StemCell Therapy

Michael Ringel, PhD, JD, Managing Director & Senior Partner, Boston Consulting Group (BCG), ... [+] presenting at the 9th Aging Research and Drug Discovery meeting organized by the University of Copenhagen and Insilico Medicine. Presentation title "The Emerging Commercial Landscape for Aging Biology-Based Therapeutics"

While I had very high expectations traveling to the 9th Aging Research and Drug Discovery (ARDD) forum, the largest five-day annual gathering of the longevity biotechnology industry organized by the University of Copenhagen, the event did not fail to impress. I can spend endless hours covering the lectures of top-tier academics, pharmaceutical industry leaders, and venture capitalists, but these would be better covered in the conference proceedings. However, one lecture titled The Emerging Commercial Landscape for Aging Biology-Based Therapeutics by Dr. Michael Ringel, captivated even the most experienced industry executives and the established aging researchers.

Dr. Michael Ringel at the 9th ARDD conference

The sheer fact that Boston Consulting Group (BCG), the worlds most venerated consulting firm specializing primarily in strategy and management consulting, became a knowledge partner of the ARDD indicates that the meeting has reached a certain level of credibility and longevity biotechnology is a clear trend. BCG is known for being very impartial, knowledge- and experience-driven, and providing valuable strategic insights to the boards and CEOs of the worlds largest corporations. The firm is used by governments all around the world when they want to get deep industry insights or when they want to formulate a national strategy around a specific trend. From what I know, BCG was used by the Kingdom of Saudi Arabia to help formulate their famous Longevity Strategy, which resulted in the creation of the $1 Billion a year non-profit, Hevolution Foundation.

Dr. Michael Ringel, BCG presenting at the 9th ARDD in Copenhagen

One differentiating feature of BCG is the quality of its slides. They often manage to turn a very complicated story into a set of visually appealing, easy-to-comprehend slides that provide a clear problem definition, recommendation, situation assessment, and alternatives. These slides are rarely shared by the customers as they usually represent a substantial investment and intellectual property.

Therefore, when during his 30-minute talk, Dr. Ringel went through over thirty of these valuable slides, those of us who understand the value made sure to get the recording of the lecture.

Here are some of the top takeaways from Dr. Ringels presentation that Im able to share:

Michael Ringel, PhD, JD, Managing Partner, BCG, presenting at the 9th Aging Research and Drug ... [+] Discovery meeting

I knew Dr. Michael Ringel prior to the ARDD as a well-known strategy and management consultant in the pharmaceutical industry. After almost 25 years at BCG in healthcare practice, he is on a first-name basis with every pharma CEO, board member, investor, and government official, and is a walking encyclopedia who also knows most of the emerging technologies and their applications.

From left to right: Eric Verdin, MD, CEO of the Buck Institute for Research on Aging, Mehmood Khan, ... [+] MD, CEO, Hevolution Foundation, Michael Ringel, PhD, JD, Managing Director, BCG, Alex Zhavoronkov, CEO, Insilico Medicine

Here, I asked Dr. Ringel a few questions to get his perspective on longevity biotechnology and the future of this exciting new field:

Alex Zhavoronkov: Michael, I know that aging biology is not only your professional focus but also your personal interest. What made you interested in this field?

Dr. Michael Ringel: Alex, thanks so much for having me. It truly is a pleasure to sit down with you. One disclosure before we start the discussion. One of the investors in your company, Insilico Medicine, is B Capital Group. My company, BCG, is a partner to B Capital Group, and so I have an indirect and small financial stake in your company that we need to mention.

As to my interest in the field, Ive spent my career working in healthcare, trying to help companies bring better medicines to people. And when I found out there is an area of biology that underpins not just one, but the majority of the chronic diseases that burden us, I realized the impact it might have on human health. Preventing multiple diseases with one intervention is a potential game-changer, if you can make it work. The key word being *if*. But when you dig into the science, you find out in fact theres really good evidence to support the notion. We just have to do the work to translate what weve seen in the lab to humans.

Alex Zhavoronkov: You have been in biopharma for over 25 years and you have seen everything. You saw Geron, Sirtris, ResTORbio, Unity, and many other companies in this area. How do you see the field of aging biology evolving and propagating into the biopharma industry and how did the field change over the past decade?

Dr. Michael Ringel: Understanding a new area of science can sometimes take a long time and then sometimes there are these great leaps forward. In my youth in the 70s we knew about caloric restriction, which is still one of the best-validated interventions. But we didnt know much about how it works. That began to change in the 90s, kicked off in part by Cynthia Kenyons seminal work in worms, as we began to understand the biological pathways involved. We saw the first pharmaceutical intervention proven to work in a mammal, in mice, just over a decade ago with the NIHs Interventions Testing Program. Today there is a small but growing pipeline of drug candidates in clinical testing. I believe we are on the cusp of the first demonstrated effective intervention in humans, which I believe will be one of those great leap-forward moments that galvanize interest in the field.

Alex Zhavoronkov: In your opinion, how long will it take the pharmaceutical industry to buy into the concept of utilizing aging biology as a platform for drug discovery for a range of therapeutic areas?

Dr. Michael Ringel: We are already seeing activity. We know from publicly available information that many companies have external partnerships or internal units, including AbbVie, Novartis, Regeneron, and others. For instance, UCB has partnered with your own company, Insilico Medicine. So it has already started. I believe that over the next decade, we will see a burgeoning pipeline focused on various pathways of longevity biology, and once the first clinical studies demonstrate proof-of-concept, we will really see interest grow.

Alex Zhavoronkov: Of course, you can not talk about Saudi Arabia and Hevolution since these are clients but I was one of the key opinion leaders interviewed for this project in 2019, and BCG was clearly involved. Why is longevity biotechnology so important for any emerging economy and do you think other countries should prioritize longevity in a similar way?

Dr. Michael Ringel:I cant give opinions on specific companies or foundations and would refer you to their leadership for questions about them. But as to the general point of why this matters all over the world, in developed and emerging economies, it is because it has the promise of being such a powerful way to improve human health. Weve seen that just throwing more money at the current healthcare system has not improved lifespan or healthspan, and we even have had retrograde motion in some areas, with lifespans declining. In part, that is due to the growing burden of metabolic disorders like diabetes. What we need is a better way, more focused on prevention an ounce of prevention is worth a pound of cure. And thats where longevity biology is critical. It is, at heart, a preventative approach. And the core pathways are the very same ones that are implicated in the metabolic disorders that are a growing issue all over the world.

Alex Zhavoronkov: What is your advice to the young entrepreneurs in this nascent longevity biotechnology industry?

Dr. Michael Ringel: Theres a lot that you need to do as an entrepreneur you need to figure out funding, build a team, set up operations, choose your preclinical and development plans, develop partnerships, and a million other things Im always incredibly impressed by how much thesel young entrepreneurs can accomplish, juggling all these things at once. But the sine qua non, the thing you cannot do without in biotech, is good science. All the rest of the work is built on the foundation of a good idea, a new way to help people. So my advice is make sure youre investing your time and energy getting as deep into the science as you can.

Alex Zhavoronkov: Finally, how did you like the ARDD conference, what were your major takeaways, and will you come again next year?

Dr. Michael Ringel: To me ARDD is a unique conference in longevity, bringing a heavyweight mix of the most impressive scientists in the field together with the most promising start-ups and a great set of investors. For anyone already in the field, it is the place to be, and for anyone looking to learn more, I cannot think of a better place to get a crash course. Particularly the large pharmaceutical companies would benefit by bolstering their attendance to get deeper into this field.

The 9th Aging Research and Drug Discovery meeting, Grand Hall, University of Copenhagen, September ... [+] 2022

Michael Ringel, PhD, JD, Managing Director and Senior Partner, Boston Consulting Group

Michael Ringel, PhD, JD, is Boston Consulting Group's global leader for innovation analytics and research and product development, and is a core member of the firms Corporate Finance & Strategy practice. Michael is a frequent contributor to industry journals, including Nature Reviews Drug Discovery, and has coauthored numerous BCG reports on innovation, R&D, and corporate strategy. He received a BA in biology from Princeton, a PhD in biology from Imperial College London, and a JD from Harvard Law School.

Read more:
Celebrity Strategy Consultant Predicts What Will Be The Most Impactful Area In The Pharmaceutical Industry - Forbes

Participants will be introduced to the identification, degradation, and preservation of common photographic print materials, including the salted paper, albumen, silver gelatin, and chromogenic color processes. Ethical and other factors to consider in the preventative care of at-risk print materials will be outlined. We will address early direct positive processes the daguerreotype, ambrotype and tintype briefly. Well also discuss details pertaining to the manufacture, identification and preservation of gelatin dry plate and film-base negatives, along with basic considerations in the care of photographic albums. Well review preservation challenges related to large and diverse photographic collections with attention paid to the importance of proper environments and storage materials, emergency planning, and risk analysis. The value and significance of photography, global initiatives, and the pressing need to secure external funding and support through effective preservation advocacy will be emphasized throughout the webinar. Participants will receive a small selection of historic prints, to be returned at the conclusion of the webinar, for in-depth study. A listing of key publications and online resources will be provided. While each session will start with a webinar presentation, but we will include time for discussions with questions welcomed during or following each session using Zoom meeting.

The statements and opinions expressed by panelists, hosts, attendees, or other participants of this event are their own and do not necessarily reflect the opinions of, nor are endorsed by, the American Alliance of Museums.

Here is the original post:
C2C Care Course The Preservation of Our Global Photographic Heritage: Here, There and Everywhere - aam-us.org

The American Psychological Association (APA) defines loneliness as the affective and cognitive discomfort or uneasiness from being or perceiving oneself to be alone or otherwise solitary.

In other words, loneliness is the mental or emotional discomfort you may experience from either being alone or feeling as though you are alone. This feeling stems from your social needs not being met and/or an inability to get the social connection you desire.

Although loneliness and being alone are commonly confused, being alone doesnt necessarily mean someone is lonely. Loneliness is a feeling, while being alone is a situation or state of being, which is not inherently negative, says Nina Vasan, M.D., psychiatrist and professor at Stanford University School of Medicine and chief medical officer at Real, an online mental wellness membership site.

You can feel lonely even when youre surrounded by other peoplesuch as a partner, family, co-workers or friends, continues Dr. Vasan.

Its also possible to be alone, but not feel lonely, she adds. For example, if youre by yourself but connecting to others through good communication or activities like volunteering, you dont feel lonely.

Follow this link:
Loneliness: Causes, Effects And Prevention Forbes Health - Forbes

Emily Moorhead is the chief operating officer of the central market at Detroit-based Henry Ford Health System.

Ms. Moorhead will serve on the panel "Building a Resilient, High-Reliability Organization With Accountable Leaders" at Becker's 10th Annual CEO + CFO Roundtable. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference on Nov. 7-10 in Chicago.

To learn more and register, click here.

Becker's Healthcare aims to foster peer-to-peer conversation between healthcare's brightest leaders and thinkers. In that vein, responses to our Speaker Series are published straight from interviewees. Here is what our speakers had to say.

Question: What is the smartest thing you've done in the last year to set your system up for success?

Emily Moorhead: The smartest thing I could've done was foster a culture of belonging and supporting leaders so they can best front-line support staff. After two or more years of living through COVID-19, the great resignation, staffing crises, supply shortages, and now high inflation rates, the financial challenges and staff burnout are prevalent throughout all departments in the care continuum. Leaders must pause, breathe and ensure that we care for one another. Strengthening our culture to create a strong foundation will be vital to preparing for a large amount of change that will be required to be successful in the future.

Q: What are you most excited about right now and what makes you nervous?

EM: Value-based care is exciting. We've talked about the evolution from fee-for-service to value-based care for over a decade. Moving the industry away from sick care and focusing on prevention gets me out of bed in the morning!

Q: How are you thinking about growth and investments for the next year or two?

EM: Growth is about meeting the broader community's needs, which means expanding virtual care platforms to areas not easily served in the past. Having a data-driven approach to anticipate upcoming provider shortages to be proactive about unmet care needs and how we can help fill the voids through provider access and create more streamlined care models. Investments in technology make it easier for people to access the care they need. We must reduce the friction patients experience when seeking care.

Prevention and wellness is the new model we as healthcare leaders need to evolve that thinking to be true healthcare partners to the communities we serve. We need to align care with the patient's preferences to make getting the preventative care they need easier. Examples include virtual visits with a specialist in the ED, during the primary care visit before leaving, or same-day appointments.

Q: What will healthcare executives need to be effective leaders for the next five years?

EM: I think leading through a large amount of change and evolution needed in our industry will be leaders' primary focus for the next several years. This will require some tough decisions but can be done in a way that fosters integrity, respect and kindness. At its core, leadership is about caring for everyone in our sphere of influence. That means making sure they feel safe, valued, and purposeful. Leaders should strive for authenticity over perfection. Future health care leaders need to be more "heart grounded." Would our processes be the same if we were leading with our hearts? I'd argue they wouldn't; they'd be centered a little more closely around our patients, peers, and families. I think Simon Sinek says it best, "Leadership is not about being in charge. Leadership is about taking care of those in your charge."

Q: How are you building resilient and diverse teams?

EM: As it relates to diversity, we have an enterprise-wide DEIJ strategy that leads to the local committee work, including action plans related to intentional recruitment, unconscious bias training for all staff, governance members and providers, educational partnerships, the establishment of a voice of the community work group, and strategic planning efforts to improve access for under-represented communities.

Diversity makes us smarter, more innovative, and less married to the status quo. Diversity also offers the opportunity to see with new eyes. Diversity is broader than gender and race; we must tap into diverse experiences and cultures. The more varied the experiences around the table, the better the chance of change being successful and sustainable!

In terms of resiliency: fostering a culture of belonging, caring for one another and regular leadership check-ins. People stay in supportive, fun and collaborative environments, so fostering a strong culture is the foundation of a resilient team. But we must also be accountable for knowing when we are approaching burnout and need to unplug, rejuvenate and seek help.

See the article here:
Prevention and wellness is the new model, a leader from Henry Ford Health System says - Becker's Hospital Review

With more employees resuming pre-pandemic lives, employers have an opportunity to offer routine health and wellbeing services.

During the pandemic, employers focused on Covid mitigation, social distancing and remote work, shares Susan Kirks, RN BSN COHN, manager of Employee Health and Wellness. With more employees back in person, we have a great opportunity to help people get back on track, especially when it comes to preventative and routine healthcare.

According to the CDC, more than four in 10 U.S. adults avoided getting necessary medical care during the height of the pandemic. While many Americans are ready to resume routine medical visits, rising costs and inflation have them thinking twice.

With many employees looking for work flexibility and support, resuming or offering new occupational health services can be a win-win opportunity for employers offering:

Convenient onsite services: With Cone Health onsite providers, employers can offer initial baseline physicals and one-on-ones to help employees choose a primary care provider. According to the governments Office of Disease Prevention and Health Promotion, having access to primary careis associated with positivehealthoutcomes. Primary care providers support preventative care, early diagnosis and treatment of disease and chronic disease management.

Screenings and vaccinations: Employers hosting mobile screening[HS1], flus shot clinics, or biometric screenings for cholesterol, glucose, blood pressure and BMI send a strong message that they care about employee health and wellbeing.

Listen and learn presentations: With Cone Healths new virtual sessions, employees can log in from work, home or on-the-go to join to hear from experts on a range of topics, including nutrition, preventative health and exercise.

Onsite training: Make sure supervisors and staff are prepared with CPR or first aid training. Whether you want a refresher course or first-time training, our providers are ready to assist you with your workplace needs.

To learn more about occupational health offerings, contact Jacqueline Heyward at (336) 832-7315.

See more here:
Getting Back to Employer Health and Wellness Programs - Cone Health

Today, the White House and U.S. Department of Treasury are hosting a White House Summit on Building Lasting Eviction Prevention Reform. As funds for Emergency Rental Assistance (ERA) are beginning to wind down, the Summit will focus on the need for an all-out effort to build lasting reform including through the use of remaining American Rescue Plan (ARP) funds from ERA and State and Local Fiscal Recovery Fund (SLFRF) assistance. Having created a first-ever national infrastructure for eviction prevention, now is the time to ensure we build on this progress and prevent a return to an eviction system that allowed 3.6 million eviction filings a year, often for small amounts of funds and without any legal representation or eviction diversion options. The Summit will feature top Administration officials, Chairman of the Senate Banking, Housing, and Urban Affairs Committee Sherrod Brown, Eviction Lab Founder Matthew Desmond, and will include State Supreme Court Justices and national, state, and local leaders who have pioneered lasting reform approaches that can serve as national models (see Appendix).

The Biden-Harris Administration is also highlighting the most current data on the impact of the Emergency Rental Assistance available as of this moment.

The White House Summit Will Highlight Overall Progress of the Emergency Rental Assistance Program and Top Models of Reform at the State and Local Court and Government Levels.

The Summit will feature overall policy views from top Administration Officials, Matthew Desmond, President and CEO of the National Low Income Housing Coalition Diane Yentel, and Chairman of the Senate Banking Committee Sherrod Brown, as well as models of visionary court-led reform, presented by Michigan Supreme Court Chief Justice Bridget Mary McCormack, New Mexico Supreme Court Chief Justice C. Shannon Bacon, and New Orleans First City Court Chief Judge Veronica Henry. The Summit will also highlight top eviction prevention innovations in Chicago, IL, presented by Mayor Lori Lightfoot; Philadelphia, PA, presented by Councilmember Helen Gym (At Large); Cleveland, OH; Colorado; and Oregon.

The program will begin at 12:30 pm ET and is scheduled to conclude at 2:30pm ET.

The Urgent Need for Eviction System Reform

Visionary Court-Led Eviction System Reform

Innovations in State and Local Eviction Prevention

Charge to Invest Remaining American Rescue Plan Funds in Housing Stability

Congressional Efforts to Secure Housing Stability and Eviction Prevention

The Path Forward on Eviction Protections and Closing Remarks

APPENDIX: Eight Models of Top State and Local Innovations that Build on the Emergency Rental Assistance Infrastructure to Sustain Eviction Reform

Visionary Court-Led Eviction System Reform

Michigan: Adopting Long-Term Court-Based Eviction Diversion to Prevent Avoidable Evictions

Michigan Supreme Court Chief Justice Bridget Mary McCormack issued one of the earliest standing orders during the pandemic to pause the eviction process once a rental assistance application has been submitted. Building on these best practices, the Michigan Supreme Court has proposed a new statewide order permanently adopting the stay of eviction action when a tenant applies for assistance. The proposed order requires a mandatory pre-trial convening to ensure tenants have access to rights and resources and prevents default judgments. It also prohibits five-day eviction orders, offers remote hearings for tenants with barriers to accessing courts, and attaches detailed information about assistance to every summons, among other best practices. The state also dedicated ERA housing stability funds to increase tenant access to legal counsel, with Detroit legislatively adopting right to counsel in 2022.

New Mexico: Leveraging American Rescue Plan Funding and Collaborating with Landlords and Tenants to Design Sustainable Eviction Diversion Programs

New Mexico Supreme Court Chief Justice C. Shannon Bacon created a task force of tenant and landlord groups, ERA program administrators, housing programs and state and local officials to design and launch one of the longest, most successful court-ordered eviction diversion programs in the country, including a mandatory extension of the lease term where landlords accept rental assistance. The eviction diversion program includes increased access to legal representation, mediation, and financial navigators to provide holistic services to tenants at risk of eviction. Due to the success of the program in reducing evictions, the state will continue to fund the eviction diversion program with state funds initially made possible with American Rescue Plan funds.

New Orleans: Implementing Eviction Diversion and Right to Counsel to Secure Court-Based Reform

Chief Judge Veronica Henry developed the First and Second City Courts award-winning Eviction Diversion Program, a partnership between the City of New Orleans, First and Second City Courts, Southeast Louisiana Legal Services, Louisiana Fair Housing Action Center (LFHAC), Jane Place Neighborhood Sustainability Initiative, and Parochial Offices of the Court. The program diverts eviction cases to on-site ERA administrators, Eviction Help Desks, the Right to Counsel Program, and other supportive services to prevent eviction and stabilize housing. New Orleans built on the diversion program by legislatively adopting the right to counsel for tenants facing eviction in 2022 and initially funding the intervention with $2 million in ERA funds.

State and Local Innovations in Eviction Prevention

Philadelphia, Pennsylvania: Mandating Pre-filing Eviction Diversion and Prohibiting Harmful Tenant Screening Practices

Philadelphia Councilmember Helen Gym (At Large) introduced thenations first city ordinancemandating pre-filing eviction diversion, which went into effect in August 2020. As a result, tenants at risk of eviction receive access to rental assistance and legal representation and tenants and landlords are required to participate in a free mediation session with the goal of resolution through an agreement. The diversion program has changed the culture to one where eviction litigation is a last resort. The city is committing long-term funding for rental assistance, a key component of diversion. In addition, Philadelphia adopted the Renters Access Act, which prohibits screening of tenants based on certain eviction filings and requireslandlords to tell tenants why they were rejected and provide an opportunity to correct errors.

Chicago, Illinois: Access to Legal Services for Tenants and Landlords and Early Eviction Resolution

In July 2022, Chicago dedicated $8 million in ERA housing stability funds to adopt a three-year Right to Counsel pilot. The city is collaborating with legal service providers Lawyers Committee for Better Housing, Legal Aid Chicago, and CARPLS to provide legal representation and increase housing stability. The program is expected to double the number of tenants who have access to attorneys, serving 2,000 to 3,000 tenants per year, and greatly reduce eviction orders. Chicago landlords and tenants have also benefited from the Cook County Early Resolution Program that diverts eviction cases to mediation and provides free legal aid to both tenants and unrepresented landlords. These programs have also effectively leveraged state law to seal pandemic-era eviction filing records for tenants, preventing the Scarlet E of eviction that results in a downward move and long-term hardship.

Cleveland, Ohio: Permanently Adopting Right to Counsel and Serving Tenants at Highest Risk of Eviction

The City of Clevelandwas among the first cities in the United States to legislatively adopt right to counsel, immediately prior to the onset of the COVID-19 pandemic, initially funding the program through a public-private partnership including the City of Cleveland, United Way and the Cleveland Foundation, among others. As private funds sunset, Cleveland has allocated Emergency Rental Assistance funds and is working to sustain right to counsel with long-term government support and additional American Rescue Plan funding, and amplifying its effectiveness through the development of an eviction diversion program that includes pre-filing mediation. To ensure services reach those with the greatest need, partners have combined data analysis with canvassing and door knocking. Zip code data on eviction rates and the lowest number of requests for assistance allows partners to identify and target outreach to the most marginalized, highest risk tenants.

Colorado: Partnering with Nonprofits to Provide Immediate Eviction Prevention and Rental Assistance

In Colorado, the COVID-19 Eviction Defense Project launched the Colorado Stability Fund, a unique revolving rental assistance fund capable of issuing quick, accurate ERA payments in less than 24 hours through a new partnership between the COVID-19 Eviction Defense Project (CEDP), Colorado Housing and Finance Authority (CHFA), and Colorados Division of Housing (DOH). The Stability Fund is available to all Colorado renters and gives those facing eviction a single point of contact for housing stability services and integrates intake and navigation, rapid rental aid payments, eviction legal defense, and, when necessary, rehousing support. The initiative is strengthened by partnerships with legal aid organizations and organizations by and for Black, Indigenous, people of color (BIPOC) communities to ensure resources reach those at greatest risk of displacement with deference to cultural context. In Denver, the program works seamlessly with the right to counsel, adopted in 2021. To ensure continued eviction prevention, partners are working to sustain the program long-term with funds from the state and are expanding to other housing areas, including foreclosure.

Oregon: Community Partnerships to Provide Rapid Eviction Prevention to the Highest Risk Tenants

Oregon was one of the first states to supplement ERA funds with SLFRF and state funding. In addition, the state developed and funds the Eviction Prevention Rapid Response Program, a partnership between the Oregon Law Center and the Oregon Housing and Community Services (OHCS) that serves as a critical element of the Eviction Defense Project. The program allows for rapid financial assistance to prevent eviction and homelessness, since legal aid can verify tenant eligibility and provide flexible funds to prevent evictions, including rental assistance, cleaning services, moving expenses, and more.OHCS also partners with community-based tenant organizations and nonprofits, including Unite Oregon, Bienestar, and the Springfield Eugene Tenants Association. During the height of the pandemic, these trusted community groups conduct outreach to community members at risk of eviction, including engaging in multi-lingualdoor knocking, and connecting their neighbors with resources to avoid eviction. As part of ongoing eviction prevention efforts, OHCS is also partnering with the Urban League of Portland, Immigrant and Refugee Organization (IRCO), and other community organizations statewide to conduct community outreach and provide critical eviction prevention services.

###

Go here to see the original:
FACT SHEET: White House Summit on Building Lasting Eviction Prevention Reform - The White House

Contemporary guidelines highly recommend patients with heart failure with reduced ejection fraction (HFrEF) be on all four drug classes that together have shown clinical clout, including improved survival, in major randomized trials.

Although many such patients don't receive all four drug classes, the more that are prescribed to those with primary prevention implantable defibrillators (ICD), the better their odds of survival, a new analysis suggests.

The cohort study of almost 5000 patients with HFrEF and such devices saw their all-cause mortality risk improve stepwise with each additional prescription they were given toward the full quadruple drug combo at the core of modern HFrEF guideline-directed medical therapy (GDMT). The four classes are SGLT2 inhibitors, betablockers, mineralocorticoid receptor antagonists (MRA), and renin-angiotensin system (RAS) inhibitors.

That inverse relation between risk and number of GDMT meds held whether patients had solo-ICD or defibrillating cardiac resynchronization therapy (CRT-D) implants; independently of device-implantation year and comorbidities; and regardless of HFrEF etiology.

"If anybody had doubts about really pushing forward as much of these guideline-directed medical therapies as the patient tolerates, these data confirm that by doing so, we definitely do better than with two medications or one medication," Samir Saba, MD, University of Pittsburgh Medical Center, Pennsylvania, told theheart.org| Medscape Cardiology.

The analysis begs an old and challenging question: Do primary prevention ICDs confer clinically important survival gains over those provided by increasingly life-preserving recommended HFrEF medical therapy?

Given the study's incremental survival bumps with each added GDMT med, "one ought to consider whether ICD therapy can still have an impact on overall survival in this population," proposes a report published online July27 in JACC Clinical Electrophysiology, with Saba as senior author and Mehak Dhande, MD, also from University of Pittsburgh Medical Center, as lead author.

In the adjusted analysis, the 2-year risk for death from any cause in HFrEF patients with primary prevention devices fell 36% in those with ICDs and 30% in those with CRT-D devices for each added prescribed GDMT drug, from none up to either three or four such agents (P< .001 in both cases).

Only so much can be made of nonrandomized study results, Saba observed in an interview. But they are enough to justify asking whether primary prevention ICDs are "still valuable" in HFrEF given today's GDMT. One interpretation of the study, the published report notes, is that contemporary GDMT improves HFrEF survival so much that it eclipses any such benefit from a primary prevention ICD.

Both defibrillators and the four core drug therapies boost survival in such cases, "so the fundamental question is, are they additive. Do we save more lives by having a defibrillator on top of the medications, or is it overlapping?" Saba asked. "We don't know the answer."

For now, at least, the findings could reassure clinicians as they consider whether to recommended a primary prevention ICD when there might be reasons not to, as long there is full GDMT on board, "especially what we today define as quadruple guideline-directed medical therapy."

Recently announced North American guidelines defining an HFrEF quadruple regimen prefer beyond a betablocker, MRA, and SGLT2 inhibitor that the selected RAS inhibitor be sacubitril/valsartan (Entresto, Novartis), with ACE inhibitors or angiotensin-receptor blockers (ARBs) as a substitute, if needed.

Nearly identical European guidelines on HFrEF quad therapy, unveiled last year, include but do not necessarily prefer sacubitril/valsartan over ACE inhibitors as the RAS inhibitor of choice.

Primary prevention defibrillators entered practice at a time when expected background GDMT consisted of betablockers and either ACE inhibitors or ARBs, the current report notes. In practice, many patients receive the devices without both drug classes optimally on board. Moreover, many who otherwise meet guidelines for such ICDs won't tolerate the kind of maximally tolerated GDMT used in the major primary prevention device trials.

Yet current guidelines give such devices a classI recommendation, based on the highest level of evidence, in HFrEF patients who remain symptomatic despite quad GDMT, observed GreggC. Fonarow, MD, University of California Los Angeles Medical Center.

The current analysis "further reinforces the importance of providing all four foundational GDMTs" to all eligible HFrEF patients without contraindications who can tolerate them, he told theheart.org| Medscape Cardiology. Such quad therapy, he said, "is associated with incremental 1-year survival advantages" in patients with primary prevention devices. And in the major trials, "there were reductions in sudden deaths, as well as progressive heart failure deaths."

But the current study also suggests that in practice, "very few patients can actually get to all four drugs on GDMT," said Roderick Tung, MD, University of Arizona College of Medicine, Phoenix. Optimized GDMT in randomized trials probably represents the best-case scenario, he told theheart.org| Medscape Cardiology. "There is a difference between randomized data and real-world data, which is why we need both."

And it asserts that "the more GDMT you're on, the better you do," he said. "But does that obviate the need for an ICD? I think that's not clear," in part because of potential confounding in the analysis. For example, patients who can take all four agents tend to be less sick than those who cannot.

"The ones who can get up to four are preselected, because they're healthier," Tung said. "There are real limitations such as metabolic disturbances, acute kidney injury and cardiorenal syndrome, and hypotension that actually make it difficult to initiate and titrate these medications."

Indeed, the major primary prevention ICD trials usually excluded the sickest patients with the most comorbidities, Saba observed, which raises issues about their relevance to clinical practice. But his group's study controlled for many potential confounders by adjusting for, among other things, Elixhauser comorbidity score, ejection fraction, type of cardiomyopathy, and year of device implantation.

"We tried to level the playing field that way, to see if despite all of this adjustment the incremental number of heart failure medicines stills make a difference," Saba said. "And our results suggest that yes, they still do."

The analysis of patients with HFrEF involved 3210 with ICD-only implants and 1762 with CRT-D devices for primary prevention at a major medical center from 2010 to 2021. Of the total, 5% had not been prescribed any of the four GDMT agents, 20% had been prescribed only one, 52% were prescribed two, and 23% were prescribed three or four. Only 113 patients had been prescribed SGLT2 inhibitors, which have only recently been indicated for HFrEF.

Adjusted hazard ratios for death from any cause at 2years for each added GDMT drug (P< .001 in each case), were:

0.64 (95%CI, 0.56- 0.74) for ICD recipients

0.70 (95%CI, 0.58- 0.86) for those with a CRT-D device

0.70 (95%CI, 0.60- 0.81) for those with ischemic cardiomyopathy

0.61 (95%CI, 0.51- 0.73) for patients with nonischemic disease

The results "raise questions rather than answers," Saba said. "At some point, someone will need to take patients who are optimized on their heart failure medications and then randomize them to defibrillator versus no defibrillator to see whether there is still an additive impact."

Current best evidence suggests that primary prevention ICDs in patients with guideline-based indications confer benefits that far outweigh any risks. But if the major primary prevention ICD trials were to be repeated in patients on contemporary quad-therapy GDMT, Tung said, "would the benefit of ICD be attenuated? I think most of us believe it likely would."

Still, he said, a background of modern GDMT could potentially "optimize" such trials by attenuating mortality from heart failure progression and thereby expanding the proportion of deaths that are arrhythmic, "which the defibrillator can prevent."

Saba discloses receiving research support from Boston Scientific and Abbott; and serving on advisory boards for Medtronic and Boston Scientific. The other authors report they have no relevant relationships. Tung has disclosed receiving speaker fees from Abbott and Boston Scientific. Fonarow has reported receiving personal fees from Abbott, Amgen, AstraZeneca, Bayer, Cytokinetics, Edwards, Janssen, Medtronic, Merck, and Novartis.

JJ Am Coll Cardiol EP. Published online July27, 2022. Abstract

Follow Steve Stiles on Twitter: @SteveStiles2. For more from theheart.org, follow us on Twitter and Facebook.

Read the rest here:
Do ICDs Still Work in Primary Prevention Given Today's HF Meds? - Medscape

The combustible combination of lightning, a record-setting heat wave, a weeks-long dry spell and gale-force winds on Sunday afternoon, July 31, contributed to Baker Countys biggest wildfire so far this year.

The Big Rattlesnake fire burned 425 acres in the remote Powder River Canyon between Thief Valley Reservoir and Highway 203, and for a few hours posed a threat to several homes.

The Baker County Sheriffs Office issued a Level 2 evacuation notice be prepared to leave at a moments notice for five or six homes on the west side of Highway 203 on Sunday evening, and a Level 1 notice be ready for the possible need to evacuate for residents east of the highway along Miles Bridge Road.

No one was evacuated, and no structures were damaged, said Jason Yencopal, the countys emergency manager. The evacuation notice was canceled for areas east of the highway on Monday morning, Aug. 1, and reduced to Level 1 for homes west of the highway, Sheriff Travis Ash said.

There are three levels of evacuation notice. Under Level 3, which was not initiated for the Big Rattlesnake fire, residents are told to leave immediately.

Ash said on Monday morning that the preliminary evacuation notices were given as a precaution mainly due to the strong winds that initially caused the fire, which was reported a little before 5 p.m., to grow rapidly.

When the wind calmed later Sunday evening, the fire activity also slowed, Ash said.

Jonathan Dunbar, fire duty officer for the Bureau of Land Managements Vale District, said the fire did not grow overnight Sunday into Monday.

Crews will continue to secure the perimeter and mop up today, Dunbar said in a press release Monday morning.

Rancher grateful for fast work by firefighters

Mike McGinnis smelled the smoke and watched the powerful gusts bending the grass near the ranch he and his wife, Nicky, own just west of Highway 203 between the Powder River and Medical Springs.

McGinnis feared that if the flames crossed the Big Creek canyon, which is between his home and where the fire started, those winds could quickly push the fire toward his house and outbuildings.

But later on Sunday evening the wind shifted direction, he said, blowing the flames back toward areas that had already burned.

McGinnis said the fire didnt get closer than about a mile to his home.

On Monday morning McGinnis said he was grateful for the amazing response by firefighters, many of them volunteers from local districts.

You just cannot say enough about these rural volunteer firefighters, McGinnis said. Theyre willing to put everything on the line. Were blessed with a great community. People truly care. Its a great feeling.

McGinnis said he was home when the storm that sparked the fire passed through.

Terrain blocks his view of the spot where the lightning bolt struck, but McGinnis said a neighbor, John Wirth, saw the lightning and phoned after seeing the smoke rising.

Wirth said he was driving on Blue Mountain Ridge Road, which follows a spine of high ground east of Highway 203, when he saw the thunderstorm approaching.

Wirth said when lightning threatens he usually tries to find an elevated vantage point to watch for downstrikes and the fires that are likely to start as a result. He said he has seen that happen several times.

On Sunday evening, Wirth said he could see flames within just a few seconds of the bolt hitting west of Big Creek.

Its just about immediate fire, he said. Theres a lot of fuel, and there was a lot of wind then.

On Monday morning, McGinnis said he was watching through binoculars as firefighters worked on the blaze, which seemed to be mainly out, although he did see some smoke.

Theyre doing a great job, he said.

Winds caused major concern

Although there are no weather stations close to the fire, the wind gauge at the Baker City Airport recorded a peak gust of 62 mph at 7:38 p.m. on Sunday.

Winds propelled a dust cloud from a fallow field just north of Baker City a little after 7 p.m.

Buzz Harper, chief of the Keating Rural Fire Protection District, estimated winds were gusting between 45 and 50 mph when he arrived Sunday evening.

Colby Thompson, chief of the North Powder Rural Fire Protection District, said the wind direction shifted four times while he was working on the fire Sunday evening.

Three single-engine aircraft dropped retardant ahead of the fire on Sunday evening, said Larisa Bogardus, public affairs officer for the Bureau of Land Managements Vale District.

Harper served as incident commander for areas along Highway 203, and he assigned fire trucks to protect the McGinnis ranch and several other homes west of the highway, which leads north through Pondosa and Medical Springs to Union.

The trucks were reassigned later on Sunday evening after the threat eased, Ash said.

Highway 203 was closed temporarily except for fire vehicles and local traffic.

Everybody did really well, Harper said on Monday morning. We had a lot of resources.

He credited the Sheriffs Office and Oregon State Police for helping notify residents about evacuation levels, and the Oregon Department of Transportation for coordinating the highway closure.

Harper said the Sheriffs Offices mobile communications trailer was also a benefit to the multiple agencies that responded.

Fuels have dried during recent rainless stretch

The fire started about half a mile north of the Powder River and about a mile west of Big Creek.

Both the river and the creek flow through deep, steep canyons.

The fire burned in dense thickets of sagebrush, with lighter fuels on ridgetops, Bogardus said.

Fuels have dried considerably during a lengthy rainless stretch that followed the damp, cool spring.

The Baker City Airport has recorded just 0.08 of an inch of rain scarcely enough to dampen the ground since June 4.

Phil Whitley, chief of the Medical Springs Rural Fire Protection District, said rain fell in the area Sunday evening, but amounts were generally meager.

The fire burned on both public and private land, Bogardus said.

The area includes sage grouse habitat, she said.

The fire is within the BLMs 5,880-acre Powder River Canyon Area of Critical Environmental Concern. The agency manages the public land to protect raptor and wildlife habitat and scenic qualities, according to a BLM press release.

On Monday morning, six fire engines were working on the fire and two 20-person crews were en route, Bogardus said.

Single-engine tankers and helicopters were available if needed, she said.

Whitley, who lives near Medical Springs, said he saw several lightning bolts before receiving a page on his radio about the fire.

Whitley said seven volunteers from the Medical Springs district assembled. They tried to reach the fire from a dirt road that leads west from Highway 203, but Whitley said the road, which descends into the Big Creek canyon, crosses the creek and continues west up the Powder River, was too rough to negotiate with a truck laden with water.

Whitley said crews from other agencies were able to get to the fire via that route later.

Thompson, chief of the North Powder Rural Fire Protection District, said volunteers from the department used a bulldozer to make the road passable to fire engines, including four from the North Powder district. A total of 17 volunteers from the district worked on the fire Sunday, Thompson said.

A major focus initially was to protect the McGinnis ranch, Whitley said.

Their home was closest to the fire, and the powerful winds, which were shifting direction frequently, made it difficult to predict where the fire was moving, Whitley said.

Other agencies that responded to the Big Rattlesnake fire include the Baker Rural Fire Protection District, Lookout-Glasgow Rangeland Fire Protection Association and Eagle Valley Rural Fire Protection District.

Other, smaller fires reported

Lightning from a series of thunderstorms that moved through the region Sunday afternoon and evening sparked at least two other, much smaller, blazes.

One burned a quarter of an acre about 2.5 miles north of Anthony Lakes.

The other burned less than a tenth of an acre near the Kelly Mine, about 2 miles north of Bourne.

The combination of hot temperatures a record high was set at the Baker City Airport on July 29, and the record tied on July 30 and lack of rain has resulted in rapidly rising fire danger.

The Energy Release Component, a measurement of how fast a fire would spread, had been below average for most of the summer for each of the six regions that the Blue Mountain Interagency Dispatch Center in La Grande monitors.

But over the last week of July that figure, which is updated daily, climbed above average in each region.

Read the original post:
Wind-fanned lightning fire prompted precautionary evacuation notices near Medical Springs Sunday evening - Baker City Herald

Aliria Rosa Piedrahita de Villegas should have developed Alzheimers disease in her 40s and died from the disease in her 60s because of a rare genetic mutation.

Instead, she lived dementia-free into her 70s, and now her brain is yielding important clues about the pathology of dementia and possible treatments for Alzheimers disease.

As researchers at Massachusetts General Hospital and other centers first described in 2019, the woman, from Medellin, Colombia, was a member of an extended family with a mutation in a gene labeled PSEN1. The PSEN1 E280A mutation is autosomal dominant, meaning that only a single copy of the gene is required to cause disease. Carriers of the mutation typically exhibit symptoms of Alzheimers in their 40s or 50s, and die from the disease soon after, but this woman did not begin to show signs of Alzheimers until her early 70s. She died in 2020 from metastatic melanoma at the age of 77.

The key difference in the Colombian womans ability to fend off the disease for three decades appeared to be that in addition to having the PSEN1 E280A mutation, she was also a carrier of both copies of a mutation known as APOE3 Christchurch.

This exceptional case is an experiment designed by nature that teaches us a way to prevent Alzheimers: lets observe, learn, and imitate nature.

Francisco Lopera, director of the Neuroscience Group of Antioquia in Medelln, Colombia.

The APOE family of genes control production of apolipoproteins, which transport lipids (fats) in blood and other bodily fluids.The APOE2 variant is known to be protective against Alzheimers dementia, while the APOE4 variant is linked to an increased risk for the disease.

APOE3, the most common variant, is not typically associated with either reduced or increased risk for Alzheimers.

This is a ground-breaking case for Alzheimers disease and has already opened new paths for treatment and prevention, which were currently pursuing with some collaborators. This work is now bringing light into some of the mechanisms of resistance to Alzheimers disease says investigator Yakeel T. Quiroz

Quiroz is director of theMulticultural Alzheimer Prevention Program (MAPP) at Mass General, an associate professor of psychology at Harvard Medical School, andPaul B. and Sandra M. Edgerley MGH Research Scholar 2020-2025.

As Quiroz and colleagues now report in the neuropathology journalActa Neuropathologica, the woman did, in fact, have pathologic features of Alzheimers disease in her brain, but not in regions of the brain where the hallmarks of Alzheimers are typically found.

This patient gave us a window into many competing forces abnormal protein accumulation, inflammation, lipid metabolism, homeostatic mechanisms that either promote or protect against disease progression, and begin to explain why some brain regions were spared while others were not, says Justin Sanchez, co-first author, and an investigator at MGH Neurology.

Researchers identified in Alirias brain a distinct pattern of abnormal aggregation or clumping of tau, a protein known to be altered in Alzheimers disease and other neurologic disorders.

In this case, the tau pathology largely spared the frontal cortex, which is important for judgment and other executive functions, and the hippocampus, which is important for memory and learning. Instead, the tau pathology involved the occipital cortex, the area of the brain at the back of the head that controls visual perception.

The occipital cortex was the only major brain region to exhibit typical Alzheimers features, such as chronic inflammation of protective brain cells called microglia, and reduced levels of APOE expression.

Thus, the Christchurch variant may impact the distribution of tau pathology, modulates age at onset, severity, progression, and clinical presentation of [autosomal dominant Alzheimers disease], suggesting possible therapeutic strategies, the researchers write.

It is seldom that we have nice surprises while studying familial Alzheimers disease brains. This case showed an amazingly clear protected phenotype. I am sure our molecular and pathologic findings will at least suggest some avenues of research and elicit hope for a successful treatment against this disorder. says co-first author Diego Sepulveda-Falla, research lead at University Medical Center Hamburg-Eppendorf in Hamburg, Germany.

This exceptional case is an experiment designed by nature that teaches us a way to prevent Alzheimers: lets observe, learn, and imitate nature, concludes Francisco Lopera, director of the Neuroscience Group of Antioquia in Medelln, Colombia. Lopera is a co-senior author and the neurologist who discovered this family and has been following them for the last 30 years.

Quiroz is a co-senior author of the report, along with Kenneth S. Kosik, University of California, Santa Barbara; Lopera, and Sepulveda-Falla. Sanchez contributed equally to the study.

The study was supported by grants from the National Institutes of Health, MGH Executive Committee on Research (MGH Research Scholar Award), Alzheimers Association, the Deutsche Forschungsgemeinschaft, Universidad de Antioquia, the Werner Otto Stiftung, and the Gernam Federal Ministiry of Education and Research.

Sign up for daily emails to get the latest Harvardnews.

Read the original:
Alzheimer's-defying brain offers clues to treatment, prevention - Harvard Gazette

Health awareness

In this Teal Talks episode, TV host and cancer survivor Samantha Harris leads the conversation about the advances in cancer screenings and early prevention with three renowned cancer specialists

You may know Samantha Harris from hosting eight seasons of Dancing with the Stars and her many years on Entertainment Tonight, but shes also a cancer survivor or cancer thriver, as she prefers to be called.

At age 40, Harris was diagnosed with stage II invasive breast cancer and underwent a double mastectomy. Since her diagnosis, the Emmy-winning TV personality has become a fierce advocate for living a healthier life to help prevent chronic diseases like cancer.

We need to be our own best health advocates by knowing our body so we can recognize any changes and then find the right expert in the medical field to assess if there is or isnt something to worry about, said Harris, whos been in remission since October 2014.

In episode 5 of Teal Talks, Harris sits down with Dr. Laura Makaroff, SVP, prevention and early detection, American Cancer Society, and Mercks Dr. Scot Ebbinghaus, VP, late-stage oncology, and Steve Keefe, AVP, global clinical development, oncology, to discuss cancer prevention and advances in screening.

According to the American Cancer Society, about 18% of cancers in the U.S. are related to modifiable risk factors, and thus could be preventable.

Screening tests are another component of cancer prevention. Certain screenings aim to find cancer before it causes symptoms and when it may be easier to treat. There arent currently screening tests for every type of cancer, but there are several tests that health agencies recommend for breast, cervical, colorectal and lung cancers.

Cancer screening recommendations vary from country to country, so its important to talk to your doctor about which tests are right for you.

There are some people who fit a high-risk category because they have a family history of cancer or some other inherited condition and might need to start screening earlier or do a different kind of screening test than the average-risk population, said Makaroff. Its an important topic to bring up with your doctor and make sure that you, as a patient, know to ask the right questions.

[Source: American Cancer Society]

The COVID-19 pandemic caused a significant interruption to cancer screening services. In the U.S., it is estimated that 9.4 million cancer screenings were missed from January through July 2020 vs the same period in 2019.

Theres no one-size-fits-all type solution to get things back on track, said Keefe. But community outreach can help get peoples awareness about the importance of screenings back on track and help reassure people that when they return to the doctors office or clinic, precautions will be in place to help keep them safe from COVID-19.

Despite some of the dire statistics around cancer care disruptions, the health care industry gained some valuable lessons from the pandemic.

One of the things that the pandemic has taught us is that we can reach our patients even if they cant come into the doctors office, Ebbinghaus said. Being able to leverage telemedicine to counsel patients and arrange for testing could really help improve cancer preventative care.

Follow this link:
Experts discuss importance of cancer screenings and early detection - Merck

All samples will be referred through the Directorate of Public Health and Preventive Medicine and the Regional Integrated Disease Surveillance Programme network

All samples will be referred through the Directorate of Public Health and Preventive Medicine and the Regional Integrated Disease Surveillance Programme network

After being the first laboratory in Tamil Nadu to initiate COVID-19 testing and having tested about 31 lakh samples so far, the Department of Virology, King Institute of Preventive Medicine and Research (KIPMR), will now test samples for monkeypox.

Health Minister Ma. Subramanian, who inspected the facilities at the laboratory on Thursday, told reporters that clinical specimens collected from the skin, lesions, urine, serum/plasma would be tested for monkeypox at the 123-year-old KIPMR.

According to a release, the Indian Council of Medical Research (ICMR)/National Institute of Virology (NIV), Pune, trained the laboratory, along with 15 facilities in the country, to initiate monkeypox testing. All samples would be referred through the Directorate of Public Health and Preventive Medicine/the Regional Integrated Disease Surveillance Programme network to KIPMR and tested by real-time PCR. The sample should be accompanied with the clinical history.

There would be parallel testing at NIV, Pune, and the results would be released after confirmation by NIV, Pune, initially, the release said.

Monkeypox has been reported in 77 countries. In India, four cases have been reported so far and there has been no case in Tamil Nadu, he said.

Samples of two persons who had returned from Canada and the U.S. were sent for testing to NIV, Pune, after they developed lesions on the face last month. Both samples were negative for monkeypox. There has been no case of monkeypox in Tamil Nadu so far, he said.

He added that there was mass fever screening at the international airports. An advisory was issued to screen passengers travelling from the 77 countries or on transit. They were screened for symptoms, including for lesions, he said.

The Department of Virology of KIPMR is a World Health Organization (WHO)-National Polio Laboratory, a WHO reference laboratory for measles and rubella and an ICMR/DHR regional influenza referral laboratory as well. It also serves as the State-level Virus Research and Diagnostic Laboratory under ICMR/DHR, the release said.

Health Secretary P. Senthilkumar, Director of Medical Education R. Narayana Babu, Director of Public Health and Preventive Medicine T.S. Selvavinayagam and Director of KIPMR Kaveri were present.

Go here to read the rest:
King Institute of Preventive Medicine and Research to test samples for monkeypox - The Hindu

Key populations provide valued contribution to development of new WHO guidelines

In 2020 the global key population networks including the International Network of People Who Use Drugs (INPUD), the Global Action for Trans Equality (GATE), the Network of Sex Worker Projects (NSWP) and the Global Action for Gay Mens Health Rights (MPACT) were commissioned by WHO to conduct values and preferences research within their communities in relation to HIV, viral hepatitis and STI services. This research has been used to inform the development of the new WHO Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations, launched on 29 July 2022 at AIDS2022 in Montreal, Canada.

To celebrate the launch of these important guidelines for improving the health and rights of the key populations in relation to HIV, viral hepatitis and STIs, INPUD reached out to several study participants from the community of people who use drugs and asked them to briefly reflect on why the key populations values and preferences research is important and what the new guidelines mean in the context of their lives. Here are extracts of their responses:

Why is it important to include the values and preferences of key populations living with and affected by HIV, viral hepatitis and STIs in the development of the WHO Key Populations Guidelines?

For people from marginalized and criminalized communities it often feels like no ones really listening to the knowledge we have to offer. Involving key populations in the development of the guidelines was critical to ensuring that lived and living experience was embedded within the guidelines not just being asked to make some comments after the guidelines are already developed. That happens way too often and it is tokenistic.

Involving the community is important for lots of reasons, including that peers are best placed to detect and identify stigma and discrimination. By making sure that the language of the guidelines is stigma-free and non-discriminatory, it establishes the standard we expect from health professionals using the guidelines and providing services. It is a practical way to show why our community must be at the heart of these kinds of processes.

Peers are clued into the real world settings of living with or being at risk of HIV, viral hep and STIs, where the clinical meets the real world. We will not achieve the elimination of HIV and viral hepatitis without the valuable perspective, insights, and expertise of peers.

Do WHO Key Population Guidelines such as these make a tangible difference in the lives of people living with and affected by HIV, viral hepatitis and STIs, including people who inject drugs?

As a trans person who injects drugs and is living with HIV, I feel empowered through the consultation process to inform the guidelines. I was able to contribute to the global response to HIV, viral hep, and STIs with something much bigger than myself and my work at the community level.

We are always talking about ways we can use policies and guidelines like these for our advocacy on behalf of people who use drugs. For example, we can use them to demand better services or human rights, but we can also use them to check against current guidelines, services and programmes and advocate for improvements.

Sometimes documents like these can seem far from our everyday lives as people who inject drugs, but if those providing harm reduction and other health services to people who inject drugs are aware of the guidelines and use them, it can really change the way we experience those services by removing some of the barriers.

The 2016 WHO Consolidated Guidelines focused on HIV, the revised Guidelines will focus on HIV, viral hepatitis and STIs among key populations. Was this shift important in your view?

The shift beyond HIV to include viral hepatitis and STIs brings a more holistic perspective of the interactions between belonging to priority populations and various risk factors HIV doesn't operate in a vacuum.

A lot can be shared and learnt by collaborating across infectious diseases at government, community, research, and clinical levels. Issues of human rights, criminalization, stigma, and discrimination all impact HIV, viral hepatitis and STIs. The experience of stigma is a shared experience across the priority communities.

Many of us are affected by multiple conditions and experiences and there are so many intersectionalities, as a queer woman of colour who injects drugs, it just makes sense to bring a wider lens to these issues rather than trying to put people into narrow boxes.

What can be done to make people who inject drugs globally more aware of the new Key Population Guidelines?

Well, community conversations are always a good place to start.

People who inject drugs are highly networked. It's important to consistently and constantly remind people who inject drugs about their inherent worth; we are beautiful human beings that deserve to be loved, have our human rights upheld, and be treated with respect, understanding, and compassion. The guidelines support these key messages.

Acknowledgement: we thank INPUD for conducting the interviews and writing this article and to the INPUD study participants who generously gave their time and offered their views.

View post:
Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations - World - ReliefWeb

JERSEY CITY, N.J., Aug. 01, 2022 (GLOBE NEWSWIRE) -- SCYNEXIS, Inc. (NASDAQ:SCYX), a biotechnology company pioneering innovative medicines to overcome and prevent difficult-to-treat and drug-resistant infections, today announced that the U.S. Food and Drug Administration (FDA) has accepted the Companys submission of a supplemental New Drug Application (sNDA) to expand the label of BREXAFEMME (ibrexafungerp tablets) to include the prevention of recurrent vulvovaginal candidiasis (RVVC). The FDA granted the submission Priority Review and assigned the Prescription Drug User Fee Act (PDUFA) target decision date as November 30, 2022.

If approved for this second indication, BREXAFEMME, an oral non-azole therapy, would be the first and only product approved in the U.S. for both the treatment of vulvovaginal candidiasis (VVC) and the prevention of RVVC, defined as three or more infections in a 12-month period.

The FDAs acceptance of this submission is excellent news for patients, and it brings us another step closer to our vision of addressing significant unmet needs in womens health, said Marco Taglietti, M.D., President and Chief Executive Officer of SCYNEXIS. Our pivotal CANDLE study was the basis of the sNDA submission, and we look forward to presenting details of these data to the medical community.

SCYNEXIS will present CANDLE study results this week at the Infectious Diseases Society for Obstetrics and Gynecology (IDSOG) Annual Meeting being held in Boston August 4-6, 2022.

Ibrexafungerp is designated by the FDA as a qualified infectious disease product (QIDP), allowing for a six-month priority review.

About BREXAFEMME(ibrexafungerp tablets)

BREXAFEMME is a novel oral antifungal approved for the treatment of vulvovaginal candidiasis (VVC), also known as vaginal yeast infection. Its mechanism of action, glucan synthase inhibition, is fungicidal againstCandidaspecies, meaning it kills fungal cells.BREXAFEMME was approved by the U.S. Food and Drug Administration (FDA) on June 1, 2021. The approval was supported by positive results from two Phase 3, randomized, double-blind, placebo-controlled, multi-center studies (VANISH-303 and VANISH-306), in which oral ibrexafungerp demonstrated efficacy and a favorable tolerability profile in women with VVC. BREXAFEMME represents the first approved drug in a new antifungal class in over 20 years and is the first and only treatment for vaginal yeast infections which is both oral and non-azole.

INDICATION

BREXAFEMME is a triterpenoid antifungal indicated for the treatment of adult and postmenarchal pediatric females with vulvovaginal candidiasis (VVC).

DOSAGE AND ADMINISTRATION

The recommended dosage of BREXAFEMME is 300 mg (two tablets of 150 mg) twice a day for one day, for a total treatment dosage of 600 mg. BREXAFEMME may be taken with or without food.

IMPORTANT SAFETY INFORMATION

To report SUSPECTED ADVERSE REACTIONS, contact SCYNEXIS, Inc. at 1-888-982-SCYX (1-888-982-7299) or FDA at 1-800-FDA-1088 orwww.fda.gov/medwatch.

For more information, visitwww.brexafemme.com. Please clickherefor Prescribing Information.

About SCYNEXIS

SCYNEXIS, Inc. (NASDAQ: SCYX) is a biotechnology company pioneering innovative medicines to help millions of patients worldwide overcome and prevent difficult-to-treat infections that are becoming increasingly drug-resistant. SCYNEXIS scientists are developing the companys lead asset, ibrexafungerp, as a broad-spectrum, systemic antifungal for multiple fungal indications in both the community and hospital settings. SCYNEXIS launched its first commercial product in the U.S., BREXAFEMME(ibrexafungerp tablets). The U.S. Food and Drug Administration (FDA) approved BREXAFEMME on June 1, 2021. In addition, clinical investigation and development of oral ibrexafungerp for the prevention of recurrent vulvovaginal candidiasis (VVC) and the treatment of life-threatening invasive fungal infections in hospitalized patients is ongoing. For more information, visitwww.scynexis.com.

Forward-Looking Statements

Statements contained in this press release regarding expected future events or results are "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995, including but not limited to statements regarding: progressing filing of an sNDA for RVVC, of ibrexafungerp, its potential use by physicians and patients in multiple healthcare settings. Because such statements are subject to risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements. These risks and uncertainties include, but are not limited, to: risks inherent in SCYNEXIS' ability to successfully develop and obtain FDA approval for ibrexafungerp for additional indications, including the IV formulation of ibrexafungerp; unexpected delays may occur in the timing of acceptance by the FDA of an NDA submission; the expected costs of studies and when they might begin or be concluded; SCYNEXIS need for additional capital resources; and SCYNEXIS' reliance on third parties to conduct SCYNEXIS' clinical studies and commercialize its products. These and other risks are described more fully in SCYNEXIS' filings with the Securities and Exchange Commission, including without limitation, its most recent Annual Report on Form 10-K and Quarterly Report on Form 10-Q, including in each case under the caption "Risk Factors," and in other documents subsequently filed with or furnished to the Securities and Exchange Commission. All forward-looking statements contained in this press release speak only as of the date on which they were made. SCYNEXIS undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made.

CONTACT:

Investors:Irina KofflerLifeSci Advisorsikoffler@lifesciadvisors.com

Media:Debbie EtchisonSCYNEXISDebbie.Etchison@scynexis.com

Go here to read the rest:
SCYNEXIS Announces U.S. Food and Drug Administration - GlobeNewswire

The pandemic, which has held the United States and almost every other country in its grip, should have taught us valuable lessons about how to manage a public health emergency, but it seems we are making some of the same mistakes we made not even three years ago, when the SARS-CoV-2 virus started to spread.

It is now clear: Preparedness alone does not guarantee a rapid response. With Covid-19, and now monkeypox, we were too slow to respond. It was as if we are sitting in a turbo-charged Ferrari, capable of massive acceleration, but instead only idling in the driveway.

Cavalry culture

Over the past three years, we have witnessed something counterintuitive. It was predominantly wealthy countries that were hit hardest during the Covid-19 pandemic. They had some of the highest death rates, despite their enormous resources.

While there are many reasons for this, including misinformation, lack of public trust, and the entangling of public health and politics, I think there is something else, as well: We have adopted what I call a "cavalry culture." We wait for the cavalry to ride in and rescue us, instead of taking smaller preventive steps -- such as establishing modern and reliable data systems, mastering our supply chain along the way, and acting early to head off the outbreak in the first place.

There are a couple of important axioms in public health. One is, by the time you think you must act to contain an outbreak, it is already too late. And, if you think you are overreacting, you are probably reacting just the right amount. In the case of Covid, and now monkeypox, we seem to have forgotten those basic public health principles. And, the real question now seems to be: When will the government finally hit the gas pedal on our highly tuned Ferrari?

I don't want to suggest any of this is easy. There are significant issues of uncertainty and unpredictability. Much like a hurricane forming at sea, we often don't know exactly where or how hard it will hit. We want to be measured, calm in our response and to cause as little disruption as possible. We want to be thoughtful and gather as much information as is available.

And therein lies one of our biggest problems: basic data. I have often wondered, how is it that a numbers-driven, high-tech country like the United States can't get basic data right?

Data disaster

As long as I've been reporting on the Covid pandemic, I have always had to offer the caveat that case numbers are probably off, sometimes wildly so. We have probably never had a clear vision on just how widely the virus was spreading at any given time in the United States, and going into the fall 2022, the situation isn't really any better.

"First, there's a lack of data access needed to understand where disease outbreaks are spreading. This is due to data collection limitations that Congress needs to fix," said Dr. Tom Frieden, president and CEO of Resolve to Save Lives and a former director of the US Centers for Disease Control and Prevention.

He said there is also a need to update analog systems and connect them to each other -- getting them to speak the same language. Right now, it's the Tower of Babel.

"Second, we lack sufficient numbers and, in some cases, skills of people and systems at the federal, state and local levels that can deliver services and communicate effectively with communities. Finally, we are in perpetual panic and neglect funding cycles," he said.

As a result of all of the things Frieden is describing, our current data collection and reporting system leaves important information fractured into dozens of states and territories, and thousands of county pieces for the CDC to puzzle together.

"I have been struck as we at CDC are now conquering another public health challenge -- monkeypox -- as to how little authority we at CDC have to receive the data," CDC Director Dr. Rochelle Walensky told the Washington Post.

Walensky is talking about basic data, like where the vaccine has gone, who has been vaccinated, whether the vaccine is working, and even monkeypox case data like who is getting infected, their age and race/ethnicity. Why might this be so?

"States don't routinely share vaccine doses administered data with the federal government -- Covid was really the first time that we were able to successfully put data use agreements in place," Claire Hannan, the executive director of the Association of Immunization Managers, told CNN. Part of the reason is because "states have laws in place to protect identifiable information."

Some information has been getting to the CDC, but it is challenging to get and incomplete. The CDC director told the Washington Post, "We have been speaking to our state and local partners probably at least three times a week, all of them. ... That is not how you synthesize data. We need ... standardization of those data, and we need to have those data come to us in a standardized fashion so that they can be connected, we can compile them and rapidly report them out. We cannot at CDC collect the data and make informed decisions by calling 64 jurisdictions, and honestly, 3,000 counties."

The CDC is currently working on agreements that would broaden the agency's access to states' data, as they successfully did with Covid. Hannan explained, "The need to quickly get the [monkeypox] vaccine out left no time to get data sharing agreements in place."

But even if those agreements were in place, it still doesn't mean the states' ability to actually obtain vaccine doses would be made any easier. That's because the states wouldn't be using the same data system for ordering and tracking doses they generally use. Because the US Department of Health and Human Services and the Administration for Strategic Preparedness and Response are in charge of monkeypox vaccine distribution, there would be yet another data system involved.

"They were asking states to request the vaccine using paper forms and email," said Hannan. "They were asking states to complete forms [with fillable fields] on those who were receiving the vaccine and return these forms to the federal government."

The problem was there weren't even the right fields for the specific questions being asked, such as reason for vaccination or type of exposure or risk, Hannan said. It wasn't that the necessary forms weren't being filled out, it was that they couldn't be filled out because of disparate data platforms.

It is a baffling level of bureaucracy in the middle of an unfolding outbreak.

Testing, vaccines, therapeutics

As things stand now, the issues with data collection, testing, vaccines, treatments and communication are sounding a lot like the ones we experienced with Covid-19.

The monkeypox outbreak is also different for another fundamental reason. Unlike with Covid, which was caused by a novel virus, the basic tools already exist either for monkeypox or its close relative, smallpox. We didn't have to build them from scratch. That means we could have had them or put them to better use by now.

Another tool that could be tremendously helpful is testing of wastewater. As we have seen with Covid, it can better define the scope of the outbreak and where it will emerge next. Two months into the outbreak, we still aren't doing this widely for monkeypox.

It also means that the vaccine, which can be given within 14 days of exposure (but preferably within four) to prevent or reduce the severity of disease, is currently being used more as a treatment -- a post-exposure prophylaxis -- rather than as a real preventive measure.

As National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci said on CNN, that focus will have to shift.

"It's very clear with the spread of this that there now has to be a balance between vaccines available for those who clearly have been exposed, as well as those at risk," Fauci said. "What you want to do is a balance between vaccinating those who clearly have had an exposure but go well beyond that."

Finally, there is the issue of treatment. The CDC has made the antiviral smallpox treatment tecovirimat, called TPOXX, available to monkeypox patients who have or are at high risk of severe disease under an "alternate regulatory mechanism."

There are 1.7 million courses of TPOXX stockpiled. But once again, getting the medication to patients who could immediately benefit has proven to be bureaucratically burdensome for both patients and providers.

"You're talking about a five, six-day time lag to get that medication to you at a local doctor's office, no matter where you are. And the paperwork, and all of the bureaucracy to make that happen is very cumbersome, takes a few hours of your time. And that's the barrier," Dr. Stacy Lane, founder of the LGBTQ-centered Central Outreach Wellness Center in Pittsburgh, told me recently.

In the meantime, though, patients are suffering. Even though most cases are "mild," they are still uncomfortable, or downright painful, depending on where sores appear. Plus, there is a risk of long-term complications if the pox lesions develop in areas around the eye or GI tract.

All of these gaps have the hardest hit community on edge.

"Largely public health officials know how this has spread. They know how to vaccinate people ... we know how to treat it, and we know how to prevent it," says Samuel Garrett-Pate, managing director of external affairs of Equality California, the largest statewide LBGTQ+ civil rights organization.

"It unfortunately seems that despite two years of building up our public health infrastructure to prevent what happened with Covid-19 from ever happening again, despite the fact that we are better prepared in terms of already having a vaccine available, the CDC and FDA seem to be caught flat-footed once again. And I think as a result, you're seeing very real and understandable fear anxiety among the LGBTQ community."

Is it too late?

Dr. Scott Gottlieb, a former FDA commissioner and current board member of Pfizer, has been pessimistic about the trajectory of monkeypox in the United States.

"We're now at the cusp of this becoming an endemic virus, where this now becomes something that's persistent that we need to continue to deal with. I think the window for getting control of this and containing it probably has closed and if it hasn't closed, it's certainly starting to close," he said on Face the Nation on July 17.

CDC's Walensky pushed back on Gottlieb's assessment calling it "misinformed and off base," saying that while it's true there is much work to do, the US has made dramatic progress on priorities like testing, vaccines and education.

There has been measurable progress in these areas, no doubt. But, I do worry that we once again waited too long. We sat idling in our Ferrari, perhaps not wanting to believe that somehow we had suddenly found ourselves in the middle of yet another outbreak.

The world, however, is changing, as we have been reminded of twice in the last few years. There are new pathogens emerging, and existing pathogens are more easily traveling the world.

We have learned painful lessons in the last few years, and we are now in the midst of our first significant test since the Covid pandemic began, to see if we do any better this time around.

There is no doubt we are capable, and we are prepared. The question is will we use all those remarkable resources and respond, or we will wait and suffer until the cavalry has to rescue us once again?

CNN Health's Andrea Kane contributed to this report.

Read the original here:
Dr. Sanjay Gupta: While monkeypox cases rise, why are we waiting for the cavalry to rescue us? - CNN

Indigenous Milk Medicine Week Aug. 8-14; Asian American, Native Hawaiian and Pacific Islander Breastfeeding Week Aug. 15-21; Black Breastfeeding Week Aug. 25-31

LANSING, Mich. Michigan is committed to encouraging a strong foundation for life in all infants by supporting breastfeeding parents for the first year of their childs life and beyond. As part of this effort, Gov. Gretchen Whitmer has issued a proclamation declaring August 2022 as Breastfeeding Month.

During National Breastfeeding Month we recommit ourselves to supporting infants and new parents and ensure that every Michigander has equitable access to the resources and support they need to give their child a great start, said Governor Whitmer. We will work with Michigans health care providers and local organizations to broaden public understanding about the impact breastfeeding has on improving infant health and reducing infant mortality rates within communities of color across the state. I will work with anyone to ensure every baby in Michigan has what they need to grow up and pursue their potential.

Breastfeeding is a public health imperative central to successful health equity strategies that confront racism, classism and sexism which are the root causes of inequities and combatting these are a key strategy in reducing maternal and infant mortality. Disparities in breastfeeding rates and other maternal and infant health outcomes are most evident among Black and Indigenous families in Michigan. Increased efforts highlighting increased support to breastfeeding are part of Governor Whitmers Healthy Moms Healthy Babies initiative.

Proper nutrition for infants is critical for their growth and development, and it is important for hospitals, business, communities and coalitions to work together to provide consistent support for breastfeeding parents in Michigan, said Dr. Natasha Bagdasarian, MDHHS chief medical executive.

The American Academy of Pediatrics has updated its recommendation to breastfeed up to 2 years of age because of the benefits to the infant and the parent. Breastfeeding provides countless benefits to the nursing infant including easy digestion, production of antibodies and reduced risk of infections and childhood obesity. It also offers faster recovery from birth and reduced risk for postpartum hemorrhage and uterine cancer for the breastfeeding parent.

Ways to support breastfeeding include advocating for paid maternity leave and adequate pumping time while at work and school, and by bolstering Baby Friendly hospitals. National Breastfeeding Month is also a time to highlight under-resourced communities where families do not have equal access to support, care and education. The national formula shortage amplified how food disparities impact our most vulnerable populations, black and brown families. It has shown us the areas where improvement is needed to protect babies and ensure that parents are provided adequate prenatal breastfeeding education to make an informed decision.

Although 86.9% of Michigan families initiate breastfeeding, only 58% are still breastfeeding at three months (PRAMS 2020), and there are barriers such as lack of access to supportive health care and childcare providers and lack of paid work leave that leads to early weaning. Additionally, there are fewer lactation professionals from communities of color.

According to the Centers for Disease Control and Prevention, Black infants are 20% less likely to have ever received breast milk than any other race. In Michigan, seven of every 1,000 babies born die by age one, and among Black babies, the number is more than double. Between 80 and 90 maternal deaths occur each year with Black women dying 2.4% more often.

The states Women, Infants and Children (WIC) program is celebrating National Breastfeeding Month with the theme In Every Drop. Michigan is committed to encouraging to improving outcomes for breastfeeding parents and helping community health workers such as community-based doulas and the WIC Peer Counseling support program to help diversify lactation support and increase breastfeeding rates in local communities across the state.

WIC supports breastfeeding in the following ways:

For more information, visit Michigan WIC.

# # #

Read this article:
Governor Whitmer declares August 2022 as Breastfeeding Month, highlights additional breastfeeding observances - Michigan (.gov)

The Ohio State University is instituting a new educational requirement for all first-year and transfer undergraduate students targeting drug, tobacco and alcohol misuse.

The new online educational modules will cover alcohol and other drug misuse prevention, mental wellness and prescription drug abuse. The program will be used on all Ohio State campuses and begin this fall.

This initiative centers the health, safety and wellbeing of every Buckeye, said Senior Vice President for Student Life Melissa Shivers. We have historically communicated and provided a wide variety of education and prevention information and we continue to identify ways to improve programming to best reach all of our students. Education is critical to creating a community of informed, responsible Buckeyes.

Students will access the modules through BuckeyeLearn. Incoming students must complete the educational modules to register for classes next spring or fall semester.

Local and national data demonstrate the growing need for education around alcohol, tobacco and other drug misuse, especially in light of increasing overdose deaths due to alcohol and other drugs, said Shawnt Elbert, associate vice president for health and well-being, Office of Student Life. These educational modules are a best-in-class opportunity to help prepare our students for a safe and healthy Buckeye experience.

Vector Solutions, the provider of the modules, works with 2,200 colleges and universities. The company provides evidence-based education used by millions of students at institutions across the U.S.

The new modules help educate students about a growing problem facing campuses across the country: Nationally, from 2019 to 2021, deaths from synthetic opioids, such as fentanyl, doubled. In Ohio, as of January 2021, incidents of opioid overdose were at the highest rate in 10 years.

According to the 2022 National College Health Assessment:

These modules will be an additional requirement to those related to sexual misconduct and hazing, and part of a strong portfolio that builds on Ohio States commitment to the health, wellness and safety of the campus community, Shivers said.

While the modules are required for first-year and transfer undergraduate students, Ohio State is making the program available to and will actively encourage completion by any student who wants to take part by summer 2023.

Continued here:
New student education program supports drug and alcohol abuse prevention - The Ohio State University News

Public Health | Social science | UW News blog

July 19, 2022

Most health care providers who took a suicide prevention training program developed by the University of Washington said they were better able to identify and respond to patients at risk of suicide.

Most people who die by suicide had contact with the health care system in the year before their deaths but only about one-third have received mental health services. This means that primary care and emergency room doctors, nurses and other specialists may be more often positioned to evaluate a person in crisis.

After Washington in 2012 became the first state to require suicide prevention training for health care professionals, the University of Washington developed a program, All Patients Safe, to help providers identify people at risk of suicide.

A new study, published online June 23 in the journal Psychiatric Services, finds large-scale training in this critical work is possible. The first wave of health care professionals to try All Patients Safe also report improved understanding of suicide and how to respond to people at risk.

The new Suicide & Crisis Lifeline is available by texting or calling 988.

The results suggest that it is possible to provide high-quality training to health care professionals about suicide, which is an important but not sufficient step in the prevention of suicide, said Jenn Stuber, associate professor of social work at the UW and the studys lead author. Its also essential to look at systems and policies to ensure there is maximum support for health care professionals to implement the clinical skills they were taught in the training.

Nearly 46,000 people died by suicide in 2020, according to the Centers for Disease Control and Prevention. It is among the leading causes of death for teens.

Stuber, who co-founded Forefront Suicide Prevention at the UW, helped push for the Washington state legislation to train health care providers, following the death of her husband by suicide. The law is named for him. A few years after passage, the law was amended to include all licensed health care providers not just behavioral health specialists in the requirement for training. Behavioral health specialists must participate in training every six years, whereas other health professionals must take a course only once.

In addition to Washington, 17 other states encourage or require such training for health care providers.

All Patients Safe was developed in collaboration with a variety of experts and heath care organizations, including the UW AIMS Center, and is one of a few dozen suicide prevention trainings that have been approved by the Washington State Department of Health.

Administered online in three- and six-hour versions, All Patients Safe is structured in modules and uses case-based materials and videos that model provider-patient interactions. The aim is to educate and empower providers to identify at-risk behaviors and to discuss with their patients, among other things, limiting access to lethal means.

Between November 2018 and December 2020, more than 1,500 providers completed the six-hour course and a pre-training survey. Just over half filled out a post-training survey and were included in the new study. Participants were asked about their understanding of and confidence in addressing a number of topics with a patient, including storage of medication and firearms, and thoughts of suicide.

Results from that survey showed improved levels of confidence and understanding in all areas. For example, the number of respondents who believed they could identify warning signs of suicide increased by 60%, while confidence in asking about medication and firearms also rose.

Researchers say the results indicate at least a short-term knowledge gain, as well as the potential for delivering the training to large numbers of providers. They say more study is warranted on the longer-term efficacy of the training in specific health care settings.

Co-authors were Sarah Porter of the UW School of Social Work; Anne Massey of the UW School of Public Health; and Betsy Payn and Anna Ratzliff of the UW Department of Psychiatry and Behavioral Sciences.

For more information, contact Stuber at jstuber@uw.edu.

Continue reading here:
Suicide prevention training for health care providers a first step in longer-term efficacy - University of Washington

And so, another working week will soon draw to a close. Not a moment too soon, yes? This is, you may recall, our treasured signal to daydream about weekend plans. Our agenda is still getting sorted out, but we hope to catch up on our reading and hang with our oh-so-busy short person. And what about you? Normally, we would suggest you enjoy the great outdoors, but given the heat, we hesitate to do so, unless you have a Jetsons-like portable air conditioner you can strap on your back. With that in mind, this may be an opportunity to enjoy a flick or two on the telly, meet a fun friend at a whiskey bar, or simply take a few naps. Well, whatever you do, have a grand time. But be safe. Enjoy, and see you soon.

The European Medicines Agency has recommended a vaccine made by Bavarian Nordic for protection against monkeypox, Reuters writes. The vaccine, which is the only one to have won approval for preventing monkeypox disease in the U.S. and Canada, has in the European Union so far only been approved to treat smallpox. But the company has supplied the vaccine to several EU countries during the current monkeypox outbreak for off-label use. The recommendation from the EMA is expected to be referred to the European Commission for final approval shortly.

Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!

Read the rest here:
Pharmalittle: Congress may miss deadline to pass FDA user-fee bill; ViiV is urged to lower price for its HIV prevention drug - STAT

If you live with bipolar disorder, you may have wondered if you can prevent manic or depressive episodes. While everyone is different, there may be some options that can help you.

Bipolar disorder is a complex condition.

Some people may find that they are able to prevent some manic and depressive episodes.

Others may find that, while they are not able to prevent episodes completely, they can lessen or manage the symptoms. We asked two experts for tips on how to cope.

You may find that some depressive and manic episodes are preventable to some extent, though this may not be with 100% accuracy.

Thats because bipolar disorder is caused by a combination of factors that are unique to you some factors that are in your control and some that are not.

These include:

With that said, there are some preventive measures that can be put in place in order to decrease the frequency, intensity, or duration of manic and depressive episodes, says Chanel Johnson, a licensed professional counselor in Detroit, Michigan, who lives with bipolar disorder.

The most recent research supports this view. The goal of long-time management is to help prevent episodes with a combination of medication, psychotherapy, and psychoeducation.

A 2020 study noted that the earlier there is support and intervention, the better the treatment outcomes will be.

You may find it helpful to try a combination of approaches to see what works best for you.

A number of self-care strategies can help prevent bipolar disorder episodes, but first, its important to accept your symptoms and seek professional support, says Dr. Lee Phillps, a psychotherapist and certified sex and couples therapist in Virginia and New York.

Once you accept your diagnosis, you can work with a therapist on a treatment plan, he says. The most effective treatment for bipolar [disorder] is a combination of psychotherapy and medication management.

While in therapy, says Phillips, you can build your coping skills to help prevent or lessen future episodes. These coping skills can include joining a bipolar disorder support group, so you can be around others for support, he adds.

Research from 2018 shows that those living with bipolar disorder experience sleep disturbances and differences in their circadian rhythm, which is the bodys sleep-wake schedule.

If possible, try to wake up and go to sleep at the same time every night. Having a routine allows you to go on auto pilot and trains your body physiologically, says Johnson.

If your body knows that you go to bed at 10 p.m., it knows to release some extra melatonin around that time, which certainly helps if youre having racing thoughts (a symptom of mania) and having a hard time shutting things down, she says.

Research from 2020 notes that regular movement can be helpful in managing symptoms, thanks to the release of neurotransmitters in your brain, says Phillips.

Staying active can be helpful because it can help prevent a depressive episode. If youre [experiencing mania], exercise can help calm the nervous system, he says.

Research suggests that substance use may heighten some symptoms of bipolar disorder.

For example, a 2019 study noted that smoking tobacco (alone or while using other substances), was a risk factor for suicide attempts during depressive episodes.

You may find it helpful to reduce or limit substances, including:

Stress can be a trigger for bipolar episodes.

Some studies suggest that regular mindfulness practice may help bring you into the present moment and feel more balanced, says Johnson.

Adding meditation, yoga, and exercise to your daily routine is a great way to manage stress and help stabilize your mood. Activities that invoke mindfulness, focus, awareness, and physical activity help to soothe the nervous system, she says.

Research shows that weather can be a trigger for bipolar disorder, like temperature and sunlight, says Phillips.

During the winter months, you may feel more depressed. In the spring, you may become manic. Therefore, a therapist can help you prepare for these seasons with an action plan on how you are going to cope, he says.

A growing body of evidence suggests that a healthy diet of whole foods plays an important role in preventive maintenance, says Johnson.

Processed foods wreak havoc on our gut microbiome, affecting the neurotransmitters and hormones that regulate and stabilize our mood, she says.

Processed foods often come in the form of simple sugars that cause insulin levels to spike and drop drastically. Unstable insulin levels lead to an unstable mood, Johnson explains.

You may find it helpful to ask your doctor for a referral to a dietitian or nutritionist.

There may be times when you feel like you dont need your medication anymore.

You may stop taking medication because you feel great while experiencing mania. But this may only cause your symptoms to become worse, explains Phillips.

Instead, work with a doctor or therapist before making any adjustments to your medication. If necessary, ask a loved one to help keep you accountable.

You dont have to do this on your own. In most cases, the prevention and treatment of bipolar disorder include a multi-pronged approach.

Therapy can help you identify your thoughts, feelings, and situations that may be triggering symptoms of depression and mania, and then challenge your thinking by introducing cognitive restructuring, says Phillips.

Somatic therapy is great in helping you identify what is happening in your body first before naming your emotions. Mindfulness-based interventions are great because they can bring awareness of what is happening in the moment, he says.

You may find it helpful to find a therapist who specializes in bipolar disorder.

A medication regime may be effective in preventing some bipolar symptoms.

Current research shows that combining certain types of medications can help prevent the onset of more severe symptoms, like hospitalizations during mania, or suicidal thoughts during a depression episode.

Medications for bipolar disorder may include:

For some, antidepressants alone can actually lead to a manic episode, says Johnson. The ideal combination is going to be different for everyone. It may take some time to figure out how you respond to certain medications.

I was switched from an antidepressant and anxiety medication regimen to a mood stabilizer. I couldnt believe it after 2 weeks. I felt like myself again. If you have bipolar disorder, you know what a huge deal that is, says Johnson.

Bipolar disorder is a complex condition.

While there may be no way to prevent manic or depressive episodes 100% of the time, there are some supportive practices that may help, like keeping a regular routine, getting enough sleep, and balancing your nutrition, among other strategies.

Bipolar disorder, in general, is highly treatable and there is hope. A typical treatment plan includes a combination of therapy, medication, and lifestyle adjustments. Be sure to work with a professional to find the right treatment approach for you.

Originally posted here:
Prevention of Bipolar Disorder Episodes: Is It Possible? - PsychCentral.com

CNN

A driver who apparently suffered a medical emergency crashed into beachgoers at Daytona Beach on Sunday afternoon, a beach safety official told CNN.

A little before 5 p.m., we had a driver go down the beach ramp at the International Speedway Boulevard and crash into the water, said Tamra Malphurs, deputy chief of Volusia County Beach Safety Ocean Rescue. He hit a toll booth and he entered the water, she added.

The driver appeared to have suffered from a medical condition, Malphurs said without elaborating.

At least five people were taken to local hospitals for precautionary reasons, including the four occupants of the vehicle and a young boy who was in the water at the time, Malphurs added. The boy was in stable condition late Sunday afternoon, Malphurs told CNN.

Video obtained by CNN affiliate WKMG shows a sedan partially in the water off Daytona Beach with visible damage to the front bumper and back doors.

People who saw the car drive through the toll booth and onto the sand said a group of at least 15 people jumped out of the way before the car hit the water.

One witness whose son was in the water said she took off trying to find him when she saw where the vehicle was headed. Another witness said people on the beach rushed to help and that adults with children were in the car.

Officials have not released information about the driver and say the investigation into the incident is ongoing.

Read the rest here:
Florida man in apparent medical distress crashes car through beach crowd before hitting the water - CNN