withdrawal or they will start purchasing tianeptine online or cross state lines to obtain it. | Drug Discoveries |
Junior doctors entered their fifth round of strikes on Friday in the latest protest over pay. But even without the 35pc wage rise they are demanding, striking doctors are on course to pocket six-figure salaries and bumper gold-plated pensions.
Young doctors, who have staged 16 days of industrial action this year, argue their wages have fallen in real terms while inflation has rocketed. The strikes have cost the NHS an estimated total of £1bn so far, official figures suggest.
Steve Barclay, the Health Secretary, said the gross cost to the NHS pay bill would be £2bn a year. The total NHS budget is £160 billion.
The BMA argues a “lack of investment in wages” by the Government has made it harder to retain junior doctors and harder to deliver care to professional standards.
Average pay for junior doctors in their third year has increased on average by 2pc annually over the past 12 years, according to NHS data.
According to the BMA, however, junior doctors have experienced a real-terms cut of more than 25pc to their salaries since 2008.
But analysis suggests junior doctors are still on track to receive retirement income worth close to 75pc of their salaries – and guaranteed to rise with inflation by the taxpayer.
In his Spring Budget, Chancellor Jeremy Hunt abolished the lifetime allowance on pension savings that was stinging doctors with tax bills and forcing them to retire early. The change meant senior NHS doctors will be spared large tax bills once owed on their generous pension deals which are often worth well over £1 million.
This year public sector pensioners are set to receive an increase worth twice as much as the average pay rise, the Telegraph reported in April.
Currently, those starting out as doctors in England take home a basic pay of £29,384. This moves up to £34,012 in year two, and £40,257 in year three when they start to specialise.
The Government has said, however, that these figures look more like £38,000, £46,000, and £55,000 respectively, once you take into account additional earnings for working unsocial hours.
Junior doctors in their first year make up about 11pc of all junior doctors in England, with the majority of them on higher pay bands according to NHS England workforce statistics published late last year.
The British Medical Association, the registered union for doctors, claimed back in March that junior doctors make just £14.09 per hour – less than someone who works at Pret a Manger.
However, fact-checking organisation Full Fact suggested this is not wholly true, arguing hourly pay for the average junior doctor – once extra earnings and holiday is accounted for – is more like £20 to £30 per hour.
Independent pension consultant John Ralfe said a junior doctor earning the third-year pay average of £40,257 would retire after 40 years with an NHS pension paying £29,790 each year – if their salary remained the same throughout their career.
He said the pension deal was “spectacularly bigger” than those offered to private sector workers today. He added that if the same junior doctor saw their pay rise 35pc to £54,347, they would retire on a pension paying £40,000 a year.
The analysis is also based on a scenario where the junior doctor in question never moves off junior pay. The majority of doctors go on to earn far more than £40,257 during their lengthy careers.
Consultants earn a basic salary of anywhere between £88,364 to £119,133 per year, according to the NHS.
Tom Selby, head of retirement policy at investment broker AJ Bell, said a 35pc pay rise for junior doctors would not necessarily keep pay high in the long run and could mean contribution rates had to rise.
He said: “A future government might hold back wage rises, for example. If the costs of public sector pensions go up significantly, adjustments will be made to address that. As these are member costs rising, you’d assume that would mean member contributions going up or accrual rates reducing.”
On top of this junior doctors can already claim up to £10,000 tax-free in “life admin” expenses on the NHS, including redirecting their post and nursery fees.
In the last five years, more than £40m has been claimed by junior doctors in moving expenses, according to figures obtained under the Freedom of Information Act.
Since 2012, junior doctors have also been able to access bursaries and £1,000-a-year grants from the NHS, funded by the taxpayer.
Those with access to bursaries and studying a graduate-entry accelerated degree in medicine – i.e. it is not their first degree – can also receive £3,715 a year to cover tuition fees for up to three years.
Junior doctors can also earn between £30 and £35 an hour working “locum” shifts, equating to up to £5,600 a month before tax (close to £70,000 annually), according to data from Messly’s Locum Salary Calculator, which analyses more than 80,000 locum jobs offered to doctors. The BMA has called for an increase of 80pc on market rates for such shifts “in parallel with the campaign for pay restoration and associated strike action”.
There are, however, some hidden costs to being a junior doctor. Training doctors have to pay for their own exams, the price tags for which can sometimes total thousands of pounds.
There are also yearly licensing fees doctors have to foot, as well as medical indemnity cover which doctors take out to protect themselves when things go wrong.
Licensing fees through the General Medical Council are £161 a year for newly qualified doctors, before it jumps to £420, while basic indemnity insurance can cost anywhere upwards of around £30 a month.
In April 2019, state-backed indemnity schemes were launched in England and Wales. This removed the need for GPs and their staff to arrange and fund their own clinical negligence cover.
These schemes can, however, also be accessed by junior doctors, potentially saving them hundreds of pounds a year.
This article was originally published on April 12 2023 and has since been updated | Health Policy |
Two new treatment options for aggressive prostate cancer have shown promise in a major clinical trial that demonstrated improved survival odds.
Both of the treatments for men with recurrent prostate cancer helped patients live longer than the current standard treatment without their disease progressing.
“If these treatments are approved by the Food and Drug Administration, our results will be practice changing,” said Stephen Freedland, MD, a prostate cancer researcher at Cedars-Sinai, and lead author of the study. “Both of these new options improved metastasis-free survival while preserving quality of life.”
The results of the Phase III international study led by Cedars-Sinai Cancer investigators were published this week in the New England Journal of Medicine.
Cancer of the prostate, a walnut-sized gland that helps make semen, is not always a deadly diagnosis. For some, treatment may never be needed because they have a slow-growing form of the disease, but those with more aggressive prostate cancer are often first treated with surgery or radiation therapy.
Unfortunately, in about a third of those patients, the cancer recurs within 10 years.
Patients with aggressive recurrence are treated with a hormone therapy called androgen deprivation therapy (ADT), which reduces the patient’s production of the male sex hormone testosterone, which aids in the growth and spread of prostate cancer cells—as the hormone therapy effectively reduces the growth-stimulating effects.
But ADT has two downsides: It doesn’t completely eliminate testosterone, and it can cause many side effects.
“When you go on ADT, the testosterone level in the blood is reduced, but not completely eliminated,” Freedland said. “And the concern is that the testosterone that remains may still be enough to stimulate tumor growth. Also, patients don’t love the idea of being on hormones.”
In this study of 1,068 prostate cancer patients from 244 sites in 17 countries, Freedland and fellow investigators tested two experimental interventions—one to address each of these issues.
MORE PROSTATE GOOD NEWS: Large Dose of Iron Could be Used to Kill Off Drug-Resistant Prostate Cancer, Scientists Believe
In the randomized clinical trial, one-third of the patients received ADT plus a medication called enzalutamide, which blocks the effects of testosterone. Enzalutamide keeps any testosterone remaining in the blood from stimulating the growth of cancer cells.
Another third of the patients received enzalutamide alone. This option relied on the medication to block the effects of testosterone even though testosterone levels in the patients’ blood were not reduced.
“We wanted to see whether enzalutamide on its own was so effective that we didn’t need the ADT,” Freedland said.
The final group of patients received ADT alone, which is the current standard treatment.
Investigators found that the combination of ADT plus enzalutamide reduced the risk of metastasis or death by 58% over ADT alone. They found that enzalutamide alone reduced the risk of metastasis or death by 37% over ADT alone. Both treatments maintained quality of life relative to the ADT alone.
“While the combination therapy offers greater risk reduction, some men might prefer enzalutamide alone. It does a good job of preventing cancer spread or death, with different side effects that may be more acceptable for some men,” Freedland said.
The next step is for the makers of enzalutamide to apply for FDA approval, so the experimental therapy can come into wide use, Freedland said. The study was funded by Pfizer and Astellas Pharma, the co-developers of enzalutamide.
SHARE Some Good News (for a Change) With Friends on Social Media… | Drug Discoveries |
A librarian took his own life while suffering from seasonal affective disorder (SAD), an inquest heard.Hamish Ratley, 25, passed away at his home in Monkton Combe near Bath, on October 4, 2022. He had moved there five years ago to study English Literature at Bath Spa University before landing his 'dream job' as a librarian.An inquest into his death was held at Avon Coroners Court in Flax Bourton (Thursday, January 19). The inquest heard how the young man had been taking anti-depressant medication for the last three years.Assistant Coroner Dr Simon Fox read evidence from the emergency services, medical professionals, and Hamish's family, before reaching his conclusion. Hamish Ratley, 25, (pictured) took his own life while suffering from seasonal affective disorder (SAD), an inquest heardIn a witness statement, Hamish's mother Louise said she had received a 'concerning' text message from him on the morning of Tuesday, October 4. She tried calling and texting him but, after receiving no reply, she rang the police and Hamish's girlfriend.PC Dominic Anders from Avon and Somerset Police was on duty that morning and attended Hamish's home at 9.12am. When he arrived, he found Hamish's girlfriend in an 'emotional' state after she had found him in an unresponsive condition. PC Anders attempted CPR while they waited for an ambulance to arrive.A post-mortem examination by Dr Kathryn Urankar confirmed hanging to be the cause of death. An inquest into his death was held at Avon Coroners Court in Flax Bourton on Thursday, January 19Louise Ratley described her son as 'kind, caring and intelligent'. At the time of his death, he had just passed his probation review as a librarian with 'flying colours', she said.'Hamish had a lovely girlfriend and he was just about to exchange contracts on a flat in Bath. 'He still kept in touch with his school friends from Devon and said he had made friends for life at university, with whom he was in regular contact.'He had an amazing group of work colleagues, enjoyed going to the gym and ate healthily.'Mrs Ratley added that Hamish suffered from seasonal affective disorder (SAD) in the winter months, but that he was aware of this and had 'strategies' to combat it, like exercising outdoors and seeing his family and friends. What is Seasonal Affective Disorder? Commonly known as SAD, the disoder is a depression that's linked to the seasons, and is most common in winter. Howver, a few people will experience it more intensely in summer and feel better in winter. As well as a persistent low mood and feelings of tiredness, despair and guilty, people may find themselves craving carbohydrates and gaining weight.As well as talking therapies and anti-depressants, some peopl may benefit from light therapy with a special lamp used to simulate exposure to sunlight.Source: NHS SAD is sometimes known as 'winter depression' because the symptoms are usually more apparent and more severe during the winter. Symptoms can include a persistent low mood, a loss of pleasure or interest in normal everyday activities, irritability, feelings of despair, and feeling lethargic and sleepy during the day.The inquest also heard from a GP at Oldfield Surgery, where Hamish was a patient. Dr Claire Quiggin said in a statement that Hamish had asked to restart a prescription of the anti-depressant drug citalopram, which he continued until his death.'We are very sorry to hear of his sudden death and extend our condolences to his family,' Dr Quiggin added.The coroner Dr Fox noted that Hamish's family had questioned why he had been allowed to continue taking medication for three years without a review.In a follow-up statement, Dr Quiggin responded that the usual practice was to review annually to check the patient's symptoms and discuss any concerns. She said that Hamish was twice asked to attend a review, but he did not arrange one.She added that he was on a low dose of citalopram, 10mg, and that there was no evidence to suggest he was over-ordering it or had stopped taking his medication. However, if he had suddenly ceased taking the drug, it would have worsened his depression.Mrs Ratley said Hamish was in regular contact with his family in the days leading up to his death. 'From Friday, September 30 until Monday, October 3, we had normal conversations. He talked about his SAD affecting him, but he seemed in good spirits,' she said.In a statement to Somerset Live, Mrs Ratley said: 'He had a kind and gentle demeanour and a passion for Gothic literature and academia. He had a wonderful network of friends and work colleagues and was working in the library at the University of Bath which he loved.'To us, it brings home the importance of talking about mental health and checking in on those around you, even if on the face of it they seem to have their life totally in order. 'As someone said to us recently, 'the world is a poorer place without him'. He is sadly missed by all who knew him.'The coroner Dr Fox recorded a verdict of suicide and expressed his condolences to the family.For confidential support call the Samaritans on 116123 or visit a local Samaritans branch, see www.samaritans.org for details | Mental Health Treatments |
Joey 'Jaws' Chestnut won the 2023 Nathan's hotdog competition held in Coney Island, but the victorious feat could have grim health consequences.
The 16-time winner consumed 62 hotdogs in 10 minutes, the equivalent of almost 20,000 calories and up to four times the entire daily salt and fat recommendation for an adult in one sitting.
The true health effects of competitive eating are not well known - because its such a new phenomenon and studying it in the general public would be deemed unethical.
But the limited studies that do exist show that wolfing down dozens of hot dogs in one go stretches the stomach by up to quadruple its normal size, turning it into 'a massively distended food-filled sac occupying most of the upper abdomen'.
Experts warn that over time, this could eventually cause the body to stop emptying solid food, leaving competitive eaters with intractable nausea and vomiting.
Competitive eaters also spend months stretching their stomachs using 'dangerous' techniques like 'water loading', or downing gallons of milk and eating mountains of cabbage and fibrous foods.
More than 30,000 spectators descended on Coney Island, New York, today to watch people compete in Nathan's famous annual hot dog eating contest that first began in the early 1970s.
For 10 minutes, men and women scarfed down franks and buns, hoping to take home $10,000 and the title of hot dog king or queen.
Chestnut won the 2023 crown with 62 hot dogs and Miki Sudo took the women's championship with 39.5
According to the nutritional information on Nathan's website, one of its Original Coney Island natural casing beef hot dogs contains 170 calories, 16 grams of fat (including 6 grams of saturated fat), and 480 milligrams of sodium.
This means Chestnut consumed 10,540 calories in 10 minutes, not including the bun. Each of the buns has 130 calories, pushing the amount to 18,600, which is well above the daily and even weekly recommended amount.
High sodium intake is enough to send blood pressure soaring, which can trigger a heart attack or stroke. The recommended sodium level is no more than 2,300 milligrams each day, just shy of five hot dogs.
And the high fat can lead to nausea, diarrhea and gastrointestinal distress, Academy of Nutrition and Dietetics spokesperson Debbie Petitpain told CBS News.
However, experts said as long as these competitors return to regular eating, their bodies should also return to normal.
Chestnut said he trains for every Nathan's contest for three months straight by performing mouth exercises to strengthen his mouth and throat, Insider reported.
'Every practice, I record it and I try to push a little bit harder and figure out what I can do differently,' Chestnut said in 2021.
'You can only practice so much. If I practice too much I start gaining weight, and if I start gaining weight then I start slowing down. So it's a weird double-edged sword. You have to love to eat, but you can't eat so much that it becomes unhealthy.'
The first Nathan's hot dog eating contest, held in 1972, was won by Jason Schechter, who ate just 14 wieners.
While it is unclear why the amount eaten has changed over the decades, it was likely due to people training for months to expand their stomachs.
A 2007 study conducted by the University of Pennsylvania analyzed a 29-year-old man who ranked among the top 10 worldwide in competitive eating.
The man was asked to ingest an effervescent agent and high-density barium before eating hot dogs for 12 minutes, which allowed researchers to see the food move through his body.
Another group of regular eaters consumed seven franks before reporting symptoms of sickness.
Following the study, the competitive eater's stomach showed it could expand as he consumed the food.
'The key to success in competitive speed eating is the ability to slowly train and adapt the stomach so that it can expand and dilate to a remarkable degree, enabling the speed eater to consume an extraordinary volume of food in an extremely short time (possibly superimposed on an innately compliant stomach),' according to the published paper.
The team compared a competitive eater to 'a predatory carnivore that periodically gorges itself on its kills, ingesting massive amounts of food for sustenance until it captures another prey days or even weeks later.'
However, these eaters may also lose the sensation of fullness and satisfaction when eating regularly.
The researchers noted that there is not enough data to predict what will happen to competitive eaters.
The team wrote in the study that there is a potential risk that the dilated, flaccid stomach may eventually decompensate, becoming an enormous sac incapable of shrinking to its original size and emptying solid food.
While Chestnut is the reigning champ for the 16th contest in a row, Nathan's event was transformed when in 2001 when Takeru Kobayashi came on the scene.
Kobayashi won the contest by eating 50 hotdogs, double the previous year.
He admitted to health issues from competitive eating in 2021 and almost stopped altogether because of a painful and arthritic jaw.
Speaking to AFP, Kobayashi said: 'When my stomach becomes very full with that amount of food inside, the organs in my body begin to shift places.
'So, for example, my lungs get shifted up, and they can't expand. They have no room to expand. So, when I breathe, I become very short of breath.' | Nutrition Research |
A new study has found that states which have legalised medical cannabis have seen a drop in the average cost of individual healthcare premiums.
Researchers from Bowling Green State University in Ohio and Illinois State University looked at the impact of state-specific medical cannabis legalisation laws on individual health insurance premiums.
They compared trends in premium costs in states with and without legalisation over an 11 period from 2010 – 2021.
According to the findings, published in the International Journal of Drug Policy, prices for individual premiums fell in states with legal access to medical cannabis, when compared with those jurisdictions where it remained prohibited.
The researchers observed an ‘statistically significant’ reduction of $1662.7 in insurance premiums seven years after the introduction of medical cannabis laws, compared to a control group which saw a reduction of $1541.8 in year eight, and a reduction of $1625.8 in year nine.
They determined: “Initial concerns about medical cannabis legalisation leading to increases in medical care costs, which would be reflected in higher insurance premiums, appear to be unfounded.”
Due to the pooled nature of insurance, the reduction in premiums benefit both medical cannabis consumers and non-consumers in states with legalisation. This is particularly important given the rising costs of healthcare facing US citizens, with health insurance premiums increasing at a rate faster than inflation and now eating into a significant share of household budgets.
The authors estimate that the national legalisation of medical cannabis could see overall heath insurance savings of more than $16.8 billion in the individual market.
They conclude: “The implementation of MCLs [Medical Cannabis Laws] lowers individual-market health insurance premiums. Health insurance spending, including premiums, comprises between 16% and 34% of household budgets in the United States. As healthcare costs continue to rise, our findings suggest that households that obtain their health insurance on the individual (i.e., not employer sponsored) market in states with MCLs appreciate significantly lower premiums.”
Consistent with previous research
A previous study from 2017 found that access to medical cannabis is associated with a reduction in Medicaid costs.
Researchers at the University of Georgia assessed the association between medical cannabis regulations and the average number of prescriptions filled by Medicaid beneficiaries between the years 2007-2014.
They estimated that nationwide legalisation could reduce Medicaid costs by over $1 billion, stating: “Researchers reported: “[T]he use of prescription drugs in fee-for-service Medicaid was lower in states with medical marijuana laws than in states without such laws in five of the nine broad clinical areas we studied.
“If all states had had a medical marijuana law in 2014, we estimated that total savings for fee-for-service Medicaid could have been $1.01 billion.”
A separate study from 2016 reported that medical cannabis access was associated with significantly reduced spending by patients on Medicare Part D approved prescription drugs.
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The government is aiming to quadruple the number of patients taking part in commercial clinical trials in the next four years as part of an ambitious plan to boost UK life sciences.
Unveiling a package of measures for the sector, the chancellor, Jeremy Hunt, said patients would get quicker access to new medicines and the government would cut the bureaucratic burden of approving clinical trials, which has been blamed for a rapid decline in NHS-based trials for cancer and Alzheimer’s drugs. Other measures announced include funding for an upgrade of the UK Biobank and details of a proposed train route between Oxford and Cambridge.
“It’s a very important part of the offer to life science companies that they don’t just do their R&D [research and development] here, but they’re able to trial their drugs on human beings,” Hunt said. “The data you get from that is the most valuable of all.”
The new policies aim to reverse a collapse in commercial clinical trials in the NHS, with a 44% drop in participants recruited since before the pandemic from more than 50,000 in 2017 to about 28,000 in 2021. The UK is also losing ground to countries such as Spain, Poland and Australia.
A government-commissioned review into the decline, led by former health minister James O’Shaughnessy, will be published on Friday and sets out a range of ambitious targets. This includes the goal – which the government has accepted – of doubling patient participation in commercial trials within two years and doubling the number again by 2027. To achieve this, the review recommends offering financial incentives to GPs to increase recruitment through primary care and using the NHS app to inform patients about trials in their area.
It also calls for an overhaul of a sluggish regulatory process, highlighting backlogs at the regulator and in the bespoke processes for the set-up and costing of trials used by many trusts.
The latest performance data shows that the medicines and healthcare products regulator (MHRA) is now taking about 110 days to turn around clinical trial approvals – double the time it was taking a year ago. The government said it is pushing for a national “one contract fits all” approach and allocating an additional £3m to the MHRA to help it reach a goal of a 60-day turnaround time for all clinical trial approvals.
“We’re doing everything we can to get us back to the brilliant support for clinical trials we had in the pandemic,” said Hunt. “We know what we’re capable of in the NHS.”
Hunt added that overall pressures on the NHS may have contributed. “I don’t think it’s any secret that it’s been a period of very high pressure in the NHS with the backlog, post-pandemic, with a workforce that showed such incredible commitment in the pandemic but which are pretty exhausted,” he said.
Separately, the Treasury said it would give £150m in funding to expand the UK Biobank, including a move to a new facility in Manchester featuring a robotic freezer that stores and retrieves 20m biological samples that have been donated by UK Biobank’s 500,000 volunteer participants. A pilot “Yellow Card biobank”, run jointly by the MHRA and Genomics England, was also announced. The database will contain genetic data and patient samples and run alongside the MHRA’s Yellow Card reporting scheme for suspected side effects and adverse incidents involving medicines and medical devices.
Richard Torbett, chief executive of the Association of the British Pharmaceutical Industry (ABPI), said: “Today’s announcements show that the government recognises the huge opportunity waiting to be grasped if the UK can unlock the economic potential of its life science industry – already worth £94.2bn in 2021. These measures demonstrate the government has listened to industry and will help put the UK on track to meeting its life science vision.
“Lord O’Shaughnessy is right that making the UK an attractive destination for industry clinical trials requires regulatory reform, speedier study set-up and approvals, and improved access to data.” | Drug Discoveries |
Hannah Barnes’s book about the rise and calamitous fall of the Gender Identity Development Service for children (Gids), a nationally commissioned unit at the Tavistock and Portman NHS Foundation Trust in north London, is the result of intensive work, carried out across several years. A journalist at the BBC’s Newsnight, Barnes has based her account on more than 100 hours of interviews with Gids’ clinicians, former patients, and other experts, many of whom are quoted by name. It comes with 59 pages of notes, plentiful well-scrutinised statistics, and it is scrupulous and fair-minded. Several of her interviewees say they are happy either with the treatment they received at Gids, or with its practices – and she, in turn, is content to let them speak.
Such a book cannot easily be dismissed. To do so, a person would not only have to be wilfully ignorant, they would also – to use the popular language of the day – need to be appallingly unkind. This is the story of the hurt caused to potentially hundreds of children since 2011, and perhaps before that. To shrug in the face of that story – to refuse to listen to the young transgender people whose treatment caused, among other things, severe depression, sexual dysfunction, osteoporosis and stunted growth, and whose many other problems were simply ignored – requires a callousness that would be far beyond my imagination were it not for the fact that, thanks to social media, I already know such stony-heartedness to be out there.
Gids, which opened in 1989, was established to provide talking therapies to young people who were questioning their gender identity (the Tavistock, under the aegis of which it operated from 1994, is a mental health trust). But the trigger for Barnes’s interest in the unit has its beginnings in 2005, when concerns were first raised by staff over the growing number of patient referrals to endocrinologists who would prescribe hormone blockers designed to delay puberty. Such medication was recommended only in the case of children aged 16 or over. By 2011, however, Barnes contends, it appeared to be the clinic’s raison d’etre. In that year, a child of 12 was on blockers. By 2016, a 10-year-old was taking them.
Clinicians at Gids insisted the effects of these drugs were reversible; that taking them would reduce the distress experienced by gender dysphoric children; and that there was no causality between starting hormone blockers and going on to take cross-sex hormones (the latter are taken by adults who want fully to transition). Unfortunately, none of these things were true. Such drugs do have severe side effects, and while the causality between blockers and cross-sex hormones cannot be proven – all the studies into them have been designed without a control group – 98% of children who take the first go on to take the latter. Most seriously of all, as Gids’ own research suggested, they do not appear to lead to any improvement in children’s psychological wellbeing.
So why did they continue to be prescribed? As referrals to Gids grew rapidly – in 2009, it had 97; by 2020, this figure was 2,500 – so did pressure on the service. Barnes found that the clinic – which employed an unusually high number of junior staff, to whom it offered no real training – no longer had much time for the psychological work (the talking therapies) of old. But something else was happening, too. Trans charities such as Mermaids were closely – too closely – involved with Gids. Such organisations vociferously encouraged the swift prescription of drugs. This now began to happen, on occasion, after only two consultations. Once a child was on blockers, they were rarely offered follow-up appointments. Gids did not keep in touch with its patients in the long term, or keep reliable data on outcomes.
A lot of this is already known, thanks largely to a number of whistleblowers. Last February, the paediatrician Dr Hilary Cass, commissioned by the NHS, issued a highly critical interim report into the service; in July, it was announced that Gids would close in 2023. But a lot of what Barnes tells us in Time to Think is far more disturbing than anything I’ve read before. Again and again, we watch as a child’s background, however disordered, and her mental health, however fragile, are ignored by teams now interested only in gender.
The statistics are horrifying. Less than 2% of children in the UK have an autism spectrum disorder; at Gids, more than a third of referrals presented with autistic traits. Clinicians also saw high numbers of children who had been sexually abused. But for the reader, it is the stories that Barnes recounts of individuals that speak loudest. The mother of one boy whose OCD was so severe he would leave his bedroom only to shower (he did this five times a day) suspected that his notions about gender had little to do with his distress. However, from the moment he was referred to the Tavistock, he was treated as if he were female and promised an endocrinology appointment. Her son, having finally rejected the treatment he was offered by Gids, now lives as a gay man.
As Barnes makes perfectly clear, this isn’t a culture war story. This is a medical scandal, the full consequences of which may only be understood in many years’ time. Among her interviewees is Dr Paul Moran, a consultant psychiatrist who now works in Ireland. A long career in gender medicine has taught Moran that, for some adults, transition can be a “fantastic thing”. Yet in 2019, he called for Gids’ assessments of Irish children (the country does not have its own clinic for young people) to be immediately terminated, so convinced was he that its processes were “unsafe”. The be-kind brigade might also like to consider the role money played in the rise of Gids. By 2020-21, the clinic accounted for a quarter of the trust’s income.
But this isn’t to say that ideology wasn’t also in the air. Another of Barnes’s interviewees is Dr Kirsty Entwistle, an experienced clinical psychologist. When she got a job at Gids’ Leeds outpost, she told her new colleagues she didn’t have a gender identity. “I’m just female,” she said. This, she was informed, was transphobic. Barnes is rightly reluctant to ascribe the Gids culture primarily to ideology, but nevertheless, many of the clinicians she interviewed used the same word to describe it: mad.
And who can blame them? After more than 370 pages, I began to feel half mad myself. At times, the world Barnes describes, with its genitalia fashioned from colons and its fierce culture of omertà, feels like some dystopian novel. But it isn’t, of course. It really happened, and she has worked bravely and unstintingly to expose it. This is what journalism is for.
Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children by Hannah Barnes is published by Swift Press (£20). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply | Mental Health Treatments |
A research group from the University of Turku and Turku Bioscience Centre together with Misvik Biology Ltd in Finland have developed a new method for studying how cancer cells function in softer and stiffer tissue environments. This insight challenges the existing paradigm, opening up new possibilities for research in cancer biology and tissue engineering.
A longstanding belief has been that cells outside the body prefer to spread and grow on stiffer surfaces. This is similar to when we walk on a concrete sidewalk (very stiff) and find it preferable to walking in mud (very soft). For this reason, cells, including stem cells, are continuously cultured on very stiff plastic or glass for research purposes. This idea also resonates with cancer cells thriving within a hard lump they form in tissues. Usually, the stiffer the tumour, the poorer the patients’ prognosis. However, the stiffness of the tissues in our body (e.g., bone versus brain) is not the same. In fact, some cells like neurons and fat cells grow and function effectively in very soft surroundings.
The research group from the University of Turku and Turku Bioscience Centre collaborated with Misvik Biology Ltd, a biotechnology company based in Turku, Finland, to understand how cells function in softer environments and how these could be better modelled outside the human body. They used computational modelling and a large array of growth conditions to meticulously compare cell behaviour on soft and stiff surfaces at an unprecedented resolution.
New perspective on an old idea
Using an automated machine, the researchers microprinted different protein mixtures onto soft and stiff surfaces. The proteins chosen were those that typically surround cells in the body and give texture and information about the tissue environment.
“By using more diverse protein mixtures in cell culture, we begin to get closer to a more physiologically relevant setting outside the body with which we can more effectively model diseased and healthy states,” says Postdoctoral Researcher, Dr James Conway from the InFLAMES research flagship, the lead researcher of the Turku Bioscience team.
“We had a specific system for microcontact printing of different protein mixtures onto culture plates and decided to see how we could expand the system. Once the researchers at Turku Bioscience had the idea, it was straightforward for us to then use the system on different stiffness hydrogels,” explains CEO Juha Rantala from Misvik, a key collaborator on the project.
By working together, the team demonstrated that the right combination of proteins can support cells on a soft surface, providing crucial survival cues that result in cell growth similar to that observed on a stiffer surface.
“These findings have unveiled a fundamental new perspective in mechanobiology. We have identified a mechanism through which we can explain how cells can effectively adhere, function, and signal on soft substrates. This insight challenges the existing paradigm, opening up new possibilities for research in cancer biology and tissue engineering,” notes Professor Johanna Ivaska, the principal investigator of the project.
The results of the study have been published in the esteemed journal PNAS.
InFLAMES Flagship is a joint initiative of the University of Turku and Åbo Akademi University, Finland. The goal of the Flagship is to integrate the immunological and immunology-related research activities to develop and exploit new diagnostic and therapeutic tools for personalised medicine. InFLAMES is part of Research Council of Finland’s Flagship Programme. | Disease Research |
Several key COVID-19 trends that authorities track are now accelerating around the country, the Centers for Disease Control and Prevention announced Friday. It's the first major nationwide uptick in the spread of the virus seen in months.
The largest increases are in the Midwest and the Mid-Atlantic, the agency said in its weekly report updated Friday, though virtually all regions of the country are now seeing accelerations.
Data reported by the agency from emergency rooms and wastewater sampling have tracked some of the steepest increases so far this season in the region spanning Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin.
Rates of infections of nursing home residents across this Midwestern region have also soared in recent weeks, higher than in most other parts of the country, approaching levels not seen since the peak of last winter's COVID-19 wave.
"Remember we had a late summer wave of COVID. We came down from that. We are going back up again, which we expect again, after a lot of travel and gathering at Thanksgiving," CDC Director Dr. Mandy Cohen said Thursday at a House committee hearing.
Close to 2 million Americans are now living in counties deemed to have "high" levels of COVID-19 hospitalizations, where the CDC urges masking in public and other precautions to curb the threat posed by the virus.
Around 1 in 10 Americans are now in communities with "medium" levels of hospitalizations, where the agency counsels some additional precautions for at-risk Americans.
Cohen said the agency has also been tracking other respiratory illnesses accelerating in recent weeks ahead of COVID-19's rise, in line with previous fall and winter virus seasons.
Respiratory syncytial virus, or RSV, is now "near peak" in many southern states that first saw cases and hospitalizations rise in young children earlier this year.
In an updated report this week, the CDC's disease forecasters said RSV hospitalizations were at levels worse than pre-pandemic seasons, but likely on track to reach a "lower and later peak" than last year.
Flu trends have also been accelerating nationwide, the agency said, with more expected increases into December. However, data from emergency rooms suggest influenza has yet to eclipse COVID-19 levels overall.
"Even though those are both going up and we're at the peak of RSV, COVID is still the respiratory virus that is putting the most number of folks in the hospital and taking their lives," said Cohen.
Officials say they have also been keeping tabs on reports of other causes ofthis year, like the common mycoplasma bacteria that has shared the blame for in pediatric hospitalizations. Health authorities have also reported seeing mycoplasma pneumonia in the mix among cases of sick children .
Several countries abroad have also seen steeper increases of the bacterial infections in kids this season, which experts said had largely disappeared around the world during the COVID-19 pandemic. Denmark recently warned it was reaching epidemic levels of mycoplasma.
Cohen said Friday in a briefing with reporters that U.S. trends suggested respiratory illnesses in children were not "atypical" so far.
Health officials in Ohio had also not seen unusual strain on their hospitals, she said, and most children in the outbreaks were "recovering at home."
"We are seeingas well as some pneumonia, but nothing outside the typical of what we would see," Cohen said, citing data analyzed by the agency from testing laboratories and emergency rooms around the country.
Weekly counts of emergency room visits for influenza — which, in a CDC study before the pandemic, had ranked among the most common causes of pneumonia – have surged among school-age kids nationwide in recent months.
In the opposite of what is seen in adults, rates of influenza in emergency room visits for children remain multiple times higher than for COVID-19.
"At this time, what we are seeing is quite typical of this moment in the winter respiratory virus season," Cohen said.
for more features. | Epidemics & Outbreaks |
A demonstrator near the Capitol, June 8Allison Bailey/AP Facts matter: Sign up for the free Mother Jones Daily newsletter. Support our nonprofit reporting. Subscribe to our print magazine.On Sunday, a bipartisan group of 20 US senators announced a “commonsense” proposal for making progress on gun safety, including enhanced background checks for gun buyers under 21, funding for states to implement “red flag” laws, and greater protection from gun violence for victims of domestic abuse. The proposal further contains “major investments” in mental health services and resources for communities nationwide, and funding for school security and violence prevention programs.
“Families are scared, and it is our duty to come together and get something done that will help restore their sense of safety and security in their communities,” announced the group of lawmakers led by Democrat Chris Murphy of Connecticut and Republican John Cornyn of Texas, who were reportedly working on the legislative text along with Democrat Kyrsten Sinema of Arizona and Republican Thom Tillis of North Carolina.
Though by no means a done deal—as underscored by a somewhat tepid and hedged statement of support from Minority Leader Mitch McConnell—the announcement clearly aimed to soothe a nation deeply distressed by a recent spate of mass shootings, including the massacre of 19 school children and two teachers in Uvalde, Texas.
The agreement in principle falls well short of major legislative changes that a strong majority of Americans consistently say they want in public opinion polling, including comprehensive background checks for gun buyers. But if ultimately passed by Congress in the form outlined on Sunday, the plan would bring significant change in a political arena that has remained in an infamous state of paralysis for many years. Notably, the support of 10 GOP senators indicates a possible path to get beyond the threat of a filibuster.
Even if the full proposed set of measures goes through, however, the legislative details will of course matter greatly. Key questions hang over several in particular:
Enhanced background checks for buyers under age 21. Though still narrow in terms of overall gun buyers, the young demographic came grimly into view with the recent mass shootings in Uvalde and in Buffalo, New York, where the accused perpetrators both were 18 years old when they legally purchased AR-15-style rifles and other weapons. Senate Republicans already dismissed outright the idea of raising the gun buying age to 21; instead, the proposal describes “an investigative period to review juvenile and mental health records, including checks with state databases and local law enforcement.” But how long might that period last, and with what scope? It’s unclear how such efforts would gather information that frequently isn’t shared among disparate authorities or remains sealed under juvenile law. And many school and mass shootings have involved perpetrators who had no official record of criminal or mental health problems.
Funding for red flag laws in states. What the proposal calls “crisis intervention orders” (also known as “extreme risk protection orders”) was the subject of model legislation produced by the Justice Department in June 2021 and currently exists in 19 states. The laws seek to keep guns away from people deemed by a judge to be a significant danger to themselves or others. (A majority of mass shooters are both, being suicidal.) This policy goes straight to many Republicans’ desire to blame mental health for mass shootings—to fundamentally false effect—instead of access to guns. Initial research on the efficacy of red flag laws has shown promise for preventing violent outcomes, but there are also questions about how well the laws are understood let alone put to use. In the case of the Buffalo shooter, New York’s law was not applied. Nor was Indiana’s red flag law used in 2021 to keep legally purchased firearms from a 19-year-old who committed a massacre at a FedEx facility.
Protection for victims of domestic violence. This addresses the so-called intimate partner or “boyfriend” loophole, by expanding who can be disarmed if they are convicted for domestic violence or subject to a domestic-violence restraining order. The proposal would add to the National Instant Criminal Background Check System abusers “who have or have had a continuing relationship of a romantic or intimate nature”—and not just current or former spouses. Many women have been shot to death by such individuals beyond the reach of state laws, and violent misogyny is a rising behavioral factor among mass shooters. Yet, under what parameters that information in the NICS system would even be used toward possible enforcement of gun prohibition or removal remains wholly unclear.
“The language is still not negotiated” on the domestic violence measure, a person knowledgeable about the ongoing process told me on Sunday.
Additional hedging came from Republicans on Sunday. Sen. Mike Lee of Utah announced his interest in reviewing the pending legislation by first declaring that he “will always stand on the side of the Second Amendment.” According to reporting from Politico, a GOP aide warned that “the details will be critical for Republicans, particularly the firearms-related provisions,” and that “one or more of these principles could be dropped if text is not agreed to.”
Nonetheless, this may be a signal moment for one of America’s most fraught political problems. The Democrats and gun safety advocates appear to have embraced like never before a strategy of seeking incremental change at the federal level. And some Republican lawmakers appear to recognize that a nation frayed by all manner of existential turmoil may not do well to see the mass murder of innocent children again be met with congressional inaction, despite even some shocking indication of its acceptance.
If Congress does prove capable of passing bipartisan legislation that is recognizably close to the proposal announced on Sunday, that will go a long way toward breaking free from the entrenched national narrative of polarized deadlock and despair. Beyond the merits of the new measures themselves, it would create undeniable momentum for further progress on our nation’s unacceptable—and solvable—epidemic of gun violence. | Mental Health Treatments |
Medicare’s broken pay formula threatens pathologists again
Nearly everyone agrees Medicare’s payment system for physicians is broken. After years of Medicare cuts and temporary mitigating fixes by Congress, physicians face more decreases to the services they provide to seniors next year.
Without additional relief, pathologists will receive a Medicare cut of 6.5 percent in 2024 despite the steadily increasing value of accurate and reliable diagnoses and clinical laboratory test results to patients. The reduction stems from a complex set of budgetary rules and systemic flaws within the Medicare physician fee schedule that, unless addressed, will continue to plague physicians for years to come. These include the budget-neutrality requirement for Medicare mandating that any increase for certain physician services must be offset by cuts elsewhere.
Congress needs to act with short- and long-term measures to stabilize Medicare’s fee schedule and protect access to services by physicians in rural and urban settings.
Margins at physician practices are extremely thin as inflationary pressures have increased costs in all sectors of the economy, including health care. Future cuts to Medicare reimbursement will only threaten the ability for some practices to stay open if rising costs exceed revenue.
We have seen pressures faced by pathologists and the rest of the laboratory workforce increase throughout the pandemic. For pathologists, we are unique as our work touches every aspect of the health care continuum as we are the ones who diagnose the disease that patients are facing.
According to an American Medical Association analysis of Medicare data, when adjusted for inflation, payments to physicians have declined by 22 percent from 2001–2021. While Congress has taken action to address some of these fiscal challenges by mitigating some of the cuts, overall payment continues to decline.
Financial challenges, administrative burdens, and staff shortages, combined with outdated Medicare payment policies, make it more difficult for physicians to maintain their practices and serve their communities. Many state Medicaid agencies, managed-care plans, and private payers base their payment rates on Medicare’s fees. Low Medicare payment rates translate to insufficient payment rates across multiple payers nationwide.
It’s critical that this problem be addressed and that we invest in ensuring a physician workforce ready to care for the next generation. We can’t simply shift funding and neglect a broken system producing cuts year-after-year.
Simply put, Congress must pass legislation to provide additional relief from the Medicare cuts scheduled to take effect in 2024. This desperately needed pay fix, albeit a temporary one, will help provide crucial short-term financial stability until permanent, bipartisan payment reforms are enacted. The call to action is clear: Congress must take action to protect patients’ access to care by halting the payment cuts that will take effect in January.
Emily E. Volk, MD, FCAP, is president of the College of American Pathologists.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Health Policy |
As the future of Roe v. Wade hangs in the balance, several major U.S. companies including Apple, Citigroup and Yelp have taken public stances in support of abortion care and promised to cover employees' travel expenses to access the procedure. The Supreme Court is expected to make a decision on Dobbs v. Jackson Women's Health Organization, a Mississippi case that directly challenges the right to abortion established by Roe v. Wade nearly 50 years ago, sometime this month. Following the leak of a draft decision on the case in early May, which showed that the court is poised to overturn Roe v. Wade, more employers have introduced new health-care benefits or expanded existing policies to support employees in obtaining an abortion, regardless of what the court decides. Still, the logistics of such offerings remain unclear, including how companies will protect employees' privacy and if state legislatures could come after corporate insurance policies as part of an abortion ban. How will abortion benefits work? In April, Yelp announced that it would cover costs for employees and their spouses who must travel out of state to access abortion care in response to the Texas law that bans the procedure after about six weeks of pregnancy.Following the announcement, executives received an "outpouring" of messages from leaders at other companies asking them "how to do the same," Miriam Warren, Yelp's chief diversity officer, tells CNBC Make It. "They want to know how the benefit works, what employees' feedback has been, everything right down to the brass tacks," she says. "Many companies, like ours, are thinking about abortion care, and thinking really hard about it — not just how to safeguard employees' right to health care, but what it means as a brand to stand up for this right." Johnny C. Taylor Jr., the president and CEO of the Society for Human Resource Management, has also fielded calls from business leaders interested in offering benefits to cover abortion care. "One of the safest, least controversial moves a company can make without isolating employees or customers who don't support abortion is tweaking their benefits policy, whether it's offering a travel stipend or getting abortion to be categorized as an elective procedure," he explains, which would be covered under an employer-sponsored health-care plan.Both Warren and Taylor predict that companies introducing abortion benefits would follow Apple, Citigroup, Tesla and other well-known companies in focusing on travel reimbursement for employees who have to leave their state to access the procedure. Companies are getting creative in how they offer this benefit, too, Taylor notes, to avoid potential legal and administrative hurdles, whether it's offering employees a one-time bonus or setting up donation-based relief funds that employees and their spouses can access if they need to travel for an abortion. In all cases, companies need to consider how they will protect the privacy of employees who do seek an abortion, Warren says. Under Yelp's policy, for example, employees submit travel receipts directly to their health insurance provider for reimbursement, so no one else at the company would know. Ultimately, Taylor adds, "the overwhelming majority of CEOs want to remove barriers to people who choose to have an abortion to access the procedure, without taking a position on whether abortion is good or bad." Will more companies take a public stance on abortion? The thorniest issue companies have faced since the draft opinion became public — and during the heated debate over abortion access that's followed — is whether to make a public statement in support of or against the court's decision, if Roe v. Wade is overturned. "I'm convinced that organizations are going to do their best to avoid making any public statements, because it is such a divisive issue," Taylor says. "You might see some larger companies take a stance, but we forget that most companies in America are small and medium-sized … and we're not seeing any indication that those CEOs are willing to do this, and risk losing talent or customers."Instead, Taylor predicts that companies will quietly tweak their benefits policies or send an internal memo to employees once the court's decision is announced. Warren, however, expects more employees to call on their companies to take a firm stance on abortion in the coming months. A new Gallup poll has found that 55% of Americans consider themselves "pro-choice.""Folks might feel like they don't have to speak up about abortion care right now because we're in a bit of a holding pattern until the decision is announced," Warren adds. "But I can't imagine that they'll feel the same ability to stay quiet if Roe v. Wade is overturned."Check out:How the CEO of Planned Parenthood is preparing for a future without Roe v. Wade: 'We've been planning for this moment for years'Corporate boards continue to make slow progress toward gender parity, new report showsJanet Yellen: Overturning Roe v. Wade would be 'very damaging' to the economy, womenSign up now: Get smarter about your money and career with our weekly newsletter | Women’s Health |
Matt Hancock's handling of the COVID pandemic has come under fresh scrutiny following a leaked trove of more than 100,000 WhatsApp messages.
An investigation by The Daily Telegraph alleges the former health secretary rejected testing advice on care homes and expressed concern this could get in the way of meeting his targets.
The MP strongly denied the "distorted account" with a spokesman alleging the conversations, leaked by journalist Isabel Oakeshott after she worked on his Pandemic Diaries memoir, have been "spun to fit an anti-lockdown agenda".
Former chancellor George Osborne and Conservative MP Jacob Rees-Mogg are also the subject of some of the messages.
Here, Sky News looks at the key exchanges that reportedly took place:
The Telegraph's investigation claims chief medical officer Professor Sir Chris Whitty told the then health secretary in April 2020 there should be testing for "all going into care homes".
Mr Hancock described it as "obviously a good positive step".
But the messages suggest he ultimately rejected the guidance, telling an aide the move just "muddies the waters".
According to the investigation, he said: "Tell me if I'm wrong but I would rather leave it out and just commit to test and isolate ALL going into care from hospital.
"I do not think the community commitment adds anything and it muddies the waters."
However, a source close to Mr Hancock said The Telegraph "intentionally excluded reference to a meeting with the testing team from the WhatsApp".
"This is critical," the source added, "because Matt was supportive of Chris Whitty's advice, held a meeting on its deliverability, told it wasn't deliverable, and insisted on testing all those who came from hospitals.
"The Telegraph have been informed that their headline is wrong, and Matt is considering all options available to him."
Meanwhile, a spokesperson for Mr Hancock said: "It is outrageous that this distorted account of the pandemic is being pushed with partial leaks, spun to fit an anti-lockdown agenda, which would have cost hundreds of thousands of lives if followed. What the messages do show is a lot of people working hard to save lives."
Care home testing could 'get in way' of the 100,000 daily test target
Mr Hancock also expressed concerns that expanding care home testing could "get in the way" of the 100,000 daily test target he wanted to hit, the investigation said.
On 2 April, the then cabinet minister put his reputation on the line with a pledge to significantly increase testing by the end of the month as the UK lagged behind Europe in capacity.
Those eligible for the tests initially included the general public and NHS staff, and when advised to widen access to include people in COVID-hit care homes later that month, Mr Hancock said this would be "OK" so long as it did not "get in the way of actually fulfilling the capacity in testing".
He did not say why this would get in the way of his target but at the time, the government had acknowledged the challenges of getting tests to care homes.
Mr Hancock later approved the extra testing in care homes which was announced on 28 April.
As he struggled to meet his target, leaked messages show Mr Hancock texted former Tory chancellor George Osborne to ask for help.
He said the thousands of spare testing slots were "obvs good news about spread of virus" but "hard for my target".
How were the WhatsApps leaked?
Mr Osborne, editor of the Evening Standard until July 2020, had reportedly responded: "Yes - of course - all you need to do tomorrow is give some exclusive words to the Standard and I'll tell the team to splash it."
Mr Hancock had later added: "I WANT TO HIT MY TARGET!"
Unions accused of being 'arses' and teachers 'workshy'
In May 2020, as teachers prepared for classrooms to reopen, the then education secretary Sir Gavin Williamson had messaged Mr Hancock asking for help in securing personal protective equipment (PPE) for schools.
He said this was so staff could not use a lack of it as "a reason not to open", according to The Telegraph.
He added: "All of them will but some will just want to say they can't so they have an excuse to avoid having to teach, what joys!!!"
It was a rather different view to the one he expressed in public that same month, praising teachers for "going above and beyond the call of duty", adding: "You have simply been outstanding and we are so grateful for what you've done"
Five months later, Mr Hancock messaged Sir Gavin to congratulate him on his decision to delay A-level exams for a few weeks, due to the virus.
"What a bunch of absolute arses the teaching unions are."
Sir Gavin responded: "I know they really really do just hate work."
Mr Hancock's reply was two laughing face emojis and a bullseye.
On Wednesday night Mr Williamson tweeted what he claimed were clarifications about his messages, saying it was certain unions, not teachers themselves that he was criticising.
Building a centralised test and trace system was one of the biggest challenges for the government during the pandemic.
The £37bn service is widely seen as having failed in its main objective to reduce the spread of the virus and prevent further lockdowns after its launch on 28 May 2020.
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The "lockdown files" suggest then prime minister Boris Johnson was frustrated over its capacity after it got up and running.
On 4 June he appeared to message Mr Hancock saying: "It's all about testing. That's our Achilles' heel. We can't deliver a sensible border policy or adequate track and trace because we can't test enough. Did we go to the Germans for those kits that Angela Merkel was offering? What is wrong with us as a country that we can't fix this?"
In another message, Mr Johnson adds: "We have had months and months.
"I am going quietly crackers about this."
Mr Hancock replied: "Don't go crackers. We have test capacity enough to do this. We now have the biggest testing capacity in Europe. The problem is the false negatives - so the medics are against releasing from self-isolation (whether for quarantine or T&T) with a negative test."
The files also appear to suggest Boris Johnson and the government's most senior advisers raised concerns about shielding - but the guidance was kept in place despite the reservations.
According to The Telegraph, Sir Patrick Vallance, the Chief Scientific Adviser, said in a WhatsApp in Aug 2020 that shielding had not been "easy or very effective".
Meanwhile Professor Chris Whitty, the chief medical adviser, said he would "think twice" about following the advice himself unless it was to protect the NHS - which was not the policy's aim.
Shielding was an intervention to protect extremely vulnerable people from coming into contact with coronavirus and required them to isolate for months on end.
In the WhatsApp group with key officials, Mr Johnson proposed giving over-65s "a choice" between shielding or an "ever-diminishing risk" of living a more normal life. He compared the risk of people in this age group dying from COVID to that of "falling down stairs", adding: "And we don't stop older people from using stairs."
Despite the concerns, the government reintroduced shielding throughout each of the national lockdowns and only officially ended the policy in September 2021.
The "lockdown files" investigation also claims that officials couriered Jacob Rees-Mogg a COVID test for one of his children while there was a shortage in September 2020.
The aide messaged Mr Hancock to say the lab had "lost" the original test for one of the then Commons leader's children, "so we've got a courier going to their family home tonight".
He added: "Jacob's spad [special adviser] is aware and has helped line it all up, but you might want to text Jacob."
It is not clear if Mr Hancock sent a text flagging up the intervention or if the test was delivered.
Commenting on the claim, Liberal Democrat deputy leader Daisy Cooper said: "This is yet more evidence that it's one rule for Conservative ministers and another for everyone else.
"The COVID inquiry must look into reports Conservative ministers were able to get priority access to tests at a time of national shortage."
Appearing on GB News on Wednesday evening, Mr Rees-Mogg confirmed his child's test had been lost, meaning he had to quarantine and was "unable to do my job as a government minister for several days, until it was admitted that this had been lost".
But he insisted he did not ask for another test, adding: "At that point it was raised with the Department of Health, and they decided to send a test to a member of my family so the test could be carried out.
"Not something I asked for, so if I received any special treatment, it wasn't because I had requested it, but actually it allowed a government minister to get back to work with a child that didn't have COVID in the first place, who wouldn't have needed a special test had the system actually been working, but I accept it wasn't working for other people too."
The Telegraph's investigation also claims social care minister Helen Whately advised the health secretary not to stop "husbands seeing wives" in October 2020.
This was in relation to care home visits, which were to be restricted as the UK went into a tiered lockdown system, with tighter rules in areas with higher COVID rates.
Ms Whately said: "I'm hearing there's pressure to ban care home visiting in tier 2 as well as tier 3. Can you help? I really oppose that. Where care homes have COVID-secure visiting we should be allowing it. To prevent husbands seeing wives because they happen to live in care homes for months and months is inhumane."
Mr Hancock replied: "Hearing from whom? Tier 2 was agreed yesterday as far as I'm concerned."
The rules that came into place that month allowed some visits for those in tier one, but banned them unless under "exceptional circumstances" in other tiers.
In January 2021, when some restrictions still remained on care home visits despite the vaccine rollout, Ms Whately also reportedly said: "I am getting v positive updates from David P on care home vaccinations, with just a handful left to do. As I think I've flagged, we do need to be ready with policy on visiting, given risks of lives lost through old people just giving up as well as COVID... and expectation that vaccine = safe to visit."
Hancock replied: "Yes on visiting but only after a few weeks. Meanwhile we need to hit the end-of-month target!"
Osborne: No one thinks testing is going well
Other revelations contained in the files appear to show a disagreement between Mr Hancock and Mr Osborne after the former chancellor gave a radio interview criticising testing.
Mr Hancock messaged his ex-colleague asking: "What was this for?"
Mr Osborne, who was still the editor of the London Evening Standard, replied: "Trying to spread the responsibility from you to Number 10 - I've said it before."
Mr Hancock retorted: "Ok but mass testing is going v well - I fear this looks like you asked for me to be overruled…"
Mr Osborne shot back: "No one thinks testing is going well. If I wanted a test today I can't get one, unless I fake symptoms - and XXXX [redacted] is still waiting test results from three weeks ago (XXXX went private in the end)."
The files obtained by The Telegraph also appear to show a behind the scenes clash between Mr Hancock and Sir Gavin in December 2020 over whether schools should reopen as the second wave of COVID took hold.
After the then education secretary persuaded Boris Johnson to keep classrooms open, Mr Hancock is said to have text one of his aides saying they needed to fight a "rear-guard action" to prevent a "policy car crash".
The exchange took place during a Zoom meeting about school closures, when Mr Hancock's special adviser Emma Dean said the education secretary was "freaking out", adding: "You can tell he isn't being wholly rational. Just by his body language."
Mr Hancock replied: "I'm having to turn the volume down."
At the end of the meeting, Mr Hancock said: "I want to find a way, Gavin having won the day, of actually preventing a policy car crash when the kids spread the disease in January. And for that we must now fight a rear-guard action."
In the event, on 4 January, after many younger children had returned to classes for a single day, Mr Johnson announced schools would close and exams would be cancelled amid a national lockdown. They did not reopen until 8 March 2021.
Johnson said it was 'superb' people were fined for breaking quarantine
On 2 March, The Telegraph published its latest findings from the "lockdown files".
It contained messages which appeared to show Prime Minister Boris Johnson saying it was "superb" that two people were fined £10,000 for failing to quarantine after returning from Dubai.
These messages were reportedly exchanged on 2 March 2021 in response to a Sky News story.
The report also claimed to show Cabinet Secretary Simon Case saying it was "hilarious" that 149 people were quarantining in hotels - after asking how many had been "locked up".
Mr Hancock supposedly said that "we are giving big families all the suites and putting pop stars in the box rooms".
The then-health secretary is also reported to have said - in August 2020 - that "we are going to have to get heavy with police" when asked who is enforcing lockdown restrictions. | Epidemics & Outbreaks |
One woman will be diagnosed with breast cancer every 10 minutes in this country and one man every day and yet until the 1990s it wasn't a topic for discussion. Ever.
Evelyn Lauder, whose mother-in-law Estee Lauder founded the famous cosmetics company of the same name, was one of the first to change that.
Co-creator of the pink ribbon in 1989, a few years later Lauder signed up the actress and model Liz Hurley to be the global ambassador for the Estee Lauder Companies' Breast Cancer Campaign.
The move helped open up the breast cancer conversation.
Hurley, whose grandmother died of breast cancer, tells Sky News: "I think we've come a long way in the years that I've been with Estee Lauder Companies' breast cancer campaign.
"Certainly when the campaign was started 30 years ago there was virtually no awareness of breast cancer.
"The pink ribbon hadn't been invented. October as Breast Cancer Awareness Month didn't exist.
"When my grandmother was diagnosed in the early 90s she found her own lump and was mortified and embarrassed and didn't tell anyone including her doctor for about a year by which time unfortunately it had spread. So that's why this campaign was started to try and make breast cancer not something that was whispered but shouted about."
And yet despite all the publicity every October, 10% of women never check their breasts and two in five rarely do.
They think it will never happen to them but Hurley says that's a big risk.
She continues: "Unfortunately one in eight of us will get breast cancer in our lifetime. So it's sort of playing the odds quite dramatically if you think you won't be one of those eight.
"I think it's probably better when you're of the age to get screened, which is 50 plus in the UK, and I personally believe because I know so many women who found their own lumps in their own breasts when they're younger, that I feel it would be good advice to check your breasts regularly.
"But I think knowing that mortality rates have dropped more than 42% since the late 80s is because treatments are better, treatments are targeted and most breast cancers are found earlier."
Breast cancer remains a taboo subject in some Asian and African communities, where cancer treatment can amongst other things affect fertility.
Hurley says: "'It's very important for us to learn about these difficulties. Different types of breast cancer affect different types of women very differently. And we're finding out more and more about that and putting more and more of our research money actually into studies to examine how breast cancer can affect diverse communities."
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Going to the GP quickly can be the key to surviving this disease, which still kills 11,500 women in the UK every year, or 31 every day.
And if you find a lump it will be acted upon.
Hurley continues: "'From the women I've spoken to if they found a lump in their breasts the NHS deals with it very quickly in taking them to the next stage, which is biopsy.
"Most people sort of know their bodies and we know if something doesn't feel right.
"It might not be something as tangible as a lump. It could just be feeling bad and then in that case you have to be very firm and try and get as many tests as you can - at the very least a blood test. I would advise people if they feel something is wrong to be as persistent as you can with your doctor."
Scientists are closer to finding a cure than they were 10 years ago but they are not there yet.
Hurley says: "The fact that there's targeted treatments now means women are more likely to survive today than in the past. But everything hinges on early detection, for a breast cancer to be found early and it's still localised there's more than a 90% chance of survival.
"I would say be breast aware, familiarise yourself with your own breasts. Be aware of any changes and don't be afraid to go to the doctor. Quickly. Speed is of the essence." | Women’s Health |
You don't need to be surrounded by grass to struggle with hay fever as city-dwellers suffer from worse symptoms, a study suggests.
Scientists from the University of Manchester analysed 35,000 reports of symptoms over five years by 700 people.
Participants logged how often they experienced a runny nose, sore eyes and wheeziness on an app, along with where they lived.
The researchers found that all three of these symptoms were twice as severe in urban areas than in rural ones.
Increasing pollution may be to blame, study author Professor Sheena Cruickshank says.
Rising cannabis use among British teenagers is a 'ticking time-bomb' for mental health services, one of the UK's most senior psychiatrists has warned.
One in five 16- to 19-year-olds regularly use the Class B drug, according to the ONS.
Dr Shubulade Smith, the incoming president of the Royal College of Psychiatrists, tells the BMJ: 'If you start smoking cannabis regularly, your risk of developing a psychotic illness is five times higher by the time you're 25.
'The Government should see this as a potential ticking time-bomb.'
Studies have linked frequent use to psychosis and schizophrenia. Dr Smith has called for a public campaign to inform young people on the harms of cannabis. She says: 'We have lots of education about alcohol, so we know what it does. But that's not the same for cannabis.'
Two thirds of people in the UK have avoided the dentist in the last year due to financial concerns.
Older adults were most likely to be impacted, with 81 per cent of over 65s saying they had swerved dental check-ups due to the high costs.
A survey of 2,000 Britons also shows an 83 per cent rise in child tooth extractions in the last year, which dentists say is related to a lack of check-ups.
Meanwhile, the survey, by medical solicitors Patient Claim Line, found that half of respondents avoided opticians and a third didn’t buy prescription medication.
A spokesman from the legal firm advised those with financial concerns to visit the NHS website for advice and support with covering medical costs.
The Covid-19 pandemic slowed the development of new diabetes and cancer drugs for eight out of ten of the world’s biggest drug companies.
The focus on creating tests and jabs for the virus caused the delay, according to a poll of 100 pharmaceutical chiefs by medical firm LogiPharma.
Only one in five say they are still on track to launch every drug pipelined for this year. Senior executives at the firms say safety trials of new drugs ground to a halt to help beat the virus.
A 2021 analysis found that Covid-19 had disrupted 1,200 clinical trials of medical treatments worldwide. | Epidemics & Outbreaks |
Politicians, military generals and first responders are just some high-stress positions which should avoid taking important decisions after a night without sleep, new research from the University of Ottawa indicates.
We all understand the power of sleep and the vital role it plays in human health, cognitive performance and in regulating our emotional well-being. Numerous studies into a lack of sleep have shown drops in neurocognitive functions, particularly vigilant attention, motor responses, inhibition control, and working memory. Despite this, sleep loss continues to challenge public health and affect people of all ages.
Sleep and risky decision-making
With little insight into the impact of a lack of sleep on risky decision-making at the neuroimaging level, researchers from the University of Ottawa and the University of Pennsylvania found a 24-hour period of sleep deprivation significantly impacted individuals' decision-making processes by dampening neural responses to the outcomes of their choices.
In other words, people tend to exhibit reduced positive emotions in response to winning outcomes and diminished negative emotions when faced with losses after pulling an all-nighter compared to their well-rested baseline condition.
“If you experience even just one night of sleep deprivation, there will be an impact, even on a neural level.”
Zhuo Fang
— First author and Data Scientist in the Department of Psychology at FSS
“Common sense does dictate if people incur sleep loss, sleep disturbance or a sleep disorder that their cognitive function will be impacted, their attention and efficiency will decrease. But there is an emotional impact, too,” says Zhuo Fang, a Data Scientist in the Department of Psychology at the Faculty of Social Sciences.
“If you experience even just one night of sleep deprivation, there will be an impact, even on a neural level. So, we wanted to combine brain imaging and behaviour to see that impact,” adds Fang, who is affiliated with uOttawa’s Brain and Mind Research Institute and The Royal.
The study, which evaluated the impact of one night of total sleep deprivation on 56 healthy adults, found:
- Total sleep deprivation had the detrimental effect by disrupting the relationship between neural response and individual’s risk-taking behavior, which might be related to the altered perception for risk-taking.
While numerous studies have previously illustrated the wide-ranging effects of sleep deprivation on various brain and cognitive functions, including attention processing, memory consolidation, and learning, this study addresses the specific impact of sleep loss on decision-making.
“In specific professions where decision-makers are required to operate under accumulated sleep loss, specialized training or fatigue risk management might be necessary to enable them to handle such situations effectively.”
Media requests: [email protected] | Stress and Wellness |
One month after a Maryland man received an experimental pig heart transplant, the patient is doing well and shows no sign of infection or rejection of the organ, doctors say.
"We are withdrawing all the drugs that were initially supporting his heart," Muhammad Mohiuddin, M.D., professor of surgery and co-director of the cardiac xenotransplantation program at the University of Maryland School of Medicine, said in an update shared by the University of Maryland Medical Center (UMMC) on Friday.
"So now his heart is doing everything on its own."
Lawrence Faucette, 58, who is a 20-year Navy veteran and a married father of two, had end-stage heart disease when he arrived at UMMC.
"He was deemed ineligible for a traditional transplant with a human heart due to his pre-existing peripheral vascular disease and complications with internal bleeding," Dr. Bartley Griffith, professor of surgery at the University of Maryland School of Medicine, who performed the surgery, told Fox News Digital.
"My only real hope left is to go with the pig heart, the xenotransplant," said Faucette during an interview from his hospital room a few days before his surgery, as reported by UMMC.
"At least now I have hope, and I have a chance."
Added his wife, Ann Faucette, "We have no expectations other than hoping for more time together. That could be as simple as sitting on the front porch and having coffee together."
The U.S. Food and Drug Administration (FDA) granted emergency approval for Faucette’s surgery on Sept. 15 through its single-patient expanded access ("compassionate use") pathway.
"This approval process is used when an experimental medical product — in this case, the genetically modified pig’s heart — is the only option available for a patient faced with a serious or life-threatening medical condition," Griffith said.
"The approval was granted in the hope of saving the patient’s life."
The FDA describes "compassionate use" as "a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic or medical device) for treatment outside clinical trials when no comparable or satisfactory alternative therapy options are available."
"At least now I have hope, and I have a chance."
Faucette had the eight-hour surgery on Sept. 20.
The procedure itself is similar to a traditional human heart transplant, "with some surgical adjustments made for some anatomical differences," the surgeon said.
Pigs are considered the most ideal organ donor for a xenograft — a transplant from one species to another — because their organ size, physiological metabolism and immune system are similar to those of human beings, Griffith said.
Before transplanting the pig’s heart, the scientists had to "knock out" three genes in the donor pig in order to prevent the recipient’s antibodies from rejecting the organ.
"Six human genes responsible for immune acceptance of the pig heart were inserted into the genome," said Mohiuddin in a statement to Fox News Digital.
"One additional gene in the pig was knocked out to prevent excessive growth of the pig heart tissue, for a total of 10 unique gene edits made in the donor pig."
There were risks involved in the procedure, the surgeons acknowledged.
"Acute rejection of the heart on the operating table and other complications could have led to death, since the patient was very sick before the transplant," Mohiuddin noted.
Only one other patient has had this experimental transplant.
David Bennett, 57, received a genetically modified pig heart on Jan. 7, 2022.
Similar to Faucette, Bennett received emergency authorization from the FDA, as he was also in end-stage heart failure and did not qualify for a traditional heart transplant.
That surgery was deemed a success, but the patient died from heart failure two months later.
"The extensive investigation following Mr. Bennett’s death demonstrated that the pig heart functioned well in the patient for several weeks with no signs of acute rejection," Griffith told Fox News Digital via email.
"Now his heart is doing everything on its own."
"Mr. Bennett’s death from heart failure was likely caused by a multitude of factors, including his poor state of health that left him hospitalized on a heart-lung bypass machine for six weeks prior to the transplant," the doctor added.
Prior to performing the first surgery on Bennett in 2022, the UMMD research team — which included Griffith and Mohiuddin — spent five years perfecting the surgical technique on non-human primates.
Looking ahead, Faucette’s doctors will continue to monitor his progress, Griffith noted — "likely more extensively than a traditional heart transplant patient."
The medical team is now focusing on building Faucette’s strength.
"We are working very hard with our physical therapy team, who are spending a lot of time helping him regain the strength that he’s lost during last month of his hospital stay," Mohiuddin said in the statement.
The hope is that this successful surgery will pave the way for clinical trials, the surgeon said, which are required before the FDA can approve xenotransplants for use in the general population of patients in need of organs.
Despite efforts to encourage organ donation, Griffith warned that there is still a critical shortage of organs for transplant in the U.S. and around the world.
"Through xenotransplantation, we can potentially create an unlimited supply of hearts, kidneys and other organs for transplant, available practically on demand," he said.
"In some cases, we see xeno-organs used as bridges to a human organ transplant, but we think they could be good long-term solutions for patients who may have no other options." | Medical Innovations |
A woman who called 999 for an ambulance and was told she faced an eight-hour wait drove herself to hospital but later died, MPs have heard.
Liberal Democrat leader Ed Davey raised the case of the woman, named as Jean, at prime minister's questions (PMQs).
He said: "She paid for parking and made it to the entrance of A&E where she collapsed. Jean died an hour later."
Prime Minister Rishi Sunak gave his condolences to the family. He said ambulance wait times were improving.
Mr Davey said: "No-one should lose their mother or grandmother like that, so will the prime minister apologise to Jean's family and to all those who have lost loved ones due to the government's appalling ambulance delays?"
'Breaking point'
Mr Sunak replied: "My thoughts and condolences go to Jean and Jean's family for what has happened. It is absolutely right that we continue to make progress on improving the performance in urgent and emergency care.
"We outlined plans to do this just the other month and I am pleased to say that we are seeing performance improve, whether it is waits in A&E or ambulance performance times - a considerably marked improvement over the last several weeks compared to the peak pressures that we saw over the winter due to Covid and flu.
"And because of the investments we are putting in more ambulances, more doctors and nurses and more discharge. I'm confident that we will continue to make progress."
But in a statement issued after PMQs, Mr Davey said Mr Sunak's response was "not good enough".
He said: "Years of neglect and underinvestment are stretching our local health services to breaking point, but Conservative ministers just don't seem to get it.
"The prime minister should visit Eastbourne general hospital A&E department to see for himself the true extent of this ambulance crisis."
A spokesman for South East Coast Ambulance Service said: "Our thoughts are with this patient's family and we would invite them or a representative to contact us so we can look further into the circumstances.
"We are working hard to respond to everyone who needs us as quickly as possible, prioritising those in a life-threatening condition, and recognise the need to improve our response times."
The Department of Health and Social Care referred the BBC to Mr Sunak's response in parliament. | Health Policy |
NEWYou can now listen to Fox News articles! We do not want to deliver another depressing show, and we won't. But if you're looking at the country and thinking, "How do we measure the health of the United States?" there are pretty obvious ways to do it. The average life expectancy is one, the marriage rate, the effectiveness of the U.S. military, housing costs, the value of the U.S. dollar, health of the financial markets, the safety of our streets, etc. By every single one of those very basic measures, the Biden administration has failed and done so dramatically. Biden isn't simply incompetent, though obviously he is. Biden is the single most destructive force in the history of the United States. In just a year and a half, Biden and Ron Klain, his strange, shadowy chief of staff, have done more damage to this country than anybody could possibly have imagined. We read the numbers every night, but they don't capture it. You know, what captures it? This story. This story comes from the reliably liberal financial news outlet CNBC. Here's the second sentence of the piece: "A rising number of former Californians are migrating out of the country altogether and are instead heading south of the border. Many are seeking a more relaxed and affordable lifestyle in Mexico."Yes, in Mexico, not Switzerland. Mexico. So, things are so bad in Joe Biden's America that thousands of Americans are voluntarily moving to a Third World country in the middle of a brutal drug war. Yes, there are human heads littering the side of the road in Acapulco, but at least it's not Los Angeles. HUNTER BIDEN BRAGGED JOE BIDEN WOULD 'TALK ABOUT ANYTHING THAT I WANT HIM TO' IN 2018: REPORT Darrell Graham works in real estate in Mexico. He says of the people he sells to "at least half are coming down from California... Suddenly the cost of taxes, the crime rates, the politics, all the things that people are unhappy with in California make them want to come down to Mexico." Another analyst who studies the trend at the Migration Policy Institute says so many Americans are relocating to Mexico right now that locals are being priced out of their own neighborhoods. So, it's mass migration in reverse. It's pretty amazing. No matter how bad you thought this administration was going to be, you probably could not have imagined ever caravans of Biden refugees fleeing our country across the southern border, looking for a better life in Mexico. At this rate, the next stop will be Port au Prince. Say what you will about Haiti, it's better than Baltimore. Now, one upside of moving to Latin America is like-minded neighbors. Hispanics despise Joe Biden, too. Biden's approval rating among Hispanic voters in this country has fallen to 24%. That's his lowest among any demographic group. Meanwhile, as of tonight, guess who's the preferred candidate for 2024 among self-described Latinos? That's right. The Taco Bowl Guy, Donald J. Trump. Let that sink in for a second. Donald Trump, supposedly the most anti-Hispanic racist this country has ever produced, that man, is far more popular among actual Hispanics than a cringing White liberal like Joe Biden. So, the guy who tried to build a border wall is loved. The guy who uses the word Latinx, not ironically, is hated. Remarkable. It's also—and this is not an overstatement—politically, a disaster of generational magnitude for the Democratic Party. Latinos dislike Joe Biden intensely, and they dislike him for the same reason that everybody else does. Biden has made things worse, a lot worse. The median income in this country is $44,000 a year – a year. Imagine trying to live on that right now. Do the math. You couldn't do it. Not in any recognizably American way. Inflation is too high. It's making you poorer. Well, today in Philadelphia, Joe Biden unveiled his plan to fix inflation. Now watch this tape and keep in mind as you do that, it is real. We've not edited it in any way. Here it is:BERNIE SANDERS-BACKED CANDIDATE LOOKS TO UNSEAT MODERATE DEMOCRAT IN LATEST TEST FOR PROGRESSIVE WING OF PARTY PRESIDENT BIDEN: We can do all this. I'm asking, all I'm asking is for the largest corporations and the wealthiest Americans to begin to pay their fair share in taxes. I'm deadly earnest. Anybody out there think the tax system is fair? Raise your hand. This guy. The AFL-CIO. How many private sector labor union members support Joe Biden? 12%? 15%? It's not 50% And yet they host the guy. They're so corrupt.But listen to the message. Higher taxes will make the things that you buy cheaper. That's what Biden just said. Inflation is up because taxes aren't high enough. Now, it's hardly a defense of corporate America, which we would never defend, to point out that as an economic analysis is completely insane. It's not true. We've lost control of inflation because people like Joe Biden pushed a species of lunacy called modern monetary theory. They printed an endless torrent of fake money to enrich and empower themselves and by doing that, they crashed the U.S. dollar and made you much poorer. That's what happened. There's not much debate about that and they're not going to acknowledge it, of course. They can't even be bothered to pretend to care about baby formula shortages. Here's Joe Biden's publicist just yesterday. BOXER JAKE PAUL BLASTS BIDEN FOR GAS PRICES, INFLATION, CLAIMS BIDEN VOTERS ARE ‘THE AMERICAN PROBLEM’ White House press secretary Karine Jean-Pierre speaks during a press briefing at the White House, Monday, June 13, 2022, in Washington. (AP Photo/Patrick Semansky)REPORTER: So, I have two questions on baby formula. So first, what is the White House, what is the latest update the White House has received on the current formula situation across the country? KARINE JEAN-PIERRE: Yeah. Let me see if I have anything new for you on that. So, I think it's been a couple of days since we have been asked that question. Okay. I don't have anything new. I know we made some announcements last week. I don't, I just don't have them in front of me. Oh, mothers can't feed their babies. "Let me see what I have here." Somehow, the White House communications team forgot to load the baby formula talking points into the binder, leaving our historic LGBTQ+ immigrant, class ceiling shattering press secretary speechless. "I just don't have them in front of me." In other words, "What does that question have to a trans rights? Nothing? Okay, next." WHITE HOUSE PRESS SECY LAUGHS OFF QUESTION ABOUT BIDEN'S HEALTH: 'NOT A QUESTION WE SHOULD BE ASKING' The one thing Karine Jean-Pierre can say with dead certainty is that Joe Biden is great. Joe Biden is energetic. He's fully in charge of his faculties. In fact, he's planning on running again in 2024, by which time all of suburban Chicago will have moved to Haiti in search of a higher standard of living. She actually said that, "To be clear, as the president himself has said repeatedly, he plans to run in 2024." And we can just guess how you feel about that, but how do leaders of the Democratic Party feel about that? He's their guy, and yet they're horrified. Even Sandy Cortez, who can defend anything if she has to up and including another pointless neo con war in Ukraine, even she can't get behind another Joe Biden run. Watch. AOC: We'll cross that bridge when we get to it, but I think if the president has a vision and that's something certainly we're all willing to entertain and examine when the time comes. DANA BASH, CNN: That's not a yes. AOC: I believe that the president has been doing a very good job so far and, you know, should he run again, I think that, I you know, I think it's, it's, we'll take a look at it. BIDEN LOSES CONTROL OF INFLATION, AND THE TRUST OF AMERICAN PEOPLE "Yeah. We'll cross that bridge, right? We'll take a look at it." So, what they're really saying and this is their latest talking point is, "We don't like Joe Biden and we never have." They've got nothing to do with Joe Biden, turns out. David Axelrod and Joe Scarborough, the other professional liars who foisted this senile mannequin on America, are now trying to run away from him. The New York Times, which is their newsletter, ran a front-page story two days ago on Sunday about Joe Biden's mental decline. Really? That topic was completely off limits just a year ago. You couldn't say it. The New York Times quoted one DNC official who's advising Biden to announce now, right after the midterms, that he's not running again. As David Axelrod masterminding the Obama victories, put it himself, "The presidency is a monstrously taxing job and the stark reality is the president would be closer to 90 than 80 at the end of a second term, and that would be a major issue." In other words, he's too freakin' old. Biden has got dementia. Who knew? Well, actually, they all knew, and they all knew all along, and they should not be allowed at this late date to evade their culpability for knowing and lying about it. They committed this crime. These people are cynical. They're ruthless. They're morally disfigured and if you need more proof of that, consider how they're treating poor Kamala Harris. BIDEN LASHES OUT AT CRITICS AND DEFLECTS BLAME FOR SOARING INFLATION, TWITTER RESPONDS They've abandoned Kamala Harris completely. It's shocking, really, given that just 18 months ago, these very same people were yelling at you about how lucky you were to have this historically Indian, Black female vice president, the very first in history. It was thrilling. They got emotional just thinking about it. Kamala Harris was that wonderful. Here's a recap. DOUGLAS BRINKLEY: Kamala Harris is being sworn in, the first woman vice president. AMY KLOBUCHAR: And our first woman vice president. STEVE SCHMIDT: We'll see our first woman vice president. It will be a historic day. JOHN KING: Kamala Harris will be the first woman vice president of the United States.BIDEN: We mark the swearing in of the first woman in American history elected to national office, Vice President Kamala Harris. Don't tell me things can't change. BIDEN ADMIN MAY RELAX CHINA TARIFFS IN BID TO EASE INFLATION, COMMERCE SECRETARY SAYS Vice President Kamala Harris waves as she departs after speaking at the Tribal Nations Summit in the South Court Auditorium on the White House campus, Tuesday, Nov. 16, 2021, in Washington. (AP Photo/Patrick Semansky)"Don't tell me things can't change!" Oh, they can change and they have. That was just the other night. We were getting goose bumps listening to it, but now they're ghosting Kamala Harris like a bad tinder date. They're pretending she doesn't exist. In effect, in doing that, the Democratic Party is embracing White supremacy. How? Well, Democratic Party leaders plan to deny Harris a job that she has earned as Democratic nominee and replace her in the next cycle with yet another—wait for it now—White man. Let's try Beto. How about Mayor Pete? Notice a theme here? Pale and male as they are forever telling us because it turns out diversity isn't actually our strength. Equity and inclusion are fine if you're hiring middle managers at a big company. You would never hire a middle-aged White guy at Citibank. That's probably illegal, same with the airlines and hospitals. We've got way too many White male pilots and heart surgeons and Supreme Court justices. The Biden administration tells us that constantly. They seem to me that they use DOJ to enforce their rules. Yet somehow the most anti-White political party in the English-speaking world is suddenly pushing another White man for president. How does that work, Joe Biden and friends Ron Klain? Well, it turns out the presidency is a different thing. Affirmative action is essential for vice presidents, obviously. That's how we got Kamala Harris in the first place, but not for presidents. Presidents have too much power, so the usual diversity standards don't apply. We've had 46 White male presidents in a row, and the Democratic Party wants you to have another. THESE 27 DEMOCRATS VOTED AGAINST PROTECTIONS FOR SUPREME COURT JUSTICES Oh, not so fast, racists. Hold on a second. Now, the rest of official Washington may be completely on board with this coup against Kamala Harris, who, again earned the job. They may be willing to stand back and allow America's highest-ranking woman of color to be degraded and humiliated in the pages of The New York Times, but we're not. We believe Kamala Harris is a human being with hopes and dreams and aspirations. She's a first in so many ways. She celebrated Kwanzaa before it was even invented and of course, now that Oprah is retired, Kamala Harris is America's main source of life affirming aphorisms that don't actually mean anything. Watch this montage, which we have lovingly collected. Ask yourself how anyone who stand in the way of this woman becoming president United States. KAMALA HARRIS: You know, when we talk about our children, I know for this group, we all believe that when we talk about the children of the community, they are the children of the community. KAMALA HARRIS: And so what we all experienced is on an electric school bus, on an electric bus, no exhaust, no diesel smell. KAMALA HARRIS: It is time for us to do what we have been doing, and that time is every day. Every day it is time for us to agree. President Joe Biden, with Vice President Kamala Harris, arrives to speak before signing the $1.2 trillion bipartisan infrastructure bill into law during a ceremony on the South Lawn of the White House in Washington, Monday, Nov. 15, 2021. (AP Photo/Susan Walsh)KAMALA HARRIS: This whole thing about the border. We've been to the border. We've been to the border. LESTER HOLT, NBC NEWS: You haven't been to the border. KAMALA HARRIS: And I haven't been to Europe. I mean, I don't think... KAMALA HARRIS: And my pronouns are she, her and hers. KAMALA HARRIS: She would look down at me and, "Kamala, what do you want? What do you want?" And I looked back up and I said, "fweedom." KAMALA HARRIS: You're going to literally see the craters on the moon with your own eyes, with your own eyes. I'm telling you. KAMALA HARRIS: We must together, work together to see where we are, where we are headed, but also see it as a moment, yes, to together. KAMALA HARRIS: It is the perspective of a woman who grew up a Black child in America, who was also a prosecutor, who also has a mother who arrived here at the age of 19 from India, who also, you know, likes hip hop. Like, what do you want to know? CNN POLITICAL ANALYST SAYS CHATTER AROUND BIDEN NOT RUNNING IN 2024 'WEAKENS HIS ABILITY TO GOVERN' What do you know? She's unbelievable. You would deny that person a chance to serve? That is the person the Democratic insiders are tonight, ladies and gentlemen, trying to remove from the public stage and if no one else to say it, we will. It's wrong. Despite appearances, Kamala Harris is not a disposable consumer product. She's a pioneer. Do you what she went through trying to get a fair shake in the systemically racist country as the daughter of college professors? It wasn't easy. You know how hard she worked? At one point, she even dated Montel Williams. Few would go that far, but Kamala Harris did. No wonder she's sick and tired of being sick and tired. We get it. Watch as she did the work and unpacked her generational trauma live on television for you. KAMALA HARRIS: You know, there was a little girl in California who was part of the second class to integrate her public schools, and she was bussed to school every day and that little girl was me. "Yeah, that little girl was me." Now, that little girl actually grew up in French-speaking Canada, not in the Jim Crow South, but whatever. Look what she's become. Now, simply because she's a moron and no one likes or even agrees on how to pronounce her first name, the Democratic Party is trying to throw Harris away, toss her out the window like a used Big Mac wrapper. Now, Kamala Harris may be stained with secret sauce, but she deserves more than that. Yes, she does. Mediocrity is no excuse for firing someone. A low IQ, a terrible personality, a total inability to do the prescribed job – those are not reasons to deny someone a job. The Biden administration has told us that repeatedly. CLICK HERE TO GET THE FOX NEEDS APP By the way, democracy plays a role in this, too. You just saw the woman who Liz Cheney tells us a lot that 81 million votes in the last election. Now that's the most votes of any vice president in history. That's more votes than Liz Cheney's dad got. So, denying Kamala Harris the Democratic nomination in 2024 is nothing less than a form of insurrection. It's an attack on democracy and on our sacred norms. It's disinformation, probably Russian in origin. Whatever it is, we cannot allow it and as long as this show is on the air, we won't. Tonight, we are endorsing Kamala Harris for the 2024 Democratic primaries. She deserves it and so do Democrats. They created her. They should be forced to live with her and anyone who disagrees with that is, by definition, a racist. Tucker Carlson currently serves as the host of FOX News Channel’s (FNC) Tucker Carlson Tonight (weekdays 8PM/ET). He joined the network in 2009 as a contributor. | Health Policy |
The NHS is struggling to provide safe and effective care for all cancer patients, say senior doctors.
The Royal College of Radiologists is warning that all four UK nations are facing "chronic staff shortages", with patients waiting too long for vital tests and treatments.
Half of all cancer units are now reporting frequent delays for both radiotherapy and chemotherapy.
Ministers say a workforce strategy for the NHS in England is due shortly.
The plan, which is meant to spell out how the government will plug staffing gaps over the next 15 years, has been repeatedly delayed, to the frustration of some in the health service.
In other parts of the UK, ministers say cancer waiting lists are a priority and extra investment is being made in staff and diagnostic equipment.
In June 2022, Carol Fletcher, from South Wales, finally had her routine screening appointment for breast cancer, which was itself overdue.
"It took another eight weeks after my mammogram before I was told there might be something wrong," she said.
Since her cancer diagnosis, there have been more waits - for scans, tests, surgery and then chemo.
"I was told that I might not get results back [quickly] after my mastectomy because they haven't got enough pathologists, so there was another eight-week delay for chemotherapy," she said.
"I can't plan for the future and it's had a huge impact on my family."
NHS services across the whole UK have been struggling to meet cancer targets since well before Covid.
The pandemic increased the backlog, with scans and treatment disrupted by lockdowns.
Across England, Scotland and Northern Ireland, one key target is to start treatment within two months of an urgent referral by a GP.
In Wales the measure is slightly different as it includes all urgent and non-urgent referrals.
All four nations are operating well below those levels. In England just 61% of patients start treatment in that time against a target of 85%.
Growing delays are, in part, the flip side of a medical success story.
Scientific progress in cancer care has been remarkable, with cutting-edge drugs offering hope where previously there was little that could be done.
New techniques are more effective but often far more complex for doctors to deliver.
At the same time the UK population is getting older - and as cancer risk is strongly linked to age it means more more demand for expensive scanners, along with more staff to analyse those scans, and more specialist doctors and nurses.
The Royal College of Radiologists (RCR) describes the situation as a perfect storm - and says the workforce is struggling to keep up.
Across the four UK nations, it calculates there is now a 15% shortfall of specialist cancer doctors - or clinical oncologists - who deliver chemotherapy and radiotherapy.
Without action, it says this gap will grow to 25% - or a shortage of 368 full-time consultants - by 2027.
Just as concerning is an even larger shortage of consultant radiologists - highly trained doctors who interpret scans to diagnose cancer or monitor its progression.
'Perfect storm'
The RCR says for each month a patient waits to start cancer treatment, the risk of death is increased by about 10%.
In its annual survey, 44% of cancer service managers say they are now "highly concerned" about patient delays, up from 29% in the previous year.
"There are examples in almost every cancer centre where parts of the service just aren't running as well as we would like," said Dr Tom Roques, a consultant oncologist and vice-president of the RCR.
"We're having to tell patients all the time that we can't quite treat them as quickly as we would like, or in the way that we'd like, and that's a stressful thing to have to do."
Kevin O'Hara, 60, from County Durham, broke five ribs in a motorbike accident last November.
A scan of his upper body also picked up a shadow near one of his kidneys that was later diagnosed as cancer.
He was offered drug treatment meant to slow the growth of the tumour and - in early February - was told the waiting list for surgery would be three to four months.
That period has now been and gone but he is still waiting for a date for his operation.
"Every day you are waiting and waiting and nothing changes," he said.
"I come home from work and go to the door and, when there's no envelope that says NHS on the top, I just get so depressed."
There is another trend in cancer care which is often overlooked.
The last decade has seen a dramatic increase in people coming forward to get checked after spotting a possible symptom such as an unusual lump, strange mole or unexplained weight loss.
The reasons for that are complex and include a bounceback in demand since Covid, stronger guidance for GPs to refer to cancer specialists, major NHS publicity drives and the work of campaigners such as "Bowelbabe" Deborah James.
Cancer doctors view the spike in demand as a "very good thing", as a growing proportion of patients are now diagnosed earlier when cancer is easier to treat.
But it also puts more pressure on NHS services, with waiting times for diagnosis and other scans one of the key bottlenecks in the system.
Since Christmas there have been some signs of progress, with the NHS in England reducing the backlog of long waits for treatment and hitting one of its other standards - for faster diagnosis - for the first time.
The RCR also says there is a "chink of light" - with recruitment of oncologists rising over the last three years, particularly in parts of the country with the worst staff shortages.
It wants each UK nation to increase medical school places and training posts, and says more also needs to be done to stop experienced staff cutting their hours or leaving the profession early.
The Department of Health said that the total number of full-time staff in the cancer workforce in England had risen by 51% to 33,093 since 2010.
A spokesman added: "We want to build on this progress and will publish a workforce plan shortly to ensure we have the right numbers of staff, with the right number of skills."
The Scottish government is also expected to publish its new 10-year cancer strategy within weeks, setting out ways to attract and retain more staff.
The Welsh government recently published a cancer improvement plan and says it is now investing heavily to train more staff and build more diagnostic and treatment centres.
In Northern Ireland, the health department said it is "extremely disappointing" that cancer targets are being missed. It has recently opened two new rapid diagnostic centres and started a "cancer strategy workforce review".
Data visualisation by Liana Bravo.
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Andrew is in recovery after a decade of alcoholism.
Ten years ago, he suffered a mental breakdown and his drinking spiralled.
It led to the loss of a career in finance and the breakdown of family relationships.
But the 62-year-old told BBC Scotland that his darkest point came last year.
"In June, my partner died and my drinking just got totally out of control," he said. "I couldn't function as a human being. I had to be cared for."
A GP referral led Andrew to Scotland's only NHS-funded rehab community, the Lothian and Edinburgh Abstinence Project (Leap).
After 15 weeks of intensive therapy, he completed the programme four months ago and said his physical and mental health vastly improved.
Andrew credits his reversal to peer support volunteers, who have experience of addiction themselves, who have helped him overcome his "cravings" and "obsession" with drink.
"It was the first time in many, many years that I was actually being honest about myself," he said.
"I could trust the volunteers implicitly. I got to understand that actually this isn't just me that has these problems.
"They gave me hope that actually I can recover and lead a fulfilling life."
'We want to offer people hope'
Andrew's experience of the value of peer support through recovery has helped inform a new programme designed to guide those addicted to alcohol or drugs through the "difficult journey" to rehab.
NHS Lothian has employed six "peer bridgers" - individuals with their own history of addiction - to help others between their referral to rehab and their eventual admission.
Dr David McCartney, project lead at Leap, said there were still "barriers to some individuals getting to rehab" including uneven referral rates and geography.
He told BBC Scotland that the peer bridgers will help those waiting for access.
"We get someone with lived experience who's been through rehab, who knows what it feels like to be at the coalface and to be struggling with addictions," he said.
"That person is employed by us to help the people who want to get to rehab or think they want to come to rehab to actually navigate that quite difficult journey through referral assessments, admission support during treatment and then after-care."
He added: "The first thing you want to do is offer people hope - that's where somebody with life experience can be hugely more powerful than employed staff or professionals.
"You have someone who's walked the walk, who greets you on your own terms, who has the same kind of language, who understands what it feels like to be where you are."
'Courage and motivation to change'
Phil Hayes is one of the new peer bridgers and draws on his own battle with drug addiction in the 1990s.
The 54-year-old said: "One of the important things is when somebody finds the courage and motivation to change their selves and change their addiction.
"As an organisation, we're able to connect with them and offer them consistent personal support all throughout that process."
He said that the project "helps fill the gaps" in support, adding: "I think in terms of addiction in society, I mean we need to be able to offer anybody suffering an addiction the complete wide range of options open to them, whether that's harm reduction or residential rehab and complete abstinence."
One part of the Scottish government's "National Mission" to reduce drug deaths is improving access to residential rehabilitation.
It is committed to investing £100m for such referrals over the next five years.
Figures released by Public Health Scotland on Tuesday revealed that there were more than 1,300 state-funded placements between April 2021 and March 2023, costing more than £10m.
The average monthly number of placements being approved by alcohol and drug partnerships has increased over the last two years.
In April-June 2021, there were 140 funded placements under way. By the end of March, there were 233 placements running in Scotland.
'Access is important'
Dr Nina MacKenzie is psychiatry registrar and was commissioned by NHS Lothian and University of Edinburgh to study the outcomes of those leaving residential rehab at Leap.
She told BBC Scotland that - for those who completed the full programme - 61% remained abstinent from substances after four years.
Dr MacKenzie said the data was "adding to the evidence" on the long-term effects of residential rehabilitation.
"Our study shows that there is a possibility for improvement in a range of of outcomes for people who have gone through residential rehabilitation," she said.
"That is in comparison to other types of treatment for substance use disorder."
She added: "I think it's important that people have access to a range of treatment options.
"Residential rehabilitation will be right for some people and it's important that they can access that when they need it across all of Scotland."
If you have been affected by any of the issues raised in this story you can visit BBC Action Line. | Mental Health Treatments |
And, just like in humans, packing on additional pounds can often lead to a host of different health problems in cats, including changes to their digestive system, type 2 diabetes and chronic inflammation, according to a study published Sept. 29 in the Journal of Animal Science.
"It is a huge problem," study co-author Kelly Swanson, a professor of human nutrition and the interim director of the Division of Nutritional Sciences at the University of Illinois Urbana-Champaign, told Live Science in an email. "Similar to other species, feline obesity is associated with numerous health problems. If we can avoid obesity, many other health issues may be prevented or delayed."
To find out what happens when our feline friends habitually overindulge, scientists corralled 11 adult spayed female cats and let them gobble up as much standard dry cat food as they wanted, according to a statement. The study also included several cats that were fed a controlled diet to compare the effects of their food intake.
The overeating cats' average body condition score (BCS) — a measurement system similar to body mass index (BMI) in humans — was 5.41 on a 9-point scale at the beginning of the study, but after 18 weeks of overindulging, that number shot up to 8.27, which corresponded to being 30% overweight, according to the study.
As the felines tipped the scales, researchers observed not only a surge in poop production but also a rise in gastrointestinal transit time, which is the amount of time between eating and bowel movements. (To measure this, cats were fed a bright-green, non-digestible dye that turned their poop green.)
"That led to a reduced amount of time for the body to digest the food consumed, resulting in a reduced digestive efficiency (nutrient digestibility)," Swanson said. "That also affected the fecal microbiota of the cats, likely due to the reduced digestion (more nutrients passing through)."
Because the cats were not getting all of their proper nutrients, the researchers noticed "significant changes" in the gut microbial compositions in the fat cats. For instance, they recorded an increase in Bifidobacterium, bacteria that inhibit pathogens and stimulate the immune system, and a decrease in Collinsella, bacteria that break down fiber and can protect against inflammatory diseases, according to the statement.
Interestingly, this is the opposite of what happens in overweight humans. However, more research is needed to understand why.
The cats' poop also became more acidic due to a decrease in fecal pH, indicating poor absorption of carbohydrates and fat — which is related to "higher food intake and reduced digestibility," according to the statement.
Swanson said that because the study was relatively short and lasted only 18 weeks, none of the cats developed any long-term health conditions, and that once the study commenced, researchers "placed [them] on a weight-loss study so they are all back at a healthy body weight again."
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Jennifer Nalewicki is a Salt Lake City-based journalist whose work has been featured in The New York Times, Smithsonian Magazine, Scientific American, Popular Mechanics and more. She covers several science topics from planet Earth to paleontology and archaeology to health and culture. Prior to freelancing, Jennifer held an Editor role at Time Inc. Jennifer has a bachelor's degree in Journalism from The University of Texas at Austin. | Nutrition Research |
Scientist, after decades of study, concludes: We don't have free will
Before epilepsy was understood to be a neurological condition, people believed it was caused by the moon, or by phlegm in the brain. They condemned seizures as evidence of witchcraft or demonic possession, and killed or castrated sufferers to prevent them from passing tainted blood to a new generation.
Today we know epilepsy is a disease. By and large, it's accepted that a person who causes a fatal traffic accident while in the grip of a seizure should not be charged with murder.
That's good, says Stanford University neurobiologist Robert Sapolsky. That's progress. But there's still a long way to go.
After more than 40 years studying humans and other primates, Sapolsky has reached the conclusion that virtually all human behavior is as far beyond our conscious control as the convulsions of a seizure, the division of cells or the beating of our hearts.
This means accepting that a man who shoots into a crowd has no more control over his fate than the victims who happen to be in the wrong place at the wrong time. It means treating drunk drivers who barrel into pedestrians just like drivers who suffer a sudden heart attack and veer out of their lane.
"The world is really screwed up and made much, much more unfair by the fact that we reward people and punish people for things they have no control over," Sapolsky said. "We've got no free will. Stop attributing stuff to us that isn't there."
Sapolsky, a MacArthur "genius" grant winner, is extremely aware that this is an out-there position. Most neuroscientists believe humans have at least some degree of free will. So do most philosophers and the vast majority of the general population. Free will is essential to how we see ourselves, fueling the satisfaction of achievement or the shame of failing to do the right thing.
Saying that people have no free will is a great way to start an argument. This is partly why Sapolsky, who describes himself as "majorly averse to interpersonal conflict," put off writing his new book "Determined: A Science of Life Without Free Will."
Sapolsky, 66, has a mild demeanor and a Jerry Garcia beard. For more than three decades, he escaped the politics of academia to study baboons in rural Kenya for a few months every year.
"I'm really, really, really trying not to sound like a combative jerk in the book," he said. "I deal with human complexities by going and living in a tent. So yeah, I'm not up for a lot of brawls about this."
Analyzing human behavior through the lens of any single discipline leaves room for the possibility that people choose their actions, he says. But after a long cross-disciplinary career, he feels it's intellectually dishonest to write anything other than what he sees as the unavoidable conclusion: Free will is a myth, and the sooner we accept that, the more just our society will be.
"Determined," which comes out today, builds on Sapolsky's 2017 bestseller "Behave: The Biology of Humans at Our Best and Worst," which won the Los Angeles Times Book Prize and a slew of other accolades.
The book breaks down the neurochemical influences that contribute to human behaviors, analyzing the milliseconds to centuries preceding, say, the pulling of a trigger or the suggestive touch on an arm.
"Determined" goes a step further. If it's impossible for any single neuron or any single brain to act without influence from factors beyond its control, Sapolsky argues, there can be no logical room for free will.
Many people with even a passing familiarity with human biology can comfortably agree with this—up to a point.
We know we make worse decisions when hungry, stressed or scared. We know our physical makeup is influenced by the genes inherited from distant ancestors and by our mothers' health during her pregnancy. Abundant evidence indicates that people who grew up in homes marked by chaos and deprivation will perceive the world differently and make different choices than people raised in safe, stable, resource-rich environments. A lot of important things are beyond our control.
But, like—everything? We have no meaningful command over our choice of careers, romantic partners or weekend plans? If you reach out right now and pick up a pen, was even that insignificant action somehow preordained?
Yes, Sapolsky says, both in the book and to the countless students who have asked the same question during his office hours. What the student experiences as a decision to grab the pen is preceded by a jumble of competing impulses beyond his or her conscious control. Maybe their pique is heightened because they skipped lunch; maybe they're subconsciously triggered by the professor's resemblance to an irritating relative.
Then look at the forces that brought them to the professor's office, feeling empowered to challenge a point. They're more likely to have had parents who themselves were college educated, more likely to hail from an individualistic culture rather than a collective one. All of those influences subtly nudge behavior in predictable ways.
You may have had the uncanny experience of talking about an upcoming camping trip with a friend, only to find yourself served with ads for tents on social media later. Your phone didn't record your conversation, even if that's what it feels like. It's just that the collective record of your likes, clicks, searches and shares paints such a detailed picture of your preferences and decision-making patterns that algorithms can predict—often with unsettling accuracy—what you are going to do.
Something similar happens when you reach for that pen, Sapolsky says. So many factors beyond your conscious awareness brought you to that pen that it's hard to say how much you "chose" to pick it up at all.
Sapolsky was raised in an Orthodox Jewish household in Brooklyn, the son of immigrants from the former Soviet Union.
Biology called to him early—by grade school he was writing fan letters to primatologists and lingering in front of the taxidermied gorillas at the American Museum of Natural History—but religion shaped life at home.
That all changed on a single night in his early teens, he says. While grappling with questions of faith and identity, he was struck by an epiphany that kept him awake until dawn and reshaped his future: God is not real, there is no free will, and we primates are pretty much on our own.
"That was kind of a big day," he said with a chuckle, "and it's been tumultuous since then."
Skeptics could seize on this to rebut his arguments: If we aren't free to choose our actions or beliefs, how does a boy from a deeply religious conservative home become a self-professed liberal atheist?
Change is always possible, he argues, but it comes from external stimuli. Sea slugs can learn to reflexively retreat from an electrical shock. Through the same biochemical pathways, humans are changed by exposure to external events in ways we rarely see coming.
Imagine, he offers, a group of friends that goes to see a biopic about an inspiring activist. One applies the next day to join the Peace Corps. One is struck by the beautiful cinematography and signs up for a filmmaking course. The rest are annoyed they didn't see a Marvel film.
All of the friends were primed to respond as they did when they sat down to watch. Maybe one had heightened adrenaline from a close call with another car on the drive over; maybe another was in a new relationship and awash in oxytocin, the so-called love hormone. They had different levels of dopamine and serotonin in their brains, different cultural backgrounds, different sensitivities to sensory distractions in the theater. None chose how the stimulus of the film would affect them anymore than the sea slug "decided" to wince in response to a jolt.
For fellow adherents of determinism—the belief that it's impossible for a person in any situation to have acted differently than they did—Sapolsky's scientific defense of the cause is welcome.
"Who we are and what we do is ultimately the result of factors beyond our control and because of this we are never morally responsible for our actions in the sense that would make us truly deserving of praise and blame, punishment and reward," said Gregg Caruso, a philosopher at SUNY Corning who read early drafts of the book. "I am in agreement with Sapolsky that life without belief in free will is not only possible but preferable."
Caruso is co-director of the Justice Without Retribution Network, which advocates for an approach to criminal activity that prioritizes preventing future harm rather than assigning blame. Focusing on the causes of violent or antisocial behavior instead of fulfilling a desire for punishment, he said, "will allow us to adopt more humane and effective practices and policies."
Theirs is very much a minority viewpoint.
Sapolsky is "a wonderful explainer of complex phenomena," said Peter U. Tse, a Dartmouth neuroscientist and author of the 2013 book "The Neural Basis of Free Will." "However, a person can be both brilliant and utterly wrong."
Neural activity is highly variable, Tse said, with identical inputs often resulting in non-identical responses in individuals and populations. It's more accurate to think of those inputs as imposing parameters rather than determining specific outcomes. Even if the range of potential outcomes is limited, there's simply too much variability at play to think of our behavior as predetermined.
What's more, he said, it's harmful to do so.
"Those who push the idea that we are nothing but deterministic biochemical puppets are responsible for enhancing psychological suffering and hopelessness in this world," Tse said.
Even those who believe biology limits our choices are wary of how openly we should embrace that.
Saul Smilansky, a philosopher at the University of Haifa in Israel and author of the book "Free Will and Illusion," rejects the idea that we can will ourselves to transcend all genetic and environmental constraints. But if we want to live in a just society, we have to believe that we can.
"Losing all belief in free will and moral responsibility would likely be catastrophic," he said, and encouraging people to do so is "dangerous, even irresponsible."
A widely cited 2008 study found that people who read passages dismissing the idea of free will were more likely to cheat on a subsequent test. Other studies have found that people who feel less control over their actions care less about making mistakes in their work, and that disbelief in free will leads to more aggression and less helpfulness.
Sapolsky discusses such concerns in his book, ultimately concluding that the effects seen in such experiments are too small and their lack of reproducibility too great to support the idea that civilization will crumble if we think we can't control our fates.
The more compelling critique, he says, is eloquently articulated in the short story "What's Expected of Us," by speculative fiction writer Ted Chiang. The narrator describes a new technology that convinces users their choices are predetermined, a discovery that saps them of their will to live.
"It's essential that you behave as if your decisions matter," the narrator warns, "even though you know that they don't."
The greatest risk of abandoning free will, Sapolsky concedes, isn't that we'll want to do bad things. It's that, without a sense of personal agency, we won't want to do anything.
"It may be dangerous to tell people that they don't have free will," Sapolsky said. "The vast majority of the time, I really think it's a hell of a lot more humane."
Sapolsky knows he won't persuade most of his readers. It's hard to convince people who have been harmed that perpetrators deserve less blame because of their history of poverty. It's even harder to convince the well-off that their accomplishments deserve less praise because of their history of privilege.
"If you have time to be bummed out by that, you're one of the lucky ones," he said.
His true hope, he says, is to increase compassion. Maybe if people understand how thoroughly an early history of trauma can rewire a brain, they'll stop lusting for harsh punishments. Maybe if someone realizes they have a brain condition like depression or ADHD, they'll stop hating themselves for struggling with tasks that seem easier for others.
Just as previous generations thought seizures were brought on by witchcraft, some of our current beliefs about personal responsibility may eventually be undone by scientific discovery.
We are machines, Sapolsky argues, exceptional in our ability to perceive our own experiences and feel emotions about them. It is pointless to hate a machine for its failures.
There is only one last thread he can't resolve.
"It is logically indefensible, ludicrous, meaningless to believe that something 'good' can happen to a machine," he writes. "Nonetheless, I am certain that it is good if people feel less pain and more happiness."
2023 Los Angeles Times. Distributed by Tribune Content Agency, LLC. | Mental Health Treatments |
In an era where a world of information is just a few clicks away, health anxiety has taken on a new dimension. Many of us have experienced moments of worry when seemingly innocuous symptoms trigger thoughts of dire health conditions. Could that persistent headache be a sign of a brain tumour rather than just a consequence of too many late nights? Is that peculiar skin lump a harbinger of melanoma? A quick Google search often exacerbates these worries, leaving us awash in a sea of potential ailments. Fortunately, for most, these fears dissipate once the headache subsides or a reassuring word from a trusted GP alleviates concerns.
In the wake of a devastating global pandemic, there is naturally a greater concern for the health of ourselves and those around us. But for those grappling with health anxiety, this concern is not so easily overcome by rationalising or reassurance. Their fears persist and intensify, and their worry about health is frequent, severe and resistant to the soothing words of medical professionals. Temporary relief is short-lived, as fears and doubts quickly resurface or latch on to a new symptom. Their ceaseless preoccupation with health obstructs their ability to relax and savour life, compelling them to seek perpetual and expensive medical consultations, procedures and tests.
This condition used to be called hypochondriasis and it was often met with derision and misconceptions that it stemmed from attention-seeking or malingering. As our understanding of the condition has deepened, we have become more aware of the profound distress experienced by those afflicted and the incapacitating anxiety underlying their health concerns. The latest version of the Diagnostic and Statistical Manual has also replaced hypochondriasis with two related disorders: illness anxiety disorder and somatic symptom disorder.
In illness anxiety disorder, individuals harbour an overwhelming fear of contracting a severe, potentially life-threatening illness, even in the absence of any significant symptoms. For instance, in the wake of the pandemic a small percentage of the population are so afraid of getting Covid that they can’t function normally. They remain housebound, compulsively sanitise and order everything online. In contrast, those grappling with somatic symptom disorder do manifest subjectively experienced symptoms, such as back pain, breathlessness or heart palpitations, which support their belief that they have a grave illness. However, there is an excessive focus on these symptoms and a catastrophising of their meaning. Instead of attributing their real back pain to tension or their palpitations to panic, they are convinced of sinister ailments like tumours or impending heart attacks. This having been said, the first port of call is of course always to rule out a physical cause before assuming a psychological condition.
Ironically, in a cruel twist of fate, health anxiety fuels itself through the physiological symptoms of anxiety, attentional bias and the nocebo effect. When confronted with fear, the body’s natural response is to trigger the fight-or-flight reaction, eliciting a wide array of somatic symptoms, such as elevated heart rate, shortness of breath, chest pain, sweating, nausea, diarrhoea and dizziness. These somatic responses reinforce the belief that something is seriously amiss, exacerbating anxiety and creating a feedback loop. Furthermore, once we fixate on a symptom, we develop an attentional bias, magnifying its importance and intensifying our experience of it, often neglecting other signs that we are well and healthy.
Health anxiety can also be complicated by the nocebo effect, which operates in the opposite direction of the more familiar placebo effect. It occurs when we read about the symptoms of a possible illness or the negative side effects of a medication and subsequently experience those symptoms or side effects, even when we’ve unknowingly been given a sugar pill rather than the real drug. Clearly our mind exerts a profound influence over our bodily experience.
The advent of Dr Google has had detrimental consequences for health anxiety sufferers, enabling them to delve into endless rabbit holes for every symptom and participate in forums and subreddits where they inadvertently amplify each other’s fears. While their aim is to seek reassurance, the outcome frequently involves heightened anxiety and newfound information that fuels rumination. The escalation in this trend has culminated in the coining of the term cyberchondria.
One of the challenges in treating health anxiety is persuading sufferers that their anxiety, not a physical ailment, is the root issue. While it’s essential to acknowledge the possibility of a physical ailment, and to attempt to rule this out, complete certainty can never be guaranteed. There will always be a minute chance that something has been overlooked and a dreaded illness may lurk in the shadows. Consequently, a crucial facet of treatment involves helping patients to tolerate the reality that life inherently lacks absolute certainty and we have limited control over it.
Treatment also encompasses challenging erroneous thought patterns and relying on empirical evidence for specific outcomes. For example, a vast majority of headaches do not signify brain tumours, so it makes sense to consider more benign causes unless symptoms become severe. Nevertheless, research into death anxiety, a cornerstone of health anxiety, suggests that solely addressing the specific health-related concern, such as a headache, may fail to target underlying existential fears. In this case, the anxiety may simply shift to a different symptom. Consequently, treatment strategies that focus on an acceptance of mortality may prove more effective.
While it can be initially challenging to persuade health anxiety sufferers to seek psychological assistance, most respond well to treatment once they embrace it. Health anxiety exists on a spectrum that encompasses our ordinary apprehensions about illness and death, making it a condition we can all empathise with. Accepting uncertainty and coming to terms with our mortality is a challenge for us all, but an important one to reckon with if we wish to free ourselves from the tyranny of many forms of anxiety, including health anxiety. | Mental Health Treatments |
Disposable vapes cause litter problems, are a fire hazard and appeal too strongly to children, according to local councils in England and Wales.
The Local Government Association has called for them to be banned by 2024.
Single use varieties have surged in popularity in recent years, driven by Chinese brands such as Elfbar and Lost Mary.
But the UK Vaping Industry Association says they help smokers quit and can be recycled.
Disposables offers a few hundred puffs of nicotine-containing vapour, often with an added flavour of fruit or sweets, in bright plastic packaging â which are thrown away when empty.
They are easier to use than conventional vapes, or e-cigarettes, which need to be refilled with pods or liquid.
Disposable ones also contain a small lithium battery, which can increase in temperature when crushed, causing fires in bin lorries, the Local Government Association (LGA) warns.
They are difficult to recycle without specialist equipment, and with 1.3 million thrown away each week, they are a litter problem too, the LGA says.
Figures from research firm NielsenIQ suggest the problem could be even bigger than that. It says nearly 300m e-cigarettes (disposable and otherwise) were sold in the UK over the last year.
Elfbar and Lost Mary, which are made by the same Chinese firm, Shenzhen Imiracle Technology Co, made up more than half that number. That is an increase of more than four times compared to their sales the year before.
Councillor David Fothergill, chairman of the LGAâs Community Wellbeing Board, said: âDisposable vapes are fundamentally flawed in their design and inherently unsustainable products, meaning an outright ban will prove more effective than attempts to recycle more vapes.â
Councils are not against vaping altogether as they believe vapes are less harmful than tobacco and can help smokers to quit.
John Dunne, director general of the UK Vaping Industry Association, said that the âlow price, accessibility and ease of useâ of disposable products had helped bring UK smoking rates to an "all-time lowâ.
âThe vape industry is working hard to minimise its environmental impact, but this is mainly a consumer education issue about how to dispose of used vapes, which overall are evidenced to be highly recyclable," he said.
A blanket ban could see âpotentially deadlyâ black-market products flood the UK, Mr Dunne warned.
Councils are also worried that disposable varities with âfruity and bubble gum flavours, and colourful child-friendly packagingâ could appeal to under-age vapers, and called for restrictions on their display and marketing, similar to those used for conventional tobacco.
The anti-smoking charity ASH said it did not support a ban, as it would "turbo-charge" illegal sales, increasing the risk that children would be able to buy them. It favours higher taxes on disposables and stronger controls on import and sales, deputy chief executive Hazel Cheeseman said.
A government spokesperson said it was also concerned about the use of vaping products, particularly among young people. Earlier this year it launched a consultation looking into the environmental and health impacts of vaping, and is considering responses.
âWe strongly encourage all consumers to consider the environment and dispose of electrical waste, including by making use of take-back schemes at participating retailers,â the spokesperson said.
In Scotland, Lorna Slater, Minister for Circular Economy, said in June that single use vapes had become a "big problem - for our environment, local communities and young people,â and promised to announce new plans in the autumn.
Elfbar did not provide a comment for this article. It has previously told the BBC it recognised the fast growth of the vape market has had "environmental implications" and said it plans to introduce recycling boxes for retailers to collect used disposables. | Epidemics & Outbreaks |
My mother, Jena, died on March 3, 2006. She was 85 and had lived for many years in O’Grady Court, a block of sheltered accommodation in Ealing, West London, run by a housing association.
Jena said those were the happiest years of her life, because she was able to live well, independently and with dignity, on a small supplementary pension.
The warden, Birgit, a woman in her forties (I think), was caring and fun.
Some residents needed a lot of physical and mental support. The council sent daily carers; meals on wheels came in for those who couldn’t cater for themselves. I went over every week.
She could ring from her landline if she needed extra council help. Some of the staff who answered the phone became her mates and attended her funeral.
If she was reaching her 80s today, how unimaginably harder, more confusing and unhappy her life would have been.
My mum was a Labour voter. She thought the Tories were a heartless bunch. And so they are. They’ve now run the whole country for 12 miserable years.
Most services that enabled Jena to have a good old age have been discontinued. Key council workers have been made redundant. Now, new technology is marginalising senior citizens further.
It’s a triple whammy.
As Baroness Altmann, a doughty champion of older Britons, has pointed out: “The majority of those left behind by the drive to digitise even the most vital services are elderly or disabled.
“For assorted reasons they cannot – or do not feel confident enough to – embrace digital technology and, as a result, they find themselves excluded from accessing vital services.
“Many elderly people rely on simple human contact for help with their queries or complaints. But all too often the first point of contact is an automated system designed to make it as difficult as possible to speak to an actual person.”
Automation and online communication is the norm for GP surgeries, too.
Edward D, a Falklands War veteran, has decided he would rather die than go through the “humiliation, delays and being made to feel like a fool”. He lives alone and has a weak heart.
Last September, a neighbour took him to A&E after he collapsed.
The mayhem of emergency treatment was far less stressful, he says, than trying to see his GP. This could be one reason why A&E departments are under increased pressure.
Progress isn’t progress if it creates an underclass. Technology is not a solution if it leads to misery and disorientation.
We should remember most pensioners are stoics who only ask for help when they really need it. Vera, my late English mother-in-law, didn’t call the GP practice even with serious ailments because she didn’t want to “cause them trouble”.
Once she was rushed to hospital delirious and confused 10 days after she’d had symptoms of a serious uterine infection.
Needless to say, some older people have no problem using emails, social media, automated appointment systems and on-screen form filling. These unsung heroes often help other oldies who find it all too much.
Are we who object to enforced technology just stubborn people who want to live in the past? Not at all.
We are beneficiaries of massive medical and social improvements. Last summer I fell and broke my right arm and had surgery at the Chelsea and Westminster hospital in West London.
The injections now don’t hurt like they once did; X-ray departments are more efficient because imaging is computerised; the op was done using modern technology. I marvelled at it all.
But this NHS hospital has not lost sight of patient needs. They send appointments via email, text and paper. And human beings answer the phone faster than at many local surgeries. Age UK tells me that too many people are being left behind in our fast times.
Many of their clients feel forgotten.
I recently read about a woman in her seventies who can’t visit her ailing husband in hospital because her arthritic fingers make it impossible for her to get to the new automated parking app on a smartphone.
M Wilson wrote in a letter to the i newspaper in January: “My sister recently encouraged me to get a smartphone.
“But I found my arthritic hands could not hold it and I kept dropping it. I have difficulty seeing screens...
“The move to digital is creating a barrier for older people and causes much isolation.” Countless other Britons suffer in silence in this hostile environment.
Alina, a British-Pakistani pensioner in the Midlands, has a weak heart. She gets appointments via email. Her eldest son dealt with those. He is now mentally ill. The GP is helpful but very busy. When I rang her, she was praying for death, saying: “I am no good for this world. I worked so hard in a canteen. But today can’t even see the doctors. Allah will take me soon. I hope so”.
Her younger son, a secondary school teacher in Scotland, feels guilty and angry that his mum and so many others are lost in the digital wilderness. He says: “They learnt essential English and eventually managed to negotiate life. Computers, the internet, is another foreign language.
“They feel humiliated.”
Many of my interviewees used that “H” word. Joan Bakewell recently tweeted: “I know I’m old. But I can still present TV programmes, write articles, speak in the House of Lords; so why can’t I reset my passwords?”
Rupa Huq, the popular Labour MP for Ealing, is concerned about these left-behinds, saying: “It is a worry that everything is online when not everyone can access this digital utopia. I remember going with my mum and dad to the council to jump on a computer to get their blue badge.
“Since Covid that facility has gone. All applications for services are now only online. The local authority does its best. You can get assistance in certain libraries, but not enough people know it’s on offer.”
Councils can’t be blamed for this exclusion. It happened as new technology pushed out old ways, often for good reasons. But key people in public services should have been more aware of unintended consequences.
Arthur Breens, 76, a recent widower, has been an overseas volunteer, a factory inspector, market trader, teacher and instructor, and is foster dad to three grown-up children.
He has a computer, uses the internet and knows his rights.
Yet even he often ends up frayed and furious. He says: “Councillors don’t do live Q&As any more.
“When I was overcharged for my residential car park permit, I went to the town hall and two guys in uniforms stop people going in. It’s not right.”
One of his fostered daughters, who has special needs, had a caring support worker – but not any more.
Arthur is her computer support, enabling her to access the help and money she is entitled to.
All institutions and organisations should offer accessible technology, paper info, as well as human communication. As Baroness Altmann put it: “You can judge a society by how it treats its elderly and vulnerable. And by that reckoning, we are failing.”
Experienced something similar? Write to Daily Mirror, 1 Canada Square, Canary Wharf, London E14 5AP or tell us at [email protected]. | Global Health |
Disposable vapes will be banned to stop children becoming addicted to the devices under government proposals to be unveiled as early as next week.
The Telegraph can reveal that health ministers are preparing to act, having decided that single-use vapes are overwhelmingly targeted at those aged under 18.
Disposable vapes are often sold in bright colours and with flavours such as “bubble gum”. In some shops they are positioned by front counters near sweets.
The decision will be revealed in a consultation issued by the Health Department shortly. It has been pencilled in for next week, though timings could yet slip.
Ministers are understood to have decided not to go a step further and copy Australia by banning all vaping without a prescription, because they have accepted the benefits of e-cigarettes to help smokers to quit.
A senior Whitehall insider told The Telegraph: “Disposable vapes are almost entirely aimed at kids and they are environmentally damaging. There is a wide consensus emerging on the need to act.”
Sunak raised alarm
Ministers from Rishi Sunak down have voiced alarm at the scale with which nicotine e-cigarettes have been taken up by children in the UK in recent years.
Back in May the Prime Minister, who has two young daughters, Krishna, and Anoushka, who were aged 12, and 10 at the time, voiced concerns that vape companies were focusing on children.
Mr Sunak said on ITV’s This Morning: “I have two young girls. I’m also worried about that. It looks like they are targeted at kids, which is ridiculous. I don’t want my kids to be seduced by any of these things.”
The Government has a nuanced position on vaping, seeing it as a good alternative for adults who smoke but a habit that has health downsides for those who do not.
Prof Sir Chris Whitty, England’s Chief Medical Officer, has said: “If you smoke, vaping is much safer; if you don’t smoke, don’t vape, and marketing to children is utterly unacceptable.”
A call to evidence was issued last April, with the aim of clamping down on youth vaping.
A new consultation, honing in on specific proposals, will put forward the disposable vape ban.
The ban would apply in England, with other devolved administrations having to set policy for Scotland, Wales and Northern Ireland.
A law change would likely be needed, but it remains to be seen if time could be found in Parliament before the next general election, expected in autumn 2024.
Earlier this week it was estimated that 11.6 per cent of 11 to 17-year-olds in Britain had tried vaping, up from 7.7 per cent last year. | Health Policy |
Peter Haden
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A vendor weighs green vein kratom to sell by the gram at a vape shop in Lake Worth, Fla. Kratom is derived from the dried leaves of a tree in the coffee family. It's been used as traditional medicine in Southeast Asia for centuries.
Peter Haden
A vendor weighs green vein kratom to sell by the gram at a vape shop in Lake Worth, Fla. Kratom is derived from the dried leaves of a tree in the coffee family. It's been used as traditional medicine in Southeast Asia for centuries.
Peter Haden
Kavasutra is a dimly lit bar in Lantana, Florida, with a rotating cast of characters: the magician, the repo man, the metalhead picking Slipknot on his unplugged Stratocaster. On a recent Friday night, there's about a dozen other patrons drinking, flirting, swiping at their phones.
What's not here is booze. The bar serves only nonalcoholic botanical drinks. And tonight, like most nights, one drink is clearly winning out: jumbo plastic cups filled with icy kratom tea.
Kavasutra is among thousands of U.S. businesses that sell kratom, an herbal supplement that's spurring debate in statehouses and courtrooms nationwide over how it should be classified and regulated.
And there are dozens of wrongful death lawsuits that have been filed over the product and how it is marketed. Last week, a jury in Washington state awarded a $2.5 million verdict in the first kratom wrongful death trial in the U.S.
Peter Haden
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Kavasutra, a bar in Lantana, Fla., is one of thousands of U.S. businesses that sells the controversial herbal supplement kratom.
Peter Haden
A Southeast Asian folk medicine used widely in the U.S.
Kratom is derived from the dried leaves of a tree in the coffee family. It's native to Southeast Asia, where it's been used for centuries as a folk medicine. Millions of American users pick it up at gas stations, vape shops, bars or online.
Ash Turner, one of Kavasutra's patrons, has been drinking kratom tea for around six years. He says the community at the botanical bars is really inclusive and that it's helped bring him out of his shell.
"It relaxes you," says Turner, 30, as he holds a cup of red tea the size of a football. "I feel like being more social and open to these cool conversations."
Peter Haden
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Nico Westley, 30, drinks raspberry hibiscus kratom tea while gaming at Kavasutra in Lantana, Fla. He says kratom makes him "feel more focused."
Peter Haden
Lit up by the red glow from his laptop screen, Niko Westley, 30, says the herb helps elevate his gaming skills. "I feel more focused," he says, stabbing a digital stake through a vampire's heart on his computer. "I'm more on point."
In low doses, kratom acts as a stimulant and a social lubricant that can help relieve aches and pains, depression and anxiety, and symptoms of opioid withdrawal. At higher doses, it can produce a euphoric state much like an opioid does — and has been linked to addiction, seizures and death.
Peter Haden
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Behind the bar, Carlee Palermo, 25, keeps the kratom coming at Kavasutra. She says she drinks the tea to help with a degenerative condition in her spine.
Peter Haden
Behind the bar, Carlee Palermo, 25, keeps the kratom coming at Kavasutra. She says she drinks the tea to help with a degenerative condition in her spine.
Peter Haden
Behind the bar, Carlee Palermo, 25, keeps the kratom coming. She says she drinks the tea to help with a degenerative condition in her spine: "It completely took away my back pain."
The customers tonight at Kavasutra say they aren't aware of anyone who has been harmed by kratom. Then Palermo spills a little tea: Many of the people who come to the bar are in recovery from substance abuse.
Asked whether kratom helps with that, she says, "One hundred percent. It's done nothing but help anybody that I've seen."
But it hasn't helped everybody.
Peter Haden
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Cindy Ross celebrates her son, Max, in Palm Beach Gardens, Fla. Max died in 2021 from a lethal combination of alcohol and kratom, according to the Palm Beach County Medical Examiner
Peter Haden
Cindy Ross celebrates her son, Max, in Palm Beach Gardens, Fla. Max died in 2021 from a lethal combination of alcohol and kratom, according to the Palm Beach County Medical Examiner
Peter Haden
'I need to tell you that Max is dead'
"When you lose your child, it isn't anything that you've ever prepared for in life. Nothing!" says Cindy Ross of Palm Beach Gardens, Fla.
On Dec. 11, 2021, Ross's 30-year-old son, Max, was about to start a new job as a sous chef. He went to the mall with a friend to get the shoes he needed to work in the kitchen.
A few hours later, Ross got a call from her ex-husband.
"He said, 'Who are you with?' I said, 'I'm with my sisters.' He said, 'I need to tell you that Max is dead,' " Ross says.
Max collapsed while walking home. He'd had a few beers at the mall and, at some point, a significant amount of kratom, possibly as a concentrated extract. The medical examiner determined the combination killed him.
Ross and thousands of other Americans are calling for increased government regulation of kratom — especially for labeling and guidance on how to use it safely.
"You know what? I believe them, that people are taking it and it helps with their pain," Ross says. "I believe it, that it's helping with their anxiety." But she says people need to know: "What's the dosage, and what do you advise them not to interact with?"
Image provided by MCT Law
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Krystal Talavera, a mother of four from Boynton Beach, Fla., died in 2021 from what a medical examiner said was acute kratom intoxication. In May, a federal judge ordered the kratom vendor to pay more than $4.6 million in damages to her family.
Image provided by MCT Law
U.S. District Court, Southern District of Florida
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Talavera's fiancé found her lying unconscious next to a packet of powder with "Space Dust" scrawled on it. The powder turned out to be a concentrated kratom extract.
U.S. District Court, Southern District of Florida
Krystal Talavera lived in the next town over, in Boynton Beach. She was 39, a nurse and mother of four. On Father's Day 2021, her fiancé woke up and found her lying face down on the floor, unconscious, according to a lawsuit. Beside her was a cup of coffee and an open packet of powder with the words "Space Dust" scrawled in black marker.
It was a concentrated kratom extract. She'd ordered it off the internet from a company in Idaho. The medical examiner determined acute kratom intoxication was the sole cause of death. In May, a federal judge ordered the vendor to pay more than $4.6 million in damages to Talavera's family.
Atlanta attorney Matt Wetherington doesn't represent the Talavera family, but his firm is partnering on dozens of other similar wrongful death lawsuits that accuse vendors of selling a dangerous product without proper warnings and instructions.
"When you're selling a drug next to Skittles or energy drinks," Wetherington says, "you have no means of knowing that you're dealing with something that is exponentially more dangerous than anything else on the shelf."
Peter Haden
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Shelves festooned with kratom powders, capsules, liquids and extracts greet customers at Tifton Tobacco & Vapor in Tifton, Ga. Kratom is a billion-dollar business in the U.S., according to the American Kratom Association.
Peter Haden
Shelves festooned with kratom powders, capsules, liquids and extracts greet customers at Tifton Tobacco & Vapor in Tifton, Ga. Kratom is a billion-dollar business in the U.S., according to the American Kratom Association.
Peter Haden
What's safe and what isn't?
The U.S. Food and Drug Administration warns Americans not to use kratom, saying it stimulates the same brain receptors as morphine and could be addictive. But the agency doesn't regulate the product or classify it a drug. Rather, as a food. That leaves consumers to guess at the makeup of myriad powders, capsules and concentrates flooding the market, and how to use them safely.
The FDA declined to comment for this story.
Peter Haden
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Kratom plants cultivated for research frame University of Florida medicinal chemist Dr. Chris McCurdy as his customized background display during a Zoom interview with a reporter.
Peter Haden
"The case in Florida was egregious," says Mac Haddow, a lobbyist with the American Kratom Association. "They had nothing on it. It's called, 'Space Dust!' It's the poster child for why regulations need to be put into effect."
Peter Haden
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The counter at Glass Chamber smoke shop in West Palm Beach, Fla., features an ad for Feel Free, a tonic sponsored by the athletic departments of the University of Texas, Florida State University and the University of Southern California. The ad doesn't mention that Feel Free contains kratom, a controversial herb linked to fatal overdoses.
Peter Haden
The American Kratom Association says it advocates for the rights of Americans to consume kratom safely and legally. According to the group, kratom is a billion-dollar business in the U.S., with vendors importing more than 2,000 tons of it into the country every month. It's asking for government regulation — so long as kratom is regulated as a legal, over the counter supplement and not as a drug. The association is pushing states and the federal government to pass some version of the Kratom Consumer Protection Act.
About a dozen states now regulate kratom. Five states have banned it.
"It really brings to bear the question in the marketplace: What is safe? What isn't safe?" says Dr. Christopher McCurdy, a medicinal chemist at the University of Florida. He's been studying kratom for nearly two decades, supported by millions in grant funding from the National Institute on Drug Abuse. McCurdy says the plant shows tremendous medicinal potential, interacting with novel combinations of brain receptors.
"It's like a complex symphony orchestra," McCurdy says.
But a fresh leaf plucked and chewed by a farmer in Southeast Asia is vastly different from the concentrated kratom extracts U.S. companies are squeezing out. And McCurdy says there's at least one big reason why there's no usage guidance listed on many kratom products: No one knows what it should be.
"There's just a ton more science that needs to be done," he says.
Peter Haden is a freelance journalist based in Florida. | Drug Discoveries |
As the United States enters its third full covid winter, a top administration official is warning that the permanence of the coronavirus in the disease landscape could mean brutal and long-lasting seasonal surges of cold-weather illnesses for years to come, resulting in hospitals struggling to care for non-covid emergencies and unable to give patients timely, lifesaving treatments.Winter has traditionally been crunchtime for hospitals because of influenza and another seasonal pathogen, respiratory syncytial virus, or RSV. Now SARS-CoV-2 has joined them to form an unholy trinity of pathogens that surge in the cold months.Subscribe to The Post Most newsletter for the most important and interesting stories from The Washington Post. White House covid-19 response coordinator Ashish Jha said the American health-care system may not be able to withstand the continued viral onslaught, straining the system's ability to care for other serious illnesses."I am worried that we are going to have, for years, our health system being pretty dysfunctional, not being able to take care of heart attack patients, not being able to take care of cancer patients, not being able to take care of the kid who's got appendicitis because we're going to be so overwhelmed with respiratory viruses for ... three or four months a year," Jha told The Washington Post.He described a scenario in which the typical winter logjam of patients begins much earlier than usual - in August or September - because of the coronavirus. It's a darker scenario than the administration has portrayed in the past, and one Jha said most Americans have yet to realize."I just think people have not appreciated the chronic cost, because we have seen this as an acute problem," Jha said. "We have no idea how hard this is going to make life for everybody, for long periods of time."James Jarvis, a senior executive at Bangor-based Northern Light Health, the second-largest health system in Maine, shares Jha's concerns. He said hospitals now expect to see patients who are sicker, including people with long covid, children more at risk for diabetes because of covid-19 infections and patients suffering from heart conditions related to previous bouts of the disease.Jarvis, who also works in a small family medicine practice, had a patient who was hospitalized two months ago for covid-19, and then again for influenza. He was discharged to an acute rehabilitation facility but then suffered a stroke. There was no bed available at Northern Light's flagship hospital, Eastern Maine Medical Center, so he was treated in the emergency room for four days."He never left the emergency room," Jarvis said. "I felt horrible. I'd see him and say, 'I'm so sorry that you're still in the emergency room.'" The patient received the care that was needed and eventually returned home, but Jarvis was frustrated that the patient never got a hospital bed.These warnings come at a moment when public health officials are still waiting to see how bad the current winter surge in viral infections turns out to be. So far, this covid winter in the United States has been challenging, though not nearly as disastrous as the past two. But most of the winter still lies ahead, and covid-19 hospitalizations have risen significantly since October.Hospitalizations remained generally flat during the early part of January, with about 45,000 inpatients suffering from covid-19 as of Wednesday. The national numbers can mask geographical surges: States along the East Coast have been hit hardest so far, while the West has been largely spared.Public health officials are closely monitoring the spread of XBB.1.5, an omicron subvariant that is the most transmissible form of the coronavirus yet seen. It has already become the dominant lineage in the Northeast and will probably, at current rates, take over everywhere, outcompeting other omicron variants.Despite its transmissibility, XBB.1.5 does not appear more likely than earlier forms of omicron to cause severe disease, and as it spreads in a population with significant levels of immunity, it has not managed to create the same devastating surge of hospitalizations seen in the past two years.In January 2021, more than 3,000 people a day were dying of covid-19, because almost no one had immunity at that point and vaccines had just started rolling out. Last year, the situation was only marginally better. The U.S. population had much more immunity from vaccines and previous infections, but the omicron variant was leaps and bounds more transmissible than previous ones. Omicron was less likely to be fatal for an infected patient, but so many people got sick so quickly that the nationwide death toll in January 2022 spiked to more than 2,500 a day.This winter, the "tripledemic" of the coronavirus, the flu and RSV has not been as terrible as feared. Pediatric hospitalizations for RSV rose sharply in the fall but have dropped recently. The flu started its cold-weather assault relatively early in the fall, rose quickly and has declined steadily for the past five weeks.The big unknown now is what will happen as the health-care system feels the effects of holiday gatherings.Jha told The Post that he compares the health-care system to a sea wall, holding back a certain level of water. In winter, when case numbers pile up, the water splashes over a little. Hospitals staff up temporarily and try to make it through until the water recedes. That's the old normal.But SARS-CoV-2 has dumped new water in that sea, and the flood of patients has cascading effects on other types of medical care.Anne Zink, chief medical officer for the Alaska Department of Health, said Jha's sea wall analogy accurately describes the stress of the pandemic on America's overall declining health."The sea wall was crumbling before the pandemic, and the waves of the pandemic created great holes, and that continual onslaught will degrade the wall and make it worse," said Zink, an emergency room physician who is also president of the Association of State and Territorial Health Officials.In addition, uncertainties in the medical supply chain have become the new normal, said Jarvis of Northern Light Health. Medication and supply shortages happen with greater frequency. Critical shortages for nurses and other staff are expected to worsen as physicians and nurses retire but aren't replaced in the same numbers. More than 7,000 nurses at two major New York hospital systems walked off the job Monday after labor talks broke down over staffing and workloads, though tentative deals were reached Thursday enabling them to return to work.Before the pandemic, the hospital system had always had some flexibility and had been able to manage its shortage of acute-care beds, Jarvis said. "But that flexibility is now gone," he said. "There is no wiggle room or expansion room that we would have for anything in reserve."Since the start of the pandemic, experts have warned that covid-19 is not the only killer when health-care systems are under stress. People with ailments may delay tests and screenings, they may be more reluctant to go to the hospital for fear of catching an infection, and patients may wind up waiting hours for an examination when minutes count."Delays of care will result in people having either more severe disease or, unfortunately, dying, and there's little that we can do to prevent that," Jarvis said. "You know, that has always happened, but never to the extent that it's happening now."As for the future, "it's only going to get worse," Jarvis said.Hospitals are already under financial stress because of rising labor costs, physician burnout and the trend toward outpatient treatment. The added coronavirus strain is likely to push some facilities over the edge, noted Robert Wachter, a professor and chair of the Department of Medicine at the University of California at San Francisco."With all of this, you'll see hospitals ... begin closing at a faster pace, leaving some rural/suburban communities without a hospital, and fewer hospitals in urban areas," Wachter said by email.So far, Congress and the federal government broadly have not taken concerted action to address these chronic challenges. There is no cavalry on the horizon for the health-care system.Some officials in the Biden administration aren't sure the scenario will be quite as grim as Jha outlined."It's not an unreasonable hypothesis," said one senior administration official involved with the coronavirus response, who was not authorized to speak publicly and spoke on the condition of anonymity. "But I don't think we have hit a steady state of disease to be able to say for sure what we will see year in and year out. ... It's very dynamic.""We all agree that the virus is evolving faster than we thought. We just don't know where the virus is headed. We don't even know what the next three weeks are going to hold."As always, the unknown factor in predicting the coming months and years is evolution: Viruses mutate. There is no way to predict what the coronavirus will do next, but experts do not think it has run out of evolutionary space.Still, for more than a year, all of the new circulating versions of the virus have been subvariants of omicron and have not shown signs of making people sicker."If XBB.1.5 had the virulence of delta, we would be in deep weeds," said Ross McKinney, chief scientific officer for the Association of American Medical Colleges.McKinney and other experts stress the importance of improving vaccine uptake to reduce the respiratory disease burden - to ward off severe covid-19 cases, as well as other diseases like the flu. Despite all the pain and suffering inflicted during the pandemic, vaccine acceptance remains dismayingly low, experts say."The willingness of the public to accept vaccines to limit the spread of these respiratory diseases is very limited," said William Schaffner, an infectious-disease doctor at Vanderbilt University School of Medicine. "If the public doesn't accept them, there'll be more people sick and greater stress on the health-care system."Related ContentA 6-year-old is accused of shooting someone at school. He isn't the first.These dogs ride a bus like humans 'and now the internet is in love'Fani Willis, the Georgia prosecutor investigating Trump, often takes on seemingly untouchable targets | Epidemics & Outbreaks |
Aug 16 (Reuters) - A U.S. appeals court ruled on Wednesday to restrict access to the abortion pill mifepristone, partially upholding a lower court ruling that alarmed abortion advocates and pharmaceutical companies.
The New Orleans-based 5th U.S. Circuit Court of Appeals ruled to block changes that made the drug more accessible, but reversed a lower court ruling that suspended the drug's approval in 2000.
Mifepristone's availability remains unchanged for now, following an emergency order from the U.S. Supreme Court in April preserving the status quo during the appeal.
The three-judge 5th Circuit panel was reviewing an order issued in April by U.S. District Court Judge Matthew Kacsmaryk in Amarillo, Texas. While it was a preliminary ruling that applied while the case was pending, Kacsmaryk said he was ultimately likely to make it permanent.
The ruling stems from a lawsuit brought by four anti-abortion groups headed by the recently formed Alliance for Hippocratic Medicine and four anti-abortion doctors who sued in November.
They contend the U.S. Food and Drug Administration used an improper process when it approved mifepristone in 2000 and did not adequately consider the drug's safety when used by minors.
All three judges on the panel are staunchly conservative, with a history of opposing abortion rights.
The decision will almost certainly be appealed first to the full 5th Circuit and then to the U.S. Supreme Court, which last year overturned its landmark Roe v. Wade ruling that had legalized abortion nationwide.
Since then, at least 15 of the 50 states have banned abortion outright while many others prohibit it after a certain length of pregnancy, according to the Guttmacher Institute, a research organization that supports abortion rights.
Mifepristone is part of a two-drug regimen with misoprostol used for medication abortions, which account for more than half of U.S. abortions. It is approved for use in the first 10 weeks of pregnancy.
Numerous medical studies and many years of real-world use have concluded that the drug is safe and effective.
Major medical associations, including the American College of Obstetricians and Gynecologists and the American Medical Association, have said in court filings that pulling mifepristone off the market would harm patients by forcing them to undergo more invasive surgical abortions.
Hundreds of biotech and pharmaceutical company executives have called or the reversal of Kacsmaryk's ruling, saying it ignores decades of scientific evidence on the drug's safety and undermines the FDA's authority, potentially creating chaos for the industry that relies on the agency.
Reporting By Brendan Pierson in New York Editing by Chris Reese
Our Standards: The Thomson Reuters Trust Principles. | Women’s Health |
If a delivery person leaves a package on your front step without pinging you, you likely won't know it's there. A hungry cell awaiting refuel is in a similar position. It has to be alerted to the presence of nutrients outside of the cell wall by a sensing mechanism so that a transporter protein can bring the nourishment inside.
The handful of these nutrient-sensing mechanisms thus far identified have had a profound impact on human health. One prime example is the discovery of the nutrient sensing mechanism for cholesterol, which led to the development of life-saving statin drugs (and the Nobel Prize).
These discoveries have focused on how an entire cell detects nutrients. But within every human cell are self-contained, membrane-bound organelles, all of which are equally in need of fuel to carry out important functions. Might they, then, have nutrient sensors of their own?
As described in a new paper published in Science, Kıvanç Birsoy and his colleagues in Rockefeller's Laboratory of Metabolic Regulation and Genetics have discovered the first such sensor for an organelle -- specifically mitochondria, the cell's power center. The sensor is part of a protein that does triple duty: it senses, regulates, and delivers the antioxidant glutathione into the mitochondrial interior, where it plays critical roles in tamping down oxidizing reactions and maintaining appropriate iron levels.
"I believe this is going to be a very fruitful find," says Birsoy. "Every time people have studied nutrient sensing, we've learned a lot about biology, and many drugs have been developed as a result."
Antioxidant power
Glutathione is an antioxidant produced throughout the body that plays many important roles, including neutralizing unstable oxygen molecules called free radicals, which cause damage to DNA and cells if left unchecked. It also helps repair cellular damage and regulates cell proliferation, and its loss is associated with aging, neurodegeneration, and cancer. As a result, glutathione supplements have become increasingly popular as an over-the-counter approach to wellness.
The antioxidant is especially abundant in mitochondria, which cannot function without it. "As the respiratory organelle, mitochondria produces energy," Birsoy notes. "But mitochondria can also the source of a lot of oxidative stress," which has been implicated in cancer, diabetes, metabolic disorders, and heart and lung diseases, among others. If glutathione levels aren't precisely maintained in mitochondria, all systems fail. None of us can survive without it.
But how glutathione actually enters mitochondria was unknown until 2021, when Birsoy and his team discovered that a transporter protein called SLC25A39 delivers the package. It also appeared to regulate the amount of glutathione. "When the antioxidants are low, the level of SLC25A39 increases, and when the antioxidant levels are high, the transport level goes down," Birsoy says.
The findings strongly suggested that the mitochondria had some sort of way to detect and adjust these fluctuating levels. "Somehow mitochondria figures out how much antioxidant it has, and depending on that amount, it regulates the amount of antioxidant it lets inside," he says.
Independent domains
To ferret out how the mitochondria does it, the researchers used a combination of biochemical studies, computational methods, and genetic screens to discover that "SLC25A39 is both a sensor and a transporter at the same time," Birsoy explains. "It has two completely independent domains. One domain senses the glutathione, and the other transports it."
The protein's unique structure may explain its abilities, says Birsoy. When Yuyang Liu, a graduate student in his lab and first author of the study, compared SLC25A39's structure against others in the SLC family of transporters in the AlphaFold protein structure database, Liu spotted a unique extra loop in the protein. When they snipped it from the protein, its transporter abilities remained intact, but it lost the ability to sense glutathione. "Finding that interesting loop later led to our understanding of the sensing mechanism," Birsoy says.
Iron worker
The study also bolsters the theory that glutathione is a "chaperone" for iron, which is required for virtually all functions within a cell, Birsoy says.
"Iron is not only the most abundant metal on Earth, it's also the most abundant metal in our cells," he says. But iron is also highly oxidative; without glutathione to keep it in line, it initiates oxidative stress in cells, causing damage. "We believe maintaining the glutathione-to-iron ratio is very important, because if you have too little glutathione, then iron becomes very reactive, and if you have too much glutathione, the iron will not be usable." Their experiments determined that SLC25A39 carries a unique iron signature on its surface as part of the glutathione sensing mechanism.
Now that the researchers know how SLC25A39's package delivery system operates, they can experiment with manipulating it. "This particular transporter protein is upregulated in a group of cancers," Birsoy says. "People have tried to change overall glutathione levels, but now we have a way to change it in mitochondria without impacting other parts of the cell. This kind of targeted therapy could potentially lower the number of side effects that can come with altering glutathione levels across the whole body. I could see a lot of translational outcomes leveraging this new understanding."
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New method combines synthetic biology with AI in the cell-free quest for new antibiotics
The rising resistance of bacteria to antibiotics presents an escalating global health risk. Now, researchers at the Max Planck Institute for Terrestrial Microbiology in Marburg, Germany, have combined synthetic biology and artificial intelligence (AI) to develop a more efficient approach to finding and creating new antimicrobial peptides that are effective against a wide range of bacteria. Their paper is published in the journal Nature Communications.
Bioactive peptides play a key role in health and medicine. More than 80 peptide-based drugs are currently in use, all isolated from natural sources. However, antibiotic resistance is estimated to cause more than 1 million deaths worldwide each year. This number is expected to rise to 10 million by 2050, creating an urgent need for novel methods to accelerate the development of new antimicrobials. An untapped potential lies in the non-natural space, where an estimated number of 2,010 to 2,030 different peptides have yet to be explored.
Pipeline for new bioactive peptides
In collaboration with several laboratories at the Max Planck Institute for Terrestrial Microbiology, the University of Marburg, the Max Planck Institute for Biophysics, the Bundeswehr Institute for Microbiology, the iLung Institute and INRAe France, a team of scientists at the Max Planck Institute led by Tobias Erb has established a new pipeline for the development of bioactive peptides.
"In deep learning, a neural network—algorithms inspired by the human brain—learns from large amounts of data. This type of machine learning holds great promise for peptide discovery and de novo design. However, it is usually followed by chemical synthesis of peptides for experimental validation, which is rather difficult and time-consuming and severely limits the number of peptides that can be chemically synthesized," explains Amir Pandi, lead author of the study.
To overcome these limitations, the research team established a cell-free protein synthesis pipeline for the rapid and cost-effective production of antimicrobial peptides directly from DNA templates. The new protocol provides a rapid, low-cost, high-throughput method for antimicrobial peptide screening.
The team first used generative deep learning to design thousands of antimicrobial peptides de novo, and then predictive deep learning to narrow them down to 500 candidates. Among these, screening with the cell-free pipeline identified 30 functional peptides, which the researchers further characterized through molecular dynamics simulations, antimicrobial activity, and toxicity.
Broad-spectrum activity against pathogens
Notably, six of the de novo peptides exhibited broad-spectrum activity against multidrug-resistant pathogens and did not develop bacterial resistance. "We have benefited greatly from this combination of cell-free synthetic biology, artificial intelligence, and a high-throughput approach. By increasing the number of candidates that can be experimentally tested in less than 24 hours, the chance of finding active antimicrobial peptides increased," says Pandi.
"Thus, our cell-free protein synthesis pipeline not only complements recent advances in computational design. It also has the potential to explore the relationship between design and function of bioactive peptides more quickly and cost-effectively."
Tobias Erb adds, "This new method at the interface of synthetic biology and machine learning will be of interest to scientists working in the fields of biomedicine and bioactive peptides."
The next steps include further improving the yield of peptide production as well as employing AI and synthetic biology approaches to design new antimicrobial peptides that are more stable and less toxic, or add a specific mode of action. The researchers also plan to apply augmented deep generative models where the machine learns molecular representations for desired properties, which would improve the success rate of identifying active candidates.
More information: Amir Pandi et al, Cell-free biosynthesis combined with deep learning accelerates de novo-development of antimicrobial peptides, Nature Communications (2023). DOI: 10.1038/s41467-023-42434-9
Journal information: Nature Communications
Provided by Max Planck Society | Drug Discoveries |
For the first time, a patient received a whole new eye and a partial face in a groundbreaking transplant procedure.
The transplant recipient, a 46-year-old from Arkansas named Aaron James, had sustained a 7,200-volt electric shock while working as a high-voltage lineman on June 10, 2021.
"Most individuals don't survive that level of injury," Dr. Eduardo Rodriguez, the lead surgeon for James' transplant and director of NYU Langone's face transplant program, said in a news conference Thursday (Nov. 9). In the accident, a live wire touched James' face. He needed several reconstructive surgeries and ultimately lost his left eye, nose, lips, front teeth, left cheek and chin, as well as his left arm above the elbow.
Now, James is about five months out from his transplant procedure, which involved 140 medical providers at NYU Langone and took place over 21 hours on May 27 and May 28, 2023.
"From the time I woke up from a six-week coma, they were already talking about a possible chance of a face transplant," James said at the news conference.
The surgery allowed him to stop using breathing and feeding tubes, and he can taste, smell and eat solid foods again. He finally returned home to Arkansas in September and now travels to New York monthly for monitoring. He also has ongoing physical, occupational and speech therapy.
Beyond these functional improvements, "I can't walk past a mirror without looking at it. It's making me stand up taller," James said of his new face. "Before the transplant, emotionally I was a little down, confidence level was a little low."
The NYU team first learned of James two months after the accident, when they started consulting his care team at a medical center in Texas. James' left eye needed removal due to severe pain, so the NYU team advised the surgeons to snip his optic nerve as close to the eyeball as possible, to potentially allow for a whole-eye transplant, along with his planned face transplant.
But the eye transplant would come with risks. "The eye is an extension of the brain," Dr. Vaidehi Dedania, a retina specialist in NYU Langone's Department of Ophthalmology, said at the news conference. A transplant that plugs into the central nervous system introduces a risk of deadly infection and inflammation of the brain, Rodriguez said.
It wasn't clear at first that this transplanted eye would ever be able to see, but early tests suggest light-detecting cells at the back of his eye do, at least, respond to light.
"His retina is able to tell us that it's 'seeing' the light, which is quite remarkable," Dedania said. Scans suggest that this signal makes it to the visual cortex at the back of James' brain. However, James can't yet perceive those incoming signals, so it's still unknown if he'll ever have vision in that eye, Dedania said.
Related: What are eyes made of?
To help the eye to plug into James' optic nerve, the team also transplanted adult stem cells, which are unspecialized and can give rise to other types of cells. The goal for these cells, which were isolated from the donor's bone marrow, was to have them help repair James' snipped optic nerve, potentially restoring its function.
During the procedure, two surgical teams — one for the donor and one for the recipient — operated simultaneously in nearby rooms. The teams thoroughly rehearsed all the steps of the procedure and printed 3D "cutting guides," to precisely carve out the donor's bone and tissue so they would fit into the space on James' face — "just like a puzzle," Rodriguez said.
Between 9:14 a.m. on May 27 and 7:51 a.m. on May 28, the team transplanted the nose, left upper and lower eyelids, left eyebrow, and upper and lower lips, as well as the tissues below the right eye. They also transplanted the underlying skull, cheek, nasal and chin bone segments that went with those tissues, as well as the left eye and accompanying optic nerve.
Now, five months out, James takes immunosuppressive drugs daily and has not shown signs of rejection. He cannot yet lift his upper left eyelid to open his left eye, which is brown, while his right eye is light blue. However, he's now able to squint and tighten the muscles around the eye, and the eyelid is protecting the eye well enough that he now doesn't need an eyepatch, Rodriguez said.
At the news conference, James expressed great thanks to the NYU team, the donor and the donor's family, and to his wife and daughter.
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Nicoletta Lanese is the health channel editor at Live Science and was previously a news editor and staff writer at the site. She holds a graduate certificate in science communication from UC Santa Cruz and degrees in neuroscience and dance from the University of Florida. Her work has appeared in The Scientist, Science News, the Mercury News, Mongabay and Stanford Medicine Magazine, among other outlets. Based in NYC, she also remains heavily involved in dance and performs in local choreographers' work. | Medical Innovations |
Throughout the course of the pandemic, officials and ministers wrestled with how to ensure the public complied with ever-changing lockdown restrictions. One weapon in their arsenal was fear.
“We frighten the pants off everyone,” Matt Hancock suggested during one WhatsApp message with his media adviser.
The then health secretary was not alone in his desire to scare the public into compliance. The WhatsApp messages seen by The Telegraph show how several members of Mr Hancock’s team engaged in a kind of “Project Fear”, in which they spoke of how to utilise “fear and guilt” to make people obey lockdown.
An Imperial College survey of Covid infections in the community – called the React programme and led by the eminent professor Lord Darzi – provided “positive” news for Mr Hancock and his team.
The study they referred to appeared to have been a survey showing “decreasing prevalence” of Covid through May and an R number – the reproduction rate of the virus – of just 0.57.
The study was in line with an Office for National Statistics (ONS) survey. But when the media focused on a separate report by Public Health England and Cambridge University showing a high transmission rate in some parts of the country - prompting speculation that local lockdowns could follow - Mr Hancock said: “That’s no bad thing.” Sir Patrick Vallance, the Government’s Chief Scientific Adviser, agreed. On June 5 2020, there were 1,020 reported daily cases of Covid and 160 deaths.
With recorded Covid cases now down to just 689, the Government was days away from reopening pubs, restaurants and hairdressing salons.
But on June 30 2020, Leicester had just gone into a local lockdown. In a WhatsApp group called “Local Action Committee”, Emma Dean, Mr Hancock’s special adviser on policy, reported back to the group a rumour that Milton Keynes may be the next town plunged into a local lockdown.
Jamie Njoku-Goodwin, Mr Hancock’s media adviser, replied that it would not be “unhelpful” for the public to think they could be next.
Ms Dean appeared to start the conversation by forwarding messages sent to her about the Milton Keynes rumour. Baroness Harding, who ran the Test and Trace scheme, replied.
The Government had started publishing a so-called “watchlist” of the worst-affected areas in the country, not least to justify and explain to the public the need for local lockdowns.
But on Oct 7 2020, ministers scrapped the list’s publication – the thinking seemingly being that the numbers were increasing and that it would cause residents and politicians in places like Leicester to question why they had been singled out for local lockdowns.
In a WhatsApp group called “MH Top Team” that involved a number of advisers and civil servants, the group agreed to scrap the surveillance data watchlist because no such local “interventions” were being planned.
In a conversation with a civil servant, Damon Poole, Mr Hancock’s media adviser, said that failing to publish the data can be turned to their advantage because it “helps the narrative that things are really bad”.
Boris Johnson, then the prime minister, had promised that families would be reunited at Christmas – the first since the pandemic struck in early 2020. He said foregoing long-awaited reunions “would be inhuman and against the instincts of many people in this country”.
But behind the scenes, his ministers and officials were increasingly aware that vast swathes of the public faced a grave disappointment and that the Johnson administration would take the blame for their frustration.
The solution in December was “to frighten the pants off everyone” with a declaration of a new strain of Covid-19, known as the Alpha or Kent variant.
In a conversation between Mr Hancock and Mr Poole on Dec 13, the pair discussed how to survive the coming backlash and storm. On the day, there were 18,409 cases of Covid recorded and 410 deaths. Five days later, on Dec 18, Mr Johnson would scrap his planned five-day Christmas amnesty in an about turn.
The conversation started with a discussion about a fear that Sadiq Khan, the London Mayor, could attack the Government for plunging the capital into its own lockdown - just as Andy Burnham, the Mayor of Greater Manchester, had waged a battle in his city a few months earlier.
The pair discussed a withering leader in the Mail on Sunday, before Mr Hancock seemingly expressed a worry that bad news on the new variant might be knocked off the top of the agenda by wrangles over Brexit.
That led them into a discussion about when to “deploy” the new variant, although Mr Hancock was seemingly wary that it could have led to closing schools.
In Jan 2021, Britain is in a third national lockdown, with schools shut and people told to work from home.
Four days later, on Jan 10, Mr Hancock and Simon Case, the Cabinet Secretary and therefore the country’s most powerful civil servant, discussed more stringent measures that they could introduce.
They agreed that minor adjustments, such as banning angling, would be “parodied galore” - so decided that “fear” and/or “guilt” were vital tools in ensuring compliance.
They discussed making mask-wearing mandatory in “all settings” because it had a “very visible impact”.
Another example given is the reopening of the Nightingale hospital in London, which had been built hurriedly at the start of the pandemic for a rush of Covid patients. In reality, the Nightingale hospitals across the UK were barely used. The one in London re-opened on Jan 12 2021 for non-Covid patients, but only a handful were admitted. | Epidemics & Outbreaks |
Bill allowing past cannabis users to become feds advances in House
The bipartisan legislation was amended this week to remove provisions allowing current marijuana users to be eligible for federal employment or a security clearance.
A House panel on Wednesday voted 30-14 to advance bipartisan legislation that would allow past marijuana users to qualify for security clearances and serve as federal employees.
The Cannabis Users Restoration of Eligibility Act (H.R. 5040), introduced by Reps. Jamie Raskin, D-Md., and Nancy Mace, R-S.C., would end the practice by which a job applicant’s past cannabis use are unable to apply for jobs in the federal government and can be the basis of denying them a security clearance. The bill also would allow those who have been previously denied a federal job or security clearance to see reconsideration of that decision, provided it occurred in 2008 or later.
The rapid expansion of both medicinal and recreational marijuana programs at the state level in recent years has put pressure on the federal government to ease regulations barring federal workers from having ever used marijuana. Currently, 38 states and Washington, D.C., allow for the use of cannabis for medicinal purposes, while 23 states and D.C. enacted laws legalizing the sale and consumption of marijuana recreationally.
On the federal level, movement has been much slower, although it has picked up in recent years. In 2021, Director of National Intelligence Avril Haines issued guidance to agencies stating that cannabis should no longer be a “determinative” factor that leads to an automatic rejection of security clearance application. And last year, President Biden announced that his administration would review marijuana’s status as a federal controlled substance.
Raskin said Wednesday that he introduced the legislation after a constituent of his was denied a job opportunity at the Centers for Medicare and Medicaid Services a week before their start date because they had admitted to using cannabis for medicinal purposes.
“Despite the rapid expansion of all of these laws across the country, thousands of our constituents every year are being denied a federal security clearance or are losing the chance of obtaining federal employment solely because they admit honestly to having used marijuana in the past, even when it was completely awful for them to do so,” he said.
When it was first introduced, the CURE Act also barred the government from denying applicants for federal jobs or security clearances based on current cannabis use. On Wednesday, the House Oversight and Accountability Committee amended the legislation to remove those provisions.
But some conservative Republicans on the committee remained opposed to the measure, citing the alleged danger of marijuana and reciting old—and often debunked—myths about cannabis, such as contentions that it is an addictive “gateway drug” or causes users to become violent.
“We’re seeing more and more research all over the world that excessive use of marijuana with higher levels of THC causes psychosis, depression and violence,” said Rep. Gary Palmer, R-Ala. “This is a serious issue.”
Proponents of the bill countered that federal policymakers did not rely on evidence when they first pushed to have cannabis labeled a Schedule I dangerous substance, instead moving to ban marijuana for racist motives, and argued that cannabis is less destructive than alcohol.
“If we are concerned about dangerous substance use or abuse, we ought to look first to alcohol, alcoholism and the addiction that runs there,” Mace said. “It was Harry Ainslinger the bureaucrat who led the prohibition effort against marijuana many, many years ago. So lets quote him today: ‘There are 100,000 marijuana smokers in the U.S., and most of them are n-words, Hispanics, Filipinos and entertainers. Their satanic music—jazz and swing—result from marijuana use. This causes white women to seek sexual relations with n-wrods, entertainers and many others.’ The whole premise of prohibition of marijuana and cannabis use way back when was racist, and I’m not going to peddle in any future racism on that prohibition.”
Rep. Clay Higgins, R-La., said he was opposed to the bill, albeit not for the same reason as most of his colleagues. He argued that Congress should first move to reclassify marijuana as a Schedule III drug, a move that is currently under consideration by the Biden administration, before taking ancillary steps like adjusting the federal hiring and security clearance processes.
“I was a cop for a long time . . . and had to deal with difficult situations, including fighting and arresting American citizens that were under the influence of probably every controlled substance and every combination of controlled substances that you can possibly imagine,” Higgins said. “And I’ll tell you, I never had to fight a guy who was smoking a joint. They’re too busy sitting on the couch, eating Oreos and watching cartoons . . . Our real obligation as Congress, having allowed states to establish precedent now for many years, it is incumbent on the federal government to follow the lead of the states and we should take action to change the schedule of marijuana from Schedule I to Schedule III . . . or IV.”
The bill now heads to the House floor for consideration. | Health Policy |
Shorter medical degrees, apprenticeships, and £2.4bn in funding are among the radical plans being put forward to solve NHS England's severe staffing crisis.
The long-awaited NHS workforce plan is due to be published in full on Friday, outlining how the service will address existing vacancies and meet the challenges of a growing and ageing population.
It has been hailed as a "once-in-a-generation opportunity" to put staffing in the service on a sustainable footing over the next 15 years.
Staffing vacancies currently stand at 112,000, with fears shortfalls could grow to 360,000 by 2037.
The additional funding will help train "record numbers of doctors, nurses, dentists, and other healthcare staff" in England, with plans to employ 300,000 extra staff in the coming years. The funding works out at approximately £21,000 per vacancy.
Other plans include consulting with the General Medical Council and medical schools on the introduction of a four-year medical degree - one year less than the five it currently takes to complete - which, alongside a medical internship, would mean students could start work six months earlier.
Student nurses will also be able to take up jobs as soon as they graduate in May, rather than waiting until September as they do at present.
With demand for healthcare staff rising around the world, the Long Term Workforce Plan will set out a path to double medical school training places to 15,000 by 2031, with more places in the areas of greatest need.
More places will also be offered through degree apprenticeships so staff can "earn while they learn", gaining a full degree as they work towards a full qualification. One in six (16%) of all training for clinical staff will be done this way by 2028 - including more than 850 medical students.
Officials say the plans set out, along with new retention measures, could mean the health service has at least an extra 60,000 doctors, 170,000 more nurses, and 71,000 more allied health professionals in place by 2036/37.
The NHS workforce plan comes at a time when large parts of the health service are striking over the staffing crisis, and levels of pay.
The NHS plan aims to reduce reliance on expensive agency spend, which would cut the bill for taxpayers by around £10bn between 2030 and 2037.
The plan will focus on the retention of staff, with better opportunities for career development, improved flexible working options, and government reforms to the pension scheme, which is hoped will keep 130,000 staff working in NHS settings longer.
Amanda Pritchard, NHS chief executive, said: "As we look to adapt to new and rising demand for health services globally, this long-term blueprint is the first step in a major and much-needed expansion of our workforce to ensure we have the staff we need to deliver for patients.
"We will take practical and sustained action to retain existing talent, we will recruit and train hundreds of thousands more people and continue to accelerate the adoption of the latest technology to give our amazing workforce the very best tools to provide high-quality care to millions of people across the country each day."
The NHS will mark its 75th anniversary on 5 July. The prime minister argued the workforce plan was a significant moment in its history.
Rishi Sunak said: "On the 75th anniversary of our health service, this government is making the largest single expansion in NHS education and training in its history. This is a plan for investment and a plan for reform."
The chancellor, Jeremy Hunt, added: "Our plan will end the reliance on expensive agency staff, while cutting waiting lists in the coming years and building an NHS which can match up to the scale of tomorrow's challenges."
'They should have done this a decade ago'
Wes Streeting MP, Labour's Shadow Health Secretary, responded to the publication of the NHS workforce plan.
He said: "The Conservatives have finally admitted they have no ideas of their own, so are adopting Labour's plan to train the doctors and nurses the NHS needs.
"They should have done this a decade ago - then the NHS would have enough staff today."
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Mr Streeting added: "Instead, the health service is short of 150,000 staff and this announcement will take years to have an impact.
"Patients are waiting longer than ever before for operations, in A&E, or for an ambulance.
"The Conservatives have no plan to keep the staff working in the NHS, no plan to end the crippling strikes, and no plans to reform the NHS." | Health Policy |
Once thought to be a danger largely reserved for travelers, a flesh-eating parasite known as Leishmania mexicana is now likely spreading locally through some sand flies native to the southern U.S., a new Centers for Disease Control and Prevention analysis has concluded.
Skin sores caused by Leishmania mexicana typically erupt weeks to months after people are bitten by an infected fly. The parasite's lesions can last for years, the CDC says, leading to scarring in its wake.
Hospitals have some options for drugs to use in trying to treat patients suffering from this disease caused by the parasite, which doctors call cutaneous leishmaniasis, though the CDC says not all cases require treatment with medications to combat the parasite.
No vaccine is available for leishmaniasis in humans.
The immediate concern triggered by the discovery is raising awareness of the parasite, officials say, which now appears to be "endemic" in Texas as well as some southern border states.
"This genetic information adds credence to this idea that leishmaniasis is occurring here in the United States, it's endemic here in the United States, at least in Texas and maybe southern border states," Dr. Mary Kamb, of the CDC's Division of Parasitic Diseases and Malaria, said in an interview with CBS News.
Kamb co-authored the new findings, which were released Thursday in an abstract at the annual meeting of the American Society of Tropical Medicine and Hygiene.
Cases of leishmaniasis have previously been reported in Americans who had not traveled internationally. The World Health Organization already includes the U.S. on its list of countries where cutaneous leishmaniasis is "endemic."
A "very distinct" genetic fingerprint
When trying to diagnose patients, doctors typically collect samples by taking biopsies from their infected lesions.
Those are then often shipped off to the CDC, which until 2020 ran the only lab outside the military that could test for these parasites.
"For every case that we got, we reported this data. And after those years, you're just pulling those results together to do this report, on cases collected during 2005 to 2019," said Marcos de Almeida, who had helmed the CDC lab at the time.
The CDC's review found a majority of leishmaniasis patients without travel history were infected by Leishmania Mexicana.
Among these cases, 50 were infected by a strain of the parasite which carried a slight but distinctive set of genetic changes that set them apart.
"Those two snips, those two polymorphisms in the sequence, are very distinct between those who reported travel history compared to those who did not," said the CDC's Vitaliano Cama, a microbiologist and veterinarian who also worked on the study.
At least one case with this genetic fingerprint had been reported each year, Cama said.
How leishmania parasites spread
Battling so-called "vector-borne" diseases like leishmaniasis often focuses on stamping out bugs that transmit the between humans, as well as controlling the risk posed by other animals like rodents that can also serve as a "reservoir."
Controlling sand flies can pose steep challenges compared to other larger insects. Sand flies are a fourth of the size of mosquitoes and do not need standing water to breed.
The World Health Organization estimates that leishmania parasites infect up to a million each year. Most cases in the Americas are diagnosed in Brazil, though infections from these parasites have also been reported throughout Latin America.
For U.S. doctors, leishmaniasis is not a reportable disease in most states, limiting the CDC's ability to track whether cases are now accelerating.
However, Cama said the agency has been fielding a growing volume of requests to help with diagnosing leishmaniasis cases.
"It's a trend, it's not a huge jump, but there's a trend of increasing requests," said Cama.
Dogs could bring a more deadly parasite
The discovery comes as new recommendations are now being drawn up to help officials address concerns that a different and deadlier cousin — Leishmania infantum — could also gain a U.S. foothold.
Leishmania infantum causes a more severe form of the disease called visceral leishmaniasis. More than 90% of visceral leishmaniasis patients who are not given timely treatment die, the Pan-American Health Organization says.
Symptoms include fever, weight loss and swelling of the liver and spleen.
In countries battling outbreaks of visceral leishmaniasis, dogs are considered "the main reservoir" of the parasite. Now a boom in recent years of dog arrivals from abroad, either through travel, adoptions or moving, has raised concerns of this parasite's spread.
"All of us have been fielding these calls from state public health veterinarians, from Army veterinarians, that are trying to figure out what to do," said Christine Petersen, director of the University of Iowa's Center for Emerging Infectious Diseases.
Sporadic cases of leishmania infantum have already been reported spreading into dogs who have not traveled abroad. In addition to giving the parasite to flies, dogs can also spread the parasite directly through contact or bites.
Humans can also be unwitting carriers. Blood tests suggest as many as 1 in 5 American soldiers who were deployed to Iraq may have developed asymptomatic infections.
Working with scientists from the military and the CDC, Petersen co-authored a new "risk assessment tool" they hope will help veterinarians and public health officials figure out how to handle infected dogs if they catch the parasite. A draft of the tool was previewed at the ASTMH's meeting.
Decisions on whether to euthanize the dog can be made guided by weighing factors like where the dog is from and the likelihood of local sand flies which might transmit the parasite.
"That's what this whole risk assessment thing was about. Aside from rabies, maybe we should actually start talking about the other things that dogs carry that can kill us," said Petersen.
for more features. | Epidemics & Outbreaks |
Pelvic floor doctor explains why going pee ‘just in case’ is a really bad idea
Nobody saw that coming.
A pelvic floor doctor from Boston, Massachusetts, has caused a stir by explaining that something we all thought was good for our health can cause real problems. In a video that has more than 5.8 million views on TikTok, Dr. Alicia Jeffrey-Thomas says we shouldn’t go pee “just in case.”
How could this be? The moment we all learned to control our bladders we were also taught to pee before going on a car trip, sitting down to watch a movie or playing sports.
The doctor posted the video as a response to TikTok user Sidneyraz, who made a video urging people to go to the bathroom whenever they get the chance. Sidneyraz is known for posting videos about things he didn’t learn until his 30s. "If you think to yourself, 'I don't have to go,' go." SidneyRaz says in the video. It sounds like common sense but evidently, he was totally wrong, just like the rest of humanity.
“Pelvic floor physical therapist here, and I work with a lot of people with overactive bladders, stress incontinence, urge incontinence, the whole nine yards,” Dr. Jeffrey-Thomas began her clip. “And here's why you shouldn't go ‘just in case."'
In the video, Dr. Jeffrey-Thomas explains the three levels of feeling the need to pee.
“The first one is just an awareness level that tells you that there's some urine in the bladder,” she said. “The second one is the one that tells you to make a plan to use the toilet, and the third is kind of the panic button that says, ‘Get me there right now, I'm about to overflow.’”
@sidneyraz
on vacation and remembering #vacation #tips #bathroom #travel #tipsandtricks #todayilearned #todayyearsold #islandlife #traumabrain #roadtrip #inmy30s
Then she made her case by giving a visual explanation of how going when we don’t need to teaches our bodies to prematurely send signals that it’s time to pee. The simple explanation has a lot of people wondering if their pee sensor is still working correctly.
@thepelvicdancefloor
#stitch with @sidneyraz I know it sounds counterintuitive and goes against everything your momma taught you - just out here trying to save your bladder 🤍
In a rare display of humility on the internet, Sidneyraz saw the video and thanked the doctor for the correction. "Oh hey thanks for correcting me!" he wrote.
The video shocked a lot of people who feel like their entire lives have been based on a lie—at least when it comes to something most of us do six to eight times a day. “TikTok is basically just a bunch of videos telling me I'm doing life wrong,” joked one commenter. “Like Jesus, really? I'm peeing wrong?”
Yes, you are.
"Who else hears their mom in their head say 'go just in case' when you’re out and about and near a bathroom?" another commenter asked.
The good news is that if you’ve always been the type to go “just in case” and you constantly feel like you need to go pee, there is hope. With the help of a doctor, you can retrain your bladder so that you only feel the need to go when it’s time. Now, who’s going to be the first brave person who doesn’t go when they feel the need, just to see if their body’s pee sensor is off?
This article originally appeared on 05.12.22
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Baby boomers are the fastest-growing group of cannabis users in the United States and also happen to possess half of the nation’s $140 trillion in wealth. As such, a bit more attention is being paid to this 73-million-member group among analysts and researchers who are asking why and how much weed their parents and grandparents are consuming.
To answer one of those questions, seniors born between 1946 and 1964 (with their $78.3 trillion in assets) are consuming weed with great gusto, especially in the past 8 years when their consumption tripled.
Why? There's No Negative Impact
Scientists honed in on this demographic of pot smokers and found that consumption of whole-plant cannabis (old school style, of course) does not have a negative impact on cognition. In fact, the opposite is true.
A study done at the University of Colorado Boulder examined the effects of cannabis use in a group of adults between 60 and 88 with no history of alcohol or other substance abuse.
Researchers found that while high THC levels can have negative effects on the adolescent brain, quite the opposite is the case with older brains. Indeed, senior cannabis users, compared to non-users, had significantly greater neuronal communication between the cerebellum and hippocampus.
Age-related changes in the endocannabinoid system (ECS), a complex cell-signaling system in the brain and body that helps maintain homeostasis, include a decrease in the number of cannabinoid receptors throughout the brain. This decrease correlates with increased levels of inflammation in the brain, which can lead to a loss of neurons in the hippocampus, the learning and memory area wherein we don’t want any neuron losses.
"Low-dose, daily cannabis use after age 55 might effectively reduce the degenerative effects of chronic brain inflammation," said Gary Wenk Ph.D., a scientist not involved in the study.
CNN’s Dr. Sanjay Gupta Concurs
“Over the last decade reporting on medical marijuana, time and time again, what has surprised me the most is the optimism, the possibility, and the impact that carefully controlled cannabis can have, even on seniors, for a better quality of life,” Dr. Gupta said.
In the newest installment of "The Whole Story with Anderson Cooper," Dr. Gupta will be presenting his award-winning cannabis series: “Weed 7: A Senior Moment,” that will explore the risks and benefits of cannabis in treating chronic issues such as pain, anxiety and Alzheimer’s disease in patients over 50.
In the first episode, airing this Sunday, August 6 at 8 pm ET/PT, Gupta travels from research facilities in Tel Aviv to a senior living community in West Palm Beach, which is running an experimental cannabis treatment pilot program.
The good doctor talks about how baby boomers are using marijuana for pain relief, better sleep, reducing anxiety, keeping their weight up and more.
Want to learn more about medical and adult-use marijuana and what the researchers are saying? Join us at the Benzinga Cannabis Capital Conference in Chicago on September 27 and 28. All information is available on bzcannabis.com
© 2023 Benzinga.com. Benzinga does not provide investment advice. All rights reserved.
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Join us on September 27-28, 2023 at Chicago Marriott Downtown Magnificent Mile in Chicago, IL. | Medical Innovations |
Consultants and junior doctors in England are set to stage their first joint strike in the history of the NHS.
Consultants will walk out at 07:00 BST on Tuesday, and will be joined by junior doctors on Wednesday morning.
The British Medical Association-organised strike by consultants will last two days, while the one by junior doctors is scheduled for three.
Emergency care will be covered throughout - but NHS bosses said patients were still in danger.
It marks an escalation of the pay dispute between the government and doctors.
What services will be affected?
People needing emergency care are being advised to use accident-and-emergency units as normal or call 999.
For other health concerns, 111 or GP services should be used - although they could be disrupted, as some junior doctors work as GP trainees.
Routine services, including non-emergency operations and appointments, are expected to be significantly disrupted.
Patients should have been told about any postponements in advance.
During their 48-hour walkout, consultants will provide "Christmas Day" cover - emergency services will be staffed and there will be some basic level of cover on the wards.
When junior doctors join them on Wednesday there will be a similar arrangement for them.
Junior doctors account for nearly half NHS doctors - from medics fresh out of university to those sometimes with 10 years' experience.
On Thursday, when the consultant strike ends, junior doctors will stage a full strike, meaning consultants will have to be drafted across to provide cover.
NHS England medical director Prof Sir Stephen Powis said: "The NHS has simply never seen this kind of industrial action in its history. It poses an enormous challenge."
Matthew Taylor, of the NHS Confederation, said he feared ministers were underestimating the risks of the strikes, describing the situation as dangerous.
Hospitals were reporting some patients were facing having treatments and appointments cancelled for the second or third time, he said.
What impact will this have?
This is the third walkout by consultants and the sixth by junior doctors. In each case, significant amounts of routine work has had to be rescheduled.
Some hospitals have reported up to half their normal levels of activity have had to be put off during the strikes.
Nearly one million appointments and treatments, including some cancer care, have been postponed because of industrial action since December.
This includes disruption caused by walkouts by other staff groups including nurses, radiographers and ambulance workers.
But the doctors' walkouts have caused the most disruption.
Last week, the Shelford Group, which represents 10 of the biggest hospital trusts in the country, warned the scale of the disruption now being seen had "inevitably heightened the risk of harm" to patients.
But plenty of doctors will continue working.
As well as BMA doctors providing official cover during the strikes, these will include specialty and specialist (SAS) doctors, between the grade of junior and consultant, who make up just under 10% of the medical workforce.
What is more, about one out of every three doctors is not a BMA member.
How far apart are the two sides?
It is more than 100 days since the health secretary has sat down with BMA leaders for pay talks - and none are planned.
Mr Barclay said this year's pay rise was a "final and fair" settlement and it met the independent pay review body's recommendations.
Consultants are being given 6%, junior doctors an average of 8.8% depending on their level.
Mr Barclay also said he was looking at introducing minimum service levels in hospitals during strikes - defining the number of doctors, nurses, and other staff needed to cover urgent and emergency cover.
Currently life-and-limb cover has to be provided, but the extent of that is negotiated locally.
The pay increase mean junior doctors' basic salary ranges from £32,400 to £63,150, while consultants can earn up to £126,300.
And doctors earn about a quarter to a third more on top of this, on average, for things such as unsociable hours and additional work.
Junior doctors were after a 35% increase, to make up for what they say are years of below-inflation wage rises.
Consultants have not put a figure on what they would like but insist it must be above inflation, to start restoring pay they have lost once inflation is taken into account.
BMA leader Dr Philip Banfield said if the government cared about patients it would "reopen talks and come to the table with a credible offer". | Health Policy |
The takeaway of Robert Sapolsky’s Determined: A Science of Life Without Free Will is basically the same as that espoused by those Snickers commercials: You’re not you when you’re hungry. Except according to Sapolsky, there is no “you”—the hunger is what dictates your behavior, along with your stress level, whether or not you were born with fetal alcohol syndrome or grew up in a culture that valorizes individual freedoms versus one that prioritizes communal responsibility or in one that believes in an omniscient, omnipotent, vengeful deity.
Hormones, neurotransmitters, and how they are affected by your current and historical circumstances—these are the only things that determine how you will act and what decisions you will make at those inflection points when you're called upon to make impactful choices. And all of them are things you did not choose and cannot control.
Sapolsky, a neurobiologist at Stanford University, is not averse to the notion of our having free will; it’s just that he can’t find it. And he’s looked everywhere. He has studied—intensely—not only neurobiology but also endocrinology, behavioral science, philosophy, primatology, criminology, psychiatry, sociology, anthropology, evolution, and history. Not a single one of these disciplines precludes free will, but all of them together do. All there is to us is biology and the way that biology is affected by our environment. That’s it. We are not, as Yoda suggested, luminous beings; we are only crude matter.
This is tough stuff for Americans, who are practically addicted to our meritocratic, rags-to-riches, pull-yourself-up-by-your-bootstraps mythology. So in chapter four, “The Myth of Grit,” Sapolsky deals with people who overcome their circumstances (along with their foils, those who “squander” their good fortune). The secret of their success (and failure) all comes down to their prefrontal cortex (PFC).
The PFC is famously the last part of the brain to mature; it's not fully constructed in humans until we're in our mid-20s. Not because it's harder to build—it’s made of the same components as the rest of the brain, which has been largely functional for the past couple of decades. Rather, Sapolsky claims that it matures late specifically to enable it to become the brain region most influenced by the experiences we have in those first two decades—to learn from those experiences and have them shape us. Grit, pluck, willpower, stick-to-it-iveness, and self-restraint are controlled by the PFC and are shaped by the environment we grew up in. And that’s an environment we do not choose or control.
“What the PFC is most about is making tough decisions in the face of temptation—gratification postponement, long-term planning, impulse control, emotional regulation,” he writes. “The PFC is essential for getting you to do the right thing when it is the harder thing to do.”
Difficult decisions take a ton of mental energy. That’s not a metaphor; the PFC consumes an immense amount of cellular energy. So much so that if you're hungry, tired, stressed, or lack resilience because you were born poor, which gave you chronically elevated glucocorticoid levels, your PFC simply does not have the juice to make good decisions when it matters. Sapolsky points out that “a substantial percentage of people incarcerated for violent crime have a history of concussive head trauma to the PFC.”
An ambitious goal
“This book has a goal,” Sapolsky writes. “To get people to think differently about moral responsibility, blame, and praise.” Although the world is wholly deterministic, we can, and have, learned to change our views and behaviors—both on the individual and the societal levels. We learn and we change when our environment modulates the same molecules, genes, and neuronal pathways that controlled our original views and behaviors. Incidentally, these are the same molecules, genes, and neuronal pathways modulated when a sea slug learns to avoid being shocked by a researcher—i.e., not free will.
Sapolsky’s stated goal of rethinking blame is exceedingly difficult, even for him. He refers to Bettelheim, the self-hating Jew who insisted that autism in kids is caused by their cold “refrigerator mothers” as “a sick, sadistic fuck.” He calls Anders Breivik, who carried out the largest terrorist attack in Norwegian history when he murdered 69 kids at summer camp in 2011, “a lump of narcissism and mediocrity” who “finally found his people among white supremacist troglodytes.”
Yet he thinks that punishing them is as unjust as punishing someone with diabetes. He promotes a public health-based approach to criminal justice: Criminals should be removed from society so they don’t further harm others, much like those with infectious diseases should be quarantined so they don’t harm others. (Because that worked out well.) | Mental Health Treatments |
Making several specific lifestyle changes could slow biological aging by six years, according to the American Heart Association (AHA).
A new study from the organization has found that improved heart health is key to helping to slow down the aging process, which in turn reduces the risk of cardiovascular disease and other medical issues.
The key is to incorporate "Life’s Essential 8," which the AHA defines as "the key measures for improving and maintaining cardiovascular health."
The details of the findings will be presented at the AHA’s Scientific Sessions 2023 from Nov. 11-13 in Philadelphia.
"Improving heart health through healthy lifestyle changes does not just lower the risk of developing cardiovascular disease, but can also slow down the rate of biological aging, which can increase the number of years of life lived in good health," said study senior author Nour Makarem, PhD, an assistant professor of epidemiology at the Mailman School of Public Health at Columbia University Irving Medical Center in New York City, in a statement to Fox News Digital.
Dr. Bradley Serwer, a Maryland-based cardiologist and chief medical officer at VitalSolution, a company that offers cardiovascular and anesthesiology services to hospitals, was not involved in the AHA’s study, but shared his findings on the highlights that have been released.
"This is not surprising data, as those who focus on health tend to do well clinically," he told Fox News Digital.
"There are many health benefits, beyond coronary artery disease, to following a healthy lifestyle."
Chronological vs. phenotypic age
While chronological age is based strictly on calendar years, the AHA tracks phenotypic age, which takes into account both actual age and blood markers that measure things like metabolism, inflammation and organ function, according to a press release from the AHA.
"Phenotypic age is a practical tool to assess our body’s biological aging process and a strong predictor of future risk of disease and death," said Makarem.
"We observed a dose-response relationship, meaning that as heart health improves, biological aging slows down."
"Any progress toward improving heart health is clinically meaningful and promotes healthy longevity."
Even gradual improvements in lifestyle behaviors can be beneficial, the researcher added.
"Any progress toward improving heart health is clinically meaningful and promotes healthy longevity," she told Fox News Digital.
Cardiologist Dr. Ernst von Schwarz, who practices in Culver City, California, was not involved in the study but shared his thoughts on longevity with Fox News Digital.
"Biological aging [refers to] the continuation of the natural life cycle of cells or organisms, which follows a biologic clock that directs the processes of growth, repair and senescence (cellular aging) until apoptosis or necrosis leads to death," he said.
In the study, researchers calculated the difference between actual and biological age for over 6,500 adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 2015 and 2018.
The participants, who averaged 47 years of age, were 50% male and 50% female.
Those who scored high for heart health had a younger physiological age; the opposite was true for those with poor heart health.
Per an example cited in the release, the average actual age of those with high cardiovascular health was 41, while their average biological age was 36.
For those with low cardiovascular health, the average actual age was 53 — compared to an average biological age of 57.
One limitation of the study is that the participants’ heart health markers were evaluated at only one point in time, the AHA noted, which means any later changes were not taken into account.
8 key factors for optimal heart health
The AHA calculates heart health based on an individual’s score for what it calls "Life’s Essential 8."
Those who score high in those eight areas are, on average, six years younger biologically than their actual age.
The eight lifestyle behaviors for optimal heart health are the following:
- Following a healthy sleep schedule
- Not smoking
- Getting regular physical activity
- Adhering to a healthy diet
- Maintaining a healthy body weight
- Maintaining healthy blood glucose levels
- Maintaining healthy cholesterol levels
- Maintaining healthy blood pressure
After an evaluation for all eight markers, individuals received a score of high, moderate or low heart health, per the AHA.
"We still need to review the study for more details, but this reinforces that healthy diet, regular exercise, not smoking, and watching your cholesterol, blood sugar and blood pressure will make you live longer and better," Serwer said.
"Everyone wants to live longer, yet more importantly, we want to live healthier longer, so we can really enjoy a good quality of life for as many years as possible."
"The Essential 8 as recommended by the American Heart Association addresses risk factors that can be manipulated by applying medical recommendations in addition to self-management," noted von Schwartz.
"Besides these eight, social and spiritual fulfillment is as important to achieve longevity," he added.
"Advances in biotechnology and anti-aging research have helped to discover certain biochemical steps and mediators that lead to and determine senescence (cellular deterioration)," von Schwarz told Fox News Digital.
"Knowing these facts enables us to interfere by using senolytic drugs and mechanisms to delay or even inhibit these processes, as we are doing in clinical studies right now."
"These findings help us understand the link between chronological age and biological age and how following healthy lifestyle habits can help us live longer," said Donald M. Lloyd-Jones, M.D., chair of the writing group for Life’s Essential 8 and a past volunteer president of the AHA, in the release.
"Everyone wants to live longer, yet more importantly, we want to live healthier longer, so we can really enjoy a good quality of life for as many years as possible."
Fox News Digital reached out to the American Heart Association for additional comments on the study findings.
Founded in 1924 and headquartered in Dallas, Texas, AHA is the world’s leading nonprofit organization dedicated to fighting heart disease and stroke. | Longevity |
Want to make your annual resolutions stick? Two in five Americans believe the best strategy is to “start small,” according to a new poll.
The results showed they prefer to make long-term goals rather than short-term ones, with 42% choosing to kick off their goals gradually, rather than jumping in headfirst (18%).
Those who prefer long-term goals do so because they believe they can take their time reaching them (62%), the results are usually bigger and better (57%)—and because they think other people won’t know if they fall off track (56%).
Among the 27% who prefer short-term goals, their reasons include having had more success in reaching them (61%) and seeing results faster (59%).
The easiest goals for respondents to achieve are practicing better hygiene (62%), drinking more water (55%), taking daily vitamins and supplements (49%) and working on flexibility, such as simply being able to touch your toes (41%).
Conducted by OnePoll on behalf of The Vitamin Shoppe and Ancient Nutrition, the random double-opt-in survey of 2,000 adults revealed that New Years Day is not necessarily the best moment to kick off your wellness goals.
Although 34% of respondents believe that January is the best month to start a new goal or habit, it is noteworthy that 14% selected February and 12% claim that any month will do.
“Resolutions and goals, whether long-term or short-term, can be powerful motivators for each of us to work towards improving our health and sense of well-being,” says Dr. Josh Axe, co-founder of dietary supplement brand Ancient Nutrition and a member of The Vitamin Shoppe’s Wellness Council.
“I always recommend that resolutions be specific, measurable, and achievable, such as aiming to get eight hours of sleep per night or taking collagen each day to improve skin, joint, and gut health.”
Three-quarters (75%) of respondents set at least one resolution each new year, and view the start of a new year in different ways—63% see resolutions as a motivator, 50% as a tradition, and 44% as a way to improve their health.
Of those respondents, an astounding 83% claim to have success with their resolutions over the years—including goals pertaining to relationships and friendships (51%), physical health (49%), socializing (44%) and mental health (39%).
The top health goals for 2024 include weight management (53%), hair and nail health (46%), fitness and strength (45%), and immune health (45%). To achieve these goals, respondents say they will be exercising more regularly (55%), taking vitamins and supplements (55%) and enlisting the help of family and friends (52%).
“Lots of people are setting goals at this time of year so you can feel supported and part of something bigger than just yourself,” noted Dr. Axe.
SHARE This With Your Own Plans And Strategies for 2024 on Social Media… | Stress and Wellness |
Thousands of years ago, a woman underwent two surgeries to her head — and survived both procedures, her skull reveals.
Scientists in Spain made the discovery after analyzing the woman's skeletal remains, which were unearthed at a Copper Age burial site known as Camino del Molino, located in Caravaca de la Cruz in southeastern Spain, according to a study published in the December issue of the International Journal of Paleopathology.
The woman, who was between 35 and 45 years old when she died, was one of 1,348 individuals found at the funerary site, which was used from 2566 to 2239 B.C. However, unlike the other skeletons, her skull showed evidence of a series of trepanations, which are surgical procedures that involved drilling or scraping holes through the skull to expose the dura mater, the outermost layer of tissue surrounding the brain and spinal cord, as a form of medical treatment.
Further examination revealed two overlapping holes between her temple and the top of her ear. One opening measured 2.1 inches wide by 1.2 inches long (53 by 31 millimeters), while the second was smaller, at 1.3 by 0.47 inches (32 by 12 mm).
Researchers don't think the openings were caused by an injury, based on a few factors. For example, there were no fractures radiating from the lesions, and each hole contained well-defined edges. They concluded that the holes were the remnants of two separate surgeries.
"We identified two distinct holes, resulting from two different interventions," study lead author Sonia Díaz-Navarro, a postdoctoral researcher in the Department of Prehistory at the University of Valladolid in Spain, told Live Science in an email.
Based on the holes, along with the "oblique orientation of the hole walls," the researchers determined that the trepanations were done using a "scraping technique."
"This involves rubbing a rough-surfaced lithic [stone] instrument against the cranial vault, gradually eroding it along all its edges to create the hole," Díaz-Navarro said. "To perform this surgery, the affected individual likely had to be strongly immobilized by other members of the community or previously treated with a psychoactive substance that would alleviate pain or render them unconscious."
Amazingly, the woman appears to have survived both operations, evidenced by healed bone in her skull. Researchers think she lived several months after the second surgery.
Documentation of prehistoric surgical procedures is a "rare occurrence," especially on this area of the head, known as the temporal region, Díaz-Navarro said. In the Iberian Peninsula, it was more common for trepanations to be performed in the frontal and parietal (top) regions of the skull.
The risks of operating on the temporal region included "inherent challenges associated with accessing this area through the scalp," she said. This region in particular contains numerous blood vessels and muscles that are vulnerable and could easily bleed out during surgery.
However, prehistoric trepanations using the scraping technique were far more successful — and safer — than drilling. Ancient surgeons generally did not damage the meninges or the brain, lowering the risk for potential post-surgical infections, she said, adding that using sterile instruments and plants with natural antibiotic properties could help curb any infection.
Unfortunately, researchers aren't sure why the woman had the surgery in the first place. Even though her skeleton did show healed rib fractures and some dental caries, these afflictions were likely unrelated.
"The high prevalence of traumatic injuries documented in the skeletons from Camino del Molino leads us not to rule out the possibility that the surgery may have been performed as a result of trauma," she said. The surgery could have eliminated any evidence of bruising or incisions, and damaged bone fragments may have been removed during the procedure.
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Jennifer Nalewicki is a Salt Lake City-based journalist whose work has been featured in The New York Times, Smithsonian Magazine, Scientific American, Popular Mechanics and more. She covers several science topics from planet Earth to paleontology and archaeology to health and culture. Prior to freelancing, Jennifer held an Editor role at Time Inc. Jennifer has a bachelor's degree in Journalism from The University of Texas at Austin. | Medical Innovations |
Researchers at the University of Wisconsin–Madison have identified a protein key to the development of a type of brain cell believed to play a role in disorders like Alzheimer’s and Parkinson’s diseases and used the discovery to grow the neurons from stem cells for the first time.
The stem-cell-derived norepinephrine neurons of the type found in a part of the human brain called the locus coeruleus may enable research into many psychiatric and neurodegenerative diseases and provide a tool for developing new ways to treat them.
Yunlong Tao, an investigator at Nanjing University in China who was a research professor at UW–Madison’s Waisman Center when the study was performed, and Su-Chun Zhang, a UW–Madison professor of neuroscience and neurology, published their work on the cells, which they call LC-NE neurons, today in the journal Nature Biotechnology.
Norepinephrine neurons in the locus coeruleus regulate heartbeat, blood pressure, arousal, memory, attention and “fight or flight” reactions. Humans have approximately 50,000 LC-NE neurons in the hindbrain, where the locus coeruleus is. From there, the LC-NE neurons reach into all parts of the brain and the spinal cord.
“The norepinephrine neurons in the locus coeruleus are essential for our life. We call it the life center,” Zhang says. “Without these nerve cells, we would probably be extinct from Earth.”
These neurons also play a role, albeit unknown, in various neurodegenerative and neuropsychiatric diseases. In many neurodegenerative diseases such as Alzheimer’s and Parkinson’s, the neurons start degenerating at a very early stage — sometimes years before other brain regions begin to falter.
“People have noticed this for a long time, but they don’t know what the function of the locus coeruleus is in this process. And partly because we don’t have a good model to mimic the human LC-NE neurons,” says Tao, first author of the study.
Previous attempts at creating these neurons from human stem cells followed a protocol based on the development of LC-NE neurons in mouse models. For two years, Tao explored why these attempts were failing and how development of the neurons from stem cells was different in humans.
In the new study, he identified ACTIVIN-A, a protein that belongs to a family of growth factors, as important in regulating neurogenesis in human NE neurons.
“We have some new understanding about locus coeruleus development,” Tao says. “That’s the major finding in this paper, and based on that finding, we are able to generate locus coeruleus norepinephrine neurons.”
To create LC-NE neurons, the researchers converted human pluripotent stem cells into cells from the hindbrain. Then, using ACTIVIN-A and a series of additional signals, they steered cell development toward their fate as LC-NE neurons.
Once converted, the cells showed typical characteristics of functioning LC-NE neurons in the human brain, releasing the neurotransmitter norepinephrine. They also showed axonal arborization — extension of the long, branching arms of neurons that enable the connections between brain cells — and reacted to the presence of carbon dioxide, which is crucial for breathing control.
The new cells may serve as models for disease in humans, allowing scientists to screen drugs for potential treatments and answer questions such as why the cells in the locus coeruleus die so early in neurodegenerative diseases.
“If this is somewhat causative, then we could potentially do something to prevent or delay the neurodegeneration process,” Zhang says.
The LC-NE cells may someday serve as stem-cell therapy themselves.
“The application of these cells is quite broad in its significance,” Zhang says.
Next, the researchers plan to examine the detailed mechanisms through which ACTIVIN-A regulates LC-NE neuron development. The group will also use the cells for the translational work of drug screening and disease modeling.
This research was supported by grants from the National Institutes of Health (NS096282, NS076352, NS086604, U54 HD090256, HD106197 and 1S100OD018202-01), Aligning Science Across Parkinson’s, National Medical Research Council of Singapore, Ministry of Education of Singapore, Bleser Family Foundation and Busta Foundation.
###
— Charlene N. Rivera-Bonet, [email protected]
Journal
Nature Biotechnology
Article Title
Generation of locus coeruleus norepinephrine neurons from human pluripotent stem cells
Article Publication Date
16-Nov-2023 | Disease Research |
The BBC's Naga Munchetty has revealed she has a debilitating womb condition.
Naga lives with a constant pain that can become so acute that she has to scream. A flare-up at the weekend was so bad her husband called an ambulance.
The presenter told her BBC Radio 5 Live listeners: "The pain was so terrible I couldn't move, turn over, sit up. I screamed non-stop for 45 minutes."
One in 10 women is thought to have adenomyosis, yet it can often go undiagnosed for years.
Naga has been sharing with her listeners her agonising wait for answers and a treatment.
She said: "Right now as I sit here talking to you: I am in pain. Constant, nagging pain.
"In my uterus. Around my pelvis. Sometimes it runs down my thighs.
"And I'll have some level of pain for the entire show and for the rest of the day until I go to sleep."
Other women have been in touch sharing their experiences.
What is adenomyosis?
- It is a condition where the womb lining (the endometrium) grows within the muscular wall of the womb too
- Although not life-threatening, it can cause severe symptoms
- These include extremely heavy and painful periods, a bloated tummy and pain during sex or when going to the toilet to poo
- Contraceptives can be tried to see if they lessen the symptoms, but for some women, surgery to remove the womb, a hysterectomy, is the only solution
Naga, 48, says she is resisting the hysterectomy route at the moment.
Jen Moore, 34 and from Cambridge, had a hysterectomy very recently to treat hers.
Naga recorded an interview with her in the days leading up to the surgery.
Jen said: "I know it's the right decision for me and my body. But it's a massive decision at any age."
Jen does not have children but says she always thought she would have the option or chance. "So there is a little bit of emotional rollercoaster going on."
She says the pain of adenomyosis "feels like I have a bowling ball sat inside my pelvis pushing out on the bones from the inside out trying to break them. It's excruciating... It's relentless."
Like Naga, Jen's symptoms began as a teenager when she started her periods.
"I vividly remember being 11 and on my parents' bedroom floor unable to stand up straight, passing out every month from pain and blood loss."
When the family sought medical help, Jen was put on the contraceptive pill to "regulate" her hormones and sent home with no other investigations or a diagnosis.
Jen remained on it until she turned 30, still experiencing monthly bleeds that were "crazy heavy" and "like a horror scene".
"Whenever I would go to the doctor to explain it's happening, again, I was just told 'it's normal'. At one point I was told to 'stop making a fuss'.
"So eventually you just start questioning yourself, don't you? Almost gaslighting yourself."
Jen persevered with seeking help though and was recently referred to a specialist doctor who diagnosed her condition - adenomyosis, plus another period-related problem called endometriosis.
Jen says: "I'm angry, I'm infuriated, I am devastated. I'm all of these things."
She got tired of people saying "but you don't look sick" and turned to her make-up artist friend, Kate, to help show what the condition feels like, by painting bruises and cuts on her abdomen and thighs. She has posted photos on Instagram to raise awareness.
GP Nighat Arif, who specialises in women's health and has written a book about menstruation and menopause, says awareness about the condition among healthcare professionals is improving.
But she says it can be difficult to "join the dots" and make a speedy diagnosis because the symptoms can be mistaken for other things and can vary between women.
"Even on an ultrasound scan the diagnosis of adenomyosis can be missed or not seen. Many younger women also can get placed on hormonal contraceptive treatments to manage heavy periods and therefore 'mask' the diagnosis," she says.
Consultant gynaecologist Liza Ball advised: "Period issues often get 'normalised', which is frustrating. Ask to see a GP with gynaecology training to discuss treatment options that suit you.
"Don't suffer in silence and seek help if you think you have adenomyosis."
The Department of Health and Social Care says it is committed to improving the health of women - it recently launched a 10-year Women's Health Strategy for England - and will be updating health information provided on the NHS website to provide more detail on conditions such as adenomyosis.
'It crushed me'
Julia Allen from Cardiff was eventually diagnosed with adenomyosis and endometriosis in her mid-forties after decades of suffering.
She says she was "back and forth to the doctor" from the age of 14 due to very heavy and painful periods.
"I would have to take spare clothes to school and eventually work due to the flooding I experienced. This was mortifying, especially in a time when people didn't talk about these kinds of things," she says.
"Over the years I was told it was irritable bowel syndrome or constipation. I eventually had a scan, where speckling in my uterus showed up. The GP turned to me and said 'I don't know how to treat you' and that was that."
Julia says she was never able to conceive, despite repeated rounds of IVF treatment, which she believes may have made her adenomyosis worse.
"When I eventually had my hysterectomy my consultant came to my room and said 'if I had seen you 20 years earlier, you could've had a baby'. It crushed me. My organs and insides have been ravaged."
Have you been affected by the issues raised in this story? Help and support is available via BBC Action Line. | Women’s Health |
July 10, 2023 â Eileen Brewer is the mother of an 11-year-old who often gets severe headaches.
âShe started showing signs of headache when she was a baby,â said Brewer, of Columbia, MD, where she is the president of Clusterbusters, an organization that supports research into treatments for cluster headaches and advocacy for people struggling with the condition.
Brewerâs daughter often cried for as many 8-10 hours a day. A pediatrician said she had colic. But as she got a bit older, she began banging her head on the floor or hitting her head with her hands. The pediatrician said it was all behavioral.
But in preschool, the teacher told Brewer that her daughter was complaining about headaches on bright sunny days after outdoor play. âShe would go and lie down in the book corner,â Brewer said. The teacher suggested that the little girl might be having migraines.
âI was surprised and a little embarrassed that I had missed the signs, including frequent vomiting,â Brewer said. âI myself have migraine disease, and itâs genetic. And I work in the headache space, not only at Clusterbusters, but also as the administrative manager for the Alliance for Headache Disorders. And Iâm a member of the National Headache Foundationâs Patient Leadership Council.â
The pediatrician referred Brewer to several specialists, including an ear, nose, and throat doctor, a pediatric eye doctor, a dentist, and a pediatric neurologist. There were no problems with her child's ears, sinuses, or teeth, but the eye doctor discovered a blocked tear duct as well as problems with tracking.Â
âThis means that when my daughter got to the end of a line of reading, finding the next line was difficult for her because the way her eyes were moving was different than the way most peopleâs eyes move,â Brewer said.Â
Although she received physical therapy for her eyes, Brewerâs daughter continued to have headaches. The neurologist diagnosed her with chronic migraine. Now, she takes propranolol, a medication sometimes used to prevent migraine attacks, as well as sumatriptan, a medication used when a migraine attack has already begun.
âWindow to the Brainâ
About 60% of children and adolescents have headaches, according to research cited by authors of a new study published in the journal Ophthalmic Epidemiology. These headaches can impact a childâs quality of life, make then less able to function well, and impact school attendance and performance.
The authors of the new study were interested in finding out how frequent eye-related problems are in children with headaches. They studied children who visited an ophthalmologist with complaints of a headache, said lead study author Lisa Lin, MD, a recent graduate of the ophthalmology residency program at Massachusetts Eye and Ear in Boston. The study was done at the Childrenâs Hospital of Philadelphia, where Lin attended medical school.
Lin and her colleagues reviewed the medical records of 1,878 children, ranging in age from 2 to 18, who had headache symptoms at an outpatient ophthalmology clinic.Â
All children had eye exams to see if they had eye problems or other issues that may be contributing to headaches.Â
The researchers found that about one-quarter of the children had one or more new eye-related findings that may have contributed to their headaches.Â
Close to a fifth of the children had refractive eye issues, such as nearsightedness, farsightedness, or astigmatism.
The second most common eye condition, found in 4.4% of the children, was strabismus (eye misalignment). Very small percentages of the children had other conditions that may cause eye pain or could be a sign of an intracranial problem, including uveitis, glaucoma, and optic nerve elevation.
Patients with eye problems typically had shorter-lasting headaches, but there was no connection between eye issues and how often they had headaches, sensitivity to light, nausea/vomiting, and visual changes.
Lin acknowledges that the study was âlimitedâ because the researchers didnât follow the children to see if their headaches improved when the eye problem was corrected; for example, by wearing glasses.Â
But the findings are important because roughly âa quarter of the children had a treatable eye condition. The eyes are often a âwindow to the brainâ and may need to be examined if children are complaining of headaches,â she said.Â
Take Childrenâs Headaches Seriously
Paul G. Mathew, MD, an assistant professor of neurology at Harvard Medical School, said he was not surprised by the findings.
âMost children with eye problems in the study had refractive issues and probably needed glasses,â he said.Â
He said that not all eye problems can be found using the standard test doctors use, and that sometimes, a more thorough eye exam is necessary.Â
âI think itâs reasonable for a child to see an ophthalmologist if the child has headaches and visual complaints, but I would also caution against sending every single child with headaches to the ophthalmologist, which would drive up the cost of care and delay evaluation and treatment for children with more urgent ophthalmological issues,â Mathew said.Â
Eye problems can cause headaches, but can also worsen headaches in people with disorders like migraine. He warned that a child complaining of headaches should not be ignored or dismissed.Â
âIâve noticed that parents often do not take headaches in children seriously enough, especially when they are infrequent or episodic,â said Mathew, who is on the board of directors of the National Headache Foundation. âAll too often, children are told, âYouâre just being dramaticâ or âyouâre exaggerating.ââ
Mathew, whose 11-year-old daughter has headaches, said more awareness is being brought to migraine in children. âHistorically, children with migraine have been given treatments that were underwhelming, at best, but now there are more treatments being made available, and migraines in children are starting to be taken more seriously.â
Heâs glad about this because âfor children to have headaches that take them out of school, sports, and other activities is detrimental to their development.â
Advice to ParentsÂ
If your child has headaches, Mathew recommends starting with a pediatrician, who can decide if the child needs further consultation with a specialist such as an eye doctor or neurologist.Â
âTake nausea and vomiting seriously,â he said. âOften, children go through appropriate, extensive gastrointestinal evaluations, but these stomach symptoms can be a symptoms of migraine.â
Even if the episodes don't happen very often, Mathew feels they should not be dismissed, because they can become more frequent and intense after puberty, especially in girls.Â
If your pediatrician does not take the problem seriously, Brewer advises seeking another opinion. âYou know your child better than anyone else. Even if youâre a new parent, trust your gut and push for the best diagnostic efforts,â she said. âAdvocate for your child, and donât stop until you find someone who takes the symptoms seriously and has a good answer for you.â
Mathew also recommended being aware of headache triggers, such as a lack of sleep, stress, dehydration, delayed meals, and weather changes. âAt this point, my daughterâs headaches are still infrequent and pretty predictable,â he said. âThey tend to happen after air travel or when sheâs severely sleep-deprived. So if we go on vacation, we build in plenty of downtime to make sure she gets enough rest.â
This is an important message for todayâs parents, many of whom have children who are under a lot of pressure from a combination of schoolwork and extracurricular activities. âMake sure your child has plenty of downtime, eats regular nutritious meals, stays hydrated, and gets adequate sleep, and be mindful of what might trigger their attacks,â Mathew said. | Disease Research |
Depression is a mood disorder marked by feelings of sadness and a loss of interest in things you usually enjoy doing. You might also have a hard time thinking or getting things done, among other symptoms. Thoughts of suicide are possible in more severe cases.
The good news? There are lots of ways to treat depression and get you back to your best self. Hereâs what you need to know.
Depression vs. Depressed Mood
A diagnosis of depression is different from feeling down one day or being in a crappy mood for a few days. These are normal reactions if you lose your job, a loved one dies, or something else happens. But with major depression disorder (MDD), chemicals in your brain donât always work the way theyâre supposed to. Other things, like genetics, sometimes play a role. So you feel this way for a much longer period of time -- typically 2 or more weeks.
David A. Adler, MD, a senior psychiatrist and director of the Mental Health Services Research Group at Tufts Medical Center, says that 50% of people diagnosed with MDD will have a second episode of depression. And if youâve had two episodes, thereâs a 75% chance itâll happen a third time, and then a 95% chance of a fourth.
Depression can come on by itself or be triggered by a life event. There are different kinds, some of which include:
Major depression disorder (MDD). This is considered the classic type. It includes common symptoms like loss of interest in hobbies, trouble sleeping, and more.
Seasonal affective disorder. This can happen as the seasons change and the days get shorter. Experts think it may have something to do with not getting enough sunlight, among other things.
Bipolar disorder. If you have this condition, you may get depressed but also have periods of really high or intense energy levels.
Treating Major Depression Disorder
Treatment depends on the person. What worked for a friend or family member may not work for you. And just because they had certain side effects doesnât mean thatâll happen to you. For example, just because a certain antidepressant triggered weight gain in your mom doesnât mean the same thing will happen to you. Itâs important to approach treatment with an open mind.
Options include:
Psychotherapy. Also called talk therapy, this involves meeting with a mental health professional in person or virtually to talk about and work through your feelings. It âhelps the person optimize their coping strategies to deal with lifeâs stressors,â says James Murrough, MD, PhD, director of the Depression and Anxiety Center for Discovery and Treatment at Mount Sinai.
Antidepressants. These are prescription medications that help balance brain chemicals.
Brain stimulation therapies. This is when doctors use electrical pulses in hopes of changing brain activity. Itâs an option for people who donât respond to psychotherapy or antidepressants.
Electroconvulsive therapy (ECT). This is used for severe depression. Unlike brain stimulation therapies, your doctor puts you to sleep during the procedure. They send electrical currents through the brain to cause a short seizure. This seems to ease symptoms of some mental health conditions.
Murrough says talk therapy and medication are equally likely to be effective in treating a person with MDD. John Greden, MD, founder of the Eisenberg Family Depression Center in Michigan, says he believes people with MDD who receive both psychotherapy and antidepressants fare better.
âIt shouldnât be [psychotherapy] versus [antidepressants],â Greden says.
Itâs important to talk with your doctor honestly about whatâs going on so they can help you decide what might work best. It may take a few tries, but youâll figure it out together.
âThe best evidenced-based treatments follow an individualâs preference, since both medication therapy and the psychotherapies have demonstrated good outcomes,â Adler says.
Side Effects
These also depend on the person. Some people have zero side effects, while others have to try a few antidepressants before they find one whose side effects they can handle.
The older class of traditional antidepressants (monoamine oxidase inhibitors, or MAOIs) were known to cause significant weight gain or lower your sex drive. They worked, but people tend to choose the newer ones that have better âside effect profiles,â Greden says
Lifestyle Changes and Alternative Treatments
Researchers are also looking into ketamine for treating severe depression.
If youâre having suicidal thoughts or feelings of self-harm, know that youâre not alone. There are resources and people that can help. Reach out to your doctor, a family member, or friend. You can also call the National Suicide Prevention Lifeline at 800-273-8255 or the Substance Abuse and Mental Health Services Administration Helpline at 800-662-4357. | Mental Health Treatments |
Three years ago, I was briefly dating a primary school teacher who happened to be a part-time animal rights activist. The experience made me take a decision I’ve been living with ever since: veganism. Things didn’t work out with the primary school teacher, but my initial commitment to veganism did last.
At times, I’ve wondered if I’m depriving myself of great pleasure or, as some studies have suggested, even risking my mental health. So, as a scientist, last year I concluded that I finally needed to study what effect this decision was having on me, and decide whether I should stick to veganism for life or give it up.
I didn’t have scientific grant funding to conduct the gold standard of a large randomised control trial, but I did have the time and inclination to conduct a study on myself, the results of which were recently published in Physiology and Behaviour.
I started, as many do, by taking part in Veganuary. On a daily basis, I recorded what I’d done that day and importantly how much I had enjoyed the food I’d eaten. Every week I was weighed, and my waist circumference measured. I also completed questionnaire measures of depression and anxiety symptoms every week.
During January, I led my normal vegan life but was particularly strict in checking whether food and drink was vegan. My diet looked like a lot of other vegan diets: chickpea curry (check), tofu stir-fry (check), lentil pasta (check). I was still eating out, and even enjoyed a weekend away. The latter was great, with the exception of a well-intended but very odd vegan hotel breakfast of stir-fried noodles.
In February, I stopped being vegan and repeated the same daily and weekly measures. During the non-vegan period I made a concerted effort to eat meals that were not vegan. I ditched oat milk for normal milk. I ate cheese, meat and fish rather than my usual diet of tofu, beans and pulses. As in January, I still ate out and happened to have another weekend trip away, this time to Spain. It was great, with the exception of a culinary experience never to be repeated – callos a la madrileña: blood sausage and tripe.
During both months, I diligently measured how often I was drinking alcohol, eating out and exercising, but luckily these things didn’t differ much. Then, after a “wash-out” period, in which I returned to my normal relaxed vegan lifestyle, I started phase two in August, changing the order of the vegan versus non-vegan periods and starting with two months of non-veganism. I didn’t measure anything on a daily basis, as I was worried this may be making me more conscious of my behaviour and potentially making me act more healthily. The idea that recording one’s own behaviour can influence subsequent behaviour is well established in psychology, and referred to as “self-monitoring”. It’s a tool that is used to help manage mental health, weight loss and increase adherence to medicine usage.
When December rolled round, I had finally finished my self-experiment.
As a scientist with a psychology background, I am used to looking at qualitative and quantitative data. Qualitative data refers to personal experiences in a study. When planning the study, I thought I might have an affirming experience or “defining moment” that made me commit to veganism for life, or to ditch it. That didn’t happen. But I did notice a few things.
First, as a non-vegan, some friends and family were keener to hang out with me when food was involved and expressed disappointment during the vegan periods of the study. When switching between non-vegan versus vegan study periods, I also noticed how veganism was acting as a red light to unnecessary eating. For instance, as a non-vegan, snacks, treats and desserts were available in abundance, and temptation turned into eating. But as a vegan, those temptations were very often removed. We’ve long known that vegan diets tend to be lower in saturated fat, but I hadn’t suspected this could be in part due to veganism preventing eating of it altogether.
The quantitative data was really clear cut. My body weight was lower when vegan and higher during non-veganism. After two months of non-veganism, I’d gained 1.6kg, then when switching to veganism for the next two months I lost 1.2kg. But my rated daily enjoyment of food was close to identical during vegan and non-vegan days. There was a similar story for my mental health. My weekly recordings of depression and anxiety symptoms were nearly identical during both study periods.
Self-experiments come with lots of caveats. Results come from a single participant, and can’t always be generalised. Another limitation of my study is that it was short. But, if my data could be generalised, they would predict that veganism may have a causal influence on body weight; that concerns over how much a person would enjoy a vegan diet might not ring true; and that a vegan diet probably doesn’t causally affect mental health.
When I read studies that show vegans are more likely to be X or Y compared with non-vegans, I am highly suspicious. Instead, vegans and non-vegans differ in lots of ways, and these differences will not be causal. Take gender as an example. Vegans are far more likely to be female than male. Do we conclude from this that veganism makes you female? Of course not.
And what did I decide about long-term veganism? For me, the likely benefits for my health, the environment and reducing animal suffering outweigh the minor inconveniences. As I write this, nine months after the experiment finished, I’m still a committed vegan.
Eric Robinson is a behavioural scientist and professor in psychology at the University of Liverpool. To read a longer version of this article go to The Conversation | Nutrition Research |
Airports around the country have welcomed the Australian Health Protection Principal Committee's recommendation that mask mandates for workers and travellers be scrapped as soon as Friday.Health experts have urged state and territory governments to scrap the mask mandates for airports as soon as Friday.The Australian Health Protection Principal Committee shared its recommendation on Tuesday following a national review of the current COVID-19 situation.“The AHPPC notes that all states and territories have relaxed mask mandates in most settings within the community and considers that it is no longer proportionate to mandate mask use in airport terminals,” it said in a statement.“The AHPPC proposes that mask wearing in airport terminals no longer be mandated from as early as midnight 17 June 2022.”Stream the latest news on COVID-19 with Flash. 25+ news channels in 1 place. New to Flash? Try 1 month free. Offer ends 31 October, 2022.State and territory governments currently require masks to be worn indoors by those aged 12 and older at all airports around Australia.But the face coverings are not required in most other indoor settings like at the shops or when visiting the cinema.The Australian Airports Association welcomed the announcement in a statement on Wednesday and called on state and territory governments to relax the current settings.“The end of mask mandates within the terminal will assist airport staff by allowing them to carry out their busy roles without the need to monitor the use of masks,” AAA chief executive James Goodwin said.“Masks have not been required in supermarkets, shopping centres and many other indoor public areas for some time, so this now brings airports in line with those venues and avoids confusion for travellers.”Sydney’s Kingsford Smith Airport CEO Geoff Culbert echoed the sentiments labelling the AHPPC's statement a “common sense move and great for everyone who works at the airport”.“We’re desperately trying to rebuild the aviation workforce and the mask mandate was making it really difficult. We’re grateful to the Government for listening to our concerns,” he said.Melbourne Airport also supported the recommendation from the health experts as it had been calling for the removal of face masks since March.“We are hopeful the Victorian Government adopts this recommendation,” a spokesperson from the airport said. “The airport is a great place to work, but in a highly competitive labour market, the mask mandate makes it harder for tenants to attract new employees when competing with locations where masks are not required.”The Brisbane Airport Corporation also praised the move from the AHPPC and called on all state and territory governments to enact the recommendation.“This is welcome news not only for airline passengers but for the tens of thousands of employees who work in airport terminals, including cleaners, hospitality, retail, security and check-in staff,” a BAC spokesperson said.“We’ve received feedback from those working in the terminal the requirement to wear a mask for a full eight to 12 hour shift can be quite challenging.”Face masks would still be required on planes should state and territory governments accept the recommendation from the AHPPC.The European Union stopped recommending face masks in airports in May.NSW Health, Victoria's Department of Health and Queensland Health were contacted for comment but no reply was received at the time of publication. | Epidemics & Outbreaks |
Scientists find way to wipe a cell's memory to better reprogram it as a stem cell
In a groundbreaking study published in Nature, Australian scientists have resolved a long-standing problem in regenerative medicine.
Led by Professor Ryan Lister from the Harry Perkins Institute of Medical Research and The University of Western Australia and Professor Jose M Polo from Monash University and the University of Adelaide, the team developed a new method to reprogram human cells to better mimic embryonic stem cells, with significant implications for biomedical and therapeutic uses.
In a revolutionary advance in the mid-2000s, it was discovered that the non-reproductive adult cells of the body, called ‘somatic’ cells, could be artificially reprogrammed into a state that resembles embryonic stem (ES) cells which have the capacity to then generate any cell of the body.
The ability to artificially reprogram human somatic cells, such as skin cells, into these so-called induced pluripotent stem (iPS) cells provided a way to make an essentially unlimited supply of ES-like cells, with widespread applications in disease modelling, drug screening and cell-based therapies.
“However, a persistent problem with the conventional reprograming process is that iPS cells can retain an epigenetic memory of their original somatic state, as well as other epigenetic abnormalities,” Professor Lister said. “This can create functional differences between the iPS cells and the ES cells they’re supposed to imitate, and specialised cells subsequently derived from them, which limits their use,”.
Professor Jose Polo, who is also with the Monash Biomedicine Discovery Institute, explained that they have now developed a new method, called transient-naive-treatment (TNT) reprogramming, that mimics the reset of a cell’s epigenome that happens in very early embryonic development.
“This significantly reduces the differences between iPS cells and ES cells and maximises the effectiveness of how human iPS cells can be applied,” he said.
Dr Sam Buckberry, a computational scientist from the Harry Perkins Institute, UWA, and Telethon Kids Institute, and co-first author of the study, said by studying how the somatic cell epigenome changed throughout the reprogramming process, they pinpointed when epigenetic aberrations emerged, and introduced a new epigenome reset step to avoid them and erase the memory.
“This significantly reduces the differences between iPS cells and ES cells and maximises the effectiveness of how human iPS cells can be applied."Professor Jose Polo, Director of Adelaide Centre for Epigenetics, University of Adelaide.
Dr Xiaodong Liu, a stem cell scientist who also spearheaded the research said the new human TNT-iPS cells much more closely resembled human ES cells – both molecularly and functionally – than those produced using conventional reprograming.
Dr Daniel Poppe, a cell biologist from UWA, the Harry Perkins Institute and co-first author, said the iPS cells generated using the TNT method differentiated into many other cells, such as neuron progenitors, better than the iPS cells generated with the standard method.
Monash University student and co-first author Jia Tan, said the team’s TNT method was dynamite.
“It solves problems associated with conventionally generated iPS cells that if not addressed could have severely detrimental consequences for cell therapies in the long run,” he said.
Professor Polo said the precise molecular mechanisms underlying the iPS epigenome aberrations and their correction were not fully known, and further research was needed to understand them.
“We predict that TNT reprogramming will establish a new benchmark for cell therapies and biomedical research, and substantially advance their progress,” Professor Lister said.
The collaborative research project also included researchers from the Australian National University, Westlake University, Queen Mary University of London, Mater Research Institute, University of Queensland, Queensland Brain Institute, South Australian Health & Medical Research Institute, Duke-NUS Medical School and CSIRO.
Media contacts
Doug MacLaurin, UWA Media & PR Advisor. Phone: +61 8 6488 2802
Miriam Borthwick, Harry Perkins Institute of Medical Research. Mobile: +61 (0)437 411 683
Tania Ewing, Monash University. Mobile: +61 (0)408 378 422
Johnny von Einem, University of Adelaide. Mobile: +61 (0)430 476 300 | Medical Innovations |
I was desperate for a boob job at 15 - but now I've embraced my 'no-cup' chest and love showing off my bodyLisa Banks, 31, felt embarrassed for having 'the smallest boobs' at her school Originally from Tokyo, she even tried to gain weight to help her breasts growShe lives in Sydney and set up a brand focusing on women with smaller breastsRead more: Bullies called me T-rex but now I wouldn't change anything about me Published: 07:36 EST, 10 January 2023 | Updated: 07:36 EST, 10 January 2023 A 'flat chested' woman who was desperate for a boob job at the age of just 15 has finally embraced her 'no-cup' chest and now loves showing off her body.Lisa Banks, 31, originally from Tokyo, felt insecure throughout her teen years after being embarrassed at her all girls' school for having 'the smallest boobs'.At the age of 15 she even begged her parents for a boob job and went to a Chinese herbalist for a remedy to help her breasts grow in her twenties.Desperate to gain a bustier figure, Lisa even gained a stone in weight in her mid 20s but says it made her feel worse and didn't make a difference to her chest. Lisa Banks, 31, originally from Tokyo, felt insecure throughout her teen years after being embarrassed for having 'the smallest boobs' at her schoolShe started finding other women like her through the hashtag #IttyBittyTittyCommittee on social media and cleansed her channels of bustier women that she wished she looked like.In 2019, with size AA cup, she decided to embrace her slender figure and 'non-existent boobs' and has started uploading body-positivity content on social media.Lisa has even created a brand called Itty Bitty Label - selling clothing and nipple covers for women with smaller breasts.Lisa, an influencer now living in Sydney, said: 'I struggled throughout school - I was really self-conscious.'I went to a performing arts school in Ascot, Surrey, and I dreaded PE and dance classes. In 2019, with size AA cup, she decided to embrace her slender figure and 'non-existent boobs' and has started uploading body-positivity content on social media The influencer, now living in Sydney, created a brand called Itty Bitty Label - selling clothing and nipple covers for women with smaller breasts'I loved dance classes but I hated being in a leotard as I couldn't wear a padded bra.'We were teenage girls and people would compare their boobs - I hated being the one with the least amount.'I would get changed and try and hide in the corner so people wouldn't notice.'The teen used to wear baggy clothes to hide her flat chest and always donned a padded bra.'Throughout my 20s I carried on feeling I wasn't good or womanly enough,' she said.'When I was 15, I asked my mum to take me to a surgery consultancy to get an augmentation and I tried to save up money for it. Lisa (pictured in her teens) 'dreaded PE and dance classes' and would get changed in the corner She changed her social media feed, swapping curvaceous women for women who looked like her Lisa said: 'I feel so good. I'm so focused on trying to encourage other girls to feel great in their own skin''It was some kind of filler procedure and it seemed dangerous so luckily my mum didn't allow me to do it.'I think my Instagram feed was toxic - it was full of bustier girls who had perfect Barbie doll shapes.'I tried everything I saw in magazines or in the media to grow my boobs.'When I was 15, I purchased tablets from a magazine - they gave me acne and cramps. I had no idea what was in them - they could have been dangerous.'In my mid 20s I even went to a Chinese herbalist who gave me three types of herbs to grow my bust.'She said it was what men transitioning to women used to grow boobs. It didn't work and gave me bad cramps.'Petite Lisa - who weighs 8st 3lbs - said: 'Doctors have told me to gain weight but I eat well, and I stay the same weight and I am healthy.'Once I gained a stone because I thought it would make my boobs grow. It didn't and I felt worse in myself.' Lisa's tips for finding self-love with a flat chest - Follow women who look like you and fill your feed with them- Try to write down things you love about yourself and do inner work and talk to yourself nicely - you can't control what other people say to you but you can control the way you speak to yourself- Journal your thoughts and read self-help books- Change what you consume in the media - stop following women who are making you feel bad about yourself and follow women who look like you- Work towards going braless or wearing a bra without pads- Try to make your own clothing items In July 2019, aged 29, Lisa found a large online community called the 'Itty bitty titty committee' and started to find self-love and confidence.She changed her social media feed, swapping curvaceous women for women who looked like her and her heroes now include Keira Knightley and Natalie Portman 'Everything shifted once I changed my feed,' Lisa said.'I started to follow women who looked like me.'I decided I wanted to make a brand for women with small chests and I created Itty Bitty in 2019 as I was inspired by the community.'Lisa's brand sells clothing for petite women and nipple covers called 'pasties' so small chested girls don't have to wear bras.She trained at TAFE - a fashion school in Sydney, Australia - to be a garment technician.Her partner, Tommy Ge, 37, works in fashion and has encouraged her on her journey to self-acceptance and love.She said: 'I feel so good. I'm so focused on trying to encourage other girls to feel great in their own skin.'When you get older you realise being unique and different is something to be proud of.'If you enjoyed this story...You've been using sunscreen wrong your whole life: Brand shocks thousands after revealing how many pumps you should be applyingPeople can't believe what 45-year-olds looked like in the 90s as photo of Steve Martin and Diane Keaton in Father of the Bride goes viralMy children pick their own bedtimes, have a vegan diet and go barefoot - people accuse me of 'abuse' but I'm confident in my decisions Advertisement | Women’s Health |
Scientists say a new way to treat prostate cancer may be on the horizon after finding it is possible to reverse its resistance to therapy.
More than a million men worldwide are diagnosed with the disease each year. The chances of survival are generally good, particularly if it is diagnosed early. Many can live for decades without symptoms or needing treatment.
But some with advanced forms of prostate cancer find it is able to evade treatment by using their immune system to resist the impact of drugs. Now scientists have discovered a way to stop it being able to do this, opening up the possibility of treatments for men left with little hope.
By blocking the secret messages that cancer cells send to hijack healthy white blood cells, researchers were able to reverse resistance to therapy in a small group of patients. In some, they were able to shrink tumours or halt their growth. The findings were published in Nature.
“This is tremendously exciting and it suggests we have an entirely new way to treat prostate cancer on the horizon,” said Johann de Bono, a professor of experimental cancer medicine at the Institute of Cancer Research and consultant medical oncologist at the Royal Marsden NHS foundation trust.
In a trial led by the ICR, the Royal Marsden and the Institute of Oncology Research in Switzerland, scientists recruited 23 patients with advanced prostate cancer that had stopped responding to hormone therapy.
They were given a combination of AZD5069, an experimental drug that prevents white blood cells from being dragged inside tumours, and enzalutamide, a hormone therapy commonly used to treat prostate cancer.
Of 21 patients who could be evaluated, five (24%) showed evidence of their tumours responding to the combination, the ICR reported.
Their tumours shrunk by more than 30%, they experienced “dramatic decreases” in circulating levels of prostate specific antigen (PSA), a marker often elevated by cancer, or their blood levels of circulating tumour cells dropped, it said.
Patients also showed a drop in the white blood cells targeted by the treatment – myeloid cells – in the blood, and biopsies revealed fewer of them in their tumours.
“It’s hugely rewarding to see our theory proven in a trial of patients with this disease,” said De Bono. “Myeloid cells may be implicated in treatment resistance in a range of cancers, so the impact of this research could be very broad, across multiple cancer types.”
Prof Kristian Helin, chief executive of the ICR, said the results acted as a proof of principle for disrupting cancer and represented a smart new way to attack tumours.
“I look forward to seeing how this work progresses and hope it will pave the way to a new treatment that is beneficial to people with prostate cancer and potentially also many other cancer types.”
The study was funded by Prostate Cancer UK, Cancer Research UK, the Swiss Card Onco grant organisation, the Prostate Cancer Foundation, AstraZeneca, Wellcome and the NIHR Biomedical Research Centre at the Royal Marsden and ICR, with support from the Experimental Cancer Medicine Centres network.
Prostate Cancer UK’s director of research, Dr Matthew Hobbs, said he was extremely excited about the findings.
He said: “Now we want to see pharmaceutical companies working with researchers to develop new drugs based on what we’ve learnt and to test them in larger trials – turning research into reality for men.” | Drug Discoveries |
- Summary
- Companies
- Kariko and Weissman were pioneers of COVID-19 shots
- Scientists win first 2023 Nobel prize and $1 million
- Pair lauded for helping save millions of lives
STOCKHOLM, Oct 2 (Reuters) - Hungarian scientist Katalin Kariko and U.S. colleague Drew Weissman, who met in line for a photocopier before making mRNA molecule discoveries that paved the way for COVID-19 vaccines, won the 2023 Nobel Prize for Medicine on Monday.
"The laureates contributed to the unprecedented rate of vaccine development during one of the greatest threats to human health in modern times," the Swedish award-giving body said in the latest accolade for the pair.
The prize, among the most prestigious in the scientific world, was selected by the Nobel Assembly of Sweden's Karolinska Institute medical university and comes with 11 million Swedish crowns (about $1 million) to share between them.
Kariko, a former senior vice president and head of RNA protein replacement at German biotech firm BioNTech, is a professor at the University of Szeged in Hungary and adjunct professor at the University of Pennsylvania.
In an interview after the award, she said her late mother had long speculated that she might win the Nobel - to which she would remind her there was a time when she could not even get a grant for her research.
"She (my mother) said, 'but you work so hard'. And I told her that many, many scientists work very, very hard," added Kariko, who was sleeping when she received the call from Stockholm and initially thought it was a joke.
Co-winner Weissman, a professor in vaccine research also at Pennsylvania, said it was a "lifetime dream" to win and recalled working intensely with Kariko - including middle-of-the-night emails as they both suffered disturbed sleep.
"For the 20 years that we worked together, before anybody knew what RNA is or cared, it was the two of us, literally, side by side at a bench working together, talking and discussing new data," he said in a recording on the Nobel website.
The two laureates in 2005 jointly developed so-called nucleoside base modifications, which stop the immune system from launching an inflammatory attack against lab-made mRNA, previously seen as a major hurdle against any therapeutic use of the technology.
MASS USE
BioNTech said in June that about 1.5 billion people across the world had received its mRNA shot, co-developed with Pfizer (PFE.N). It was the most widely-used shot in the West.
BioNTech, whose Germany-traded shares were up 3.8%, praised Kariko and Weissman for their passion and persistence.
Having grown up in a village in a house without running water or a refrigerator, Kariko got a biochemistry doctorate in Szeged before she and her husband sold their Soviet-made Lada car, sewed the money into their daughter’s teddy bear and went to the U.S. on a one-way ticket.
The daughter, Susan Francia, became a U.S. national rower and Olympic gold winner.
At the University of Pennsylvania, Kariko tried to turn mRNA into a treatment tool throughout the 1990s but struggled to win grants because work on DNA and gene therapy captured most of the scientific community’s attention at the time.
Kariko has said she endured ridicule from university colleagues for her dogged pursuit, and her failure to secure research grants led to her demotion in the 1990s.
Weissman received his doctorate from Boston University in 1987 and joined the University of Pennsylvania in 1997.
The two have said they met in 1998 while waiting for rationed photocopying machine time. The ensuing chat piqued immunologist Weissman’s interest in Kariko’s RNA work.
"It is absolutely right that the ground-breaking work on RNA led by Kariko and Weissman should be recognised by a Nobel Prize,” said Sir Andrew Pollard, an immunology professor at Oxford University, who pursued a different technology when co-developing the lesser-used COVID vaccine by AstraZeneca (AZN.L).
The award comes even as Germany’s CureVac (5CV.DE), which failed to bring a COVID shot to market, as well as rival Moderna, are separately suing BioNTech and Pfizer for alleged mRNA patent infringements.
BioNTech and Pfizer, in turn, have launched legal challenges against the validity of the intellectual property rights in question.
PANDEMIC BREAKTHROUGH
Messenger or mRNA, discovered in 1961, is a natural molecule that serves as a recipe for the body’s production of proteins. Use of man-made mRNA to instruct human cells to make therapeutic proteins, long regarded as impossible, was commercially pioneered during the pandemic, also by Moderna (MRNA.O).
Prospective mRNA uses include drugs against cancer and vaccines against malaria, influenza and rabies.
The medicine prize kicks off this year's Nobel awards with the remaining five to be unveiled in coming days.
The prizes, first handed out in 1901, were created by Swedish dynamite inventor and wealthy businessman Alfred Nobel.
Last year's medicine prize went to Swede Svante Paabo for sequencing the genome of the Neanderthal and other past winners include Alexander Fleming, who shared the 1945 prize for the discovery of penicillin.
($1 = 11.0129 Swedish crowns)
Reporting by Niklas Pollard, Johan Ahlander in Stockholm, Ludwig Burger in Frankfurt, Krisztina Than in Budapest, Terje Solsvik in Oslo; editing by Andrew Cawthorne
Our Standards: The Thomson Reuters Trust Principles. | Vaccine Development |
Train-obsessed toddler Teddy has just a 40% chance of living past his fifth birthday.
The three-year-old, who has charmed nurses and doctors at hospitals around the UK, is facing one of the most aggressive - and rare - forms of childhood cancer.
But for children like Teddy, there is the possibility of long-term remission in the form of a "lifesaving" cancer vaccine. Currently, it's only available in the US, but there is a chance the game-changing jab could be coming to the UK.
There are less than 100 cases a year of neuroblastoma in the UK, and the cancer is most common in children under the age of five.
Treatment is a gruelling regime of surgery, stem cell transplants, immunotherapy and chemotherapy. It is hoped when this is finished - scheduled for November - the disease will be in remission.
The next stage would be a vaccine that would stop it from returning because if Teddy does relapse, his chance of survival drops to just 5%.
While a vaccine against cancer seems like the work of science fiction, the results from early-phase trials are promising.
Described as a "maintenance option" it doesn't cure the disease but is given to patients in remission. It works by inducing a patient's immune response to produce its own Anti-GD2 antibodies which then find and attach themselves to residual neuroblastoma cells, preventing cancer from returning and spreading again through the body.
"This would give not just short-term effects, but actual potential long-term immunity to cancer," said Katherine Lichten, Teddy's mum.
The treatment, currently in phase two trials at the Memorial Sloan Kettering Cancer Centre in New York, is the only paediatric tumour vaccine in existence.
For Liam Scott it really was lifesaving. After being diagnosed with neuroblastoma aged three, and following months of his own treatment, he was given the jab.
In 2022, three years after that awful diagnosis day, his parents proudly reported he was cancer-free and thriving.
And Vicky Inglis, head of family support services at Solving Kids Cancer, said he remains in remission to this day.
"This gives hope to those families who have decided to pursue this option," she said.
But the cost of getting on a trial for the vaccine is not cheap, and the Lichten family are currently fundraising £250,000 to pay for it.
Katherine's "whole world was turned upside down" when Teddy, feared initially to need surgery for appendicitis, was found to have a cancerous mass that had spread to his hips, spine, and bone marrow.
Since his diagnosis in June 2022, Teddy has faced six rounds of induction chemotherapy, a stem cell harvest, high-dose chemotherapy, and a stem cell transplant.
He still has another round of high-dose chemotherapy and a stem cell transplant, before potential surgery and 12 sessions of radiotherapy.
His frontline treatment will conclude with six months of immunotherapy.
It is only then that Teddy will be eligible for the vaccine, and he has to receive it within a month of finishing immunotherapy - a tight window for the family to finish raising funds and get him to the US.
"Our absolute worst nightmare is Teddy relapsing and losing him," said Katherine.
Treatment 'like being hit over the head with a sack of bricks'
Families forced to seek potentially life-changing treatment abroad face an impossible choice - raise the eye-watering amount of money required, or face losing their children.
While the Lichten family raised an impressive £24,000 within a few days of launching their fundraising page, they are aware they still have a long way to go.
Katherine said: "When Teddy was first diagnosed I took to the internet like any Millennial mum and stumbled upon news of this vaccine quite quickly. And my initial reaction was, we've got to do this."
But she said the reality of treatment soon hit them.
"You feel like you've been hit over the head with a sack of bricks and you can barely think forward to getting out of bed in the morning, let alone thinking about fundraising that huge amount."
But after a few weeks at home with Teddy, during a gap in his treatment, the family had the space to decide now was the right time to go abroad.
Could the vaccine come to the UK?
There is a chance the jab could come to Britain and the whole of Europe with Solving Kids Cancer lobbying the UK government to roll out trials in this country.
"It is a huge amount of money and a huge amount of stress when you've got a sick child," said Vicky, from the charity. "So to be able to have an international trial where a centre is open here in the UK would just be incredible."
At the moment, some parents choose not to seek treatment abroad: "It's a choice for parents to access this maintenance option because it's just not proven, and the problem with that is the NHS can't fund something that is not proven."
Katherine said while it would be too late for Teddy she would be pleased for the families that come after them.
"I feel really strongly that this vaccine offers a huge potential to save children's lives," she said.
"And if it could be trialled internationally across a large enough number of children you could get meaningful results that could prove it categorically works.
"And then to become a part of NHS treatment, that would be fantastic. Maybe the parents of children who get diagnosed in a few years' time, maybe they won't be having to do what we're doing." | Vaccine Development |
Our ability to pay attention to tasks -- a key component of our everyday lives -- is heavily influenced by factors like motivation, arousal and alertness. Maintaining focus can be especially challenging when the task is boring or repetitive.
"In many activities, it is difficult to maintain a high level of focus over time. Our research asks why this is the case," said Matthew K. Robison, assistant professor of psychology at The University of Texas at Arlington.
He and colleagues at the University of Oregon have published a new study on maintaining attention in the peer-reviewed journal Attention, Perception & Psychophysics.
"Our results provide evidence that a simple and easily implementable change in behavior -- setting specific goals for oneself -- can significantly improve our ability to maintain task focus over time," Robison said. "This can have implications for settings such as studying or working, where a failure to stay focused can lead to impaired performance."
Although humans generally perform fine in situations that require sustained attention, they are often distracted, which can lead to lapses in attention. Common distractions can be anything from thinking about a new romantic interest to reacting to a car honking.
Most attention lapses have minor consequences like forgetting to forward an email or pick up an item at the grocery store. However, other lapses can lead to serious repercussions, such as a train operator not reacting to an incident, a surgeon forgetting a step in an operation or an individual forgetting to turn off an oven.
Sustaining attention can be easier said than done, as attention fluctuates across short and long intervals, Robison said. One of the most common approaches to studying lapses in attention has been to examine response time to a variety of tasks.
For this study, Robison and colleagues recruited more than 100 participants to complete reaction time tasks for about 25 minutes. In a standard control condition, participants were simply told to respond as quickly as possible on each trial (about 200 total). Collectively, the results suggest that goal-setting manipulations enhanced sustained attention and reduced lapses in attention.
"In this condition, reaction times systematically increased across time, consistent with the idea that task focus was decreasing," Robison said. "However, when we gave them specific goals to pursue and made those goals harder over time (e.g., keeping their reaction time below 450 milliseconds, then 400, then 350), they did not show that effect."
Collectively, the current results suggest that goal-setting techniques can help individuals better sustain their attention and reduce attention lapses.
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Receptionists at GP surgeries should not be a medical 'triage' service, campaigners claimed today.
Under an NHS drive to free up doctors' time, clerical staff have been trained as 'care navigators'.
Medical unions insist they play a key role in ensuring GPs focus on patients and not paperwork.
They ask patients ringing practices about why they're contacting — with the aim of signposting them to the correct place. Practices argue this is not clinical triage and that patients can still bypass them to speak to a GP or health professional instead.
Dennis Reed, of Silver Voices — which represents senior residents, told MailOnline: 'It's all very well saying it's efficient to have them "triage".
Mr Reed added: 'They don't necessarily know what lies behind a basic description of a symptom whereas a doctor will.'
The call comes after MailOnline revealed that receptionists now outnumber GPs at practices in England, with levels spiking in recent years.
He also said patients were often left worried their illnesses were not being taken seriously if receptionists told them the issue didn't need an urgent appointment.
'If you're talking to a receptionist, you're not confident that any reassurance that's being given is appropriate,' he said.
Mr Reed also decried receptionists giving patients an ultimatum to divulge their sometimes intimate or embarrassing symptoms to secure an appointment with a family doctor.
'The process is humiliating for older people,' he said.
However, medical unions have said primary care is actually suffering from a shortage of receptionists to deal with the level of queries from patients.
Union officials have said while they understand patients' frustration in delays to see a GP the abuse receptionists receive daily is unacceptable.
Mr Reed's call came as NHS data shows that only a quarter of all 143,000-plus staff working at surgeries across the nation are family doctors.
Nurses, healthcare assistants and admin staff, including receptionists, secretaries and call handlers, make up the rest of the workforce.
Brits are continuing to have to fight to get appointments with their family doctor — with many stuck in lengthy phone queues or simply unable to get through at all.
And those who manage to secure an appointment are facing battles to see their GP face-to-face.
Experts have blamed the crisis, which has seen patient groups describe the service as like a 'stretched elastic band ready to snap', on a rising population and shrinking workforce.
Many family doctors are choosing to retire in their 50s, move abroad or leave to work in the private sector because of complaints about soaring demand, paperwork and a toxic environment.
It means the number of patients per fully qualified GP has rocketed to its highest-ever level, with an average of 2,273 people scrambling for appointments with each family doctor – an increase of 15 per cent in five years.
Up-to-date NHS statistics show there were 39,782 full-time equivalent (FTE) receptionists across the country in December.
But there were only 36,686 FTE family doctors in the same month.
By comparison, there were almost 1,400 more GPs than receptionists in 2015, when NHS stats began.
The ratio has been slowly dropping since then, reaching parity in 2017 before rapidly deteriorating.
GPs, who are paid on average around £110,000, now only make up about 25 per cent of the workforce.
Admin staff — the bulk of which are receptionists — account for just over 50 per cent.
Nurses and other health professionals made up the rest.
FTE records total hours worked in each role — allowing a fairer comparison than pure headcount, which can count part-time staff on par with full-timers.
Mr Reed said the data was a sign of the 'sick situation' in England's primary care system.
'The number of GPs has fallen so low that there is a need for gatekeepers to try and police the number of appointments,' he said.
'It's a sign of the times that there's this broader need for gatekeepers to control access to GPs than the GP's themselves seeing patients.'
Mr Reed also said that patients are tired of receptionists being used as a GP triage service.
'It's all very well saying its efficient to have them triage but these aren't medically trained people, they don't necessarily know what lies behind a basic description of a symptom whereas a doctor will,' he said.
He added that while receptionists may tell a patient they did not need to see a doctor urgently older Brits were often left to fret if this was the correct advice for their health problem.
'If you're talking to a receptionist, you're not confident that any reassurance that's being given is appropriate,' he said.
Mr Reed also decried receptionists give patients an ultimatum to divulge their sometimes intimate or embarrassing symptoms to secure an appointment with a family doctor.
'The process is humiliating for older people,' he said.
NHS data for December also shows only 27,000 of the FTE GPs were fully qualified, with rest in training.
This means the ratio of fully qualified GPs to admin staff is even more dire.
Dr Mike Jones, researcher for the thinktank TaxPayers' Alliance, said the figures would frustrate patients struggling to see their GP.
'With huge pressure on the NHS, this smacks of misplaced priorities,' he said.
'NHS funds should be focused on employing clinical staff to meet patients' demands.'
Connor Axiotes, director of communications at another thinktank, The Adam Smith Institute, said the figures were another sign that GP system needed an overhaul.
'Our dysfunctional GP system needs reform,' he said.
'It's in such a bad place that it's even stopping people from wanting to become GPs in the UK.
'This means other areas of our already overstretched NHS are becoming even more overwhelmed.
'At the minute, GPs are perversely incentivised to have more patients signed up but to see them less.
'We want to see a GP system wherein those who need to see their GP can and do so quickly.'
He added that England should move to a system where patients paid to see a doctor directly, instead of through taxes.
'Those who need to see the GP urgently would get an appointment quicker. Rather than all patients having to pay by proxy - with both parties' precious time being wasted,' he said.
Professor Kamila Hawthorne, chair of the Royal College of GPs (RCGP) said: 'GPs work in multi-disciplinary teams, including both other healthcare professionals and non-clinical staff, such as practice managers and receptionists.
'All members of the GP team play an invaluable role in ensuring patients receive timely, safe and appropriate care.'
She added that while family doctors share patients' frustrations regarding appointments, they and other practice staff groups were blameless.
'It is not the fault of hard-working GPs and members of their practice teams, but due to decades of underfunding and poor resource planning,' she said.
'While the number of fully qualified, full-time equivalent GPs has fallen by 734 since 2019, the number of patients needing our care and the complexity of their health conditions has escalated.'
Professor Hawthorne added that RCGP is calling for the Government to commit to a GP workforce strategy as well as taking steps to 'cut unnecessary bureaucracy that takes GPs away from patient care.'
Speaking to MailOnline in January, Dr Kieran Sharrock, the British Medical Association England GP committee acting chair, said practices were actually suffering from a shortage of receptionists.
'Practice receptionists are trained 'care navigators' and will do all they can to get patients seen by the most appropriate professional in the most timely way possible,' he said.
'But alongside a shortage of GPs, many practices do not have enough receptionists to manage the incoming queries.'
He added that too many GP receptionists face abuse from frustrated patients over the phone, causing some to leave their jobs.
An NHS England spokesman said: 'Since 2019, over 25,000 new members of staff with direct patient care roles, such as pharmacists and physiotherapists, have started working in general practices, alongside more non-clinical, but public-facing workers such as receptionists.'
'Thanks to these expanded GP teams, record numbers of appointments are being delivered for patients, with the latest figures showing that more than 27million appointments took place in December 2022 – up almost 12 per cent compared to before the pandemic.'
A Department of Health and Social Care spokesperson added: 'The number of doctors in general practice has risen by almost 500 in 2022 compared to 2021 and is more than 2,000 higher than before the pandemic.'
'The Health and Social Care Secretary is focused on ensuring resources are targeted to improve care for patients, funding is directed to frontline services and the NHS operates as effectively and efficiently as possible.
'Since 2019 we have recruited over 25,000 additional staff into various roles in general practice and we are ahead of schedule to hit the 26,000 target for primary care staff by March 2024.'
NHS data analysed by MailOnline includes an estimation for some GP practices that did not provide fully valid staff records.
However, these estimations only account for 2 to 9 per cent of the total number of practices analysed, depending on the year. | Health Policy |
Legalise Cannabis MPs are launching a coordinated push to make marijuana legal for personal use in three states and overhaul what the party says is outdated legislation that unnecessarily criminalises people.
The party’s drug reform bill will be introduced on Tuesday in state parliaments in Victoria, New South Wales and Western Australia – the jurisdictions where it has representation in the state’s upper houses.
Legalise Cannabis says it is the first time the same bill has been introduced across three states on the same day. The reform, which would allow adults to possess and grow small quantities of cannabis at home, is similar to ACT’s model that came into effect in 2020.
Rachel Payne, a Victorian Legalise Cannabis MP, said the bill encouraged state governments to be on the “the right side of history when it comes to cannabis law reform”.
She said longstanding prohibition meant Australians were criminalised for consuming cannabis, which was particularly prevalent among First Nations people, who are over-represented in the criminal justice system.
“These laws are currently causing real harm and we should as a society come together to prevent any further harm,” she said.
The Legalise Cannabis NSW MP Jeremy Buckingham said the party wanted consistency on cannabis across Australia to ensure there was a national debate about responsible use of the drug.
“At the moment each state has a set of laws that are being deregulated – that’s the trajectory of cannabis law reform. But in a very ad hoc way,” he said.
Buckingham said he believed cannabis law reform was inevitable in NSW. He pointed to previous commentary by NSW premier Chris Minns, who in 2019 when in opposition argued for the legalisation of cannabis. Minns ruled out decriminalisation in the lead-up to the March state election.
Payne, Buckingham and Legalise Cannabis WA MP Dr Brian Walker will introduce the bill in their respective parliaments on Tuesday.
The party calls for states to amend existing legislation to make it legal for adults to possess small quantities of cannabis for personal use and cultivate a maximum of six cannabis plants for personal use.
Titled “Regulation of Personal Adult Use of Cannabis Bill 2023”, the bill would also allow an adult who is lawfully in possession of cannabis to gift the drug to another adult. It would not allow people aged under 18 to access the drug and would make no changes to the offence of selling cannabis.
The reform is similar to the ACT’s reforms that came into effect in 2020. Under the territory’s legislation, an adult can lawfully possess up to 50g of dried cannabis or up to 150g of fresh cannabis, grow up to two cannabis plants per person (a maximum of four plants per household) and use cannabis in a household.
Payne pointed to a recent study that concluded there was no evidence that cannabis use had a significant effect on the incidence of psychosis for people at high risk of psychosis.
The authors of that report, published in the Psychiatry and Clinical Neuroscience journal, noted their findings were not consistent with epidemiological data linking cannabis use to an increased risk of developing psychosis.
The researchers said they could not exclude the possibility that an association between cannabis use and transition to psychosis might have been evident if the follow-up period had been longer than two years. But they said most transitions to psychosis occurred within the two-year timeframe.
The Victorian premier, Daniel Andrews, has previously said he has no plans to legalise marijuana beyond medical use, saying drug-induced psychosis was a “significant” issue for some in the community. | Health Policy |
A junior doctor said NHS workers who had taken strike action for a pay rise had struggled with "enormous" workplace pressures and financial difficulties.
Dr Shivam Sharma, from Birmingham, said he was worried for the future of the healthcare system after seeing an increase in patient waiting times.
It comes as thousands of junior doctors across England took to picket lines for three days of industrial action.
More than 36,000 NHS workers are striking from Monday until Thursday.
Members of British Medical Association (BMA) in England has asked for a pay rise of 35% however the government said the union's demands were "completely unaffordable".
The BMA called it "pay restoration" and claimed staff had seen pay cuts of 26% since 2008.
Dr Sharma, who is in his fourth year working as a doctor after graduating from the University of Birmingham, is a member of BMA Junior Doctor committee.
Currently working on a geriatric ward, he said he had seen many patients tended to in the corridors of the hospital.
"I think it's really becoming more and more tough, I've never seen it this bad," he said, adding the doctors work on average about 48 hours a week but sometimes as many as 72.
He was worried for the future of the healthcare system, he said, adding the average waiting time for patients to be seen was now 12 hours.
More pay and better working conditions would allow doctors to retain a work-life balance and would allow them to deliver the care they wanted to deliver, he said, adding taking industrial action was a "last resort" for doctors.
The term junior doctor covers a huge variety of roles, from those just graduating from university, to others with years of front-line experience.
The BMA's campaign focuses on the £14 per hour starting salary, although that quickly rises for anyone entering the profession.
There are five core pay points in the junior doctor contract. By the end of training they will be earning around £28 an hour in basic salary - although this can take 10 years to get to.
Junior doctors, including those fresh out of university, also receive an additional 30% more in extra payments, on average, for things like working unsociable hours.
Health Secretary Steve Barclay said he valued the hard work of junior doctors and that he wanted unions to "come to the negotiating table" to enter formal talks.
Outside the Queen Elizabeth Hospital in Birmingham Naomi Collier, a junior doctor with four years' experience, said she was moving to Australia on Wednesday.
Doctors like her are choosing to work elsewhere for better pay, and ultimately, a better work-life balance, she said.
"I've always wanted to visit Australia, but because we have a structured training programme in the NHS, I'm at a point where it's the only natural break I can really see, before going on to train for eight years to become a consultant.
"I think I would be speaking for quite a few people if I say the last few years have been full of burnout."
An NHS spokesperson said patients should not be put off from seeking emergency care during strike action.
Patients have also been told to continue to attend appointments unless advised otherwise. | Health Policy |
Jason Bleak runs Battle Mountain General Hospital, a small facility in a remote Nevada gold mining town that he described as “out here in the middle of nowhere.”
When several representatives from private health insurance companies called on him a few years ago to offer Medicare Advantage plan contracts so their enrollees could use his hospital, Bleak sent them away.
“Come back to the table with a better offer,” the chief executive recalled telling them. The representatives haven’t returned.
Battle Mountain is in north-central Nevada about a three-hour drive from Reno, and four hours from Salt Lake City. Bleak suspects insurance companies simply haven’t enrolled enough of the area’s seniors to need his hospital in their network.
Medicare Advantage insurers are private companies that contract with the federal government to provide Medicare benefits to seniors in place of traditional Medicare. The plans have become dubious payers for many large and small hospitals, which report the insurers are often slow to pay or don’t pay.
Private plans now cover more than half of all those eligible for Medicare. And while enrollment is highest in metropolitan areas, it has increased fourfold in rural areas since 2010. Meanwhile, more than 150 rural hospitals have closed since 2010, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. Largely rural states such as Texas, Tennessee, and Georgia have had the most closures.
Medicare Advantage growth has had an outsize impact on the finances of small, rural hospitals that Medicare has designated as “critical access.” Under the designation, government-administered Medicare pays extra to those hospitals to compensate for low patient volumes. Medicare Advantage plans, on the other hand, offer negotiated rates that hospital operators say often don’t match those of traditional Medicare.
“It’s happening across the country,” said Carrie Cochran-McClain, chief policy officer of the National Rural Health Association, whose members include small-town hospitals.
“Depending on the level of Medicare Advantage penetration in individual communities, some facilities are seeing a significant portion of their traditional Medicare patient or beneficiary move into Medicare Advantage,” Cochran-McClain said.
Kelly Adams is the CEO of Mesa View Regional Hospital, another rural hospital in Nevada. He said he applauds Battle Mountain’s Bleak for keeping Medicare Advantage plans out of his hospital “as long as he has.”
Mesa View, which is a little more than an hour’s drive east of Las Vegas, has a high percentage of patients enrolled in Medicare Advantage plans.
“Am I going to say I’m not going to take care of 40% of our patients at the hospital or the clinic?” Adams said, adding that it would be a “tough deal” to be forced to reject patients because they didn’t have traditional Medicare.
Mesa View has 21 Medicare Advantage contracts with multiple insurance companies. Adams said he has trouble getting the plans to pay for care the hospital has provided. They are either “slow pay or no pay,” he said.
In all, the plans owe Mesa View more than $800,000 for care already provided. Mesa View lost about $1.3 million taking care of patients, according to its most recent annual cost report.
NRHA’s Cochran-McClain said the growth in the plans also narrows options for patients because “the contracting that is happening under Medicare Advantage frequently has an influence on steering patients to specific types of providers.” If a hospital or provider does not contract with a Medicare Advantage plan, then a patient may have to pay for out-of-network care. That generally wouldn’t happen with traditional Medicare, which is widely accepted.
At Mesa View, patients must drive to Utah to find nursing homes and rehabilitation facilities covered by their Medicare Advantage plans.
“Our local nursing homes are not taking Medicare Advantage patients because they don’t get paid. But if you’re straight Medicare, they’d be happy to take that patient,” Adams said.
David Allen, a spokesperson for AHIP, an industry trade group formerly known as America’s Health Insurance Plans, declined to respond to Bleak’s and Adams’ specific concerns. Instead, he said enrollees are signing on because the plans “are more efficient, more cost-effective, and deliver better value than original Medicare.”
Centers for Medicare & Medicaid Services press secretary Sara Lonardo said CMS has acted to ensure “that private insurance companies are held accountable for providing quality coverage and care.”
The reach of private Medicare Advantage plans varies widely in rural areas, said Keith Mueller, director of the Rural Policy Research Institute at the University of Iowa College of Public Health. If recent trends continue, enrollment could tip to 50% of all rural Medicare beneficiaries in about three years — with some regions like the Upper Midwest already higher than 50% and others lower, such as Nevada and the Mountain States, but trending upward.
In June, a bipartisan group of Congress members, led by Sen. Sherrod Brown (D-Ohio), sent a letter urging federal agencies to do more to force Medicare Advantage insurers to pay health systems what they owe for patient care.
In an August response, CMS Administrator Chiquita Brooks-LaSure wrote that a final rule issued in April made “impactful changes” to speed up care and address concerns about prior authorization — when a hospital and patient must get advance permission for care to ensure it will be covered by an insurer. Brooks-LaSure noted another proposed rule that, once finalized, could mandate that insurers provide specific reasons for denying care within seven days.
Hospital operators Adams and Bleak also want more federal action, and fast.
Bleak at Battle Mountain said he knows Medicare Advantage plans will eventually move into his area and he will have to contract with them.
“The question is,” Bleak said, “how can we match the reimbursement so that we can sustain and keep our hospitals in these rural areas viable and strong?” | Health Policy |
WASHINGTON — White House Press Secretary Karine Jean-Pierre spoke to FOX4’s John Holt Tuesday after Biden announced the 10 drugs pharmaceutical companies must negotiate their prices on for people on Medicare.
The goal, cut costs for seniors and taxpayers.
Republicans call it a ploy to buy votes as President Joe Biden seeks re-election. But patients who could benefit may not care “who’s” behind it, as what it could mean for them.
“The President did something that leaders have been trying to do for 33 years, and that is beat Big Pharma,” Jean-Pierre said Tuesday.
The drugs the Centers for Medicare and Medicaid Services chose were: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and NovoLog.
A local registered nurse FOX4 talked to also said that Medicare will often not cover these types of drugs because they’re so expensive, and the drugs they will cover won’t work as well on the patients she sees.
“And where that really hurts our population is that then these patients are getting to where they have to make the choice or, ‘Am I paying for groceries, or am I paying for my insulin or my depression medication?” Mercy & Truth Registered Nurse Christina Dryer said in an interview with FOX4 Tuesday.
Dryer is also the Clinic Manager for Mercy & Truth. The group provides care for people who are insured, but they may not be able to get the medical care that they need. Dryer says a list of patients she’s seen in the past have had to use the blood thinner Warfarin, but it’s not on President Biden’s list like Eliquis and Xarelto.
“The problem with that medication is if you eat certain foods, it alters the level of medication,” Dryer continued. “But Medicare and Medicaid would not cover Eliquis or Xarelto, which do not need monitoring. Warfarin needs monitoring three times a week at minimum.”
The move faces litigation though from drug makers. Companies that people refuse to be a part of the negotiation process will face heavy taxes.
“Let’s be really clear John. So, for the past couple of decades, these pharmaceutical companies have paid hundreds of millions of dollars per year to make sure that Medicare was not able to negotiate to lower costs for Americans,” Jean-Pierre said when asked whether the rule from President Biden’s administration will be struck down in the courts on the grounds of The Eighth Amendment.
You can watch Holt’s full interview with Jean-Pierre Sunday, Sept. 3 on “4 The People.” It airs at 10 a.m. right after FOX News Sunday. Negotiations for these drugs will take place later this year and next. The new prices won’t go into effect until 2026. | Health Policy |
Britain's medicines regulator has authorized the world's firsttreatment for , 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, which won its makers a
Casgevy — made by the(Europe) Ltd. and CRISPR Therapeutics — was approved by the agency for the treatment for patients with sickle cell disease and thalassemia who are 12 years old and over.
To date, bone marrow transplants, extremely arduous procedures 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— which is particularly common in people with African or Caribbean heritage — 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. 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.
Patients first receive a course of chemotherapy, before 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. Patients must be hospitalized at least twice — once for the collection of the stem cells and then to receive the altered cells.
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 can cost millions of dollars and experts have previously raised concerns that they could remain out of reach for the people who would benefit most.
Last year, Britain approved a gene therapy for a fatal genetic disorder that had a list price of £2.8 million ($3.5 million). England's National Health Service negotiated a significant confidential discount to make it available to eligible patients.
Vertex Pharmaceuticals said it had not yet established a price for the treatment in Britain and was working with health authorities "to secure reimbursement and access for eligible patients as quickly as possible."
In the U.S., Vertex has not released a potential price for the therapy, but a report by the nonprofit Institute for Clinical and Economic Review said prices up to around $2 million would be cost-effective. By comparison, research earlier this year showed medical expenses for current sickle cell treatments, from birth to age 65, add up to about $1.6 million for women and $1.7 million for men.
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 isby the U.S. Food and Drug Administration; the agency is expected to make a decision early next month, before considering .
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.
Dr. Jon LaPook has reported on another effort to harness gene therapy to cure sickle cell disease. Watch that story in the video below:
for more features. | Drug Discoveries |
State and local health officials across the United States are bracing for a rise in respiratory illnesses this fall, and they are making plans to urge everyone who is eligible to get vaccinated against Covid-19, flu and respiratory syncytial virus once those shots become available.
“We are very, very concerned about the upcoming pan-respiratory season,” Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials, said in a briefing Wednesday.
Local health departments will work with their state and federal counterparts to encourage eligible people to get their flu shots, updated Covid-19 boosters and RSV vaccines, says Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials.
“The focus for the fall will be clear and integrated messaging, especially for people who are most at risk, because we’re talking about a unique new normal of coexisting respiratory viruses,” she said. “There’s conscientious thought being given to how to communicate this. It’s really about public health and keeping everybody safe during a season when respiratory diseases happen.”
On a national scale, the US Centers for Disease Control and Prevention also is preparing for the threat of respiratory illnesses this fall.
“Protecting against respiratory diseases this fall is a central focus for CDC. Efforts will include preparing Americans for what to expect, helping them understand the risk for illness in their communities, and providing information on how they can protect themselves,” spokesperson Kathleen Conley said in an email. “CDC will use every lever at its disposal to help people understand how they can protect themselves and their families from serious illness, including staying up to date on their vaccinations.”
Getting vaccinated before Halloween
Some major US pharmacy chains have begun rolling out flu and RSV vaccine appointments, and an updated Covid-19 booster shot could be ready by the latter part of September.
Health officials recommend that adults 60 and older get vaccinated against RSV as soon as their doctors advise doing so, and everyone older than 6 months is urged to get their flu shots, preferably by Halloween — an approach called “flu before boo.”
As for the new Covid-19 booster, health officials are waiting for the US Food and Drug Administration to officially approve it and then for the CDC to make recommendations on it. But they plan to recommend Covid-19 boosters before Halloween as well.
“I don’t think it’s unreasonable to think of Covid-flu before boo,” Dr. Manisha Juthani, commissioner of the Connecticut Department of Public Health, said during Wednesday’s briefing. “For many people, we really want to make this easy and simple.”
She added that the flu shot and the updated Covid-19 vaccine, when it’s available, may be given at the same time for people who might want to have a single appointment.
“There is not a single vaccine that is going to be 100%. But having said that, the efficacy of these vaccines is so high in preventing some of our worst outcomes that that is the main thing we want to drive home,” Juthani said. “And that is going to make a difference in the overall health of a person who receives them.”
Where to get vaccinated this fall
Pharmacies and doctor’s offices will continue to offer flu, Covid-19 and RSV vaccines this fall, but some states are also considering organizing vaccination events.
“One of the other lessons that we learned from Covid is that you can’t wait for people to come to you. You have to really make an effort to go meet them where they’re at,” Dr. Joseph Kanter, state health officer and medical director at the Louisiana Department of Health, said during Wednesday’s briefing.
“As we looked at the back-to-school season, we’re leveraging one of the more effective programs we had during Covid, which is bringing vaccine out to people. We have teams that we instituted during Covid that we’re now leveraging for flu and RSV, to go out into the communities and host vaccine events at convenient locations for families,” he said. “We’re going to continue those campaigns because we know we need to reduce barriers wherever we find them, and we can help bring vaccines to people.”
Walgreens, Rite Aid and CVS are among the major US pharmacy chains that have begun rolling out flu and RSV vaccine appointments already.
Walgreens is now offering both shots, the company said last week. Anyone 3 or older can get a flu shot at the pharmacy, and adults 60 and older are eligible for the RSV vaccine.
Rite Aid also plans to announce availability of those vaccines soon, according to a company spokesperson.
CVS is scheduling flu vaccinations, as well as allowing walk-in vaccinations at certain pharmacies. The chain is also preparing to offer the new RSV vaccines.
Those chains have said they will offer the new Covid-19 boosters once they’re available.
Entering ‘uncharted territory’
Although it’s hard to predict exactly how much flu, Covid-19 and RSV infections the United States may see this fall and winter, state health officials said they’re putting plans in place now to prepare for possible surges.
“We’re in uncharted territory. We don’t really know what this season is going to look like, and it’s going to look different in different areas of the country,” Juthani said.
“One of the things we are doing in Connecticut is meeting with our children’s hospitals, understanding what their plan is going to be for if we see a surge starting this fall,” she said, referring specifically to RSV preparations. “So this is the type of planning that happens at the state level across the United States.”
As health officials plan for the worst but hope for the best, they are closely monitoring data on how many respiratory illnesses are now being reported in the United States – as well as viral spread in the Southern Hemisphere and around the world.
“We are all watching closely the respiratory season. It’s something that state health officials are always preparing for every fall, particularly this fall,” Dr. Anne Zink, chief medical officer for the state of Alaska and president of Association of State and Territorial Health Officials, said during Wednesday’s briefing.
“Flu continues to circulate. We’re watching closely what’s happening down in the Southern Hemisphere right now. Last year, we saw over 9 million illnesses, 4 million medical visits, 10,000 hospitalizations and 5,000 deaths are associated with influenza,” she said. “However, we did see that vaccine prevented 1.8 million of those illnesses, 1 million of his medical visits, 22,000 hospitalizations and 1,000 deaths.”
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Each year, she noted, RSV appears to cause about 2.1 million hospital visits for children younger than 1 and up to 300 pediatric deaths. Among adults, RSV causes up to 160,000 hospitalizations and 10,000 deaths a year.
Also, “we continue to see Covid,” Zink said. “It continues to spread and be around.”
Covid-19 was associated with about 244,000 deaths in the United States last year, according to CDC data.
A report released last year by the Commonwealth Fund found that in the first two years that Covid-19 vaccines were available in the United States, they kept more than 18 million people out of the hospital and saved more than 3 million lives.
CNN’s Amanda Musa contributed to this report. | Vaccine Development |
For decades, Rose Stone counted on the Alliance HealthCare System in rural Holly Springs, Mississippi, for her medical needs. But after she retired and signed up for a Medicare Advantage plan, she was surprised to learn it didn’t cover her visits to nonprofit Alliance, the only health-care provider within 25 miles. Stone had a choice: use her own money to keep seeing her regular doctor or drive out of town to see a physician she didn’t know but whose costs were covered.
“It was a mess,” Stone told NBC News. “I didn’t go to the doctor because I was going to have to pay out-of-pocket money I didn’t have.”
Some 31 million Americans have Medicare Advantage plans, private-sector alternatives to Medicare introduced in 2003 by Congress to encourage greater efficiency in health care. Just over half of Americans on Medicare are enrolled in one of the plans offered by large insurance companies, including UnitedHealthcare and Humana.
Problems are emerging with the plans, however. Last year, a federal audit from 2013 was released showing that 8 of the 10 largest plans had submitted inflated bills to Medicare. As for the quality of care, the Medicare Payment Advisory Commission, a non-partisan agency of Congress, said in a March report that it could not conclude Medicare Advantage plans “systematically provide better quality” over regular Medicare.
Even worse, because the plans routinely deny coverage for necessary care, they are threatening the existence of struggling rural hospitals nationwide, CEOs of facilities in six states told NBC News. While the number of older Americans who rely on Medicare Advantage in rural areas continues to rise, these denials force the hospitals to eat the increasing costs of care, causing some to close operations and leave residents without access to treatment.
“They don’t want to reimburse for anything — deny, deny, deny,” Dr. Kenneth Williams, CEO of Alliance HealthCare, said of Medicare Advantage plans. “They are taking over Medicare and they are taking advantage of elderly patients.”
Williams is something of a local hero in Holly Springs. When the area hospital was in danger of closing in 1999, he marshaled resources and bought it to keep it open. Alliance serves a county with 38,000 people.
Still, this spring he had to shut down a long-time geriatric psychiatry program that had served the community for over eight years. Coverage denials from Medicare Advantage plans killed the program, Williams said.
Medicare Advantage plans are sold assiduously by celebrity pitchmen — one is Joe Namath — as a better way for Americans who qualify for Medicare to get insurance coverage. Many plans add services such as dental and hearing care and wellness programs not offered under traditional Medicare, for which beneficiaries pay extra.
The U.S. government pays most of beneficiaries’ premiums to the insurers offering the plans.
If the government hoped Medicare Advantage plans would reduce the costs of care, that has not been the outcome. Medicare pays the plans 6 percent more than it would spend if plan enrollees were covered under regular, fee-for-service Medicare, the MedPAC report found. Medicare payments to the plans will total $27 billion more in 2023 than if patients were enrolled in traditional Medicare, the report projected.
A new enrollment period for the plans began this month. State insurance commissioners told NBC News they, too, receive many complaints from customers saying they were sold Medicare Advantage plans without understanding their limitations. A major complaint, said Mike Chaney, the Mississippi Insurance Commissioner: “Consumers are not aware their doctors are likely to change under the Medicare Advantage plans.”
‘We can’t pay our bills’
Medicare Advantage plans have grown in popularity in recent years, with enrollment more than doubling nationwide since 2013. One explanation: The plans are often cheaper than paying for a Medicare supplement, sometimes referred to as Medigap.
Another reason for the growth may be the significantly larger commissions the government pays to brokers selling Medicare Advantage plans. In 2024, the Centers for Medicare and Medicaid will pay brokers a commission of between $611 and $762 for the first year of a Medicare Advantage plan, depending on the state, and roughly half that on annual renewals. On Medicare supplements, by contrast, CMS will pay just $100 in initial commissions and $50 a year on renewals.
Brokers selling the so-called advantage plans aren’t the only ones making money on them. UnitedHealth Group, the largest Medicare Advantage provider with 7.6 million people in its plans, generated $257 billion in premium revenues in 2022, some 13% over the previous year. A significant driver of that growth was its Medicare Advantage plans, the company’s financial filings said. Humana, the next largest provider, counts 5.3 million Medicare Advantage customers; during the six months that ended June 30, almost 80% of Humana’s $51 billion in premium revenues came from individual Medicare Advantage plans, its filings show.
Meanwhile, CEOs of rural nonprofit hospital systems in Arkansas, Colorado, Mississippi, Missouri, South Dakota and Texas told NBC News that Medicare Advantage plans repeatedly refuse to reimburse them for the care they provide. Some 170 rural hospitals are at risk of closing in those six states alone, according to a report from the Center for Healthcare Quality and Payment Reform, a nonprofit advocacy organization.
While there are multiple reasons for rural hospitals’ financial woes, coverage denials from Medicare Advantage plans play a big part, said Harold Miller, president of the Center that conducted the study. For years, Medicare Advantage plans had been rare in rural areas, now they are becoming ubiquitous. In 2022, enrollment in Medicare Advantage plans grew 13 percent in rural areas versus 7 percent in urban zones, according to the MedPAC report.
Mary Beth Donahue, president of the Better Medicare Alliance, an advocacy group that supports Medicare Advantage plans, said in a statement: “We acknowledge the challenges facing some health systems, but we need to ensure coverage is maintained for millions of seniors. As Medicare Advantage continues to grow, it is essential that hospitals provide access for seniors and people with disabilities who rely on this program.”
A UnitedHealthcare spokeswoman said in a statement, “Over 6,000 hospitals participate in our UnitedHealthcare network, and we have built collaborative relationships with them to help ensure we are meeting our shared goal of providing quality care to the people we serve.”
By law, Medicare Advantage plans are supposed to base their reimbursements on Medicare rules. But there’s room for interpretation, says the Department of Health and Human Services. For example, insurers can use their own clinical criteria to determine whether to authorize or pay for care. A report last year by the department’s Inspector General found that in June 2019, the 15 top Medicare Advantage plans denied authorization for 13 percent of claims that had met Medicare rules. The plans also denied payment for 18 percent of claims that met Medicare coverage and billing rules, the report said.
Even when the plans pay, they reimburse providers far less than traditional Medicare, rural hospital CEOs and doctors told NBC News. The plans are effectively rationing health care, these providers said.
For example, the hospital officials cited specific cases in which plans take a week to approve care but agree to pay only for a three-night stay; deny coverage after approving it, clawing money back from hospitals; or contend a provider is “out of network” when it isn’t. They also deny routine tests and refuse to pay for rehabilitation, saying patients should go home before their doctors think it’s wise.
“Any study we order — X-ray, CT scan, MRI, stress tests — they’re going to deny,” said Craig Pendergrass, a doctor at Ozarks Community Hospital, a nonprofit critical access hospital in Gravette, Arkansas, in the northwest corner of the state. “With straight Medicare we just schedule it.” He estimated that his staff spends one-quarter of each week trying to persuade the plans not to deny the tests or treatment.
Large hospital systems with big staffs can dedicate time and energy to fighting claims denials, the American Hospital Association says. Small rural hospitals cannot. In response, some smaller systems are starting to reject Medicare Advantage plans. This summer, Jason Merkley, chief executive of Brookings Health System, a highly rated nonprofit hospital chain in South Dakota, stopped accepting the plans because of coverage denials and pre-authorization problems. Only a small percentage of the system’s patients had Medicare Advantage plans, Merkley told NBC News, but the effort required to battle the denials was considerable.
A Humana spokesman provided this statement: “In our Medicare Advantage hospital contracts, Humana pays rates, on average, that are above fee-for-service Medicare rates. Moreover, the fee-for-service Medicare reimbursement model is focused on patient volume and the quantity of services provided, whereas we are focused on delivering better outcomes for patients.”
In mid-September, Samaritan Health Services, a five-hospital system in Oregon, said it ended its contract with UnitedHealthcare, including its Medicare Advantage plans. “United Healthcare’s processing of requests and claims has made it difficult for Samaritan to provide timely access to the appropriate care to United’s members,” the system said.
Refusing to accept Medicare Advantage plans is not an option for hospitals with many plan customers and whose facilities are the only ones in their rural areas, the CEOs say. If they stopped accepting the plans, their communities would have to forego local health care.
“We’re a system with a proud history of taking all patients, insured or not,” said Paul Taylor, CEO of the 25-bed Ozarks Community Hospital. “But this makes it really difficult for us to continue to care for at-risk patients. We can’t pay our bills.” Medicare Advantage plans make up 40% of his reimbursements now, up from 20% a few years ago, he said.
Taylor recently conducted a two-year study of what his hospital received treating traditional Medicare patients versus what it received from Medicare Advantage plans. He found that the plans paid $4.5 million less than he received under Medicare for the same treatments. That’s roughly what his facility generates in revenues each month.
Ozarks Community, which serves approximately 30,000 people, narrowly averted a bankruptcy filing this spring, Taylor said. He is selling assets to stay afloat.
$29,458 of care denied
In late August, a patient with chronic obstructive pulmonary disease and Covid arrived at San Luis Valley Health Regional Medical Center, a 49-bed, level 3 trauma center in Alamosa, Colorado. The nonprofit hospital serves a six-county region in south central Colorado that’s home to about 50,000 people. Roughly the size of Delaware, the area is one of the poorer in the state, said Konnie Martin, San Luis Valley Health’s chief executive.
The doctor handling the patient recommended admitting her to the hospital, but her UnitedHealthcare Medicare Advantage plan balked. They agreed to pay only for “observation” of the patient, a lower standard of care that generates much smaller reimbursements.
The facility went ahead and treated her as an inpatient for two weeks, a stay that cost $29,458, all of which San Luis Valley Health absorbed, it said. Had the Medicare Advantage plan agreed to cover the claim, it would have paid one-third, the hospital estimated.
“This is the norm — they push back on people to try to keep them out of the hospital or delay their hospital care,” Martin said. The hospital’s staff has to spend time resubmitting claims, she added, saying: “It costs us 2 or 3 times the amount of labor and investment to collect on one claim.” Her staff provided documentation of four recent denials of coverage by United Healthcare in one week.
The coverage denials the CEOs described to NBC News are similar to those found in last year’s Health and Human Services report. They included erroneous rejections of MRIs and CT scans, paying only for “observation” rather than inpatient care, denials of long-term acute care, rehab, lab tests and medical equipment.
The Inspector General said that “human error” and “system processing error” caused most of the denials by Medicare Advantage plans. But the hospital executives NBC News spoke with say they believe the denials are a strategy by insurers to improve their profits by refusing to pay claims.
“This world of medical billing is so automated if you’re denying a claim, you’re doing it intentionally,” said Martin, of San Luis Valley Health.
UnitedHealthcare declined to comment.
The Cuero Regional Health System, a small hospital in Cuero, Texas, serves a population of 22,000. Its officials say Medicare Advantage plans often deny care based on the insurers’ internal determinations about the type of care required, overruling the physicians handling the cases. When the hospital questions a determination — called a peer-to-peer review — officials often have to argue with a physician who doesn’t specialize in the care the patient requires, said Lynn Falcone, its chief executive.
A Medicare Advantage plan recently denied a referral to long-term acute care for a patient with sepsis, Falcone said. When the family practice doctor overseeing the case asked for a peer-to-peer review, the insurance company physician defending the denial was an ob-gyn specialist. “A surgeon that delivers babies maybe isn’t used to handling sepsis,” Falcone said.
‘It had to be extreme’
Sandra Tate of Cuero, Texas, said her family’s Medicare Advantage plan created problems for her family in Feb. 2022. Her husband required physical and respiratory therapy after a 10-day stay in the ICU at Cuero Regional Health, she said; although a previous plan from Humana had paid for this treatment four years earlier, the second request for reimbursement was denied under her new plan from United Healthcare. After arguing with the insurer for 30 minutes, Tate, a former school nurse, said she was never told why.
“I pay my Medicare premiums and also my insurance premiums,” Tate told NBC News. “I don’t understand why Medicare Advantage is not wanting to pay the rural hospitals that are taking care of you.”
The UnitedHealthcare spokeswoman said the company could not comment on Tate’s experience unless she signed a waiver; Tate declined to do so.
In its financial filings, United Healthcare describes how rates paid by the government on Medicare Advantage plans can fall below what the insurer calls its “cost trends.” To combat these profit pressures, the insurer said, it “can seek to intensify our medical and operating cost management” and “adjust member benefits.”
For eight-and-a-half years, Alliance HealthCare System's inpatient geriatric psychiatry program helped older patients in Holly Springs, Mississippi, with depression and other mental health issues. The 15-bed facility offered group and family therapy as well as an inpatient program that could run from one to three weeks, said Ejerra J. Selma Dukes, its former director.
Medicare always paid for the services, Dukes said. But a few years ago, she started seeing more patients with Medicare Advantage plans declining to pay. The insurers would reject claims for patients with depression and dementia, she said, agreeing to reimburse only for those who were suicidal, paranoid or homicidal. “It had to be extreme for them to say we will allow you all to bring them in,” Dukes told NBC News.
On March 28, the program closed its doors, Dukes said, a result of the denials. “It was heartbreaking, especially with those who had been dealing with us a long time,” she recalled. “You know you can help, but you can’t bring people in for free.”
Meanwhile, Rose Stone is once again receiving care at Alliance HealthCare System. She junked her Medicare Advantage Plan and returned to Medicare, with a supplement. “Everything is fine now,” she said. | Health Policy |
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It’s over three years now since a visibly chastened Boris Johnson emerged from his near-fatal brush with Covid to declare that he had seen the light.
He had, he said candidly, been “way overweight” when he got the virus and only now did he understand how vulnerable that had made him; so now he stood before us a changed man. There would be no more scoffing at Jamie Oliver, no more chuntering about nanny statism; instead, he promised not just a ban on junk food advertising or (yet another) national obesity strategy, but what looked positively like a national crusade, led by a prime minister who’d had his own battles with cheese and chorizo and wasn’t going to judge anyone else for raiding the fridge late at night.
And just for a moment it felt as if this might be his one useful contribution to public life; that paunchy, middle-aged men everywhere who hate being nudged to eat more salad might listen to him. (Almost two-thirds of British adults are either obese or overweight now, and for all the gimlet-eyed policing of women’s bodies, it’s men who are most likely to have piled on extra pounds.) The nation could have counted calories alongside him like a kind of giant communal Weight Watchers class, knowing we weren’t alone in occasionally falling off the wagon into a bowl of chips, and feeling supported to climb back up again. But as so often with Johnson, he said it and then seemingly clean forgot about it. And Britain did not build back fitter: quite the reverse.
Child obesity is up, not down, since lockdown. That promised ban on junk food advertising has been repeatedly delayed (it’s currently pencilled in for 2025) and Rishi Sunak has rebuffed calls to extend the sugar tax (though at least he didn’t scrap it, which Liz Truss might well have done had she stayed in Downing Street much longer).
This week the National Audit Office concluded that government targets to boost walking and cycling, in order to increase exercise while cutting car emissions, are likely to be missed. And there’s been barely any attempt to tackle the deeper root causes of obesity, from familiar ones like poverty to still poorly understood ones like the precise role played by ultra-processed foods (UPFs) – often high in fat, sugar or salt, and explicitly engineered to get you craving more. (Think of doughnuts, or anything where you finish one and inexplicably want another, in a way you wouldn’t with an apple; from sausages to crisps and breakfast cereals, UPFs now provide over half of the calories in an average British diet).
Instead, ministers are seemingly pinning their hopes on a trial of Wegovy, the British version of the heavily hyped new US weight loss drug Ozempic, reportedly now being eyed up in the Treasury as a relatively cheap and quick way of getting obese people off sickness-related benefits and into work, thus freeing up money just as the chancellor is desperately trying to find headroom for tax cuts.
The health secretary, Steve Barclay, was quick to play down that idea on BBC Radio 4’s Today programme, presumably because there are few things less likely to persuade people to try a new drug than the sneaking suspicion that they’re only doing it to make Jeremy Hunt’s life easier. While nobody doubts the economic or human costs of obesity, losing weight has to be something people want to do for their own good.
And in fairness, Wegovy may well be part of the answer. Originally developed to treat diabetes, it works by suppressing appetite; you stop wanting to eat much, so you don’t. Covert users who got hold of it early on private prescription are easily identified not just by the weight dropping off them, but by the telltale habit of disinterestedly pushing food around the plate like a 90s supermodel. But it’s not a magic bullet: it’s meant to work alongside, not replace, changes to diet and exercise, which is why in Britain it’s meant to be prescribed by specialist NHS weight management services who can help patients keep the weight off for the long term. Since there aren’t enough specialist clinics to treat the millions who could potentially benefit, however, the trial announced this week is designed to short-circuit all that and see if it can work with support from pharmacists or apps alone.
For anyone who has spent a life shuttling miserably from failed diet to failed diet, Wegovy could be transformative. It could save lives at risk of being lost to heart attacks or strokes, and prevent some chronic illnesses forcing people into painful premature retirement. But drugs don’t address the deeper social or emotional reasons that people overeat – and they don’t tackle the junk food industry that so many doctors argue is fuelling the problem.
Instead, they offer a sticking plaster solution to the underlying crisis, which is that too much of what we eat barely resembles food as we would once have recognised it – and that neither our daily lives nor our urban environment are yet geared to incentivising healthy behaviour.
At best, drugs tackle the damage only after it’s been done, which means they don’t magically erase the need for all those politically difficult preventive measures that for a fleeting moment three years ago, it looked as if the government was willing to confront. Weight loss injections or no weight loss injections, it’s political leadership on obesity that really needs a shot in the arm.
Gaby Hinsliff is a Guardian columnist | Drug Discoveries |
BBC presenter Naga Munchetty has told a committee of MPs that doctors told her to "suck it up" after experiencing extreme menstrual health problems.
Ms Munchetty and TV personality Vicky Pattison said GPs had repeatedly called their gynaecological symptoms "normal".
Both turned to private healthcare to have their conditions treated.
The pair were giving evidence to the Women and Equalities Committee as part of an inquiry into women's reproductive health.
Earlier this year, BBC presenter Ms Munchetty revealed she had adenomyosis, which affects the womb, but called the process of being diagnosed "so frustrating".
She had suffered debilitating symptoms, including excruciating pain and heavy menstrual bleeding, since her teens, with her husband even calling an ambulance because of the pain, she told the committee.
But the attitude of the GPs had been: "Those are your [treatment] options - and if they don't work for you, then suck it up."
'Crippling anxiety'
Ms Pattison was diagnosed with pre-menstrual dysphoric disorder (PMDD) diagnosis, after hearing about it during conversations on social media.
"For 10 days of the month, I was feeling really fatigued, suffering with insomnia, having crippling anxiety, terrible self-doubt, no passion for the things I normally loved," she said.
She had visited doctors around the country but always been told: "This is PMS [premenstrual syndrome]. This is what women go through. Every other woman in the world is dealing with this," making her feel "even more invalidated".
"Women's health, be it reproductive, sexual, everything, is given less gravity because we are just expected to get on with it, to suffer it, to be brave. It's got to change," Ms Pattison told the MPs.
Ms Munchetty said of seeking treatment privately: "It was the only time I felt I could sit there and take time and force an issue, force understanding, force explanations from my gynaecologist and not feel bad that I was taking up more than 10 minutes of my GP's time because there was a queue of people in the waiting room."
Both Ms Munchetty and Ms Pattison told the MPs that women must be properly listened to in the health service.
'Better understanding'
Ms Pattison said: "GPs, anyone within the NHS, any medical professionals at all, they just need to start to take women seriously when they say something's wrong.
"I know loads of brilliant women and I don't feel like we're the weaker sex at all. I feel like we're brilliant.
"I feel like we're strong and powerful and we put up with a lot more than blokes do most of the time.
"If we have got ourselves up and gone into a doctor's, a hospital, whatever, to say something's wrong, I feel like the least people can do is listen to her and believe that there is something wrong."
And "better knowledge, better understanding" about health issues affecting women specifically was needed.
After talking about adenomyosis publicly, Ms Munchetty said she had been approached by medical professionals who had never heard of the condition.
"There's not enough training, there's not enough focus in the medical profession on women," she said. | Women’s Health |
As the "triple threat" of COVID-19, influenza and RSV (respiratory syncytial virus) caused a spike in patients seeking medication in the winter of 2022, drug shortages were the highest they had been in five years, according to a March 2023 Senate report.
In terms of what caused the shortages, a new report from the Milken Center for Public Health in Washington, D.C., suggested those shortages stemmed from individuals and providers "panic-buying" more medications than they needed amid fear and confusion.
"During COVID, we were faced with a unique situation — a pandemic that we hadn't been faced with as a society for hundreds of years — and it did expose some fragilities," said report co-author Sarah Wells Kocsis, director of the Milken Center for Public Health, during an interview with Fox News Digital.
'Three-part epidemic’ triggered shortages
The convergence of COVID, flu and RSV led to a spike in demand for medications, Milken experts said.
"As respiratory illnesses spread across the country, social media and news media fueled a frenzy around rising cases and deaths, leading many households to stockpile cold and flu medications," stated Milken’s report, titled "Envisioning the Future of the Pharmaceutical Supply Chain to Advance Public Health in the United States."
"Alongside households, hospitals began stockpiling these medications, which made it difficult for pharmacies to get what they needed to meet community demands," the report added.
This stockpiling resulted in localized "spot" shortages of Tamiflu (the most popular flu medication in the U.S.) and albuterol (an asthma treatment that opens up the airways to facilitate breathing).
"Social media and news media fueled a frenzy around rising cases and deaths."
It also led to shortages in antibiotics such as amoxicillin and Augmentin.
"It’s commonly acknowledged that when respiratory viruses spread, antibiotics are often prescribed inappropriately … Although highly effective against bacterial infections, antibiotics are not effective against viruses," the report explained.
Stockpiling led to ‘artificial’ shortage
While it may have appeared that the supply chain wasn’t making enough medications to handle the influx of illness, the Milken report stated that the issue was caused by consumers buying more than they actually needed, causing an "artificial" shortage.
"I think it's very easy to immediately assume that the supply chain was broken or that people weren't doing their part," said Kocsis.
Kocsis believes the shortage was prompted by an increase in demand that caught some of the manufacturers off guard, which resulted in consumers and health care providers "stockpiling temporarily."
"These ‘spot shortages’ became a self-fulfilling prophecy, where the less [information] that was communicated about them, the more panic-buying there was," said one unnamed expert quoted in the report.
Dr. Shana Johnson, a physical medicine and rehabilitation physician in Scottsdale, Arizona, who reviewed the Milken report, is a bit skeptical about the claim that hospitals and households have stockpiled medications.
"These statements are not supported by any data or references," she told Fox News Digital.
Communication key to preventing shortages
To prevent stockpiles that can cause shortages, the Milken report calls for greater transparency across the supply chain, particularly in times of crisis.
"When people get panicked or they're unsure of information, that results in certain behaviors," Kocsis told Fox News Digital.
"I think it's very easy to immediately assume that the supply chain was broken."
"We need to work on more comprehensive communication — not only to those who are responsible for getting the medications to the dispensing point, but also deeper into the communities we serve," she added.
When distributors and manufacturers openly communicate the true state of supply and demand, the report said this would "better inform decisions to release public health stockpiles, help facilitate redistribution or provide alternative guidance when the recommended medications were unavailable."
It’s also important for health care providers and pharmacists to serve as "trusted messengers" in their communities, the report added.
Use of primary care doctors over hospitals
When the "three-part epidemic" hit communities, many parents took their sick children straight to hospitals instead of to their pediatricians — which could have played a part in the drug shortage, per Milken’s report.
"This was an inefficient, expensive way to get health care," the report said.
"Had the public health system encouraged patients to go to their primary care providers, they could have obtained clear, accurate information about appropriate levels of care and would have known how to prepare for and treat RSV, flu or COVID-19 symptoms."
For parents with young children, Kocsis stressed the importance of having a trusted relationship with their pediatricians to ensure that the appropriate medications are prescribed.
Johnson, however, questioned the statement about parents choosing hospital visits over primary doctors and noted that the statement is not supported by a reference or data.
"In my personal experience across two pediatrician offices in Washington and Arizona, pediatricians are particularly good at keeping kids out of the ER unless their vital signs are unstable," she told Fox News Digital.
"They had extended hours, special weekend hours and telemedicine visits. The message was ‘call us’ and they helped."
Overall, Kocsis said there is a need to consider the appropriate use of resources throughout the health care system.
"We need to think practically about where we channel our care and make sure people know where to show up when they need that care," she added.
The report stressed the need for health literacy education to "quell panic-buying, prevent artificial shortages and incentivize people to follow best practices when sicknesses are spreading."
Situation is improving, expert says
Milken’s Kocsis does see a light at the end of the tunnel.
"I think the situation is improving," she told Fox News Digital. "I think manufacturers have learned from that experience and are thinking more intentionally about anticipating increases in demand that might have caught them off guard before. They are more prepared now."
"The pandemic highlighted weak links in public health and medical supply chain logistics."
Johnson agreed that some opportunities have arisen from what she calls "COVID chaos."
"The pandemic highlighted weak links in public health and medical supply chain logistics," she told Fox News Digital.
"It’s an opportune time to use AI or other strategies to better monitor supply and demand variations, and to better anticipate need and move toward managing the supply chain as a single, integrated system," she added.
The doctor also noted that the pandemic stressed the need to provide the public with accurate, trusted information.
"For many, that source is not the government," she said. "Health care providers without special interests or upcoming elections are better messengers."
After completing this report, Kocsis said she feels more optimistic about the future of the pharmaceutical supply chain.
"We engaged with a diverse representation of stakeholders so we could really think about this and make sure all parties were represented, which is particularly important when you start thinking about underserved communities," she said.
"All the leaders I spoke with are deeply committed to doing the right thing." | Drug Discoveries |
Tens of thousands of patients in England face surgeries being cancelled this summer with consultants striking for 96 hours, after Steve Barclay ruled out an improved pay offer.
Routine care across the NHS will come to a virtual standstill from 7am on Thursday as consultant doctors and hospital-based dentists begin their first industrial action in a decade for 48 hours until 7am on Saturday.
The British Medical Association (BMA) had threatened to strike for another two days on 24 and 25 August but only if the health secretary refused to back down.
On Thursday Barclay defiantly announced that his offer of a 6% pay rise was “final”, meaning four days of chaos and mass cancellations now look inevitable.
“I am disappointed the BMA is going ahead with this week’s strike, given the average consultant’s NHS earnings are expected to increase to £134,000 a year,” he said.
“My door is always open to discuss non-pay issues, but this pay award is final so I urge the BMA to end their strikes immediately.”
More than 600,000 appointments, procedures and operations have already been missed, ditched or postponed in eight months of industrial action across the health service.
This week alone brought the longest period of industrial action in the history of the NHS by junior doctors. The five-day strike from last Thursday to Tuesday morning resulted in 101,977 appointments and procedures being cancelled, according to NHS England.
An even bigger impact was anticipated from consultants going on strike for four days, senior health sources said. That is largely down to two factors. First, consultants won’t be performing any operations themselves. But second, any planned care delivered by junior doctors or other healthcare professionals that requires even remote consultant supervision will also need to be rescheduled.
This means a significant amount of planned care involving junior doctors and other health workers, as well as consultants, will be affected, according to people familiar with the matter.
The NHS England medical director, Prof Sir Stephen Powis, warned patients this week that mass disruption was expected across the NHS as consultants move to providing just emergency cover.
For the next two days, the health service will be able to operate at the level of service usually seen on Christmas Day. Most outpatient appointments and elective surgeries such as hip and knee replacements and cataract removals will be cancelled and will have to be rescheduled for later in the year.
The public is still being told to dial 999 in life-threatening emergencies and to use NHS 111 online for other health concerns. GP services and pharmacies will also be running as normal.
Barclay on Thursday criticised consultants for going ahead with the strike despite him last week awarding them a 6% salary increase.
“I hugely value the work of NHS consultants, which is why we have accepted the independent pay review body recommendations in full, giving them a 6% pay rise this year, on top of last year’s 4.5% increase.”
Consultants say they have suffered a 35% drop in the real-terms value of their income since 2008-09 and are seeking “full pay restoration”.
The BMA published a new analysis on Thursday suggesting that consultant pay had fallen behind lawyers, architects and financial advisers over the past 14 years, with cash increases for those professions growing at six times the rate of NHS consultants.
The chair of the BMA consultants committee, Dr Vishal Sharma, said: “This dispute is not just about one year’s pay settlement, it is about the reality of 14 years of consultant pay falling behind, about a loss in our pay in real terms of 35% and the broken pay review system that has allowed this to happen.
“There is absolutely no justification for the wages of some of the country’s most senior doctors to not have kept pace with those of comparable professions.
“Consultants will stand on the picket lines today because we are angry and at rock bottom. This government is failing us, failing patients and failing to see ministers have the ability to stop the crisis unfolding in front of their eyes.” | Health Policy |
“I can’t breathe.”
A gasping declaration by a Black man under the knee of a cop that will go down in history and infamy, touching off worldwide protests against police brutality.
“We can’t breathe!”
A sobbing Iranian schoolgirl, sitting on the ground, back up against a wrought iron fence, as a man passes her a bottle of water, as seen on a video that has gone viral.
Poisoned. Among the more than 1,200 students — mostly girls, at schools segregated for girls — sickened by unidentified toxins released in their midst. Rushed by ambulance to hospital — watch them crying and moaning in their emergency department beds, all in a row, oxygen masks clutched to their faces. Symptoms include vomiting, burning eyes, neurological complications, shortness of breath, numbness and even paralysis of limbs.
A week ago, on one day alone, upwards of 200 schoolgirls fell ill at 17 schools in the northwestern city of Ardabil.
All of them are said to have recovered.
These suspected poisonous assaults began three months ago, in the holy city of Qom, rocketing recently to every province across the country. Many Iranians blame the incidents of schoolgirls on “revenge attacks” by religious fanatics, punishment for the protests — with teenage girls at the forefront — following the death in custody last September of 22-year-old Mahsa Amini, plucked off the street by the morality police for wearing her hijab improperly.
“They released gas, everyone is sick!”
On this, International Women’s Day — March 8 — where are the global demonstrations in solidarity with the girls and women who so bravely cast off their mandated hijabs, exposed the forbidden-to-be-seen hair in the theocratic Islamic Republic of Iran? If not in moral support of females who are simply demanding the choice to cover their heads or not — the anti-government protests haven’t abated, despite violent suppression by the regime — then right now, in outraged unanimity with these schoolgirls.
Tuesday, Iran’s Supreme Leader Ayatollah Ali Khamenei finally got around to condemning the “unforgivable’’ crimes. “If there are any people involved in the matter, and there certainly are … the perpetrators must be given the most severe of punishments,” said Khamenei, as translated by BBC Persian, which has been doing an admirable job of documenting the story in a nation immensely difficult for foreign journalists to penetrate and the national media rigidly state-controlled.
Government officials have spent the past three months denying there was anything nefarious afoot, utterly skeptical of a deliberate poisoning conspiracy, blaming foreign “enemies” and international media for inflaming the public and triggering a mass psychological illness, as if all these afflicted schoolgirls were suffering from mass hysteria or psychosomatic symptoms. “Over 99 per cent of this is caused by stress, rumour and psychological war started particularly by hostile TV channels, to create a stressful situation,” Majid Mirahmadi, the deputy interior minister, told state television.
No evidence of poisons has been publicly revealed, though in many of the stricken schools, girls recounted a smell of tangerines and chloride. Thus, with no clear cause of illness, at least not disclosed, it’s unclear who or what is behind the poisoning.
It was only last week, following a protest demanding answers organized by Iran’s teachers association, furious parents appealing to politicians for better protection for their children, and a claim to the Sunday Telegraph by the group Human Rights Activists it had counted 2,426 students poisoned at 69 schools, that officials even acknowledged the noxious miasma. The head of Iran’s parliamentary education committee revealed that toxicologists in the health ministry had identified toxins found in some of the schools as nitrogen gas, which has no odour. Others have speculated the substance is Tabun, a synthetic nerve agent with a faintly fruity smell that was deployed by Saddam Hussein in the Iran-Iraq war.
Deputy health minister Younes Panahi told a press conference that the motive appeared to be to prevent girls from attending schools, which raised alarm about the possible infiltration of Islamic extremist groups. Although “extremist”, in the Iranian context, is relative.
“They closed the school doors. I fainted in the corridor.”
Hardline president Ebrahim Raisi has now ordered an investigation. But we know from Iran’s coverup of the January 2020 downing of Ukraine International Airlines Flight 752 — killing all 176 aboard, including 55 Canadian citizens and 30 permanent residents, the plane allegedly mistaken for an American cruise missile — what Iranian investigations amount to.
Iran is not Afghanistan, where the Taliban has forbidden education for girls since resuming power after two insurgent decades of burning down schools and murdering teachers. It is by many measures a sophisticated and educated society. Since the Iranian Revolution in 1979, the totalitarian regime has taken no steps to repress education for females. In fact, women make up a majority of Iran’s university students and nearly half of the workforce, according to government statistics. They’ve been robustly active in civil society, fighting for women’s rights, no small challenge when misogyny is at the heart of theocracy.
Iran has squelched several public arisings over the decades but they’ve never before been confronted by such vocal and aggressive protests with women — schoolgirls — in the vanguard and undaunted by a lethal response from security forces, who’ve raided schools and arrested girls. Last October, security forces were accused of beating to death teenager Asra Panahi, after she refused to sing a pro-regime anthem. Officials insisted she died from chronic heart disease.
“They’re poisoning the girls, they’re all lying down on the ground, they’re chanting death to Khamenei.”
That crackdown has seen at least 530 people killed and 19,700 detained, according to Human Rights Activists. Under Islamic Sharia law, contravention of religious edicts — “enmity against God” the all-encompassing charge — has seen scores of dissidents and social media activists condemned to death. Iran’s execution spree reached 553 in 2022, according to Amnesty International, and 94 through January and February this year.
While one of the theories advanced about who’s behind the poisoning is that it’s the demonic work of a an extremist group called Fidayeen Velayat — roughly translated as “Devotees of the Guardianship” — which has purportedly declared that girls’ education “is considered forbidden” and threatened in the past to “spread the poisoning of girls throughout Iran” if girls’ school remained open, it’s understandable that many civilians have laid the blame directly at the doorstep of the regime as retribution for the girls-led hijab protests and an intimidation tactic, or at least tacitly sanctioned.
I’m loath to believe that, even of Iran’s reprehensible regime. But who knows how far the state would go when its iron-cast despotism is threatened?
Late Tuesday, Iran’s deputy interior minister announced that several arrests — the first — had been made in relation to the spate of poisoning. No details were provided.
“Where is my child! They’ve poisoned the students with gas!”
It’s so damnably hard being a girl. | Epidemics & Outbreaks |
A military veteran who received the first-ever whole-eye and partial-face transplant is speaking out about the life-changing surgery.
The recipient, 46-year-old Aaron James of Hot Springs, Arkansas, was working as an electrical lineman in 2021 when his face touched a live wire — and received a 7,200-volt electric shock.
As a result of the accident, James lost his left eye, most of his left arm, his nose and lips, his front teeth, his left cheek area and his chin, according to a press release from NYU Langone Health.
On May 27 of this year, James underwent a 21-hour surgery.
It was led by Eduardo D. Rodriguez, M.D., DDS, director of the Face Transplant Program and chair of the Hansjörg Wyss Department of Plastic Surgery at NYU Langone.
The surgical team included more than 140 medical professionals.
James received an entire left eye and a portion of a face from a single donor.
This was the world’s first transplant of a whole human eye and the only successful combined transplant, the release stated.
It was Rodriguez’s fifth face transplant.
In a press conference on Thursday, Nov. 9, James spoke about the progress he's made in the months since his surgery.
"We’ve made one major step forward and have paved the way for the next chapter to restore vision."
He described June 10, 2021, the day of the accident, as "a day I don’t remember but one I’ll never forget."
He also said, "It was a test of strength and willpower. From the time I woke up from a six-week coma, they were already talking about a possible chance of a face transplant."
James said he already knew of Dr. Rodriguez’s and NYU Langone’s strong reputation.
"I didn’t feel like there was anyone else who could do this the way that Dr. Rodriguez and his team could — and I think they’ve proven that."
James went on to thank the donor and the donor family.
"Without them, none of this could have been possible," he said. "I have the utmost respect for them, to be able to make this decision to help people that they don’t know, and to give me this gift from their family to live on with, to take care of … We are so grateful and thankful."
James also thanked his doctors and care team, as well as his wife, Megan, and his daughter, Allie.
"Without them and their support, I don’t think I could have made it through this," he said.
"The mere fact that we’ve accomplished the first successful whole-eye transplant with a face is a tremendous feat many have long thought was not possible."
"The mere fact that we’ve accomplished the first successful whole-eye transplant with a face is a tremendous feat many have long thought was not possible," Dr. Rodriguez said in a press release from NYU Langone.
"We’ve made one major step forward and have paved the way for the next chapter to restore vision."
Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in the surgery, but he described Dr. Rodriguez as a "groundbreaking facial transplant surgeon."
Said Dr. Siegel to Fox News Digital, "He is a pioneer in the field, and his success rate of recipients returning to normal life is increasing with each case."
After the transplant surgery, James spent 17 days in the intensive care unit.
Doctors are still not sure whether James will regain sight in the transplanted eye — but there are encouraging signs.
Six months after the surgery, his new eye is receiving direct blood flow to the retina and it is showing "remarkable signs of health."
Based on the restoration of blood flow to the retina, Siegel said he is "optimistic that at least some vision might be restored, which could be crucial for those who lose vision traumatically or for other reasons."
Even if James’ eye does not regain sight, "from a cosmetic standpoint, it would still be a remarkable achievement," Rodriguez said in the NYU Langone release.
"Aaron has been extremely motivated to regain the function and independence he lost after his injury. We couldn’t have asked for a more perfect patient," the doctor said.
"We owe much of our success in this monumental endeavor to the exceptional institutional support we receive at NYU Langone and the unwavering dedication of our world-class team in delivering the highest level of care to our patient."
The doctor also said, "This achievement demonstrates our capacity to embrace the most difficult challenges and drive continuous advancements in the field of transplantation and beyond."
The road to healing and recovery
After the transplant surgery, James spent 17 days in the intensive care unit.
He was then discharged for outpatient physical, occupational and speech therapy.
In September, he returned to his Arkansas home with his wife and daughter.
He will continue to visit New York City for monthly follow-up appointments with his care team.
"I will forever be thankful to Dr. Rodriguez and his team for changing my life," James stated in the NYU Langone release.
"My family and I wouldn’t have been able to navigate this difficult journey without their expertise and support."
"Our hope is that my story can serve as inspiration for those facing severe facial and ocular injuries." | Medical Innovations |
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NEW YORK (AP) — U.S. health officials released data Tuesday showing how chlamydia, gonorrhea and syphilis cases have been accelerating, but doctors are hoping an old drug will help fight the sexually transmitted infections.
Experts believe STDs have been rising because of declining condom use, inadequate sex education and reduced testing during the COVID-19 pandemic.
Millions of Americans are infected each year. Rates are highest in men who have sex with men, and among Black and Hispanic Americans and Native Americans.
“Sexually transmitted infections are an enormous, low-priority public health problem. And they’ve been a low-priority problem for decades, in spite of the fact that they are the most commonly reported kind of infectious disease,” said Dr. John M. Douglas Jr., a retired health official who lectures at the Colorado School of Public Health.
To try to turn the tide, many doctors see promise in doxycycline, a cheap antibiotic that has been sold for more than 50 years.
The Centers for Disease Control and Prevention is drafting recommendations for using it as a kind of morning-after pill for preventing STDs, said Dr. Leandro Mena, director of the agency’s STD prevention division.
Texas judge’s ruling on birth control threatens a nationwide program for minors
The drug is already used to treat a range of infections. A study published last week in the New England Journal of Medicine showed its potential to prevent sexually transmitted infections.
In the study, about 500 gay men, bisexual men and transgender women in Seattle and San Francisco with previous STD infections took one doxycycline pill within 72 hours of unprotected sex. Those who took the pills were about 90 percent less likely to get chlamydia, about 80 percent less likely to get syphilis, and more than 50 percent less likely to get gonorrhea compared with people who did not take the pills after sex, the researchers found.
The study was led by researchers at the University of California, San Francisco and built on a similar French study that saw promise in the idea.
“We do need new approaches, new innovations” to help bring sexually transmitted infections under control, said Dr. Philip Andrew Chan, who is consulting with the CDC on the doxycycline recommendations.
Mena, of the CDC, said there is no sign the STD trend is slowing.
Mississippi had the highest rate of gonorrhea cases, according to 2021 CDC data released Tuesday. Alaska saw a sharp increase in its chlamydia case rate that allowed it to overtake Mississippi at the top of that list. South Dakota had the highest rate of early-stage syphilis.
And Arizona had the tragic distinction of having the highest rate of cases in which infected moms pass syphilis on to their babies, potentially leading to death of the child or health problems like deafness and blindness.
Using an antibiotic to prevent these kinds of infections won’t “be a magic bullet. but it will be another tool,” said Chan, who teaches at Brown University and is chief medical officer of Open Door Health, a health center for gay, lesbian and transgender patients in Providence, Rhode Island.
WATCH: Beauty products for vulvas? These doctors say don’t buy it
Experts noted the CDC will have many factors to weigh as it develops the recommendations.
Among them: The drug can cause side effects like stomach problems and rashes after sun exposure. Some research has found it ineffective in heterosexual women. And widespread use of doxycycline as a preventive measure could contribute to mutations that make bacteria impervious to the drug, as has happened with antibiotics before.
Nevertheless, the San Francisco Department of Public Health in October became the first U.S. health department to issue guidance about doxycycline as an infection-prevention measure. And some other clinics have been been recommending the antibiotic to patients who may be at higher risk.
Derrick Woods-Morrow, a 33-year-old artist and an assistant professor at the Rhode Island School of Design, is an early adopter. Woods-Morrow, said he isn’t a fan of condoms — they can break and sometimes people slip them off during sex. But he wants to stay healthy.
About a decade ago, he started taking an anti-viral medication before sex to protect himself from HIV infection. Five years ago, a doctor told him about research into whether doxycycline might protect people from other diseases.
“I thought it was probably in my best interest to protect myself, and my partners as well,” he said. He said it’s been a positive experience and that he hasn’t tested positive for chlamydia, gonorrhea or syphilis while using it.
“I feel like it’s a tool to sort of take back the sexual freedoms that someone may have lost and to really enjoy sex and interactions with people with a piece of mind,” he said.
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Nov. 20, 2023 â For those who have gotten the flu shot this season, there's good news: This yearâs formulation looks like it will be very effective at preventing severe cases and hospitalization. Thatâs based on how the vaccine performed in the parts of the world where flu season is wrapping up.
As flu season sets in across the United States,  health officials look to see how flu vaccines performed in countries in the Southern Hemisphere, where the flu season tends to run from about April to September. An analysis published by the CDC that looked at mid-season flu data for South America showed that the flu vaccine was more than 50% effective at preventing flu hospitalizations there.
But since that reportâs publication earlier this year, the vaccine used in South America was found to be less and less effective as the flu season progressed. So the flu shots in the U.S. were updated to better protect against versions of the virus that were seen toward the end of flu season in parts of South America where the data was collected.
âFinal estimates can vary from interim estimates, and it does look like â I did look at some of the final season data the other week â and it does look like the effectiveness probably dropped a bit later in the season, and this is what happens when we see changes in the virus circulating, which was mostly a type called influenza A H1N1,â said epidemiologist Annette Regan, PhD, MPH, a co-author of the CDC report on Southern Hemisphere flu. âIt does look like weâve updated the formulation for the Northern Hemisphere based on that change.â
âIt was a good report because it gave us an indication that in the middle of the season, the vaccine was working really well, but when everythingâs said and done and weâre at the end of the season, it doesnât always look exactly the same. So we have a slightly different formulation in the Northern Hemisphere than what went out in South America,â said Regan, who formerly tracked flu data for the CDC and the Australian government. Sheâs now an associate professor at the University of San Franciscoâs Orange County campus.
Tracking flu trends below the equator helps medical teams and public health officials prepare for flu season up north, although the influenza virus is so adept at changing that predictions are helpful but not a guarantee of whatâs to come, said Paula Couto, MD, an influenza surveillance epidemiologist with the Pan American Health Organization, which is a regional office of the World Health Organization for the Americas.
She said the interim report, which used data from Argentina, Brazil, Chile, Paraguay, and Uruguay, can help with preparations such as estimating this seasonâs needs for health services and also demand for antiviral drugs used to treat flu.
âOf course, influenza is a tricky virus because it has pandemic and epidemic potential, so it may not necessarily be the same [between hemispheres], but thatâs why we are always monitoring and alert about these viruses,â said Couto, who also co-authored the CDC report.
There is no official start date for flu season each year in the U.S. The start date varies because itâs usually determined after the fact, based on a combination of factors such as increasing rates of positive flu tests and hospitalizations. That tends to be in late November.
âIn the U.S., we tend to see the flu season start in the Southeast, like in Florida and Texas, and surrounding states, and then we kind of see it spread from there,â said Regan. âUsually it doesnât take too long, like weâre talking a couple weeks max ... because people move a lot and people are much more mobile nowadays than they were during the height of the pandemic.â
The U.S. appears to be on the verge of flu season.
The CDC indicated that flu cases are on the rise in the Southeast, as well as in South Central and West Coast states, according to the agencyâs latest weekly flu report. Currently, about 4% of flu tests are coming back positive nationally. Already, one child has died due to influenza. Children are one of the groups with low flu vaccination rates in the U.S. and around the world, Regan noted.
âI just donât think any kid should die from flu, not in 2023, if we can help it,â she said.
The CDC recommends that everyone in the U.S. ages 6 months and older get vaccinated for the flu. After getting a shot, it takes the body about 2 Â weeks to make enough antibodies for maximum protection, Regan said, and the effectiveness typically lasts at least 4 months. That means the time to get one is now, since flu cases are on the rise.
About one-third of U.S. adults and kids have gotten this yearâs flu shot, according to the CDC, which is lagging several percentage points compared to last year. The adult vaccination rate varies from one state to another, ranging from 22% to 51%. The severity of flu season can vary, but federal data show there are between 9 million and 41 million cases annually, with up to 710,000 hospitalizations and between 12,000 and 52,000 deaths.
Between Oct. 1 and Nov. 11 this year, the CDCÂ estimates that in the U.S. there have already been:
- Between 780,000 and 1.6 million cases of flu
- Between 360,000 and 770,000 flu medical visits
- Hospitalization of 8,000 to 17,000 people
- Between 490 and 1,500 flu deaths
The COVID-19 pandemic disrupted seasonal flu trends, resulting in lower-than-normal flu cases when stay-at-home orders and quarantines were common. Last winter, though, flu returned with a vengeance. Both Couto and Regan said all indicators point toward a return to normal this season.
But the risk of serious illness or death from flu remains, particularly among high-risk populations like very young children and older people. Regan urged people, even if they have gotten the flu vaccine, to do other things to prevent the spread of flu in order to protect themselves but also people who are at high risk, like grandparents or newborn babies.Â
Vaccines are not 100% effective, Regan said, so it's vital that people wash their hands and cover their mouths when sneezing and coughing.Â
âAnd I think the big one is staying home when weâre feeling ill, especially because children are very good spreaders of influenza, thereâs good data to show that. So keeping them home when theyâre under the weather can be really helpful for helping to control the spread of influenza and RSV and helping to stop these epidemics," she said.Â
So just because this flu season is a return to normal or going according to predictions, each personâs actions â from getting vaccinated to washing their hands â is important, Regan and Couto concurred.
âIn the particular case of influenza, we know that the next pandemic is going to happen,â Couto said. âYou can never really know when, and thatâs why being vigilant about influenza, itâs key. Of course, the last pandemic was COVID-19, but we cannot forget that influenza is still a threat.â | Vaccine Development |
Within weeks of Covid-19 shutting down the world in 2020, teams at archrivals Apple and Google partnered on a rare joint project. They developed a way to log people’s proximity using Bluetooth chips in iPhones and Android phones, enabling the creation of apps that let someone who tested positive for the virus to anonymously notify fellow users whom they'd been near in the preceding few days. Those alerted to the exposure could then isolate, test, and quarantine, hopefully slowing the spread of Covid.Covid is still around, but the grand experiment in semi-automated contact tracing by smartphone is now nearing its end in the US, following similar shutdowns in many other countries as concerns about the virus have eased.On May 11, the Biden administration will stop paying for the two cloud servers that underpin the US system and power exposure-tracking apps offered by individual states. States will now have to boot up their own servers, and in many cases redesign their apps, if they want to keep the alerts flowing. Though a few, including California, are considering the idea, it remains to be seen whether any will follow through. California’s Department of Public Health did not provide comment for this story by publication time.Virginia, Massachusetts, and New Mexico confirmed last week that they will be bowing out. Wisconsin deactivated its app on April 3. “We were very clear up-front that it comes down when we no longer need it,” says Jeff Stover, chief of staff for the Virginia Department of Health, the first state agency in the US to launch exposure notifications. “Doing what we said we are going to do, it’s going to instill a little bit more public trust.” Google and Apple, which said in a 2020 FAQ that they would disable the system regionally when “it is no longer needed,” so far aren’t pulling the plug on their end. Apple spokesperson Zaina Khachadourian and Google spokesperson Christa Muldoon say the companies plan to keep supporting state exposure-tracking apps that are updated to keep working after the federal shutdown.At the height of the pandemic, millions of people in the US activated exposure notifications, as Apple and Google call them. The system arrived as a way to make loosening of strict lockdown measures safer, enabling people to be around one another without massively accelerating the spread of the coronavirus. Making Bluetooth signals the foundation of the system was inspired in part by US high schoolers’ prototype for automating contact tracing for Ebola in rural Africa.Public health authorities insist that exposure notifications have been a success, preventing infections by prompting people to isolate or test, and demonstrating the potential for public health apps. Critics say too few Americans turned on exposure notifications to make them truly useful. Concerns about whether anonymity would be preserved deterred some people from switching alerts on, and states struggled with limited marketing budgets to fight back. Measures such as vaccinations, face masks, and rapid tests became bigger contributors to people feeling comfortable about leaving the home.Overall, 47 countries and 29 US states and territories have used Apple and Google’s exposure-notification technology at some point. Of the 20 US states and territories that still offered exposure notifications last week, six, including Arizona and Virginia, had brought on engineers to develop custom apps to tap the Bluetooth technology that Apple and Google added to devices with software updates early in the pandemic. The remainder had relied on a generic, free app from the two companies that will stop working when the servers go offline next month.States reliant on the free system, such as California, would have to start from scratch and maintain their own servers to preserve exposure notifications after the May 11 cutoff. “There was discussion among some states, but I don’t think that’s going anywhere,” Virginia’s Stover says.The two national servers scheduled for shutdown are operated by the Association of Public Health Laboratories, or APHL, a group that serves as a liaison between local and federal health agencies. Emergency funds from the Centers for Disease Control have supported the servers since they went online in August 2020. But President Biden announced in January of this year that he would let the declaration of a national public health emergency—and the funding that comes with it—expire on May 11. (This month he also terminated a separate emergency declaration for Covid.) One of APHL’s servers acts as a sort of nationwide clearinghouse for the Bluetooth data that records phones in proximity, enabling users to travel to any participating state and still get Covid exposure alerts. The other server helps verify that a particular user tested positive before anonymously notifying their close contacts, although a few states established their own setups for this function. In a message from APHL to partners that was re-posted on Twitter in February, the group’s CEO wrote that it would coordinate with Apple and Google to support a “graceful turn down process” ahead of May 11.States giving up on exposure notifications are able to send mobile push notifications to users informing them that the system is being shut down, and that users can delete their state app or turn off the service in their smartphone settings, depending on how it is set up on their devices. Death knells for Covid exposure notifications have already been blasted out in other countries. Australia, Belgium, and Canada dropped their apps last year. Singapore, an influential early proponent of exposure notifications, announced in February that users can delete the app, which had been mandatory for a time, but added that it would be maintained and kept in app stores in case of a Covid resurgence.The UK’s National Health Service is shutting down its own exposure-notifications system on April 27. “The number of people actively using the NHS COVID-19 app has steadily reduced since July 2021,” the agency said on its website last month. The volume of positive test results entered into the app, and notifications sent out, dropped after the UK reduced access to government-funded testing last year.Researchers at the Universities of Oxford and Warwick estimated that the NHS app prevented about 9,600 deaths and 1 million infections during its first year of operation. But the exact efficacy is difficult to calculate. The anonymity built into the system and the need to make assumptions about how people would have behaved had they not received an alert make any estimates rough.Massachusetts Department of Public Health spokesperson Ann Scales says its MassNotify system was activated on about 3.2 million phones in the state of 7 million people, with an estimated 1.5 million users currently active. Since June 2021, over 88,700 MassNotify users alerted a total of about 1.8 million fellow users about potential exposure, Scales says.Several states and countries spent hundreds of thousands to millions of dollars to develop custom exposure-tracking apps. The race to build them also galvanized many startups, some of which have more recently shifted their apps into a broader array of health or even unrelated services as Covid-19 infection rates fell. When Apple and Google introduced the free, generic technology in September 2020, it brought many more governments on board.But most of the apps struggled with a number of issues that ultimately contributed to low adoption, according to the US Government Accountability Office, which oversees purchasing and provides guidance to lawmakers. Its report on state Covid apps, released in September 2021, found that people were left skeptical by the possibility of inaccurate alerts due to technical limitations in measuring distance, a lack of independent privacy and security audits, and delays in issuing alerts, as states couldn’t keep pace with verifying test results. While there have been bugs and frustrations, there has not yet been a privacy scandal tied to the Bluetooth system, and errant notifications have not appeared to be a widespread problem. “There are a lot of caveats, but we did a good job and won over a lot more people than we lost,” says Virginia’s Stover, who valued the one exposure alert he received, which came last year and led him to seek testing that came back negative.Apple and Google aren’t letting on what they’ll do to the guts of the exposure system that they pushed into smartphones. Will exposure notifications technology be pulled from devices in future updates or sit dormant, awaiting the next big crisis? Company spokespeople declined to say. Some government officials do not want the conversation to end. Stover says Covid apps—Virginia’s was called COVIDWISE and drew about 3 million downloads in a state of 9 million people—have made him excited about the possibility of launching a mutlifaceted state public health app one day. It could provide exposure notifications during flu season or help parents track immunization schedules for children. “We learned too much,” Stover says, “to just put it in the closet.” | Epidemics & Outbreaks |
A two-year-old boy who is being treated in hospital in Portugal is unable to return to Wales for medical help.
Theo Jones from Maesteg, Bridgend county, has a virus attacking his brain but cannot be flown to hospital in Cardiff because of insurance company delays, his parents have said.
They are now concerned his condition will deteriorate and he will never be able to travel home.
AXA Partners insurance company has been asked to comment.
Theo became unwell on 13 September, during a family holiday to Portugal, and was taken to Faro Hospital by ambulance two days later.
His parents were initially told he had a stomach flu, but an MRI scan revealed he had a problem with his cerebellum, a part of the brain.
His mother, Sarah Jones, said: "Our beautiful chatty, active boy has lost the ability to speak, sit, walk."
She added that doctors told her they believed a virus was attacking Theo's brain.
Sarah said she had been in contact with University Hospital Wales in Cardiff, which accepted a transfer for Theo.
Doctors told Theo's parents that he could travel, but it would need to be by medical plane.
"We now just need to get him there," she said.
Sarah is in Portugal with her husband and five-month-old daughter and they are due to have to leave their accommodation at the beginning of October.
She said their insurance company said Theo was a priority case, but had failed to update the family since receiving a medical report on Tuesday.
Sarah said she had to resort to getting her taxi driver to translate some of the documents because the company said they did not have a translator available.
She said she has now been told that AXA wants to wait two more days to see if Theo's condition improves.
But she could not understand the logic in waiting for him to deteriorate, when he has been approved to travel in his current stable condition.
"I can't speak to the people making these decisions. They're an elusive entity within AXA that no-one seems to be able to penetrate and get access to," she said.
"It's a nightmare. It's not that we haven't got the cover, they've accepted responsibility. They're just sitting on their hands now." | Epidemics & Outbreaks |
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Olivia Culpo has never really had a normal period. And yes, she talks openly about periods and everything that goes along with them, because people sharing their experiences was her key to finally getting diagnosed with endometriosis.
Through her frustrating journey to figure out what was causing her extremely painful periods, the model, social media influencer, and former Miss Rhode Island eventually became an expert on endometriosis, a condition in which tissue similar to the uterine lining, or endometrium, grows outside of the uterus.
It can take an average of eight to 10 years to receive a proper diagnosis, she said. And it may look different in every body, because the tissue can grow anywhere — your liver, ovaries, rectum, appendix, colon, and more. The result is debilitating pain and sometimes infertility.
Dozens of doctors told Culpo she was fine, suggesting over-the-counter pain relievers like Advil, or questioning how bad her pain really was, regardless of the fact that she was in absolute agony. The pain only got worse over time — at first happening only during her period, then in between cycles, and eventually constantly. Finding ways to manage her pain and still live her life while she fought for answers was not easy.
“I lived in the bath. I would do all of my work in the bath,” she said. Her pain was mostly in her lower back, and applying heat was one of the few things that helped.
Adding some Epsom salts (a source of magnesium) to baths can make them even more effective when it comes to easing swelling, stiffness, and pain, and even reducing stress.
When she couldn’t be in the bath, she applied targeted heat to her lower back. Hot water bottles worked better for her than electric heating pads, particularly this super soft one from Naked Cashmere that she traveled everywhere with.
You can buy Anytime CBD Gummies from Highline Wellness for around $42. (There is limited scientific evidence for the effectiveness of CBD for pain relief. We suggest consulting your doctor and following dosage guidelines.)
Bananas were helpful for the cramping, as was generally managing her diet to limit sugar and caffeine (although she did rely on chocolate for a dopamine release). Midol, a menstrual period classic, was another saving grace.
Despite the years of debilitating pain, Culpo said she never would have gotten the help she needed if she had not found a support system.
“It was from looking online, just like sobbing in the bath, looking on Reddit and YouTube and following other people’s journeys that I was finally like, ‘Oh, these are my symptoms. This is what this person had. This is what they did,’” she said.
She found a strong endometriosis community called Endo Warriors. “Everybody really supports one another on a ton of different forums, from Reddit, YouTube, Instagram, TikTok. I would encourage anybody out there to use those resources, not only to get answers, but also to feel like they’re not alone.”
This online community is what made her realize that although her doctors were doing their best, they didn’t know everything, and specifically didn’t know enough about endometriosis. Armed with new information and confidence about what was causing her pain, she finally found a specialist who would treat her.
“No doctor told me that I [had endometriosis]. I had to go in there and be like, This is what I have, I know that this is what I have, please help me,” she said. “It was that doctor that found the endometrioma, and then it was another doctor who also specialized in endometriosis who did my surgery.”
Endometriomas are cysts that can be seen on an ultrasound. If those can’t be visualized during a scan, surgery followed by a biopsy of the abnormal tissue is needed for a solid diagnosis. Not all doctors are able to or want to do this surgery, which is one reason why it can take so long to be diagnosed. The ones who do specialize know exactly what it is when they see it and are often able to scrape out the endometrioma during surgery; this is what happened for Culpo.
Her life changed after the surgery. Culpo had the Mirena IUD inserted, essentially halting her menstrual bleeding to suppress future flare-ups; her symptoms evaporated.
“It’s scary when you feel like you're in so much pain and nothing helps, and it's even scarier when you feel like nobody believes you or has the answer,” she said. It took years of advocating for herself to find the answer and the solution, but she hopes her story can help others avoid that prolonged, painful experience. So she’s not going to stop talking about periods, even if it makes you uncomfortable. | Women’s Health |
A plan for free social care in England will be at the centre of the Liberal Democrats' offer to voters at the party's annual conference.
The party's leader Sir Ed Davey will pledge a care package worth £5bn a year at the conference in Bournemouth.
He says reforming social care is one of the biggest challenges facing the country and a major priority for his party.
The party will use the conference as a platform to launch its policy agenda.
Starting on Saturday, the conference in Bournemouth will see the Lib Dems debate and vote on their pre-manifesto policies ahead of the next general election, which is expected next year.
The fourth-largest party in the UK Parliament, the Lib Dems are looking to build on recent successes in by-elections they have won in traditional Conservative strongholds, collectively known as the "Blue Wall".
The conference - their first such event in person since 2019 - gives them a shop window to showcase their vision for the country and sell their ideas to voters.
Prominent among those policies is the party's plan for social care, which the Conservatives attempted to reform under the governments of Theresa May and Boris Johnson.
Last year, analysis by Age UK found that 2.6 million people aged 50 and over were living with some form of unmet need for care in England.
Many of the pressures felt by the NHS are put down to a shortage of social care staff.
£3bn savings estimate
Another key factor is that most patients cannot leave hospital when they are ready because of a lack of care support in the community, meaning beds are blocked.
The Lib Dems say if they were in government, they would fund free nursing care for everyone who needs it, as well as support with mobility, hygiene and medication.
They say this would allow more people to receive the care they need in their homes.
The party estimates the proposal would cost £5bn a year before savings are factored in, but with an estimated £3bn of savings in NHS and care home costs, it says the real net cost would be £2bn.
The party said it would set out how this policy would be funded next week, when Sir Ed will address the conference.
Speaking ahead of the event - which was cancelled last year after the death of Queen Elizabeth II - Sir Ed said the Conservatives had "failed on care and the NHS for far too long".
"People cannot get the care they need at home and are far too often either left in hospitals or sent to live in care homes," said Sir Ed, who is a carer for his disabled son, John.
"That's why the Liberal Democrats are bringing forward a proper alternative. We are calling for free personal care so that everyone can live independently and with dignity."
Other Lib Dem policies being launched at Bournemouth include:
- Doubling statutory shared parental leave to 46 weeks and expanding it to include self-employed workers - and doubling shared parental payments from £172.48 per week to £350 per week
- Making childcare more "flexible, affordable and fair" by reviewing the rates paid to providers for free hours to ensure they cover costs for high-quality services
- More small-group tutoring to help pupils who have fallen behind in class - schools, sixth forms and further education colleges in England would get £390m a year to offer 12-week tailored support to about 1.75 million children under the proposals
'Off the table'
Much of the Lib Dem pre-manifesto will look familiar to the party faithful.
Pledges to reform the UK's electoral system, grant the vote to people aged 16 and over, and forge a closer relationship with Europe are expected to be included.
But the party has moved away from the Europhile stance of its previous leader, Jo Swinson, who promised to take the UK back into the EU and stood down after a poor showing in the 2019 general election.
In an interview with the BBC, Sir Ed said rejoining the EU was currently "off the table" and most people on the doorstep just "aren't talking about Europe".
He said: "We want Britain to be back at the heart of Europe, but we're also realistic that's going to take some time."
Sir Ed has also insisted he is not interested in a pre-election pact with Labour.
He rejected the idea the Lib Dems could form deals with Labour ahead of by-elections next month in Mid Bedfordshire and Tamworth, seats won by the Tories at the last general election.
"I'm focused - and I won't be distracted - from my top task, which is to defeat Conservative MPs," Sir Ed said.
In the past, the party has held the balance of power, most recently in 2010, when it entered a coalition government with the Conservatives under David Cameron.
If neither Labour nor the Tories win a majority in the next general election and the Lib Dems perform well, the party could be in a position to share power again. | Health Policy |
Lee Clayton was a shy and innocent teenager, “cotton woolled” in parental love and protection while growing up in Wahroonga, on Sydney’s north shore. She didn’t know what a lesbian was, having never even heard the word – but she knew she had a crush on her English teacher, a kind woman who taught her for four years, and who would patiently listen to her speak about her personal troubles.
Most days, Clayton would pick this teacher a rosebud and leave it for her on her desk. “I had no idea that loving her was a bad thing,” she recalls, with a rueful laugh.
Clayton, now 71, believes her late mother “must have known I had lesbian tendencies”, because Clayton would come home and declare that she “really loved” her teacher, who was also a member of her scripture union. Her mother would just roll her eyes.
“My mother had been in the air force, and she probably knew of such women – she didn’t want me to be one of them,” Clayton says.
Concealing her same-sex attraction contributed to Clayton having a nervous breakdown when she was just 19, then becoming distressed again at 21. It was because of this, while she was training to become a nurse, that she was referred to a private hospital in Sydney for treatment.
Clayton was a virgin, and had yet to act on her same-sex attraction at all. “My mum said to one of the nursing sisters at the hospital that I was ‘interested in girls’, and the sister replied, ‘Oh, we’ll sort her out’,” she recalls.
Clayton’s story has inspired a semi-fictional storyline in a new play titled CAMP, written by Elias Jamieson Brown, which will premiere during Sydney WorldPride. CAMP, or the Campaign Against Moral Persecution, was a queer rights group that rallied against so-called “cures” for homosexuality and fought to decriminalise homosexual acts, then illegal between men. CAMP provided safety in numbers, fighting persecution through protests and providing support through their regular newspaper CAMP Ink, a phone counselling service and a drop-in centre at Glebe.
Clayton was admitted to the hospital in the late 1960s, a few years before Australia’s golden age of LGBTQ activism. The hospital would become notorious for the controversial “deep sleep” therapy for psychiatric illnesses, a treatment regime developed by the psychiatrist Dr Harry Bailey.
People were admitted for all sorts of reasons, but patients at the hospital were sometimes the subject of controversial brain surgery. Patients could be sent to another hospital for a cingulo-tractotomy, a “psychosurgery” Bailey claimed in a paper was a “potentially life-saving therapeutic measure” for patients suffering from severe chronic depressive illness. In 1973, according to an article in CAMP Ink, Bailey himself estimated that 15% of his patients who underwent the procedure, which he also described as a “treatment for sexual immaturity”, were homosexual.
“One woman I befriended, a nun, came back from having this operation and she wasn’t herself anymore,” Clayton says. “Awful.”
Clayton believes she was probably at the hospital for around three weeks – she cannot recall exactly how long – but she says the experience left her with lifelong physical and psychological damage. She says that, about three times a week, the doctors would come to treat patients in the middle of the night. Clayton vividly recalls Bailey as a “strange character”, who was “very flamboyant” and “blustery” and always wore a monocle and “very loud” Hawaiian shirts.
Clayton says she was kept in a treatment room with two other patients, a sheet over each of them, and at times her wrists and ankles were shackled to the bed. Patients were typically given sedative pills between deep sleep intravenous barbiturate treatments, Clayton says, but she would often only pretend to take her pills, secretly spitting them into a pot plant or the bottom of a cigarette packet.
She describes being given electro-convulsive therapy, the sudden jolts from which she believes have wrecked her back for life. She says she also suffered urinary tract infections for years after lying on a constantly wet mattress.
One time after pretending to take her pills, Clayton hid behind a curtain. She says it was then that she overheard that she had been nominated by staff for brain surgery. “I heard them saying ‘Lee Clayton, we’re going to send her off to have a cingulo’. I thought, ‘No you’re not’. I had to get out of there.”
That same night, Clayton escaped out the front door, which staff had kept unlocked for smoking breaks. She ran to a phone booth and rang a trusted doctor, who she says admitted her to a general hospital for safety.Robyn Kennedy, an associate producer on the play and co-author of the 2022 book CAMP, points out that when Clayton was hospitalised, homosexuality was still considered a mental disorder.
“People decided they could cure homosexuality,” she says. “There was no real objection from the medical profession … we had to wait until homosexuality was taken off [the Diagnostic and Statistical Manual of Disorders, in 1973].”
Bailey killed himself in 1985. He appears as a character in Jamieson Brown’s play, which includes the moment queer activists tipped a bucket of blood and sheep’s brains into the foyer of his Sydney practice.
Kennedy rejected her own education by the Catholic Sisters of Charity at school that “particular friendships” – the nuns’ codeword for lesbianism – were “unhealthy”. At CAMP, which Kennedy joined in 1975, eventually becoming the New South Wales secretary, she found “like-minded people whom I loved and who loved me”.
Clayton also joined CAMP around the same time as Kennedy, a year or two after her traumatic time in the hospital. It was at CAMP that she finally found support for who she was. Today, she is a mother of one and grandmother of two, and has had good romantic relationships in her life (she is currently single). She knows that holding on to anger about what happened to her would only lead to bitterness.
“I’m very grateful for all the good things in my life and also having gone through this experience,” she says. “It’s helped me to be more open, compassionate and understanding of people.” | Mental Health Treatments |
These little wearables reduce your reliance on a phone while keeping you connected.A Great timepiece doesn’t just display the time of day; it can elevate your outfit and make you feel good. Smartwatches can do even more, from tracking your workouts and measuring your heart rate to serving up notifications and access to voice assistants. While you’re wearing a connected watch, you can leave your phone in your pocket and use your wrist for simple tasks. The Apple Watch is our favorite for iPhone owners, but Samsung’s Galaxy Watch4 is a great wearable for anyone on Android. We also like several other options—in various styles and with different levels of smarts. Below is a roundup of the best smartwatches we've tested. Looking for a fitness tracker instead? We"ve got plenty of more workout-friendly options in our Best Fitness Trackers and Best Garmin Watches guides.Updated June 2022: We added the Casio PRW61-1A, mentioned the upcoming Google Pixel Watch, and added more information about upcoming Apple Watches and WatchOS 9.Special offer for Gear readers: Get a 1-year subscription to WIRED for $5 ($25 off). This includes unlimited access to WIRED.com and our print magazine (if you'd like). Subscriptions help fund the work we do every day.If you buy something using links in our stories, we may earn a commission. This helps support our journalism. Learn more. Please also consider subscribing to WIREDPhotograph: AppleBest for iPhone OwnersApple Watch Series 7The Apple Watch is the best smartwatch money can buy. It has the best operating system, WatchOS—which is slick, with plenty of apps to help reduce the number of times you need to pull out your phone. The Series 7 (8/10, WIRED Recommends) has a larger and brighter screen, faster charging, improved resistance to water and dust, and the ability to automatically detect when you've hopped on an ebike so it can properly log that activity. The bigger screen means you can use a full-screen keyboard for swipe-typing short messages.The health features haven't changed much since the last version, though they're set to improve with the upcoming WatchOS 9 update later this fall. There's a sensor to measure oxygen saturation in the blood (SpO2)—helpful for athletes training at altitude or anyone with an underlying health condition—and the FDA-cleared electrocardiogram sensor. Unfortunately, battery life is still mediocre; you'll need to charge it in the evening (before you go to bed) if you want to track your sleep, especially if you used the watch to track a workout during the day. Check out our Best Apple Watch Accessories guide for all the extras.Comes in 41-mm or 45-mm sizes.★ Cheaper alternative: The Apple Watch SE ($279) is worth a look. It debuted alongside the Series 6 and is the model for those who balk at a $400 price and don't need an electrocardiogram, SpO2, or the always-on display found on Apple's premium watches. Apple is set to launch new Apple Watches this September, so if you'd rather have the latest and greatest, it might be worth waiting. Our Apple Watch guide has more details.Photograph: SamsungBest for Android OwnersSamsung Galaxy Watch4Samsung’s Galaxy Watch4 and Watch4 Classic (7/10, WIRED Recommends) are the first to use Google's Wear OS 3 instead of the company's homegrown Tizen operating system. This brings broader app support, making it one of the best options if you have an Android smartphone. Third-party apps are still trickling in since Samsung's switch to Wear OS, but recent updates have added apps like Google Assistant.Samsung managed to retain nearly the same interface and many features from its previous smartwatches, including a bright OLED screen, easy ways to respond to messages, smooth performance, and accurate health and fitness tracking (heart rate and SpO2). Unfortunately, the electrocardiogram and blood pressure monitoring features only work if you have a Samsung phone. (The latter isn't available in the US yet.) Battery life is lackluster, with the smaller models lasting just a day. If your wrist can manage it, I recommend sizing up to get the more capable battery. The Classic version of the watch is made of stainless steel instead of aluminum, and it has a mechanical rotating bezel around the screen for navigating the interface. It's nice, but not worth the upcharge.Watch4 comes in 40-mm or 44-mm sizes. Watch4 Classic comes in 42- or 46-mm sizes.Photograph: GarminBest Fitness WatchGarmin Vívomove SportWho says Garmins have to be hulking, sporty-looking watches? The new Vívomove Sport comes in a few fun colors and looks like a normal watch—except for the tiny display on the lower half of the face. You can tap and swipe across this touchscreen to start tracking workouts, see notifications, and look at your calendar entries. Just because it looks snazzy doesn't mean it lacks the fitness-tracking chops that Garmin is known for. You can track your heart rate, blood oxygen, respiration, and sleep, and this data can be synced to Garmin's Connect app. That also means the watch can gauge your Body Battery, which speculates how much energy you might have for the day based on a range of data collected by the sensors. It'll last around three to five days doing all of this. The downside? There's no onboard GPS, so you'll have to bring your phone with you if you want to track your running routes. For more fitness-focused watches, read our Best Garmin Watches and Best Fitness Trackers guides.Comes in a 40-mm size.Photograph: WithingsA Classy Health WatchWithings ScanWatchWithings' ScanWatch (8/10, WIRED Recommends) has nearly all the same functions as Garmin's Vívomove Sport—heart rate and sleep tracking, basic notifications—but it goes further with its FDA clearance for the blood-oxygen and electrocardiogram measurements. The latter can be helpful to detect atrial fibrillation and irregular heartbeats, though you should always consult your physician if you're concerned about the results. This minimalist watch can go a whole month between charges—who doesn't love that? The face is covered by sapphire glass, and the case is stainless steel, so it's durable and feels well-built. What gives away its smart sensibilities is the OLED subdial, which is also one of the ScanWatch's biggest downsides. This screen is tiny! You'll be reading texts like the news ticker in New York's Times Square. It's better for quickly glancing at the date and your heart rate and step count. Comes in 42-mm or 38-mm sizes. Photograph: MobvoiBest Battery LifeMobvoi Ticwatch Pro 3 Ultra GPSMobvoi has been churning out smartwatches that run Google's Wear OS platform for years, and the latest TicWatch Pro 3 Ultra shows this level of refinement. It doesn’t have Google's newest Wear OS 3 version, but it is slated to get it sometime this year. Nevertheless, it does all the things I need. Scrolling through the interface is very smooth, with speedy app launches; I get timely notifications I can respond to or dismiss; and it does a surprisingly great job of tracking the most important health metrics, like SpO2, step count, 24/7 heart-rate monitoring, and sleep. It's a bulky watch, so it's not for all wrists. Also, the design is a bit ordinary; I recommend swapping the 22-mm strap for something more exciting. What makes this watch special is the dual-layer screen. Tap it and you'll be treated to a wonderful AMOLED, but when the screen goes into standby mode, it'll switch to a monochrome LCD panel that merely sips battery juice. That makes this one of the few full-featured smartwatches that can comfortably last two full days on a charge. Even if it dies, it switches on an Essential mode that shows the time, plus heart rate, sleep-tracking data, and step count—and this mode can last much longer. You'll rarely have a completely dead watch with nothing on the screen.Comes in a 47-mm size.Photograph: SkagenBest Hybrid SmartwatchSkagen Hybrid HR JornI love wearing the Skagen Jorn, which is what matters most with a watch. The round design and mechanical hands make it very much like a traditional timepiece, but I can immediately see my heart rate data, step count, and the weather on the E Ink screen. You can control music playback, and the companion app lets you choose which apps you'll get notification alerts from. The whole thing lasts well over a week on a single charge.You can use it to track workouts, but I wouldn't rely on it, as activity tracking isn't very accurate (though resting heart rate matched up with results from other smartwatches). E Ink screens just aren't suited for this. It can also monitor sleep, but I didn't find that feature helpful. The Jorn tries to do too much, and the interface is clunky, but it's a good watch if you like the look and want very simple health data alongside basic notification alerts.Comes in 42-mm and 38-mm sizes.Photograph: FossilAn Even Simpler Hybrid WatchFossil Hybrid Smartwatch Retro PilotOut of all the watches in this guide, the Retro Pilot looks the most like a classy analog watch. It's attractive, if a bit masculine, but you can get it in different face and case colors. I like it for checking notifications, which does require a bit of work. In the companion app, you can set an app to a specific hour. When I get an email from Gmail, for example, the watch vibrates, and the hour and minute hand moves to 3 o'clock. It took me a day or two to fully remember the apps I had assigned to each hour, but once I did, it was helpful. I'd check the watch when it vibrated and didn't pull out my phone when I just got a Gmail notification. In the app, you can configure the buttons to take a photo when the camera app is open, control music playback, show another time zone, and even track step count and sleep. The latter is accurate, but the watch regularly undercounts steps, so I wouldn't rely on it much for tracking your walks. Comes in a 44-mm size.Photograph: CasioBest Barely Smart WatchCasio ProTrek PRW-61I've had this Casio on my wrist for more than a month, and I've used one of its handful of functions every single day, something I can't say for many smartwatches. I use the stopwatch to track my rest intervals between sets at the gym. I set my world time to New Delhi, India, the time zone my sister and parents are in. I've actually used the compass to navigate when I emerge from the subway in New York City and can't get my bearings, and I've learned to read the barometer—mostly just to see how cool it is to predict the weather without having to ask a voice assistant. I love how this watch looks. It's rugged and outdoorsy, but still relatively classy. Even better, it's incredibly comfortable to wear. Seriously, I have never taken it off since I unboxed it. It's been fine in the shower and through workouts. I love that it's made of biomass plastics from regenerative resources, such as castor seeds and corn (and other raw materials). Don't let that worry you about durability; I've been through a move, dinging it on various walls, got paint on it, and yet it looks pristine. The dial is easy to read—the indices glow or you can press a button right below the case to light 'em all up for nighttime visibility. And you never need to recharge it. Casio’s Tough Solar tech means it recharges itself via sunlight. Comes in a 54.2-mm size.Photograph: FossilMy Favorite SmartwatchSkagen Falster Gen 6A smartwatch is as much a fashion accessory as it is a utility, and the Skagen Falster ticks a lot of boxes for me. I love the simple design and the minimalist watch faces that never look too busy, and I'm always a sucker for leather straps (though there are several straps to choose from). It goes well with much of my wardrobe, and I always feel good when I glance at it on my wrist. I love it.Internally, this Wear OS smartwatch is akin to Fossil's Gen 6 smartwatch. It runs the same Snapdragon Wear 4100+ processor, and while it currently operates Wear OS 2, it will get the update to Wear OS 3 this year. Performance is smooth—I can ask Google Assistant to turn off the lights in my apartment, swipe the keyboard to send responses back to friends, and easily change the color of the watch face to match my outfit. There's heart rate and sleep tracking, plus SpO2 measurements. All of the results matched my Apple Watch Series 7, though the Skagen usually took longer to get me those numbers. I just wish battery life was better; it only lasts about a day with sleep tracking, but it recharges fairly quickly.Photograph: GoogleA Google-Made Watch Is ComingPixel WatchEver since Google started getting serious about making its own hardware—when the first Pixel phone arrived in 2016—we've seen rumors about a Pixel Watch, powered by Google's Wear OS operating system. Well, it's finally happening. In May, Google announced that its first Pixel Watch will launch in the fall of 2022 alongside its flagship Pixel 7 and Pixel 7 Pro. Details are slim, but Google is positioning it as a premium watch, so expect Apple Watch-like pricing. It's a round watch with a very smooth and sleek-looking case. There's a tactile crown, recycled stainless steel in the frame, and swappable bands that are, unfortunately, proprietary (a very Apple-like move). Google says the interface will be improved to make it “tappable, voice-enabled, and glanceable,” with more first-party Google apps available than ever. There's deep integration with Google-owned Fitbit, along with a slew of unsurprising health and fitness features, such as continuous heart-rate monitoring and sleep tracking. The big catch? Unlike many Wear OS smartwatches that support iPhones, the Pixel Watch will only work with Android phones. If you've been eyeing a Wear OS-powered watch and can hold off till the fall, it's worth waiting to see what the Pixel Watch is like. Photograph: MobvoiA Word on Wear OS 3More Watches Are ComingLast year, Google announced the new version of its wearable operating system, used by such tech and fashion brands as Mobvoi, the Fossil Group, and Samsung. It's called Wear OS 3, and it was co-developed by Google, Samsung, and Fitbit (the latter is now Google-owned). As we've seen on the Galaxy Watch4, it delivers better performance and longer battery life and includes more third- and first-party apps, along with robust health and fitness improvements. (The Pixel Watch will be running Wear OS 3.)Existing smartwatches powered by Qualcomm's Wear 4100 chips are the only models that are eligible to upgrade to Wear OS 3. That includes Mobvoi’s TicWatch Pro 3, TicWatch Pro 3 Ultra, TicWatch E3, and Fossil's Gen 6 smartwatches like the Skagen Falster Gen 6, but the upgrade won't be available until the middle of 2022 (and will require a factory reset). Google and Fitbit will also be releasing premium Wear OS 3 watches in 2022. There are a ton of older Wear OS watches out there, but we recommend buying one of the aforementioned models that will get the new version. Photograph: FossilHonorable MentionsOther Watches We Sorta LikeThe number of smartwatches on the market is staggering. We've tested models from Tag Heuer, Citizen, Montblanc, Diesel, and many other fashion brands, but most of them are simply too expensive for what you get. (Not to mention they're Wear OS watches that won't get the update to the latest version). Here are a few other options we like.★ Casio PRT-B50 for $156: If you like the sound of the Casio PRW61 above but hate the price, consider this model. You get many of the same perks, like a compass, altimeter, and barometer, but for a lot less. It's not made of biomass plastics, and it doesn't have solar charging, though its battery lasts two years. It does track steps and can automatically adjust the time to wherever you are in the world. You can place virtual markers along your route that are viewable through the map in the companion app (paired via Bluetooth), and it's easy to make your way back to them using the watch. It comes in a 50.8-mm size.Fossil Gen 6 for $299: Fossil's newest flagship smartwatch isn't as speedy as the TicWatch Pro 3 Ultra, and it has a lackluster design. Its battery doesn't last as long, though you get a similar Essential mode that ensures the time is displayed even if the battery is dead (for a few days). The health-tracking features are fairly accurate, though, and it's slated to get Wear OS 3 this year. It comes in 44- or 42-mm sizes. (It functions almost exactly like the Skagen Falster Gen 6 above.)Mobvoi TicWatch E3 for $200: The E3 has the same speedy processor as the TicWatch Pro 3 Ultra above, and it will get the upgrade to Wear OS 3. It's not as long-lasting, usually requiring a recharge in the morning after tracking sleep (with the always-on display turned off), and the 44-mm case size is still rather large. Its fitness-tracking results were similar to other watches I tested alongside it, like the Galaxy Watch4. But my gripe is with the build quality: It's plasticky, feels cheap, and isn't very pretty to look at.Photograph: Natalya Trofimchuk/Getty ImagesSwap Your StrapsFresh BandYou don't need to stick with the strap you get in the box! Nearly every smartwatch these days has straps that can easily be swapped out. Apple Watches (and Google's upcoming Pixel Watch) have a proprietary strap system, but analog watch straps will work for others, making your options nearly endless. All you need to do is figure out the strap size of your smartwatch. You can usually find this on the back of the strap itself (you'll see “20 mm” or just “22”), or you can check the manual or the website you purchased the watch from. It's an easy way to further match your timepiece to your look.Photograph: UMIDIGIBuyers BewareKnow What You BuySearch Amazon for "smartwatches" and you'll be greeted with a long list of devices from brands you've probably never heard of. One brand that frequently pops up is Yamay, but a quick visit to the company's Twitter page shows that it's offering "full refunds" for people who post reviews. Look at the 1-star reviews and you'll see complaints of the watch malfunctioning after a few weeks of use. This is a warning not to buy the first thing you see, even if it's cheap and has plenty of positive reviews on Amazon. Research the company and look for other reputable websites that have reviewed the products before you make your decision.Julian Chokkattu is the reviews editor at WIRED, covering personal technology and reviewing consumer products. Previously he was the mobile and wearables editor at Digital Trends, steering coverage and reviews of smartphones and smartwatches, and an intern at TechCrunch. He graduated from Rutgers University with a bachelor's degree in English... Read more | Medical Innovations |
People who used a mindfulness self-help book for eight weeks and had six sessions with a counsellor experienced a 17.5% greater improvement in recovery from depressive symptoms than those who underwent cognitive behavioural therapy (CBT) while being supported by a mental health practitioner.
The study’s authors say their findings have shown supported mindfulness-based cognitive therapy (MBCT) is “clinically superior” to CBT, which is the treatment the NHS usually offers people with mild or moderate depression. Half a million people a year are referred to NHS talking therapy services in England, in which CBT is the commonest form of treatment.
MBCT is “significantly” more effective than CBT, and cheaper for the NHS to offer, they concluded. Their results have been published in JAMA Psychiatry, an American medical journal.
The NHS says mindfulness involves people paying attention to “what is going on inside and outside ourselves, moment by moment” and “the sights, sounds, smells and tastes of the present moment” as well as being aware of their thoughts and feelings as they happen.
About one in 10 people experience some form of depression during their life.
Researchers led by Prof Clara Strauss, the deputy director of research at the Sussex Partnership NHS mental health trust, undertook a randomised control trial involving 410 people who had been referred to NHS talking therapy services in England. They investigated whether practitioner-supported MBCT self-help was better or worse than practitioner-supported CBT at relieving symptoms of mild to moderate depression, such as low mood.
More people would be able to banish their depression if the NHS began offering the mindfulness-based treatment as an alternative to CBT, Strauss and her fellow researchers believe.
“If study findings are translated into routine practice, this would see many more people recovering from depression while costing the health service less money,” they say in the paper.
Strauss added that guided MBCT self-help could “give people experiencing mild to moderate depression another choice for how to support their recovery and if our findings were replicated at scale could lead to more people from mild to moderate depression than do currently”.
People using mindfulness in the LIGHTMind 2 trial spent eight weeks following the advice in The Mindful Way Workbook, which helps them build up their mindfulness skills by guiding them on what they should do every day in order to be aware of their thoughts, feelings and physical sensations in a non-judgmental way. Doing that helps people address some of the behaviours that can maintain feelings of depression and steer away from negative thoughts.
They also had six one-to-one half-hour “support sessions” on the telephone with a therapist discussing their progress, experience of practising mindfulness and asking questions.
The other participants used CBT, though they were also supported by a counsellor. Trial participants were analysed 16 weeks after their treatment ended.
“In our study 63% of people receiving CBT self-help recovered from depression, compared with 74% of people receiving MBCT self-help. That means that 17.5% more people recovered from depression in the MBCT self-help arm of the study than in the CBT self-help arm,” said Strauss.
Mindfulness-based treatment is also a cheaper way of tackling depression because people using it needed on average £526 less of subsequent treatment for the illness and visited NHS services such as GP surgeries less often than those who had used CBT, the study also found.
Andy Bell, the interim chief executive of the Centre for Mental Health thinktank, said: “This is a welcome study that helps to deepen our understanding about the most effective ways to treat depression. The more we know about the range of options people find helpful, the more people can get effective therapy that’s attuned to their needs.
“Depression is a very common condition, and most people with it never get any treatment. The NHS in England has invested in expanding the provision of talking therapies for people with anxiety or depression over the last 15 years: predominantly in the form of CBT.
“It’s vital that these services also offer people the full range of effective therapies without long waits. There’s never going to be a one-size-fits-all solution for everyone with depression, so offering people a choice of effective options will enable more people to recover.” | Mental Health Treatments |
About a decade ago, 125 amateur cyclists from all over the UK filed into the laboratories at King’s College London. Aged between 55 and 79, they were there to participate in a long-term study examining how regular physical activity affects the ageing process.
Janet Lord, professor of immune cell biology at Birmingham University, who conducted the study in collaboration with King’s professor Steve Harridge, said the team were surprised by some findings when they examined the cyclists’ bodies and took blood samples over several years.
Her subjects, described as “very keen cyclists”, were fairly fit, riding up to 60 miles a week.
“We found things like increased fat in the body, which a lot of people tell you ‘oh, there’s nothing you can do about that, that’s part of ageing’ – just were not true. They didn’t happen in this group. We compared them with healthy older adults who were not regular exercisers. Our group did not lose muscle … and didn’t lose much bone mass either,” said Lord, who is the director of the university’s Institute for Inflammation and Ageing, and a special adviser to the House of Lords inquiry into ageing, which published a report in 2021.
The biggest surprise related to the thymus gland, which sits on top of the heart and makes white blood cells called T-cells. It normally shrinks in older people – but not in the cyclists. Its decline affects people’s immune system. “And that’s why you’re not very good at responding to new infections like Covid, or vaccines,” Lord said.
She and her team are still monitoring the cyclists to figure out how much exercise is needed, and how intense it needs to be, to reap the health benefits.
The study is one of many projects undertaken at British universities in recent years, as the UK carves out a leading role in ageing research globally. While still in its infancy, the longevity science sector is set to become a multibillion-dollar industry, forecast to grow to $2bn (£1.6bn) by 2030, according to Insight Analytics.
A number of longevity biotech startups have sprung up, such as Senisca in Exeter, Genflow Biosciences in London, and Shift Bioscience and clock.bio in Cambridge. In the US, the pack is led by California firms such as Altos Labs, which also has a research institute in Cambridge, Calico, backed by Google’s owner Alphabet, Unity Biotechnology and Retro Biosciences.
“We punch way above our weight in terms of the quality and the quantity of our scientific output in the ageing space,” said Lorna Harries, professor of molecular genetics at the University of Exeter, who set up the spinout Senisca in 2020. “But while we’re a scientific powerhouse, we need to develop our ability to turn our findings into things that are tangible outcomes in the real world.”
What many of these firms are working towards is a recipe for helping us live longer by ensuring our cells stay healthy. Currently, girls born in the UK in 2020 are expected to live for about 90 years, while boys are predicted to live about 87 years.
“Potentially, you could live to 120 if you did all the right things and you were lucky enough to have the right genes,” said Prof Lynne Cox at the University of Oxford, who specialises in cell senescence – the way cells that have been damaged or stressed change to a state that can damage surrounding tissues.
Ageing is generally regarded as the accumulation of damage to cells, or wear and tear, over time, that can lead to loss of function and common diseases such as diabetes, heart disease, dementia and cancer.
More than 60 years ago, the American anatomist Leonard Hayflick discovered that human cells have limited capacity to divide, after which they become senescent.
In 1993, Cynthia Kenyon at the University of California at San Francisco conducted a pioneering study which demonstrated that mutations in one gene in a species of worm could double their lifespan. But this could not be reproduced in humans. Today, there are various attempts at cellular reprogramming or other tweaks to halt or reverse ageing.
London-listed Genflow Biosciences, which last December became the first longevity company to float in Europe, uses a gene variant found in centenarians to try to develop a therapy that can repair DNA damage and extend the time we stay in good health by 25%. It intends to test an experimental therapy on people with an age-related liver disease called NASH within 18 months.
“Some people are lucky to have the good gene, and what we want to do is share that luck with everybody,” said Eric Leire, Genflow’s founder. “So it’s not just a few people who will have the chance to even live to 120 and never see chemotherapy in their life.”
Senisca is working on ways to restore the ability of cells to fine-tune the expression of their genes, in order to rejuvenate aged cells.
“Our fundamental discovery dates back almost 15 years,” said Harries. “Each gene can make several different messages that contain instructions depending on what the cell encounters in its environment. We discovered that as we age, our cells lose this ability, which means they cannot react to challenging signals from the environment and they become senescent.”
She added: “We have found that if we restore the activity of those genes, we can restore the ability of the cell to make what it needs, which allows the cells to rejuvenate.” Senisca aims to develop therapies that can benefit older people within the next 10 years.
Shift Bioscience, co-founded by the former Cambridge University biologist Daniel Ives, uses machine learning to explore cellular reprogramming.
The German-American geneticist Steve Horvath pioneered the first accurate “clock” to determine human ageing by examining chemical changes to DNA in different tissues. Similarly, Shift has developed a single cell ageing clock and will use it to find safe combinations of genes for cellular reprogramming. This is expected to take two years, followed by testing in human cells in the lab, on mice and eventually in humans.
Ives’s father, Steve, who is Shift’s finance chief, said: “The idea is to introduce genes into cells to trigger processes which make those cells biologically younger. This new focus on reprogramming really represents a new paradigm targeting the root causes of ageing.”
The co-founder of clock.bio, Mark Kotter, and its chief executive, Markus Gstöttner, plan to start a clinical trial before 2030 that aims to rejuvenate cells.
The anti-ageing industry in the US has attracted a flurry of interest from a clutch of health-obsessed tech entrepreneurs, some of whom are known as “buff billionaires” for their newfound fitness. Among those is Amazon founder Jeff Bezos, who backs Altos Labs.
Bezos and PayPal founder Peter Thiel are investors in San Francisco-based Unity Biotechnology, which focuses on eliminating or modulating senescent cells to restore damaged tissues, initially for neurological conditions and eye diseases. The artificial intelligence entrepreneur Sam Altman, chief executive of OpenAI, has invested in Retro Biosciences, which is betting on cellular reprogramming, as is NewLimit, backed by the cryptocurrency billionaire Brian Armstrong, chief executive of Coinbase.
“In the UK, there are way fewer startups in this space than you would expect, based on how much research we do,” said Harries. “I suspect it’s because as academics in the UK, we are not necessarily trained to be entrepreneurial.”
Cox says British academics often have too many other commitments. “The incentives are not there at the moment for academics to push to startups – it’s an incredibly risky thing to do … A lot of universities really struggle with the idea of commercialising.”
Lord points to the lack of a thriving venture capital sector to fund startups. “It’s huge in the US, and we just don’t have that here. So we’re very reliant on government funding. If we could get more venture capitalists interested in what’s going on in the UK, that would help.”
One area of research is inflammation, a main driver of biological ageing. Cox said: “The human genome is full of bits of viral DNA that crept in there over our evolution, and they’re normally repressed. But as we get older, they jump out again and trigger inflammation, the body’s response to an infection. The problem is the immune system is also old, and so it can’t deal with it.”
A group at Oxford University is looking at ways of improving elderly immune systems by making cells more able to clear out their rubbish, in a process called autophagy.
Centenarians tend to pass on longevity genes, but having the right gut bacteria is also key, academics say. Researchers in Japan found that gut bacteria in centenarians are different from those of other older people; one bacterium even acts as an antibiotic and kills harmful bacteria in the gut.
Social and economic factors come into play too. “People living with socioeconomic deprivation have a higher level of cell senescence; they’ve got more inflammation,” says Cox. “They’re exposed to things like pollution or poor diets. And you can see this molecular signature of them ageing faster.”
Researchers talk about a paradigm shift – moving to treating the shared causes of ageing diseases rather than their consequences, which will relieve the pressure on the NHS and other health systems.
Some are confident that the UK can be among the leaders in the longevity industry. Miles Witham, a professor of clinical trials for older people at Newcastle University, says: “We are world leaders in terms of laboratory ageing research in the UK; we’re also world leaders in the epidemiology of ageing in the UK. What is hard is to make sure that what we’ve learned comes through into clinical trials in humans and eventually into the clinic [to patients]. Nobody’s really doing enough of this in any country in the world. We’re trying to make sure that the UK is at the forefront of this.” | Longevity |
he Prime Minister has insisted people being brought into new roles in the NHS will be trained and regulated properly as he said the Tories can be trusted with the health service.
The Government has published its plan for a massive shake-up in how the NHS recruits and retains staff, promising thousands more workers, some of whom will train on the job.
Rishi Sunak told reporters on a visit to Addenbrooke’s Hospital in Cambridge that the General Medical Council (GMC) will bring new roles like physician associates into its remit, so they can prescribe.
He said “that’s what having a modern workforce is about”, adding: “It’s about adapting to how people’s health needs to be treated and if you talk to some of the people that I was talking to earlier, they’re doing all these new roles.
“We should be modernising the NHS so it’s fit for the future.
“Healthcare is evolving and the NHS needs to evolve with it, and that’s what the plan does.”
Mr Sunak later told a Downing Street press briefing the service was under pressure, in part due to an aging population.
He said: “Our society is growing older, the burden of illness is changing, and all of this will put pressure on an already overstretched workforce.”
He said governments from all parties had “ducked” the workforce challenge for decades but that “overcoming this won’t be quick or easy”.
He added: “It’s only possible because of the difficult decisions we’re taking elsewhere to cut the debt and by prioritising the NHS, there will be other things that we can’t afford.
“But the NHS is too important. So we’re making the tough calls, and doing things differently, to protect the long-term future of the NHS and this country.”
He said the plan eases pressures today but also protects “this precious national institution for the long term”.
He added: “You can trust this Government with the NHS.”
Under the plan, more than 300,000 extra nurses, doctors and other health workers are expected to be employed in the NHS in England over the coming years.
The possibility of cutting the amount of time doctors spend in medical school, driving up the number of home-grown NHS staff and ramping up apprenticeship places are among the ideas to deal with severe staff shortages.
It comes as officials warned that, without action, there could be 360,000 vacancies in the health service by 2037.
The plan, along with new retention measures, could mean the health service has at least an extra 60,000 doctors, 170,000 more nurses and 71,000 more allied health professionals in place by 2036/37.
Officials have asked the GMC regulator and medical schools to consult on the introduction of four-year medical degrees, which are five years at present, and medical internships, allowing students to start work six months earlier.
The document says the Government and NHS will:
– Double medical school training places to 15,000 by 2031, with more places in areas with the greatest shortages of doctors.
– Increase the number of GP training places by 50% to 6,000 by 2031.
– Almost double the number of adult nurse training places by 2031, taking the total number of places to nearly 38,000 by 2031/32.
– Ramp up apprenticeships so students can “earn while they learn”. The aim is to provide 22% of all training for clinical staff through apprenticeship routes by 2031/32, up from 7% today. To support this ambition, the NHS plans to reach 16% by 2028/29.
– Introduce medical degree apprenticeships, with pilots running in 2024/25, so that by 2031/32, 2,000 medical students will train via this route. Medical degree apprenticeships will be boosted to more than 850 by 2028/29.
– Expand dentistry training places by 40% so there are more than 1,100 places by 2031/32. To support this ambition, the Government says it will reach 24% more by 2028/29, taking the overall number that year to 1,000 places.
-Train more NHS staff domestically to reduce reliance on international recruitment and agency staff. In 15 years’ time, the Government expects around 9–10.5% of the NHS workforce to be recruited from overseas, compared to nearly a quarter now.
– Increasing training places for nursing associates to 10,500 by 2031/32. By 2036/37, there will be more than 64,000, compared to 4,600 today.
– Increasing physician associate (PA) training places to more than 1,500 by 2031/32. This will establish a workforce of 10,000 PAs by 2036/37.
Meanwhile, the NHS is to crack down on spending on expensive agency staff, with health leaders ordered to cut the bill by £10 billion by 2036/37.
Nurses will also be allowed to start work as soon as they graduate in May, instead of in September as they do currently.
Officials said the document will also have a “renewed focus on retention” – with more flexible working options and better career development.
It is hoped the plans, along with reforms to pension schemes, could mean up to 130,000 staff stay working in NHS settings longer.
The new plan has been backed by a £2.4 billion investment by the Government.
Health leaders have also agreed the plan needs to be revised every two years to accommodate changing needs across the service.
NHS chief executive Amanda Pitchard told the Downing Street briefing the plan was good for both staff and patients.
She said demand for health workers is increasing, and will continue increasing across the world.
“Doing nothing is not an option,” she added.
Writing in The Daily Telegraph, Health Secretary Steve Barclay said: “This plan presents a historic opportunity to do things differently to help ease pressures on staff and increase capacity so they can spend more time with patients.
“Whilst we need to attract new staff, we also want to make sure we support and retain existing staff who possess invaluable skills and experience.”
Labour’s shadow health secretary Wes Streeting claimed the Conservatives were taking ideas from his party.
He added: “The Conservatives have finally admitted they have no ideas of their own, so are adopting Labour’s plan to train the doctors and nurses the NHS needs. They should have done this a decade ago – then the NHS would have enough staff today.”
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The maker of weight-loss drug Wegovy has become Europe's most valuable firm, dethroning the French luxury conglomerate LVMH.
Shares rose after the Danish pharmaceutical giant, Novo Nordisk, launched the popular drug in the UK.
At the close of trading on Monday, the firm had a stock market valuation of $428bn (£339bn).
The drug is now available on the National Health Service in the UK and also on the private market.
Wegovy is an obesity treatment that is taken once a week which tricks people into thinking that they are already full, so they end up eating less and losing weight.
Famous personalities such as Elon Musk are among the reported users of the drug, which has captivated Hollywood and the public more widely since it was approved by regulators in the US in 2021.
Wegovy and Ozempic - a diabetes treatment with similar effects - have been described as "miracle" drugs.
But experts warn the jabs are not a quick fix nor a substitute for a healthy diet and exercise.
In trials, users often put weight back on after stopping treatment.
'Fanfare'
There has been a global shortage of the jabs so only limited stock arrived for the NHS in the UK.
The company has said it will continue to restrict global supplies as it works to ramp up manufacturing.
Sophie Lund-Yates, lead equity analyst at Hargreaves Lansdown, told the BBC's Wake Up to Money programme the firm had been "genuinely surprised" by the uptake and said it had been "a victim of its own success".
"It's not common that you see a pharmaceutical company so entrenched in popular culture but there are people saying that we need to take a step back and ensure it is being used appropriately and responsibly. Of course, with a lot of fanfare for a drug, you are risking a lot of blowback in the future," she said.
In the UK, NHS guidelines say patients can only access Wegovy, which contains the drug semaglutide, if they are significantly overweight and have weight-related health problems.
According to the Organisation for Economic Co-operation and Development (OECD), nearly one in three adults are obese in the UK, which is the highest level in Europe.
Last month, a new trial showed Wegovy has also been proven to reduce the risk of a stroke or heart attack.
While the findings still have to be fully reviewed, experts agreed the results were potentially significant. | Drug Discoveries |
It may feel like we should all be done with Covid-19, but sadly Covid-19 is not done with us. At the moment, cases in England are rising again, with a 10% rise overall in hospital admissions and the greatest increase in the north of England. With testing reduced, national monitoring paused, the ONS infection survey paused since spring and only recently relaunched, we have much less data about Covid than we ever had before. We know Covid hasn’t stopped evolving, and we have a good idea about what sort of situations might result in new and dangerous mutations, but with less surveillance of emerging variants and spread, we are losing what used to be a near real-time picture of the situation.
This makes it harder to know which variants are driving the increase in cases. The latest estimates suggest there is a soup, with several variants, including some derived from XBB, which emerged last year, as well as EG5.1 (Eris) and a small amount of BA.2.86 (Pirola), both of which were identified in the past few months. It seems as though this virus is ever-changing, and as a reflection of that, new data released in the last few days shows that the so-called Pirola variant has evolved again – and could be more immune-evasive than the XBB-derived variants.
So what drives this virus to change so much and so quickly? As viruses rapidly replicate, they are more prone to acquiring mutations. So the larger the number of infections, the more chance the virus will change. Many countries such as the UK have moved to a position of “living with the virus” without investing in testing, ventilation and infrastructure changes, and masking. Add to this that vaccine coverage and access to boosters is quite limited, and there’s a recipe for many Covid infections – and a greater likelihood of the virus changing.
There is also a theory that dangerous variants may be more likely to emerge when immunocompromised people are infected. Patients who are immunocompromised may struggle to completely clear the infection and this can enable the virus to persist at low levels and mutate over a long period of time. This has led to speculation that the BA.2.86 (Pirola) subvariant, which shares some similarities with the older BA.2 Omicron subvariants, may be an offshoot of these viruses that persisted in an immunocompromised host and became dramatically altered over time. This theory has been proposed for some time for other Covid variants of concern.
It is also becoming clear that the very drugs that can be used to help treat those with Covid can contribute to viral changes. This has been recently demonstrated with the antiviral agent molnupiravir. Molnupiravir actually works by creating mutations in the virus genome – many of these mutations stop the viral proteins from working properly, helping tackle the infection. Ideally the mutated virus wouldn’t spread, but a team of citizen scientists and researchers in the UK used sequencing data to show this is actually happening. The types of mutations caused by molnupiravir are quite different to those that occur most often in Sars-CoV-2 evolution, so it doesn’t necessarily mean that the use of the drug is driving a more dangerous set of viral variants. However, it does show that, akin to antibiotic resistance, we need to be aware and vigilant for the possibility of drug resistance emerging.
Molnupiravir is not as widely used in the UK – but it’s notable how variable access to antivirals and monoclonal therapies can be. Countries such as the United States widely prescribe antiviral agents and other countries have enabled such drugs to be bought over the counter, while many middle-income countries have limited access. The result is a patchwork landscape of inequitable access and potential overuse of particular drugs. This risks increasing viral resistance, more dangerous variants – and keeping those who need the drugs most without the help they need.
The vaccine-only strategy that the UK is using for vulnerable populations is an insufficient approach. Even with boosters, not everyone will have as effective a response to the vaccine – for example if they are immunocompromised or on drugs that affect the function of their immune system. Any person considered more vulnerable to Covid should be able to access well-regulated treatments, including monoclonals and antiviral drugs, to enhance their likelihood of tackling the virus – and head off the possibility of a chronic infection that could incubate new variants. In reality, access in the UK is patchy, with a “Goldilocks effect” whereby patients requesting them must be deemed ill enough to warrant the drug(s) yet not so ill the drugs would no longer be effective.
At least 500,000 people in the UK are considered clinically vulnerable. One recently told me that “I’d feel much braver if I knew there was a backup should I get infected. But it’s not clear any treatment would be available, so I feel like the responsibility for my health falls on me.” We urgently need a plan across the world that addresses such inequalities – and assesses how we use and prescribe the drugs that can help those most in need.
Sheena Cruickshank is an immunologist and professor in biomedical sciences and public engagement at the University of Manchester | Epidemics & Outbreaks |
A senior A&E doctor has described the "broken" system that consultants are trying to hold together on the second day of the junior doctors' strike.
Dr Mark Harmon clocked on at 8am for his shift inside the emergency department at Lewisham hospital in south London.
Contingency plans worked well through the morning, but the strain quickly showed as the numbers of patients coming through the doors increased.
"There's lot of inexperienced staff on the floor. Lots of nurses have been brought in as well and nurse practitioners," Dr Harmon told Sky News.
"The issue really is one of flow because as soon as those patients start coming in and presenting at the front door there's a limited capacity within the department, and obviously there's a limited number of beds within the hospital."
Halfway through his shift and the number of patients coming through the doors was increasing fast.
Their sister hospital in Woolwich put out a warning to patients that they could face up to a 12-hour wait for emergency care.
In Lewisham, Dr Harmon was very busy by early afternoon. "Majors cubicles are now all occupied, we have got over 20 patients waiting to be triaged at the front door," he said.
"The challenge is how we can free up majors cubicles and prevent a lengthy wait for patients arriving at the front door."
These are just some of the roles that junior doctors usually perform.
"No matter how hard we work within the department and within hospitals… there is limited capacity, but the priority is to make sure patients are safe," said Dr Harmon.
Read more:
Why are doctors striking - and why it could be the worst yet
Strike organiser on holiday as doctors stage walkout
'We need to fix the system'
While supportive of his junior colleagues outside on the picket lines, he said the system they were all working in, even on non-strike days, was unsustainable with current demands and staffing levels.
"The system is broken and we need to fix it," he warned.
"The workforce crisis is an immediate issue that we need to face, particularly with the junior doctor strike… that's just an immediate issue.
"There are many challenges facing the NHS and the only way we're going to address those in the short term and build a sustainable future is to invest in technology, because we're not going to solve the workforce crisis overnight."
As he finished his day shift, Dr Harmon was weary and stressed - that's fairly standard.
"Like most of my colleagues I have stayed a little bit longer to finish a few things for my patients," he said.
"It has been very busy this afternoon and quite stressful and the department is full."
Halfway through this 96-hour walkout and the strain is starting to show in England's hospitals and health services. | Health Policy |
AleksandarGeorgiev/Getty Images
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Extreme heat can slow cognition and increase anxiety, research finds.
AleksandarGeorgiev/Getty Images
Extreme heat can slow cognition and increase anxiety, research finds.
AleksandarGeorgiev/Getty Images
If you're feeling a bit brain-fogged these days, you might not be wrong to blame it on the heat.
Several summers back, researchers in Boston studied young adults living in college dorm rooms during a heat wave. Some had central AC, and slept at a cool 71 degrees Fahrenheit. But others slept in rooms without air-conditioning, where the temperature hovered around 80 degrees.
Each morning for nearly two weeks the students took a few tests, administered on their cell phones. The people who slept in the hotter dorm rooms performed measurably worse on the tests.
The tests included a math test requiring simple addiction and subtraction and a second test, the Stroop test, that jumbles colors and words. "So, if I show the word 'red' in the color blue, participants have to respond 'blue'," says study author Jose Guillermo Cedeño Laurent, an assistant professor at the Rutgers School of Public Health.
It's easy to get tripped up if your attention or reaction time is slowed, he says, and that's exactly what heat appears to be doing. "The magnitude of the effect was really striking," Cedeño Laurent says. "We saw reductions in the order of 10% in their response times and also their accuracy."
Part of this effect may be explained by interrupted sleep. It can be hard to get a good night's rest if you're not accustomed to the heat, and a lack of sleep could certainly impair reaction time and focus. But there's a body of evidence suggesting it may be something about the heat itself that interferes with cognition.
A similar study published in 2021 also documented a dip in cognitive performance at air temps of 79 degrees. Researchers found that as the temperature rose, activity in the parasympathetic nervous system, the anti-stress system that can help us stay calm and relaxed, was lowered. Plus oxygen saturation levels in the blood were lower at the elevated temperatures as well, which the researchers said could be expected to result in reduced cognitive performance.
Other studies have found an effect from heat on office workers and on standardized test score performance, says Caleb Dresser, an emergency medicine physician who also serves as the director of health care solutions at the Harvard Chan Center for Climate, Health and Global Environment.
One of these studies showed that productivity in the workplace is highest when the air temperature is about 72 degrees, and productivity starts to drop off in the mid-70s. And another shows that for high school students, taking a standardized test on a hot day is linked to poorer performance.
Dresser says the evidence suggests that heat can influence us in sometimes indiscernible ways. "All of these [studies] seem to point to a reduced ability to think clearly and quickly and efficiently when the body is too hot," he says.
There's also research to suggest that heat can make you moodier or irritated, in part, perhaps, by raising cortisol levels, and inducing a stress response.
Of course, you can acclimate to heat after several days of exposure, and our bodies have several built-in coping mechanisms that help us cool down. For instance, you'll begin to sweat sooner and blood flow to the skin increases, which can carry heat away from the body's core.
But, given the extreme heat waves that are becoming more common, there's increasing interest in better understanding the mechanisms by which heat may exacerbate or set off mood and anxiety-related problems. Dresser points to a study published in JAMA Psychiatry in 2022 that found hospital ER visits, for mental health conditions, rise during extremely hot days.
"I think this is consistent with what a lot of physicians will tell you if they have worked during hot conditions," Dresser says. Mental health is a concern all of the time, "but it can become a bigger concern during really hot conditions," he says.
Multiple factors likely explain how heat exacerbates the risks, beyond changes in stress hormones and sleep disturbances. Dresser points out that there's an overlap between populations who are vulnerable to mental health issues and populations that are unhoused or have intermittent access to housing.
And, clearly, if someone is living outside during a heat wave, there's a greater likelihood of significant impact. "There may be complicated social issues going on," he says.
A better understanding of all of these factors could help inform strategies to prevent or manage the challenges. "As we learn to live in a warming world where the summers are getting hotter, we need to be extra alert to recognize when conditions are dangerous and take steps to stay safe," Dresser says.
One of the key strategies is to stay well hydrated. This may sound obvious, but dehydration is common in the summer, and many people underestimate how much fluid they need to replace when they're sweating a lot or spending time outdoors.
In fact, the participants in the college dorm study benefited from staying well-hydrated. During the study, the researchers sent text messages asking all the participants how much liquid they'd consumed, and it turned out that the participants who slept in the hot dorm rooms, and drank less than 6 glasses of liquid per day, performed worse on the tests. And prior research has shown that being even a little dehydrated can impair cognitive performance.
It's a reminder that a simple step – remembering to drink plenty of water – can help protect not just our physical health, but our mental wellbeing, too. | Mental Health Treatments |
Matt Hancock took his mistress to private dinners with the US health secretary then altered a ministerial response to remove suggestions he invited her, leaked messages have revealed.
The latest revelation from more than 100,000 WhatsApp messages leaked to the Telegraph shows a conversation between Mr Hancock's former political adviser, Allan Nixon, and the former health secretary.
Gina Coladangelo, who Mr Hancock was having an affair with, attended two dinners with him at a G7 summit of health ministers held in Oxford about a month after their relationship started.
She was appointed a non-executive director of the Department of Health and Social care (DHSC) in September 2020, eight months before the pair started seeing each other in early May 2021.
Journalist Isabel Oakeshott said she leaked the messages in the interests of "public interest" after Mr Hancock handed them to her as she helped him write his Pandemic Diaries book.
The latest messages, revealed on Sunday, show Ms Coladangelo was invited to the dinners as Mr Hancock's guest with Xavier Becerra, US health secretary, on 3 and 4 June at Mansfield College, Oxford University.
After Mr Hancock was forced to resign over the affair in late June 2021 when CCTV footage was published of them kissing in his office, Labour MP Ben Bradshaw asked what role Ms Coladangelo played at the G7 meeting and what expenses she claimed.
Allan Nixon, Mr Hancock's former political adviser who had stayed on at DHSC to help Sajid Javid take over, had a WhatsApp conversation with Mr Hancock suggesting how he should answer the question.
Read more: How have Hancock's WhatsApps been leaked - and what is an NDA?
In the first exchange, Mr Nixon appeared to have scribbled out a printed answer and suggested another in biro.
The original suggested reply said: "Gina Coladangelo attended the G7 Health Ministers' Meeting at the request of the previous Secretary of State, for the Department of Health and Social Care."
But Mr Nixon wrote this should be changed to: "Gina Coladangelo played an advisory role to the Secretary of State at the G7 meeting."
Mr Hancock then suggested a further version that erased any link to him: "Gina Coladangelo attended the G7 in her role as a non-executive director of DHSC."
The final response, published on 28 October 2021, removed any reference to Mr Hancock or the DHSC by name.
"Gina Coladangelo attended the G7 health ministers' meeting as a part of the UK delegation," it read.
Read more:
Hancock told aides he wanted to 'frighten the pants off everyone' on COVID
Leaked messages show Hancock's reaction to filmed 'snog' with aide
In response to the question about expenses, Mr Hancock had wanted it to say "zero" but Mr Nixon said this was overruled by Sir Chris Wormald, DHSC's permanent secretary.
Mr Hancock said it was true she incurred no expenses and warned: "This will be another s*** show if it goes wrong."
The final answer read: "All travel and subsistence costs were covered as part of the Department's overall booking. Ms Coladangelo did not claim any additional expenses."
Sky News understands Matt Hancock believes it is normal for parliamentary questions to be amended, with ministers doing so frequently.
Sources close to him said it is outrageous to suggest he did anything wrong and the response was reasonable and accurate.
Also released on Sunday were WhatsApp messages from head of the civil service Simon Case, who was the cabinet secretary under Mr Johnson.
He said to Mr Hancock the public needed to be told to isolate by "trusted local figures, not nationally distrusted figures like the PM" in October 2020, as the government was expanding testing, the Telegraph reported.
Earlier this week, the Telegraph released messages showing Mr Hancock and others discussing how to use the Kent COVID variant to scare the public so they would obey the rules in December 2020.
Mr Hancock told aides he wanted to "frighten the pants off everyone" to ensure restriction compliance.
Another set of messages was revealed this week showing Mr Hancock's former aide called Boris Johnson's senior adviser Dominic Cummings a "f***ing piece of s***".
Jamie Njoku-Goodwin made the remark in March 2021 after Mr Cummings described the DHSC as having been reduced to a "smoking ruin" by the pandemic during a parliamentary committee hearing.
He also called him a "psychotherapist" before quickly correcting the typo to: "Psychopath." | Health Policy |
Scientists develop gel from spider venom to boost erectionsOne of the key advantages of this treatment is its topical application, which can expedite approval processes thanks to lower risks of adverse effects.Rizwan Choudhury| Sep 28, 2023 07:33 AM ESTCreated: Sep 28, 2023 07:33 AM ESThealthBrazilian wandering spider Phoneutria nigriventer.Credits: TacioPhilip/iStock Get a daily digest of the latest news in tech, science, and technology, delivered right to your mailbox. Subscribe now.By subscribing, you agree to our Terms of Use and Policies You may unsubscribe at any time.A spider that can kill you with its bite may also hold the key to a better sex life for some men. A new gel made from the venom of the Brazilian wandering spider is being tested as a treatment for erectile dysfunction. The gel has already passed the first stage of human trials and is ready for the next phase.Venomous spider with a surprising potentialThe star of this scientific breakthrough is the Phoneutria nigriventer, commonly known as the banana spider or wood tree spider. Found in South American countries, including Brazil, this arachnid's venom is notorious for its toxicity. Its bite can cause rapid heartbeat, seizures, shock, and even death in humans. But it can also cause another effect: a prolonged erection that can last for hours. This effect, known as priapism, can be painful and harmful to the penis if left untreated. However, it has also sparked the curiosity of scientists looking for new ways to treat erectile dysfunction. They have been studying the venom for more than 10 years and are close to finding a solution. See Also Related Georgia faces brain-infecting worm invasion, study warns Scientists developed synthetic tissue that restores erectile function in pigs First over-the-counter erectile dysfunction gel gets FDA nod, will hit shelves in 2025 Under the leadership of Professor Maria Elena de Lima, researchers from the Federal University of Minas Gerais (UFMG) embarked on a journey to understand the pharmacological mechanisms behind priapism caused by the spider's venom. Their ultimate goal was to develop a safe and effective drug for erectile dysfunction.The result of their efforts is a synthetic molecule named BZ371A. This molecule has garnered 22 international and nine applied patents, underscoring its potential as a groundbreaking solution.The origins of this remarkable drug date back to the doctoral thesis of researcher Kenia Pedrosa Nunes in 2008. Her work delved into the activity of the Phoneutria nigriventer toxin on erectile function, unveiling the pharmacological effects behind priapism.Further research, including the crucial contribution of Carolina Nunes da Silva, led to the identification of the synthetic peptide PnPP-19. This peptide, derived from the spider's toxin, proved to be a potential model for erectile dysfunction treatment.BZ371AThe drug candidate BZ371A recently received approval for phase 1 clinical trials by the Brazilian Health Regulatory Agency (Anvisa). Early trials have already shown that the compound is non-toxic to humans, a crucial milestone in drug development.Preliminary tests demonstrated that the topical application of BZ371A leads to vasodilation and increased local blood flow, facilitating penile erection. This promising result suggests that BZ371A could offer an effective solution to the 30% of patients who cannot use existing oral remedies, such as Viagra and Cialis, due to contraindications like hypertension or severe diabetes.Biozeus Biopharmaceutical, the company that acquired the patent for BZ371A, is gearing up for phase 2 clinical trials. These trials will focus on prostatectomy men with erectile dysfunction, potentially expanding the drug's application to this specific group.Paulo Lacativa, the executive director of Biozeus, believes this project could mark a historic moment for Brazilian research and innovation. He envisions it as an opportunity for Brazil to lead the way in developing a medication with global implications, showcasing the country's prowess in drug development."So far, the tests have shown that the gel works with a minimum amount and without any toxicity, as it is hardly detected in the blood," said Maria Elena de Lima, one of the developers of BZ371A and a professor at the Federal University of Minas Gerais, in a statement translated from Portuguese.One of the key advantages of BZ371A is its topical application, which can expedite approval processes due to lower risks of adverse effects. The drug has shown no detectable side effects, even when administered in high doses.Moreover, BZ371A holds promise for women as well. Phase 1 trials confirmed the safety of its topical application in women, raising the possibility of developing a medication for female sexual dysfunction, which affects approximately 40% of women worldwide.Viagra and other similar drugs are already quite effective at treating erectile dysfunction. But they do not work for everyone and some people have medical conditions or drug interactions that prevent them from using them. Biozeus claims that BZ371A has a novel mechanism of action, which means that it could be a good alternative for these people.According to clinicaltrials.gov, Biozeus's Phase II trial will test BZ371A on patients who have had their prostate removed, which can damage the nerves that control erections. The trial will involve 72 people, who will be divided into three groups. Some will receive a low dose of tadalafil (the active ingredient in Cialis) along with a fake gel, others will receive BZ371A along with a fake pill, and the third group will receive both BZ371A and tadalafil. The trial is expected to be finished by April 2024. HomeHealthAdd Interesting Engineering to your Google News feed.Add Interesting Engineering to your Google News feed.SHOW COMMENT (1) For You Huge star unleashes surprising mass prior to supernovaPredictions for what the world will be like in 2100?How much water is there on the Moon? Maybe not enoughMaybe you can hear sounds in space after allUS intelligence agencies may get AI intel bots soonUS Navy's first active giant 'Triton' drone squadron now liveAre smart phones destroying our mental health?Is carbon capture the missing piece in the net zero puzzle?Giorgio Rosa, the engineer who built his own islandAntimatter attracted by gravity find CERN scientists Job Board | Drug Discoveries |
Teachers complained about a lack of PPE in order “to have an excuse not to teach”, Gavin Williamson said in a leaked WhatsApp chat, commenting later that some teaching unions “really do just hate work”.
In new leaked WhatsApp messages from the Telegraph’s investigation, Matt Hancock, the then heath secretary, was asked by Williamson, who was the education secretary, to help unblock school requests for protective equipment if a child became ill at school as classrooms prepared to reopen after the first lockdown.
Williamson said it was “basically as a last resort so they can’t use it as a reason not to open. All of them will but some will just want to say they can’t so they have an excuse to avoid having to teach, what joys!!!”.
Teaching unions, including the National Education Union, were deeply critical of the government’s approach to schools reopening and exams, including a fiasco over A-level results predicted by an algorithm.
In October 2020, Williamson said publicly the following year’s exams would be postponed for a few weeks to make up teaching time. According to the leaked messages, Hancock then got in touch with his cabinet colleague to say “what a bunch of absolute arses the teaching unions are”.
Williamson replied: “I know they really really do just hate work.” Hancock then responded with a laughing emoji and a bullseye.
Dr Mary Bousted, joint general secretary of the National Education Union, said in response to the leak: “Why am I utterly unsurprised to now have it absolutely confirmed that Gavin Williamson was unfit to be secretary of state for education?”
In a statement on Wednesday, Williamson said: “Further to reports in the Telegraph and other outlets, I wish to clarify that these messages were about some unions and not teachers. As demonstrated in the exchange, I was responding regarding unions.
“I have the utmost respect for teachers who work tirelessly to support students. During the pandemic, teachers went above and beyond during very challenging times and very much continue to do so.”
The messages also reveal Hancock fought against Williamson to persuade the government to close schools in January at the height of the wave of the new Covid variant.
After initially losing the argument during a cabinet meeting, the then health secretary told an aide that “the next U-turn [was] born”, and added: “I want to find a way, Gavin having won the day, of actually preventing a policy car crash when the kids spread the disease in January. And for that we must now fight a rearguard action.”
Other disclosures on Wednesday indicated Boris Johnson bemoaning the likelihood of “another U-turn” over face masks in schools after advisers said it was “not worth an argument” over why Scottish schools would enforce them in the classroom but not schools in England.
Hancock also reportedly said No 10 did not want to change the “rule of six” for meetings to include children during lockdown, even though another minister said there was “no robust rationale”.
Discussing the issue of face masks in schools in a WhatsApp group with the prime minister, England’s chief medical officer, Prof Chris Whitty, appeared to say there were “no very strong reasons” either way, but Johnson received advice from senior aides that he would have difficulty communicating the difference.
The Scottish first minister, Nicola Sturgeon, had already announced children would need to wear face coverings in corridors. In a group chat, Johnson said: “Folks I am about to [be] asked about masks in schools. Before we perform another U-turn can I have a view on whether they are necessary?”
Two senior advisers apparently warned against conflicting communications advice. His then director of communications, Lee Cain, said: “Considering Scotland has just confirmed it will I find it hard to believe we will hold the line. At a minimum I would give yourself flex and not commit to ruling it out … Also why do we want to have the fight on not having masks in certain school settings.”
Simon Case, a senior official in No 10 who would become Johnson’s cabinet secretary, indicated that unless Whitty and the chief scientific adviser, Sir Patrick Vallance, were “willing to go out and say WHO and Scots are wrong, I think some nervous parents will freak out about this happening in Scotland, but not in England”.
But Whitty admitted there were “no strong reasons against in corridors etc, and no very strong reasons for”, and then added: “So agree not worth an argument.”
A day after the conversation, the government announced that secondary schoolchildren in areas with heightened lockdown rules would need to wear face masks in corridors. It included many parts of the north-west, Yorkshire and Leicester.
In October 2020, the rule of six policy was questioned by Helen Whately, the minister for adult social care, who said she wanted to “loosen [it] on children under 12 … it would make such a difference to families and there isn’t a robust rationale for it”.
Hancock said No 10 “don’t want to go there on this … Also on curfew – they don’t want to shift an inch.” The rule of six – where gatherings of more than six people were against the law, except in certain circumstances – remained in place for much of the rest of the pandemic, apart from during stricter lockdowns when no social mixing was allowed.
Whately defended her former colleague in the Commons on Wednesday, saying “selective snippets” of leaked WhatsApp messages were misleading.
Hancock issued a furious response to the leaking of his WhatsApp messages, which he had previously given to the journalist Isabel Oakeshott to ghostwrite his book. Oakeshott, who is said to have signed an NDA, said she had made them available to the Telegraph in the public interest. | Health Policy |
Researchers say the central districts in Sydney are close to becoming the first place in the world to reach the U.N.'s target for ending transmission of HIV. The city was once at the heart of Australia's HIV epidemic but new infections among gay men have fallen by 88% between 2010 and 2022. The U.N.'s goal is a 90% reduction in cases by 2030.
In 1987, the 'Grim Reaper' advert warned Australians about the march of a deadly virus.
"At first, only gays and IV drug users were being killed by AIDS," the TV spots said, "but now we know everyone one of us could be devastated by it."
HIV attacks the body's immune system, and if not treated, can lead to AIDS.
In the central parts of Sydney, Australia's biggest city, thousands of gay men died in the 1980s and '90s.
In remarkable turnaround, researchers say that only 11 new HIV cases were recorded in central Sydney last year.
Almost all HIV-positive people in Australia are on antiretroviral drugs. They suppress the level of the virus in the blood, reducing the risk of sexual transmission. There's also the use of pre-exposure prophylaxis. These are preventative medicines taken by people who don't have HIV to lower their chance of infection.
Gay men make up about 20% of the male population in inner Sydney, and they represent most of the city's HIV cases.
The research confirming the change in HIV rates in Sydney was presented to the International AIDS Society's HIV science conference being held in the Queensland city of Brisbane by Andrew Grulich, an epidemiologist at the University of New South Wales. He told the Australian Broadcasting Corp's 7.30 program earlier this month that he's seen HIV gradually being conquered over his academic career.
"My life in research has been over that period," Grulich said. "So, it has been terrible, and it has been extraordinary and now it is getting close to wonderful, really, with the possibility that we have."
However, rates of infection have fallen by only a third in some outer Sydney suburbs, where public health awareness, access to medical treatments and testing new cases are more limited.
Jane Costello, the chief executive officer of Positive Life, an organization that helps people living with HIV, told VOA about some groups still being left behind.
"Overseas-born men who have sex with men, heterosexual populations, people from culturally and linguistically-diverse backgrounds and Aboriginal and Torres Strait Islander people," she said. "So, it is a question of equity as well."
The AIDS conference in Brisbane has heard that parts of the United Kingdom and Western Europe have also seen rapid drops in new HIV cases. But few places, if any, can rival Sydney's fall in infections of almost 90% over the past decade. | Epidemics & Outbreaks |
Competitive eating champ Joey Chestnut gulps downeach Fourth of July at the Nathan's Famous Hot Dog Eating Contest — and comes back do it again year after year. But no one really knows what long-term impacts it might have on his body or the bodies of other competitive eaters.
Chestnut has eaten as many as, setting a world record in 2021, and to win again in 2022.
Long-term consequences are not well known because competitive eating is a relatively new sport with a relatively small number of participants, Academy of Nutrition and Dietetics spokesperson Debbie Petitpain said.
But health experts say the practice does raise some potential health concerns.
The stomach, which normally contracts after people eat, could end up permanently stretched out, Dr. Rajeev Jain with Texas Digestive Disease Consultants said. It could also impact gastric emptying, the process by which food moves from the stomach into the duodenum.
"Nobody is going to get funded for a randomized, controlled trial where you say, 'Hey, I'm going to quadruple your stomach size and see what happens to you,' because there's no reason to do that type of thing from a medical perspective," Jain said.
Still, gastroenterologists have some idea of what happens when a trained competitor speed-eats dozens of hot dogs. A 2007 University of Pennsylvania study published in the American Journal of Roentgenology offers some clues.
What happens to the stomach of competitive eaters?
In the study, a control subject and a competitive speed eater — a 29-year-old man who was ranked in the top 10 worldwide — were asked to eat as many hot dogs as they could during a 12-minute period. While most contests call for including the buns, the study stuck to just hot dogs. Researchers studied the participants' stomachs beforehand, and asked each man to ingest an effervescent agent and high-density barium before eating the hot dogs so they could watch the food as it moved through the participants' bodies.
Based on fluoroscopy scans during the study, the researchers found the competitive eater's stomach was capable of expanding to accommodate significantly more extra food.
The control subject ate seven hot dogs before he felt sick and needed to stop. At the 10-minute mark, the competitive speed eater had ingested 36 hot dogs; researchers asked him to stop because they were worried for him.
"His stomach now appeared as a massively distended, food-filled sac occupying most of the upper abdomen, with little or no gastric peristalsis and emptying of a small amount of barium into the duodenum," the researchers wrote.
At the end, they said his abdomen protruded "enough to create the distinct impression of a developing intrauterine pregnancy."
Dr. David Metz, who was one of the authors of the study and has worked as a professor of medicine at the University of Pennsylvania's Perelman School of Medicine, said speed eaters have the ability to relax their stomachs so they can ingest more food.
The average, empty stomach is about the size of a fist or a fist and a half, he said. It's made of two parts: a receptacle on top and a grinder, of sorts, on the bottom. The stomach muscles will stretch to accommodate food as people eat, but every muscle "has its point at which there's no return."
"You could potentially end up with a big bag that doesn't contract properly," Metz said.
The study noted that competitive eaters have reported using "varying methods of training" to try to expand their stomach capacity, including ingesting "vast amounts of cabbage" or "water loading," which can be hazardous.
In the immediate aftermath of eating contests, participants report feeling extremely bloated and tired. They also report gastrointestinal distress in the day or two after a competition.
Other side effects of competitive eating
Competitive eating impacts more than just the stomach. Participants can become sweaty, light headed and faint in the aftermath, experts said. Some speed eaters have noted pain in their face, jaw and neck afterwards because of the amount of chewing and swallowing involved.
"Some athletes have reported arthritis in the jaw, excruciating pain in that area," Petitpain said.
It's not just the large quantity of food that's a problem. It's also the type of food. Hot dogs are high in sodium. According to the nutritional information on Nathan's website, one of its Original Coney Island natural casing beef hot dogs contains 170 calories, 16 grams of fat (including 6 grams of saturated fat), and 480 milligrams of sodium. Other varieties are higher. The USDA's 2020–2025 Dietary Guidelines recommend that Americans consume less than 2,300 milligrams of sodium each day. It would take fewer than five hot dogs to go over the daily limit.
"If they're absorbing too much sodium, their thirst mechanism is going to kick in and they're going to drink a lot of water afterwards," Jain said. "My concern is, if your stomach is so full of food, how are you going to get the other compensatory liquids in?"
Ingestingcan impact kidney function. The spike in sodium can also cause blood pressure to soar, putting pressure on blood vessels in the body, Petitpain said.
"If there's a weak spot in those blood vessels that gets stressed, that could cause a heart attack," Petitpain said. "Or if there is a bursting of the vessels in the brain, a stroke."
The high level of fat ingested could cause nausea, diarrhea and gastrointestinal distress, Petitpain said.
During the annual contest, the competitors also eat the buns, which means a lot of carbs.
"This large load of protein, of carbohydrates, of starches, all these things, they're now going to be dumped into the small intestine. And while this is going on, your body has to crank up its insulin," Jain said.
But all told, if the competitive eater goes back to a normal diet once a contest is over, their body should regulate back to normal.
"Your body is a very adaptive organism," Metz said. "The kidneys flush out the excess sodium and other micronutrients"
There are still dangers, though. Beyond the immediate stomach pains competitors might feel, there are much worse possibilities. Competitors who vomit risk aspirating or tearing the lining of their esophagus, Metz said.
People have died during eating competitions. In 2017, a 20-year-oldafter choking during a pancake-eating contest. That same year, a during a donut eating contest.
"There's a lot of danger involved and many of us have been very concerned about this," Metz said.
Major League Eating, the organization that oversees professional competitions, does have safety teams on hand at events, and says it "strongly opposes and discourages home training of any kind." The organization did not respond to repeated requests for comment.
for more features. | Nutrition Research |
DHAKA,Bangladesh -- Bangladesh is struggling to deal with higher casualties and infections from dengue this year, with officials warning that the death toll this month could break records.
The government’s Directorate General of Health Services reports the 2023 death toll from the mosquito-born illness has reached 364 in the south Asian country. More than 78,000 people have been infected since January this year, it said.
Officials warn that the number of deaths and infections this month could set a new, grim record. In the first 10 days of August, more than 23,000 people were diagnosed with dengue, compared to 43,854 cases during all of July. More than 100 people have died so far this month, over a third as many deaths from the illness during all of last year.
In 2022, 62,382 people were infected and 281 people died of dengue, according to government figures.
Dengue causes flu-like symptoms that most people recover from, but also can rapidly lead to internal bleeding, organ failure and even death. There generally is no specific treatment for the disease, but vaccines are available Other countries, such as Cyprus and Bolivia, also have seen outbreaks this year.
Experts say monsoon season could exacerbate the outbreak in the country of more than 160 million people. Intermittent rains in August is one of the major reasons for the outbreak, according to experts. Many people work outside on Bangladesh's numerous construction projects, including residential and big infrastructure projects across the capital city of Dhaka.
Infected people are overwhelming hospitals across the country, but some doctors and nurses are not sufficiently experienced, or trained, in how to treat dengue cases, experts say.
Mohammed Niatuzzaman, Director of Mugdha Medical Collage Hospital, said on Thursday that they were struggling to provide critical support to serious patients who have other ailments. Many of the critical patients are dying, he said.
People with immune suppression — like cancer patients — or people with co-morbidities like diabetes, kidney dialysis or organ transplants are particularly vulnerable, he said.
“People who have weaker immune system are at higher risk to be infected multiple times by a virulent variant (of dengue),” he said.
The Ministry of Health has arranged extra beds in state-run hospitals in Dhaka and outside, but a shortage of IV saline has become a challenge. The authorities have asked the manufacturers to increase their production of IV fluid.
Niatuzzaman said it's critical to fight the disease on multiple fronts.
"It must start from individual level and rise to our collective effort. Doctors are only a part of it. If we work together and everybody shows awareness and acts responsibly, our collective effort will make dengue prevention possible,” he said.
Two city corporations in Dhaka opened emergency teams to coordinate anti-mosquito drive and urged the residents to be aware of the breeding possibilities of Aedes mosquitoes, which thrive in the region.
Mobile teams have been deployed to search homes to see if water is stored where mosquitoes could breed.
But local residents gave the government effort mild reviews.
Salma Jahan, a Dhaka resident and mother of a Dengue patient, said that she was worried.
“The government took a lot of measures last time. They applied insecticide in a lot of water bodies and its surroundings in our area. They also went to people’s houses and applied liquid insecticide on drains and dirty places. We still have such places but no insecticide is being applied,” she said, questioning whether the treatments are even effective.
The teams come with insecticide every few days, she added, "but mosquitoes don’t die from it.” | Epidemics & Outbreaks |
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