StemCell Therapy

In the mid-2000s, Dr. Nadine Burke Harris opened a children's medical clinic in the Bayview section of San Francisco, one of the city's poorest neighborhoods. She quickly began to suspect something was making many of her young patients sick.

She noticed the first clues in the unusually large population of kids referred to her clinic for symptoms associated with attention deficit hyperactivity disorderan inability to focus, impulsivity, extreme restlessness. Burke Harris was struck not just by the sheer number of ADHD referrals, but also by how many of the patients had additional health problems. One child arrived in her clinic with eczema and asthma and was in the 50th percentile of height for a 4-year-old. He was 7. There were kindergarteners with hair falling out, two children with extremely rare cases of autoimmune hepatitis, middle-school kids stricken with depression and an epidemic number of kids with behavioral problems and asthma.

Burke Harris noticed something else unusual about these children. Whenever she asked their parents or caregivers to tell her about conditions at home, she almost invariably uncovered a major life disruption or trauma. One child had been sexually abused by a tenant, she recalls. Another had witnessed an attempted murder. Many children came from homes struggling with the incarceration or death of a parent, or reported acrimonious divorces. Some caregivers denied there were any problems at all, but had arrived at the appointment high on drugs.

Although none of her mentors at medical school back in the early 2000s had suggested that stress could cause seemingly unrelated physical illnesses, what she was seeing in the clinic was so consistentand would eventually so alarm herit sent her scrambling for answers.

"If I were a doctor, and I was seeing incredibly high rates of autism, I'd be doing research on autism," she says. "Or if I saw incredibly high rates of certain types of cancer, I'd be doing that research. What I was seeing was incredibly, incredibly high rates of kids who were experiencing adversity and then having really significant health outcomes, whether it was difficulty learning, or asthma, or weird autoimmune diseases. I was seeing that the rates were highest in my kids who were experiencing adversity. And that drove me to the latest scientific literature."

What Burke Harris found there would eventually thrust her to the forefront of a growing movement that aims to transform the way the medical profession handles childhood adversity. Childhood stress can be as toxic and detrimental to the development of the brain and body as eating lead paint chips off the wall or drinking it in the waterand should be screened for and dealt with in similar ways, in Burke Harris' view. As California's first Surgeon General, a newly created position, she is focusing on getting lawmakers and the public to act.

Earlier this year, thanks in part to her advocacy, California allocated more than $105 million to promote screening for "Adverse Childhood Experiences" (ACEs)10 family stressors, first identified in the late 1990s, that can elicit a "toxic stress response," a biological cascade driven by the stress hormone cortisol that is linked to a wide range of health problems later in life.

In recent years, epidemiologists, neuroscientists and molecular biologists have produced evidence that early childhood experiences, if sufficiently traumatic, can flip biological switches that can profoundly affect the architecture of the developing brain and long-term physical and emotional health. These "epigenetic" changesmolecular-level processes that turn genes on and offnot only make some people more likely to self-medicate using nicotine, drugs or alcohol and render them more susceptible to suicide and mental illness later in life. They can impair immune system function and predispose us to deadly diseases including heart diseases, cancer, dementia and many others, decades later. Not only does childhood stress harm the children themselves, but the effects may also be passed down to future generations.

A groundswell of support has arisen in the world of public health in favor of treating childhood adversity as a public health crisis that requires interventiona crisis that seems to run in families and repeat itself in trans-generational cycles. At last count, at least 25 states and the District of Columbia had passed statutes or resolutions that refer to Adverse Childhood Experiences. Since 2011, more than 60 state statutes aimed at ACEs or intervening to mitigate their effects have been enacted into law, according ACEs Connection, a website devoted to tracking the phenomenon and providing resources. California's effort is among the most aggressive. The state has set aside $50 million for next year to train doctors to provide screening, and $45 million to begin reimbursing doctors in the state's MediCal program for doing so ($29 for each screening). If it proves effective, other states may soon follow.

"The social determinants of health are to the 21st century, what infectious disease was to the 20th century," says Burke Harris. She rose to national prominence after writing a 2018 book on the subject, embarking on a national book tour and recording a TED Talk that has been viewed more than 6 million times. She was tapped for her new post by Governor Gavin Newsom in January 2019.

The research is so fresh that many clinicians are still debating the best way to tackle the problem, most significantly whether the science is mature and the interventions effective enough to implement universal screening. And the details of California's approach to screening are controversial in the world of public health. (The epidemiologist who developed a key questionnaire being used as a screening tool says it was never intended to be used to evaluate individuals.) But there is broad consensus, at least, about one thing. For all the buzz in public health and policy circles about "ACEs," few people have heard the term before. The first task, many people on the front lines of health education agree, will be to change that so that caregivers themselves can learn about the vicious cycle of childhood adversity, and get the help they need to break it.

The Science of Toxic StressThe research on ACE stems from a seminal 17,000-person epidemiological study published in 1998. The first clue came years earlier, however, with the plight of an obese, 29-year-old woman from San Diego named Patty.

Over the course of a 52-week trial of a weight-loss diet, Patty dropped from 408 lbs. all the way down to 132. Then, over a single three-week period, she abruptly gained 37 pounds of it backa feat that her doctors didn't even know was scientifically possible.

Patty's dramatic weight swings got the attention of Vincent Felitti, the head of the preventative medicine program at the massive managed care consortium Kaiser Permanente, and the man who had designed the obesity study. Felitti had been astounded at the rapid pace with which the study subjects lost weight. "In the early days of the obesity study, I remember thinking 'wow, we've got this problem licked,'" Felitti recalls. "This is going to be a world-famous department!"

Then, for reasons nobody could explain, patients began dropping out of the program in droves. Felitti found it particularly alarming because the ones leaving the fastest seemed to be the ones losing the most weight. When Felitti heard about Patty, he arranged a chat. Patty claimed she was just as mystified by her massive weight gain as he was; she assured him she was still vigilantly sticking to the diet. But then she offered up a suggestive clue: Every night when she went to bed, she told Felitti, the kitchen was clean. Yet when she woke up, there were boxes and cans open and dirty dishes in the sink. Patty lived alone and had a history of sleepwalking. Was it possible, she wondered, that she was "sleep eating?"

When Felitti asked her if anything unusual had happened in her life around the time the dirty pots and pans began to appear, one event came to mind. An older, married man at work had told her she looked great and suggested they have an affair. After further questioning, Felitti learned Patty had first started gaining weight at age 10, around the time her grandfather began sexually molesting her.

Felitti came to believe that for Patty, obesity was an adaptive mechanism: she overate as a defense against predatory men. Felitti began asking other relapsing study participants if they had a history of sexual abuse. He was shocked by their answers. Eventually, more than 50 percent of his 300 patients would admit to such a history.

"Initially I thought, 'Oh, no, I must be doing something wrong. With numbers like this, people would know if this were true. Somebody would have told me in medical school,'" he recalls.

Felitti started bringing patients together in groups to talk about their secrets, their fears and the challenges they facedand their weight loss began to stick. Within a couple years, the program was so successful that Felitti was receiving regular invitations to speak about his program to medical audiences. Whenever he brought up sexual abuse and its apparent link to obesity, however, audience members would "storm explosively" out of the room or stand up to argue with him, he says. Nobody, it seemed, wanted to hear what he had to say.

At least one person was intrigued by his findings. Robert Anda, a researcher at U.S. Centers for Disease Control (CDC), had been studying chronic diseases and the counterintuitive links between depression, hope and heart attacks. He knew firsthand what it was like to deal with colleagues who considered his work flaky. Anda and Felitti got to talking. They realized there was only one way that both of them would be able to overcome the skepticism they were encountering: they needed to do a rigorous study. At Anda's urging, Felitti agreed not just to recruit a larger sample but to expand its scope to examine the link between a wide array of common childhood stressors and health later in life.

This became the ground-breaking "ACE Study," a 17,000-person retrospective project aimed at examining the relationship between childhood exposure to emotional, physical and sexual abuse and household dysfunction, and risky behaviors and disease in adulthood. Starting in 1998, and continuing with follow-ups well into the 2000s, Felitti and Anda's team published a series of counterintuitive papers that upended much of what we thought we knew about the mind-body connection.

To gather the data, Felitti persuaded Kaiser Permanente-affiliated doctors to recruit patients in Southern California undergoing routine physical exams. The patients were asked to complete confidential surveys detailing both their current health status and behaviors, and the types of adversity they've endured: physical, emotional and sexual abuse, neglect, domestic violence, parental incarceration, separation or divorce, family mental illness, the early death of a parent, alcoholism and drug abuse. To analyze the data, the researchers added up the number of ACEs, calculated an "ACE score," then correlated those scores with high-risk behaviors and diseases to see if they could find any patterns.

The first shocker was just how common these ACEs were. More than half of those participating had at least one, a quarter had two or more and roughly 6 percent reported four or more. This was not just a problem of the poor. Childhood emotional adversity cut across all racial, ethnic and economic lines. Even more surprising was the impact of these stressors later in life. When the researchers ran their analysis, they discovered a direct, dose-dependent link between the number of ACEs and behavioral issues like alcoholism, smoking and promiscuitythose who had experienced four or more categories of childhood exposure had a four- to 12-fold increased risk of alcoholism, drug abuse, depression and suicide attempts.

The results went beyond these common trauma-related health risks. The study also linked childhood trauma to a host of seemingly unrelated physical problems, including ischemic heart disease, cancer, chronic lung disease, skeletal fractures and liver disease.

What made the study so shocking was that the data suggested that even those who didn't drink, use drugs or act out in risky ways still had a far higher rate of developing ischemic heart disease, cancer, chronic lung disease, skeletal fractures and liver disease. Unexpectedly, the researchers had discovered that childhood adversity seemed to be an independent risk factor for some of the leading causes of death decades later.

"We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults," the authors wrote.

The study dropped like a bomb in the world of public health. But the scientific work was just beginning. In the years since, scores of researchers have begun to dig into the biological mechanisms in play. And with emerging brain scanning technologies and advances in molecular biology, an explanation for the ACE study has begun to emerge. Some clinicians and scientists have begun to turn these findings into concrete interventions and treatments they hope can be used to reverse or at least attenuate the impact.

Much of the research has focused on how ACEs affect the functioning of the hypothalamic-pituitary-adrenal (HPA) axis, a biological system that plays a key role in the mind-body connection. The HPA axis controls our reactions to stress and is crucial in regulating an array of important body processes including immune function, energy storage and expenditureeven our experience of emotions and mood. It does so by adjusting the release of key hormones, most notably cortisol, the release of which is increased by stress or low blood sugar levels.

Cortisol has many functions. On a daily basis, it regulates the level of energy we have as the day progresses: we generally experience our highest levels of cortisol, and energy, upon waking up. These levels gradually diminish throughout the day, reaching very low levels just prior to bedtime.

Cortisol also serves a role in the body's energy allocation during times of crisis. When all is calm, the body builds muscle or bone and socks away excess calories for future consumption as fat, performs cellular regeneration and keeps its immune system strong to fight infection. In the case of a child, the body fuels normal mental and physical development.

In an emergency, however, all these processes get put on hold. The HPA axis floods the bloodstream with adrenaline and cortisol, which signals the body to kick into overdrive immediately. Blood sugar levels spike and the heart pumps harder to provide a fast boost in fuel. If an 11-foot-tall grizzly bear is lumbering in your direction and licking his chops, the additional burst of energy helps you run screaming through the woods or wrestle the critter to the ground and plunge a Bowie knife into its heart.

However, when the emergency goes on for a long timeperhaps over an entire childhood of abusethe resulting high levels of cortisol take a big and lasting toll.

Almost as soon as the ACE study was published, dysregulated cortisol levels seemed a likely culprit to explain the study's startling implications. Was it possible that the chronic stressors identified by Felitti and Anda led to elevated cortisol levels in children? And could those elevated levels account for seemingly unrelated diseases and the range of additional problems that researchers were beginning to link to ACEs?

In the decade after the 1998 ACE study, researchers began seeking out children in Romanian orphanages and measuring cortisol levels, in the hopes of verifying this hypothesis. When researchers began to compare their levels to that of children who had not faced adversity, they found substantial differences. But the results were difficult to interpret.

"There was growing evidence that there was an impact, but the studies were contradictory," says Jackie Bruce, a research scientist at the Oregon Social Learning Center, an NIH-funded research center in Eugene that studies child development. "Sometimes people were finding kids with early adversity had low cortisol and sometimes they were finding they had high cortisol."

In 2009, Bruce and her colleagues demonstrated a possible explanation for the discrepancies. Since morning cortisol levels play such an important role in getting well-functioning individuals ready for the day, they sought out a group of 117 maltreated 3- to 6-year-old children transitioning into new foster care placements in the United States. The researchers then trained the children's caregivers to collect saliva samples before breakfast. For comparison, they recruited a control group of 60 low-income children living with their biological parents who had no previous record of abuse or maltreatment.

Children who had experienced more severe emotional, physical and sexual maltreatment did indeed have abnormally high morning cortisol levels. But scientists also found that children who experienced more severe neglect had abnormally low morning cortisol levels. Different types of adversity, in other words, had different impacts on the HPA system. But whether the adversity took the form of an absence of stimulation or the presence of negative, threatening stimulation, the effect was bad for normal development.

"Low cortisol levels, particularly in the morning, had been linked to externalizing disordersthings like delinquency and alcohol usewhereas high cortisol levels have been linked to more anxiety and depression," and post-traumatic stress disorder, Bruce says.

Even so, Bruce and her colleagues noted that within both groups, "some kids are doing really well, some kids are not doing well." This suggested other factors were also involved. And in recent years, much of the research has focused on understanding the complex interaction between external stressors, genetics and interpersonal interventions.

One of the most important findings to emerge recently is that the experience of childhood adversity, by itself, does not appear to be enough to lead to toxic stress. Genetic predispositions play a role. But even among those predisposed, the effects can be blunted by what researchers call emotional "buffering"a response from a loving, supportive caregiver that comforts the child, restores a sense of safety and allows cortisol levels to fall back down to normal. Some research suggests that this buffering works in part because a good hugor even soft reassuring words from a caregivercan cause the body to release the hormone oxytocin, sometimes referred to as the "cuddle" or "love" hormone.

One of the reasons the ACE study was so effective at highlighting the potential long-term health effects that early childhood adversity can have on health, says Burke Harris, was the nature of the stressors measured. The stressors took place within the context of a family situation that often reflected the failure of a caregiver to intervene as a needed protector.

"The items that are on the ACE screening have this amazing combination of being high stress and also simultaneously taking out the buffering protected mechanisms," Burke Harris says. "If you're being regularly abused, often it's partially because your parents are not intervening."

This hypothesis is supported by experiments in rodents. Back in the 1950s, the psychiatrist Seymour Levine demonstrated that baby rats taken away from their mothers for 15 minutes each day grew up to be less nervous and produce less cortisol than their counterparts. The reason, he suggested, was due to affection from their distressed parent in the form of extra licking and grooming. Studies in the 1990s confirmed that the extra affection and comfort offered by the affectionate parents seemed to have flipped biological "epigenetic" switches that caused their offspring to internalize the sense of safety that had been provided and replicate it biochemically as adults.

Scientists have since documented many biochemical mechanisms by which emotional buffering can help inoculate children exposed to adversity to long-term consequences, and how chronic overactivation of the HPA axis can interfere with developmentor, as one widely cited scientific paper put it, can have an impact akin to "changing the course of a rocket at the moment of takeoff." Neglected and abused Romanian orphans were shown to have smaller brains as a population than those placed in loving foster homes, suggesting a lack of stimulation interfered with normal neuronal growth. Adversity and stress without adequate buffering can turn on genes that flood the system with enzymes that prime the body to respond to further stress by making it easier to produce adrenaline and reactivate the fight-or-flight response quickly, which can make it harder for children with toxic stress to control their emotions.

Toxic stress can also have powerful influences on the developing immune system. Too much cortisol suppresses immunity and increases the chance of infection, while too little cortisol can cause an inflammatory immune response to persist long after it is needed. That can act directly on the brain to produce "sickness behavior," characterized by a lack of appetite, fatigue, social withdrawal, depressed mood, irritability and poor cognitive functioning, according to a 2013 review paper aimed at bringing pediatricians up to speed on the emerging science. As adults, children maltreated during childhood are more likely to have elevated inflammatory markers and a greater inflammatory response to stress, the researchers reported. Chronic elevations in cortisol have also been linked to hypertension, insulin resistance, obesity, type 2 diabetes and cardiovascular disease.

In recent years, Fellitti and Anda's original 1998 paper has been cited more than 10,000 times in further studies. And as awareness in the public health community has risen, so too has the amount of data available to work with, and the vast body of research documenting the far-reaching consequences of ACEs. Last fall, the CDC analyzed data from 25 states collected between 2015 and 2017, and more than 144,000 adults (a sample 8.5 times larger than the original 1998 study). The authors noted that ACEs are associated with at least five of the top 10 leading causes of death; that preventing ACEs could potentially reduce chronic diseases, risky health behaviors and socioeconomic challenges later in life and have a positive impact on education and employment levels. Reducing ACEs could prevent 21 million cases of depression; 1.9 million cases of heart disease; and 2.5 million cases of obesity, the authors said.

Hundreds of new studies are published every year. In just the last month, studies have come out analyzing the "mediating role of ACEs in attempted suicides among adolescents in military families," the impact of ACEs on aging and on "deviant and altruistic behavior during emerging adulthood."

How to Save the KidsWhile these findings help explain the link to chronic diseases, Harris Burke and other public health officials believe they also provide the basis for some of the most promising interventions in the clinic today. Not surprisingly given her background, Burke Harris looks to pediatric caregivers and other doctors to lead the effort to detect and treat patients suffering from toxic stress. To help them do it, late last year, California released a clinical "algorithm": basically a chart spelling out how doctors should proceed once they compiled a patient's ACE score.

Patients are found to be high-risk for negative health outcomes if the doctor, using a questionnaire, can identify four or more of the adverse childhood experiences or some combination of psychological, social or physical conditions found in studies to be associated with toxic stress. For children, that's obesity, failure-to-thrive syndrome and asthma, but also other indicators such as drug or alcohol use prior to the age of 14, high-school absenteeism and other social problems. For adults, the list includes suicide attempts, memory impairment, hepatitis, cancer and other conditions found to be higher in populations with high ACE scores.

Doctors are encouraged to educate all patients about ACEs and toxic stress regardless of their ACE scores. For patients found to be at intermediate or high risk, additional steps are recommended. The first step in the case of children is to make sure parents or caregivers understand the links ACEs can have to adverse health outcomes. That way, they can be on the lookout for new conditions and take action to prevent them.

Key to this educational process is making sure caregivers understand the protective role buffering can play in countering the corrosive effects of stress. Buffering includes nurturing caregiving, but it can include simple steps like focusing on maintaining proper sleep, exercise and nutrition. Mindfulness training, mental health services and an emphasis on developing healthy relationships are other interventions that Burke Harris says can help combat the stress response.

The specifics will vary on a case-by-case basis, and will rely on the judgment and creativity of the doctor to help adult caregivers design a plan to protect the childand to help both those caregivers and high-risk adults receive social support services and interventions when necessary. In the months ahead, the protocols and interventions will be further refined and expanded. "Most of our interventions are essentially reducing stress hormones, and ultimately changing our environment," says Burke Harris. "But some of the things that I think are really exciting are on the horizon."

In recent years researchers have begun to explore whether the "love drug," oxytocina hormone released when a parent hugs a child might form the basis for potent pharmaceutical interventions. For now, however, "we're on the scientific frontier," she says.

The relatively young state of the science and the fuzziness and subjective nature of the tools California plans to use to evaluate the threat have alarmed some public-health experts. They worry that the state is moving too fast, before more is known about the science of toxic stress. Robert Anda, for one, is uncomfortable with the use of screening tools that rely on an ACE score. He worries it might be misused in the doctor's office because it doesn't measure caregiver buffering or genetic predispositions that might prove protective. The questionnaire he and Felitti developed for the original study was always meant to be a blunt instrumentsuited for a survey of a huge population of patients. The problem with applying it to individual patients, he says, is that it doesn't take into account the severity of the stressor. Who's to say, for instance, that someone with an ACE score of one who was beaten by a caregiver every day of their life is less prone to disease than someone with an ACE score of four who experienced these stressors only intermittently? On a population level, surveying thousands, the outliers would cancel each other out. But on the individual level they could be misleading.

It's a concern echoed by others. "I think the concept behind ACE screening, if it's about sensitizing all of us to the importance of looking for that part of the population that's experiencing adversity, I'd say that's good," says Jack Shonkoff, a professor of child health and development who directs the Center on the Developing Child at Harvard University. "But if it's used as an individual diagnostic test or indicator child by child, I would say that's potentially dangerous in terms of inappropriate labeling or inappropriate alarm. We need to make sure that people don't misuse this information so that parents don't feel like they've just been given some kind of deterministic diagnosis. Because it's not that. It's also dangerous to totally give a clean bill of health for a kid who may be showing symptoms of stress."

Burke Harris notes that she has been using ACE scores as part of her clinical care for more than a decade. When used correctly, it is only one part of a larger screening process. And she points out that despite the early phase of the field, the stakes are too high to wait any longer. "This is extremely urgent," she says. "It's a public health crisis. We have enough research now to act. And once we have enough research to act, not acting becomes an unconscionable path."

In the years ahead, more precise methods of detection will likely be available. Harvard's Shonkoff recently completed a large, nationwide feasibility study aimed at developing and rolling out a saliva test which could be used to screen for biomarkers that indicate a toxic stress response in both children and adults. The test, developed as part of a six-year, $13 million grant, measures the level of inflammatory cytokines present in the spit sample. Shonkoff and his colleagues are in the process of taking the next step, which involves gathering enough data to develop benchmarks that indicate normal and abnormal levels for stress markers by age, sex, race and ethnicity.

Even the cautious agree a little education will go a long way. "The most important fundamental prevention idea is that people who are caring for children, who are parenting children, need to understand that childhood adversities are likely leading to issues in their own lives," Shonkoff says. "And if they don't find a way to do things differently with support, they will be embedding that same biology back in their children."

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Yes, Stress Really Is Making You Sick - Newsweek

Leaving aside the troubling political agenda at play in the provincial governments review of supervised consumption sites, there were still a few themes that emerged from the report warranting further thought.

In particular, the review focused on a pattern of social disorder in areas around the sites provocative words like chaos, feces, and debris figured prominently in the governments presentation along with a need for better pathways to get people into treatment.

Those are fair concerns.

But instead of sensationalizing the extent of the issues and trying to have us believe the sites are largely to blame, Id respectfully suggest that any such problems have a deeper connection to a separate and more profound concern: alack of permanent, supportive housing.

In Edmonton, the construction of 900 units over the next six years is a need verging on the desperate, and one of city councils top priorities.

In fact, the initiative has been ready to move for some time, with the federal government poised to contribute and non-profit partners lined up to build.

All thats missing is a sense of urgency from the province, whose contributions would have a farbigger impact and far less controversy than shuttering consumption sites. Instead, it has delayed funding for any new projects while it conducts another of its countless reviews.

For those unclear what this sort of housing entails, it caters to low-income residents who have challenges beyond the financial.

In many cases, such clients have experienced chronic homelessness along with issues ranging from addiction struggles and mental illness to domestic violence and other complex trauma. Some have cognitive and physical impairment. A substantial percentage are Indigenous.

Generally speaking, permanent supportive homes are offered at rents affordable to those who depend on AISH payments (about $800 monthly), and provide a variety of services depending on need. Often there are 24-7 on-site managers to respond to issues and check in on residents, but sites can also have full-time nurses and elders, counselling, home care and meal services.

Fortunately, Edmonton is blessed with community agencies that are very good at providing this kind of housing.

One is the Right at Home Housing Society, which operates 500 units of various types around the city for around 1,200 Edmontonians.

Unfortunately, wait times for a home operated by the society now average between three and four years, an awfully long delay for vulnerable people.

The organization has been developing new properties, but further progress is largely dependent on further grants. As an example, the society is ready to begin a project for 100 people in the citys northeast that would fill a need for large family accommodation, but it cant proceed anytime soon without provincial help.

To be clear, permanent supportive housing is not the silver bullet solution to ending all homelessness and addiction.

However, there is strong evidence that a safe place to live prompts a chain reaction of positive effects. Stability allows residents to focus on their treatment, make healthier choices, become less vulnerable to crime and abuse, become better parents and make more positive contributions to society, including employment schooling and volunteering.

This, in turn, has positive results for government, some of which can be measured.

For instance, a study of Ambrose Place, a permanent supportive housing facility north of Downtown, reported a big reduction in inpatient and emergency department costs per resident, per year, and that resident interactions with the police decreased by nearly half.

Other studies have found similar savings, while less-quantifiable advantages, such as reduced need to apprehend children from their parents and less social disorder in front of businesses, are also important to note.

In effect, this is a form of preventative medicine.

The citys plan calls for a $241-million investment over six years, in which Edmonton would contribute about $37 million to acquire 20-30 sites, the federal government would provide $80 million and the province $124 million.

The province would also be called upon for about $24 million in operating funds annually once all 900 units are constructed, but the savings in health and justice costs alone would more than pay for that.

Though details are thin, the review thats holding up new announcements seems to be focused on ways in which the government can reduce its responsibility, possibly through more private sector involvement.

If the province can find a way to make that work with the same outcomes, so be it, though Im skeptical thats feasible.

But regardless of where the review goes, the province owes it to at-risk Albertans to move with haste and listen to municipalities like Edmonton, where patience is wearing thin.

They dont seem interested in doing anything other than lecturing people on how these problems should be solved, says Coun. Michael Walters.

Such comments are borne of frustration and again demonstrate how the relationship breakdown between the provincial and municipal governments plays out not just in budget balance sheets, but in consequences that hurt vulnerable people.

Instead of exploiting social disorder as a political tool to discredit supervised consumption sites (which serve a necessary, though limited purpose), the province would be far better served with a big investment in housing that will actually make a difference on Edmontons streets.

kgerein@postmedia.com

twitter.com/keithgerein

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Keith Gerein: Social disorder better solved with housing investments than discrediting consumption sites - Edmonton Journal

AI can be used for the early detection of virus outbreaks that might result in a pandemic. (Photo by ... [+] Emanuele Cremaschi/Getty Images)

AI detected the coronavirus long before the worlds population really knew what it was. On December 31st, a Toronto-based startup called BlueDot identified the outbreak in Wuhan, several hours after the first cases were diagnosed by local authorities. The BlueDot team confirmed the info its system had relayed and informed their clients that very day, nearly a week before Chinese and international health organisations made official announcements.

Thanks to the speed and scale of AI, BlueDot was able to get a head start over everyone else. If nothing else, this reveals that AI will be key in forestalling the next coronavirus-like outbreak.

BlueDot isn't the only startup harnessing AI and machine learning to combat the spread of contagious viruses. One Israel-based medtech company, Nanox, has developed a mobile digital X-ray system that uses AI cloud-based software to diagnose infections and help prevent epidemic outbreaks. Dubbed the Nanox System, it incorporates a vast image database, radiologist matching, diagnostic reviews and annotations, and also assistive artificial intelligence systems, which combine all of the above to arrive at an early diagnosis.

Nanox is currently building on this technology to develop a new standing X-ray machine that will supply tomographic images of the lungs. The company plans to market the machine so that it can be installed in public places, such as airports, train stations, seaports, or anywhere else where large groups of people rub shoulders.

Given that the new system, as well as the existing Nanox System, are lower cost mobile imaging devices, it's unsurprising to hear that Nanox has attracted investment from funds looking to capitalise on AI's potential for thwarting epidemics. This month, the company announced a $26 million strategic investment, led by Foxconn. It also signed an agreement this week to supply 1,000 of its Nanox Systems to medical imaging services across Australia, New Zealand and Norway. Coronavirus be warned.

Its CEO and co-founder, Ran Poliakine, believes that such deals are a testament to how the future of epidemic prevention lies with AI-based diagnostic tools. "Nanox has achieved a technological breakthrough by digitizing traditional X-rays, and now we are ready to take a giant leap forward in making it possible to provide one scan per person, per year, for preventative measures," he tells me.

Importantly, the key feature of AI in terms of preventing epidemics is its speed and scale. As Poliakine says, "AI can detect conditions instantly which makes it a great source of power when trying to prevent epidemics. If we talk about 1,000 systems scanning 60 people a day on average, this translates to 60,000 scans that need to be processed daily by the professional teams."

Poliakine also argues that no human force available today that can support this volume with the necessary speed and efficiency. Time and again, this is a point made by other individuals and companies working in this burgeoning sector.

"When it comes to detecting outbreaks, machines can be trained to process vast amounts of data in the same way that a human expert would," explains Dr Kamran Khan, the founder and CEO of BlueDot, as well as a professor at the University of Toronto. "But a machine can do this around the clock, tirelessly, and with incredible speed, making the process vastly more scalable, timely, and efficient. This complements human intelligence to interpret the data, assess its relevance, and consider how best to apply it with decision-making."

Basically, AI is set to become a giant firewall against infectious diseases and pandemics. And it won't only be because of AI-assisted screening and diagnostic techniques. Because as Sergey Young, a longevity expert and founder of the Longevity Vision Fund, tells me, artificial intelligence will also be pivotal in identifying potential vaccines and treatments against the next coronavirus, as well as COVID-19 itself.

"AI has the capacity to quickly search enormous databases for an existing drug that can fight coronavirus or develop a new one in literally months," he says. "For example, Longevity Vision Funds portfolio company Insilico Medicine, which specializes in AI in the area of drug discovery and development, used its AI-based system to identify thousands of new molecules that could serve as potential medications for coronavirus in just four days. The speed and scalability of AI is essential to fast-tracking drug trials and the development of vaccines."

This kind of treatment-discovery will prove vitally important in the future. And in conjunction with screening, it suggests that artificial intelligence will become one of the primary ingredients in ensuring that another coronavirus won't have an outsized impact on the global economy. Already, the COVID-19 coronavirus is likely to cut global GDP growth by $1.1 trillion this year, in addition to having already wiped around $5 trillion off the value of global stock markets. Clearly, avoiding such financial destruction in the future would be more than welcome, and artificial intelligence will prove indispensable in this respect. Especially as the scale of potential pandemics increases with an increasingly populated and globalised world.

Sergey Young also explains that AI could play a substantial role in the area of impact management and treatment, at least if we accept their increasing encroachment into society. He notes that, in China, robots are being used in hospitals to alleviate the stresses currently being piled on medical staff, while ambulances in the city of Hangzhou are assisted by navigational AI to help them reach patients faster. Robots have even been dispatched to a public plaza in Guangzhou in order to warn passersby who aren't wearing face-masks. Even more dystopian, China is also allegedly using drones to ensure residents are staying at home and reducing the risk of the coronavirus spreading further.

Even if we don't reach that strange point in human history where AI and robots police our behaviour during possible health crises, artificial intelligence will still become massively important in detecting outbreaks before they spread and in identifying possible treatments. Companies such as BlueDot, Nanox, and Insilico Medicine will prove increasingly essential in warding off future coronavirus-style pandemics, and with it they'll provide one very strong example of AI being a force for good.

Read the original here:
How AI May Prevent The Next Coronavirus Outbreak - Forbes

Its another Monday morning.

You sluggishly get out of bed and get ready for a day of classes and work. But this time, you cant shake off a runny nose, bad cough and flu-like symptoms. Were you one of the few people to have been infected with the novel coronavirus?

Chances are slim.

As of Feb. 22, there have been about 310,000 hospitalizations and 18,000 deaths in the U.S. because of the flu, according to the Center for Disease Control (CDC). In comparison, the coronavirus has caused six deaths, all in the state of Washington, as of March 1, according to The Washington Post.

The coronavirus is similar to the influenza viruses in that they are comprised of single strands of RNA, or ribonucleic acid. This virus has a very high capability of mutation and adaptation, which creates trouble in terms of treatment purposes.

There is a huge amount of misdirected angst because [the virus] is new and it came from another part of the world. We encountered a similar situation in 2014 with the West Africa Ebola virus, said Dr. Sean Elliott, an infectious disease physician affiliated with the University of Arizona College of Medicine - Tucson and the Department of Pediatrics.

Like most other viruses, the coronavirus transmits itself through respiratory secretions. Similar to preventing the flu and other viruses, washing hands and proper sneezing etiquette is the best mechanism for prevention. In an effort to remain healthy, individuals who have not been infected oftentimes resort to wearing loop masks in the community setting.

The relative transfer of bacteria using three different greetings handshakes, high-fives and fist bumps.

Source: The fist bump: A more hygienic alternative to the handshake from the American Journal of Infection Control

There is no reason to do it ... In the healthcare setting, where one does use masks like that, we need to protect resources, Elliott said. It makes no sense to use them in the general community.

Recently in Tucson, the number of individuals who have read about the virus and present themselves to healthcare providers has increased. Oftentimes, after reading about COVID-19 (coronavirus disease 2019), patients can trick themselves into believing they are infected with it.

Its fear of the unknown, Elliot said. People sometimes are susceptible to being scared by the most recent bully-man out there and it happens to be COVID-19 today.

Interestingly enough, the low fatality rate around 2.3% of COVID-19 makes it all the more susceptible to the hype it has received. Because it kills a very small minority of the people it infects, the virus is more easily transmitted and thus talked about more often. Patients are often not aware that they have been infected with the virus.

Were going to see more cases, but a huge majority of those are going to be mild, and theyll only be detected because people who are worried will come in to get tested, Elliott said. I think we will not see any higher amount of death rates than the other parts of the world are experiencing and potentially far fewer because we have access to very advanced health care and support.

Despite the mass paranoia about the coronavirus, the influenza virus presents itself as more of an issue to people due a to greater fatality rate.

If one is going to compare risks, we should get this amped up about the flu every single season, Elliott said. The mortality rate [of the coronavirus] is going to be low because the infection itself is not a severe disease.

Even with the current hype around the virus, medical students have learned to respond to this the same as any other infection: learn how to treat and respond to general pandemics without being bogged down by the specifics of any one virus, since a new year could bring an entirely novel virus.

Students who are in clinical environments are learning about COVID-19 and its clinical manifestations. However, since next year could bring a completely different virus, it is more important for students to learn about pandemics and how to respond to them, said Dr. Kevin Moynahan, M.D., a professor of medicine and deputy dean for education at the UA College of Medicine Tucson, in an email. This is already part of the curriculum.

Given the extremely low fatality rate combined with the fact that the United States is the world leader in healthcare and medical treatment, the coronavirus presents itself with very little reason to keep yourself up worrying at night. Preventative techniques most notably washing your hands used against any other virus will come in handy and is undoubtedly the best way to remain healthy.

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The attack of the worried well: Is the coronavirus the next pandemic? - Arizona Daily Wildcat

All over the world, people are startled by the growing fatalities that the coronavirus disease (COVID-19) has caused.

First reported in December 2019 in the Chinese city of Wuhan, the deadly virus has made its way from China to at least 15 countries such as Italy, Malaysia and the US.

Because of this widespread transmission, countries are on high alert for more potential fatalities and issuing preventative measures for protection, thus highlighting the importance of preventive health.

To tackle global health challenges like these, Concordia University in Montreal, Canada believes that the world needs creative and interdisciplinary approaches to health education and research.

The university is currently putting in place a Health Institute to continue to advance health technologies, diagnostic tools, wearable devices and biometric textiles by merging the knowledge of more than 150 Concordia faculty members across several faculties.

By viewing health challenges from all angles, the universitys Health Institute is envisioned to create imaginative new research, teaching and outreach programmes that others are not positioned to offer.

As Concordia President, Graham Carr says, Increasingly, society needs health research outside the traditional framework of medical faculties research that answers how Canadians can stay healthy and reduce their dependence on an overburdened healthcare system.

Concordias Health Institute will be helping to fill this vital gap.

While the creation of the Health Institute inspires Concordia Universitys community to challenge their perceptions of health, its inception will also be supported by well-established academic programming.

For instance, the Master of Health and Exercise Science (MSc) programme encourages students to research important fundamental and clinical questions. This includes exploring how the body produces new muscle proteins to face challenges or how stress can influence the cardiovascular system.

Shutterstock

This programmes research agenda is also strong in basic mechanistic sciences. Students gain a clearer understanding of how the body works in the clinical areas of injury prevention and care, as well as in the everyday management of certain chronic diseases through exercise training.

Whereas the Doctorate in Health and Exercise Science (PhD) takes students health research one step further, through fortified links between specialised sciences as diverse as athletic therapy, molecular biology, neurology, nutrition, sleep, and behavioural medicine.

It is very fulfilling to see graduate students succeed in many areas of research, from basic science to clinical applications, says Graduate Programme Director in Health, Kinesiology, and Applied Physiology Dr Geoffrey Dover.

According to the Chair of Health, Kinesiology and Applied Physiology at Concordia Vronique Pepin, the research drive in the Department has really escalated in the past decade or so, to the benefit of undergraduate and graduate students.

Not only do we have new academic programmes (PhD and two new honours in Athletic Therapy and Kinesiology & Clinical Exercise Physiology), but we also have new lines of research in nutrition (Dr. Sylvia Santosa), immunology (Dr. Peter Darlington), sleep (Dr. Thien Thanh Dang Vu), weight stigma reduction (Dr. Angela Alberga) and lower back pain (Dr. Maryse Fortin).

The great thing about these new lines of research is their collaborative potential with each other and with other established research endeavours in the Department, the Faculty, and the University. The possibilities for students interested in health research now seem endless, she says.

Supplementing these programmes is Concordias PERFORM Centre an 8,000 m2 facility housing laboratories, conditioning equipment and functional assessment suites each dedicated to research.

Each of the PERFORM Centres eight suites is equipped with state-of-the-art equipment for students to use.

For instance, the Nutrition Suite has a Metabolic Kitchen, the Imaging Suite has a GE MR750 MRI Scanner and the Functional Assessment Suite has a Gait-Pressure-Mat.

In addition to exclusive facility access, students also become automatic members of the Health, Kinesiology and Applied Physiology Student Association (HKAPSA).

And through this HKAPSA membership, students get to join the Learning Lab where they can use the video library, skeletal and muscular anatomical models, computer software and physiology.

HKAPSA students also attend valuable networking events where they collect useful contacts for their future careers.

Source: Shutterstock

At the Department of Health, Kinesiology & Applied Physiology, the focus is on functional mechanisms from the molecular level to whole systems.

Research topics at the department include nutrition, hormones, body composition, behavioural medicine, chronic illnesses, sleep physiology, neural control of movement, movement and balance control in neuromuscular disorders.

One student benefiting from the universitys vibrant and interdisciplinary research culture is MSc Health and Exercise Science student Jesse Whyte.

The certified athletic therapist chose Concordia to make a long-term impact with his research on women who have undergone breast cancer treatment and developed secondary effects. He is supported by Robert Kilgour, professor in the Department of Health, Kinesiology and Applied Physiology.

The aim of my study is to advance our understanding of secondary lymphedema and its effects on tissues, he said.

Through my research, I compare tissue characteristics of women with stage two, unilateral breast cancer-related lymphedema (BCRL) to their unaffected arms and healthy control arms.

Last year, he delivered an oral presentation titled, Forearm skeletal muscle ultrasound properties in women with breast cancer-related lymphedema at the 2019 National Lymphedema Conference in Toronto.

He has also opened his own studio in Montreal West called ReFitMTL where he hosts classes for cancer patients, the young at heart and children where he addresses movement and balance to encourage a safe and active lifestyle.

Whytes story is just one of many that demonstrate Concordia Universitys capacity to offer meaningful experiential learning to their students.

By providing the next generation of health leaders with contemporary facilities and future-facing curricula, students leave campus confident to evoke real-world change in their communities.

And with continuous support from a faculty of top-tier researchers, Concordia graduates carry their degree forward into careers that positively impact todays health sector.

Follow Concordia University on Facebook, Twitter, YouTube, Flickr, Instagram, Google+ and LinkedIn.

How this Canadian university is fighting fake news

Innovative teaching approaches: Virtual reality in the classroom

Link:
Concordia University: A next-generation approach to health education and research - Study International News

It probably feels as though recruitment is worse now than it ever was.

But, general practice being what it is, there have been plenty of recruitment crises through the ages. (And don't forget to click on the pictures to expand!)

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This 1961 piece says the first decade of the NHS (1948-1958) was characterised by a surplus of doctors, but this situation is in the process of being reversed.

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Later in the year, the Dissector suggests that the number of vacancies in the BMJ show that, as he puts it (it was always he in 1960s Pulse), Practice applicants are below demand.

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There were plus sides to this, of course as we pointed out the following year, GPs scarcity put them in a strong position.

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Fast forward a few years and we report in 1970 on GP manpower in low gear, leading to a growing reliance on foreign doctors. Of course, this is nothing like these days back then, the NHS could actually attract overseas doctors.

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Things are still not getting any better in 1981. More GPs are needed, said a report from MPs. This is especially so because of the move for GPs to help with the hospital service, and preventative medicine. This is a great help to the current Pulse team, of course, because if reporters ever miss a deadline, they can just submit this story. Again. And again.

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But, a mere year later, it looks like things were picking up. It revealed that in 1981, there had been success in attracting record numbers 826 in all (Messrs Hunt and Hancock look wistfully on).

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However, there are always losers in these scenarios. Spare a moment for Dr Parat Jit Singh who, in the same month, was featured on the front page of Pulse because of his 400 job applications with no success. (Dr Jit Singh if you are reading this, please get in touch, as we know of a few thousand practices looking for a GP now).

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At the start of the 1990s, things were glowing in GP land, and it wasnt just the lava lamps and glowsticks. A report showed that the number of patients per GP was 12% lower than a decade earlier.

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But, as seems to increasingly be the case, two years later and we see that a recruitment crisis is looming in general practice. Trainee numbers are down due to poor pay and the increasing business ethics involved in general practice. Interestingly, the former trainee representative to the RCGP is quoted a Dr Sarah Jarvis, who later became one of the most prominent media doctors around.

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And so it came to pass. In 1995, the crisis showed no sign of abatement.

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An editorial three years later rightly points out that focusing on the recruitment crisis is probably a better way for the BMA to be successful in increasing pay and probably not before time either.

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Thats not to say there were not solutions. One, which seemed eminently sensible, was to recruit more EU doctors. Maybe we can think about that now?

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And another involved incentives for partnerships. Though that will probably never catch on.

Visit link:
The 60-year recruitment crisis | Article - Pulse

WACO, Texas (KWTX) Baylor Scott & White Health today opened a new Sports and Orthopedic Center Thursday on the campus of Baylor Scott & White Hillcrest Medical Center in Waco.

The 106,000-square-foot, four-story Ted and Sue Getterman Baylor Scott & White Sports and Orthopedic center provides a full spectrum of sports medicine including rehab, surgery and recovery all under one roof.

The center was a dream of Dr. Jon Ellis and Dr. David Haynes who started as Southwest Sports medicine in 2005.

"It's a wonderful day right? All the contributions of so many people that have gone into making this a reality. This was a 15 year vision that we now stand in front of. It's an amazing feeling, very grateful," Haynes said.

Hundreds of employees of Baylor Scott & White and top business people and community leaders were on hand for the grand opening.

The center provides primary care and preventative medicine, 48 exam rooms, advanced diagnostic imaging, orthopedic surgery center and indoor and outdoor sports performance areas.

See the original post here:
Waco: Sports and Orthopedic Center opens - KWTX

ALTON - OSF HealthCare Saint Anthonys Health Center said today there have not been any coronavirus (COVID-19) cases investigated at their location in the Riverbend.

We are aware of a reporting about a suspected COVID-19 case in Belleville, Colleen Reynolds, media relations coordinator for OSF HealthCare based out of Peoria said. I can say to date, OSF HealthCare Saint Anthonys Health Center and related OSF medical clinics have not requested testing and have not put anyone under investigation in the Riverbend as a result of being seen by us.

Below is a story released that the flu is a much bigger threat in Illinois than COVID-19.

Flu Remains Larger Threat than COVID-19

NOTE: CDC reports flu-related deaths in the U.S. has reached 16,000 with six pediatric deaths in Illinois and two in Michigan. This story was updated 2/26/2020 to reflect updated number of pediatric deaths nationally, including in Illinois and Michigan.

Despite heightened alerts about the novel coronavirus, COVID-19, local health leaders stress the seasonal flu remains far more concerning. The two Illinoisans diagnosed with COVID-19 have recovered and returned to work. Meanwhile, the Centers for Disease Control and Prevention says flu activity remains high in the US and expected to continue for weeks. The agency emphasizes pediatric deaths, at 105, are the second highest since they were included in weekly reporting in 2004.

In Illinois and throughout the country, health facilities are mostly treating the unusual Influenza B-Victoria strain of flu virus. The last time this occurred was the the1992-1993 season. Terri McCrery, infection preventionist for OSF HealthCare says the numbers affected by the new coronavirus cant compare to the seasonal flu.

Youre talking a handful nationally here with the coronavirus and youre talking millions with the flu so we need to be watchful of the flu, she warned.

McCrery says this latest flu strain is affecting children most significantly. The overall cumulative hospitalization rate 47.4 per 100,000 population is similar to that seen in recent influenza seasons; however, "rates in children and young adults are higher than at this time in recent seasons," the CDC reports.

The Centers for Disease Control and Prevention (CDC) says there have been increased hospitalizations but fewer deaths from the flu so far this season. Illinois is among the states where the risk remains widespread and high.

Even if you dont often get sick, McCrery says it only takes one exposure to influenza which is a long-lasting airborne virus. She says the flu can have a devastating impact, even on those considered young and with a healthy immune system.

A 16-year-old junior at Glenwood High School in the Ball-Chatham, Illinois school district died from complications of the flu. Joey Sandhaas, came down with pneumonia and fought for his life for more than a week.

Its not too late to get the flu shot. Dont think youre going to be one of the ones that it skips by and not get the flu because you could get it and it could be deadly, she advised.

OSF HealthCare has imposed visitor restrictions at its hospitals because of the elevated risk. The restrictions encourage people to voluntarily limit hospital visits, especially if feeling ill. Visitors 18 and over must wash or sanitize their hands and wear masks available at hospital and medical office entrances.

McCrery also encourages those who have flu-like symptoms to be seen early, especially if they have underlying health issues.

She urges everyone, Dont go out in public if you have the signs and symptoms the fever, the cough, runny nose. Stay home but then if youre home for a day or two, go be seen. Dont let it wait. The flu can turn into pneumonia, bronchitis and that would be required to be seen by the doctor so please be cautious.

Be seen early if you suspect the flu

Anti-viral drugs can be used to treat flu illness. The CDC recommends prompt treatment for people who have flu infection or suspected flu infection and who are at high risk of serious flu complications, such as people with asthma, diabetes (including gestational diabetes), or heart disease.

If you suspect you have the flu, please call ahead to your health care provider including OSF Urgo or OSF PromptCare so staff can take proper precautions to assess you. OSF OnCall is also an online option where you can be connected virtually to be assessed.

Here are tips to know when to seek emergency care for flu-like symptoms.

Most people with the flu have mild illness and do not need medical care or antiviral drugs. If you get sick with flu symptoms, in most cases, you should stay home and avoid contact with other people except to get medical care.

If, however, you have symptoms of flu and are in a high risk group, or are very sick or worried about your illness, contact your health care provider (doctor, physician assistant, etc.).

Certain people are at high risk of serious flu-related complications (including young children, people 65 and older, pregnant women and people with certain medical conditions). This is true both for seasonal flu and novel flu virus infections. (For a full list of people at high risk of flu-related complications, see People at High Risk of Developing FluRelated Complications). If you are in a high risk group and develop flu symptoms, its best for you to contact your doctor early in your illness. Remind them about your high risk status for flu. CDC recommends that people at high risk for complications should get antiviral treatment as early as possible, because benefit is greatest if treatment is started within 2 days after illness onset.

No. The emergency room should be used for people who are very sick. You should not go to the emergency room if you are only mildly ill.

If you have the emergency warning signs of flu sickness, you should go to the emergency room. If you get sick with flu symptoms and are at high risk of flu complications or you are concerned about your illness, call your health care provider for advice. If you go to the emergency room and you are not sick with the flu, you may catch it from people who do have it.

What are the emergency warning signs of flu?

People experiencing these warning signs should obtain medical care right away.

These lists are not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning.

Yes. There are drugs your doctor may prescribe for treating the flu called antivirals. These drugs can make you better faster and may also prevent serious complications. See Treatment Antiviral Drugs for more information.

CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or other necessities. Your fever should be gone without the need to use a fever-reducing medicine, such as Tylenol. Until then, you should stay home from work, school, travel, shopping, social events, and public gatherings.

CDC also recommends that children and teenagers (anyone aged 18 years and younger) who have flu or are suspected to have flu should not be given Aspirin (acetylsalicylic acid) or any salicylate containing products (e.g. Pepto Bismol); this can cause a rare, very serious complication called Reyes syndrome. More information about Reyes syndrome can be found hereexternal icon.

Stay away from others as much as possible to keep from infecting them. If you must leave home, for example to get medical care, wear a facemask if you have one, or cover coughs and sneezes with a tissue. Wash your hands often to keep from spreading flu to others.

Here are some frequently asked questions about flu vaccines.

Even healthy people need a flu vaccine. Influenza (flu) is a contagious disease which can lead to serious illness, including pneumonia. Even healthy people can get sick enough to miss work or school for a significant amount of time or even be hospitalized. An annual flu vaccine is recommended for everyone 6 months of age and older. Pregnant women, young children, older people, and people with certain chronic medical conditions like asthma, diabetes and heart disease are at increased risk of serious flu-related complications, so getting a yearly flu vaccine is especially important for them. Is the flu vaccine safe? Yes. The flu vaccine is safe. Hundreds of millions of Americans have safely received flu vaccines over the past 50 years, and there has been extensive research supporting the safety of seasonal flu vaccines.

Each year, CDC works closely with the U.S. Food and Drug Administration (FDA) and other partners to ensure the highest safety standards for flu vaccines. The most common side effects of flu vaccines are mild. The flu vaccine cannot cause flu illness; however, it can cause mild side effects that may be mistaken for flu. Common side effects from the flu shot include soreness, redness, and/or swelling from the shot, headache, fever, muscle aches, and nausea.

These side effects are NOT the flu. If experienced at all, these effects are usually mild and last only 1-2 days. Even if I get sick, wont I recover quickly? Not necessarily. Influenza can be serious and anyone can become sick with flu and experience serious complications, including active and healthy kids, teens and adults. Even if you bounce back quickly, however, others around you might not be so lucky. You could spread your illness to someone who is more vulnerable to flu. Some people can be infected with the flu virus, but have no symptoms.

During this time, you can still spread the virus to others. Dont be the one spreading flu to those you care about. National Center for Immunization and Respiratory Diseases Office of Health Communication Science Last Updated November 17, 2016 Page 2 of 2 Cant I wait and get vaccinated when/if flu hits my community? It is best to get vaccinated before flu begins to spread. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against the flu, so the sooner you get vaccinated, the more likely it is that you will be protected once flu begins to circulate in your community. Flu vaccines cant give you the flu. Even if you got a flu vaccine, there are reasons why you might still get flu or a flu-like illness.

You may have been exposed to a non-flu virus. The flu vaccine can only prevent illnesses caused by flu viruses. It cannot protect against other viruses that may cause symptoms similar to flu, like the common cold.

You might have been exposed to flu after you got vaccinated, but before the vaccine took effect. It takes about two weeks after you receive the vaccine for your body to build protection against the flu.

You may have been exposed to an influenza virus that was very different from the viruses included in that years vaccine. The flu vaccine protects against the influenza viruses that research indicates will cause the most disease during the upcoming season, but there can be other flu viruses circulating.

Unfortunately, however, some people who get a flu vaccine may still get sick. How well the flu vaccine works (or its ability to prevent flu) can range from season to season and also can vary depending on who is being vaccinated. However, if you do get sick, flu vaccination might make your illness milder than it would have been otherwise dont avoid getting a flu vaccine because you dont like shots.

The minor pain of a flu shot is nothing compared to the suffering that can be caused by the flu. A flu vaccine reduces your risk of illness, hospitalization, and can prevent you from spreading the virus to your loved ones. So, whatever little discomfort you feel from the minor side effects of the flu shot is worthwhile to avoid the flu. You need to get a flu vaccine every year.

There are two reasons for getting a flu vaccine every year: a) Flu viruses are constantly changing and so flu vaccines may be updated from one season to the next. You need the current seasons vaccine for the best protection. b) A persons immune protection from the vaccine declines over time. Annual vaccination is needed for the best protection.

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OSF HealthCare Saint Anthony's: No Reported Cases of Coronavirus Investigated Here, Flu Stats, Preventative Steps Given - RiverBender.com

Whats one thing about cardiology youre most passionate about?

Cardiovascular disease is the number-one cause of death for both men and women. I feel like its not talked about enough that its the number-one cause of death in women, specifically. Theres a big movement for breast cancer, etc., but more women actually die of heart disease or stroke.

What is something you wish your patients would speak up about more?

Often people who have chest discomfort say, Oh I just assumed it was this. I think its human nature to assume its something less serious than your heart. But its better to make sure its NOT your heart, and to not assume its heartburnwhich presents differently in everyone, particularly in women. Women who get chest pain may have atypical symptoms: it could be shoulder pain, jaw pain or shortness of breath or nausea. If theyre getting any of those symptoms with exertion, and only with exertion, its much more concerning for heart disease.

Tell us about the testing available to help prevent heart disease?

I am more into non-invasive testing, so I love being able to get answers for patients non-invasively if possible. I think for women in general, theres more research going into the risk factors that lead to heart disease. If we can help make them aware that their risk is higher, and start more preventative measures earlier in life (between their childbearing years and when cardiovascular disease usually presents), theres good potential to help.

Link:
Munson Shares Heart Disease Symptoms for Women to Watch - MyNorth.com

JaneCastorFL/Facebook

Health officials, politicians, business owners and apprehensive residents have a healthy fear about the spread of coronavirus, or COVID-19, in the Tampa area.

Tampa Mayor Jane Castor is one of those concerned citizens, and she addressed her concerns alongside Hillsborough County Commissioner Chair Les Miller in downtown Tampa in a Thursday afternoon press conference.

Were here to address a global issue that has the potential to impact our entire communitythe coronavirus, or COVID-19, Miller said to start the conference. But let me make one thing clearthere are no reported cases in Hillsborough County, or in the state of Florida.

Throughout the press conference, Castorwith the help of Dr. Charles Lockwood, USFs Health Dean of the Morsani College of Medicinestressed that Bay area officials are continuously preparing for the unfortunate day that coronavirus might make its way into the Bay area.

Were here to ensure our residents that we are as prepared as possible to deal with this disease if and when it arrives in our community, Castor said.

Castor urged Tampa residents to obtain their information from reputable sources and to not fall victim to online rumors, like the paranoid South Floridians who bought all of the face masks in their area. Dr. Lockwood said face masks dont prevent the spread of coronavirus.

Tampa Bays aggressive preventative and prepared measures are similar to that of Floridas approach to coronavirus as a whole. Although some Floridians may worry about the heavy international tourism surrounding Disney World, Gov. Ron DeSantis squashed anxieties in a his own Thursday press conference, stating that the state of Florida is fully committed, and is doing everything we can to prepare and respond to coronavirus.

Earlier this month, US. Rep. Charlie Christ wrote a letter to the Center for Disease Control and Prevention (CDCP), stating that there should be more of an emphasis on transparency about how coronavirus is spread. But Florida health officials arent currently revealing information about monitoring possible cases since the virus has yet to be declared a public health crisis.

Perhaps the scariest thing about coronavirus is the fact that it is so contagious, and one can be infected without showing symptoms. Concerned citizens can meet that challenge with strong preventative measures, like simply washing their hands, and education about the virus. In the Thursday press conference Dr. Lockwood said that 80% of people with coronavirus are asymptomatic or only show mild symptoms.

RELATED:Wash your damn hands, Tampa Bay

It's probably also worth pointing out that a different virus, influenza (aka the flu), has already sickened at least 13 million Americans this winter and killed 6,600 people.

The first cases of the coronavirus were reported in Wuhan City, Hubei Province, China in late December 2019, and now there are 48 countries reporting infections, according to live updates from the New York Times.

According to the CDCP, various symptoms associated with coronavirus are fever, cough and shortness of breath.

Although there are no reported cases of coronavirus in Florida, Mayor Castor and the rest of Tampa Bay are making sure the Bay area is prepared if the unfortunate day ever comes. In the spirit of preparedness, Castor promises minute-by-minute updates on any further news surrounding coronavirus.

Miller added Floridians and Tampeos alike should not fear the coronavirus at this point because states health officials have not yet declared it acrisisbut that might change very soon.

Early on Thursday, the state of California reported the first instance of a community-transferred infection. All other reported cases in the U.S. have been obtained overseas.

But in the meantime, wash your damn hands and chill out.

Follow @cl_tampabay on Twitter to get the most up-to-date news + views. Subscribe to our newsletter, too.

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Mayor Castor eases Tampa Bay's coronavirus worries by talking prevention and preparation in Thursday's press conference - Creative Loafing Tampa

ROCHESTER, N.Y. (WROC) Dr. Jeff Harp of Highland Family Medicine discussed the Coronavirus, its spread, and what you need to know about it Thursday during News 8 at Sunrise.

Actually, theres not one coronavirus, theres a whole bunch of coronaviruses, explained Dr. Harp. They basically range from the common cold to very serious diseases like this SARS thing that just happened, MERS, and what were having right now. So, its a whole family of one type of virus.

The current strain, COVID-19, originated in China. When it comes to symptoms, Dr. Harp said theyre not dissimilar to the common cold. So look for cough, fever, and trouble breathing. But the trouble is with some of these viruses, like the one that were seeing here, it can go on to very serious diseases like pneumonia, kidney failure, and even death.

Dr. Harp said this strain of Coronavirus, COVID-19, has been identified in 32 countries. Were learning more about exactly how deadly it is at this point. So at one point, it seemed like a lot of people who were getting it were getting very seriously ill. Now, it looks like perhaps about 2% of the people who get the disease will eventually succumb to it, die from it, which is a lot less serious. For example, the Middle Eastern virus that was around a couple years ago, it was about a third of people that got it would die from it.

Fear of Coronavirus and its impact has been reflected across the global economy and in the actions of individual people. Some have taken to wearing masks as a preventative measure. Its serious if ones exposed to it, noted Dr. Harp. Its not as contagious as many viruses, but its also preventable through the same kind of way that you would prevent the common cold. So we recommend that people take precautions. Obviously, traveling to China right now is not really the thing to do. Dont go outside when youre sick. Dont hang around sick people. If youre sneezing or someones sneezing, you know, cover the sneeze. Throw out the stuff that you use to clean it up. And then just use common sense in terms of, you know, touching objects, cleaning surfaces, that sort of thing.

If you want to learn more about Coronavirus and the current strain, COVID-19, Dr. Harp said go online to cdc.gov/coronavirus.

Read the rest here:
Highland Family Medicine doctor helps us understand the threat of Coronavirus - RochesterFirst

(MENAFN - Somali Land Sun)

Somalilandsun : It is estimated that every year more than 300 young cheetahs are illegally snatched from Ethiopia, northern Kenya, Somalia and Somaliland.

Illegal wildlife trafficking is an ever-increasing problem for the conservation of species in the wild, and the trafficking of cheetahs is no exception. It is estimated that every year more than 300 young cheetahs are illegally snatched from Ethiopia, northern Kenya, Somalia and Somaliland, then smuggled out of Somaliland to be sent across the Gulf of Aden to the Arabian Peninsula where they are bought and sold in illegal online sales to the wealthy.

Most of these cubs are pulled from their mothers prematurely and kept in poor conditions with inadequate food and water. Less than 25% of these captured cheetah survive to the buyers. And those that do survive are often in poor health, with fractured bones, infections and malnutrition.

Of those that are sold, the average lifespan is only 5 years of age, and most die due to causes related to stress and malnutrition. With less than 7,500 cheetahs surviving in the wild, compiled with the low reproductive rates of wild cheetahs, these numbers are unsustainable. Experts estimate that, than in less than 10 years, the cheetah could be extinct in Northern Africa.

The Cheetah Conservation Center (CCF) led by Dr. Laurie Marker, along with the Somaliland government's Ministry of Environment and Rural Development (MoERD), has been working since 2011 to set up a task force to help rescue confiscated cheetah cubs. Rescued cubs were initially sent out to sanctuaries in Ethiopia and Djibouti. After the laws changed in Somaliland, a cheetah sanctuary was started in the capital city of Hargeisa in 2017. Currently there are more than 45 cheetah cubs at the cheetah safe house, with more than 30 of those arriving in 2019.

Most of the confiscated cubs come into the safe house in critical condition, including severe dehydration, injuries and infectious diseases and require intensive care. Needless to say, in-country resources for cheetah care are very limited.

Because of the scarce in-country resources, CCF contacted Dr. Margarita Woc Colburn to help assist with the cheetahs. Dr. Woc Colburn assisted with the care of these confiscated cheetahs by acting as one of the veterinary consultants, utilizing her cheetah expertise.

Overall, Nashville Zoo has been supporting the Somaliland-CCF cheetah efforts through donations of medications and equipment, but last September, the Zoo sent Dr. Woc Colburn to Somaliland to assist with the health assessment of 30 cheetahs.

She worked in conjunction with Laurie Marker and a South African veterinary team led by Dr. Peter Cadwell. During her time there, the team fully examined the cheetahs at the safe house, as well as evaluated and developed preventative care protocols and assisted in the training of local veterinarians. Based on the findings of the exams, improved nutrition and preventative medicine protocols were set in place. Dr. Woc Colburn continues to be a core veterinary consultant for the project.

Future plans include the building of a cheetah conservation center outside of Hargeisa, where the cheetahs will have room to roam and breed, as well as creating a main education center to help educate the public about cheetahs and how to stop illegal wildlife trade. Nashville Zoo continues to support these efforts by ongoing donations of medications and medical equipment, as well as allowing Dr. Woc Colburn to provide veterinary expertise via telecommunication consults with Somaliland.

This press release was produced by the Nashville Zoo . The views expressed here are the author's own.

By. Press Release Desk, News Partner

MENAFN2702202001620000ID1099767727

The rest is here:
Working To Stop Illegal Wildlife Trade Of Cheetahs In Somaliland - MENAFN.COM

February 25, 2020

Today is the Canadian Federation of Medical Students National Day of Education and the Max Rady College of Medicines Global Health Portfolio is highlighting an initiative by students involved with the reproductive and sexual health component of their portfolio. The group is hoping to fill in the gaps in Manitobas current sexual education curriculum by training medical students to deliver workshops to high school students.

After the groups successful campaign last year for universal coverage of the abortion pill Mifegymiso in Manitoba, this year its focus is on preventative medicine, including the prevention of unplanned pregnancy and sexually transmitted infections (STIs) and an overall emphasis on sexual health and well-being.

They have planned training sessions for interested medical students to gain the skills they need to effectively lead formal and engaging sexual health education workshops in the community. The group is working with the Womens Health Clinic and is receiving guidance from the Clinic in designing the program. They hope to collaborate with local high schools and begin delivering the workshops in the spring or fall of this year.

We caught up with Jacqueline Donner, a second-year medical student and a local officer of reproductive and sexual health with the Global Health portfolio to talk about this project.

How did this initiative come about?

I think many Manitobans feel theres a big gap in the sexual health component of our school system. A lot of our peers feel that they didnt really get a comprehensive education, and certainly not a sex positive one. We realized as future physicians, we will have the privilege and responsibility at times of playing the role of sexual health educator for people, so we wanted to be as well-equipped as possible.

Why do you think sexual education is important?

Sexual health is all-encompassing. It plays into many aspects of our life. Many people in our community feel excluded by the way sexual health is currently taught. Sexual health is not just for people who are cis and straight. Were being very careful about our terminology so everybody feels included. When you have a good knowledge of sexual health and are able to take some ownership of your own sexual health, its very liberating, and allows you to enter other parts of your life feeling autonomous and independent.

How will you train medical students to deliver this information?

Were working with the Womens Health Clinic to do a series of three workshops that will provide us with legitimate training to enter schools and educate young people. We had our first workshop this past Sunday.

The format that Womens Health Clinic uses, that we will emulate, is using interactive, group-based activities for students of all ages to break down those barriers to talking about sex and sexual health. It looks at the different components of sexual health from a more holistic approach. It doesnt just involve the biology of sex, but everything from body positivity to self-love to the role of media in our perception of ourselves and our sexuality.

What are some of the things you learned about in the workshop?

We did some exercises that broke down basic terminology. We also talked about body image, body positivity and the harms of dieting. They do a cool activity using skittles to help visualize the spread of STIs. The visualization of these issues translates well into a classroom environment, especially since we are trying to reach youth.

Do you hope that once established, these workshops will continue on an on-going basis?

We want to establish a long-standing relationship with Womens Health Clinic and also hope that it becomes something that can perpetuate on its own. Once we gain this training, we can continue to train our fellow students. I hope theres a snowball effect and more students can be involved in coming years.

CHANTAL SKRABA

See original here:
Med students aim to fill in sexual education gaps in high schools with new initiative - UM Today

All over New Zealand, prisoners are breaking out of their cells and the Department of Corrections is quite happy about it.

The freedom the prisoners are finding has nothing to do with the physical bars that contain them they are escaping their mental prisons, using the keys of meditation to open the door.

For more than three years, Ishaya monks of the Bright Path have been teaching ascension meditation techniques in prisons around the country. This follows a successful trial at Rimutaka Prison.

Savitri and Prasada Ishaya first approached Corrections in 2016 to volunteer as meditation teachers in prison, inspired byA Mindful Choice a documentary film made by two Kiwi colleagues about the positive power of ascension meditation including in one of Mexico's most notorious prisons.

Chris McKeen/Stuff

For more than three years, Savitri Ishaya and other monks have been teaching ascension meditation techniques in prisons around the country.

"I was so impressed and inspired by the fact that people who had suffered terribly traumatic lives and experiences were able to find peace even in a prison environment," Savitri says.

She showed the film to Corrections and they decided to trial meditation at the Drug Treatment Unit (DTU) at Rimutaka Prison.

Since then, the teachers have returned for many block courses and the teaching of ascension meditation has expanded to six prisons across the country. Last year, 46 courses were delivered in prisons teaching about 400 people, including some Corrections staff.

Chris McKeen/Stuff

The main benefit to inmates from ascension meditation is in the way they're able to stop themselves from falling back into old behaviour patterns.

Frith Dunlop, clinical manager at the Rimutaka DTU, says the men come to the high security unit through a dual mechanism first their case manager will recommend the DTU as part of their rehabilitation but the prisoners also have to agree to it, so there is an element of self-selection.

Then as part of their course they are offered the opportunity to take the ascension meditation course. Dunlop says around half the inmates in each intake put up their hands.

"There are always people in the group who are motivated and are willing to try anything. We do a lot of preparation before the coursewhat's involved, what to expect and, basically asking them: 'What have you got to lose?"'

Dunlop said the main benefit she's seen from ascension meditation is the way the inmates are able to stop themselves from falling back into old behaviour patterns they are less reactionary.

"When they start falling back into old thinking patterns, they've got a simple way to find a moment to pause to reset themselves and put themselves back on track we see that all the time, right in front of our eyes: you can see they are going down a certain path and they just stop. And then they have the time to rationalise what they are doing and get back on the right track."

Chris McKeen/Fairfax NZ

Savitri says her students are motivated because they are "hungry for peace".

And she's seen success where she least expected it, recalling one prisoner who grudgingly volunteered for the programme.

"One that I'm thinking of, I really didn't expect him to be interested, I didn't expect him to last the first day," she says.

"But after the first session he started to make noises that showed something was changing in him. And then he started to talk about how he suddenly realised that he was in charge of his thoughts. We encourage our guys to journal and he started journalling about how his reality has changed because he's been able to change the way he thinks.

"That was a huge revelation for him because he was at the start of a long sentence and was quite depressed about it he made it clear that he feels positive [now] about doing the rest of the sentence and that he can handle anything he can just practise his techniques at any time when things get hard or he gets frustrated or overwhelmed. And this is a person I didn't expect to last the first day."

Savitri says some of the changes she's witnessed in the prisoners have been profound.

"These guys are interested because they are hungry for peace they have got powerful motivation to drop their thoughts and they are very interested in learning how to drop emotions particularly anger.

"They know that when the red mist comes they often can't control what happens next. So, to have a tool that allows them to notice when they are starting to get triggered into traditional patterns of behaviour and to use the technique as a circuit breaker is great," she says.

"The guys who are ready to change areso good at putting this into practice that the change can happen rapidly because they really want it."

She says it's amazing to see the difference in the individuals and the group from the beginning to the end of the course.

One of the reasons a depressed or angry prisoner can make a sudden change within a few days is because the ascension meditation techniques are simple and easy to practise, says Savitri.

Chris McKeen/Stuff

Ascension meditation enables you to release stress through the day. "I call it preventative medicine if you're doing it every day, the stress levels don't overflow. You're much more resilient, calm and coming from a much more present place."

"It's a simple tool that allows us to let go of our thoughts and emotions there are lots of patterns of behaviour that come about through the way people relate to their thoughts, and when we are always focused on our thoughts and believing them, we don't realise how they often drive our actions."

Corrections lists the benefits of the meditation programmes as: managing anger, stress, tension and trauma; improved communication with others, including whnau and Corrections staff; motivation to participate in rehabilitation programmes to address offending, and education and offender employment activities.

There has been a lot of research on what is known as emotional contagion, the transfer of moods among people in a group. The basic premise is summed up in the old quote "misery loves company" one person's negative mood can influence others in a family, workplace or group. And the reverse is true a positive mood is equally catchy; it can increase co-operation and decrease conflict important in a prison setting.

It's something Dunlop has noticed within Rimutaka's DTU, with a ripple effect based on how many men in the unit have taken the course.

"The last time that Savitri and Prasadacame through was the most powerful I've seenwe noticed a real shift," Dunlop says.

"We noticed significant shifts in behaviour, compliance and morale. It changed the whole unit even when the whole unit didn't undertake the programme. But those who did brought peace back to the unit with them."

Dunlop speculates that because the unit always has some inmates who have been there for a while, they can positively affect newcomers by talking up meditation and continuing to practise it themselves.

"We've always got a few people left from the last intake that have done the ascension course. This is about the fourth or fifth time in the past two years that we've had them in so there's a number of people who have done it, so when we are trying to encourage newcomers to give it a shot, we've got men saying, 'This is really valuable."'

Those who have already learned are keen to resit the course and the new students come more willingly because their peers have recommended it, she says.

"We've got another course coming up in March and we will have even more people in the unit who have done it once or twice before, so we expect the next time around will be a more powerful effect."

This doesn't surprise Savitri her experience is that the prisoners who embrace the techniques are strong advocates for its power.

"The guys who get keen on it are very good at passing on their experience to others they all like to talk about it and how they are changing.

"It takes a while for them to trust us and then to be willing to open up and try the techniques and sometimes people aren't ready to do that but for those who are ready, once they've done the first couple of lessons they start to meditate in their cells and they get quite enthusiastic."

She likens regular practice of meditation to a pressure valve that can release stress, a huge benefit in a prison where anger and quick tempers can cause trouble.

"It enables you to release a lot of stress through the day so it's not building up. I call it preventative medicine if you're doing it every day, the stress levels don't overflow. You're much more resilient, calm and coming from a much more present place.

"A guy might have someone say something to him and in the past he would have flared up or even given him the bash but, after learning to meditate, they say things like. 'I just used my technique and I was able to let it go.' That might seem like a small thing, but it's huge to these guys. For them to be able to let that stuff go is just amazing."

The next step in the programme, besides spreading to other prisons beyond the current six, is to get some real measurement of what until nowhas been anecdotal success stories.

Dunlop says thereare national statistics available on what's calledRQthe rehabilitation quotient of all the DTUs around the country, but there are no site-specific stats held, so it's hard to pull out variables such as what difference meditation has had on prisoners once they are released.

But Dunlop is a believer and it seems Corrections can see the benefits too.

"I can't speak for Corrections but I can speak for the support they've shown the programme they believe in and want it to keep happening.

"I've sat in on a few of the courses with the men and it's something I practise several times daily and this is what people don't understand: it doesn't have to take time if you're busy.

"I sometimes do just a couple of minutes four times a day like when I'm shifting from one job to another it's like getting closure in my mind about what I've just been working on and freshen up for the next step.

"Definitely before I get out of the car and walk into the prison, I do a quick session and if something particularly stressful is going on, I use it as a strategy."

Another measure of success is that the rest of the world is starting to take notice of what is happening in some New Zealand prisons.

Since prisons in Mexico and New Zealand began offering ascension meditation, their counterparts in other countries are also getting involved. The Ishaya monks have started going into prisons in Norway and Spain and the first course is about to be taught in a facility near Perth, Australia.

"We want to wake people up to know that peace is possible," says Savitri.

FINDING YOUR PEACE: TESTIMONIALS FROM PRISON STUDENTS

"Like many other men in my situation, I wasn't granted the luxury of a healthy upbringing. [This] led me to develop many very negative unhelpful views about myself, others and the world. These views and beliefs are the bricks and mortar of my internal mental prison, far more secure and complex than any maximum security prison and until now I considered it escape-proof.

"I was blown back in my seat at the first class when [the teacher] said it's all too often that we think we are just bad or broken. And that's exactly what my beliefs tell me. That's what all the drug use and looking for love and acceptance outside myself has been all about. The downside to that antisocial lifestyle has been making poor choices and bad decisions in which people have been hurt. I can't undo that tragedy. However, with your knowledge and teachings of meditation I can start to break down the beliefs and views that created the thoughts... I can't thank you enough for the keys to my prison... Just know that there are others like me serving life sentences who need this."

Testimonial from a prison student

"I was burdened by raging thoughts, irregular sleep patterns and general anxiety. However by using the meditation techniques I have been able to really calm my mind. I have been experiencing deep, peaceful sleep and have noticed that my general anxiety has been reduced significantly."

Testimonial from a prison student

Mindfulness versus meditation

Mindfulness is a bit of a buzzword, butwhat's the difference between that andmeditation?

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Meditation in NZ prisons offering keys to freedom - Stuff.co.nz

Feb. 25, 2020

WASHINGTON Although the immediate side effects of antimalarial drugs are widely recognized, few studies were designed specifically to examine health problems that might occur or persist months or years after people stopped taking them. For this reason, a new report from the National Academies of Sciences, Engineering, and Medicine finds there is currently insufficient evidence to determine whether there is an association between antimalarial use and neurologic and psychiatric outcomes, including anxiety, depression, and the development of symptoms that mimic post-traumatic stress disorder (PTSD). Further research is warranted because existing studies are limited in their design.

As of 2019, six drugs have been approved by the U.S. Food and Drug Administration (FDA) for prevention of malaria and are available by prescription: tafenoquine, atovaquone/proguanil (A/P), doxycycline, mefloquine, primaquine, and chloroquine. The report examines the possible long-term health effects of these six drugs, with a particular focus on the neurologic and psychiatric effects of mefloquine, which was widely prescribed to U.S. troops until 2009; and tafenoquine, a newly approved drug. It contains 31 conclusions regarding the level of association between the antimalarial use and persistent or latent adverse events.

The committee that wrote the report defined persistent events as those that start while the drug is being taken and continue at least 28 days after the drug is stopped. Latent events are not apparent while the drug is being taken, but present any time at least 28 days after cessation.

The report also presents strategies for designing and conducting studies that would advance the understanding of possible persistent and latent events associated with antimalarial drugs.

The committee recognized that adverse events while taking some antimalarial drugs are quite common, but the pressing, well-justified question of whether health problems continue after use has simply not generated the rigorous research needed to answer it, said committee chair David Savitz, professor of epidemiology at the Brown University School of Public Health. The absence of evidence on long-term health effects of these drugs does not mean the link doesnt exist, only that there is a critical need for well-designed studies to answer important safety questions.

In 2018, there were 228 million cases of malaria worldwide, with 405,000 resulting in death. Malaria has affected nearly every U.S. military deployment since the Civil War, and it remains an ongoing threat to those involved in the current conflicts in the Middle East. In addition to U.S. service members and veterans, the report also examines the adverse events and health outcomes experienced by populations including Peace Corps volunteers, travelers, people living in malaria-endemic areas, and research volunteers. While travelers are encouraged to take an antimalarial drug as a preventative treatment, military personnel are required to do so under proper medical supervision.

Limitations of Existing Research Some of the currently available antimalarials have been in use since the 1940s, but after an extensive literature review, the committee found only 21 epidemiological studies that examined adverse events occurring at least 28 days after the final dose. The studies conducted to gain FDA approval are generally limited by small sample sizes and short follow-up periods, making it difficult to identify persistent or latent effects. In other studies, adherence rates may be inflated, as people are often reluctant to report when they modify a dose or stop taking a medication altogether.

Furthermore, because of the many other factors and stresses associated with deployed environments, like combat, it is challenging to attribute specific health effects to the use of an antimalarial drug. For a diagnosis of PTSD, the person should have directly experienced a traumatic event; the medication itself is not the traumatic event, as the diagnostic criteria explicitly state, the report says.

Conclusions on Association Between Antimalarial Use and Health Outcomes For each of the six approved drugs, the committee examined adverse events categorized by body system: neurologic, psychiatric, gastrointestinal, eye, cardiovascular, and other disorders.

There is a sufficient level of evidence of an association between tafenoquine and vortex keratopathy, a condition that involves asymptomatic deposits in the cornea, the committee found. While it was found to persist beyond 28 days, it was also found to resolve within 3 to 12 months and not result in clinical outcomes, such as loss of vision.

While the committee found little evidence for associations between the drugs and most outcome categories, it also found the evidence provides a basis for additional research into an association between the following antimalarial drugs and health outcomes:

Advancing Research on Antimalarials Given the billions of people at risk for malaria and the severity of the disease, there will be a continuing need for people to take antimalarials, the report emphasizes. The threat of drug-resistant parasites also necessitates research into new preventatives.

To establish causal links between taking antimalarial drugs and persistent or latent adverse health effects, the committee recognized the need for a series of randomized trials and multiple well-designed observational studies of varying types. Ideally, these studies would:

Researchers could also conduct studies using health care databases that cover a large number of individuals who used antimalarial drugs and reported their subsequent health experiences. Such data sources might include Department of Veterans Affairs (VA) and Department of Defense (DOD) health care databases, existing DOD and VA registries, Medicare, FDA Sentinel, commercially available claims databases, and national health care data from other countries. Adverse event registries, such as that used by FDA, would not be informative, since they do not provide comparative data, the committee concluded.

The study undertaken by the Committee to Review Long-Term Health Effects of Antimalarial Drugs was sponsored by the U.S. Department of Veterans Affairs. The National Academies are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln. For more information, visitnationalacademies.org.

Follow us:Twitter@theNASEMInstagram@thenasemFacebook@NationalAcademies Contact:Stephanie Miceli, Media Relations Officer Office of News and Public Information202-334-2138; e-mailnews@nas.edu

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Determining Whether There Is a Link Between Antimalarial Drugs and Persistent Health Effects Requires More Rigorous Studies - National Academies of...

Lead contamination in hunted meat has the potential to impact the health of millions of people in the U.S. who are connected to the hunting community, including low-income recipients of venison donations.

However, a lack of communication from public health agencies and health professionals leaves people who eat hunted meat without a trusted source of information about the health risks and advice for reducing exposure to lead.

An investigation of dozens of studies about lead in hunted meat, preventative information about lead, and questionnaires used to identify patients at high risk for lead exposure, along with hours of interviews with hunters who use lead ammunition, revealed a concerning disparity between what is known about risks of exposure to lead in hunted meat, and what is shared with the hunting community. Hunters reported either never hearing about this topic, or hearing about it from perceived anti-hunting sources, resulting in a deep mistrust about the topic of lead. In addition, healthcare providers and health departments are not including the dangers of lead in wild game in their preventative information or questionnaires to identify children and pregnant women at risk for lead exposure.

There is no safe level of lead in the blood. Levels above 5 micrograms/deciliter (g/dL) are considered elevated and have been associated with Attention Deficit Hyperactivity Disorder (ADHD) and decreased IQ. However, developing brains exposed to even lower levels are at risk for attention-related behavioral problems, decreased cognitive performance, and increased incidence of problem behaviors.

Althoughneurotoxiceffects of lead may be the most widely-known, low levels of lead in the blood have been associated with a range of serious health effects, includingkidney diseaseand impacts to thecardiovascular system. The mechanisms behind the toxic effects of lead are not fully understood.

As lead ammunition use continues to be widespread among U.S. hunters, experts say it is crucial that health officials get a message out to hunting communities, including useful advice for hunters who will continue to use lead. Hunters want to know what the risks are and what options they have to keep their families safe.

This is also an issue of environmental reproductive justice for girls and women who, with each meal of contaminated meat, add to the burden of lead in their bones that can affect the outcomes of their future pregnancies.

Dr. Ned Ketyer, Washington County, Pennsylvania-based pediatrician, told EHN, Were learning more every day about the significant adverse health impacts of lead on human health, especially childrens health.

As we continue putting more lead into the environment, and continue to expose ourselves and our children to lead, at some point it makes sense to say, Wait a minute, what are we doing?'

Researchers found lead ammunition fired from high-powered rifles contaminated carcasses more than slower-moving lead slugs fired from shotguns. (Credit: mr.smashy/flickr)

While lead was banned from waterfowl ammunition in the U.S. in 1991, the majority of people who hunt other types of game use lead ammunition.

Upon impact, a lead bullet can fragment into tiny microparticles, too small to see with the naked eye or sense when eating. A deer processor in Pennsylvania who requested anonymity shared his first-hand experience. Seventy-five percent of the time when I find a bullet in the carcass, I only find the base. I know the lead is all in the meat somewhere, he told EHN.

Scientists have used X-rays to visualize andcountsometimes hundreds of minute lead particles in hunted meat, and have detected high concentrations of lead in hunted carcasses using chemical analysis. Although the U.S. Food and Drug Administrationdoes not recognizea safe limit for the amount of lead in meat, the European Commissionsetmaximum levels at 0.1 parts per million (ppm).

Concentrations of lead more than 100 times this limit have beendetectedin the meat of lead-shot carcasses as far as six inches from the entry wound.

In 2009, biologists from the Minnesota Department of Natural Resources x-rayed deer and sheep carcasses that were shot with lead ammunition to make any lead fragments visible. Theyfoundsome types of lead bullets fragmented more than others, and that fragmentation was more extensive when poorly-placed shots struck large bones.

They also found that lead ammunition fired from high-powered rifles contaminated carcasses more than slower-moving lead slugs fired from shotguns.

For most people, lead exposure occurs primarily through eating, drinking, or inhalation. While inhaling airborne lead from gun smoke produced by a firearm is arecognizedrisk factor for lead exposure, eating lead-contaminated meat is widely ignored, despite scientific evidence.

Multiple studies have found a direct link between game harvested with lead ammunition and spikes in blood lead.

Three studies about consumption of lead-hunted meat were published in 2018.

Hunted venison is typically part of the menu at the Tent, an annual event for hunters in the Allegheny National Forest since 1947. (Credit: Mike Bleech)

After an adults digestive system absorbs lead from a meal, the resulting concentration of lead in the blood typicallydecreasesby approximately 50 percent every month. But that doesnt mean all the lead has left the body. Instead, some lead moves from the blood to the skeleton, where it remains for decades.

As a result, blood-lead levels can be deceivingly low months after peak consumption of lead-hunted meat. For example, astudyin Greenland identified a clear seasonal variation in blood lead levels, with peaks during the months when consumption of hunted meat was highest, and decreases during months of lower consumption.

No study has been conducted in the U.S. to understand monthly patterns of blood-lead levels among people who eat lead-hunted meat. Yet the National Shooting Sports Foundationstates, A study from 2008 by the U.S. Centers for Disease Control and Prevention (CDC) on blood- lead levels of North Dakota hunters confirmed that consuming game harvested with traditional ammunition does not pose a human health risk.

However, the referencedstudycollected blood samples five months after the hunting season, and reported results for people who ate wild game in general it was not determined whether the meat was hunted with archery, non-lead ammunition, or lead ammunition. A significant difference of 0.30 g/dL was observed between the average concentration of lead in the blood of people who reported eating wild game compared to those who did not.

Children hunters. (Credit: U.S. Army Corps of Engineers Savannah District)

There are some potential consequences of lead exposure unique to women and their fetuses. Due to hormonal changes during pregnancy, lead that has been stored in the skeleton is released into the blood, exposing both mother and fetus. As a result, high levels of lead in mothers bones have beenidentifiedas a risk factor for impaired mental development in infants.

In addition to neurotoxic effects, potential consequences to the fetus or infant includelow birthweightandspontaneous abortion.

Onestudyof pregnant women found the odds of a spontaneous abortion nearly doubled for each 5 g/dL increase in blood lead. Lead is also amajor risk factorfor preeclampsia, a high-blood pressure condition that can have severe consequences for the mother and infant. Women who experience adverse pregnancy outcomes such as preeclampsiafaceincreased risk of cardiovascular and metabolic diseases as they age.

Many pregnant and breastfeeding women arent receiving recommended screening for lead exposure, and even those who are screened may not be asked the right questions to detect all potential sources of exposure, Dr. Jennifer Braverman, assistant professor in the Division of Maternal Fetal Medicine at University of Colorado, told EHN. Asking women about consumption of lead-hunted meat may identify women at risk of adverse outcomes who are currently being missed.

Doctors decide whether to test a pregnant womans blood based on answers to a questionnaire about exposure to lead. However, consumption of hunted meat is not included in any of the 12 risk factors for lead exposure recognized by theAmerican College of Obstetricians and Gynecologists, and is also absent from the U.S. Centers for Disease Control and Preventions (CDC)Guidelinesfor the identification of lead exposure in pregnant and lactating women.

Even though some parts of a lead-hunted carcass may be free of lead and safe for pregnant women to eat, it is not possible to identify contaminated meat with the naked eye, and levels of contamination vary from carcass to carcass.

Dr. Braverman told EHN that since its not clear how to choose safe portions of lead-hunted meat, preventative information about lead-hunted meat could be provided along with other nutritional advice. We provide education about mercury. We talk about how to avoid listeria. I think its reasonable to add to that, dont eat lead-hunted meat.'

Braverman also emphasized that even if women avoid ingesting lead during pregnancy, the lead they accumulated before pregnancy can still pose risks.

Certainly it would be better to avoid lead exposure for your whole life.

Childhood prevention information related to hunted meat is absent from theAmerican Academy of Pediatrics, theCDC,EPA, and guidance from state health departments such as thisbrochurefrom the Pennsylvania Department of Health. Although the New York Department of Health issued the followingstatement, people who eat game harvested with lead shot may be exposed to lead.

This is of greatest concern for young children because they are particularly susceptible to the toxic effects of lead, the topic is absent from the departments advice onChildhood Lead Poisoning Prevention. The Wisconsin Department of Health Services acknowledges concerns about lead exposure from eating hunted meat, andrecommendsuse of non-lead ammunition. However, the topic is absent from the departments lead prevention information, Feeding Your Child.

The most common policy in the U.S. is for children to have their blood-lead levels tested by the age of two, before they are likely to consume large amounts of hunted meat. But exposure to lead after the age of two matters. Blood-lead levels of 6-year-olds have been more stronglyassociatedwith impaired cognitive and behavioral development compared to blood-lead levels measured earlier in childhood. This highlights the importance of questionnaires for identifying older children at high risk of lead exposure, and the need for a question about consuming hunted meat.

Its something pediatricians should be asking. Do you eat venison or other locally hunted meat? it might be useful to add this question to the lead questionnaire we give to parents of infants and toddlers, Dr. Ketyer told EHN.

Venison meat. (Credit: Chris Davies/flickr)

These concerns extend to those who eat venison donated to food pantries.

Venison donation programs have provided millions of meals to food banks across the country. States with venison donation programs include those that also harvest themost deer: Texas, Michigan, Pennsylvania, Wisconsin, and Georgia. None of these five states require x-ray inspection of meat for lead contamination.

In 2008, astudyanalyzed nearly 200 packages of venison from food pantries in Wisconsin, but it is unknown how many packages contained meat that was hunted with firearms. Lead was detected in 15 percent of packages; the average level in lead-contaminated meat was 160 ppm. At this concentration of lead, the study predicted 81 percent of children who consumed just two meals of venison per month would experience blood-lead levels above 10 ug/dL.

In terms of other states, Minnesota requires x-rayinspectiondue to documented lead contamination of donated venison. However, North Dakota and Iowa currently accept venison donations to food banks without lead inspection, despite previous findings of lead contamination.

The Iowa Department of Public Health hasresponded, pointing out that no cases of concerning blood-lead levels in the states children have ever been attributed to lead in venison. However, this fails to recognize that most children tested in Iowas program are tested from ages 0-3. This also fails to take into consideration that blood-lead levels tested several months after the hunting season may be deceptively low.

Evidence of lead contamination in donated venison first came to light in 2008. North Dakota hunter and physician Dr. William Cornatzer saw an x-ray image of a lead-contaminated carcass during a board meeting of the Peregrine Fund, a conservation organization focused on birds of prey. Soon after, he led a project to x-ray packages of venison donated to the states food banks. The images revealed lead contamination in 60 percent of samples. I about fell out of my chair. he told EHN. He realized his children and pregnant wife had likely been exposed to lead from his own hunted venison.

I dont think humans should be eating lead-contaminated meat, and I dont think we should be donating it to people who cant afford alternatives, he said. Unfortunately, a lot of people took this as, Somebodys trying to take my bullets away, somebodys trying to take my guns away.'

The Peregrine Fund issued a statement in response to accusations directed at Dr. Cornatzer and characterizations of the organization as anti-hunting extremists: To build support for their own agenda, special interest groups have deliberately tried to smear the integrity of thoughtful, dedicated health and wildlife professionals and create fear of losing hunting and gun rights among their constituents. Smear and fear is a well-known technique for manipulating public opinion when facts are absent. Their action is disingenuous and not in the interests of wildlife or human health, including the health of their own constituents.

Across the state line, Lou Cornicelli, Wildlife Research Manager and author of the Minnesota Department of Natural Resources specialreporton lead contamination of hunted meat, had a similar experience.

I got crazy accusations just because we described what might happen if you shoot a lead bullet, Cornicelli told EHN. It evoked a strong reaction from people, like The next thing youre going to do is take my guns away.'

At the time Cornicelli ran the states big game program and was responsible for regulation-setting, the annual harvest was roughly a quarter of a million deer per year. And yet he received accusations of being a secret agent for the organization People for the Ethical Treatment of Animals (PETA).

People would ask, Are you an anti-hunter? No. Just because I dont want to eat lead doesnt mean Im against hunting, he said.

When asked for a comment regarding lead-contaminated meat, the National Shooting Sports Foundation (NSSF) sent a link to theirfactsheeton lead-based ammunition, which claims the lead detected in North Dakotas donated meat was part of the Peregrine Funds agenda to ban lead ammunition. In reality, the stated mission of the Peregrine Fund is to preserve our wildlife conservation and hunting heritage through voluntary incentive-based outreach and education aimed at increasing the use of non-lead alternatives.

The NSSF also told EHN that their support for educating hunters extends to discussing options hunters have for limiting exposure such as burying entrails after field dressing and careful meat processing.

Group of deer hunters. (Credit: Florida Fish and Wildlife/flickr)

Natural resources officials may be appropriate messengers to discuss lead-contaminated meat, however, there are two problems. Elaboration on potential health effects is often avoided, viewed as the domain of health departments. Second, many hunters strongly disagree with their states deer management decisions, and view any information from the responsible department with deep suspicion.

Kevin, Perry, and brothers Robert and Gary have been hunting together with lead ammunition for decades, since they were 12. We met with them in November and they requested EHN use their first names only. They believe that advice about how to avoid the potential health effects of consuming lead-shot meat should be more accessible to the hunting community.

According to Kevin, lead exposure is not a topic of conversation among hunters.

Its not really brought up. People in the hunting community dont really know about it, he told EHN.

Robert believes this should change, and emphasized the need for information to be free of anti-hunting or anti-ammunition agendas.

I think its important not just for hunters to understand it, but for people who are ingesting the meat from hunters, whether its their families or people eating whats been donated, that they understand there are potential consequences, he told EHN. But it has to be clear theres no hidden agenda It needs to be pure, science-driven, here are the facts, were not legislating anything, just saying heres what the issues are.'

Gary sees opportunities for communication by healthcare providers. He told EHN, I was in the doctors office today, my heart doctor. You go in, just like when you go to the diagnostic center, and they have those pamphlets Are you a lady of childbearing years? Are you a pre-diabetic?' He suggested that information about lead-hunted meat be presented similarly, Why cant that information be funneled through the health industry into pamphlets?

For Perry, the issue centers on information parents should receive before their child is old enough to start eating lead-shot meat. I would say one of the biggest possibilities is a pediatrician. The biggest. Because youre feeding that baby deer meat once it gets older, he told EHN. Somebodys going to come in there with their baby, and the pediatrician will check it all over, and then say Oh here, this is what I want you to read. The doctors have to get it out there.

Dr. Ketyer emphasized that its not just about what is being communicated, but the way it is communicated.

How we communicate is the key. This is not about challenging the hunting lifestyle we need to consider what would be most useful for families that hunt, he said. People should have an opportunity to understand the risks to themselves and their children. I didnt know is not acceptable to a pediatrician.

While switching to alternative ammunition is the most effective way to eliminate lead contamination of hunted meat, Cornicelli said he understands why many hunters choose to continue using lead ammunition. There are real reasons why people dont switch the commercial availability of copper is lower, and the price is higher, he said. A large shift to copper is going to be predicated on manufacturers ramping up production, driving costs down, and making availability more broad.

As a result, Minnesotas DNR provided hunters with examples of ways to reduce lead exposure, even if they continue to use lead ammunition. These include selecting shotguns instead of high-powered rifles, and avoiding acidic cooking ingredients, since acids can dissolve even more of the lead into the food.

Additional advice for hunters who use lead ammunition is to avoid shooting the deer in regions of the body with heavy bones, such as shoulders and hips, where the resulting impact scatters more lead into the meat. The anonymous deer processor in Pennsylvania told EHN he cautions his customers, Pick your shots. If youre not comfortable shooting at a running deer, dont do it. Wait for a better shot. And its not just to have meat thats not contaminated with lead. Its also better for the animal you dont want the animal to suffer.

Dr. Braverman pointed out the need to include hunters in the process of identifying strategies to reduce lead exposure,

We need more research about what effective interventions are for people eating a lot of hunted meat, she said. Its important to ask, culturally, what works for people in their life? What do they think about this?

Gary summed up the challenge of communicating about lead exposure from hunted meat, Its easy to say, Well, its not going to happen to me. That lead, it didnt bother my dad or my grandfather, or my aunt, or my uncle, so its not going to happen to me.'

His brother Robert added, But we dont know that it didnt affect them. Now the science could exist to say, you know Grandpa had this, and this, and lead could have contributed.

Sam Totoni is a graduate student in Environmental and Occupational Health at the University of Pittsburgh Graduate School of Public Health.

James Fabisiak is an Associate Professor of Environmental Health and Director of the Center for Healthy Environments and Communities at the University of Pittsburgh Graduate School of Public Health.

Martha Ann Terry is a faculty member in the Department of Behavioral and Community Health Sciences at Pitts Graduate School of Public Health.

This article originally appeared in Environmental Heath News. It was republished under a Creative Commons license.

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Lead in hunted meat: Who's telling hunters and their families? - UPMC

As disease-wary stock markets tumble, the outbreak of the novel coronavirus, COVID-19, has continued to see global death tolls rise rapidly spreading from its Wuhan roots to gain a foothold in countries as diverse as Italy and Iran.

But virus outbreaks are nothing new: in just the past 10 years, the world has been plagued with the H1N1 pandemic of 2009 and a resurgence of the Ebola virus from 2014 to 2016 and it seems like such epidemics will continue for years to come.

Which begs the question, can scientists predict if, and when, we will see another new virus strike within the next several years?

But despite advancements in virus detection technology, according to Prof. Roy Gulick, medicine, chief of the division of infectious diseases at Weill Cornell, it is often difficult to predict when and how often such outbreaks will occur.

These difficulties are compounded by the fact that viruses cannot be singularly categorized instead, representing a wide range of illnesses, which vary considerably in both symptoms and manner of transmission.

However, the medical community is increasingly equipped with more advanced technology that can more quickly discover new viruses, though challenges still loom.

Were much better at discovering, tracking, and characterizing new viruses, Gulick said. Given that we have much better tools today to analyze these [viruses], were going to continue to discover more viruses and microorganisms and that will help us do genetic analyses and develop vaccines and medications.

For instance, a new virus, Yaravirus brasiliensis, which was discovered at the end of January in Brazil, is a testament to the gap in knowledge in the world of viruses.

Over 90 percent of the virus genome has never been seen in other organisms, and bears no resemblance to any genome cataloged in over 8,500 publicly available metagenomes, genetic samples recovered from the environment.

In fact, the virus is so foriegn it actually represents an entirely new group of viruses based on current classification protocols, the Yaravirus would not even be considered a virus.

The novel virus does not cause human disease, but its exact effects still remain unknown.

For a virus to cause diseases in humans, it has to be able to recognize a cell and target that cell, Gulick said. Different viruses target different cells in the body the cold and flu virus tend to target cells of the upper airways, nose, mouth, and the throat.

Another reason that makes viruses so difficult to track and contain is the vast variety in the way they are transmitted.

For instance, some viruses, like the common cold, spread through nasal or oral secretions that are passed from one individual to another through contact, while others, like measles, can spread through mere proximity, moving through coughs or sneezes near others.

In a type of illness Gulick called zoonosis, humans can contract viruses not only from other humans, but animals as well, such as in the case of SARS.

The occurrence and severity of outbreaks, Gulick explained, depends on which of these modes of transmission a virus uses to spread. This, in turn, affects what preventative measures are recommended by healthcare professionals to halt a virus contagion.

Typically, around cold and flu season, we remind people to wash [their] hands frequently, Gulick said. If someone is admitted to the hospital for measles, we put a mask over them and anybody entering their rooms so that measles is not transmitted through the air from one person to another.

While the nature of the next viral outbreak is uncertain, significant medical advancements, such as vaccines, have improved the treatment of viruses and the state of public health as a whole, according to Gulick.

Were much better, particularly in the last five years, about being able to develop vaccines in a rapid way, Gulick said.

Vaccines are not available for all viral ailments, but advancements in antivirals have significantly improved treatments for viral infections within the past few decades, Gulick said. Gulick explained that antivirals are commonly used for influenza and Hepatitis C.

Overall, the trend of new virus outbreaks doesnt seem to be slowing down any time soon, but preventive measures are crucial for avoiding infection.

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Evolving Viruses: What Does the Future Hold? - Cornell University The Cornell Daily Sun

Last November, at the start of the American Heart Association 2019 Scientific Sessions in Philadelphia, cardiologist and current AHA presidentRobert Harrington, MD, sent out atweetto his 14,200 followers: No MANELS! There are no all-male panels at #AHA2019.

Within an hour, the post had amassed hundreds of likes and retweets, as scientists and physicians from all over the country chimed in to express their support. Outstanding! Lets continue to support our young women in STEM and to increase the number of #WomeninMedicine, replied a preventative cardiologist from USC. The best part? This wasnt hard for @AHAMeetings to accomplish. Because #WeAreEverywhere, a cardiologist who specializes in myocardial infraction also tweeted in response.

Harrington, the Arthur L. Bloomfield Professor in Medicine and chair of the Department of Medicine at Stanford, has shown a commitment to amplifying diverse voices and leveraging innovative technologies and policies to improve health equity. And its these values that drive his work at Stanford and the AHA. Recently, Lindsey Baker, communications manager in the Department of Medicine, spoke with Harrington about his views on technology and diversity in medicine.

1. Youve taken up several initiatives during your tenure as AHA president including health equity and diversity, and research. How did you choose these topics, and why were they important to you?

Harrington:One of the great things about being the AHA president is that you realize you have a big public platform. It provides an opportunity to think about the things that matter to you.

Im a clinician and a clinical researcher, so one of the key themes of my 2019 AHApresidential addresswas the idea that evidence matters that its really important to have an evidence base to guide what we do in clinical medicine, and in order to generate that evidence base we need to support research. And in order to support research, we have to think about health equity: How do we make research more approachable for people in communities where theyve been understudied and underserved?

We now include the word equitable in all of our goal statements. And we just recently announced our2030 impact goals, which emphasize how we improve overall whole person health in the U.S. and globally.

Were also committed to supporting young investigators. Right now, over 70% of all of our new research awards go to early career investigators. Ive mentored residents and fellows for a long time now, so theres overlap with my day job. Im also a first-generation college student, and were passionately committed to supporting that group as well.

2. Fewer than 15% of cardiologists are women. How are you closing the gender gap?

Harrington:I was raised by a single mother. I have one sister, I have a wife, I have four daughters. Im surrounded by women. And yet cardiology as a field is not known for being women-friendly.

So, I decided that I was going to make it part of my AHA presidency. We now have a lot of initiatives to address this: Weve created a new group calledResearch Goes Red, which builds on our Go Red for Women campaign, which is focused on understanding heart disease in women. Weve also created a womens research working group designed to make sure that were reviewing submitted grants in a gender-equitable way, and that were including more women as part of all of our science committees. Right now, our committees are roughly 42% women, and weve made a public commitment to get to 50% in the next few years.

And in 2019, we made the official decision to stop hosting manels, which are scientific panels comprised solely of men. When we were planning the 2019 scientific sessions, I told colleagues that I will no longer serve on a panel that only contains men, and I asked them to stop hosting panels at the AHA scientific sessions that only include men.

3. Youre involved in theApple Heart Study, which saw record participant enrollment and the widespread introduction of digital technology into clinical research. What in your opinion makes this study so groundbreaking? What have been some takeaways?

Harrington:All credit for Apple Heart goes to others toMintu Turakhia,Marco Perez,Ken Mahaffey,Manisha Desaiand their teams. My role has been supportive.

Here are the real takeaways for me: Apple Heart was intended to be a technical feasibility study: Might the watch be able to detect atrial fibrillation using the sensors in the watch and algorithms? Because its not actually detecting a-fib; its detecting an irregularity that has a probability of being a-fib based on a variety of characteristics. And I think the group achieved that.

The second takeaway, and to me the most interesting part of the study, is that in only eight months we convinced 400,000 people to give us informed consent to collect their health data. Thats the power of the technology. If we can engage almost a half-million people in research the way we did the Apple Heart Study, that could change the paradigm of how we do research. These are extraordinary tools that can allow us to have reach into numbers that we just cant do in conventional research.

4. Studies like this make it clear: Technology in research is here to stay. How can we use it in ways that are more supportive and democratic, and less intrusive?

Harrington:The biggest thing that Ive been talking about recently is how do we use the watch, the phone and the web to collect data that can be used for research purposes. And if you dont have to go to the doctors office and see your clinicians or the study coordinators, wouldnt that help to democratize research so that research could reach more people?

Right now, to be involved in research youve got to be willing to come to campus or go to a clinic. What if we could do a lot of it remotely? Might we be able to engage a group of people thats more representative of the population? That to me would be a really important step.

5. Youre very active on social media particularly Twitter. What appeals to you about this platform?

Harrington:Im a big consumer of information. And I largely use Twitter as my social media conduit. I use it to engage in conversations about things I find interesting in cardiovascular medicine, and to keep up with whats going on in the field. I now track all of my academic journals through Twitter thats how I stay current.

I really enjoy the conversations around science, and Twitter makes me read things I might not otherwise read in journals that I havent subscribed to. I think that the crowdsourcing of ideas is really helpful and informative people throw stuff out and ask what you think about it. And all of the sudden you have 50, 100, 200 different voices weighing in.

Twitter democratizes medicine you dont have to be a professor to have an opinion. In fact, some of our early-career investigators are much more facile than established professors on Twitter. Now when I travel around the country to different places for conferences and meetings, I always meet some young person I know from Twitter. Ive met new people, made new friendships and encountered new ideas.

I just tell people to decide how they want to use it. I use it professionally, and there are a few things I do regularly that people know about. For example, Im always showing pictures of my socks, particularly during heart month. I wear a lot of red socks! And everyone knows I love the Boston Red Sox because I tweet about them.

In a new 1:2:1 podcast, Harrington discusses the latest advances in cardiovascular medicine, as well as efforts to address gender inequities in the field of cardiology, with Paul Costello, the School of Medicine's senior communications strategist and adviser.

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5 Questions: Robert Harrington on research, health equity and the gender gap in cardiology - Stanford Medical Center Report

Arts and Healing Across the Lifespan serves as the theme of the 4th annual Creative Age symposium organized by the Arts Council of Washington County.

Jeremy Nobel, M.D., founder of the Foundation for Art & Healing (FAH), is Board Certified in both Internal Medicine and Preventative Medicine, with masters degrees in Epidemiology and Health Policy from Harvard School of Public Health, where he serves on the adjunct faculty.(Photo: Arts Council of Washington County)

We have brought together some of the best thinkers in arts therapy for this one-day, intensive symposium, said Paula Bell, chair of the event. So much exciting research shows the proven benefits, regardless of age, of participating in the arts for longevity, mobility, cognitive ability and quality of life for all.

The symposium features two inspiring keynote speakers and 14 breakout sessions, with entertainment from a concert pianist. Bell suggests the symposium is targeted to parents and teachers; psychologists; counselors; doctors; caregivers; arts, music and drama therapists; those working with patients with dementia, Alzheimers and Parkinsons; and those aspiring to understand the loneliness epidemic.

Jeremy Nobel, M.D., founder of the Foundation for Art & Healing (FAH), embodies in a most personal way the effort to enlist art and science in the relief of human suffering. Nobel, who is Board Certified in both Internal Medicine and Preventative Medicine, with masters degrees in Epidemiology and Health Policy from Harvard School of Public Health, where he serves on the adjunct faculty, is also a poet, a photographer, and a teacher a practitioner of the humanities. He is scheduled to attempt to answer the question, Can creative expression be medicine?

Nobel will help participants discover how creative expression reduces the physical and emotional burden associated with various types of health conditions and life circumstances," said Ken Crossley, co-chair of the event.

Nobels Unlonely Project is the signature initiative of FAH, a project whose mission is to broaden public awareness of the negative physical and mental health consequences of loneliness, while promoting creative arts-based interventions to reduce its burden. The project has garnered national visibility, including being featured on the Today Show, The New York Times and Psychology Today. Nobel will present a breakout session, Deep Dive with Jeremy Nobel.

Erica Curtis, certified marriage and family therapist, as well as author, speaker and instructor at UCLArts & Healing, co-authored with Ping Ho, the award-winning book, The Innovative Parent: Raising Connected, Happy, Successful Kids through Art.(Photo: Katie Lubbers)

Erica Curtis, certified marriage and family therapist, as well as author, speaker and instructor at UCLArts & Healing, co-authored with Ping Ho, the award-winning book, The Innovative Parent: Raising Connected, Happy, Successful Kids through Art. As a keynote speaker, Curtis is scheduled to address how art may help parents temper storms of emotion, defuse sibling conflicts, get teeth brushed, and raise happy, successful kids. Her approach has been described as simple, doable and fun.

She believes talking to kids often is not effective, especially when it comes to calming emotions. In her hands-on keynote, Curtis will share art therapy trade secrets to address the countless challenges faced by children and teens when words are inadequate or inaccessible. From anger to anxiety and daily struggles, this session equips the participant with practical tools for calming kids, and is geared toward parents, grandparents, and professionals alike.

Dr. Massimiliano Frani, concert pianist and founder of Genote Health Music, is scheduled to provide entertainment at the Creative Age symposium and will also lead a breakout discussion focused on providing tools to better understand the effects of health music on aging and recovery processes.(Photo: Arts Council of Washington County)

Dr. Massimiliano Frani, concert pianist and founder of Genote Health Music, will provide entertainment on Saturday morning after breakfast and will also lead a breakout discussion focused on providing tools to better understand the effects of health music on aging and recovery processes. Participants may assess health music applications as a non-pharmacological intervention. As master pedagogue, he performs and lectures worldwide about music as medicine and its effects in physical and mental health, education and sports. He has presented Health Music papers, training sessions and conferences worldwide and is the recipient of the Melvin Jones Humanitarian Award.

Other presenters include Vicky Morgan, Victoria Petro-Eschler, Debra Eve, Joni Wilson, Chara Huckins, Dr. Brandt Wadsworth, Barbara Lewis, Nicholas Cendese, Karen Carter, Dr. David Tate, Sharon Daurelle, Emily Christensen, Alex Mack, Saundra Shanti and Rev. Claudia Giacoma.

Bell says the event should havesomething engaging for everyone, including music, dance, art, theater, singing and spiritual care.

This symposium and these workshops are topnotch," Crossley said.

The symposium is slated for Saturday, February 29, 2020, at the Eccles Fine Arts Center on the campus of Dixie State University from 8 a.m. to 5 p.m., with an opening reception in downtown St. George Friday evening from 6 p.m. to 8p.m. at ART Provides Gallery, 35 N.Main Street.

Registration and a light breakfast begin at 7:30 a.m. on Saturday, with lunch at noon, and speakers and workshops continuing until 5p.m. Both meals and symposium materials are included in a registration fee of $50, with seniors and students charged $35. To register for the event, go to http://www.artswashco.com and click on the ticket link.

For a list of hotels and lodging opportunities, additional information and questions, please call 435-238-4948 or email info@engageutah.org.

In addition, participants may earn CEU credits in physical therapy, occupational therapy, recreational therapy, social work and arts and music therapy, with up to seven credits available. Applications are available at the registration desk. CEU credits are available for a $15processing fee, which may be prepaid online or with registration at the door.

JJ Abernathy is an arts advocate and musician, and may be contacted at musictimes05@gmail.com.

Read or Share this story: https://www.thespectrum.com/story/news/2020/02/17/st-george-plays-host-creative-age-symposium-dixie-state/4789142002/

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County arts council announces 'Creative Age' symposium - The Spectrum

Artificial intelligence (AI) is becoming increasingly sophisticated at completing tasks that humans usually do, but more efficiently, quickly and at a lower cost. This offers huge potential across all industries. In healthcare, it holds particular value as it impacts patient care and wellbeing as well as the bottom-line.

The growing role of AI

Indeed, forecasts predict that medical uses of AI will be present in 90% of hospitals in the near future and replace as much as 80% of doctors roles. Investor Tej Kohli expects to see AI applications in healthcare contribute three to four times more global output than the Internet. This currently accounts for $50 trillion of the global economy.

There is clear, untapped potential in using AI. But for it to be fully utilised, the people in charge and implementing it must have a decent grasp of the opportunities and limitations. That means that doctors, nurses, and other healthcare professionals must get-to-grips with AI and its many subsets.

Many uses for AI

The uses of AI in healthcare are seemingly endless. They span the full spectrum of patient care and treatment, from drug discovery and repurposing to clinical trials, treatment adherence and remote monitoring. AIs particular strength lies in highly computerised, manual work that can be easily automated. With it doing the legwork, this frees up practitioners to focus on human tasks like speaking with patients.

Matching donors and patients

Some notable examples of AIs potential include organ donation. Matching patients with donors can be a time-consuming and inaccurate process. Through AI, more matches can be carried out in a short timeframe, compared to when a human has to manually scour the donor and patient database or find a suitable family member donor. Plus, patients can procure donors from a wide range of possible contacts, those who arent a biological fit, because AI can quickly link donors to patients based on a wide range of factors beyond blood type and relation.

Preventative care

Another huge benefit comes in preventative care. Consumer health applications and the Internet of Things (IoT) are helping people track their lifestyle and fitness activities. This encourages them toward healthier behaviour and proactive health management. Additionally putting them in control of their own health and wellbeing.

Better data

IoT devices like the Apple Watch can also, in theory, provide healthcare professionals with timely and accurate data. Blood pressure information, for example, can be tracked throughout the day without the potential of white coat syndrome skewing the results. In getting this data and having AI analyse it, professionals can provide more tailored care and advice, feedback and guidance on treatments and understanding what medicines are working.

Working together across disciplines

Of course, this is but a snapshot of what AI is achieving in medical science and so much more can be done when researchers, doctors, data scientists and other frontline health workers collaborate on problems and solutions. Because, ultimately, no data scientist can fully understand the unique environment of a hospital or doctors surgery. Vice versa, healthcare professionals arent going to be able to know all the ins-and-outs of algorithms and machine learning.

Thats not to say that healthcare professionals having a general understanding of AI isnt important. To work effectively with data science teams, there must be a baseline understanding within the healthcare sector, of the key concepts and trends in AI.

The benefits of understanding AI

There are additional benefits to knowing a bit about AI. First, healthcare leaders can make more informed decisions about AI investments and the infrastructure required. This can help projects align with the organisations wider goals and also ensure that costs dont spiral.

If doctors understand the abilities of a particular AI tool, they can also use it effectively in making decisions, diagnoses and prioritising tasks. They can use a tool to identify patients at risk of developing a specific condition, for example.

Changing culture and steering the direction

Additionally, having more of a grasp of AI can change the culture around adopting such technology. Typically, the sector has lagged behind in accepting emerging technology as was the case with electronic health records. But embracing it early can push innovation and progress further. Shaping it in a way that suits healthcare professionals, patients and the sector as a whole.

As MIT economists Andrew McAfee and Erik Brynjolfsson state, So we should ask not What will technology do to us? but rather What do we want to do with technology? More than ever before, what matters is thinking deeply about what we want. Having more power and more choices means that our values are more important than ever.

Patient communication

It can also help to reassure patients. Machine learning tools are increasingly being used in clinical settings and having a doctor with an understanding of such tools will lead to more thorough discussions. Some patients may wish to know how an AI has come to a specific decision. Doctors will have to communicate the training a machine has undertaken, the data it has been trained with and the algorithms powering its decision-making.

In any case, most patients still prefer human-to-human interactions when talking about their symptoms, test results and prognosis. AI is still mistrusted by many people, partly because they dont understand how it works and whether it is accurate or not. They also feel that an AI doesnt take in their uniqueness and experience of a disease. With a well-informed doctor explaining these things, their fears will be put to rest and they can move onto to their treatment and care.

As vital as medical knowledge

As AI becomes mainstream in the healthcare setting, the onus is on healthcare professionals to invest in their AI education. Failing to understand AI is falling short of patient expectations, People cannot be treated effectively if their physician doesnt know how their AI-powered tool works. In the future, understanding AI and medical knowledge will hold the same importance for practitioners.

So its worth learning about it now and keeping up with AI trends in the industry. For the good of your career as well as your patients.

Link:
Why healthcare professionals need to understand AI - ZME Science